WorldWideScience

Sample records for drug surveillance program

  1. OPPIDUM surveillance program: 20 years of information on drug abuse in France.

    Science.gov (United States)

    Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle

    2013-12-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities. © 2013 The Authors Fundamental and Clinical Pharmacology © 2013 Société Française de Pharmacologie et de Thérapeutique.

  2. Mono- and combination drug therapies in hospitalized patients with bipolar depression. Data from the European drug surveillance program AMSP

    Directory of Open Access Journals (Sweden)

    Haeberle Anne

    2012-09-01

    Full Text Available Abstract Background For the pharmacological treatment of bipolar depression several guidelines exist. It is largely unknown, to what extent the prescriptions in daily clinical routine correspond to these evidence based recommendations and which combinations of psychotropic drugs are frequently used. Methods The prescriptions of psychotropic drugs were investigated of all in-patients with bipolar depression (n = 2246; time period 1994–2009 from hospitals participating in the drug surveillance program AMSP. For the drug use in 2010, 221 cases were analysed additionally. Results From 1994 to 2009, 85% of all patients received more than one class of psychotropic substances: 74% received antidepressants in combination therapy, 55% antipsychotics, 48% anticonvulsants and 33% lithium. When given in combination, lithium is the most often prescribed substance for bipolar depression (33%, followed by valproic acid (23%, mirtazapine and venlafaxine (16% each, quetiapine (15%, lamotrigine (14% and olanzapine (13%. Both, lithium and valproic acid are often combined with selective serotonin reuptake inhibitors (SSRI, but also with mirtazapine und venlafaxine. Combinations of more than one antidepressant occur quite often, whereby combinations with bupropion, paroxetine, fluoxetine or fluvoxamine are very rare. In 2010, quetiapine (alone and combined was the most frequently prescribed drug (39%; aripiprazole was administered in 10%. Conclusion Combinations of antidepressants (SSRI, mirtazapine, venlafaxine with mood stabilizers (lithium, valproic acid, lamotrigine and / or atypical antipsychotics (quetiapine, olanzapine are common. Of most of those combinations the efficacy has not been studied. The use of aripiprazole and the concomitant use of two or three antidepressants contrast the guidelines.

  3. [Surveillance system on drug abuse: Interest of the French national OPPIDUM program of French addictovigilance network].

    Science.gov (United States)

    Frauger, Elisabeth; Pochard, Liselotte; Boucherie, Quentin; Giocanti, Adeline; Chevallier, Cécile; Daveluy, Amélie; Gibaja, Valérie; Caous, Anne-Sylvie; Eiden, Céline; Authier, Nicolas; Le Boisselier, Reynald; Guerlais, Marylène; Jouanjus, Émilie; Lepelley, Marion; Pizzoglio, Véronique; Pain, Stéphanie; Richard, Nathalie; Micallef, Joëlle

    2017-09-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs. Among them, 77% received an opiate maintenance treatment: 68% methadone (half of them consumed capsule form) and 27% buprenorphine (39% consumed generic form). Brand-name buprenorphine is more often injected than generic buprenorphine (10% vs. 2%) and among methadone consumers 7% of methadone capsule consumers have illegally obtained methadone (vs. 9% for syrup form). The proportion of medications among psychoactive drugs injected is important (42%), with morphine representing 21% of the total psychoactive drugs injected and buprenorphine, 16%. OPPIDUM highlighted emergent behaviors of abuse with some analgesic opioids (like tramadol, oxycodone or fentanyl), pregabalin, or quetiapine. OPPIDUM highlighted variations of drugs use regarding geographic approaches or by drug dependence care centers (like in harm reduction centers). OPPIDUM clearly demonstrated that collection of valid and useful data on drug abuse is possible, these data have an interest at regional, national and international levels. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  4. The importance of monitoring adverse drug reactions in pediatric patients: the results of a national surveillance program in Italy.

    Science.gov (United States)

    Carnovale, Carla; Brusadelli, Tatiana; Zuccotti, GianVincenzo; Beretta, Silvia; Sullo, Maria Giuseppa; Capuano, Annalisa; Rossi, Francesco; Moschini, Martina; Mugelli, Alessandro; Vannacci, Alfredo; Laterza, Marcella; Clementi, Emilio; Radice, Sonia

    2014-09-01

    To gain information on safety of drugs used in pediatrics through a 4-year post-marketing active pharmacovigilance program. The program sampled the Italian population and was termed 'Monitoring of the Adverse Effects in Pediatric population' (MEAP). Adverse drug reactions (ADRs) were collected for individuals aged 0 - 17 years treated in hospitals and territorial health services in Lombardy, Tuscany, Apulia and Campania; located to gain an appropriate sampling of the population. ADRs were evaluated using the Adverse Drug Reaction Probability Scale (Naranjo) and analyzed with respect to time, age, sex, category of ADR, seriousness, suspected medicines, type of reporter and off-label use. We collected and analyzed reports from 3539 ADRs. Vaccines, antineoplastic and psychotropic drugs were the most frequently pharmacotherapeutic subgroups involved. Seventeen percent of reported ADRs were serious; of them fever, vomiting and angioedema were the most frequently reported. Eight percent of ADRs were associated with off-label use, and 10% were unknown ADRs. Analysis of these revealed possible strategies of therapy optimization. The MEAP project demonstrated that active post-marketing pharmacovigilance programs are a valid strategy to increase awareness on pediatric pharmacology, reduce underreporting and provide information on drug actions in pediatrics. This information enhances drug therapy optimization in the pediatric patients.

  5. Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program.

    Science.gov (United States)

    Gao, Lei; Lyu, Yuan; Li, Yun

    2017-03-20

    Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China. Minimum inhibitory concentrations (MICs) were determined by a 2-fold agar dilution method, and antimicrobial susceptibility was established using the 2014 Clinical Laboratory Standards Institute-approved breakpoints. Isolates not susceptible to all the tested aminoglycosides, fluoroquinolones, β-lactams, β-lactam/β-lactam inhibitors and carbapenems were defined as extensively drug resistant. The rates of nonsusceptibility to common antimicrobial agents remained high (>65%) over the years with some fluctuations to certain agents. The prevalence of imipenem-resistant A. baumannii (IRAB) increased from 13.3% in 2004 to 70.5% in 2014 and that of extensively drug-resistant A. baumannii (XDRAB) increased from 11.1% in 2004 to 60.4% in 2014. The activity of tigecycline was stable with MIC90 ≤4 mg/L against A. baumannii from 2009 to 2014. Susceptibility to colistin remained high (97.0%) from 2009 to 2014. The prevalence of XDRAB increased in all the three surveillance regions over the years and was significantly higher in Intensive Care Unit (ICU) wards than non-ICU wards. This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more intense interventional infection control

  6. GEIS Surveillance Network Program

    Science.gov (United States)

    2013-10-01

    influenza-like illness in Kenya, determine etiologies of diarrheal illnesses and the antimicrobial resistance patterns of bacterial causes, determine ...of the blood sample. These drugs include Arteether, Pyronaridine, Primaquine, Artesunate, Proguanil, Trimethoprim , Sulfamethoxazole, Pyrimethamine...that are controlled with Trimethoprim /sulfamethoxazole (TMP/SMZ). Use of TMP/SMZ prophylaxis however might put populations at risk of developing

  7. National Cardiac Device Surveillance Program Database

    Data.gov (United States)

    Department of Veterans Affairs — The National Cardiac Device Surveillance Program Database supports the Eastern Pacemaker Surveillance Center (EPSC) staff in its function of monitoring some 11,000...

  8. Drug overdose surveillance using hospital discharge data.

    Science.gov (United States)

    Slavova, Svetla; Bunn, Terry L; Talbert, Jeffery

    2014-01-01

    We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000-2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison.

  9. Drug Overdose Surveillance Using Hospital Discharge Data

    Science.gov (United States)

    Bunn, Terry L.; Talbert, Jeffery

    2014-01-01

    Objectives We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. Methods We compared three International Classification of Diseases, Ninth Revision, Clinical Modification code-based case definitions using Kentucky hospital discharge data for 2000–2011. The first definition (Definition 1) was based on the external-cause-of-injury (E-code) matrix. The other two definitions were based on the Injury Surveillance Workgroup on Poisoning (ISW7) consensus recommendations for national and state poisoning surveillance using the principal diagnosis or first E-code (Definition 2) or any diagnosis/E-code (Definition 3). Results Definition 3 identified almost 50% more drug overdose cases than did Definition 1. The increase was largely due to cases with a first-listed E-code describing a drug overdose but a principal diagnosis that was different from drug overdose (e.g., mental disorders, or respiratory or circulatory system failure). Regardless of the definition, more than 53% of the hospitalizations were self-inflicted drug overdoses; benzodiazepines were involved in about 30% of the hospitalizations. The 2011 age-adjusted drug overdose hospitalization rate in Kentucky was 146/100,000 population using Definition 3 and 107/100,000 population using Definition 1. Conclusion The ISW7 drug overdose definition using any drug poisoning diagnosis/E-code (Definition 3) is potentially the highest sensitivity definition for counting drug overdose hospitalizations, including by intent and drug type(s) involved. As the states enact policies and plan for adequate treatment resources, standardized drug overdose definitions are critical for accurate reporting, trend analysis, policy evaluation, and state-to-state comparison. PMID:25177055

  10. Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program

    Directory of Open Access Journals (Sweden)

    Lei Gao

    2017-01-01

    Conclusions: This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more intense interventional infection control measures, while also helping to focus surveillance efforts.

  11. Reactor Vessel Surveillance Program for Advanced Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kyeong-Hoon; Kim, Tae-Wan; Lee, Gyu-Mahn; Kim, Jong-Wook; Park, Keun-Bae; Kim, Keung-Koo

    2008-10-15

    This report provides the design requirements of an integral type reactor vessel surveillance program for an integral type reactor in accordance with the requirements of Korean MEST (Ministry of Education, Science and Technology Development) Notice 2008-18. This report covers the requirements for the design of surveillance capsule assemblies including their test specimens, test block materials, handling tools, and monitors of the surveillance capsule neutron fluence and temperature. In addition, this report provides design requirements for the program for irradiation surveillance of reactor vessel materials, a layout of specimens and monitors in the surveillance capsule, procedures of installation and retrieval of the surveillance capsule assemblies, and the layout of the surveillance capsule assemblies in the reactor.

  12. Post-tensioning system surveillance program

    International Nuclear Information System (INIS)

    Drew, G.E.

    1979-01-01

    Nuclear power plant containment structure post-tensioning system tendon surveillance program is described in detail. Data collected over three yearly post-tensioning system Surveillance Programs is presented and evaluated to correlate anticipated stress losses with actual losses. In addition corrosion protected system performance is analyzed

  13. New England States environmental radiation surveillance programs

    International Nuclear Information System (INIS)

    Molloy, E.J.

    1980-01-01

    An overview of the environmental radiation surveillance programs in the New England States from the viewpoint of their organization and administration is provided. Moreover, the specific monitoring and analytical programs conducted at selected sites in each state is detailed with emphasis on sample types, collection frequencies, and analysis. Also, a comparison is made between the programs of all the states in order to determine the reasons for their differences

  14. Community-Operated Environmental Surveillance Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the environmental surveillance activities with which citizens living near the Hanford Site have been participating. Local teachers have been managing and operating three special radiological air sampling stations located in Richland, Basin City, and Franklin County, Washington. Other expansion efforts of this program are also described.

  15. Community-Operated Environmental Surveillance Program

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the environmental surveillance activities with which citizens living near the Hanford Site have been participating. Local teachers have been managing and operating three special radiological air sampling stations located in Richland, Basin City, and Franklin County, Washington. Other expansion efforts of this program are also described

  16. Risk management and post-marketing surveillance of CNS drugs.

    Science.gov (United States)

    Henningfield, Jack E; Schuster, Charles R

    2009-12-01

    Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

  17. Advanced neutron source materials surveillance program

    International Nuclear Information System (INIS)

    Heavilin, S.M.

    1995-01-01

    The Advanced Neutron Source (ANS) will be composed of several different materials, one of which is 6061-T6 aluminum. Among other components, the reflector vessel and the core pressure boundary tube (CPBT), are to be made of 6061-T6 aluminum. These components will be subjected to high thermal neutron fluences and will require a surveillance program to monitor the strength and fracture toughness of the 6061-T6 aluminum over their lifetimes. The purpose of this paper is to explain the steps that were taken in the summer of 1994 toward developing the surveillance program. The first goal was to decide upon standard specimens to use in the fracture toughness and tensile testing. Second, facilities had to be chosen for specimens representing the CPBT and the reflector vessel base, weld, and heat-affected-zone (HAZ) metals. Third, a timetable had to be defined to determine when to remove the specimens for testing

  18. Medicaid Drug Rebate Program Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Product Data for Drugs in the Medicaid Drug Rebate Program. The rebate drug product data file contains the active drugs that have been reported by participating drug...

  19. Changes in drug use patterns reported on the web after the introduction of ADF OxyContin: findings from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System Web Monitoring Program.

    Science.gov (United States)

    Vosburg, Suzanne K; Haynes, Colleen; Besharat, Andrea; Green, Jody L

    2017-09-01

    This qualitative study summarizes information that individuals shared online about use of OxyContin following the August 2010 introduction of the abuse deterrent formulation (ADF). The primary objective was to study online posts that endorsed continued use of OxyContin or a switch from OxyContin to another formulation of oxycodone or another substance altogether following the introduction of the ADF. A secondary objective was to determine whether posts revealed that the ADF led to cessation of OxyContin use. Data were collected with the Researched Abuse, Diversion, and Addiction-Related Surveillance System Web Monitoring Program, an online surveillance system that collects and organizes posts about prescription drugs from social media websites, blogs, and forums from 3Q2009 to 4Q2014 using a commercially available web platform. Posts were categorized by whether they conveyed a switch to drugs other than reformulated OxyContin or a continuation of reformulated OxyContin abuse. "Switch posts" primarily discussed switching to immediate-release opioids. "Continue abusing" posts identified tampering strategies for alternate routes of administration, oral use, and continued use although post authors were generally unhappy with the experience. No reference to OxyContin cessation as a function of the introduction of the ADF was found; however, discontinued use was discussed. Web Monitoring data are useful for capturing cross sections of Internet conversation reflecting reactions to new drug formulations. These data support the notion that users will gravitate to non-ADFs generally, and to immediate-release non-ADF opioid formulations, specifically, as long as these options remain on the market. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Surveillance of Salmonella enteritidis in layer houses: a retrospective comparison of the Food and Drug Administration's egg safety rule (2010-2011) and the California Egg Quality Assurance Program (2007-2011).

    Science.gov (United States)

    Pitesky, Maurice; Charlton, Bruce; Bland, Mark; Rolfe, Dan

    2013-03-01

    Between July 2007 and December 2011, 2660 environmental drag swab samples were collected in total from California layer flocks on behalf of the California Egg Quality Assurance Program (CEQAP), the egg safety rule (21 CFR Parts 16 and 118) of the Food and Drug Administration (FDA), or both. The samples were processed by the California Animal Health and Food Safety Lab, and positive or negative results for Salmonella enterica serovar Enteritidis (SE) were recorded. This study retrospectively compares the differences between the FDA and CEQAP programs with respect to their SE environmental sampling surveillance results. To accomplish this comparison, two different CEQAP (new and old) data sets representing different SE environmental surveillance approaches in the life of the flock were compared against each other and against the FDA's SE environmental testing plan. Significant differences were noted between the CEQAP and FDA programs with respect to the prevalence of SE in the farm environment. Analyses of the prevalence of SE at different stages in the flock's life cycle (chick papers, preproduction, midproduction, postmolt, and premarket) found the highest prevalence of SE in premarket (11.9%), followed by postmolt (3.5%) and midproduction (3.4%), and there was a tie between chick papers and preproduction (2.1%). To assess the main effects of the presence of SE in the farm environment, backwards binary logistic regression was used. Of six independent variables examined (age of flock, year, season, owner, CEQAP membership, and analysis of pooled samples vs. individual swabs), only age of flock, owner, and year were determined to be significant factors in the final model. Although CEQAP membership and pooling vs. individuals swabs were not included in the final model, Pearson chi-square tests did show significantly higher odds of SE for non-CEQAP member farms and higher odds of SE in pooled samples vs. individual swabs.

  1. SODAS: Surveillance of Drugs of Abuse Study.

    Science.gov (United States)

    Lowe, David J; Torrance, Hazel J; Ireland, Alastair J; Bloeck, Felix; Stevenson, Richard

    2017-04-01

    Novel psychoactive substance (NPS) as a form of recreational drug use has become increasingly popular. There is a paucity of information with regard to the prevalence and clinical sequelae of these drugs. The aim of this study was to detect NPS in patients presenting to the emergency department with suspected toxicological ingestion. The prospective study was performed in a large emergency department in the UK. During a 3-month period 80 patients were identified by clinicians as having potentially ingested a toxicological agent. Urine samples were analysed using liquid chromatography high-resolution mass spectrometry, and basic clinical data was gathered. Eighty patients with a history of illicit or recreational drug consumption had urine screenings performed. Forty-nine per cent (39) of the patients undergoing a screen had more than one illicit substance detected. Twenty per cent (16) of the patients tested positive for at least one NPS. Almost half of the presented patients revealed ingestion of multiple substances, which correlated poorly with self-reporting of patients. Developing enhanced strategies to monitor evolving drug trends is crucial to the ability of clinicians to deliver care to this challenging group of patients.

  2. Doing the right things and doing things right : inpatient drug surveillance assisted by clinical decision support

    NARCIS (Netherlands)

    Helmons, Pieter J.; Suijkerbuijk, Bas O.; Nannan Panday, Prashant V.; Kosterink, Jos G. W.

    Increased budget constraints and a continuous focus on improved quality require an efficient inpatient drug surveillance process. We describe a hospital-wide drug surveillance strategy consisting of a multidisciplinary evaluation of drug surveillance activities and using clinical decision support to

  3. Application of DNA barcoding in forest biosecurity surveillance programs

    Science.gov (United States)

    Leland M. Humble; Jeremy R. deWaard

    2011-01-01

    The ability to distinguish non-indigenous species from the background diversity of native taxa is critical to the success of surveillance programs for detecting new introductions. Surveillance programs for alien taxa rely on the precise diagnosis of species, which can be complicated by sizable trap samples, damaged specimens, immature life stages, and incomplete...

  4. Extension of the surveillance program at NPP Paks

    International Nuclear Information System (INIS)

    Gillemot, F.

    1992-01-01

    In WWER-440 reactors the surveillance specimens are located in accelerated irradiation positions. After five years all specimens are withdrawn and the operational changes are not monitored. At Paks NPP a new surveillance program extension is started to eliminate of this disadvantage of the original program. (author)

  5. The out-of-focus bias in drug surveillance.

    Science.gov (United States)

    Gnädinger, Markus; Mellinghoff, Hans-Ulrich

    2013-03-01

    Existing drug safety systems with phase II and III studies and post-marketing surveillance by principle do not allow for the recognition of an important class of adverse drug reactions (ADRs). ADRs that are resistant to being detected reliably may a) appear as if they are age-related chronic diseases, which also manifest themselves in a high degree without drug treatment, b) arise in "old" drugs, c) arise during long-term application, and d) arise with the administration to frail and aged populations. "Silent" and multi-factorial health problems evolving from long-term drug treatment must therefore be addressed with a systematic search strategy, as a third track along with the phase II and III studies and spontaneous reporting systems which still exist.

  6. [A review on the advancement of internet-based public health surveillance program].

    Science.gov (United States)

    Zhao, Y Q; Ma, W J

    2017-02-10

    Internet data is introduced into public health arena under the features of fast updating and tremendous volume. Mining and analyzing internet data, researchers can model the internet-based surveillance system to assess the distribution of health-related events. There are two main types of internet-based surveillance systems, i.e. active and passive, which are distinguished by the sources of information. Through passive surveillance system, information is collected from search engine and social media while the active system gathers information through provision of the volunteers. Except for serving as a real-time and convenient complementary approach to traditional disease, food safety and adverse drug reaction surveillance program, Internet-based surveillance system can also play a role in health-related behavior surveillance and policy evaluation. Although several techniques have been applied to filter information, the accuracy of internet-based surveillance system is still bothered by the false positive information. In this article, we have summarized the development and application of internet-based surveillance system in public health to provide reference for a better surveillance program in China.

  7. A four-year surveillance program for detection of Plasmodium falciparum chloroquine resistance in Honduras

    Directory of Open Access Journals (Sweden)

    Gustavo A Fontecha

    2014-07-01

    Full Text Available Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt “CVMNK” genotype in codons 72-76.

  8. A four-year surveillance program for detection of Plasmodium falciparum chloroquine resistance in Honduras.

    Science.gov (United States)

    Fontecha, Gustavo A; Sanchez, Ana L; Mendoza, Meisy; Banegas, Engels; Mejía-Torres, Rosa E

    2014-07-01

    Countries could use the monitoring of drug resistance in malaria parasites as an effective early warning system to develop the timely response mechanisms that are required to avert the further spread of malaria. Drug resistance surveillance is essential in areas where no drug resistance has been reported, especially if neighbouring countries have previously reported resistance. Here, we present the results of a four-year surveillance program based on the sequencing of the pfcrt gene of Plasmodium falciparum populations from endemic areas of Honduras. All isolates were susceptible to chloroquine, as revealed by the pfcrt "CVMNK" genotype in codons 72-76.

  9. Surveillance of drug use among young people attending a music festival in Australia, 2005-2008.

    Science.gov (United States)

    Lim, Megan S C; Hellard, Margaret E; Hocking, Jane S; Spelman, Tim D; Aitken, Campbell K

    2010-03-01

    In order to monitor trends in illicit drug use among youth, surveillance of drug use behaviours among a variety of populations in different settings is required. We monitored drug use among music festival attendees. Cross-sectional studies of young people's reported drug use were performed at a music festival in Melbourne from 2005 to 2008. Self-administered questionnaires collected information on drug use, demographics and other risk behaviour. From 2005 to 2008, over 5000 questionnaires were completed by people aged 16-29; 2273 men and 3011 women. Overall, use of any illicit drug in the past month was reported by 44%. After adjusting for demographic and behavioural characteristics, the prevalence of recent illicit drug use decreased significantly from 46% in 2005 to 43% in 2008 (OR 0.92, 95% CI 0.87-0.97). After adjusting for age and sex the downwards trend was repeated for amphetamines and cannabis, but a significant increase in prevalence was observed in hallucinogen, ecstasy and inhalant use. Drug use was more common among men, older participants and those engaging in high-risk sexual behaviour. Illicit drug use was much more common in this sample than in the National Drug Strategy Household survey, but the direction of trends in drug use were similar; drug use prevalences were much lower than in the Ecstasy and Related Drugs Reporting System, the Illicit Drug Reporting System or National Needle and Syringe Program Survey. Music festival attendees are a potentially useful group for monitoring trends in illicit drug use.

  10. Systematic review of surveillance by social media platforms for illicit drug use.

    Science.gov (United States)

    Kazemi, Donna M; Borsari, Brian; Levine, Maureen J; Dooley, Beau

    2017-12-01

    The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed. A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer-reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies. Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items. Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. Evaluation of the novel respiratory virus surveillance program: Pediatric Early Warning Sentinel Surveillance (PEWSS).

    Science.gov (United States)

    Armour, Patricia A; Nguyen, Linh M; Lutman, Michelle L; Middaugh, John P

    2013-01-01

    Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable.

  12. Medical surveillance program for uranium workers in Grants, New Mexico

    International Nuclear Information System (INIS)

    Valdivia, A.A.

    1981-01-01

    A medical surveillance program at the Grants Clinic in Grants, New Mexico designed for early detection of pre-invasive and invasive lung neoplasms is discussed. The parameters of the surveillance profile are: age, race, mining history, smoking history, radiation exposure, chest x-rays, and sputum cytology. The best tool is the cytological examination of the sputum

  13. Surveillance of gastrointestinal disease in France using drug sales data.

    Science.gov (United States)

    Pivette, Mathilde; Mueller, Judith E; Crépey, Pascal; Bar-Hen, Avner

    2014-09-01

    Drug sales data have increasingly been used for disease surveillance during recent years. Our objective was to assess the value of drug sales data as an operational early detection tool for gastroenteritis epidemics at national and regional level in France. For the period 2008-2013, we compared temporal trends of drug sales for the treatment of gastroenteritis with trends of cases reported by a Sentinel Network of general practitioners. We benchmarked detection models to select the one with the best sensitivity, false alert proportion and timeliness, and developed a prospective framework to assess the operational performance of the system. Drug sales data allowed the detection of seasonal gastrointestinal epidemics occurring in winter with a distinction between prescribed and non-prescribed drugs. Sales of non-prescribed drugs allowed epidemic detection on average 2.25 weeks earlier than Sentinel data. These results confirm the value of drug sales data for real-time monitoring of gastroenteritis epidemic activity. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Surveillance of drug resistance for tuberculosis control: why and how?

    Science.gov (United States)

    Chaulet, P; Boulahbal, F; Grosset, J

    1995-12-01

    The resistance of Mycobacterium tuberculosis to antibiotics, which reflects the quality of the chemotherapy applied in the community, is one of the elements of epidemiological surveillance used in national tuberculosis programmes. Measurement of drug resistance poses problems for biologists in standardization of laboratory methods and quality control. The definition of rates of acquired and primary drug resistance also necessitates standardization in the methods used to collect information transmitted by clinicians. Finally, the significance of the rates calculated depends on the choice of the patients sample on which sensitivity tests have been performed. National surveys of drug resistance therefore require multidisciplinary participation in order to select the only useful indicators: rates of primary resistance and of acquired resistance. These indicators, gathered in representative groups of patients over a long period, are a measurement of the impact of modern chemotherapy regimens on bacterial ecology.

  15. Irradiation temperature measurements in the surveillance program

    International Nuclear Information System (INIS)

    Pav, T.; Krhounek, V.

    1991-01-01

    Evaluation of the diamond monitor method for the determination of the irradiation temperature in the surveillance programme of WWER-440 reactors is discussed. One of the difficulties with the practical application of the method is that the measured values of irradiation temperature are unlikely high. Using a thermodynamical model of the processes in the annealing of the irradiated diamond crystals, it was shown that experimental difficulties came from the principles of the method used. An analysis was performed of the thermal field inside the capsule of the surveillance chain in operational conditions, using the finite element method. The diamond monitor method was suggested to be eliminated from the surveillance programme and the use was proposed of the value of 273+-3 degC (as the most likely value) for the irradiation temperature of surveillance samples in WWER-440 reactors. (Z.S.). 3 tabs., 6 figs., 4 refs

  16. Quality assurance applied to an environmental surveillance program

    International Nuclear Information System (INIS)

    Oakes, T.W.; Shank, K.E.; Eldridge, J.S.

    1977-01-01

    A discussion of a quality assurance program applied to environmental surveillance activities is presented. This includes the philosophy and concepts of quality assurance, along with a detailed assessment of the sources of uncertainty in a monitoring program. The role management must play for a successful program is also discussed, and the quality assurance program implemented at Oak Ridge National Laboratory is presented

  17. Master schedule for CY-1978. Hanford Environmental Surveillance Routine Program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Myers, D.A.; Fix, J.J.

    1977-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. No results are presented in this report. The data collected are available in routine reports issued by the Environmental Evaluations staff

  18. Master schedule for CY-1981 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1980-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites

  19. A model surveillance program based on regulatory experience

    International Nuclear Information System (INIS)

    Conte, R.J.

    1980-01-01

    A model surveillance program is presented based on regulatory experience. The program consists of three phases: Program Delineation, Data Acquistion and Data Analysis. Each phase is described in terms of key quality assurance elements and some current philosophies is the United States Licensing Program. Other topics include the application of these ideas to test equipment used in the surveillance progam and audits of the established program. Program Delineation discusses the establishment of administrative controls for organization and the description of responsibilities using the 'Program Coordinator' concept, with assistance from Data Acquisition and Analysis Teams. Ideas regarding frequency of surveillance testing are also presented. The Data Acquisition Phase discusses various methods for acquiring data including operator observations, test procedures, operator logs, and computer output, for trending equipment performance. The Data Analysis Phase discusses the process for drawing conclusions regarding component/equipment service life, proper application, and generic problems through the use of trend analysis and failure rate data. (orig.)

  20. Master schedule for CY-1980 Hanford Environmental Surveillance Routine Program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1979-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is presented. The enviromental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Data are reported on the following topics: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurement; portable instrument surveys; and surveillance of waste disposal sites;

  1. Current French system of post-marketing drug surveillance.

    Science.gov (United States)

    Albengres, E; Gauthier, F; Tillement, J P

    1990-07-01

    The French system of drug surveillance is characterized by several original features: thirty regional centres are selected to cover all of France to collect, analyze and enter the adverse drug events in the national data bank. The system is based on a bank of well documented files submitted to a decision of imputation; the report of severe events by prescribers is mandatory; cases are collected either by spontaneous reporting (routine) or by direct request (intensive validation study); the system is being involved in studies of epidemiological type as carried out by the national system of health or a few societies of medicine as well as by the centres themselves in cooperative works on defined populations.

  2. Surveillance of veterinary drug residues in pork meat in Madagascar

    Directory of Open Access Journals (Sweden)

    M. V. Rakotoharinome

    2015-06-01

    Table I presents the results of the percentage of positive samples in the various regions of Madagascar. On average 37.2% sam­ples were contaminated by antimicrobial residues. A significant increase from 32 to 39% was observed between 2010 and 2011, respectively. No significant differences were found between samples according to sex, breed or age class in individual ani­mals. No differences between pig farm origins were found either (Figure 1. However, Amoron’i Mania Region, and particularly suburban Ambositra, was the most contaminated area in 2010 (67%; n = 9 and Melaky region (Western Madagascar in 2011. Pork meat samples originating from the same production area were less contaminated by drug residues when the animals were slaughtered in urban abattoirs compared to provincial abat­toirs. In this first step toward a national surveillance system, we confirm that drug residues in animal products are a serious public health concern for Madagascar.

  3. The analysis of reactor vessel surveillance program data

    International Nuclear Information System (INIS)

    Norris, E.B.

    1979-01-01

    Commercial nuclear power reactor vessel surveillance programs are provided by the reactor supplier and are designed to meet the requirements of ASTM Method E 185. (3). Each surveillance capsule contains sets of Charpy V-notch (Csub(v)) specimens representing selected materials from the vessel beltline region and some reference steel, tension test specimens machined from selected beltline materials, temperature monitors, and neutron flux dosimeters. Surveillance capsules may also contain fracture mechanics specimens machined from selected vessel beltline materials. The major steps in the conduct of a surveillance program include (1) the testing of the surveillance specimens to determine the exposure conditions at the capsule location and the resulting embrittlement of the vessel steel, (2) the extrapolation of the capsule results to the pressure vessel wall, and (3) the determination of the heatup and cooldown limits for normal, upset, and test operation. This paper will present data obtained from commercial light water reactor surveillance programs to illustrate the methods of analysis currently in use at Southwest Research Institute and to demonstrate some of the limitations imposed by the data available. Details concerning the procedures for testing the surveillance capsule specimens will not be included because they are considered to be outside of the scope of this paper

  4. Fatal adverse drug reactions of anticancer drugs detected by all-case post-marketing surveillance in Japan.

    Science.gov (United States)

    Mori, Jinichi; Tanimoto, Tetsuya; Miura, Yuji; Kami, Masahiro

    2015-06-01

    All-case post-marketing surveillance of newly approved anticancer drugs is usually conducted on all patients in Japan. The present study investigates whether all-case post-marketing surveillance identifies fatal adverse drug reactions undetected before market entry. We examined fatal adverse drug reactions identified via all-case post-marketing surveillance by reviewing the disclosed post-marketing surveillance results, and determined the time points in which the fatal adverse drug reactions were initially reported by reviewing drug labels. We additionally scanned emergency alerts on the Japanese regulatory authority website to assess the relationship between all-case post-marketing surveillance and regulatory action. Twenty-five all-case post-marketing surveillances were performed between January 1999 and December 2009. Eight all-case post-marketing surveillances with final results included information on all fatal cases. Of these, the median number of patients was 1287 (range: 106-4998), the median number of fatal adverse drug reactions was 14.5 (range: 4-23). Of the 111 fatal adverse drug reactions detected in the eight post-marketing surveillances, only 28 (25.0%) and 22 (19.6%) were described on the initial global and the initial Japanese drug label, respectively, and 58 (52.3%) fatal adverse drug reactions were first described in the all-case post-marketing surveillance reports. Despite this, the regulatory authority issued only four warning letters, and two of these were prompted by case reports from the all-case post-marketing surveillance. All-case post-marketing surveillance of newly approved anticancer drugs in Japan was useful for the rigorous compilation of non-specific adverse drug reactions, but it rarely detected clinically significant fatal adverse drug reactions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. CONSTITUTIONALITY AND LEGALITY OF NSA SURVEILLANCE PROGRAM

    Science.gov (United States)

    2013-12-01

    Committee Headquarters in what would eventually culminate as the Watergate Scandal . While the far reaching consequences of the Watergate scandal are...the Church Committee that investigated the Watergate Scandal , recommended the FBI be limited to only investigating “conduct rather than ideas or...TSP wiretapping scandal , the Bush Administration instead attempted to codify into law greater surveillance powers for intelligence agencies. When TSP

  6. Master schedule for CY-1982 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1981-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites

  7. Process monitoring using a Quality and Technical Surveillance Program

    International Nuclear Information System (INIS)

    Rafferty, C.A.

    1995-01-01

    The purpose of process monitoring using a Quality and Technical Surveillance Program was to help ensure manufactured clad vents sets fully met technical and quality requirements established by the manufacturer and the customer, and that line and program management were immediately alerted if any aspect of the manufacturing activities drifted out of acceptable limits. The Quality and Technical Surveillance Program provided a planned, scheduled approach to monitor key processes and documentation illuminated potential problem areas early enough to permit timely corrective actions to reverse negative trends that, if left uncorrected, could have resulted in deficient hardware. Significant schedule and cost impacts were eliminated

  8. Drug Products in the Medicaid Drug Rebate Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Active drugs that have been reported by participating drug manufacturers under the Medicaid Drug Rebate Program. All drugs are identified by National Drug Code...

  9. Process monitoring using a quality and technical surveillance program

    International Nuclear Information System (INIS)

    Rafferty, C.A.

    1995-01-01

    The purpose of process monitoring using a quality and technical surveillance program was to help ensure that manufactured clad went sets fully met technical and quality requirements established by the manufacturer and the customer and that line and program management were immediately alerted if any aspect of the manufacturing activities drifted out of acceptable limits. The quality and technical surveillance program provided a planned, scheduled approach to monitor key processes and documentation and certification systems to prevent noncompliances or any manufacturing discrepancies. These surveillances illuminated potential problem areas early enough to permit timely corrective actions to reverse negative trends that, if left uncorrected, could have resulted in deficient hardware. Significant schedule and cost impacts were eliminated. copyright 1995 American Institute of Physics

  10. Quality-control activities of the Hanford Environmental Surveillance Program

    International Nuclear Information System (INIS)

    Price, K.R.; Jaquish, R.E.

    1982-01-01

    A comprehensive approach to quality control (QC) has been developed by the Pacific Northwest Laboratory for the Hanford Environmental Surveillance Program. The framework of quality control for the surveillance program has been documented in a QC implementation guide wherein QC requirements are specified and specific responsibilities and authorities are described. Subjects in the guide include the collection, analysis, and reporting of samples as well as equipment calibration and maintenance, training, audits, and record keeping. A QC file and library have been established to store pertinent documentation, records, and references for ready access

  11. Enhanced surveillance program FY97 accomplishments. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Mauzy, A. [ed.; Laake, B. [comp.

    1997-10-01

    This annual report is one volume of the Enhanced Surveillance Program (ESP) FY97 Accomplishments. The complete accomplishments report consists of 11 volumes. Volume 1 includes an ESP overview and a summary of selected unclassified FY97 program highlights. Volume 1 specifically targets a general audience, reflecting about half of the tasks conducted in FY97 and emphasizing key program accomplishments and contributions. The remaining volumes of the accomplishments report are classified, organized by program focus area, and present in technical detail the progress achieved in each of the 104 FY97 program tasks. Focus areas are as follows: pits; high explosives; organics; dynamics; diagnostics; systems; secondaries; nonnuclear materials; nonnuclear components; and Surveillance Test Program upgrades.

  12. 3013/9975 Surveillance Program Interim Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, K.; Hackney, B.; McClard, J.

    2011-06-22

    The K-Area Materials Storage (KAMS) Documented Safety Analysis (DSA) requires a surveillance program to monitor the safety performance of 3013 containers and 9975 shipping packages stored in KAMS. The SRS surveillance program [Reference 1] outlines activities for field surveillance and laboratory tests that demonstrate the packages meet the functional performance requirements described in the DSA. The SRS program also supports the complexwide Integrated Surveillance Program (ISP) [Reference 2] for 3013 containers. The purpose of this report is to provide a summary of the SRS portion of the surveillance program activities through fiscal year 2010 (FY10) and formally communicate the interpretation of these results by the Surveillance Program Authority (SPA). Surveillance for the initial 3013 container random sampling of the Innocuous bin and the Pressure bin has been completed and there has been no indication of corrosion or significant pressurization. The maximum pressure observed was less than 50 psig, which is well below the design pressure of 699 psig for the 3013 container [Reference 3]. The data collected during surveillance of these bins has been evaluated by the Materials Identification and Surveillance (MIS) Working Group and no additional surveillance is necessary for these bins at least through FY13. A decision will be made whether additional surveillance of these bins is needed during future years of storage and as additional containers are generated. Based on the data collected to date, the SPA concludes that 3013 containers in these bins can continue to be safely stored in KAMS. This year, 13 destructive examinations (DE) were performed on random samples from the Pressure & Corrosion bin. To date, DE has been completed for approximately 30% of the random samples from the Pressure & Corrosion bin. In addition, DE has been performed on 6 engineering judgment (EJ) containers, for a total of 17 to date. This includes one container that exceeded the 3013

  13. 3013/9975 Surveillance Program Interim Summary Report

    International Nuclear Information System (INIS)

    Dunn, K.; Hackney, B.; McClard, J.

    2011-01-01

    The K-Area Materials Storage (KAMS) Documented Safety Analysis (DSA) requires a surveillance program to monitor the safety performance of 3013 containers and 9975 shipping packages stored in KAMS. The SRS surveillance program (Reference 1) outlines activities for field surveillance and laboratory tests that demonstrate the packages meet the functional performance requirements described in the DSA. The SRS program also supports the complexwide Integrated Surveillance Program (ISP) (Reference 2) for 3013 containers. The purpose of this report is to provide a summary of the SRS portion of the surveillance program activities through fiscal year 2010 (FY10) and formally communicate the interpretation of these results by the Surveillance Program Authority (SPA). Surveillance for the initial 3013 container random sampling of the Innocuous bin and the Pressure bin has been completed and there has been no indication of corrosion or significant pressurization. The maximum pressure observed was less than 50 psig, which is well below the design pressure of 699 psig for the 3013 container (Reference 3). The data collected during surveillance of these bins has been evaluated by the Materials Identification and Surveillance (MIS) Working Group and no additional surveillance is necessary for these bins at least through FY13. A decision will be made whether additional surveillance of these bins is needed during future years of storage and as additional containers are generated. Based on the data collected to date, the SPA concludes that 3013 containers in these bins can continue to be safely stored in KAMS. This year, 13 destructive examinations (DE) were performed on random samples from the Pressure and Corrosion bin. To date, DE has been completed for approximately 30% of the random samples from the Pressure and Corrosion bin. In addition, DE has been performed on 6 engineering judgment (EJ) containers, for a total of 17 to date. This includes one container that exceeded the 3013

  14. LWR-PV Surveillance Dosimetry Improvement Program review graphics

    International Nuclear Information System (INIS)

    McElroy, W.N.; Gold, R.; Gutherie, G.L.

    1979-10-01

    A primary objective of the multilaboratory program is to prepare an updated and improved set of dosimetry, damage correlation, and the associated reactor analysis ASTM standards for LWR-PV irradiation surveillance programs. Supporting this objective are a series of analytical and experimental validation and calibration studies in Benchmark Neutron Fields, reactor Test Regions, and operating power reactor Surveillance Positions. These studies will establish and certify the precision and accuracy of the measurement and predictive methods which are recommended for use in these standards. Consistent and accurate measurement and data analysis techniques and methods, therefore, will have been developed and validated along with guidelines for required neutron field calculations that are used to (1) correlate changes in material properties with the characteristics of the neutron radiation field and (2) predict pressure vessel steel toughness and embrittlement from power reactor surveillance data

  15. Targeted surveillance for postnatal hearing loss: a program evaluation.

    Science.gov (United States)

    Beswick, Rachael; Driscoll, Carlie; Kei, Joseph; Glennon, Shirley

    2012-07-01

    The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss. All children who were born in Queensland, Australia between September 2004 and December 2009, received a bilateral 'pass' on newborn hearing screening, and had at least one risk factor, were referred for targeted surveillance and were included in this study. The cohort was assessed throughout early childhood in accordance with Queensland's diagnostic assessment protocols. During the study period, 7320 (2.8% of 261,328) children were referred for targeted surveillance, of which 56 were identified with a postnatal hearing loss (0.77%). Of these, half (50.0%) were identified with a mild hearing loss, and 64.3% were identified with a sensorineural hearing loss. In regards to risk factors, syndrome, craniofacial anomalies, and severe asphyxia had the highest yield of positive cases of postnatal hearing loss for children referred for targeted surveillance, whereas, low birth weight, bacterial meningitis, and professional concern had a particularly low yield. Limitations of the targeted surveillance program were noted and include: (1) a lost contact rate of 32.4%; (2) delays in first surveillance assessment; (3) a large number of children who required on-going monitoring; and (4) extensive diagnostic assessments were completed on children with normal hearing. Examination of the lost contact rate revealed indigenous children were more likely to be documented as lost contact. In addition, children with one risk factor only were significantly more likely to not attend a surveillance appointment. Positive cases of postnatal hearing loss were detected through the targeted surveillance program. However, the

  16. Master schedule for CY-1979 Hanford environmental surveillance routine program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1978-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site, as conducted by the Environmental Evaluation Section of Battelle, Pacific Northwest Laboratory for the Department of Energy (DOE), is given. Modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, and to monitor Hanford operations for compliance with applicable environmental criteria and Washington State Water Quality Standards. Air quality data are obtained in a separate program administered by the Hanford Environmental Health Foundation. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Water quality data for Hanford Site potable water systems are published each year by the Hanford Environmental Health Foundation. The data collected are available in routine reports issued by the Environmental Evaluations staff. Groundwater data and evaluation are reported in the series, ''Radiological Status of the Groundwater Beneath the Hanford Project for...,'' the latest issue being PNL-2624 for CY-1977. Data from locations within the plant boundaries are presented in the annual ''Environmental Status of the Hanford Site for...'' report series, the most recent report being PNL-2677 for 1977. Data from offsite locations are presented in the annual ''Environmental Surveillance at Hanford for...'' series of reports, the latest being PNL-2614 for 1977

  17. Laboratory-Based Surveillance of Extensively Drug-Resistant Tuberculosis in Eastern China.

    Science.gov (United States)

    Huang, Yu; Wu, Qingqing; Xu, Shuiyang; Zhong, Jieming; Chen, Songhua; Xu, Jinghang; Zhu, Liping; He, Haibo; Wang, Xiaomeng

    2017-03-01

    With 25% of the global burden, China has the highest incidence of drug-resistant tuberculosis (TB) in the world. However, surveillance data on extensively drug-resistant TB (XDR-TB) from China are scant. To estimate the prevalence of XDR-TB in Zhejiang, Eastern China, 30 of 90 TB treatment centers in Zhejiang were recruited. Patients with suspected TB who reported to the clinics for diagnosis were requested to undergo a smear sputum test. Positive sputum samples were tested for drug susceptibility. Data on anti-TB drug resistance from 1999 to 2008 were also collected to assess drug resistance trends. A total of 931 cases were recruited for drug susceptibility testing (DST). Among these, 23.6% (95% confidence interval [CI], 18.8-24.4) were resistant to any of the following drugs: isoniazid, rifampin, streptomycin, and ethambutol. Multidrug resistant (MDR) strains were identified in 5.1% of all cases (95% CI, 3.61-6.49). Among MDR-TB cases, 6.4% were XDR (95% CI, 1.7-18.6) and 8.9% (95% CI, 7.0-10.8) of all cases were resistant to either isoniazid or rifampin (but not both). Among MDR-TB cases, 23.4% (95% CI, 12.8-38.4) were resistant to either fluoroquinolones or a second-line anti-TB injectable drug, but not both. From 1999 to 2014, the percentage of MDR cases decreased significantly, from 8.6% to 5.1% (p = 0.00). The Global Fund to Fight TB program showed signs of success in Eastern China. However, drug-resistant TB, MDR-TB, and XDR-TB still pose a challenge for TB control in Eastern China. High-quality directly observed treatment, short-course, and universal DST for TB cases to determine appropriate treatment regimens are urgently needed to prevent acquired drug resistance.

  18. Materials surveillance program for C-E NSSS reactor vessels

    International Nuclear Information System (INIS)

    Koziol, J.J.

    1977-01-01

    Irradiation surveillance programs for light water NSSS reactor vessels provide the means by which the utility can assess the extent of neutron-induced changes in the reactor vessel materials. These programs are conducted to verify, by direct measurement, the conservatism in the predicted radiation-induced changes and hence the operational parameters (i.e., heat-up, cooldown, and pressurization rates). In addition, such programs provide assurance that the scheduled adjustments in the operational parameters are made with ample margin for safe operation of the plant. During the past 3 years, several documents have been promulgated establishing the criteria for determining both the initial properties of the reactor vessel materials as well as measurement of changes in these initial properties as a result of irradiation. These documents, ASTM E-185-73, ''Recommended Practice for Surveillance Tests for Nuclear Reactor Vessels,'' and Appendix H to 10 CFR 50, ''Reactor Vessel Material Surveillance Program Requirements,'' are complementary to each other. They are the result of a change in the basic philosophy regarding the design and analysis of reactor vessels. In effect, the empirical ''transition temperature approach,'' which was used for design, was replaced by the ''analytical fracture mechanics approach.'' The implementation of this technique was described in Welding Research Council Bulletin 1975 and Appendix G to ASME Code Section III. Further definition of requirements appears in Appendix G to 10 CFR 50 published in July 1973. It is the intent of this paper to describe (1) a typical materials surveillance program for the reactor vessel of a Combustion Engineering NSSS, and (2) how the results of such programs, as well as experimental programs provide feed-back for improvement of materials to enhance their radiation resistance and thereby further improve the safety and reliability of future plants. (author)

  19. Extending cluster lot quality assurance sampling designs for surveillance programs.

    Science.gov (United States)

    Hund, Lauren; Pagano, Marcello

    2014-07-20

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance on the basis of the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than simple random sampling. By applying survey sampling results to the binary classification procedure, we develop a simple and flexible nonparametric procedure to incorporate clustering effects into the LQAS sample design to appropriately inflate the sample size, accommodating finite numbers of clusters in the population when relevant. We use this framework to then discuss principled selection of survey design parameters in longitudinal surveillance programs. We apply this framework to design surveys to detect rises in malnutrition prevalence in nutrition surveillance programs in Kenya and South Sudan, accounting for clustering within villages. By combining historical information with data from previous surveys, we design surveys to detect spikes in the childhood malnutrition rate. Copyright © 2014 John Wiley & Sons, Ltd.

  20. Surveillance

    DEFF Research Database (Denmark)

    Albrechtslund, Anders; Coeckelbergh, Mark; Matzner, Tobias

    Studying surveillance involves raising questions about the very nature of concepts such as information, technology, identity, space and power. Besides the maybe all too obvious ethical issues often discussed with regard to surveillance, there are several other angles and approaches that we should...... like to encourage. Therefore, our panel will focus on the philosophical, yet non-ethical issues of surveillance in order to stimulate an intense debate with the audience on the ethical implications of our enquiries. We also hope to provide a broader and deeper understanding of surveillance....

  1. Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review.

    Science.gov (United States)

    Low-Beer, Daniel; Mahy, Mary; Renaud, Francoise; Calleja, Txema

    2018-04-24

    HIV programs have provided a major impetus for investments in surveillance data, with 5-10% of HIV program budgets recommended to support data. However there are questions concerning the sustainability of these investments. The Sustainable Development Goals have consolidated health into one goal and communicable diseases into one target (Target 3.3). Sustainable Development Goals now introduce targets focused specifically on data (Targets 17.18 and 17.19). Data are seen as one of the three systemic issues (in Goal 17) for implementing Sustainable Development Goals, alongside policies and partnerships. This paper reviews the surveillance priorities in the context of the Sustainable Development Goals and highlights the shift from periodic measurement towards sustainable disaggregated, real-time, case, and patient data, which are used routinely to improve programs. Finally, the key directions in developing person-centered monitoring systems are assessed with country examples. The directions contribute to the Sustainable Development Goal focus on people-centered development applied to data. ©Daniel Low-Beer, Mary Mahy, Francoise Renaud, Txema Calleja. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 24.04.2018.

  2. Tenaga Nasional Berhad dam safety and surveillance program

    International Nuclear Information System (INIS)

    Jansen Luis; Zulkhairi Abd Talib

    2006-01-01

    This paper discusses the current practice of dam surveillance, which includes dam monitoring which is a process of visual inspections, measuring, processing, compiling and analyzing dam instrumentation data to determine the performance of a dam. The prime objective of the dam surveillance system is to ensure that any occurrence and development of safety deficiencies and problems are quickly detected, identified, analyzed and the required remedial actions are determined and consequently carried out in due time. In brief, the section is responsible to ensure that the dam monitoring and surveillance works are implemented as per scheduled and in accordance with the requirement and guidelines prepared by the dam designers and in accordance with international commission on large dams, ICOLD. The paper also illustrates and recommends an alternative approach for dam surveillance program using risk management approach, which is currently being actively adopted by some countries like USA, Canada, Australia and etc, towards improving the dam safety management and the decision making process. The approach provides a wider area of opportunity, improvements and benefits particular in the evaluation and modifications to the dam performance and safety. The process provides an effective and efficient tool for the decision makers and engineers through a comprehensive evaluation and a good understanding of the hazards, risks and consequences in relation to dam safety investigations. (Author)

  3. Can surveillance systems identify and avert adverse drug events? A prospective evaluation of a commercial application.

    Science.gov (United States)

    Jha, Ashish K; Laguette, Julia; Seger, Andrew; Bates, David W

    2008-01-01

    Computerized monitors can effectively detect and potentially prevent adverse drug events (ADEs). Most monitors have been developed in large academic hospitals and are not readily usable in other settings. We assessed the ability of a commercial program to identify and prevent ADEs in a community hospital. and Measurement We prospectively evaluated the commercial application in a community-based hospital. We examined the frequency and types of alerts produced, how often they were associated with ADEs and potential ADEs, and the potential financial impact of monitoring for ADEs. Among 2,407 patients screened, the application generated 516 high priority alerts. We were able to review 266 alerts at the time they were generated and among these, 30 (11.3%) were considered substantially important to warrant contacting the physician caring for the patient. These 30 alerts were associated with 4 ADEs and 11 potential ADEs. In all 15 cases, the responsible physician was unaware of the event, leading to a change in clinical care in 14 cases. Overall, 23% of high priority alerts were associated with an ADE (95% confidence interval [CI] 12% to 34%) and another 15% were associated with a potential ADE (95% CI 6% to 24%). Active surveillance used approximately 1.5 hours of pharmacist time daily. A commercially available, computer-based ADE detection tool was effective at identifying ADEs. When used as part of an active surveillance program, it can have an impact on preventing or ameliorating ADEs.

  4. Monitoring activities review of the Radiological Environmental Surveillance Program

    International Nuclear Information System (INIS)

    Ritter, P.D.

    1992-03-01

    The 1992 Monitoring Activities Review (MAR) is directed at the Radiological Environment Surveillance Program (RESP) activities at the Radioactive Waste Management Complex (RWMC) of Idaho Engineering Laboratory (INEL). MAR panelists studied RESP documents and discussed their concerns with Environmental Monitoring Unit (EMU) staff and other panel members. These concerns were subsequently consolidated into a collection of recommendations with supporting discussions. Recommendations focus on specific monitoring activities, as well as the overall program. The MAR report also contains pertinent comments that should not require further action

  5. Sentinel surveillance of HIV-1 transmitted drug resistance, acute infection and recent infection.

    Directory of Open Access Journals (Sweden)

    Hong-Ha M Truong

    Full Text Available HIV-1 acute infection, recent infection and transmitted drug resistance screening was integrated into voluntary HIV counseling and testing (VCT services to enhance the existing surveillance program in San Francisco. This study describes newly-diagnosed HIV cases and characterizes correlates associated with infection.A consecutive sample of persons presenting for HIV VCT at the municipal sexually transmitted infections (STI clinic from 2004 to 2006 (N = 9,868 were evaluated by standard enzyme-linked immunoassays (EIA. HIV antibody-positive specimens were characterized as recent infections using a less-sensitive EIA. HIV-RNA pooled testing was performed on HIV antibody-negative specimens to identify acute infections. HIV antibody-positive and acute infection specimens were evaluated for drug resistance by sequence analysis. Multivariable logistic regression was performed to evaluate associations. The 380 newly-diagnosed HIV cases included 29 acute infections, 128 recent infections, and 47 drug-resistant cases, with no significant increases or decreases in prevalence over the three years studied. HIV-1 transmitted drug resistance prevalence was 11.0% in 2004, 13.4% in 2005 and 14.9% in 2006 (p = 0.36. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI was the most common pattern detected, present in 28 cases of resistance (59.6%. Among MSM, recent infection was associated with amphetamine use (AOR = 2.67; p<0.001, unprotected anal intercourse (AOR = 2.27; p<0.001, sex with a known HIV-infected partner (AOR = 1.64; p = 0.02, and history of gonorrhea (AOR = 1.62; p = 0.03.New HIV diagnoses, recent infections, acute infections and transmitted drug resistance prevalence remained stable between 2004 and 2006. Resistance to NNRTI comprised more than half of the drug-resistant cases, a worrisome finding given its role as the backbone of first-line antiretroviral therapy in San Francisco as well as worldwide. The integration of HIV-1 drug

  6. Surveillance and in-service inspection (SISI) program at FFTF

    International Nuclear Information System (INIS)

    Conrads, T.J.

    1980-01-01

    Assurance of the integrity of the sodium coolant pressure boundaries of the Fast Flux Test Facility systems and components is essential for safe operation. A program has been developed to monitor the integrity of the coolant boundaries and certain plant conditions. Specific equipment and features have been designed into the plant for monitoring. The purpose of SISI is to prevent failures or minimize their consequences through early detection. The program which administers the requirements for monitoring applicable plant conditions whose integrity is necessary to protect public health and safety is known as the Surveillance and In-service Inspection (SISI) Program. The SISI program utilizes a wide range of monitoring techniques to ensure that material degradation or structural deficiencies will not result in the loss of the ability to shut down the reactor, cool the reactor core, or cause the release of radioactive material to the environment

  7. A primer of drug safety surveillance: an industry perspective. Part II: Product labeling and product knowledge.

    Science.gov (United States)

    Allan, M C

    1992-01-01

    To place the fundamentals of clinical drug safety surveillance in a conceptual framework that will facilitate understanding and application of adverse drug event data to protect the health of the public and support a market for pharmaceutical manufacturers' products. Part II of this series discusses specific issues regarding product labeling, such as developing the labeling, changing the labeling, and the legal as well as commercial ramifications of the contents of the labeling. An adverse event report scenario is further analyzed and suggestions are offered for maintaining the product labeling as an accurate reflection of the drug safety surveillance data. This article also emphasizes the necessity of product knowledge in adverse event database management. Both scientific and proprietary knowledge are required. Acquiring product knowledge is a part of the day-to-day activities of drug safety surveillance. A knowledge of the history of the product may forestall adverse publicity, as shown in the illustration. This review uses primary sources from the federal laws (regulations), commentaries, and summaries. Very complex topics are briefly summarized in the text. Secondary sources, ranging from newspaper articles to judicial summaries, illustrate the interpretation of adverse drug events and opportunities for drug safety surveillance intervention. The reference materials used were articles theoretically or practically applicable in the day-to-day practice of drug safety surveillance. The role of clinical drug safety surveillance in product monitoring and drug development is described. The process of drug safety surveillance is defined by the Food and Drug Administration regulations, product labeling, product knowledge, and database management. Database management is subdivided into the functions of receipt, retention, retrieval, and review of adverse event reports. Emphasis is placed on the dynamic interaction of the components of the process. Suggestions are offered

  8. Surveillance of extensively drug-resistant tuberculosis in Europe, 2003-2007.

    NARCIS (Netherlands)

    Devaux, I.; Manissero, D.; Fernandez de la Hoz, K.; Kremer, K.; Soolingen, D. van

    2010-01-01

    This paper describes the results of second-line drug (SLD) susceptibility tests among multidrug-resistant tuberculosis (MDR TB) cases reported in 20 European countries aiming to identify extensively drug-resistant tuberculosis (XDR TB) cases. A project on molecular surveillance of MDR TB cases was

  9. Surveillance of emerging drugs of abuse in Hong Kong: validation of an analytical tool.

    Science.gov (United States)

    Tang, Magdalene H Y; Ching, C K; Tse, M L; Ng, Carol; Lee, Caroline; Chong, Y K; Wong, Watson; Mak, Tony W L

    2015-04-01

    To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers. Cross-sectional study. Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong. A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected. Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients. The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population. This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.

  10. A primer of drug safety surveillance: an industry perspective. Part I: Information flow, new drug development, and federal regulations.

    Science.gov (United States)

    Allan, M C

    1992-01-01

    To place the fundamentals of clinical drug safety surveillance in a conceptual framework that will facilitate understanding and application of adverse drug event data to protect the health of the public and support a market for pharmaceutical manufacturers' products. Part I of this series provides a background for the discussion of drug safety by defining the basic terms and showing the flow of safety information through a pharmaceutical company. The customers for adverse drug event data are identified to provide a basis for providing quality service. The development of a drug product is briefly reviewed to show the evolution of safety data. Drug development and safety are defined by federal regulations. These regulations are developed by the FDA with information from pharmaceutical manufacturers. The intent of the regulations and the accompanying guidelines is described. An illustration from the news media is cited to show an alternative, positive approach to handling an adverse event report. This review uses primary sources from the federal laws (regulations), commentaries, and summaries. Very complex topics are briefly summarized in the text and additional readings are presented in an appendix. Secondary sources, ranging from newspaper articles to judicial summaries, illustrate the interpretation of adverse drug events and opportunities for drug safety surveillance intervention. The reference materials used were articles theoretically or practically applicable in the day-to-day practice of drug safety surveillance. The role of clinical drug safety surveillance in product monitoring and drug development is described. The process of drug safety surveillance is defined by the Food and Drug Administration regulations, product labeling, product knowledge, and database management. Database management is subdivided into the functions of receipt, retention, retrieval, and review of adverse event reports. Emphasis is placed on the dynamic interaction ;of the components

  11. Population Genetics and Drug Resistance Markers: An Essential for Malaria Surveillance in Pakistan

    International Nuclear Information System (INIS)

    Raza, A.; Beg, M.A.

    2013-01-01

    Plasmodium (P.) vivax is the prevalent malarial species accounting for 70% of malaria cases in Pakistan. However, baseline epidemiological data on P. vivax population structure and drug resistance are lacking from Pakistan. For population structure studies, molecular genetic markers, circumsporozoite protein (csp) and merozoite surface protein-1 (msp-1) are considered useful as these play an important role in P. vivax survival under immune and environmental pressure. Furthermore, these genes have also been identified as suitable candidates for vaccine development. While efforts for effective vaccine are underway, anti-malarial agents remain the mainstay for control. Evidence of resistance against commonly used anti-malarial agents, particularly Sulphadoxine-Pyrimethamine (SP) is threatening to make this form of control defunct. Therefore, studies on drug resistance are necessary so that anti-malarial treatment strategies can be structured and implemented accordingly by the Malaria Control Program, Pakistan. This review aims to provide information on genetic markers of P. vivax population structure and drug resistance and comment on their usefulness in molecular surveillance and control. (author)

  12. Regional surveillance program for the detection of fatal infant abuse

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Blackbourne, B.D.; Marks, S.C.; Adams, V.I.; Karellas, A.

    1987-01-01

    From 1984 to 1986, a regional surveillance program for the detection of infant abuse was carried out. Infants dying of uncertain cause were studied with a protocol designed to identify possible cases of infant abuse. At autopsy, resection of selected osseous material was performed, followed by meticulous specimen radiography and histopathologic analysis. Characteristic injuries involving the metaphyses, posterior rib arcs and spine, as well as less specific fractures of the long bone shafts and clavicles, were identified in eight abused infants. The authors believe that this multidisciplinary approach to unexplained infant death enhances detection of abuse and provides valuable documentary evidence for criminal prosecution

  13. N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

    Directory of Open Access Journals (Sweden)

    Meaghen Hyland

    2001-01-01

    Full Text Available BACKGROUND: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD. Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

  14. SRS environmental air surveillance program 1954-2015: General trends

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, K. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Jannik, T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-06-02

    The radiological monitoring program at SRS was established under the DuPont Company in June 1951 and was used as a measurement of the effectiveness of plant controls and as an authoritative record of environmental conditions surrounding the plant. It also served as a method of demonstrating compliance with applicable federal regulations and guidance. This document serves as a general summary of changes made specifically to the environmental air monitoring program since its inception, and a discussion of the general trends seen in the air monitoring program at SRS from 1954 to 2015. Initially, the environmental air surveillance program focused not only on releases from SRS but also on fallout from various weapons testing performed through the end of 1978. Flypaper was used to measure the amount of fallout in the atmosphere during this period, and was present at each of the 10 monitoring stations. By 1959, all site stacks were included in the air monitoring program to determine their contribution to the airborne radioactivity onsite, and the number of air surveillance samplers rose to 18. This trend of an increased number of sampling locations continued to a peak of 35 sampling locations before shifting to a downward trend in the mid-1990s. In 1962, 4 outer-range samplers were placed in Savannah and Macon, GA, and in Greenville and Columbia, SC. Until 1976, air samplers were simply placed around the perimeter of the various operation locations (after 1959, this included stacks to determine their contribution to the airborne radioactivity), with the intent of creating as representative a distribution as possible of the air surrounding operations.

  15. An evaluation of the Australian Rotavirus Surveillance Program.

    Science.gov (United States)

    Roberts-Witteveen, April R; Patel, Mahomed S; Roche, Paul W

    2008-09-01

    The Australian Rotavirus Serotyping Program (ARSP) serotypes rotavirus isolates obtained from stool samples sent from Australian laboratories. In collaboration with ARSP the Australian Government Department of Health and Ageing evaluated the program for its utility and capacity to monitor effectiveness of the rotavirus vaccines recently introduced into the Australian National Immunisation Program. The system was described using ARSP annual reports and staff interviews. The attributes of the system were assessed by adapting standard guidelines for evaluating a surveillance system. Email surveys or face to face interviews were conducted with staff of ARSP, participating laboratories, rotavirus vaccine manufacturing companies and representatives of the Communicable Diseases Network Australia. The ability of the ARSP to monitor changes in rotavirus serotype epidemiology was assessed. ARSP serotypes rotavirus isolates received from participating laboratories at least bi-annually, with results being reported at least as often. Serotype analyses have informed formulation of rotavirus vaccines and contributed to forecasting the extent of outbreaks caused by novel serotypes. The ARSP will be able to monitor changes in rotavirus serotype epidemiology and identify probable vaccination failures. Enhancement of the representativeness and sensitivity of the system are needed for the data to remain useful in the public health context. Methods for transferring data between the program and state and territory health departments need to be developed.

  16. Regulatory standards applicable or relevant to the independent Hanford environmental surveillance and oversight program

    International Nuclear Information System (INIS)

    King, S.E.; Hendrickson, P.L.; Siegel, M.R.; Woodruff, M.G.; Belfiglio, J.; Elliott, R.W.

    1990-03-01

    The authors reviewed federal and state statutes and regulations, as well as Department of Energy (DOE) orders and other guidance material, for potential applicability to the environmental surveillance program conducted for the Hanford site by the Pacific Northwest Laboratory (PNL). There are no federal or state statutes or regulations which are directly applicable to the environmental surveillance program. However, other regulatory schemes, while not directly applicable to the environmental surveillance program, are important insofar as they are indicative of regulatory concern and direction. Because of the evolving nature of environmental regulations, this area needs to be closely monitored for future impact on environmental surveillance activities. 9 refs.,

  17. The temporal relationship between drug supply indicators: an audit of international government surveillance systems

    Science.gov (United States)

    Werb, Dan; Kerr, Thomas; Nosyk, Bohdan; Strathdee, Steffanie; Montaner, Julio; Wood, Evan

    2013-01-01

    Objectives Illegal drug use continues to be a major threat to community health and safety. We used international drug surveillance databases to assess the relationship between multiple long-term estimates of illegal drug price and purity. Design We systematically searched for longitudinal measures of illegal drug supply indicators to assess the long-term impact of enforcement-based supply reduction interventions. Setting Data from identified illegal drug surveillance systems were analysed using an a priori defined protocol in which we sought to present annual estimates beginning in 1990. Data were then subjected to trend analyses. Main outcome measures Data were obtained from government surveillance systems assessing price, purity and/or seizure quantities of illegal drugs; systems with at least 10 years of longitudinal data assessing price, purity/potency or seizures were included. Results We identified seven regional/international metasurveillance systems with longitudinal measures of price or purity/potency that met eligibility criteria. In the USA, the average inflation-adjusted and purity-adjusted prices of heroin, cocaine and cannabis decreased by 81%, 80% and 86%, respectively, between 1990 and 2007, whereas average purity increased by 60%, 11% and 161%, respectively. Similar trends were observed in Europe, where during the same period the average inflation-adjusted price of opiates and cocaine decreased by 74% and 51%, respectively. In Australia, the average inflation-adjusted price of cocaine decreased 14%, while the inflation-adjusted price of heroin and cannabis both decreased 49% between 2000 and 2010. During this time, seizures of these drugs in major production regions and major domestic markets generally increased. Conclusions With few exceptions and despite increasing investments in enforcement-based supply reduction efforts aimed at disrupting global drug supply, illegal drug prices have generally decreased while drug purity has generally

  18. The temporal relationship between drug supply indicators: an audit of international government surveillance systems.

    Science.gov (United States)

    Werb, Dan; Kerr, Thomas; Nosyk, Bohdan; Strathdee, Steffanie; Montaner, Julio; Wood, Evan

    2013-09-30

    Illegal drug use continues to be a major threat to community health and safety. We used international drug surveillance databases to assess the relationship between multiple long-term estimates of illegal drug price and purity. We systematically searched for longitudinal measures of illegal drug supply indicators to assess the long-term impact of enforcement-based supply reduction interventions. Data from identified illegal drug surveillance systems were analysed using an a priori defined protocol in which we sought to present annual estimates beginning in 1990. Data were then subjected to trend analyses. Data were obtained from government surveillance systems assessing price, purity and/or seizure quantities of illegal drugs; systems with at least 10 years of longitudinal data assessing price, purity/potency or seizures were included. We identified seven regional/international metasurveillance systems with longitudinal measures of price or purity/potency that met eligibility criteria. In the USA, the average inflation-adjusted and purity-adjusted prices of heroin, cocaine and cannabis decreased by 81%, 80% and 86%, respectively, between 1990 and 2007, whereas average purity increased by 60%, 11% and 161%, respectively. Similar trends were observed in Europe, where during the same period the average inflation-adjusted price of opiates and cocaine decreased by 74% and 51%, respectively. In Australia, the average inflation-adjusted price of cocaine decreased 14%, while the inflation-adjusted price of heroin and cannabis both decreased 49% between 2000 and 2010. During this time, seizures of these drugs in major production regions and major domestic markets generally increased. With few exceptions and despite increasing investments in enforcement-based supply reduction efforts aimed at disrupting global drug supply, illegal drug prices have generally decreased while drug purity has generally increased since 1990. These findings suggest that expanding efforts at

  19. Low-cost ultra-wide genotyping using Roche/454 pyrosequencing for surveillance of HIV drug resistance.

    Directory of Open Access Journals (Sweden)

    Dawn M Dudley

    Full Text Available Great efforts have been made to increase accessibility of HIV antiretroviral therapy (ART in low and middle-income countries. The threat of wide-scale emergence of drug resistance could severely hamper ART scale-up efforts. Population-based surveillance of transmitted HIV drug resistance ensures the use of appropriate first-line regimens to maximize efficacy of ART programs where drug options are limited. However, traditional HIV genotyping is extremely expensive, providing a cost barrier to wide-scale and frequent HIV drug resistance surveillance.We have developed a low-cost laboratory-scale next-generation sequencing-based genotyping method to monitor drug resistance. We designed primers specifically to amplify protease and reverse transcriptase from Brazilian HIV subtypes and developed a multiplexing scheme using multiplex identifier tags to minimize cost while providing more robust data than traditional genotyping techniques. Using this approach, we characterized drug resistance from plasma in 81 HIV infected individuals collected in São Paulo, Brazil. We describe the complexities of analyzing next-generation sequencing data and present a simplified open-source workflow to analyze drug resistance data. From this data, we identified drug resistance mutations in 20% of treatment naïve individuals in our cohort, which is similar to frequencies identified using traditional genotyping in Brazilian patient samples.The developed ultra-wide sequencing approach described here allows multiplexing of at least 48 patient samples per sequencing run, 4 times more than the current genotyping method. This method is also 4-fold more sensitive (5% minimal detection frequency vs. 20% at a cost 3-5× less than the traditional Sanger-based genotyping method. Lastly, by using a benchtop next-generation sequencer (Roche/454 GS Junior, this approach can be more easily implemented in low-resource settings. This data provides proof-of-concept that next

  20. 2003 Long-Term Surveillance and Maintenance Program Report

    International Nuclear Information System (INIS)

    2004-01-01

    are part of long-term site management. In response to post-closure care requirements set forth in UMTRCA, DOE Headquarters established the Long-Term Surveillance and Maintenance (LTS&M) Program in 1988 at the DOE office in Grand Junction, Colorado. The program assumed long-term management responsibility for sites remediated under UMTRCA and other programs. Since its inception, the LTS&M Program has evolved in response to changing stakeholder needs, improvements in technology, and the addition of more DOE sites as remediation is completed. The mission of the LTS&M Program was to fulfill DOE's responsibility to implement all activities necessary to ensure regulatory compliance and to protect the public and the environment from long-lived wastes associated with the nation's nuclear energy, weapons, and research activities. Key components of the LTS&M Program included stakeholder participation, site monitoring and maintenance, records and information management, and research and technology transfer. This report presents summaries of activities conducted in 2003 in fulfillment of the LTS&M Program mission. On December 15, 2003, DOE established the Office of Legacy Management (LM) to allow for optimum management of DOE's legacy responsibilities. Offices are located in Washington, DC, Grand Junction, Colorado, Morgantown, West Virginia, and Pittsburgh, Pennsylvania, to perform long-term site management, land management, site transition support, records management, and other related tasks. All activities formerly conducted under the LTS&M Program have been incorporated into the Office of Land and Site Management (LM-50), as well as management of remedies involving ground water and surface water contaminated by former processing activities

  1. 2003 Long-Term Surveillance and Maintenance Program Report

    Energy Technology Data Exchange (ETDEWEB)

    None

    2004-07-01

    are part of long-term site management. In response to post-closure care requirements set forth in UMTRCA, DOE Headquarters established the Long-Term Surveillance and Maintenance (LTS&M) Program in 1988 at the DOE office in Grand Junction, Colorado. The program assumed long-term management responsibility for sites remediated under UMTRCA and other programs. Since its inception, the LTS&M Program has evolved in response to changing stakeholder needs, improvements in technology, and the addition of more DOE sites as remediation is completed. The mission of the LTS&M Program was to fulfill DOE’s responsibility to implement all activities necessary to ensure regulatory compliance and to protect the public and the environment from long-lived wastes associated with the nation’s nuclear energy, weapons, and research activities. Key components of the LTS&M Program included stakeholder participation, site monitoring and maintenance, records and information management, and research and technology transfer. This report presents summaries of activities conducted in 2003 in fulfillment of the LTS&M Program mission. On December 15, 2003, DOE established the Office of Legacy Management (LM) to allow for optimum management of DOE’s legacy responsibilities. Offices are located in Washington, DC, Grand Junction, Colorado, Morgantown, West Virginia, and Pittsburgh, Pennsylvania, to perform long-term site management, land management, site transition support, records management, and other related tasks. All activities formerly conducted under the LTS&M Program have been incorporated into the Office of Land and Site Management (LM–50), as well as management of remedies involving ground water and surface water contaminated by former processing activities.

  2. Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

    Science.gov (United States)

    Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

    2012-10-01

    Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. Environmental surveillance program. Quarterly progress report, July--September, 1993

    International Nuclear Information System (INIS)

    Walker, D.W.; Hall, L.F.; Downs, J.

    1996-01-01

    This report contains data developed from monitoring site measurements and laboratory analyses of environmental samples that were collected during the period of July-September, 1993. Because some laboratory procedures are lengthy and could adversely affect the desired timeliness of reports, results of some analyses from this time period will be included in the next quarterly report. Quarterly reports, then, will be routine periodic documents that present continually updated information concerning the potential presence of environmental contaminants in the vicinity of the Idaho National Engineering Laboratory (INEL). During the third calendar quarter of 1993, Environmental Surveillance Program (ESP) measurements did not reveal unexpected levels of contaminants in any environmental samples measured or analyzed. Most of the results reported in this document are related to off-site air and ground water measurements. Future reports will include results of monitoring at additional locations and for additional environmental materials. Annual reports from the ESP will contain data generated during the previous four calendar quarters, and will display measurement trends for various combinations of locations, contaminants and environmental media. The annual report will also include more interpretive material and discussions than will normally be found in quarterly reports

  4. Type I error probability spending for post-market drug and vaccine safety surveillance with binomial data.

    Science.gov (United States)

    Silva, Ivair R

    2018-01-15

    Type I error probability spending functions are commonly used for designing sequential analysis of binomial data in clinical trials, but it is also quickly emerging for near-continuous sequential analysis of post-market drug and vaccine safety surveillance. It is well known that, for clinical trials, when the null hypothesis is not rejected, it is still important to minimize the sample size. Unlike in post-market drug and vaccine safety surveillance, that is not important. In post-market safety surveillance, specially when the surveillance involves identification of potential signals, the meaningful statistical performance measure to be minimized is the expected sample size when the null hypothesis is rejected. The present paper shows that, instead of the convex Type I error spending shape conventionally used in clinical trials, a concave shape is more indicated for post-market drug and vaccine safety surveillance. This is shown for both, continuous and group sequential analysis. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Surveillance of transmitted HIV drug resistance using matched plasma and dried blood spot specimens from voluntary counseling and testing sites in Ho Chi Minh City, Vietnam, 2007-2008.

    Science.gov (United States)

    Duc, Nguyen Bui; Hien, Bui Thu; Wagar, Nick; Tram, Tran Hong; Giang, Le Truong; Yang, Chunfu; Wolfe, Mitchell I; Hien, Nguyen Tran; Tuan, Nguyen Anh

    2012-05-01

    During 2007-2008, surveillance of transmitted human immunodeficiency virus (HIV) drug resistance (TDR) was performed following World Health Organization guidance among clients with newly diagnosed HIV infection attending voluntary counseling and testing (VCT) sites in Ho Chi Minh City (HCMC), Vietnam. Moderate (5%-15%) TDR to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) was observed among VCT clients aged 18-21 years. Follow-up surveillance of TDR in HCMC and other geographic regions of Vietnam is warranted. Data generated will guide the national HIV drug resistance surveillance strategy and support selection of current and future first-line antiretroviral therapy and HIV prevention programs.

  6. Outcomes of an Enhanced Surveillance Program for Carbapenem-Resistant Enterobacteriaceae

    OpenAIRE

    Fitzpatrick, Margaret; Zembower, Teresa; Malczynski, Michael; Qi, Chao; Bolon, Maureen K.

    2014-01-01

    Optimal surveillance strategies for identifying patients colonized with and at risk for transmitting carbapenem-resistant Enterobacteriaceae (CRE) are urgently needed. We instituted an enhanced surveillance program for CRE that identified unrecognized CRE-colonized patients but failed to identify possible CRE transmissions. We also identified risk factors associated with transmitting CRE.

  7. Increasing HIV-1 Drug Resistance Between 2010 and 2012 in Adults Participating in Population-Based HIV Surveillance in Rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Manasa, Justen; Danaviah, Siva; Lessells, Richard; Elshareef, Muna; Tanser, Frank; Wilkinson, Eduan; Pillay, Sureshnee; Mthiyane, Hloniphile; Mwambi, Henry; Pillay, Deenan; de Oliveira, Tulio

    2016-08-01

    As more human immunodeficiency virus (HIV)-infected patients access combination antiretroviral therapy (cART), higher proportions of newly infected patients may be infected with drug-resistant viruses. Regular surveillance of transmitted drug resistance (TDR) is required in southern Africa where high rates of transmission persist despite rapid expansion of ART. Dried blood spot samples from cART-naive participants from two rounds of an annual population-based HIV surveillance program in rural KwaZulu-Natal were tested for HIV RNA, and samples with HIV RNA >10,000 copies/ml were genotyped for drug resistance. The 2009 surveillance of drug resistance mutation (SDRM) list was used for drug resistance interpretation. The data were added to previously published data from the same program, and the χ(2) test for trend was used to test for trend in estimated prevalence of any TDR. Seven hundred and one participants' data were analyzed: 67 (2010), 381 (2011), and 253 (2012). No TDR was detected in 2010. Years 2011 and 2012 had 18 participants with SDRMs 4.7% and 7.1%, respectively (p = .02, χ(2) test for trend). The nonnucleoside reverse transcriptase inhibitor mutation, K103N, was the most common mutation, occurring in 27 (3.8%) of the participants, while nucleoside reverse transcriptase inhibitor (NRTI) SDRMs were detected in 10 (1.4%) of the participants, of whom eight had only a single NRTI SDRM. The increase in levels of drug resistance observed in this population could be a signal of increasing transmission of drug-resistant HIV. Thus, continued surveillance is critical to inform public health policies around HIV treatment and prevention.

  8. Linezolid Surveillance Results for the United States (LEADER Surveillance Program 2014).

    Science.gov (United States)

    Flamm, Robert K; Mendes, Rodrigo E; Hogan, Patricia A; Streit, Jennifer M; Ross, James E; Jones, Ronald N

    2016-04-01

    Thelinezolidexperience andaccuratedetermination ofresistance (LEADER) surveillance program has monitored linezolid activity, spectrum, and resistance since 2004. In 2014, a total of 6,865 Gram-positive pathogens from 60 medical centers from 36 states were submitted. The organism groups evaluated wereStaphylococcus aureus(3,106), coagulase-negative staphylococci (CoNS; 797), enterococci (855),Streptococcus pneumoniae(874), viridans group streptococci (359), and beta-hemolytic streptococci (874). Susceptibility testing was performed by reference broth microdilution at the monitoring laboratory. Linezolid-resistant isolates were confirmed by repeat testing. PCR and sequencing were performed to detect mutations in 23S rRNA, L3, L4, and L22 proteins and acquired genes (cfrandoptrA). The MIC50/90forStaphylococcus aureuswas 1/1 μg/ml, with 47.2% of isolates being methicillin-resistantStaphylococcus aureus Linezolid was active against allStreptococcus pneumoniaestrains and beta-hemolytic streptococci with a MIC50/90of 1/1 μg/ml and against viridans group streptococci with a MIC50/90of 0.5/1 μg/ml. Among the linezolid-nonsusceptible MRSA strains, one strain harboredcfronly (MIC, 4 μg/ml), one harbored G2576T (MIC, 8 μg/ml), and one containedcfrand G2576T with L3 changes (MIC, ≥8 μg/ml). Among CoNS, 0.75% (six isolates) of all strains demonstrated linezolid MIC results of ≥4 μg/ml. Five of these were identified asStaphylococcus epidermidis, four of which containedcfrin addition to the presence of mutations in the ribosomal proteins L3 and L4, alone or in combination with 23S rRNA (G2576T) mutations. Six enterococci (0.7%) were linezolid nonsusceptible (≥4 μg/ml; five with G2576T mutations, including one with an additionalcfrgene, and one strain withoptrAonly). Linezolid demonstrated excellent activity and a sustained susceptibility rate of 99.78% overall. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  9. Extending cluster Lot Quality Assurance Sampling designs for surveillance programs

    OpenAIRE

    Hund, Lauren; Pagano, Marcello

    2014-01-01

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance based on the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than ...

  10. Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

    Directory of Open Access Journals (Sweden)

    Jevremović Ivana

    2002-01-01

    Full Text Available The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome – the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization.

  11. Identifying risk factors for brain metastasis in breast cancer patients: Implication for a vigorous surveillance program

    Directory of Open Access Journals (Sweden)

    Lorraine Chow

    2015-10-01

    Conclusion: Chinese breast cancer patients with brain metastasis were more likely to have high-grade tumors and negative estrogen receptor status. A more vigorous surveillance program for the central nervous system should be considered for this group of patients.

  12. Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers

    NARCIS (Netherlands)

    van Holland, Berry J; Brouwer, Sandra; de Boer, Michiel R; Reneman, Michiel F; Soer, Remko

    2017-01-01

    Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component.

  13. Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers

    NARCIS (Netherlands)

    van Holland, Berry; Brouwer, Sandra; de Boer, Michiel R; Reneman, Michiel F; Soer, Remko

    Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component.

  14. State of the reactor vessel surveillance programs in Korea and foreign countries

    International Nuclear Information System (INIS)

    Kim, Jeong Kyu; Hwang, Jong Keun; Park, Keon Woo; Kim, Bum Sik; Jeong, Kyung Hoon

    1996-06-01

    ASTM standards are dominating all over the world in the field of the reactor vessel surveillance program. They are mainly used directly or that the national standards in use correspond quite well with ASTM. According to, however, increasing concerns about the protection of environment and safety of nuclear plant, various approaches to establish and reinforce the national standards are made actively in Europe. In addition, some methods to share the nuclear data by integrating the existing test, analysis procedures and units system are considered. For nuclear plants in Korea, MOST Notice No. 92-20 should be applied for all PWRs after UCN units 3 and 4 since it was promulgated at Dec. 1992. The notice almost reflects the contents of ASTM E 185. But, the notice has much to be desired to provide the technical back-ground for reactor vessel surveillance program because it is not a standard such as ASTM or ASME code but regulation such as CFR or RG. Several Korean Standards are also used in limited area of the surveillance program. Therefore, practical requirements and rules for surveillance program are in accordance with the ASTM and CFR. In this report, the state of application of the standards to the surveillance program in Korea and Europe are reviewed and their national standards re compared with US standards or regulations. Current level and the future prospect of surveillance technology for PWR vessel are discussed at this point of view. 15 tabs., 12 figs., 38 refs. (Author)

  15. FINAL REPORT FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    Energy Technology Data Exchange (ETDEWEB)

    Joe M. Aldrich

    2004-11-01

    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004.

  16. FINAL REPORT. FORMER RADIATION WORKER MEDICAL SURVEILLANCE PROGRAM AT ROCKY FLATS For Department of Energy Programs

    International Nuclear Information System (INIS)

    Aldrich, Joe M.

    2004-01-01

    The Former Radiation Worker Medical Surveillance Program at Rocky Flats was conducted in Arvada, CO, by Oak Ridge Associated Universities through the Oak Ridge Institute for Science and Education under DOE Contract DE-AC--05-00OR22750. Objectives of the program were to obtain information on the value of medical surveillance among at-risk former radiation workers and to provide long-term internal radiation dosimetry information to the scientific community. This program provided the former radiation workers of the Rocky Flats Environmental Technology Site (formerly Rocky Flats Plant) an opportunity to receive follow-up medical monitoring and a re-evaluation of their internal radiation dose. The former Rocky Flats radiation worker population is distinctive because it was a reasonably stable work force that received occupational exposures, at times substantial, over several decades. This report reflects the summation of health outcomes, statistical analyses, and dose assessment information on former Rocky Flats radiation workers to the date of study termination as of March 2004

  17. Clinical and molecular surveillance of drug resistant vivax malaria in Myanmar (2009-2016).

    Science.gov (United States)

    Nyunt, Myat Htut; Han, Jin-Hee; Wang, Bo; Aye, Khin Myo; Aye, Kyin Hla; Lee, Seong-Kyun; Htut, Ye; Kyaw, Myat Phone; Han, Kay Thwe; Han, Eun-Taek

    2017-03-16

    One of the major challenges for control and elimination of malaria is ongoing spread and emergence of drug resistance. While epidemiology and surveillance of the drug resistance in falciparum malaria is being explored globally, there are few studies on drug resistance vivax malaria. To assess the spread of drug-resistant vivax malaria in Myanmar, a multisite, prospective, longitudinal study with retrospective analysis of previous therapeutic efficacy studies, was conducted. A total of 906 from nine study sites were included in retrospective analysis and 208 from three study sites in prospective study. Uncomplicated vivax mono-infected patients were recruited and monitored with longitudinal follow-up until day 28 after treatment with chloroquine. Amplification and sequence analysis of molecular markers, such as mutations in pvcrt-O, pvmdr1, pvdhps and pvdhfr, were done in day-0 samples in prospective study. Clinical failure cases were found only in Kawthaung, southern Myanmar and western Myanmar sites within 2009-2016. Chloroquine resistance markers, pvcrt-O 'AAG' insertion and pvmdr1 mutation (Y976F) showed higher mutant rate in southern and central Myanmar than western site: 66.7, 72.7 vs 48.3% and 26.7, 17.0 vs 1.7%, respectively. A similar pattern of significantly higher mutant rate of antifolate resistance markers, pvdhps (S382A, K512M, A553G) and pvdhfr (F57L/I, S58R, T61M, S117T/N) were noted. Although clinical failure rate was low, widespread distribution of chloroquine and antifolate resistance molecular makers alert to the emergence and spread of drug resistance vivax malaria in Myanmar. Proper strategy and action plan to eliminate and contain the resistant strain strengthened together with clinical and molecular surveillance on drug resistance vivax is recommended.

  18. Exploiting heterogeneous publicly available data sources for drug safety surveillance: computational framework and case studies.

    Science.gov (United States)

    Koutkias, Vassilis G; Lillo-Le Louët, Agnès; Jaulent, Marie-Christine

    2017-02-01

    Driven by the need of pharmacovigilance centres and companies to routinely collect and review all available data about adverse drug reactions (ADRs) and adverse events of interest, we introduce and validate a computational framework exploiting dominant as well as emerging publicly available data sources for drug safety surveillance. Our approach relies on appropriate query formulation for data acquisition and subsequent filtering, transformation and joint visualization of the obtained data. We acquired data from the FDA Adverse Event Reporting System (FAERS), PubMed and Twitter. In order to assess the validity and the robustness of the approach, we elaborated on two important case studies, namely, clozapine-induced cardiomyopathy/myocarditis versus haloperidol-induced cardiomyopathy/myocarditis, and apixaban-induced cerebral hemorrhage. The analysis of the obtained data provided interesting insights (identification of potential patient and health-care professional experiences regarding ADRs in Twitter, information/arguments against an ADR existence across all sources), while illustrating the benefits (complementing data from multiple sources to strengthen/confirm evidence) and the underlying challenges (selecting search terms, data presentation) of exploiting heterogeneous information sources, thereby advocating the need for the proposed framework. This work contributes in establishing a continuous learning system for drug safety surveillance by exploiting heterogeneous publicly available data sources via appropriate support tools.

  19. Evaluation of Electronic Healthcare Databases for Post-Marketing Drug Safety Surveillance and Pharmacoepidemiology in China.

    Science.gov (United States)

    Yang, Yu; Zhou, Xiaofeng; Gao, Shuangqing; Lin, Hongbo; Xie, Yanming; Feng, Yuji; Huang, Kui; Zhan, Siyan

    2018-01-01

    Electronic healthcare databases (EHDs) are used increasingly for post-marketing drug safety surveillance and pharmacoepidemiology in Europe and North America. However, few studies have examined the potential of these data sources in China. Three major types of EHDs in China (i.e., a regional community-based database, a national claims database, and an electronic medical records [EMR] database) were selected for evaluation. Forty core variables were derived based on the US Mini-Sentinel (MS) Common Data Model (CDM) as well as the data features in China that would be desirable to support drug safety surveillance. An email survey of these core variables and eight general questions as well as follow-up inquiries on additional variables was conducted. These 40 core variables across the three EHDs and all variables in each EHD along with those in the US MS CDM and Observational Medical Outcomes Partnership (OMOP) CDM were compared for availability and labeled based on specific standards. All of the EHDs' custodians confirmed their willingness to share their databases with academic institutions after appropriate approval was obtained. The regional community-based database contained 1.19 million people in 2015 with 85% of core variables. Resampled annually nationwide, the national claims database included 5.4 million people in 2014 with 55% of core variables, and the EMR database included 3 million inpatients from 60 hospitals in 2015 with 80% of core variables. Compared with MS CDM or OMOP CDM, the proportion of variables across the three EHDs available or able to be transformed/derived from the original sources are 24-83% or 45-73%, respectively. These EHDs provide potential value to post-marketing drug safety surveillance and pharmacoepidemiology in China. Future research is warranted to assess the quality and completeness of these EHDs or additional data sources in China.

  20. Reference drug programs: Effectiveness and policy implications☆

    Science.gov (United States)

    Schneeweiss, Sebastian

    2010-01-01

    In the current economic environment, health care systems are constantly struggling to contain rapidly rising costs. Drug costs are targeted by a wide variety of measures. Many jurisdictions have implemented reference drug programs (RDPs) or similar therapeutic substitution programs. This paper summarizes the mechanism and rationale of RDPs and presents evidence of their economic effectiveness and clinical safety. RDPs for pharmaceutical reimbursement are based on the assumption that drugs within specified medication groups are therapeutically equivalent and clinically interchangeable and that a common reimbursement level can thus be established. If the evidence documents that a higher price for a given drug does not buy greater effectiveness or reduced toxicity, then under RDP such extra costs are not covered. RDPs or therapeutic substitutions based on therapeutic equivalence are seen as logical extensions of generic substitution that is based on bioequivalence of drugs. If the goal is to achieve full drug coverage for as many patients as possible in the most efficient manner, then RDPs in combination with prior authorization programs are safer and more effective than simplistic fiscal drug policies, including fixed co-payments, co-insurances, or deductibles. RDPs will reduce spending in the less innovative but largest market, while fully covering all patients. Prior authorization will ensure that patients with a specified indication will benefit from the most innovative therapies with full coverage. In practice, however, not all patients and drugs will fit exactly into one of the two categories. Therefore, a process of medically indicated exemptions that will consider full coverage should accompany an RDP. In the current economic environment, health care systems are constantly struggling to contain rapidly rising costs. Drug costs are targeted by a wide variety of measures. Many jurisdictions have implemented reference drug programs, and others are considering

  1. A temporal interestingness measure for drug interaction signal detection in post-marketing surveillance.

    Science.gov (United States)

    Ji, Yanqing; Ying, Hao; Tran, John; Dews, Peter; Mansour, Ayman; Massanari, R Michael

    2014-01-01

    Drug-drug interactions (DDIs) can result in serious consequences, including death. Existing methods for identifying potential DDIs in post-marketing surveillance primarily rely on the FDA's (Food and Drug Administration) spontaneous reporting system. However, this system suffers from severe underreporting, which makes it difficult to timely collect enough valid cases for statistical analysis. In this paper, we study how to signal potential DDIs using patient electronic health data. Specifically, we focus on discovery of potential DDIs by analyzing the temporal relationships between the concurrent use of two drugs of interest and the occurrences of various symptoms using novel temporal association mining techniques we developed. A new interestingness measure called functional temporal interest was proposed to assess the degrees of temporal association between two drugs of interest and each symptom. The measure was employed to screen potential DDIs from 21,405 electronic patient cases retrieved from the Veterans Affairs Medical Center in Detroit, Michigan. The preliminary results indicate the usefulness of our method in finding potential DDIs for further analysis (e.g., epidemiology study) and investigation (e.g., case review) by drug safety professionals.

  2. Enhancing Seasonal Influenza Surveillance: Topic Analysis of Widely Used Medicinal Drugs Using Twitter Data.

    Science.gov (United States)

    Kagashe, Ireneus; Yan, Zhijun; Suheryani, Imran

    2017-09-12

    Uptake of medicinal drugs (preventive or treatment) is among the approaches used to control disease outbreaks, and therefore, it is of vital importance to be aware of the counts or frequencies of most commonly used drugs and trending topics about these drugs from consumers for successful implementation of control measures. Traditional survey methods would have accomplished this study, but they are too costly in terms of resources needed, and they are subject to social desirability bias for topics discovery. Hence, there is a need to use alternative efficient means such as Twitter data and machine learning (ML) techniques. Using Twitter data, the aim of the study was to (1) provide a methodological extension for efficiently extracting widely consumed drugs during seasonal influenza and (2) extract topics from the tweets of these drugs and to infer how the insights provided by these topics can enhance seasonal influenza surveillance. From tweets collected during the 2012-13 flu season, we first identified tweets with mentions of drugs and then constructed an ML classifier using dependency words as features. The classifier was used to extract tweets that evidenced consumption of drugs, out of which we identified the mostly consumed drugs. Finally, we extracted trending topics from each of these widely used drugs' tweets using latent Dirichlet allocation (LDA). Our proposed classifier obtained an F 1 score of 0.82, which significantly outperformed the two benchmark classifiers (ie, Pstrategies for mitigating the severity of seasonal influenza outbreaks. The proposed methods can be extended to the outbreaks of other diseases. ©Ireneus Kagashe, Zhijun Yan, Imran Suheryani. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.09.2017.

  3. [Active surveillance of adverse drug reaction in the era of big data: challenge and opportunity for control selection].

    Science.gov (United States)

    Wang, S F; Zhan, S Y

    2016-07-01

    Electronic healthcare databases have become an important source for active surveillance of drug safety in the era of big data. The traditional epidemiology research designs are needed to confirm the association between drug use and adverse events based on these datasets, and the selection of the comparative control is essential to each design. This article aims to explain the principle and application of each type of control selection, introduce the methods and parameters for method comparison, and describe the latest achievements in the batch processing of control selection, which would provide important methodological reference for the use of electronic healthcare databases to conduct post-marketing drug safety surveillance in China.

  4. LWR surveillance dosimetry improvement program: PSF metallurgical blind test results

    International Nuclear Information System (INIS)

    Kam, F.B.K.; Stallmann, F.W.; Guthrie, G.; McElroy, W.N.

    1985-01-01

    The ORR-PSF benchmark experiment was designed to simulate the surveillance capsule-pressure vessel configuration in power reactors and to test the validity of procedures which determine the radiation damage in the vessel from test results in the surveillance capsule. The PSF metallurgical blind test was initiated to give participants an opportunity to test their current embrittlement prediction methodologies. Experimental results were withheld from the participants except for the type of information which is normally contained in surveillance reports. Preliminary analysis of the PSF metallurgical blind test results shows that: (1) current prediction methodologies, as used by the PSF Blind Test participants, are adequate, falling within +- 20 0 C of the measured values for Δ NDT. None of the different methods is clearly superior; (2) the proposed revision of Reg. Guide 1.99 (Rev. 2) gives a better representation of the fluence and chemistry dependency of Δ NDT than the current version (Rev. 1); and (3) fluence rate effects can be seen but not quantified. Fluence spectral effects are too small to be detectable in this experiment. (orig.)

  5. Arthritis, Rheumatism and Aging Medical Information System Post-Marketing Surveillance Program.

    Science.gov (United States)

    Singh, G

    2001-05-01

    The Arthritis, Rheumatism, and Aging Post-Marketing Surveillance Program (ARAMIS-PMS) is a collection of multicenter, prospective, noninterventional, observational longitudinal studies of patients with rheumatic diseases. The ARAMIS-PMS program aims to study patients in normal clinical setting to evaluate the real-life effectiveness, toxicity, and cost effectiveness of various medications used to treat rheumatic diseases.

  6. Surveillance in Programming Plagiarism beyond Techniques: An Incentive-Based Fishbone Model

    Science.gov (United States)

    Wang, Yanqing; Chen, Min; Liang, Yaowen; Jiang, Yu

    2013-01-01

    Lots of researches have showed that plagiarism becomes a severe problem in higher education around the world, especially in programming learning for its essence. Therefore, an effective strategy for plagiarism surveillance in program learning is much essential. Some literature focus on code similarity algorithm and the related tools can help to…

  7. [Drug surveillance and adverse reactions to drugs. The literature and importance of historical data].

    Science.gov (United States)

    Mariani, L; Minora, T; Ventresca, G P

    1996-12-01

    The authors highlight the essential role of pharmacovigilance and the need for a simple, efficient and low-cost system of adverse reaction (AR) reporting which could cover the whole population and all marketed drugs, and suggest that the only one presently viable is based on spontaneous reporting. To support their proposal the authors provide a definition of AR and of the different monitoring system, and list as many drugs as possible to find in the literature that have been associated with a specific AR, together with the active molecule, the therapeutic indication, the features of the AR and the regulatory actions (withdrawal from the market, restriction of use). Moreover, by describing the "history" behind some of these drugs the authors highlight the contribution that pharmacovigilance and spontaneous reporting have had to the development of regulations for approval and marketing of new drugs. It is also highlighted how some of these unexpected events (thalidomide, DES) have had a significant and important contribution to pharmacological and toxicological knowledge.

  8. Arthropod Surveillance Programs: Basic Components, Strategies, and Analysis

    Science.gov (United States)

    2012-01-01

    CA. 9 NAMRU-3, US Navy, Cairo, Egypt . inferences from trap capture data. The following is a review of the three arthropod surveillance compo- nents...by thigmotaxis. Fig. 1. The two traps used for stored product insects, A) the commonly used Dome trap (Trècè) and B) the newly developed pyramid ...trap. The pyramid trap is made up of two elements: a cover (1) and a base (2) with a center pitfall (3). (Online Þgure in color.) 140 ANNALS OF THE

  9. [The role of drug registries in the post-marketing surveillance].

    Science.gov (United States)

    Traversa, Giuseppe; Sagliocca, Luciano; Magrini, Nicola; Venegoni, Mauro

    2013-06-01

    The aim of this article is to provide an introduction to issue of Recenti Progressi in Medicina, devoted to the role of drug registries in the post-marketing surveillance. We first motivate the need to implement registries as a tool in promoting the appropriateness of drug use and acquiring additional information on the risk-benefit profile of drugs. Then, the different role that can be played by registries in comparison with prescription monitoring systems and observational studies is clarified. The presentation of some of the most relevant registries established in Italy since the end of the '90s, with the analysis of their strengths and weaknesses, helps to understand some of the crucial issues that should be taken into account before a new registry is adopted. Specifically, we deal with the relationship between objectives - of appropriateness, effectiveness and safety - and methods; the overlapping between drug-based registries and disease-based ones; the duration and extension of data collection, which may be either exhaustive or based on a sampling frame; the importance of ensuring the quality of the data and to minimize the number of subjects who are lost to follow-up; the importance of infrastructures, and of ad hoc funding, for the functioning of a registry; the independence in data analysis and publication of findings.

  10. Summary report of the state surveillance program on the transportation of radioactive materials

    International Nuclear Information System (INIS)

    1977-11-01

    From 1973 to 1976, a surveillance program was conducted in New Jersey, Oregon, Missouri, New York, Illinois, Texas, Louisiana, South Carolina, Minnesota, and New York City to provide training support for State radiation personnel and to determine actual radiation exposure conditions and radioactive material package handling practices through the terminals of air carriers and freight forwarders. NRC and DOT along with the participating States, developed the surveillance program. In general, the results did not indicate a public health or safety problem due to the transportation of radioactive materials. Some employees of several freight forwarders, are, however, receiving annual exposures in excess of 500 mrem. Recommendations are given

  11. Evaluation of the surveillance program of Streptococcus agalactiae in Danish dairy herds

    DEFF Research Database (Denmark)

    Andersen, H. J.; Pedersen, L. H.; Aarestrup, Frank Møller

    2003-01-01

    The aim of this study was to evaluate the Danish surveillance program of Streptococcus agalactiae in dairy herds with respect to 1) fluctuation over time of the presence of S. agalactiae in bulk tank milk, 2) sensitivity and specificity of the bacteriological method used, and 3) contamination...... the isolates. Streptococcus agalactiae was found in eight of 96 herds in which S. agalactiae had never previously been found during the surveillance program. Streptococcus agalactiae was not found in all seven sampling rounds in any of the eight herds. Comparing the approved method with supplemental findings...

  12. Strengthening Acute Flaccid Paralysis Surveillance through the Village Polio Volunteers Program in Somalia.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Mohamed, Abdinoor; Owino, Brian Ogola; Mengistu, Kumlachew F; Ehrhardt, Derek; Elsayed, Eltayeb Ahmed

    2018-03-02

    Surveillance for cases of acute flaccid paralysis (AFP) is a key strategy adopted for the eradication of polio. Detection of poliovirus circulation is often predicated on the ability to identify AFP cases and test their stool specimens for poliovirus infection in a timely manner. The Village Polio Volunteers (VPV) program was established in 2013 in a bid to strengthen polio eradication activities in Somalia, including AFP surveillance, given the country's vulnerability to polio outbreaks. To assess the impact of the VPV program on AFP surveillance, we determined case counts, case-reporting sources, and non-polio AFP rates in the years before and after program introduction, i.e., 2011-2016. We also compared the stool adequacy and timeliness of cases reported by VPVs to those reported by other sources. In the years following program introduction, VPVs accounted for a high proportion of AFP cases reported in Somalia. AFP case counts rose from 148 cases in 2012, the year before program introduction, to 279 cases in 2015, during which VPVs accounted for 40% of reported cases. Further, the non-polio AFP rate improved from 2.8 cases in 2012 to 4.8 cases per 100,000 persons Somalia, similar community-based programs could play a crucial role in enhancing surveillance activities in countries with limited healthcare infrastructure.

  13. ORNL Surplus Facilities Management Program maintenance and surveillance plan for fiscal year 1984

    International Nuclear Information System (INIS)

    Coobs, J.H.; Myrick, T.E.

    1986-10-01

    The Surplus Facilities Management Program (SFMP) at Oak Ridge National Laboratory (ORNL) is part of the Department of Energy's (DOE) National SFMP, administered by the Richland Operations Office. The purpose and objectives of the national program are set forth in the current SFMP Program Plan and include (1) the maintenance and surveillance of facilities awaiting decommissioning, (2) planning for the orderly decommissioning of these facilities, and (3) implementation of a program to accomplish the facility disposition in a safe, cost-effective, and timely manner. As outlined in the national program plan, participating SFMP contractors are required to prepare a formal plan that documents the maintenance and surveillance (M and S) programs established for each site. This report has been prepared to provide this documentation for those facilties included in the ORNL SFMP

  14. The potential of the European network of congenital anomaly registers (EUROCAT) for drug safety surveillance: a descriptive study.

    Science.gov (United States)

    Meijer, Willemijn M; Cornel, Martina C; Dolk, Helen; de Walle, Hermien E K; Armstrong, Nicola C; de Jong-van den Berg, Lolkje T W

    2006-09-01

    European Surveillance of Congenital Anomalies (EUROCAT) is a network of population-based congenital anomaly registries in Europe surveying more than 1 million births per year, or 25% of the births in the European Union. This paper describes the potential of the EUROCAT collaboration for pharmacoepidemiology and drug safety surveillance. The 34 full members and 6 associate members of the EUROCAT network were sent a questionnaire about their data sources on drug exposure and on drug coding. Available data on drug exposure during the first trimester available in the central EUROCAT database for the years 1996-2000 was summarised for 15 out of 25 responding full members. Of the 40 registries, 29 returned questionnaires (25 full and 4 associate members). Four of these registries do not collect data on maternal drug use. Of the full members, 15 registries use the EUROCAT drug code, 4 use the international ATC drug code, 3 registries use another coding system and 7 use a combination of these coding systems. Obstetric records are the most frequently used sources of drug information for the registries, followed by interviews with the mother. Only one registry uses pharmacy data. Percentages of cases with drug exposure (excluding vitamins/minerals) varied from 4.4% to 26.0% among different registries. The categories of drugs recorded varied widely between registries. Practices vary widely between registries regarding recording drug exposure information. EUROCAT has the potential to be an effective collaborative framework to contribute to post-marketing drug surveillance in relation to teratogenic effects, but work is needed to implement ATC drug coding more widely, and to diversify the sources of information used to determine drug exposure in each registry.

  15. LWR surveillance dosimetry improvement program: PSF metallurgical blind test results

    International Nuclear Information System (INIS)

    Kam, F.B.K.; Maerker, R.E.; Stallmann, F.W.

    1984-01-01

    The metallurgical irradiation experiment at the Oak Ridge Research Reactor Poolside Facility (ORR-PSF) was designed as a benchmark to test the accuracy of radiation embrittlement predictions in the pressure vessel wall of light water reactors on the basis of results from surveillance capsules. The PSF metallurgical Blind Test is concerned with the simulated surveillance capsule (SSC) and the simulated pressure vessel capsule (SPVC). The data from the ORR-PSF benchmark experiment are the basis for comparison with the predictions made by participants of the metallurgical ''Blind Test''. The Blind Test required the participants to predict the embrittlement of the irradiated specimen based only on dosimetry and metallurgical data from the SSC1 capsule. This exercise included both the prediction of damage fluence and the prediction of embrittlement based on the predicted fluence. A variety of prediction methodologies was used by the participants. No glaring biases or other deficiencies were found, but neither were any of the methods clearly superior to the others. Closer analysis shows a rather complex and poorly understood relation between fluence and material damage. Many prediction formulas can give an adequate approximation, but further improvement of the prediction methodology is unlikely at this time given the many unknown factors. Instead, attention should be focused on determining realistic uncertainties for the predicted material changes. The Blind Test comparisons provide some clues for the size of these uncertainties. In particular, higher uncertainties must be assigned to materials whose chemical composition lies outside the data set for which the prediction formula was obtained. 16 references, 14 figures, 5 tables

  16. Establishment of a Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program

    Science.gov (United States)

    Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

    2015-01-01

    The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 –December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries. PMID:26600437

  17. Development of a supplemental surveillance program for reactor pressure vessel thermal annealing

    International Nuclear Information System (INIS)

    Server, W.L.; Rosinski, S.T.

    1997-01-01

    The technical decision to thermally anneal a nuclear reactor pressure vessel (RPV) depends upon the level of embrittlement in the RPV steels, the amount of recovery of fracture toughness properties expected from the anneal, and the rate of re-embrittlement after the vessel is placed back into service. The recovery of Charpy impact toughness properties after annealing can be estimated initially by using a recovery model developed using experimental measurements of recovery (such as that developed by Eason et al. for U.S. vessel materials). However, actual validation measurements on plant-specific archived vessel materials (hopefully in the existing surveillance program) are needed; otherwise, irradiated surrogate materials, essentially the same as the RPV steels or bounding in expected behavior, must be utilized. The efficient use of any of these materials requires a supplemental surveillance program focused at both recovery and reirradiation embrittlement. Reconstituted Charpy specimens and new surveillance capsules will most likely be needed as part of this supplemental surveillance program. A new version of ASTM E 509 has recently been approved which provides guidance on thermal annealing in general and specifically for the development of an annealing supplemental surveillance program. The post-anneal re-embrittlement properties are crucial for continued plant operation, and the use of a re-embrittlement model, such as the lateral shift approach, may be overly conservative. This paper illustrates the new ASTM E 509 Standard Guide methodology for an annealing supplemental surveillance program. As an example, the proposed program for the Palisades RPV beltline steels is presented which covers the time from annealing to the end of operating license and beyond, if license renewal is pursued. The Palisades nuclear power plant RPV was planned to be annealed in 1998, but that plant is currently being re-evaluated. The proposed anneal was planned to be conducted at a

  18. Opportunities for Enhanced Strategic Use of Surveys, Medical Records, and Program Data for HIV Surveillance of Key Populations: Scoping Review

    Science.gov (United States)

    Baral, Stefan D; Edwards, Jessie K; Zadrozny, Sabrina; Hargreaves, James; Zhao, Jinkou; Sabin, Keith

    2018-01-01

    Background Normative guidelines from the World Health Organization recommend tracking strategic information indicators among key populations. Monitoring progress in the global response to the HIV epidemic uses indicators put forward by the Joint United Nations Programme on HIV/AIDS. These include the 90-90-90 targets that require a realignment of surveillance data, routinely collected program data, and medical record data, which historically have developed separately. Objective The aim of this study was to describe current challenges for monitoring HIV-related strategic information indicators among key populations ((men who have sex with men [MSM], people in prisons and other closed settings, people who inject drugs, sex workers, and transgender people) and identify future opportunities to enhance the use of surveillance data, programmatic data, and medical record data to describe the HIV epidemic among key populations and measure the coverage of HIV prevention, care, and treatment programs. Methods To provide a historical perspective, we completed a scoping review of the expansion of HIV surveillance among key populations over the past three decades. To describe current efforts, we conducted a review of the literature to identify published examples of SI indicator estimates among key populations. To describe anticipated challenges and future opportunities to improve measurement of strategic information indicators, particularly from routine program and health data, we consulted participants of the Third Global HIV Surveillance Meeting in Bangkok, where the 2015 World Health Organization strategic information guidelines were launched. Results There remains suboptimal alignment of surveillance and programmatic data, as well as routinely collected medical records to facilitate the reporting of the 90-90-90 indicators for HIV among key populations. Studies (n=3) with estimates of all three 90-90-90 indicators rely on cross-sectional survey data. Programmatic data and

  19. Genetic sequencing for surveillance of drug resistance in tuberculosis in highly endemic countries: a multi-country population-based surveillance study.

    Science.gov (United States)

    Zignol, Matteo; Cabibbe, Andrea Maurizio; Dean, Anna S; Glaziou, Philippe; Alikhanova, Natavan; Ama, Cecilia; Andres, Sönke; Barbova, Anna; Borbe-Reyes, Angeli; Chin, Daniel P; Cirillo, Daniela Maria; Colvin, Charlotte; Dadu, Andrei; Dreyer, Andries; Driesen, Michèle; Gilpin, Christopher; Hasan, Rumina; Hasan, Zahra; Hoffner, Sven; Hussain, Alamdar; Ismail, Nazir; Kamal, S M Mostofa; Khanzada, Faisal Masood; Kimerling, Michael; Kohl, Thomas Andreas; Mansjö, Mikael; Miotto, Paolo; Mukadi, Ya Diul; Mvusi, Lindiwe; Niemann, Stefan; Omar, Shaheed V; Rigouts, Leen; Schito, Marco; Sela, Ivita; Seyfaddinova, Mehriban; Skenders, Girts; Skrahina, Alena; Tahseen, Sabira; Wells, William A; Zhurilo, Alexander; Weyer, Karin; Floyd, Katherine; Raviglione, Mario C

    2018-03-21

    In many countries, regular monitoring of the emergence of resistance to anti-tuberculosis drugs is hampered by the limitations of phenotypic testing for drug susceptibility. We therefore evaluated the use of genetic sequencing for surveillance of drug resistance in tuberculosis. Population-level surveys were done in hospitals and clinics in seven countries (Azerbaijan, Bangladesh, Belarus, Pakistan, Philippines, South Africa, and Ukraine) to evaluate the use of genetic sequencing to estimate the resistance of Mycobacterium tuberculosis isolates to rifampicin, isoniazid, ofloxacin, moxifloxacin, pyrazinamide, kanamycin, amikacin, and capreomycin. For each drug, we assessed the accuracy of genetic sequencing by a comparison of the adjusted prevalence of resistance, measured by genetic sequencing, with the true prevalence of resistance, determined by phenotypic testing. Isolates were taken from 7094 patients with tuberculosis who were enrolled in the study between November, 2009, and May, 2014. In all tuberculosis cases, the overall pooled sensitivity values for predicting resistance by genetic sequencing were 91% (95% CI 87-94) for rpoB (rifampicin resistance), 86% (74-93) for katG, inhA, and fabG promoter combined (isoniazid resistance), 54% (39-68) for pncA (pyrazinamide resistance), 85% (77-91) for gyrA and gyrB combined (ofloxacin resistance), and 88% (81-92) for gyrA and gyrB combined (moxifloxacin resistance). For nearly all drugs and in most settings, there was a large overlap in the estimated prevalence of drug resistance by genetic sequencing and the estimated prevalence by phenotypic testing. Genetic sequencing can be a valuable tool for surveillance of drug resistance, providing new opportunities to monitor drug resistance in tuberculosis in resource-poor countries. Before its widespread adoption for surveillance purposes, there is a need to standardise DNA extraction methods, recording and reporting nomenclature, and data interpretation. Bill & Melinda

  20. Detection of imminent vein graft occlusion: what is the optimal surveillance program?

    Science.gov (United States)

    Tinder, Chelsey N; Bandyk, Dennis F

    2009-12-01

    The prediction of infrainguinal vein bypass failure remains an inexact judgment. Patient demographics, technical factors, and vascular laboratory graft surveillance testing are helpful in identifying a high-risk graft cohort. The optimal surveillance program to detect the bypass at risk for imminent occlusion continues to be developed, but required elements are known and include clinical assessment for new or changes in limb ischemia symptoms, measurement of ankle and/or toe systolic pressure, and duplex ultrasound imaging of the bypass graft. Duplex ultrasound assessment of bypass hemodynamics may be the most accurate method to detect imminent vein graft occlusion. The finding of low graft flow during intraoperative assessment or at a scheduled surveillance study predicts failure; and if associated with an occlusive lesion, a graft revision can prolong patency. The most common abnormality producing graft failure is conduit stenosis caused by myointimal hyperplasia; and the majority can be repaired by an endovascular intervention. Frequency of testing to detect the failing bypass should be individualized to the patient, the type of arterial bypass, and prior duplex ultrasound scan findings. The focus of surveillance is on identification of the low-flow arterial bypass and timely repair of detected critical stenosis defined by duplex velocity spectra criteria of a peak systolic velocity 300 cm/s and peak systolic velocity ratio across the stenosis >3.5-correlating with >70% diameter-reducing stenosis. When conducted appropriately, a graft surveillance program should result in an unexpected graft failure rate of <3% per year.

  1. Feasibility and acceptability of a workers' health surveillance program for hospital physicians

    NARCIS (Netherlands)

    Ruitenburg, Martijn M.; Plat, Marie-Christine J.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2015-01-01

    A Workers' Health Surveillance (WHS) program is an occupational health strategy used to detect and address the health of individual workers to improve their ability to work. This study aims to investigate the feasibility and acceptability of a new job-specific WHS for hospital physicians. All

  2. Detection capacity, information gaps and the design of surveillance programs for invasive forest pests

    Science.gov (United States)

    Denys Yemshanov; Frank Koch; Yakov Ben-Haim; William Smith

    2010-01-01

    Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains...

  3. 10 CFR Appendix H to Part 50 - Reactor Vessel Material Surveillance Program Requirements

    Science.gov (United States)

    2010-01-01

    ... arrangement for data sharing between plants. d. There must be a contingency plan to assure that the... Requirements I. Introduction II. Definitions III. Surveillance Program Criteria IV. Report of Test Results I..., Rockville, MD 20852-2738. II. Definitions All terms used in this appendix have the same meaning as in...

  4. 9 CFR 145.15 - Diagnostic surveillance program for low pathogenic avian influenza.

    Science.gov (United States)

    2010-01-01

    ... low pathogenic avian influenza. 145.15 Section 145.15 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  5. Student Drug Testing and the Surveillance School Economy: An Analysis of Media Representation and Policy Transfer in Australian Schools

    Science.gov (United States)

    Taylor, Emmeline

    2018-01-01

    Anxieties relating to the health, safety and security of schoolchildren have been met with a variety of surveillance apparatus in schools internationally. Drawing on findings from a content analysis of newspaper reports relating to drug testing in Australian schools, this article seeks to excavate the ways in which the media shapes, informs,…

  6. [Training programs for staff at local Infectious Disease Surveillance Centers: the needs and usefulness].

    Science.gov (United States)

    Suzuki, Tomoyuki; Kamiya, Nobuyuki; Yahata, Yuichiro; Ozeki, Yukie; Kishimoto, Tsuyoshi; Nadaoka, Yoko; Nakanishi, Yoshiko; Yoshimura, Takesumi; Shimada, Tomoe; Tada, Yuki; Shirabe, Komei; Kozawa, Kunihisa

    2013-03-01

    The objective of this study was to assess the need for and usefulness of training programs for Local Infectious Disease Surveillance Center (LIDSC) staff. A structured questionnaire survey was conducted to assess the needs and usefulness of training programs. The subjects of the survey were participants of a workshop held after an annual conference for the LIDSC staff. Data on demographic information, the necessity of training programs for LIDSC staff, the themes and contents of the training program, self-assessment of knowledge on epidemiology and statistics were covered by the questionnaire. A total of 55 local government officials responded to the questionnaire (response rate: 100%). Among these, 95% of participants believed that the training program for the LIDSC staff was necessary. Basic statistical analysis (85%), descriptive epidemiology (65%), outline of epidemiology (60%), interpretation of surveillance data (65%), background and objectives of national infectious disease surveillance in Japan (60%), methods of field epidemiology (60%), and methods of analysis data (51%) were selected by over half of the respondents as suitable themes for training programs. A total of 34 LIDSC staff answered the self-assessment question on knowledge of epidemiology. A majority of respondents selected "a little" or "none" for all questions about knowledge. Only a few respondents had received education in epidemiology. The results of this study indicate that LIDSC staff have basic demands for fundamental and specialized education to improve their work. Considering the current situation regarding the capacity of LIDSC staff, these training programs should be started immediately.

  7. Computerized surveillance of opioid-related adverse drug events in perioperative care: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Gattis Katherine G

    2009-08-01

    Full Text Available Abstract Background Given the complexity of surgical care, perioperative patients are at high risk of opioid-related adverse drug events. Existing methods of detection, such as trigger tools and manual chart review, are time-intensive which makes sustainability challenging. Using strategic rule design, computerized surveillance may be an efficient, pharmacist-driven model for event detection that leverages existing staff resources. Methods Computerized adverse drug event surveillance uses a logic-based rules engine to identify potential adverse drug events or evolving unsafe clinical conditions. We extended an inpatient rule (administration of naloxone to detect opioid-related oversedation and respiratory depression to perioperative care at a large academic medical center. Our primary endpoint was the adverse drug event rate. For all patients with a naloxone alert, manual chart review was performed by a perioperative clinical pharmacist to assess patient harm. In patients with confirmed oversedation, other patient safety event databases were queried to determine if they could detect duplicate, prior, or subsequent opioid-related events. Results We identified 419 cases of perioperative naloxone administration. Of these, 101 were given postoperatively and 69 were confirmed as adverse drug events after chart review yielding a rate of 1.89 adverse drug events/1000 surgical encounters across both the inpatient and ambulatory settings. Our ability to detect inpatient opioid adverse drug events increased 22.7% by expanding surveillance into perioperative care. Analysis of historical surveillance data as well as a voluntary reporting database revealed that 11 of our perioperative patients had prior or subsequent harmful oversedation. Nine of these cases received intraoperative naloxone, and 2 had received naloxone in the post-anesthesia care unit. Pharmacist effort was approximately 3 hours per week to evaluate naloxone alerts and confirm adverse drug

  8. Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

    1983-12-01

    This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes

  9. The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies.

    Science.gov (United States)

    von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F; Bjerregaard-Andersen, Morten; Clemens, John D; Crump, John A; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H; Cosmas, Leonard; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R; Wierzba, Thomas F; Marks, Florian

    2016-03-15

    New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  10. Mark of the reconstitution process of the surveillance program of the CLV

    International Nuclear Information System (INIS)

    Romero, J.; Hernandez, R.; Fernandez, F.

    2006-01-01

    The surveillance program of the reactor vessel of the nucleo electric central of Mexico it evaluates the mechanical state of the vessel, for it are had surveillance capsules with a series of witness test tubes, subjected to a similar or major neutron flux to that of the vessel. The objective is to evaluate in advance the embrittlement grade of the vessel in its design life. However the number of capsules with the witness test tubes it is only for the design life of the plant and at the moment the nucleo electric plants negotiate an extension of life of these, until for 20 years or more, of there the importance of this witness material that stores the information of the damage accumulated by irradiation. This material requires to be taken advantage after being rehearsed and the normative one settles down as obligatory to qualify the rebuilding process to obtain other 'new' Charpy test tubes that are again introduced in the reactor, reusing this material, as much for the surveillance program as for the extension of the plant life. In this work the qualification of the welding process by 'Stud Welding' for the rebuilding of Charpy test tubes of the surveillance program of the BWR reactor Unit 2 of the Laguna Verde Nucleo electric plant, Veracruz, Mexico is described. (Author)

  11. Surveillance of adverse effects following vaccination and safety of immunization programs.

    Science.gov (United States)

    Waldman, Eliseu Alves; Luhm, Karin Regina; Monteiro, Sandra Aparecida Moreira Gomes; Freitas, Fabiana Ramos Martin de

    2011-02-01

    The aim of the review was to analyze conceptual and operational aspects of systems for surveillance of adverse events following immunization. Articles available in electronic format were included, published between 1985 and 2009, selected from the PubMed/Medline databases using the key words "adverse events following vaccine surveillance", "post-marketing surveillance", "safety vaccine" and "Phase IV clinical trials". Articles focusing on specific adverse events were excluded. The major aspects underlying the Public Health importance of adverse events following vaccination, the instruments aimed at ensuring vaccine safety, and the purpose, attributes, types, data interpretation issues, limitations, and further challenges in adverse events following immunization were describe, as well as strategies to improve sensitivity. The review was concluded by discussing the challenges to be faced in coming years with respect to ensuring the safety and reliability of vaccination programs.

  12. Best approaches to drug-resistance surveillance at the country level

    Directory of Open Access Journals (Sweden)

    A M Cabibbe

    2016-01-01

    Classical sequencing and NGS approaches have been successfully used in a recent study conducted in five countries with high burden of TB and multidrug resistant tuberculosis (MDR-TB and aimed at investigating levels of resistance to pyrazinamide among patients with TB by pncA sequencing [doi: 10.1016/S1473-3099(1630190-6]. This work innovatively demonstrated that the establishment of strong links between national (peripheral and reference laboratories and supranational laboratories, with the former possibly processing indirect or direct samples and generating sequencing data, and the latter supporting them for bioinformatics analysis and data interpretation, will soon make WGS and targeted NGS the preferred tools to conduct public health surveillances in TB field, thus helping the strategies adopted by TB control programs at local and national levels.

  13. Verifying Elimination Programs with a Special Emphasis on Cysticercosis Endpoints and Postelimination Surveillance

    Directory of Open Access Journals (Sweden)

    Sukwan Handali

    2012-01-01

    Full Text Available Methods are needed for determining program endpoints or postprogram surveillance for any elimination program. Cysticercosis has the necessary effective strategies and diagnostic tools for establishing an elimination program; however, tools to verify program endpoints have not been determined. Using a statistical approach, the present study proposed that taeniasis and porcine cysticercosis antibody assays could be used to determine with a high statistical confidence whether an area is free of disease. Confidence would be improved by using secondary tests such as the taeniasis coproantigen assay and necropsy of the sentinel pigs.

  14. Portsmouth Gaseous Diffusion Plant Decontamination and Decommissioning Program surveillance and maintenance plan, FY 1993--2002

    International Nuclear Information System (INIS)

    Schloesslin, W.

    1992-11-01

    The Decontamination and Decommissioning (D ampersand D) Program at the Portsmouth Gaseous Diffusion Plant (PORTS) is part of the Environmental Restoration (ER) and Waste Management (WM) Programs (ERWM). The objective of the ER Program is to provide PORTS the capability to meet applicable environmental regulations through facility development activities and site remedial actions. The WM Program supports the ER Program. The D ampersand D Program provides collective management of the sites within the plant which require decontamination and decommissioning, prioritizes those areas in terms of health, safety and environmental concerns, and implements the appropriate level of remedial action. The D ampersand D Program provides support to facilities which formerly served one or more of the many Plant functions. Program activities include (1) surveillance and maintenance of facilities awaiting decommissioning; (2) planning safe and orderly facility decommissioning; and (3) implementing a program to accomplish facility disposition in a safe, cost effective, and timely manner. In order to achieve the first objective, a formal plan which documents the surveillance and maintenance needs for each inactive facility has been prepared. This report provides this documentation for the PORTS facilities currently included in the D ampersand D Program and includes projected resource requirements for the planning period of FY 1993 through FY 2002

  15. Surveillance of transmitted HIV drug resistance in antiretroviral-naive patients aged less than 25 years, in Bangkok, Thailand.

    Science.gov (United States)

    Sungkanuparph, Somnuek; Pasomsub, Ekawat; Chantratita, Wasun

    2014-01-01

    Emergence of transmitted HIV drug resistance (TDR) is a concern after global scale-up of antiretroviral therapy (ART). World Health Organization had developed threshold survey method for surveillance of TDR in resource-limited countries. ART in Thailand has been scaling up for >10 years. To evaluate the current TDR in Thailand, a cross-sectional study was conducted among antiretroviral-naive HIV-infected patients aged Thailand after a decade of rapid scale-up of ART. Interventions to prevent TDR at the population level are essentially needed in Thailand. Surveillance for TDR in Thailand has to be regularly performed.

  16. 32 CFR 634.13 - Alcohol and drug abuse programs.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Alcohol and drug abuse programs. 634.13 Section... and drug abuse programs. (a) Commanders will refer military personnel suspected of drug or alcohol abuse for evaluation in the following circumstances: (1) Behavior indicative of alcohol or drug abuse...

  17. The Lawrence Livermore National Laboratory DOE-STD-3013 Surveillance Program for the Storage of Plutonium Packages

    International Nuclear Information System (INIS)

    Riley, D

    2005-01-01

    This document presents a site-specific DOE-STD-3013 (3013) surveillance program for 3013 material stored at Lawrence Livermore National Laboratory (LLNL) in the B332 Plutonium Facility. The 3013 standard requires the development of a surveillance program to assure the long-term safety of plutonium storage in 3013 compliant containers. A complex-wide Integrated Surveillance Program in Support of Long-Term Storage of Plutonium-Bearing Materials (ISP)(LA-UR-00-3246, Revision 1, March 2001) has been developed to give guidance on an acceptable surveillance approach and to set up a mechanism to integrate surveillance activities and facilitate the sharing of lessons learned. This LLNL 3013 surveillance program has been developed following guidelines established for Storage Sites in the ISP and is sufficient for the storage in the LLNL Plutonium Facility. The LLNL 3013 surveillance program must be coupled with the DOE complex wide Materials Identification and Surveillance (MIS) program and the ISP led by Savannah River Site (SRS). These programs support the technical basis for continuing safe storage of plutonium packages and provide the technical basis for the limited scope of the site-specific LLNL 3013 surveillance program. The LLNL 3013 surveillance program calls for surveillance of 3013 packages to begin approximately three years after packaging of the first oxide. One percent of the stored packages per year will be randomly selected and nondestructively examined (NDE) by LLNL per the guidelines of the ISP. Additional packages may be selected for NDE if recommended by the ISP Steering Committee and agreed upon by the MIS Working Group. One selected package will be shipped to SRS for destructive analysis each year starting when SRS can receive them. This is expected to be in FY2007. We expect to store a maximum of 400 3013 packages. This would result in an expected maximum of 4 surveillances per year. The activities outlined in the program evolved from the current

  18. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

    Science.gov (United States)

    Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

    2016-12-01

    There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Master schedule for CY-1983 Hanford environmental surveillance routine sampling program

    International Nuclear Information System (INIS)

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.; Dirkes, R.L.

    1982-12-01

    The current schedule of data collection for the routine Hanford environmental surveillance and ground-water monitoring programs at the Hanford Site is presented. The purpose of the programs is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. Radiological monitoring data are reported for air (particulate filter and gases/vapor), Columbia River water, sanitary water, onsite pond water, foodstuffs (whole milk, leafy vegetables, fruit, wheat/alfalfa, beef, poultry/eggs), wildlife, soil and vegetation, and direct radiation. Information is also given for on site radiation control audit surveys (roadway, railway, aerial, and waste disposal sites, and the Hanford ground-water monitoring program

  20. An Outreach Program in Drug Education; Teaching a Rational Approach to Drug Use

    Science.gov (United States)

    Sorensen, James L.; Joffe, Stephen J.

    1975-01-01

    Aimed at encouraging rational decision making about drug use, a peer oriented drug education program was conducted in a community youth project. Youth and leaders shared feelings and knowledge about drugs. Compared with four program dropouts, six participants exhibited more positive attitudes toward the drug group, its leaders and themselves.…

  1. Cost-effectiveness of surveillance programs for families at high and moderate risk of hereditary non-polyposis colorectal cancer

    DEFF Research Database (Denmark)

    Olsen, Kim R.; Bojesen, Stig E.; Gerdes, Anne-Marie M.

    2007-01-01

    for the group at high risk. The aim of the present study is to determine cost-effectiveness of surveillance programs where families at both high and moderate risk of HNPCC participate. METHODS: A decision analytic model (Markov model) is developed to assess surveillance programs where families at high......OBJECTIVES: Surveillance programs are recommended to both families at high risk (Amsterdam-positive families with known- and unknown mutation) and moderate risk (families not fulfilling all Amsterdam criteria) of colorectal cancer (CRC). Cost-effectiveness has so far only been estimated...

  2. Analysis of participation in the federally mandated coal workers' health-surveillance program

    International Nuclear Information System (INIS)

    Nickolaus, M.E.

    1987-01-01

    The Federal Coal Mine Health and Safety Act of 1969 required that periodic chest radiographs be offered to underground coal miners to protect the miners from the development of Coal Workers' Pneumoconiosis (CWP) and progression of the disease to progressive massive fibrosis (PMF). These examinations are administered by the National Institute for Occupational Safety and Health (NIOSH) through the Coal Workers' Health Surveillance Program (CWHSP). This study developed rates of participation for each of 558 West Virginia underground coal mines who submitted or had NIOSH assigned plans for making chest radiographs available during the third round, July 1978 through December 1980. These rates were analyzed in relation to desired levels of participation and to reinforcing, predisposing and enabling factors presumed to affect rates of participation in disease prevention and surveillance programs

  3. Application of advanced irradiation analysis methods to light water reactor pressure vessel test and surveillance programs

    International Nuclear Information System (INIS)

    Odette, R.; Dudey, N.; McElroy, W.; Wullaert, R.; Fabry, A.

    1977-01-01

    Inaccurate characterization and inappropriate application of neutron irradiation exposure variables contribute a substantial amount of uncertainty to embrittlement analysis of light water reactor pressure vessels. Damage analysis involves characterization of the irradiation environment (dosimetry), correlation of test and surveillance metallurgical and dosimetry data, and projection of such data to service conditions. Errors in available test and surveillance dosimetry data are estimated to contribute a factor of approximately 2 to the data scatter. Non-physical (empirical) correlation procedures and the need to extrapolate to the vessel may add further error. Substantial reductions in these uncertainties in future programs can be obtained from a more complete application of available damage analysis tools which have been developed for the fast reactor program. An approach to reducing embrittlement analysis errors is described, and specific examples of potential applications are given. The approach is based on damage analysis techniques validated and calibrated in benchmark environments

  4. Lessons learnt from 20 years surveillance of malaria drug resistance prior to the policy change in Burkina Faso.

    Science.gov (United States)

    Tinto, Halidou; Valea, Innocent; Ouédraogo, Jean-Bosco; Guiguemdé, Tinga Robert

    2016-01-01

    The history of drug resistance to the previous antimalarial drugs, and the potential for resistance to evolve to Artemisinin-based combination therapies, demonstrates the necessity to set-up a good surveillance system in order to provide early warning of the development of resistance. Here we report a review summarizing the history of the surveillance of drug resistance that led to the policy change in Burkina Faso. The first Plasmodium falciparum Chloroquine-Resistance strain identified in Burkina Faso was detected by an in vitro test carried out in Koudougou in 1983. Nevertheless, no further cases were reported until 1987, suggesting that resistant strains had been circulating at a low prevalence before the beginning of the systematic surveillance system from 1984. We observed a marked increase of Chloroquine-Resistance in 2002-2003 probably due to the length of follow-up as the follow-up duration was 7 or 14 days before 2002 and 28 days from 2002 onwards. Therefore, pre-2002 studies have probably under-estimated the real prevalence of Chloroquine-Resistance by not detecting the late recrudescence. With a rate of 8.2% treatment failure reported in 2003, Sulfadoxine-Pyrimethamine was still efficacious for the treatment of uncomplicated malaria in Burkina Faso but this rate might rapidly increase as the result of its spreading from neighboring countries and due to its current use for both the Intermittent Preventive Treatment in pregnant women and Seasonal Malaria Chemoprophylaxis. The current strategy for the surveillance of the Artemisinin-based combination treatments resistance should build on lessons learnt under the previous period of 20 years surveillance of Chloroquine and Sulfadoxine-Pyrimethamine resistance (1994-2004). The most important aspect being to extend the number of sentinel sites so that data would be less patchy and could help understanding the dynamic of the resistance.

  5. Surveillance and Maintenance Plan for the ORNL Decontamination and Decommissioning Program FY 1993--2002

    International Nuclear Information System (INIS)

    Ford, M.K.; Holder, L. Jr.

    1992-07-01

    The Decontamination and Decommissioning (D ampersand D) Program at the Oak Ridge National Laboratory (ORNL) is part of the Department of Energy (DOE) Environmental Restoration D ampersand D program. The purpose and objectivesof this program include: (1) surveillance and maintenance (S ampersand M) of facilities awaiting decommissioning; (2) planning for the orderly decommissioning of these facilities; and (3) implementation of a program to accomplish facility disposition in a safe, cost-effective, and timely manner. Participating D ampersand D contractors are required to prepare formal plans that document the S ampersand M programs established for each site. This report has been prepared to provide this documentation for those facilities included in the ORNL D ampersand D Program

  6. Establishment of a health surveillance program for reintroduction of the Eurasian beaver (Castor fiber) into Scotland.

    Science.gov (United States)

    Goodman, Gidona; Girling, Simon; Pizzi, Romain; Meredith, Anna; Rosell, Frank; Campbell-Palmer, Roisin

    2012-10-01

    In 2009 and 2010 16 Norwegian Eurasian beavers (Castor fiber) were reintroduced to Knapdale, Scotland as part of a 5-yr reintroduction trial (Scottish Beaver Trial). Despite numerous reintroduction programs throughout Europe there is no published information concerning recommended health surveillance during beaver reintroduction and only one publication describing causes of mortality. We describe the establishment of a health surveillance program based on International Union of Conservation of Nature (IUCN) and governmental guidelines, and report preliminary results based on the fecal and blood samples following the completion of the first stage of reintroduction. Animals underwent at least one general anesthetic to allow collection of fecal and blood samples and a thorough clinical examination. No bacterial enteric pathogens such as Salmonella spp., Campylobacter spp., or Yersinia pseudotuberculosis were isolated, nor were Giardia spp. or Cryptosporidium spp. However, numerous helminths including Travassosius rufus and Stichorchis subtriquetrus were detected. Five animals were positive for Leptospira antibodies. This included Leptospira saxkoebing, Leptospira canicola, Leptospira copenhageni, Leptospira icterohaemorrhagiae, Leptospira autumnalis, and Leptospira javanica. The highest loss of animals (20%) was during the statutory 6-mo rabies quarantine period. No common cause of death was determined. The rabies quarantine conditions were waived for four remaining animals, three of which were introduced to the wild successfully. The authors recommend the shortest possible quarantine period when introducing beavers, but allowing for the minimum recommended IUCN 35 days to allow for implementation of the initial stage of the health surveillance program, examination of animals, sample collection, and processing.

  7. Standard Practice for Design of Surveillance Programs for Light-Water Moderated Nuclear Power Reactor Vessels

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This practice covers procedures for designing a surveillance program for monitoring the radiation-induced changes in the mechanical properties of ferritic materials in light-water moderated nuclear power reactor vessels. This practice includes the minimum requirements for the design of a surveillance program, selection of vessel material to be included, and the initial schedule for evaluation of materials. 1.2 This practice was developed for all light-water moderated nuclear power reactor vessels for which the predicted maximum fast neutron fluence (E > 1 MeV) at the end of license (EOL) exceeds 1 × 1021 neutrons/m2 (1 × 1017 n/cm2) at the inside surface of the reactor vessel. 1.3 This practice applies only to the planning and design of surveillance programs for reactor vessels designed and built after the effective date of this practice. Previous versions of Practice E185 apply to earlier reactor vessels. 1.4 This practice does not provide specific procedures for monitoring the radiation induced cha...

  8. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    Energy Technology Data Exchange (ETDEWEB)

    Lesko, Samuel M.

    2007-07-31

    OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supports surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US

  9. The role of electronic healthcare record databases in paediatric drug safety surveillance: A retrospective cohort study

    NARCIS (Netherlands)

    S. de Bie (Sandra); P.M. Coloma (Preciosa); C. Ferrajolo (Carmen); K.M.C. Verhamme (Katia); G. Trifirò (Gianluca); M.J. Schuemie (Martijn); S.M.J.M. Straus (Sabine); R. Gini (Rosa); R.M.C. Herings (Ron); G. Mazzaglia (Giampiero); G. Picelli (Gino); A. Ghirardi (Arianna); L. Pedersen (Lars); B.H.Ch. Stricker (Bruno); J. van der Lei (Johan); M.C.J.M. Sturkenboom (Miriam)

    2015-01-01

    textabstractAim Electronic healthcare record (EHR)-based surveillance systems are increasingly being developed to support early detection of safety signals. It is unknown what the power of such a system is for surveillance among children and adolescents. In this paper we provide estimates of the

  10. Multicenter evaluation of resistance patterns of Klebsiella pneumoniae, Escherichia coli, Salmonella spp and Shigella spp isolated from clinical specimens in Brazil: RESISTNET surveillance program

    Directory of Open Access Journals (Sweden)

    Carmen Paz Oplustil

    Full Text Available Surveillance programs are essential to detect the increase of antimicrobial resistance, and several different programs are being conducted in many countries. The RESISTNET is a surveillance program for bacterial resistance against several antimicrobial agents initiated in 1998 among Latin American countries. In Brazil, several centers were invited to join this surveillance and a total of 11 centers (6 from São Paulo and 5 from other states participated in the study. All results were analyzed using the WHONET program. A total of 894 Escherichia coli, 386 Klebsiella pneumoniae, 70 Shigella spp and 57 Salmonella spp strains were analyzed in this study from April, 1998, to April, 1999. Susceptibility testing was performed by the disk diffusion method using NCCLS 1998 guidelines for several different drugs. For all strains, imipenem was the most effective drug (100% of the strains were susceptible. Klebsiella pneumoniae presented a high resistance rate to ampicillin (96.4%. The rate of probable ESBL producers among K. pneumoniae strains was 36.3%, most of them being isolated from catheters (58.8%. Among all Escherichia coli strains analyzed, the highest resistance rate was found for trimethoprim/sulfamethoxazole (46.9% and the majority of the resistant strains were isolated from urine samples (47.8%. Among Salmonella spp, the resistance rates were low for all antibiotics tested. For Shigella spp strains there was a high resistance to trimethoprim/sulfamethoxazole (80.0%. No resistance to ceftriaxone was observed in these strains. Surveillance of antimicrobial resistance is critical for the successful management of infectious diseases. The results of this survey show significant resistance rates among these bacteria which are responsible for several types of human infections.

  11. 77 FR 5317 - Medicaid Program; Covered Outpatient Drugs

    Science.gov (United States)

    2012-02-02

    ... for Medicare & Medicaid Services 42 CFR Part 447 Medicaid Program; Covered Outpatient Drugs; Proposed... Part 447 [CMS-2345-P] RIN 0938-AQ41 Medicaid Program; Covered Outpatient Drugs AGENCY: Centers for... requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the...

  12. Re-utilization by '' Stud Welding'' of capsules charpy-V belonged to surveillance programs

    International Nuclear Information System (INIS)

    Lapena, J.; Perosanz, F. J.; Gachuz, M.

    1998-01-01

    The perspectives of nuclear plants life extension that are approximating to their end of design life compels to make new surveillance programs. The re-utilization of specimens belonging to surveillance capsules already tested in these new surveillance programs seems be a solution worldwide accepted. The two possible re-utilization processes of this irradiated material are: Subsized specimens and Reconstitution. While the first alternative (Subsized specimens) outlines serious problems for apply the results, the reconstitution eliminates this problem, since the resulting specimens after of the reconstruction procedure would be of the same dimensions that the original. The reconstruction process involves welds, and therefore it has associated the specific problems of this type of joints. Furthermore, by be tried to material irradiated with certain degree of internal damage, that is the variable to evaluate, requires that the heat contribution to the piece not originate local thermal treatments that alter its mechanical qualities. In this work has been followed the evolution by the variables of the weld process and their influence on the quality by the union from metallographic al point of view as well as mechanical for a weld procedure by Stud Welding. The principal objective is to optimize said parameters to assure a good mechanical continuity, without detriment of the microstructural characteristics of the original material. To verify this last have been accomplished with metallographical tests, temperature profile, hardness and will be carried out also Charpy tests. (Author)

  13. Sheen surveillance: An environmental monitoring program subsequent to the 1989 Exxon Valdez shoreline cleanup

    International Nuclear Information System (INIS)

    Taft, D.G.; Egging, D.E.; Kuhn, H.A.

    1995-01-01

    In the fall of 1989, an aerial surveillance program was implemented to locate oil sheens (or slicks) originating from shorelines affected by the Exxon Valdez spill. The objectives of the program were to identify any oil on the water that warranted response and to identify those sections of shoreline that would be priority candidates for further cleanup in 1990. The program initially surveyed the entire affected area, but, because proportionally fewer sheens were spotted in the Gulf of Alaska, the program was refocused on Prince Williams Sound in early 1990. The surveillance program consisted of frequent low-altitude flights with trained observers in a deHavilland Twin otter outfitted with observation ports and communication equipment. The primary surveillance technique used was direct visual observation. Other techniques, including photography, were tested but proved less effective. The flights targeted all shorelines of concern, particularly those near fishing, subsistence, and recreational areas.the observers attempted to locate all sheens, estimate their size and color, ad identify the source of the oil found in the sheen. Size and color were used to estimate the volume of oil in each sheen. Samples were collected whenever possible during the summer of 1990 using a floating Teflon trademark sampling device that was developed for easy deployment from a boat or the pontoon of a float plane. Forty four samples were analyzed by UV-fluorescence spectroscopy. Eleven of these samples were also analyzed by GC/MS. In general, the analyses confirmed the observers' judgment of source. 16 refs., 9 figs., 2 tabs

  14. Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers.

    Science.gov (United States)

    van Holland, Berry J; Brouwer, Sandra; de Boer, Michiel R; Reneman, Michiel F; Soer, Remko

    2017-09-01

    Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component. Qualitative and quantitative methods were used to evaluate seven process aspects. Data were gathered by interviews with stakeholders, participant questionnaires, and from registries of the company and occupational health service. Results Two recruitment strategies were used: open invitation or automatic participation. Of the 986 eligible workers, 305 participated in the program. Average reach was 53 %. Two out of five program components could not be assessed on dose delivered, dose received and fidelity. If components were assessable, 85-100 % of the components was delivered, 66-100 % of the components was received by participants, and fidelity was 100 %. Participants were satisfied with the WHS program (mean score 7.6). Contextual factors that facilitated implementation were among others societal developments and management support. Factors that formed barriers were program novelty and delayed follow-up. Conclusion The WHS program was well received by participants. Not all participants were offered the same number of program components, and not all components were performed according to protocol. Deviation from protocol is an indication of program failure and may affect program effectiveness.

  15. Surveillance, Evaluation of Programmatic Management of Drug Resistant Tuberculosis (PMDT at DR-TB Centre, NITRD, New Delhi

    Directory of Open Access Journals (Sweden)

    Preeti Padda

    2018-03-01

    Full Text Available Background: PMDT was launched in 2007 in our country but drug resistant TB remains to be a public health problem. Effective surveillance is the backbone for success of any programme and true stands for PMDT. Aim & Objectives: To identify the strengths and constraints of the surveillance evaluation system. Material & Methods: A cross sectional study was conducted in January 2015 at DR-TB Centre of NITRD, New Delhi which caters to a population of 29 lacs. PMDT surveillance system was evaluated using attributes like simplicity, data quality, acceptability, positive predictive value, representativeness and timeliness defined by CDC, USA guidelines. Relevant information was collected using data abstraction form and interview with stakeholders. Data was analysed using EpiInfo 07 version. Results: Nodal officer and District TB officer are responsible for surveillance system activities of PMDT at DR-TB centre and district level, respectively. All the reports (100% were submitted on time and all the districts were reporting to DR-TB centre. 75% of TB-HIV coordinators found reporting formats to be simple but all the quarterly reports were found to be complete. Data quality was not found to be optimal. Conclusion: Private sector needs to be taken on board as they have no to minimal involvement in PMDT. For data quality improvement time to time training of medical officers and health workers should be organized.

  16. 75 FR 59105 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs: Federal Drug Testing...

    Science.gov (United States)

    2010-09-27

    ... 2105-AE03 Procedures for Transportation Workplace Drug and Alcohol Testing Programs: Federal Drug... the Federal workplace drug testing program but also pointed out that ``* * * the Department of.... Executive Order 12866 and Regulatory Flexibility Act This Interim Final Rule is not significant for purposes...

  17. Epidemiological Surveillance of HIV-1 Transmitted Drug Resistance in Spain in 2004-2012: Relevance of Transmission Clusters in the Propagation of Resistance Mutations.

    Science.gov (United States)

    Vega, Yolanda; Delgado, Elena; Fernández-García, Aurora; Cuevas, Maria Teresa; Thomson, Michael M; Montero, Vanessa; Sánchez, Monica; Sánchez, Ana Maria; Pérez-Álvarez, Lucia

    2015-01-01

    Our objectives were to carry out an epidemiological surveillance study on transmitted drug resistance (TDR) among individuals newly diagnosed of HIV-1 infection during a nine year period in Spain and to assess the role of transmission clusters (TC) in the propagation of resistant strains. An overall of 1614 newly diagnosed individuals were included in the study from January 2004 through December 2012. Individuals come from two different Spanish regions: Galicia and the Basque Country. Resistance mutations to reverse transcriptase inhibitors (RTI) and protease inhibitors (PI) were analyzed according to mutations included in the surveillance drug-resistance mutations list updated in 2009. TC were defined as those comprising viruses from five or more individuals whose sequences clustered in maximum likelihood phylogenetic trees with a bootstrap value ≥90%. The overall prevalence of TDR to any drug was 9.9%: 4.9% to nucleoside RTIs (NRTIs), 3.6% to non-nucleoside RTIs (NNRTIs), and 2.7% to PIs. A significant decrease of TDR to NRTIs over time was observed [from 10% in 2004 to 2% in 2012 (p=0.01)]. Sixty eight (42.2%) of 161 sequences with TDR were included in 25 TC composed of 5 or more individuals. Of them, 9 clusters harbored TDR associated with high level resistance to antiretroviral drugs. T215D revertant mutation was transmitted in a large cluster comprising 25 individuals. The impact of epidemiological networks on TDR frequency may explain its persistence in newly diagnosed individuals. The knowledge of the populations involved in TC would facilitate the design of prevention programs and public health interventions.

  18. Epidemiological Surveillance of HIV-1 Transmitted Drug Resistance in Spain in 2004-2012: Relevance of Transmission Clusters in the Propagation of Resistance Mutations.

    Directory of Open Access Journals (Sweden)

    Yolanda Vega

    Full Text Available Our objectives were to carry out an epidemiological surveillance study on transmitted drug resistance (TDR among individuals newly diagnosed of HIV-1 infection during a nine year period in Spain and to assess the role of transmission clusters (TC in the propagation of resistant strains. An overall of 1614 newly diagnosed individuals were included in the study from January 2004 through December 2012. Individuals come from two different Spanish regions: Galicia and the Basque Country. Resistance mutations to reverse transcriptase inhibitors (RTI and protease inhibitors (PI were analyzed according to mutations included in the surveillance drug-resistance mutations list updated in 2009. TC were defined as those comprising viruses from five or more individuals whose sequences clustered in maximum likelihood phylogenetic trees with a bootstrap value ≥90%. The overall prevalence of TDR to any drug was 9.9%: 4.9% to nucleoside RTIs (NRTIs, 3.6% to non-nucleoside RTIs (NNRTIs, and 2.7% to PIs. A significant decrease of TDR to NRTIs over time was observed [from 10% in 2004 to 2% in 2012 (p=0.01]. Sixty eight (42.2% of 161 sequences with TDR were included in 25 TC composed of 5 or more individuals. Of them, 9 clusters harbored TDR associated with high level resistance to antiretroviral drugs. T215D revertant mutation was transmitted in a large cluster comprising 25 individuals. The impact of epidemiological networks on TDR frequency may explain its persistence in newly diagnosed individuals. The knowledge of the populations involved in TC would facilitate the design of prevention programs and public health interventions.

  19. A Study on Drug Safety Monitoring Program in India

    Science.gov (United States)

    Ahmad, A.; Patel, Isha; Sanyal, Sudeepa; Balkrishnan, R.; Mohanta, G. P.

    2014-01-01

    Pharmacovigilance is useful in assuring the safety of medicines and protecting the consumers from their harmful effects. A number of single drugs as well as fixed dose combinations have been banned from manufacturing, marketing and distribution in India. An important issue about the availability of banned drugs over the counter in India is that sufficient adverse drug reactions data about these drugs have not been reported. The most common categories of drugs withdrawn in the last decade were nonsteroidal antiinflammatory drugs (28%), antidiabetics (14.28%), antiobesity (14.28%), antihistamines (14.28%), gastroprokinetic drugs (7.14%), breast cancer and infertility drugs (7.14%), irritable bowel syndrome and constipation drugs (7.14%) and antibiotics (7.14%). Drug withdrawals from market were made mainly due to safety issues involving cardiovascular events (57.14%) and liver damage (14.28%). Majority of drugs have been banned since 3-5 years in other countries but are still available for sale in India. The present study compares the drug safety monitoring systems in the developed countries such as the USA and UK and provides implications for developing a system that can ensure the safety and efficacy of drugs in India. Absence of a gold standard for a drug safety surveillance system, variations in culture and clinical practice across countries makes it difficult for India to completely adopt another country's practices. There should be a multidisciplinary approach towards drug safety that should be implemented throughout the entire duration spanning from drug discovery to usage by consumers. PMID:25425751

  20. Surveillance efforts after mass drug administration to validate elimination of lymphatic filariasis as a public health problem in Vanuatu.

    Science.gov (United States)

    Taleo, Fasihah; Taleo, George; Graves, Patricia M; Wood, Peter; Kim, Sung Hye; Ozaki, Masayo; Joseph, Hayley; Chu, Brian; Pavluck, Alex; Yajima, Aya; Melrose, Wayne; Ichimori, Kazuyo; Capuano, Corinne

    2017-01-01

    Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. After a baseline survey showing 4.8% antigen prevalence in 1998, the country conducted nationwide (in one implementation unit) annual mass drug administration (MDA) with albendazole and diethylcarbamazine citrate from 2000 to 2004 and achieved prevalence of 0.2% by 2006 in a representative nationwide cluster survey among all age groups. Post MDA surveillance was conducted from 2006 to 2012. After MDA, the country was divided for surveillance into three evaluation units (EUs) formed by grouping provinces according to baseline prevalence: EU1: Torba, Sanma and Malampa; EU2: Penama; EU3: Shefa and Tafea. The study compiled all past data and information on surveys in Vanuatu from the country programme. This paper reviews the surveillance activities done after stopping MDA to validate the interruption of transmission and elimination of LF as a public health problem. Post-MDA surveillance consisting of at least three transmission assessment surveys (TAS) in each of the three EUs was conducted between 2006 and 2012. Sentinel and spot check surveys identified a few villages with persistent high prevalence; all antigen positive cases in these sites were treated and additional targeted MDA conducted for 3 years in 13 villages in one area of concern. All three EUs passed all TAS in 2007, 2010 and 2012 respectively, with no positives found except in EU2 (Penama province) in 2012 when 2 children tested positive for circulating filariasis antigen. Assessment of the burden of chronic filariasis morbidity found 95 cases in 2003 and 32 remaining cases in 2007, all aged over 60 years. Vanuatu has achieved validation of elimination of LF as a public health problem. Post-validation surveillance is still recommended especially in formerly highly endemic areas.

  1. Extension of the RPV irradiation surveillance program of NPP GKN II by T0 approach

    International Nuclear Information System (INIS)

    Barthelmes, J.; Keim, E.; Hein, H.; Koenig, G.

    2015-01-01

    The nuclear power plant (NPP) Neckarwestheim II (GKN II) started operation in 1989 and was designed for 40 years of operation. During the plant life time the reactor pressure vessel (RPV) integrity is a main aspect for nuclear safety since the RPV is exposed to neutron irradiation affecting the mechanical material properties, in particular toughness. In this context the ductile to brittle transition reference temperature of the RPV materials can be determined either indirectly according to the RT(NDT) concept by means of comparative examinations of irradiated and unirradiated notched-bar impact specimens or directly according to the Master Curve concept by means of examination of irradiated fracture mechanic specimens and determination of an alternative reference temperature RT(T0). With the implementation and evaluation of the first irradiation surveillance program consisting of three sets, one unirradiated reference set (set 1) and two irradiated sets (set 2 and 3), the RPV safety could be proven for the assessment fluence (AF) of 8*10 18 cm -2 (E > 1 MeV) using the RT(NDT) concept. Against the background of a possible long term operation and the state-of-the-art of science and technology in 1998 the NPP GKN II initiated a supplemental irradiation surveillance program with two irradiation sets (set 4 and 5) containing fracture mechanic specimens for complementary proof of safety according to the Master Curve concept. The results of the first irradiated set 4 are presented and assessed by means of the reference temperatures according to the Master Curve concept and compared to the results of the irradiation sets 1 to 3 of the conventional irradiation surveillance program. As an important outcome the existing RPV integrity assessment could be ensured by the Master Curve results. The applied approach adapts to the state-of-the-art of science and technology and is best practice to ensure the safe operation of RPV supplementary. (authors)

  2. Fast neutron fluence calculations as support for a BWR pressure vessel and internals surveillance program

    International Nuclear Information System (INIS)

    Lucatero, Marco A.; Palacios-Hernandez, Javier C.; Ortiz-Villafuerte, Javier; Xolocostli-Munguia, J. Vicente; Gomez-Torres, Armando M.

    2010-01-01

    Materials surveillance programs are required to detect and prevent degradation of safety-related structures and components of a nuclear power reactor. In this work, following the directions in the Regulatory Guide 1.190, a calculational methodology is implemented as additional support for a reactor pressure vessel and internals surveillance program for a BWR. The choice of the neutronic methods employed was based on the premise of being able of performing all the expected future survey calculations in relatively short times, but without compromising accuracy. First, a geometrical model of a typical BWR was developed, from the core to the primary containment, including jet pumps and all other structures. The methodology uses the Synthesis Method to compute the three-dimensional neutron flux distribution. In the methodology, the code CORE-MASTER-PRESTO is used as the three-dimensional core simulator; SCALE is used to generate the fine-group flux spectra of the components of the model and also used to generate a 47 energy-groups job cross section library, collapsed from the 199-fine-group master library VITAMIN-B6; ORIGEN2 was used to compute the isotopic densities of uranium and plutonium; and, finally, DORT was used to calculate the two-dimensional and one-dimensional neutron flux distributions required to compute the synthesized three-dimensional neutron flux. Then, the calculation of fast neutron fluence was performed using the effective full power time periods through six operational fuel cycles of two BWR Units and until the 13th cycle for Unit 1. The results showed a maximum relative difference between the calculated-by-synthesis fast neutron fluxes and fluences and those measured by Fe, Cu and Ni dosimeters less than 7%. The dosimeters were originally located adjacent to the pressure vessel wall, as part of the surveillance program. Results from the computations of peak fast fluence on pressure vessel wall and specific weld locations on the core shroud are

  3. Clinical, Bacteriologic, and Geographic Stratification of Melioidosis Emerges from the Sri Lankan National Surveillance Program.

    Science.gov (United States)

    Sathkumara, Harindra D; Merritt, Adam J; Corea, Enoka M; Krishnananthasivam, Shivankari; Natesan, Mohan; Inglis, Timothy J J; De Silva, Aruna Dharshan

    2018-02-01

    Melioidosis, a potentially fatal tropical infection, is said to be underdiagnosed in low-income countries. An increase in melioidosis cases in Sri Lanka allowed us to analyze the relationship among clinical outcome, bacteriology, epidemiology, and geography in the first 108 laboratory-confirmed cases of melioidosis from a nationwide surveillance program. The additional 76 cases of laboratory-confirmed melioidosis confirmed further associations between Burkholderia pseudomallei multilocus sequence typing (MLST) and infection phenotype; ST1137/unifocal bacteremic infection (χ 2 = 3.86, P national genotyping-supported melioidosis registry will improve melioidosis diagnosis, treatment, and prevention where underdiagnosis and mortality rates remain high.

  4. High Throughput Screening Method for Systematic Surveillance of Drugs of Abuse by Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry.

    Science.gov (United States)

    DiBattista, Alicia; Rampersaud, Dianne; Lee, Howard; Kim, Marcus; Britz-McKibbin, Philip

    2017-11-07

    New technologies are urgently required for reliable drug screening given a worldwide epidemic of prescription drug abuse and its devastating socioeconomic impacts on public health. Primary screening of drugs of abuse (DoA) currently relies on immunoassays that are prone to bias and are not applicable to detect an alarming array of psychoactive stimulants, tranquilizers, and synthetic opioids. These limitations impact patient safety when monitoring for medication compliance, drug substitution, or misuse/abuse and require follow-up confirmatory testing by more specific yet lower throughput instrumental methods. Herein, we introduce a high throughput platform for nontargeted screening of a broad spectrum of DoA and their metabolites based on multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS). We demonstrate that MSI-CE-MS enables serial injections of 10 samples within a single run (high resolution MS with full-scan data acquisition. Unambiguous drug identification was achieved by four or more independent parameters, including comigration with a deuterated internal standard or in silico prediction of electromigration behavior together with accurate mass, most likely molecular formula, as well as MS/MS as required for confirmation testing. Acceptable precision was demonstrated for over 50 DoA at 3 concentration levels over 4 days (median coefficient of variance = 13%, n = 117) with minimal ion suppression, isobaric interferences, and sample carry-over (screening cutoff levels in human urine while allowing for systematic surveillance, specimen verification, and retrospective testing of designer drugs that elude conventional drug tests.

  5. Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

    Science.gov (United States)

    Oliven, A; Zalman, D; Shilankov, Y; Yeshurun, D; Odeh, M

    2002-01-01

    Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

  6. Clinical Relation Extraction Toward Drug Safety Surveillance Using Electronic Health Record Narratives: Classical Learning Versus Deep Learning.

    Science.gov (United States)

    Munkhdalai, Tsendsuren; Liu, Feifan; Yu, Hong

    2018-04-25

    Medication and adverse drug event (ADE) information extracted from electronic health record (EHR) notes can be a rich resource for drug safety surveillance. Existing observational studies have mainly relied on structured EHR data to obtain ADE information; however, ADEs are often buried in the EHR narratives and not recorded in structured data. To unlock ADE-related information from EHR narratives, there is a need to extract relevant entities and identify relations among them. In this study, we focus on relation identification. This study aimed to evaluate natural language processing and machine learning approaches using the expert-annotated medical entities and relations in the context of drug safety surveillance, and investigate how different learning approaches perform under different configurations. We have manually annotated 791 EHR notes with 9 named entities (eg, medication, indication, severity, and ADEs) and 7 different types of relations (eg, medication-dosage, medication-ADE, and severity-ADE). Then, we explored 3 supervised machine learning systems for relation identification: (1) a support vector machines (SVM) system, (2) an end-to-end deep neural network system, and (3) a supervised descriptive rule induction baseline system. For the neural network system, we exploited the state-of-the-art recurrent neural network (RNN) and attention models. We report the performance by macro-averaged precision, recall, and F1-score across the relation types. Our results show that the SVM model achieved the best average F1-score of 89.1% on test data, outperforming the long short-term memory (LSTM) model with attention (F1-score of 65.72%) as well as the rule induction baseline system (F1-score of 7.47%) by a large margin. The bidirectional LSTM model with attention achieved the best performance among different RNN models. With the inclusion of additional features in the LSTM model, its performance can be boosted to an average F1-score of 77.35%. It shows that

  7. Characterization of adolescent prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-related Surveillance (RADARS(®)) System.

    Science.gov (United States)

    Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

    2013-02-01

    To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS(®)) System. Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD ± 1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38% were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Drug resistant tuberculosis in Saudi Arabia: an analysis of surveillance data 2014-2015.

    Science.gov (United States)

    Al Ammari, Maha; Al Turaiki, Abdulrahman; Al Essa, Mohammed; Kashkary, Abdulhameed M; Eltigani, Sara A; Ahmed, Anwar E

    2018-01-01

    There is limited data that investigates the national rates of drug-resistant tuberculosis (TB) in Saudi Arabia.This study aimed to estimate the rates of multi-drug-resistant tuberculosis (MDR-TB), rifampicin-resistant tuberculosis (RR-TB), and monoresistance (MR) in Saudi Arabia. A retrospective cohort study was conducted on all TB cases reported to the National TB Control and Prevention Program (NTCPP) registry at the Saudi Ministry of Health between January 1, 2014 and December 31, 2015. A total of 2098 TB patients with positive TB cultures were included in the study. Subgroup analyses and multivariate binary logistic regression models were performed with IBM SPSS 23.0. Of the total TB cases, 4.4% (95% CI: 3.59%-5.40%) were found to have MDR-TB. The rates of MR were 3.8% (95% CI: 2.99%-4.67%) for ethambutol, 5.4% (95% CI: 4.50%-6.49%) for pyrazinamide, 10.2% (95% CI: 5.89%-11.52%) for isoniazid, 11% (95% CI: 9.70%-12.43%) for streptomycin, and 5.9% (95% CI: 4.90%-6.96%) for rifampicin. The high rates of MDR and RR-TB were found among the younger age group, female gender, and those who had a previous history of TB. We also discovered that renal failure tends to increase the risk of rifampicin resistance. National TB data in Saudi Arabia shows that the rate of MDR-TB was similar to the global rate reported by the World Health Organization (WHO). It is a relatively high rate as compared to Western countries. The proportion of MDR/RR-TB patients tends to be higher in the younger age group, female gender, and in patients with a previous history of TB treatment. Effective strategies for prevention of all multi-drug-resistant TB cases are warranted.

  9. Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

    Science.gov (United States)

    Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

    2016-03-15

    Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the

  10. Guidance for implementing the UMTRA Project long-term surveillance program

    International Nuclear Information System (INIS)

    1992-09-01

    The US Nuclear Regulatory Commission (NRC) has issued a general license for the custody and long-term care of US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project permanent disposal sites. The purpose of this general license is to ensure that the UMTRA disposal sites will be cared for in such a manner as to protect the public health and safety and the environment upon completion of remedial actions. The general license will be in effect for a disposal site when NRC accepts the disposal site long-term surveillance plan (LTSP) that meets the requirements of 10 CFR 40.27. The site LTSP describes in detail the long-term surveillance program, including any monitoring, maintenance, and emergency measures necessary to fulfill the conditions of the general license. This guidance document provides (1) instructions for preparing the disposal site LTSPs and (2) instructions for carrying out the UMTRA Project long-term surveillance program, including any monitoring that may be required. The information provided in this document also is in accordance with the regulatory requirements set forth in 40 CFR 192. On January 5, 1985, the US Tenth Circuit Court of Appeals remanded the groundwater standards, 40 CFR 192.02. Proposed groundwater standards were issued for comment on September 24, 1987 (52 FR 3600). When the groundwater standards become final, this document will be revised, as appropriate. This document also will be updated in response to any changes to 10 CFR 40, or in response to changes in the manner in which the long-term care of the licensed disposal sites is carried out

  11. 75 FR 3153 - Drug and Alcohol Testing Program; Correction

    Science.gov (United States)

    2010-01-20

    ... definition of prohibited drugs. In Sec. Sec. 120.103 and 120.211, we omitted the reference to Sec. 135.1 from.... FAA-2008-0937; Amendment No. 120-0A, 135-117A] RIN 2120-AJ37 Drug and Alcohol Testing Program... Aviation Administration (FAA) is correcting its drug and alcohol testing regulations published on May 14...

  12. Continuous high-temperature surveillance instrumentation for Dresden-2 hydrogen water chemistry program

    International Nuclear Information System (INIS)

    Fleming, M.F.; Mitchell, R.A.; Nelson, J.L.

    1987-01-01

    The objective of this program (under EPRI Contract RP1930-11) is to install and operate a high-temperature surveillance instrumentation system capable of monitoring the length of cracks in boiling water reactor (BWR) piping during plant operation. The ability to measure crack growth in BWR power plant piping welds is important to rapidly identify the effectiveness of repairs (such as the Hydrogen Water Chemistry Program). The feasibility of a system capable of continuous ultrasonic instrumentation at 600 0 F (288 0 C) was successfully demonstrated at the Dresden-2 suction line known as N1B. This intergranular stress corrosion cracking (IGSCC) surveillance instrumentation is sound in principal, because it survived on N1B for a time period of more than nine months from April 1985 to January 1986 (the last time data were recorded). The redesigned low-profile transducer system used for this system operated successfully for the same nine-month time period. This low profile transducer fits in the two-inch space normally occupied by insulation. As a result of poor routing of the coaxial cables running from the low-profile transducer to the electrical feed-throughs between the drywell and containment, these cables melted. Other instrument cables nearby were not damaged

  13. Environmental Restoration Program pollution prevention checklist guide for the surveillance and maintenance project phase

    International Nuclear Information System (INIS)

    1993-09-01

    DOE Order 5820.2 mandates that a surveillance and maintenance program be established in all shut-down facilities to ensure adequate containment of contamination, provide physical safety and security, and reduce potential public and environmental hazards. A key consideration in this process is the prevention of any waste to be generated from these activities. The purpose of this checklist guide is to assist the user with incorporating pollution prevention/waste minimization (PP/WM) in all Surveillance and Maintenance (S ampersand M) phase projects of the Environmental Restoration (ER) Program. This guide will help users document their PP/WM activities for technology transfer and reporting requirements. Automated computer screens will be created from the checklist data to assist users with implementing and evaluating waste reduction. Users can then establish numerical performance measures to measure progress in planning, training, self-assessments, field implementation, documentation, and technology transfer. Cost savings result as users train and assess themselves and perform preliminary waste assessments

  14. 42 CFR 423.159 - Electronic prescription drug program.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

  15. High Prevalence of HIV Drug Resistance Among Newly Diagnosed Infants Aged <18 Months: Results From a Nationwide Surveillance in Nigeria.

    Science.gov (United States)

    Inzaule, Seth C; Osi, Samuels J; Akinbiyi, Gbenga; Emeka, Asadu; Khamofu, Hadiza; Mpazanje, Rex; Ilesanmi, Oluwafunke; Ndembi, Nicaise; Odafe, Solomon; Sigaloff, Kim C E; Rinke de Wit, Tobias F; Akanmu, Sulaimon

    2018-01-01

    WHO recommends protease-inhibitor-based first-line regimen in infants because of risk of drug resistance from failed prophylaxis used in prevention of mother-to-child transmission (PMTCT). However, cost and logistics impede implementation in sub-Saharan Africa, and >75% of children still receive nonnucleoside reverse transcriptase inhibitor-based regimen (NNRTI) used in PMTCT. We assessed the national pretreatment drug resistance prevalence of HIV-infected children aged resistance surveillance protocol. We used remnant dried blood spots collected between June 2014 and July 2015 from 15 early infant diagnosis facilities spread across all the 6 geopolitical regions of Nigeria. Sampling was through a probability proportional-to-size approach. HIV drug resistance was determined by population-based sequencing. Overall, in 48% of infants (205 of 430) drug resistance mutations (DRM) were detected, conferring resistance to predominantly NNRTIs (45%). NRTI and multiclass NRTI/NNRTI resistance were present at 22% and 20%, respectively, while resistance to protease inhibitors was at 2%. Among 204 infants with exposure to drugs for PMTCT, 57% had DRMs, conferring NNRTI resistance in 54% and multiclass NRTI/NNRTI resistance in 29%. DRMs were also detected in 34% of 132 PMTCT unexposed infants. A high frequency of PDR, mainly NNRTI-associated, was observed in a nationwide surveillance among newly diagnosed HIV-infected children in Nigeria. PDR prevalence was equally high in PMTCT-unexposed infants. Our results support the use of protease inhibitor-based first-line regimens in HIV-infected young children regardless of PMTCT history and underscore the need to accelerate implementation of the newly disseminated guideline in Nigeria.

  16. Drug-induced acute myocardial infarction: identifying 'prime suspects' from electronic healthcare records-based surveillance system.

    Directory of Open Access Journals (Sweden)

    Preciosa M Coloma

    Full Text Available Drug-related adverse events remain an important cause of morbidity and mortality and impose huge burden on healthcare costs. Routinely collected electronic healthcare data give a good snapshot of how drugs are being used in 'real-world' settings.To describe a strategy that identifies potentially drug-induced acute myocardial infarction (AMI from a large international healthcare data network.Post-marketing safety surveillance was conducted in seven population-based healthcare databases in three countries (Denmark, Italy, and the Netherlands using anonymised demographic, clinical, and prescription/dispensing data representing 21,171,291 individuals with 154,474,063 person-years of follow-up in the period 1996-2010. Primary care physicians' medical records and administrative claims containing reimbursements for filled prescriptions, laboratory tests, and hospitalisations were evaluated using a three-tier triage system of detection, filtering, and substantiation that generated a list of drugs potentially associated with AMI. Outcome of interest was statistically significant increased risk of AMI during drug exposure that has not been previously described in current literature and is biologically plausible.Overall, 163 drugs were identified to be associated with increased risk of AMI during preliminary screening. Of these, 124 drugs were eliminated after adjustment for possible bias and confounding. With subsequent application of criteria for novelty and biological plausibility, association with AMI remained for nine drugs ('prime suspects': azithromycin; erythromycin; roxithromycin; metoclopramide; cisapride; domperidone; betamethasone; fluconazole; and megestrol acetate.Although global health status, co-morbidities, and time-invariant factors were adjusted for, residual confounding cannot be ruled out.A strategy to identify potentially drug-induced AMI from electronic healthcare data has been proposed that takes into account not only statistical

  17. Drug-food interaction counseling programs in teaching hospitals.

    Science.gov (United States)

    Wix, A R; Doering, P L; Hatton, R C

    1992-04-01

    The results of a survey to characterize drug-food interaction counseling programs in teaching hospitals and solicit opinions on these programs from pharmacists and dietitians are reported. A questionnaire was mailed to the pharmacy director and the director of dietary services at teaching hospitals nationwide. The questionnaire contained 33 questions relating to hospital characteristics, drug-food interaction counseling programs, and the standard calling for such programs issued by the Joint Commission on Accreditation of Healthcare Organizations. Of 792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of the pharmacists and dietitians (51.2%) did not consider their drug-food interaction counseling program to be formal; some had no program. The pharmacy department was involved more in program development than in the daily operation of such programs. The most frequent methods of identifying patients for counseling were using lists of patients' drugs and using physicians' orders. A mean of only five drugs were targeted per program. Slightly over half the respondents rated the Joint Commission standard less effective than other standards in its ability to improve patient care. A majority of teaching hospitals did not have formal drug-food interaction counseling programs. Pharmacists and dietitians did not view these programs as greatly beneficial and did not believe that the Joint Commission has clearly delineated the requirements for meeting its standard.

  18. A reliability program for emergency diesel generators at nuclear power plants: Maintenance, surveillance, and condition monitoring

    International Nuclear Information System (INIS)

    Lofgren, E.V.; Henderson, W.; Burghardt, D.; Kripps, L.; Rothleder, B.

    1988-12-01

    This report is a companion report on NUREG/CR-5078, Volume 1, ''A Reliability Program for Emergency Diesel Generators at Nuclear Power Plants: Program Structure.'' The purpose of this report is to provide technical findings and insights related to: failure evaluation, troubleshooting, maintenance, surveillance, and condition monitoring. Examples and recommendations are provided for each of these areas based on actual emergency diesel generator (EDG) operating experience and the opinions of diesel generator experts. This report expands the more general guidance provided in Volume 1. In addition, a discussion of EDG interactions with other plant systems (e.g., instrument, air, service water, dc power) is provided since experience has shown that these support systems and their operation can adversely affect EDG reliability. Portions of this report have been designed for use by onsite personnel for evaluating operational characteristics of EDGs. 5 refs., 8 figs., 7 tabs

  19. Integration of HIV testing in tuberculosis drug resistance surveillance in Kazakhstan and Kenya

    NARCIS (Netherlands)

    Klinkenberg, E.; van den Hof, S.; Tursynbayeva, A.; Kipruto, H.; Wahogo, J.; Pak, S.; Kutwa, A.; L'Herminez, R.

    2012-01-01

    In Kenya and Kazakhstan, integration of human immunodeficiency virus (HIV) testing results into the routine surveillance of multidrug-resistant tuberculosis (MDR-TB) proved feasible and useful. The integration process improved overall data quality and data validation capacity, and integrated data

  20. 12-step programs for reducing illicit drug use

    DEFF Research Database (Denmark)

    Bøg, Martin; Filges, Trine; Brännström, Lars

    2017-01-01

    12-step programs for reducing illicit drug use are neither better nor worse than other interventions Illicit drug abuse has serious and far-reaching implications for the abuser, their family members, friends, and society as a whole. Preferred intervention programs are those that effectively reduce...... illicit drug use and its negative consequences, and are cost-effective as well. Current evidence shows that overall, 12-step programs are just as effective as alternative, psychosocial interventions. The costs of programs are, therefore, an important consideration. However, the strength of the studies...

  1. Reality Television Programs Are Associated With Illegal Drug Use and Prescription Drug Misuse Among College Students.

    Science.gov (United States)

    Fogel, Joshua; Shlivko, Alexander

    2016-01-02

    Reality television watching and social media use are popular activities. Reality television can include mention of illegal drug use and prescription drug misuse. To determine if reality television and social media use of Twitter are associated with either illegal drug use or prescription drug misuse. Survey of 576 college students in 2011. Independent variables included watching reality television (social cognitive theory), parasocial interaction (parasocial interaction theory), television hours watched (cultivation theory), following a reality television character on Twitter, and demographics. Outcome variables were illegal drug use and prescription drug misuse. Watching reality television and also identifying with reality TV program characters were each associated with greater odds for illegal drug use. Also, following a reality TV character on Twitter had greater odds for illegal drug use and also in one analytical model for prescription drug misuse. No support was seen for cultivation theory. Those born in the United States had greater odds for illegal drug use and prescription drug misuse. Women and Asians had lower odds for illegal drug use. African Americans and Asians had lower odds for prescription drug misuse. Physicians, psychologists, and other healthcare practitioners may find it useful to include questions in their clinical interview about reality television watching and Twitter use. Physician and psychology groups, public health practitioners, and government health agencies should consider discussing with television broadcasting companies the potential negative impact of including content with illegal drugs and prescription drug misuse on reality television programs.

  2. Increases in self-reported fentanyl use among a population entering drug treatment: The need for systematic surveillance of illicitly manufactured opioids.

    Science.gov (United States)

    Cicero, Theodore J; Ellis, Matthew S; Kasper, Zachary A

    2017-08-01

    Recent reports indicate a sharp increase in fentanyl-related overdose deaths across the United States, much of which is likely related to the introduction of cheap, illicitly manufactured fentanyl derivatives. In this study, we sought to estimate the magnitude of illicit fentanyl use from 2012 to 2016 using a national opioid abuse surveillance system. The study program surveyed 10,900 individuals entering substance abuse treatment for opioid use disorder, with participants asked to endorse past month 'use to get high' of fentanyl drugs, stratified by identifiable (i.e., branded) fentanyl formulations or a 'type unknown' drug alleged to contain fentanyl. Total past-month fentanyl-use rose modestly from 2012 to 2016. While use of known fentanyl products remained relatively stable (mean=10.9%; P=0.25), endorsements of 'unknown' fentanyl products nearly doubled from 9% in 2013 to 15.1% by 2016 (Pfentanyl use shows that recent increases in fentanyl use seem to be due almost entirely to 'unknown' fentanyl presumed to be illicitly manufactured. Given that it is difficult to assess the extent to which fentanyl may have been substituted for another drug (i.e., oxycodone, alprazolam, etc.) or was used as a heroin admixture, our data likely represent an underestimation of the full magnitude of illicit fentanyl abuse. As such, this growing public health problem requires immediate attention and more systematic efforts to identify and track its abuse. Copyright © 2017. Published by Elsevier B.V.

  3. A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs.

    Directory of Open Access Journals (Sweden)

    Kate Sawford

    Full Text Available The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.

  4. Imported malaria in Finland 1995 to 2008: an overview of surveillance, travel trends, and antimalarial drug sales.

    Science.gov (United States)

    Guedes, Sandra; Siikamäki, Heli; Kantele, Anu; Lyytikäinen, Outi

    2010-01-01

    To improve pre-travel advice, we analyzed nationwide population-based surveillance data on malaria cases reported to the National Infectious Disease Register of Finland (population 5.3 million) during 1995 to 2008 and related it to data on traveling and antimalarial drug sales. Surveillance data comprised information on malaria cases reported to the National Infectious Disease Register during 1995 to 2008. Traveling data were obtained from Statistics Finland (SF) and the Association of Finnish Travel Agents (AFTA). SF data included information on overnight leisure trips to malaria-endemic countries during 2000 to 2008. AFTA data included annual number of organized trips during 1999 to 2007. Quarterly numbers of antimalarial drug sales were obtained from the Finnish Medicines Agency. Descriptive and time series analyses were performed. A total of 484 malaria cases (average annual incidence 0.7/100,000 population) were reported; 283 patients were Finnish- and 201 foreign-born. In all, 15% of all cases were children; 72% foreign- and 28% Finnish-born. Malaria infections were mostly acquired in Africa (76%). Among foreign-born cases, 89% of the infections were acquired in the region of birth. The most common species were Plasmodium falciparum (61%) and Plasmodium vivax (22%). Although traveling to malaria-endemic areas increased, no increase occurred in malaria cases, and a decreasing trend was present in antimalarial drug sales. Traveling to malaria-endemic countries and drug sales followed the same seasonal pattern, with peaks in the first and last quarter of the year. More efforts should be focused on disseminating pre-travel advice to immigrants planning to visit friends and relatives and travelers on self-organized trips. © 2010 International Society of Travel Medicine.

  5. The US Support Program to IAEA Safeguards Priority of Containment and Surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Diaz,R.A.

    2008-06-13

    The United States Support Program (USSP) priority for containment and surveillance (US) focuses on maintaining or improving the reliability and cost-effectiveness of C/S systems for IAEA safeguards, expanding the number of systems that are unattended and remotely monitored, and developing verification methods that help streamline the on-site inspection process. Existing IAEA C/S systems have evolved to become complex, integrated systems, which may include active seals, nondestructive assay (NDA) instruments, video cameras, and other sensors. These systems operate autonomously. They send analytical data to IAEA headquarters where it can be reviewed. These systems present challenges to the goals of improved system performance, standardization, reliability, maintainability, documentation, and cost effectiveness. One critical lesson from past experiences is the need for cooperation and common objectives among the IAEA, the developer, and the facility operator, to create a successful, cost effective system. Recent USSP C/S activities include Rokkasho Reprocessing Plant safeguard systems, production of a new shift register, numerous vulnerability assessments of C/S systems, a conduit monitoring system which identifies tampering of IAEA conduit deployed in the field, fiber optic seal upgrades, unattended monitoring system software upgrades, next generation surveillance system which will upgrade existing camera systems, and support of the IAEA's development of the universal nondestructive assay data acquisition platform.

  6. Minutes of the 13th light water reactor pressure vessel surveillance dosimetry improvement program (LWR-PV-SDIP) meeting

    International Nuclear Information System (INIS)

    1984-04-01

    Information is presented concerning ASTM LWR standards and program documentation; trend curves, PSF, and other test reactor metallurgical programs; PSF dosimetry and metallurgical capsule neutron and gamma environment characterization and metallurgical studies; PVS characterization program; other neutron fields; surveillance dosimetry measurement facility (SDMF) and perturbation studies; transport theory calculations; gamma field benchmarks and photo-reaction studies; and fission and non-fission sensor inventories and quality assurance

  7. Establishment of a High Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program [corrected].

    Directory of Open Access Journals (Sweden)

    Ryan M Wallace

    2015-11-01

    Full Text Available The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 -December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9% and an additional 36 cases were identified based on clinical diagnosis (5%, representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%. Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries.

  8. A data-capture system for post-marketing surveillance of drugs that integrates with hospital electronic health records

    Directory of Open Access Journals (Sweden)

    Yamamoto K

    2011-04-01

    Full Text Available Keiichi Yamamoto1, Shigemi Matsumoto2, Kazuhiro Yanagihara2, Satoshi Teramukai1, Masanori Fukushima1,2,31Department of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hospital, Kyoto, Japan; 2Outpatient Oncology Unit, Kyoto University Hospital, Kyoto, Japan; 3Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, JapanPurpose: In conventional clinical studies, the cost of data management for the purposes of quality control tend to be high and collecting paper-based case report forms (CRFs can be burdensome, because paper-based CRFs must be developed and filled out for each clinical study protocol. Use of electronic health records (EHRs for this purpose could reduce costs and improve data quality in clinical studies. Kyoto University Hospital launched an EHR system in January 2005. At the same time, a replicate of that database was established for other purposes. At the Outpatient Oncology Unit of Kyoto University Hospital we developed a data-capture system that includes a cancer clinical database system and a data warehouse for outcomes studies. This system allows us to accumulate data at low cost and apply it to various uses in clinical or outcomes studies. Here we report on the application of this system to the post-marketing surveillance of drugs.Methods: We evaluated the availability of this system and identified problems for future development. With this system investigators can register cases for post-marketing surveillance, and the registered cases are listed on a screen. When CRFs for a particular case are required, data can be extracted from the list and CRFs are produced in PDF format.Results and conclusion: In this study we confirmed the applicability of our new system to post-marketing surveillance in providing prompt and efficient data exchange. We expect it to reduce the cost of data management and analysis and to improve the quality of data in post

  9. What Have We Learned From the Typhoid Fever Surveillance in Africa Program?

    Science.gov (United States)

    Baker, Stephen; Hombach, Joachim; Marks, Florian

    2016-03-15

    The Typhoid Fever Surveillance in Africa Program (TSAP) was established in 2009 to fill the data void concerning invasive Salmonella disease in sub-Saharan Africa, and to specifically estimate the burden of bloodstream infections caused by the key pathogen, Salmonella enterica serovar Typhi. TSAP has achieved this ambitious target, finding high incidences of typhoid fever in both rural and urban populations in several countries in sub-Saharan Africa. The results of TSAP will undoubtedly dictate the direction of future typhoid fever research in Africa, and at last provides a key piece of the disease burden jigsaw puzzle. With the dawn of new Vi conjugate vaccines against Salmonella Typhi, the next priority for the typhoid community must be providing the required data on these vaccines so they can be licensed and provided to those in high-risk groups and locations across sub-Saharan Africa. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  10. Farmacovigilância: elementos para a discussão e perspectivas Drug surveillance: topics for discussion and prospects

    Directory of Open Access Journals (Sweden)

    Suely Rozenfeld

    1998-04-01

    Full Text Available A vigilância de medicamentos subdivide-se em dois grupos. O primeiro consiste nas ações de registro e fiscalização, que são as mais conhecidas da sociedade. O segundo grupo consiste nas ações de farmacovigilância, que são as de pesquisa e monitoramento de reações adversas. Essas últimas estão previstas na legislação federal do setor saúde que vigora desde a década de 70. Do mesmo modo, uma portaria recente prevê a criação do sistema nacional de monitoramento. O texto aborda de maneira panorâmica elementos da história, dos conceitos, das definições, da classificação, dos mecanismos de ação e do diagnóstico de reações adversas. São descritos os objetivos e as fontes de informação para os estudos de farmacovigilância, bem como a experiência nacional no campo.Drug surveillance can be grouped into two areas. The first includes registration and inspection, activities that are more familiar to society at large. The second involves research and monitoring of adverse effects. Brazilian legislation has regulated this subject since 1970. A recent directive also provides for a national pharmaceutical surveillance system. This current article provides an overview of the history, definitions, pharmacological concepts, classification, and diagnosis of the adverse effects of drugs. An analysis is presented of the goals and sources of information for drug monitoring as well as some Brazilian experience in this field.

  11. 76 FR 54599 - Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs

    Science.gov (United States)

    2011-09-01

    ...), prescription drug benefit program (Part D) and section 1876 cost plans including conforming changes to the MA... accounts (MSA) plans, cost-sharing for dual-eligible enrollees in the MA program and prescription drug pricing, coverage, and payment processes in the Part D program, and requirements governing the marketing...

  12. Impact of HIV prevention programs on drug users in Malaysia.

    Science.gov (United States)

    Kamarulzaman, Adeeba

    2009-11-01

    Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.

  13. Economic evaluation and budget impact analysis of the surveillance program for hepatocellular carcinoma in Thai chronic hepatitis B patients.

    Science.gov (United States)

    Sangmala, Pannapa; Chaikledkaew, Usa; Tanwandee, Tawesak; Pongchareonsuk, Petcharat

    2014-01-01

    The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One- way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible

  14. Use of Gestalt Therapy Within a Drug Treatment Program.

    Science.gov (United States)

    Sideroff, Stephen I.

    1979-01-01

    Presents a Gestalt therapeutic approach that has shown promise within a drug treatment program. The major issues discussed include the acquisition of self-support, taking responsibility, dealing with anxiety, contact, and the expression of pent-up feelings. (Author)

  15. A study on programmed drug release from tablets

    NARCIS (Netherlands)

    Veen, Jacoba van der

    1993-01-01

    This thesis shows the extension of the applicability of the megaloporous system for drugs with different physico-chemical properties, like solubility and pK.. Procaine HC1, a highly soluble drug, can successfully be formulated in the programmed release megaloporous system, by using Carnauba wax,

  16. Experience gained with the development of a performance test program for the monitoring and surveillance systems in the Embalse nuclear power plant

    International Nuclear Information System (INIS)

    Arestin, M.L.

    1988-01-01

    The monitoring and surveillance system for Embalse nuclear power plant are presented. The reactor, the nuclear fuel management, the equipments from monitoring and surveillance system, the activities developed by the AIEA experts in each mission of this test program and the management of the components for this test program in Argentine are described. (E.G.) [pt

  17. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    Holland, van Berry J.; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

  18. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

    NARCIS (Netherlands)

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2017-01-01

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

  19. 9 CFR 146.14 - Diagnostic surveillance program for H5/H7 low pathogenic avian influenza.

    Science.gov (United States)

    2010-01-01

    .../H7 low pathogenic avian influenza. 146.14 Section 146.14 Animals and Animal Products ANIMAL AND PLANT... pathogenic avian influenza. (a) The Official State Agency must develop a diagnostic surveillance program for H5/H7 low pathogenic avian influenza for all poultry in the State. The exact provisions of the...

  20. 8 x 8 fuel surveillance program at Monticello site - end of Cycle 6: fourth post-irradiation inspection, October 1978

    International Nuclear Information System (INIS)

    Skarshaug, N.H.

    1980-09-01

    A fuel surveillance program for a lead 8 x 8 reload fuel assembly was implemented at the Monticello Nuclear Power Station in May 1974 prior to Reactor Cycle 3. Inspection results of the fourth post-irradiation inspection performed on this surveillance fuel assembly in October 1978 at EOC 6, after a bundle average exposure of 25,900 MWd/MT, are presented. The measurement techniques, results obtained and comparisons to previous measurements are discussed. The bundle and individual rods examined exhibited characteristics of normal operation and were approved for continued irradiation during Monticello operating Cycle 7

  1. Program of environmental radiological surveillance of the radioactive wastes storage center of Maquixco in the period January-December 1991

    International Nuclear Information System (INIS)

    Gaso P, M.I.

    1991-12-01

    The primary objective of all program of environmental radiological surveillance (PVRA), it is to follow the evolution of the radioactive content of the links of the chains that constitute the different ways of transfer of the radioactivity toward the man, with the purpose of making a realistic evaluation of the environmental impact produced by the installation under surveillance. In the CADER in Mexico, only accidents or escapes of radioactivity of slow evolution can be detected. At the moment the radioactive wastes in this installation are not treated. In this report the results obtained during the year 1991 are presented. (Author)

  2. European surveillance network for influenza in pigs: surveillance programs, diagnostic tools and Swine influenza virus subtypes identified in 14 European countries from 2010 to 2013.

    Directory of Open Access Journals (Sweden)

    Gaëlle Simon

    Full Text Available Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs (ESNIP3, 2010-2013 aimed to expand widely the knowledge of the epidemiology of European SIVs. ESNIP3 stimulated programs of harmonized SIV surveillance in European countries and supported the coordination of appropriate diagnostic tools and subtyping methods. Thus, an extensive virological monitoring, mainly conducted through passive surveillance programs, resulted in the examination of more than 9 000 herds in 17 countries. Influenza A viruses were detected in 31% of herds examined from which 1887 viruses were preliminary characterized. The dominating subtypes were the three European enzootic SIVs: avian-like swine H1N1 (53.6%, human-like reassortant swine H1N2 (13% and human-like reassortant swine H3N2 (9.1%, as well as pandemic A/H1N1 2009 (H1N1pdm virus (10.3%. Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence. For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some countries from 2010 to 2013, indicating that this subtype has become established in the European pig population. Finally, 13.9% of the viruses represented reassortants between these four lineages, especially between previous enzootic SIVs and H1N1pdm. These novel viruses were detected at the same time in several countries, with increasing prevalence. Some of them might become established in pig herds, causing implications for zoonotic infections.

  3. Factors influencing moisture analysis in the 3013 destructive examination surveillance program

    Energy Technology Data Exchange (ETDEWEB)

    Scogin, J. H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-10-24

    Thermogravimetric analysis of a solid sample with mass spectrometry (TGA-MS) of the evolved gas is used in the destructive examination (DE) portion of the Integrated Surveillance Program to quantify the moisture content of the material stored in a 3013 container. As with any measurement determined from a small sample, the collection, storage, transportation, and handling of the sample can affect its ability to represent the properties of the bulk material. During the course of the DE program, questions have periodically arisen concerning the ability of the moisture sample to reflect reliably the actual moisture content of the entire material stored in the 3013 container. Most concerns are related to the ability to collect a representative sample and to preserve the moisture content of the sample between collection and analysis. Recent delays in analysis caused by maintenance issues with the TGA-MS instrument presented a unique opportunity to document and quantify the effects various factors have on the TGA-MS moisture measurement. This report will use recent data to document the effects that current sample collection and handling practices have on the TGA-MS moisture measurement. Some suggestions will be made which could improve the current sample collection and handling practices for the TGA-MS moisture measurement so that the analytical results more accurately reflect the moisture content of the material stored in the 3013 container.

  4. Overview of a comprehensive environmental monitoring and surveillance program: The role of fish and wildlife

    International Nuclear Information System (INIS)

    Gray, R.H.

    1988-05-01

    Concern about the effects of potential releases from nuclear and non-nuclear activities on the US Department of Energy's Hanford Site in southeastern Washington has evolved over four decades into a comprehensive environmental monitoring and surveillance program. The program includes field sampling, and chemical and physical analyses of air, surface and ground water, fish and wildlife, soil, foodstuffs, and natural vegetation. In addition to monitoring radioactivity in fish and wildlife, population numbers of key species are determined, usually during the breeding season. Data from monitoring efforts are used to assess the environmental impacts of Hanford operations and calculate the overall radiological dose to humans onsite, at the Site perimeter, or residing in nearby communities. Chinook salmon spawning in the Columbia River at Hanford has increased in recent years with a concomitant increase in winter nesting activity of bald eagles (Haliaeetus leucocephalus). An elk (Cervus elaphus) herd, established by immigration in 1972, is also increasing. Nesting Canada goose (Branta canadensis) and great blue heron (Ardea herodias), and various other animals, e.g., mule deer (Odocoileus hemionus) and coyotes (Canis latrans) are common. Measured exposure to penetrating radiation and calculated radiation doses to the public are well below applicable regulatory limits

  5. Factors influencing moisture analysis in the 3013 destructive examination surveillance program

    International Nuclear Information System (INIS)

    Scogin, J. H.

    2017-01-01

    Thermogravimetric analysis of a solid sample with mass spectrometry (TGA-MS) of the evolved gas is used in the destructive examination (DE) portion of the Integrated Surveillance Program to quantify the moisture content of the material stored in a 3013 container. As with any measurement determined from a small sample, the collection, storage, transportation, and handling of the sample can affect its ability to represent the properties of the bulk material. During the course of the DE program, questions have periodically arisen concerning the ability of the moisture sample to reflect reliably the actual moisture content of the entire material stored in the 3013 container. Most concerns are related to the ability to collect a representative sample and to preserve the moisture content of the sample between collection and analysis. Recent delays in analysis caused by maintenance issues with the TGA-MS instrument presented a unique opportunity to document and quantify the effects various factors have on the TGA-MS moisture measurement. This report will use recent data to document the effects that current sample collection and handling practices have on the TGA-MS moisture measurement. Some suggestions will be made which could improve the current sample collection and handling practices for the TGA-MS moisture measurement so that the analytical results more accurately reflect the moisture content of the material stored in the 3013 container.

  6. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  7. 77 FR 5027 - Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to...

    Science.gov (United States)

    2012-02-01

    ...] Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to the... entitled ``Food and Drug Administration Transparency Initiative: Exploratory Program to [[Page 5028

  8. NCAA Drug-Testing Program 2010-11

    Science.gov (United States)

    National Collegiate Athletic Association (NJ1), 2010

    2010-01-01

    The National Collegiate Athletic Association (NCAA) Drug-Testing Program was created to protect the health and safety of student-athletes and to ensure that no one participant might have an artificially induced advantage or be pressured to use chemical substances. This publication describes this program in the following chapters: (1) NCAA…

  9. Characterization of Adolescent Prescription Drug Abuse and Misuse Using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R]) System

    Science.gov (United States)

    Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

    2013-01-01

    Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all…

  10. VETSTAT - the Danish system for surveillance of the veterinary use of drugs for production animals

    DEFF Research Database (Denmark)

    Stege, H.; Bager, Flemming; Jacobsen, Erik

    2003-01-01

    The Danish Ministry of Food, Agriculture and Fisheries funds a monitoring system based on drug usage information collected at the herd level: VETSTAT. VETSTAT is constructed as a relational database and data originates from three sources: pharmacies, veterinarians and feed mills. All administration...... of drugs for use in animal production is reported on a monthly basis. Pharmacies provided 95% of the total weight antimicrobial compounds used in Denmark in 2001. More than 80% of the antimicrobial compounds reported by pharmacies were sold on prescription to end-users (owners) and included information...

  11. Drug-induced lung injury associated with sorafenib: analysis of all-patient post-marketing surveillance in Japan.

    Science.gov (United States)

    Horiuchi-Yamamoto, Yuka; Gemma, Akihiko; Taniguchi, Hiroyuki; Inoue, Yoshikazu; Sakai, Fumikazu; Johkoh, Takeshi; Fujimoto, Kiminori; Kudoh, Shoji

    2013-08-01

    Sorafenib is a multi-kinase inhibitor currently approved in Japan for unresectable and/or metastatic renal cell carcinoma and unresectable hepatocellular carcinoma. Although drug-induced lung injury has recently been the focus of interest in Japanese patients treated with molecular targeting agents, the clinical features of patients receiving sorafenib remain to be completely investigated. All-patient post-marketing surveillance data was obtained within the frame of Special Drug Use Investigation; between April 2008 and March 2011, we summarized the clinical information of 62 cases with drug-induced lung injury among approximately 13,600 sorafenib-treated patients in Japan. In addition, we summarized the results of evaluation by a safety board of Japanese experts in 34 patients in whom pulmonary images were available. For the calculation of reporting frequency, interim results of Special Drug Use Investigation were used. In the sets of completed reports (2,407 in renal cell carcinoma and 647 in hepatocellular carcinoma), the reporting frequency was 0.33 % (8 patients; fatal, 4/8) and 0.62 % (4 patients; fatal, 2/4), respectively. Major clinical symptoms included dyspnea, cough, and fever. Evaluation of the images showed that 18 cases out of 34 patients had a pattern of diffuse alveolar damage. The patients with hepatocellular carcinoma showed a greater incidence and earlier onset of lung injury than those with renal cell carcinoma. Although the overall reporting frequency of sorafenib-induced lung injury is not considered high, the radiological diffuse alveolar damage pattern led to a fatal outcome. Therefore, early recognition of sorafenib-induced lung injury is crucial for physicians and patients.

  12. Electronic surveillance systems in infection prevention: organizational support, program characteristics, and user satisfaction.

    Science.gov (United States)

    Grota, Patti G; Stone, Patricia W; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2010-09-01

    The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs.

  13. Electronic surveillance systems in infection prevention: Organizational support, program characteristics, and user satisfaction

    Science.gov (United States)

    Grota, Patti G.; Stone, Patricia W.; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2012-01-01

    Background The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. Methods A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Results Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Conclusion Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs. PMID:20176411

  14. Comparative study on drug safety surveillance between medical students of Malaysia and Nigeria.

    Science.gov (United States)

    Abubakar, Abdullahi Rabiu; Ismail, Salwani; Rahman, Nor Iza A; Haque, Mainul

    2015-01-01

    Internationally, there is a remarkable achievement in the areas of drug discovery, drug design, and clinical trials. New and efficient drug formulation techniques are widely available which have led to success in treatment of several diseases. Despite these achievements, large number of patients continue to experience adverse drug reactions (ADRs), and majority of them are yet to be on record. The purpose of this survey is to compare knowledge, attitude, and practice with respect to ADRs and pharmacovigilance (PV) between medical students of Malaysia and Nigeria and to determine if there is a relationship between their knowledge and practice. A cross-sectional, questionnaire-based survey involving year IV and year V medical students of the Department of Medicine, Universiti Sultan Zainal Abidin and Bayero University Kano was carried out. The questionnaire which comprised 25 questions on knowledge, attitude, and practice was adopted, modified, validated, and administered to them. The response was analyzed using SPSS version 20. The response rate from each country was 74%. There was a statistically significant difference in mean knowledge and practice score on ADRs and PV between medical students of Malaysia and Nigeria, both at PMalaysia, although they need improvement. Imparting knowledge of ADRs and PV among medical students will upgrade their practice and enhance health care delivery services in the future.

  15. Tracking Ecstasy Trends in the United States with Data from Three National Drug Surveillance Systems

    Science.gov (United States)

    Yacoubian, George S., Jr.

    2003-01-01

    Anecdotal reports have suggested that the use of 3,4-methylenedioxymeth-amphetamine (MDMA or "ecstasy") is a prodigious problem across the United States. Unfortunately, no longitudinal evidence exists to support this contention. In the current study, data from the Drug Abuse Warning Network (DAWN), Monitoring the Future (MTF), and…

  16. Integrated cardiac safety: assessment methodologies for noncardiac drugs in discovery, development, and postmarketing surveillance

    National Research Council Canada - National Science Library

    Turner, J. Rick; Durham, Todd A

    2009-01-01

    ... PROTEOMICS AND TRANSCRIPTOMICS 2.8 GENE EXPRESSION 2.9 PROTEINS 2.10 CELLS 2.11 CELL MEMBRANES 2.12 PROTEINS IN CELL MEMBRANES 2.13 ION CHANNELS 2.14 RECEPTORS ADVERSE DRUG REACTIONS MELANOGASTER 25 ...

  17. HIV-1 drug resistance surveillance in antiretroviral treatment-naive individuals from a reference hospital in Guatemala, 2010-2013.

    Science.gov (United States)

    Avila-Ríos, Santiago; García-Morales, Claudia; Garrido-Rodríguez, Daniela; Tapia-Trejo, Daniela; Girón-Callejas, Amalia Carolina; Mendizábal-Burastero, Ricardo; Escobar-Urias, Ingrid Yessenia; García-González, Blanca Leticia; Navas-Castillo, Sabrina; Pinzón-Meza, Rodolfo; Mejía-Villatoro, Carlos Rodolfo; Reyes-Terán, Gustavo

    2015-04-01

    The recent expansion of antiretroviral treatment (ART) coverage in middle/low-income countries has been associated with increasing prevalence of HIV pre-ART drug resistance (PDR). We assessed PDR prevalence, patterns, and trends in Guatemala. Blood samples from 1,084 ART-naive individuals, enrolled from October 2010 to December 2013 at the Roosevelt Hospital in Guatemala City, were obtained. PDR was evaluated using the WHO mutation list for transmitted drug resistance (TDR) surveillance. An overall PDR prevalence of 7.3% (95% CI 5.8-9.0%) was observed for the whole study period. TDR to nonnucleoside reverse transcriptase inhibitors (NNRTI) was the highest (4.9%, p500 and 350-500 CD4(+) T cells/μl (7.4% and 8.7%, respectively) compared to individuals with Guatemala remains at an intermediate level. Nevertheless, we have shown evidence suggesting increasing trends in NNRTI PDR, which need to be taken into account in national HIV management policies.

  18. The Department of Defense Global, Laboratory-Based Influenza Surveillance Program: Technical Report on Program Methods for the 2012-2013 Influenza Season

    Science.gov (United States)

    2013-10-01

    PNL (EPI)” in AHLTA/CHCS, where available To request col lection kits, use the current ve rsion of the “Supply Orde r Form ” avai lable (under...Influenza Surveillance Program Sentinel Sites • Order the “RESPIRATORY CULTURE PNL (EPI)” in AHLTA/CHCS, where available • Submit 6-10 specimens

  19. Surveillance programs in Denmark has revealed the circulation of novel reassortant influenza A viruses in swine

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Hjulsager, Charlotte Kristiane; Trebbien, Ramona

    2014-01-01

    avH1N1 and H3N2 which is different from the dominating European H1N2 subtype (1). The prevalence of the H1N1pdm09 virus in swine has increased since 2009 in some countries including Denmark. Here we present the results of the national passive surveillance program on influenza in swine performed from...... by the combination of the gene segments hemagglutinin (HA) and neuraminidase (NA). In most European countries, the avian-like (av)H1N1, the 2009 pandemic variant (H1N1pdm09), H1N2 and H3N2 subtypes have constituted the dominating SIV subtypes during recent years. In Denmark, the H1N2 subtype is a reassortant between......Swine influenza is a respiratory disease caused by multiple subtypes of influenza A virus. Swine influenza virus (SIV) is enzootic in swine populations in Europe, Asia, North and South America. The influenza A virus genome consist of eight distinct gene segments and SIV subtypes are defined...

  20. Minutes of the Twelfth LWR pressure vessel surveillance dosimtery improvement program meeting

    International Nuclear Information System (INIS)

    1989-01-01

    The 1983 Twelfth Light Water Reactor Pressure Vessel Surveillance Dosimetry Improvement Program (LWR-PV-SDIP) Meeting, which was held October 24-28, 1983. Sections 1 through 14 of this report provide documentation of agreements, commitments, and reports that are subject to the approval and concurrence of the participating laboratories and supporting agencies and organizations. Attachment No. 1 provides information on the preparation of a number of NUREG publications that will document the results of various aspects of the LWR-PV-SDIP. For each NUREG publication, a tentative ''Table of Contents'' is provided in addition to suggested interlaboratory writing assignments and camera-ready copy contribution due dates, as appropriate. Attachment No. 2 provides information on planning for the Fifth ASTM-EURATOM Symposium. Attachment No. 3 provides information on an ASTM press release about an MPC-6 meeting and dpa and E > 1 MeV exposure parameters. Attachments No. 4 and 5 provide copies of two LWR-PV-SDIP related papers presented at the Eleventh WRSR Information Meeting, October 24-28, 1983

  1. Corrosion surveillance program of aluminum spent fuel elements in wet storage sites

    International Nuclear Information System (INIS)

    Linardi, E; Haddad, R

    2012-01-01

    Due to different degradation issues observed in aluminum-clad spent fuel during long term storage in water, the IAEA implemented in 1996 a Coordinated Research Project (CRP) and a Regional Project for Latin America, on Corrosion of Research Reactor Aluminum Clad Spent Fuel in Water. Argentine has been among the participant countries of these projects, carrying out spent fuel corrosion surveillance activities in its storage facilities. As a result of the research a large database on corrosion of aluminum-clad fuel has been generated. It was determined that the main types of corrosion affecting the spent fuel are pitting and galvanic corrosion due to contact with stainless steel. It was concluded that the quality of the water is the critical factor to control in a spent fuel storage facility. Another phase of the program is being conducted currently, which began in 2011 with the immersion of test racks in the RA1 reactor pool, and in the Research Reactor Spent Fuel Storage Facility (FACIRI), located in Ezeiza Atomic Center. This paper presents the results of the chemical analysis of the water performed so far, and its relationship with the examination of the coupons extracted from the sites (author)

  2. The EBR-II materials-surveillance program. 4: Results of SURV-4 and SURV-6

    International Nuclear Information System (INIS)

    Ruther, W.E.; Hayner, G.O.; Carlson, B.G.; Ebersole, E.R.; Allen, T.R.

    1998-01-01

    In March of 1965, a set of surveillance (SURV) samples was placed in the EBR-II reactor to determine the effect of irradiation, thermal aging, and sodium corrosion on reactor materials. Eight subassemblies were placed into row 12 positions of EBR-II to determine the effect of irradiation at 370 C. Two subassemblies were placed into the primary sodium basket to determine the effect of thermal aging at 370 C. For both the irradiated and thermally aged samples, one half of all samples were exposed to primary system sodium while one half were sealed in capsules with a helium atmosphere. Fifteen different structural materials were tested in the SURV program. In addition to the fifteen types of metal samples, graphite blocks were irradiated in the SURV subassemblies to determine the effect of irradiation on the graphite neutron shield. In this report, the properties of these materials irradiated at 370 C to a total fluence of 2.2 x 10 22 n/cm 2 (over 2,994 days) are compared with those of similar specimens thermally aged at 370 C for 2,994 days in the storage basket of the reactor. The properties analyzed were weight, density, microstructure, hardness, tensile and yield strength, impact strength, and creep

  3. 12-step programs to reduce illicit drug use

    DEFF Research Database (Denmark)

    Filges, Trine; Nielsen, Sine Kirkegaard; Jørgensen, Anne-Marie Klint

    2014-01-01

    Many treatments are not rigorously evaluated as to their effectiveness, and it is uncertain which types of interventions are more effective than others in reducing illicit drug use. The aim of this paper is to provide a systematic mapping of the research literature of the effectiveness of 12-step...... programs in reducing illicit drug use. A systematic literature search was conducted based on 17 international and Nordic Bibliographic databases. A total of 15993 references were screened, and eleven unique studies were finally included in this mapping. The included studies demonstrated conflicting results...... regarding the effectiveness of the 12-step treatment and TSF in reducing individuals’ drug use. Two studies reported a positive effect of the TSF treatment compared to the comparison conditions in reducing drug use. Six studies reported no differences between 12-step program and the comparison condition...

  4. NASA Astronaut Occupational Surveillance Program and Lifetime Surveillance of Astronaut Health, LSAH, Astronaut Exposures and Risk in the Terrestrial and Spaceflight Environment

    Science.gov (United States)

    Keprta, Sean R.; Tarver, William; Van Baalen, Mary; McCoy, Torin

    2015-01-01

    United States Astronauts have a very unique occupational exposure profile. In order to understand these risks and properly address them, the National Aeronautics and Atmospheric Administration, NASA, originally created the Longitudinal Study of Astronaut Health, LSAH. The first LSAH was designed to address a variety of needs regarding astronaut health and included a 3 to 1 terrestrial control population in order to compare United States "earth normal" disease and aging to that of a microgravity exposed astronaut. Over the years that program has been modified, now termed Lifetime Surveillance of Astronaut Health, still LSAH. Astronaut spaceflight exposures have also changed, with the move from short duration shuttle flights to long duration stays on international space station and considerable terrestrial training activities. This new LSAH incorporates more of an occupational health and medicine model to the study of occupationally exposed astronauts. The presentation outlines the baseline exposures and monitoring of the astronaut population to exposures, both terrestrial, and in space.

  5. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  6. Surveillance and Epidemiology of Drug Resistant Infections Consortium (SEDRIC: Supporting the transition from strategy to action [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Keiji Fukuda

    2018-05-01

    Full Text Available In recognition of the central importance of surveillance and epidemiology in the control of antimicrobial resistance and the need to strengthen surveillance at all levels, Wellcome has brought together a new international expert group SEDRIC (Surveillance and Epidemiology of Drug Resistant Infections Consortium. SEDRIC aims to advance and transform the ways of tracking, sharing and analysing rates of infection and drug resistance, burden of disease, information on antibiotic use, opportunities for preventative measures such as vaccines, and contamination of the environment. SEDRIC will strengthen the availability of information needed to monitor and track risks, including an evaluation of access to, and utility of data generated by pharma and research activities, and will support the translation of surveillance data into interventions, changes in policy and more effective practices. Ways of working will include the provision of independent scientific analysis, advocacy and expert advice to groups, such as the Wellcome Drug Resistant Infection Priority Programme. A priority for SEDRIC’s first Working Group is to review mechanisms to strengthen the generation, collection, collation and dissemination of high quality data, together with the need for creativity in the use of existing data and proxy measures, and linking to existing in-country networking infrastructure. SEDRIC will also promote the translation of technological innovations into public health solutions.

  7. The EBR-II materials-surveillance program. 5: Results of SURV-5

    International Nuclear Information System (INIS)

    Ruther, W.E.; Staffon, J.D.; Carlson, B.G.; Allen, T.R.

    1998-01-01

    In March of 1965, a set of surveillance (SURV) samples was placed in the EBR-II reactor to determine the effect of irradiation, thermal aging, and sodium corrosion on reactor materials. Eight subassemblies were placed into row 12 positions of EBR-II to determine the effect of irradiation at 370 C. Two subassemblies were placed into the primary sodium basket to determine the effect of thermal aging at 370 C. One half of all samples were exposed to primary system sodium while one half were sealed in capsules with a helium atmosphere. Fifteen different structural materials were tested in the SURV program. In this work, the properties of these materials irradiated at 370 C to a total fluence of 3.2 x 10 22 n/cm 2 were determined. These materials are the fifth set of irradiated subassemblies to be examined as part of the SURV program (SURV-5). The properties analyzed were weight, density, microstructure, hardness, tensile and yield strength, and fracture resistance. Of all the alloys examined in SURV-5, only Berylco-25 showed any significant weight loss. Stainless steel (both 304 and 347) had the largest density decrease, although the density decrease from irradiation for all alloys was less than 0.4 percent. The microstructure of both Berylco-25 and the aluminum-bronze alloy was altered significantly. Iron- and nickel-base alloys showed little change in microstructure. Austenitic steels (304 and 347) harden with irradiation. The hardness of Inconel X750 did not change significantly with irradiation. The ultimate tensile strength of Inconel X750, 304 stainless steel, 420 stainless steel and welded 304 changed little due to a fluence increase from 2.2 x 10 22 n/cm 2 (the maximum fluence of the SURV-4 samples) to 3.2 x 10 22 n/cm 2

  8. Annual summary report on the surveillance and maintenance activities for the Oak Rige National Laboratory Environmental Restoration Program for fiscal year 1995

    International Nuclear Information System (INIS)

    1995-11-01

    This Annual Summary Report on the Surveillance and Maintenance Activities for the Oak Ridge National Laboratory Environmental Restoration Program for Fiscal Year 1995 was prepared to communicate the accomplishments of the Program during fiscal year 1995. This work was performed under work breakdown structure element 1.4.12.6.1.14.20 (activity data sheet 3314, ''Remedial Action Surveillance and Maintenance''). Publication of this document meets the Life Cycle Baseline milestone date of November 30, 1995. This document provides the accomplishments for both the Remedial Action and Decontamination and Decommissioning Surveillance and Maintenance programs

  9. Annual summary report of the Decontamination and Decommissioning Surveillance and Maintenance Program at Oak Ridge National Laboratory for period ending September 30, 1994

    International Nuclear Information System (INIS)

    Anderson, L.A.; Burwinkle, T.W.; Ford, M.K.; Gaddis, H.R.; Holder, L. Jr.; Mandry, G.J.; Nelson, T.R.; Patton, B.D.

    1995-03-01

    The Surplus Facilities Management Program (SFMP) was established at Oak Ridge National Laboratory (ORNL) in 1976 to provide collective management of all surplus sites under ORNL's control on the Oak Ridge Reservation. Presently, over 50 facilities, grouped into projects, are currently managed by the Decontamination and Decommissioning Program, the successor program to the SFMP. Support includes (1) surveillance and maintenance planning; (2) routine surveillance and maintenance; and (3) special maintenance projects. This report documents routine surveillance and maintenance, special projects, and special maintenance performed on these facilities for the period of October 1993 through September 1994

  10. Country-wide surveillance of molecular markers of antimalarial drug resistance in Senegal by use of positive Malaria Rapid Diagnostic Tests

    DEFF Research Database (Denmark)

    Ndiaye, Magatte; Sow, Doudou; Nag, Sidsel

    2017-01-01

    of drug resistance. Therefore, surveillance of drug resistance in the malaria parasites is essential. The objective of this pilot study was to test the feasibility of routinely sampled malaria rapid diagnostic tests (RDTs) at a national scale to assess the temporal changes in the molecular profiles...... of antimalarial drug resistance markers of Plasmodium falciparum parasites. Overall, 9,549 positive malaria RDTs were collected from 14 health facilities across the country. A limited random set of RDTs were analyzed regarding Pfcrt gene polymorphisms at codon 72-76. Overall, a high but varied prevalence (> 50...

  11. HIV Drug Resistance Surveillance in Honduras after a Decade of Widespread Antiretroviral Therapy.

    Science.gov (United States)

    Avila-Ríos, Santiago; García-Morales, Claudia; Tapia-Trejo, Daniela; Meza, Rita I; Nuñez, Sandra M; Parham, Leda; Flores, Norma A; Valladares, Diana; Pineda, Luisa M; Flores, Dixiana; Motiño, Roxana; Umanzor, Víctor; Carbajal, Candy; Murillo, Wendy; Lorenzana, Ivette; Palou, Elsa Y; Reyes-Terán, Gustavo

    2015-01-01

    We assessed HIV drug resistance (DR) in individuals failing ART (acquired DR, ADR) and in ART-naïve individuals (pre-ART DR, PDR) in Honduras, after 10 years of widespread availability of ART. 365 HIV-infected, ART-naïve, and 381 ART-experienced Honduran individuals were enrolled in 5 reference centres in Tegucigalpa, San Pedro Sula, La Ceiba, and Choluteca between April 2013 and April 2015. Plasma HIV protease-RT sequences were obtained. HIVDR was assessed using the WHO HIVDR mutation list and the Stanford algorithm. Recently infected (RI) individuals were identified using a multi-assay algorithm. PDR to any ARV drug was 11.5% (95% CI 8.4-15.2%). NNRTI PDR prevalence (8.2%) was higher than NRTI (2.2%) and PI (1.9%, p500 vs. Honduras remains at the intermediate level, after 10 years of widespread availability of ART. Evidence of ADR influencing the presence of PDR was observed by phylogenetic analyses and ADR/PDR mutation frequency correlations.

  12. Adaptive Programming Improves Outcomes in Drug Court: An Experimental Trial.

    Science.gov (United States)

    Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Croft, Jason R

    2012-04-01

    Prior studies in Drug Courts reported improved outcomes when participants were matched to schedules of judicial status hearings based on their criminological risk level. The current experiment determined whether incremental efficacy could be gained by periodically adjusting the schedule of status hearings and clinical case-management sessions in response to participants' ensuing performance in the program. The adjustments were made pursuant to a priori criteria specified in an adaptive algorithm. Results confirmed that participants in the full adaptive condition (n = 62) were more than twice as likely as those assigned to baseline-matching only (n = 63) to be drug-abstinent during the first 18 weeks of the program; however, graduation rates and the average time to case resolution were not significantly different. The positive effects of the adaptive program appear to have stemmed from holding noncompliant participants more accountable for meeting their attendance obligations in the program. Directions for future research and practice implications are discussed.

  13. Studies and research concerning BNFP: process monitoring and process surveillance demonstration program

    Energy Technology Data Exchange (ETDEWEB)

    Kight, H R

    1979-11-01

    Computerized methods of monitoring process functions and alarming off-standard conditions were implemented and demonstrated during the FY 1979 Uranium Run. In addition, prototype applications of instruments for the purpose of tamper indication and surveillance were tested.

  14. Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP.

    Science.gov (United States)

    Colombo, Arnaldo L; Janini, Mario; Salomão, Reinaldo; Medeiros, Eduardo A S; Wey, Sergio B; Pignatari, Antonio C C

    2009-09-01

    Several epidemiological changes have occurred in the pattern of nosocomial and community acquired infectious diseases during the past 25 years. Social and demographic changes possibly related to this phenomenon include a rapid population growth, the increase in urban migration and movement across international borders by tourists and immigrants, alterations in the habitats of animals and arthropods that transmit disease, as well as the raise of patients with impaired host defense abilities. Continuous surveillance programs of emergent pathogens and antimicrobial resistance are warranted for detecting in real time new pathogens, as well as to characterize molecular mechanisms of resistance. In order to become more effective, surveillance programs of emergent pathogens should be organized as a multicenter laboratory network connected to the main public and private infection control centers. Microbiological data should be integrated to guide therapy, adapting therapy to local ecology and resistance patterns. This paper presents an overview of data generated by the Division of Infectious Diseases, Federal University of São Paulo, along with its participation in different surveillance programs of nosocomial and community acquired infectious diseases.

  15. Drug Use among Seniors on Public Drug Programs in Canada, 2012.

    Science.gov (United States)

    Proulx, Jeff; Hunt, Jordan

    2015-01-01

    Seniors take more drugs than younger Canadians because, on average, they have a higher number of chronic conditions. Although taking multiple medications may be necessary to manage these conditions, it is important to consider the benefits and risks of each medication and the therapeutic goals of the patient. This article provides an in-depth look at the number and types of drugs used by seniors using drug claims data from the CIHI's National Prescription Drug Utilization Information System Database, representing approximately 70% of seniors in Canada. In 2012, almost two-thirds (65.9%) of seniors on public drug programs had claims for five or more drug classes, while 27.2% had claims for 10 or more, and 8.6% had claims for 15 or more. The most commonly used drug class was statins, used by nearly half (46.6%) of seniors. Nearly two-thirds (60.9%) of seniors living in long-term care (LTC) facilities had claims for 10 or more drug classes. Proton pump inhibitors were the most commonly used drug class among seniors living in LTC facilities (used by 37.0% of seniors in LTC facilities), while statins ranked seventh (29.8%).

  16. Facility Decontamination and Decommissioning Program Surveillance and Maintenance Plan, Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Poderis, Reed J. [NSTec; King, Rebecca A. [NSTec

    2013-09-30

    This Surveillance and Maintenance (S&M) Plan describes the activities performed between deactivation and final decommissioning of the following facilities located on the Nevada National Security Site, as documented in the Federal Facility Agreement and Consent Order under the Industrial Sites program as decontamination and decommissioning sites: ? Engine Maintenance, Assembly, and Disassembly (EMAD) Facility: o EMAD Building (Building 25-3900) o Locomotive Storage Shed (Building 25-3901) ? Test Cell C (TCC) Facility: o Equipment Building (Building 25-3220) o Motor Drive Building (Building 25-3230) o Pump Shop (Building 25-3231) o Cryogenic Lab (Building 25-3232) o Ancillary Structures (e.g., dewars, water tower, piping, tanks) These facilities have been declared excess and are in various stages of deactivation (low-risk, long-term stewardship disposition state). This S&M Plan establishes and implements a solid, cost-effective, and balanced S&M program consistent with federal, state, and regulatory requirements. A graded approach is used to plan and conduct S&M activities. The goal is to maintain the facilities in a safe condition in a cost-effective manner until their final end state is achieved. This plan accomplishes the following: ? Establishes S&M objectives and framework ? Identifies programmatic guidance for S&M activities to be conducted by National Security Technologies, LLC, for the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) ? Provides present facility condition information and identifies hazards ? Identifies facility-specific S&M activities to be performed and their frequency ? Identifies regulatory drivers, NNSA/NFO policies and procedures, and best management practices that necessitate implementation of S&M activities ? Provides criteria and frequencies for revisions and updates ? Establishes the process for identifying and dispositioning a condition that has not been previously identified or

  17. The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks.

    Science.gov (United States)

    Witt, Clara J; Richards, Allen L; Masuoka, Penny M; Foley, Desmond H; Buczak, Anna L; Musila, Lillian A; Richardson, Jason H; Colacicco-Mayhugh, Michelle G; Rueda, Leopoldo M; Klein, Terry A; Anyamba, Assaf; Small, Jennifer; Pavlin, Julie A; Fukuda, Mark M; Gaydos, Joel; Russell, Kevin L; Wilkerson, Richard C; Gibbons, Robert V; Jarman, Richard G; Myint, Khin S; Pendergast, Brian; Lewis, Sheri; Pinzon, Jorge E; Collins, Kathrine; Smith, Matthew; Pak, Edwin; Tucker, Compton; Linthicum, Kenneth; Myers, Todd; Mansour, Moustafa; Earhart, Ken; Kim, Heung Chul; Jiang, Ju; Schnabel, Dave; Clark, Jeffrey W; Sang, Rosemary C; Kioko, Elizabeth; Abuom, David C; Grieco, John P; Richards, Erin E; Tobias, Steven; Kasper, Matthew R; Montgomery, Joel M; Florin, Dave; Chretien, Jean-Paul; Philip, Trudy L

    2011-03-04

    The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program's ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia.

  18. An exploration of counterfeit medicine surveillance strategies guided by geospatial analysis: lessons learned from counterfeit Avastin detection in the US drug supply chain.

    Science.gov (United States)

    Cuomo, Raphael E; Mackey, Tim K

    2014-12-02

    To explore healthcare policy and system improvements that would more proactively respond to future penetration of counterfeit cancer medications in the USA drug supply chain using geospatial analysis. A statistical and geospatial analysis of areas that received notices from the Food and Drug Administration (FDA) about the possibility of counterfeit Avastin penetrating the US drug supply chain. Data from FDA warning notices were compared to data from 44 demographic variables available from the US Census Bureau via correlation, means testing and geospatial visualisation. Results were interpreted in light of existing literature in order to recommend improvements to surveillance of counterfeit medicines. This study analysed 791 distinct healthcare provider addresses that received FDA warning notices across 30,431 zip codes in the USA. Statistical outputs were Pearson's correlation coefficients and t values. Geospatial outputs were cartographic visualisations. These data were used to generate the overarching study outcome, which was a recommendation for a strategy for drug safety surveillance congruent with existing literature on counterfeit medication. Zip codes with greater numbers of individuals age 65+ and greater numbers of ethnic white individuals were most correlated with receipt of a counterfeit Avastin notice. Geospatial visualisations designed in conjunction with statistical analysis of demographic variables appeared more capable of suggesting areas and populations that may be at risk for undetected counterfeit Avastin penetration. This study suggests that dual incorporation of statistical and geospatial analysis in surveillance of counterfeit medicine may be helpful in guiding efforts to prevent, detect and visualise counterfeit medicines penetrations in the US drug supply chain and other settings. Importantly, the information generated by these analyses could be utilised to identify at-risk populations associated with demographic characteristics

  19. Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program

    Science.gov (United States)

    Zacharia, Brad E.; Bruce, Samuel S.; Goldstein, Hannah; Malone, Hani R.; Neugut, Alfred I.; Bruce, Jeffrey N.

    2012-01-01

    Craniopharyngioma is a rare primary central nervous system neoplasm. Our objective was to determine factors associated with incidence, treatment, and survival of craniopharyngiomas in the United States. We used the surveillance, epidemiology and end results program (SEER) database to identify patients who received a diagnosis of craniopharyngioma during 2004–2008. We analyzed clinical and demographic information, including age, race, sex, tumor histology, and treatment. Age-adjusted incidence rates and age, sex, and race-adjusted expected survival rates were calculated. We used Cox proportional hazards models to determine the association between covariates and overall survival. We identified 644 patients with a diagnosis of craniopharyngioma. Black race was associated with an age-adjusted relative risk for craniopharyngioma of 1.26 (95% confidence interval [CI], 0.98–1.59), compared with white race. One- and 3-year survival rates of 91.5% (95% CI, 88.9%–93.5%), and 86.2% (95% CI, 82.7%–89.0%) were observed for the cohort; relative survival rates were 92.1% (95% CI, 89.5%–94.0%) and 87.6% (95% CI, 84.1%–90.4%) for 1- and 3-years, respectively. In the multivariable model, factors associated with prolonged survival included younger age, smaller tumor size, subtotal resection, and radiation therapy. Black race, on the other hand, was associated with worse overall survival in the final model. We demonstrated that >85% of patients survived 3 years after diagnosis and that subtotal resection and radiation therapy were associated with prolonged survival. We also noted a higher incidence rate and worse 1- and 3-year survival rates in the black population. Future investigations should examine these racial disparities and focus on evaluating the efficacy of emerging treatment paradigms. PMID:22735773

  20. Feasibility and acceptability of a workers' health surveillance program for hospital physicians.

    Science.gov (United States)

    Ruitenburg, Martijn M; Plat, Marie-Christine J; Frings-Dresen, Monique H W; Sluiter, Judith K

    2015-01-01

    A Workers' Health Surveillance (WHS) program is an occupational health strategy used to detect and address the health of individual workers to improve their ability to work. This study aims to investigate the feasibility and acceptability of a new job-specific WHS for hospital physicians. All hospital physicians of the general surgery, radiotherapy and obstetrics and gynecology departments from 1 academic hospital were invited to participate in the WHS by the in-company occupational health service. An occupational physician and a medical assistant were trained to use the protocol. Feasibility was operationalized as the received and delivered dose, observed success factors and potential obstacles. Acceptability was assessed by asking whether the WHS was desirable and feasible for future use and by estimating the effects on health and work ability. Written questions and semi-structured interviews were conducted with the participating physicians, 5 department managers and the 2 occupational health professionals involved in the study. One-third of the hospital physicians (34%) participated in every part of the WHS. The delivered dose was 77/84 (92%). Almost all hospital physicians who received recommendations expected to adhere to this advice. The study participants appreciated the organization of the WHS. This WHS was positively graded (8 out of 10 max) in terms of acceptability. Positive effects of the WHS on health, work functioning and long-term work ability were perceived by 2/3 of the physicians. The new job-specific WHS for hospital physicians showed good feasibility and acceptability among participating hospital physicians, occupational health professionals and medical managers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. Feasibility and acceptability of a workers’ health surveillance program for hospital physicians

    Directory of Open Access Journals (Sweden)

    Martijn M. Ruitenburg

    2015-08-01

    Full Text Available Objectives: A Workers’ Health Surveillance (WHS program is an occupational health strategy used to detect and address the health of individual workers to improve their ability to work. This study aims to investigate the feasibility and acceptability of a new job-specific WHS for hospital physicians. Material and Methods: All hospital physicians of the general surgery, radiotherapy and obstetrics and gynecology departments from 1 academic hospital were invited to participate in the WHS by the in-company occupational health service. An occupational physician and a medical assistant were trained to use the protocol. Feasibility was operationalized as the received and delivered dose, observed success factors and potential obstacles. Acceptability was assessed by asking whether the WHS was desirable and feasible for future use and by estimating the effects on health and work ability. Written questions and semi-structured interviews were conducted with the participating physicians, 5 department managers and the 2 occupational health professionals involved in the study. Results: One-third of the hospital physicians (34% participated in every part of the WHS. The delivered dose was 77/84 (92%. Almost all hospital physicians who received recommendations expected to adhere to this advice. The study participants appreciated the organization of the WHS. This WHS was positively graded (8 out of 10 max in terms of acceptability. Positive effects of the WHS on health, work functioning and long-term work ability were perceived by 2/3 of the physicians. Conclusions: The new job-specific WHS for hospital physicians showed good feasibility and acceptability among participating hospital physicians, occupational health professionals and medical managers.

  2. An Impact Evaluation of a Rural Youth Drug Education Program.

    Science.gov (United States)

    Sarvela, Paul D.; McClendon, E. J.

    1987-01-01

    Examined effects of mixed affective-cognitive drug education program on rural northern Michigan and northeastern Wisconsin sixth and seventh graders' (N=265) substance use health beliefs and behaviors. Alcohol use in this population was determined to be much higher than national average for similar age groups while marijuana, cigarette, and…

  3. Lawrence Livermore National Laboratory (LLNL) Oxide Material Representation in the Material Identification and Surveillance (MIS) Program, Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Riley, D C; Dodson, K

    2004-06-30

    The Materials Identification and Surveillance (MIS) program was established within the 94-1 R&D Program to confirm the suitability of plutonium-bearing materials for stabilization, packaging, and long-term storage under DOE-STD-3013-2000. Oxide materials from different sites were chemically and physically characterized. The adequacy of the stabilization process parameters of temperature and duration at temperature (950 C and 2 hours) for eliminating chemical reactivity and reducing the moisture content to less than 0.5 weight percent were validated. Studies also include surveillance monitoring to determine the behavior of the oxides and packaging materials under storage conditions. Materials selected for this program were assumed to be representative of the overall inventory for DOE sites. The Quality Assurance section of the DOE-STD-3013-2000 required that each site be responsible for assuring that oxides packaged according to this standard are represented by items in the MIS characterization program. The purpose of this document is to define the path for determining if an individual item is ''represented'' in the MIS Program and to show that oxides being packaged at Lawrence Livermore National Laboratory (LLNL) are considered represented in the MIS program. The methodology outlined in the MIS Representation Document (LA-14016-MS) for demonstrating representation requires concurrence of the MIS working Group (MIS-WG). The signature page on this document provides for the MIS-WG concurrence.

  4. Airborne Video Surveillance

    National Research Council Canada - National Science Library

    Blask, Steven

    2002-01-01

    The DARPA Airborne Video Surveillance (AVS) program was established to develop and promote technologies to make airborne video more useful, providing capabilities that achieve a UAV force multiplier...

  5. DVT surveillance program in the ICU: analysis of cost-effectiveness.

    Directory of Open Access Journals (Sweden)

    Ajai K Malhotra

    Full Text Available BACKGROUND: Venous Thrombo-embolism (VTE--Deep venous thrombosis (DVT and/or pulmonary embolism (PE--in traumatized patients causes significant morbidity and mortality. The current study evaluates the effectiveness of DVT surveillance in reducing PE, and performs a cost-effectiveness analysis. METHODS: All traumatized patients admitted to the adult ICU underwent twice weekly DVT surveillance by bilateral lower extremity venous Duplex examination (48-month surveillance period--SP. The rates of DVT and PE were recorded and compared to the rates observed in the 36-month pre-surveillance period (PSP. All patients in both periods received mechanical and pharmacologic prophylaxis unless contraindicated. Total costs--diagnostic, therapeutic and surveillance--for both periods were recorded and the incremental cost for each Quality Adjusted Life Year (QALY gained was calculated. RESULTS: 4234 patients were eligible (PSP--1422 and SP--2812. Rate of DVT in SP (2.8% was significantly higher than in PSP (1.3% - p<0.05, and rate of PE in SP (0.7% was significantly lower than that in PSP (1.5% - p<0.05. Logistic regression demonstrated that surveillance was an independent predictor of increased DVT detection (OR: 2.53 - CI: 1.462-4.378 and decreased PE incidence (OR: 0.487 - CI: 0.262-0.904. The incremental cost was $509,091/life saved in the base case, translating to $29,102/QALY gained. A sensitivity analysis over four of the parameters used in the model indicated that the incremental cost ranged from $18,661 to $48,821/QALY gained. CONCLUSIONS: Surveillance of traumatized ICU patients increases DVT detection and reduces PE incidence. Costs in terms of QALY gained compares favorably with other interventions accepted by society.

  6. Study of operational conditions in medical radiodiagnostic services - ionizing radiation surveillance program in Sao Paulo State, Brazil

    International Nuclear Information System (INIS)

    Aldred, Marta Aurelia; Eduardo, Maria Bernardete de Paula; Carvalho, Marisa Lima

    1996-01-01

    A radiation surveillance program was created in Sao Paulo State (Brazil) in 1994 to identify the risks in health care services. A total number of 259 centres were visited and 411 radiodiagnostic rooms were inspected. During the survey an 'inspection form' of 32 items was filled in. Analysis of the answers classified 24% of services as high risk, 22% of rooms showed irregular installations, 25% of X-ray equipment presented problems and 22% of personnel used inadequate procedures. Additional and regular surveys were programmed for the services considered of high risk in order to reduce it

  7. The new classification system for slaughter-pig herds in the Danish Salmonella surveillance-and-control program

    DEFF Research Database (Denmark)

    Alban, L.; Stege, Helle; Dahl, J.

    2002-01-01

    the Danish Salmonella Database including all herds in 2000. The classification scheme has been adjusted on the following points. (1) The sampling has been simplified into 60, 75, or 100 samples per herd per year depending on herd size. This means more-precise estimates for the seroprevalence among smaller......The Danish surveillance-and-control program for Salmonella in slaughter pigs was introduced in 1995. The key element of the program is a quick and correct identification of herds with high seroprevalence. After 5 years, the classification scheme was evaluated-and a revision was made. Data from two...

  8. Surveillance of transmitted antiretroviral drug resistance among HIV-1 infected women attending antenatal clinics in Chitungwiza, Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Mqondisi Tshabalala

    Full Text Available The rapid scale-up of highly active antiretroviral therapy (HAART and use of single dose Nevirapine (SD NVP for prevention of mother-to-child transmission (pMTCT have raised fears about the emergence of resistance to the first line antiretroviral drug regimens. A cross-sectional study was conducted to determine the prevalence of primary drug resistance (PDR in a cohort of young (<25 yrs HAART-naïve HIV pregnant women attending antenatal clinics in Chitungwiza, Zimbabwe. Whole blood was collected in EDTA for CD4 counts, viral load, serological estimation of duration of infection using the BED Calypte assay and genotyping for drug resistance. Four hundred and seventy-one women, mean age 21 years; SD: 2.1 were enrolled into the study between 2006 and 2007. Their median CD4 count was 371cells/µL; IQR: 255-511 cells/µL. Two hundred and thirty-six samples were genotyped for drug resistance. Based on the BED assay, 27% were recently infected (RI whilst 73% had long-term infection (LTI. Median CD4 count was higher (p<0.05 in RI than in women with LTI. Only 2 women had drug resistance mutations; protease I85V and reverse transcriptase Y181C. Prevalence of PDR in Chitungwiza, 4 years after commencement of the national ART program remained below WHO threshold limit (5%. Frequency of recent infection BED testing is consistent with high HIV acquisition during pregnancy. With the scale-up of long-term ART programs, maintenance of proper prescribing practices, continuous monitoring of patients and reinforcement of adherence may prevent the acquisition and transmission of PDR.

  9. The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks

    Science.gov (United States)

    2011-01-01

    The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program’s ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia. PMID:21388561

  10. Transmitted antiretroviral drug resistance in New York State, 2006-2008: results from a new surveillance system.

    Directory of Open Access Journals (Sweden)

    Adam C Readhead

    Full Text Available HIV transmitted drug resistance (TDR is a public health concern because it has the potential to compromise antiretroviral therapy (ART at the population level. In New York State, high prevalence of TDR in a local cohort and a multiclass resistant case cluster led to the development and implementation of a statewide resistance surveillance system.We conducted a cross-sectional analysis of the 13,109 cases of HIV infection that were newly diagnosed and reported in New York State between 2006 and 2008, including 4,155 with HIV genotypes drawn within 3 months of initial diagnosis and electronically reported to the new resistance surveillance system. We assessed compliance with DHHS recommendations for genotypic resistance testing and estimated TDR among new HIV diagnoses.Of 13,109 new HIV diagnoses, 9,785 (75% had laboratory evidence of utilization of HIV-related medical care, and 4,155 (43% had a genotype performed within 3 months of initial diagnosis. Of these, 11.2% (95% confidence interval [CI], 10.2%-12.1% had any evidence of TDR. The proportion with mutations associated with any antiretroviral agent in the NNRTI, NRTI or PI class was 6.3% (5.5%-7.0%, 4.3% (3.6%-4.9% and 2.9% (2.4%-3.4%, respectively. Multiclass resistance was observed in <1%. TDR did not increase significantly over time (p for trend = 0.204. Men who have sex with men were not more likely to have TDR than persons with heterosexual risk factor (OR 1.0 (0.77-1.30. TDR to EFV+TDF+FTC and LPV/r+TDF+FTC regimens was 7.1% (6.3%-7.9% and 1.4% (1.0%-1.8%, respectively.TDR appears to be evenly distributed and stable among new HIV diagnoses in New York State; multiclass TDR is rare. Less than half of new diagnoses initiating care received a genotype per DHHS guidelines.

  11. Status report - The Canadian Hospitals Injury Reporting and Prevention Program: a dynamic and innovative injury surveillance system

    Directory of Open Access Journals (Sweden)

    J. Crain

    2016-06-01

    Full Text Available This status report on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, an emergency department-based injury and poisoning surveillance system, describes the result of migrating from a centralized data entry and coding process to a decentralized process, the web-based eCHIRPP system, in 2011. This secure system is improving the CHIRPP’s overall flexibility and timeliness, which are key attributes of an effective surveillance system. The integrated eCHIRPP platform enables near real-time data entry and access, has user-friendly data management and analysis tools, and allows for easier communication and connectivity across the CHIRPP network through an online collaboration centre. Current pilot testing of automated data monitoring and trend analysis tools—designed to monitor and flag incoming data according to predefined criteria (for example, a new consumer product—is revealing eCHIRPP’s potential for providing early warnings of new hazards, issues and trends.

  12. FAMILY HEALTH PROGRAM: CHALLENGES AND POTENTIALITIES REGARDING DRUGS USE

    Directory of Open Access Journals (Sweden)

    Marcelle Aparecida de Barros

    2006-04-01

    Full Text Available ABSTRACT: Epidemiological studies on drugs use point towards this phenomenon as a public health problem. Nowadays, the Family Health Program (FHP is presented by the Health Ministry as a model to restructure primary health care and aims to offer family-centered care, permeated by integrality, problem solving and community bonds. This article aims to discuss action possibilities of Family Health Care professionals involving drugs patients. It is evident that, as opposed to other actions already developed by FHP professionals in other health care areas, which has appeared clearly and objectively. This fact is observed in the daily activities of FHP professionals, which give little attention to drugs-related problems. However, research emphasizes that there exists a broad range of action possibilities for FHP professionals. Although other studies evidence this team’s fragilities in terms of care for drugs users, these can be overcome by investing in the training and valuation of these professionals. KEY WORDS: Family Health Program; Street drugs; Health Knowledge, Attitudes, Practice.

  13. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  14. Drug Assessment Program; A Community Guide. The Drug Abuse Council Handbook Series, No. 2.

    Science.gov (United States)

    Blair, Louis H.; Sessler, John

    Addiction to illicit hard drugs, and particularly opiates, has increased in the past few years. Yet, there are few comprehensive evaluations of the treatment systems, and there is little systematic planning for programs to meet current and anticipated changes in the community's need for treatment. This report has been written to assist community…

  15. 28 CFR 550.44 - Procedures for arranging drug counseling.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures for arranging drug counseling... MANAGEMENT DRUG PROGRAMS Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.44 Procedures for arranging drug counseling. The contract center staff shall hold a program...

  16. Influence of border disease virus (BDV) on serological surveillance within the bovine virus diarrhea (BVD) eradication program in Switzerland.

    Science.gov (United States)

    Kaiser, V; Nebel, L; Schüpbach-Regula, G; Zanoni, R G; Schweizer, M

    2017-01-13

    In 2008, a program to eradicate bovine virus diarrhea (BVD) in cattle in Switzerland was initiated. After targeted elimination of persistently infected animals that represent the main virus reservoir, the absence of BVD is surveilled serologically since 2012. In view of steadily decreasing pestivirus seroprevalence in the cattle population, the susceptibility for (re-) infection by border disease (BD) virus mainly from small ruminants increases. Due to serological cross-reactivity of pestiviruses, serological surveillance of BVD by ELISA does not distinguish between BVD and BD virus as source of infection. In this work the cross-serum neutralisation test (SNT) procedure was adapted to the epidemiological situation in Switzerland by the use of three pestiviruses, i.e., strains representing the subgenotype BVDV-1a, BVDV-1h and BDSwiss-a, for adequate differentiation between BVDV and BDV. Thereby the BDV-seroprevalence in seropositive cattle in Switzerland was determined for the first time. Out of 1,555 seropositive blood samples taken from cattle in the frame of the surveillance program, a total of 104 samples (6.7%) reacted with significantly higher titers against BDV than BVDV. These samples originated from 65 farms and encompassed 15 different cantons with the highest BDV-seroprevalence found in Central Switzerland. On the base of epidemiological information collected by questionnaire in case- and control farms, common housing of cattle and sheep was identified as the most significant risk factor for BDV infection in cattle by logistic regression. This indicates that pestiviruses from sheep should be considered as a source of infection of domestic cattle and might well impede serological BVD surveillance.

  17. El Sistema Cubano de Farmacovigilancia: seis años de experiencia en la detección de efectos adversos The Cuban system of drug surveillance: six years of experience in detecting adverse effects

    Directory of Open Access Journals (Sweden)

    Giset Jiménez López

    2006-04-01

    , teaching, drug information, therapeutic consultation, program for the rational utilization of drugs (PURMED and drug surveillance with the National Coordinating Unit. The objective of this paper was to present the main working results achieved in 6 years after the creation of this drug surveillance system. A retrospective descriptive study was performed to characterize the reports of suspected adverse reactions from the National Coordinating Unit of Drug Surveillance. In the period, 89 540 notifications of adverse drug reactions were received for an average of 17 908 notifications per year, and a report rate of more than 1000 notifications per 1 million inhabitants. These results reflected a regular behaviour in some of these indicators like the predominance of adverse effects in females, affected skin and digestive system as the most reported reactions and the prevalence of antimicrobials, non-steroidal antinflammatory drugs and antihypertensive drugs as the pharmacological groups with more reactions. Similarly, the number of less frequent adverse drug reactions has increased and serious adverse effects have been followed-up. Drug surveillance continue to be a very dynamic scientific and clinical discipline worldwide, being indispensable to face the possible problems of an armory of drugs that does not cease to grow in potency and variety. Therefore, it is necessary that, as soon as adverse effects or toxicity signs occur - mainly if they have not been yet classified - they must be notified and analyzed, and then the importance of the episode should be adequately reported to corresponding health professionals

  18. Air surveillance

    International Nuclear Information System (INIS)

    Patton, G.W.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995)

  19. Air surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Patton, G.W.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  20. 76 FR 18072 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2011-04-01

    ... Workplace Drug and Alcohol Testing Programs CFR Correction In Title 49 of the Code of Federal Regulations...) * * * (2) * * * (i) Positive, with drug(s)/metabolite(s) noted, with numerical values for the drug(s) or drug metabolite(s). (ii) Positive-dilute, with drug(s)/metabolite(s) noted, with numerical values for...

  1. 14 CFR 91.1047 - Drug and alcohol misuse education program.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Drug and alcohol misuse education program... Ownership Operations Program Management § 91.1047 Drug and alcohol misuse education program. (a) Each... instructor, or aircraft maintenance duties with drug and alcohol misuse education. (b) No program manager may...

  2. A trial of a job-specific workers' health surveillance program for construction workers: study protocol

    NARCIS (Netherlands)

    Boschman, J.S.; van der Molen, H.F.; van Duivenbooden, C.; Sluiter, J.K.; Frings-Dresen, M.H.W.

    2011-01-01

    Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the

  3. Development of containers sealing system like part of surveillance program of the vessel in nuclear power plants

    International Nuclear Information System (INIS)

    Romero C, J.; Hernandez C, R.; Fernandez T, F.; Rocamontes A, M.; Perez R, N.

    2009-10-01

    The owners of nuclear power plants should be demonstrate that the embrittlement effects by neutronic radiation do not commit the structural integrity from the pressure vessel of nuclear reactors, during conditions of routine operation and below postulate accident. For this reason, there are surveillance programs of vessels of nuclear power plants, in which are present surveillance capsules. A surveillance capsule is compound by the support, six containers for test tubes and dosimeters. The containers for test tubes are of two types: rectangular container for test tubes, Charpy V and Cylindrical Container for tension test tubes. These test tubes are subject to a same or bigger neutronic flow to that of vessel, being representative of vessel mechanical conditions. The test tubes are rehearsed to watch over the increase of embrittlement that presents the vessel. This work describes the development of welding system to seal the containers for test tubes, these should be filled with helium of ultra high purity, to a pressure of an atmosphere. In this system the welding process Gas Tungsten Arc Welding is used, a hermetic camera that allows to place the containers with three grades of freedom, a vacuum subsystem and pressure, high technology equipment's like: power source with integrated computer, arc starter of high frequency, helium flow controller, among others. Finally, the advances in the inspection system for the qualification of sealing system are mentioned, system that should measure the internal pressure of containers and the helium purity inside these. (Author)

  4. Progress and promise for the MDMA drug development program.

    Science.gov (United States)

    Feduccia, Allison A; Holland, Julie; Mithoefer, Michael C

    2018-02-01

    Pharmacotherapy is often used to target symptoms of posttraumatic stress disorder (PTSD), but does not provide definitive treatment, and side effects of daily medication are often problematic. Trauma-focused psychotherapies are more likely than drug treatment to achieve PTSD remission, but have high dropout rates and ineffective for a large percentage of patients. Therefore, research into drugs that might increase the effectiveness of psychotherapy is a logical avenue of investigation. The most promising drug studied as a catalyst to psychotherapy for PTSD thus far is 3,4-methylenedioxymethamphetamine (MDMA), commonly known as the recreational drug "Ecstasy." MDMA stimulates the release of hormones and neurochemicals that affect key brain areas for emotion and memory processing. A series of recently completed phase 2 clinical trials of MDMA-assisted psychotherapy for treatment of PTSD show favorable safety outcomes and large effect sizes that warrant expansion into multi-site phase 3 trials, set to commence in 2018. The nonprofit sponsor of the MDMA drug development program, the Multidisciplinary Association for Psychedelic Studies (MAPS), is supporting these trials to explore whether MDMA, administered on only a few occasions, can increase the effectiveness of psychotherapy. Brain imaging techniques and animal models of fear extinction are elucidating neural mechanisms underlying the robust effects of MDMA on psychological processing; however, much remains to be learned about the complexities of MDMA effects as well as the complexities of PTSD itself.

  5. BAQMAP. Air Quality Monitoring and Surveillance Program for Botswana. Mission 1 Report 4-22 November 1996

    Energy Technology Data Exchange (ETDEWEB)

    Bekkestad, T.; Dreiem, R.; Hermansen, O.; Knudsen, S.

    1996-12-31

    This report is concerned with the start of a joint project between the authorities in Botswana and Norway on the development of an air pollution monitoring and surveillance program for Botswana. NILU will provide assistance in the fields of (1) Siting and establishment of an air pollution monitoring network, (2) Laboratory techniques, methods and routines, (3) Quality control and quality assurance procedures, (4) Emission data bases, (5) Statistical data analysis and reporting, (6) Atmospheric dispersion model estimates for air quality planning and assessment analysis. This is the report of the Norwegian team after their first visit to Botswana. 1 ref., 13 figs., 35 tabs.

  6. BAQMAP. Air Quality Monitoring and Surveillance Program for Botswana. Mission 1 Report 4-22 November 1996

    Energy Technology Data Exchange (ETDEWEB)

    Bekkestad, T; Dreiem, R; Hermansen, O; Knudsen, S

    1997-12-31

    This report is concerned with the start of a joint project between the authorities in Botswana and Norway on the development of an air pollution monitoring and surveillance program for Botswana. NILU will provide assistance in the fields of (1) Siting and establishment of an air pollution monitoring network, (2) Laboratory techniques, methods and routines, (3) Quality control and quality assurance procedures, (4) Emission data bases, (5) Statistical data analysis and reporting, (6) Atmospheric dispersion model estimates for air quality planning and assessment analysis. This is the report of the Norwegian team after their first visit to Botswana. 1 ref., 13 figs., 35 tabs.

  7. Guidance for implementing the long-term surveillance program for UMTRA Project Title I Disposal Sites

    International Nuclear Information System (INIS)

    1996-02-01

    This guidance document has two purposes: it provides guidance for writing site-specific long-term surveillance plans (LTSP) and it describes site surveillance, monitoring, and long-term care techniques for Title I disposal sites of the Uranium Mill Tailings Radiation Control Act (UMTRCA) (42 USC Section 7901 et seq.). Long-term care includes monitoring, maintenance, and emergency measures needed to protect public health and safety and the environment after remedial action is completed. This document applies to the UMTRCA-designated Title I disposal sites. The requirements for long-term care of the Title I sites and the contents of the LTSPs are provided in U.S. Nuclear Regulatory Commission (NRC) regulations (10 CFR Section 40.27) provided in Attachment 1

  8. 75 FR 26183 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-05-11

    ... 2105-AE01 Procedures for Transportation Workplace Drug and Alcohol Testing Programs AGENCY: Office of...: For program issues, Bohdan Baczara, Office of Drug and Alcohol Policy and Compliance, 1200 New Jersey... of Federal Regulations, as follows: [[Page 26184

  9. Reporting and Surveillance for Norovirus Outbreaks

    Science.gov (United States)

    ... Vaccine Surveillance Network (NVSN) Foodborne Diseases Active Surveillance Network (FoodNet) National Outbreak Reporting System (NORS) Estimates of Foodborne Illness in the United States CDC's Vessel Sanitation Program CDC Feature: Surveillance for Norovirus Outbreaks Top ...

  10. The pharmacist and adverse drug reaction reporting.

    Science.gov (United States)

    Pearson, K

    1982-08-01

    During premarketing trials, the number of patients exposed to a drug and the length of exposure to a drug are both limited. After marketing, many thousands, frequently millions, of patients are exposed to the drug over considerably longer periods of time, and adverse drug reactions not previously recognized appear. Because of these factors, postmarketing surveillance is extremely important. Pharmacists can contribute to drug safety and improved patient care by understanding and actively participating in the Food and Drug Administration's Spontaneous Reporting Program.

  11. 75 FR 10272 - Notice Regarding 340B Drug Pricing Program-Contract Pharmacy Services

    Science.gov (United States)

    2010-03-05

    ... Regarding 340B Drug Pricing Program--Contract Pharmacy Services AGENCY: Health Resources and Services... drug pricing program by which manufacturers who sell covered outpatient drugs to particular covered... provisions, which had been previously limited to the Alternative Methods Demonstration Project program. FOR...

  12. 13 CFR 147.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-01-01

    ..., rehabilitation, and employee assistance programs; and (d) The penalties that you may impose upon them for drug...-free awareness program? 147.215 Section 147.215 Business Credit and Assistance SMALL BUSINESS... establish an ongoing drug-free awareness program to inform employees about— (a) The dangers of drug abuse in...

  13. Minutes of the 14th Light Water Reactor Pressure Vessel Surveillance Dosimetry Improvement Program (LWR-PV-SDIP) meeting, October 1-5, 1984

    International Nuclear Information System (INIS)

    1984-01-01

    Topics discussed include: ASTM LWR standards; trend curves, PSF, and other test reactor metallurgical programs; PSF dosimetry and metallurgical capsule neutron and gamma characterization and metallurgical studies; PVS characterization program; other neutron fields; Surveillance Dosimetry Measurement Facility (SDMF) and perturbation studies; transport theory calculations; gamma field benchmarks and photo-reaction studies; and fission and non-fission sensor inventories and quality assurance

  14. FY 1994 annual summary report of the surveillance and maintenance activities for the Oak Ridge National Laboratory Environmental Restoration Program

    International Nuclear Information System (INIS)

    1994-11-01

    The Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Surveillance and Maintenance (S and M) Program was initiated to manage former waste management and environmental research sites contaminated with radioactive materials and/or hazardous chemicals. The S and M Program is responsible for managing designated sites/facilities from the end of their operating lives until final disposition or site stabilization. To effectively manage and perform the various S and M Program responsibilities, five summary-level work breakdown structure (WBS) elements have been established: S and M Preliminary Investigations, Special Projects, Routine S and M, Inactive Groundwater Wells, and Project Management. Routine S and M activities were conducted as scheduled throughout fiscal years (FY) 1994 at applicable inactive waste management (WM) and other contaminated areas. Overall, the ER S and M Program maintains 47 facilities, performs vegetation maintenance on approximately 230 acres, maintains 54 inactive tanks, and provides overall site management on over 700 acres. In addition to the routine S and M activities, detailed site inspections were conducted at established frequencies on appropriate sites in the ER S and M Program. This document provides a summary of the FY 1994 ORNL ER S and M Program accomplishments

  15. U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

  16. BAQMAP Air Quality Monitoring and Surveillance Program for Botswana. Mission 2 Report 27 January - 18 February 1997

    Energy Technology Data Exchange (ETDEWEB)

    Bekkestad, T.

    1997-12-31

    This report is concerned with Mission 2 of a joint project between the authorities in Botswana and Norway on the development of an air pollution monitoring and surveillance program for Botswana. Mission 2 was undertaken as part of the annual meeting on 4 February 1997. Discussions and decision on the air quality program was performed after the annual meeting. Passive samplers for SO{sub 2} and NO{sub 2} were installed in Selebi-Phikwe and Francistown. The samplers measured air pollution from the BCL smelter and traffic, respectively, during the first two weeks of February 1997. The samplers have been analysed and the results are given in this report, which also includes a status report. 13 tabs.

  17. Standardized physics-dosimetry for US pressure vessel cavity surveillance programs

    International Nuclear Information System (INIS)

    Ruddy, F.H.; McElroy, W.N.; Lippincott, E.P.

    1984-01-01

    This paper summarizes the applications of ASTM standard methods, guides and practices to define the selection and deployment of recommended dosimetry sets, the selection of dosimetry capsules and thermal neutron shields, the placement of dosimetry, the methods of measurement of dosimetry sensor reaction products, data analysis procedures, and uncertainty evaluation procedures. It also describes the validation of these standards both by in-reactor testing of advanced PV cavity surveillance physics-dosimetry and by data development. The use of these standards to guide selection and development of advanced dosimetry sets for commercial reactors is also summarized. (Auth.)

  18. A Census of Prison-Based Drug Treatment Programs: Implications for Programming, Policy, and Evaluation

    Science.gov (United States)

    Welsh, Wayne N.; Zajac, Gary

    2004-01-01

    Despite a growing realization that unmeasured programmatic differences influence prison-based drug treatment effectiveness, few attempts to systematically measure such differences have been made. To improve program planning and evaluation in this area, we developed a census instrument to collect descriptive information about 118 prison-based drug…

  19. Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009.

    Science.gov (United States)

    Kwon, Soon-Chan; Song, Jaechul; Kim, Yong-Kyu; Calvert, Geoffrey M

    2015-01-01

    To determine the incidence and epidemiological characteristics of work-related asthma in Korea. During 2004-2009, the Korea Work-Related Asthma Surveillance (KOWAS) program collected data on new cases of work-related asthma from occupational physicians, allergy and chest physicians, regional surveillance systems, and workers' compensation schemes. The incidence was calculated on the basis of industry, occupation, sex, age, and region. In addition, the distribution of causal agents was determined. During the study period, 236 cases of work-related asthma were reported, with 77 cases from more than 1 source. A total of 22.0% (n=52) were reported by occupational physicians, 52.5% (n=124) by allergy and chest physicians, 24.2% (n=57) by regional surveillance systems, and 43.2% (n=102) by workers' compensation schemes. The overall average annual incidence was 3.31 cases/million workers, with a rate of 3.78/million among men and 2.58/million among women. The highest incidence was observed in the 50-59-year age group (7.74/million), in the Gyeonggi/Incheon suburb of Seoul (8.50/million), in the furniture and other instrument manufacturing industries (67.62/million), and among craft and related trades workers (17.75/million). The most common causal agents were isocyanates (46.6%), flour/grain (8.5%), metal (5.9%), reactive dyes (5.1%), and solvents (4.2%). The incidence of work-related asthma in Korea was relatively low, and varied according to industry, occupation, gender, age, and region. Data provided by workers' compensation schemes and physician reports have been useful for determining the incidence and causes of work-related asthma.

  20. NRC data base for power reactor surveillance programs and for irradiation experiments results

    International Nuclear Information System (INIS)

    Kam, F.B.K.; Stallmann, F.W.

    1991-01-01

    The radiation damage of pressure vessel materials in nuclear reactors depends on many different factors, primarily fluence, fluence spectrum, fluence rate, irradiation temperature, and chemistry. These factors and, possibly, others such as heat treatment and type of flux used in weldments must be considered to reliably predict the pressure vessel embrittlement and to assure the safe operation of the reactor. Based on embrittlement predictions, decisions must be made concerning operating parameters, low-leakage fuel management, possible life extension, and the need for annealing of the pressure vessel. Large numbers of data obtained from surveillance capsules and test reactor experiments are needed, comprising many different materials and different irradiation conditions, to develop generally applicable damage prediction models that can be used for industry standards and regulatory guides. The US Nuclear Regulatory Agency has, therefore, sponsored a project to construct an Embrittlement Data Base (EDB) for a comprehensive collection of data concerning changes in material properties of pressure vessel steels due to neutron irradiation. A first version containing data from surveillance capsules of commercial power reactors, the Power Reactor Embrittlement Data Base (PR-EDB) Version 1, has been completed and is available to authorized users from the Radiation Shielding Information Center at the Oak Ridge National Laboratory. This document provides a discussion of the features of the current database. 1 fig

  1. Hospital adoption of automated surveillance technology and the implementation of infection prevention and control programs.

    Science.gov (United States)

    Halpin, Helen; Shortell, Stephen M; Milstein, Arnold; Vanneman, Megan

    2011-05-01

    This research analyzes the relationship between hospital use of automated surveillance technology (AST) for identification and control of hospital-acquired infections (HAI) and implementation of evidence-based infection control practices. Our hypothesis is that hospitals that use AST have made more progress implementing infection control practices than hospitals that rely on manual surveillance. A survey of all acute general care hospitals in California was conducted from October 2008 through January 2009. A structured computer-assisted telephone interview was conducted with the quality director of each hospital. The final sample includes 241 general acute care hospitals (response rate, 83%). Approximately one third (32.4%) of California's hospitals use AST for monitoring HAI. Adoption of AST is statistically significant and positively associated with the depth of implementation of evidence-based practices for methicillin-resistant Staphylococcus aureus and ventilator-associated pneumonia and adoption of contact precautions and surgical care infection practices. Use of AST is also statistically significantly associated with the breadth of hospital implementation of evidence-based practices across all 5 targeted HAI. Our findings suggest that hospitals using AST can achieve greater depth and breadth in implementing evidenced-based infection control practices. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  2. Modification of an environmental surveillance program to monitor PCDD/Fs and metals around a municipal solid waste incinerator.

    Science.gov (United States)

    Vilavert, Lolita; Nadal, Martí; Mari, Montse; Schuhmacher, Marta; Domingo, José L

    2009-11-01

    Since the mid-90s, an environmental surveillance program has been on-going to provide information on the levels of PCDD/Fs and various metals in soil and vegetation samples collected in the vicinity of a municipal solid waste incinerator (MSWI) in Tarragona (Catalonia, Spain). However, the presence of other potential sources of pollution in the zone, such as traffic, forest fires, local industries, etc., makes hard to determine the impact concerning the MSWI. Therefore, in 2007 a change in the monitoring program was implemented by collecting additional ambient air samples through active and passive sampling devices. Mean PCDD/F levels in herbage and soil were 0.10 ng I-TEQ/kg dry weight (range: 0.05-0.17 ng I-TEQ/kg dw) and 0.64 ng I-TEQ/kg dw (range: 0.13-2.41 ng I-TEQ/kg dw), respectively. A significant reduction of the PCDD/F concentration in both monitors was observed with respect to our previous surveys. Air mean concentrations of PCDD/Fs were 12.04 and 15.21 fg WHO-TEQ/m(3) in 2007 and 2008, respectively, meaning a non-significant increase of 26%. In addition, a generalized increase of environmental metal levels with respect to our baseline study was not observed. The current concentrations of PCDD/Fs and metals in the vicinity of the MSWI of Tarragona are relatively low in comparison with other areas under the influence of emissions from waste incinerators. This indicates that the environmental impact of the MSWI of Tarragona is not significant. Moreover, the modification of the surveillance program has proven to be successful.

  3. U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-10-01

    The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

  4. Employee assistance programs, drug testing, and workplace injury.

    Science.gov (United States)

    Waehrer, Geetha M; Miller, Ted R; Hendrie, Delia; Galvin, Deborah M

    2016-06-01

    Little is known about the effects of employee assistance programs (EAPs) on occupational injuries. Multivariate regressions probed a unique data set that linked establishment information about workplace anti-drug programs in 1988 with occupational injury rates for 1405 establishments. EAPs were associated with a significant reduction in both no-lost-work and lost-work injuries, especially in the manufacturing and transportation, communication and public utilities industries (TCPU). Lost-work injuries were more responsive to specific EAP characteristics, with lower rates associated with EAPs staffed by company employees (most likely onsite). Telephone hotline services were associated with reduced rates of lost-work injuries in manufacturing and TCPU. Drug testing was associated with reductions in the rate of minor injuries with no lost work, but had no significant relationship with lost-work injuries. This associational study suggests that EAPs, especially ones that are company-staffed and ones that include telephone hotlines, may prevent workplace injuries. Copyright © 2016. Published by Elsevier Ltd.

  5. The U.S. food and drug administration's dosimetry program

    International Nuclear Information System (INIS)

    Baratta, E.

    2005-01-01

    Full text: The U. S. Public Health Service's (PHS) Food and Drug Administration (FDA) (part of the PHS) has had a Dosimetry Program at the Winchester Engineering and Analytical Center (WEAC) (formerly the Northeastern Radiological Health Laboratory). This Dosimetry Program has been in place since 1961. In 1967 it was augmented by the construction of a Whole Body Counter at WEAC for measuring internal dose. The FDA's Center for Medical Devices and Radiological Health had been handling these dosimeters since 1961 and in 2000 the WEAC took over total responsibility for this program for the FDA's Office of Regulatory affairs. This program was originally setup for the radiation workers (analysts and support personnel) and later included investigators personnel working in the medical and dental x-ray field. The field laboratories began using radionuclides in 1972 and were also issued radiation dosimeters. Investigators station at border import station alter 2003 were issued as well as radiation pages as a precaution when checking imported food and other FDA regulated products. This paper will discuss the results of radiation exposure received by analyst (including whole body measurements) at WEAC and field laboratories. Also discussed will be exposures to investigators in the medical and dental field. The exposure to the investigators at the import border stations will be included even though they have not been carrying dosimeters for slightly more than a year. In general, the exposures have been well below the Nuclear Regulatory Commission regulations for radiation workers. (author)

  6. The potential of the European network of congenital anomaly registers (EUROCAT) for drug safety surveillance : a descriptive study

    NARCIS (Netherlands)

    Meijer, Willemijn M.; Cornel, Martina C.; Dolk, Helen; de Walle, Hermien E. K.; Armstrong, Nicola C.; de Jong-van den Berg, Lolkje T. W.

    Background European Surveillance of Congenital Anomalies (EUROCAT) is a network of population-based congenital anomaly registries in Europe surveying more than I million births per year, or 25% of the births in the European Union. This paper describes the potential of the EUROCAT collaboration for

  7. Antimicrobial susceptibilities of Proteus mirabilis: a longitudinal nationwide study from the Taiwan surveillance of antimicrobial resistance (TSAR) program.

    Science.gov (United States)

    Wang, Jann-Tay; Chen, Pei-Chen; Chang, Shan-Chwen; Shiau, Yih-Ru; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Tan, Mei-Chen; Lauderdale, Tsai-Ling Yang

    2014-09-05

    Longitudinal nationwide data on antimicrobial susceptibility in Proteus mirabilis from different sources are rare. The effects of the revised Clinical and Laboratory Standards Institute (CLSI) β-lactam breakpoints on susceptibility rates and on detecting extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase-producers in this species are also seldom evaluated. The present study analyzed data from the Taiwan Surveillance of Antimicrobial Resistance program to address these issues. Isolates were collected biennially between 2002 and 2012 from 25 to 28 hospitals in Taiwan. Minimum inhibitory concentrations (MIC) were determined by reference broth microdilution method. All isolates with aztreonam, ceftazidime, or cefotaxime MIC ≥ 2 mg/L were checked for the presence of ESBL by CLSI confirmatory test and subjected to ESBL and AmpC β-lactamases gene detection by PCR. Univariate and multivariate analyses were performed. Between 2002 and 2012, a total of 1157 P. mirabilis were studied. Susceptibility to cefotaxime, ceftazidime, and ciprofloxacin decreased significantly during the past decade, from 92.6% to 81.7%, 100% to 95.2%, and 80.1% to 53.8%, respectively (P mirabilis from Taiwan in the past decade. The prevalence of ESBL remained stable but AmpC β-lactamase-producing P. mirabilis increased significantly. Cefotaxime was a better surrogate than ceftazidime for predicting the presence of these β-lactamases. Continuous surveillance on antimicrobial resistance and associated resistance mechanisms in P. mirabilis is warranted.

  8. The Social Construction of "Evidence-Based" Drug Prevention Programs: A Reanalysis of Data from the Drug Abuse Resistance Education (DARE) Program

    Science.gov (United States)

    Gorman, Dennis M.; Huber, J. Charles, Jr.

    2009-01-01

    This study explores the possibility that any drug prevention program might be considered "evidence-based" given the use of data analysis procedures that optimize the chance of producing statistically significant results by reanalyzing data from a Drug Abuse Resistance Education (DARE) program evaluation. The analysis produced a number of…

  9. Soil and vegetation surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Antonio, E.J.

    1995-06-01

    Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.

  10. Standardized physics-dosimetry for US pressure vessel cavity surveillance programs

    International Nuclear Information System (INIS)

    Ruddy, F.H.; McElroy, W.N.; Lippincott, E.P.

    1984-01-01

    Standardized Physics-Dosimetry procedures and data are being developed and tested for monitoring the neutron doses accumulated by reactor pressure vessels (PV) and their support structures. These procedures and data are governed by a set of 21 ASTM standard practices, guides, and methods for the prediction of neutron-induced changes in light water reactor (LWR) PVs and support structure steels throughout the service life of the PV. This paper summarizes the applications of these standards to define the selection and deployment of recommended dosimetry sets, the selection of dosimetry capsules and thermal neutron shields, the placement of dosimetry, the methods of measurement of dosimetry sensor reaction products, data analysis procedures, and uncertainty evaluation procedures. It also describes the validation of these standards both by in-reactor testing of advanced PV cavity surveillance physics-dosimetry and by data development. The use of these standards to guide selection and deployment of advanced dosimetry sets for commercial reactors is also summarized

  11. 75 FR 22809 - Mandatory Guidelines for Federal Workplace Drug Testing Programs

    Science.gov (United States)

    2010-04-30

    ... time for related training in Federal and federally-regulated workplace drug testing programs and will... related training in Federal and federally-regulated workplace drug testing programs, including HHS... DEPARTMENT OF HEALTH AND HUMAN SERVICES Mandatory Guidelines for Federal Workplace Drug Testing...

  12. 76 FR 34086 - Mandatory Guidelines for Federal Workplace Drug Testing Programs; Request for Information...

    Science.gov (United States)

    2011-06-10

    ... Mandatory Guidelines for Federal Workplace Drug Testing Programs; Request for Information Regarding Specific Issues Related to the Use of the Oral Fluid Specimen for Drug Testing AGENCY: Substance Abuse and Mental... may be applied to the Mandatory Guidelines for Federal Workplace Drug Testing Programs (oral fluid...

  13. 76 FR 29183 - Exclusion of Orphan Drugs for Certain Covered Entities Under 340B Program

    Science.gov (United States)

    2011-05-20

    ... and, if they are, at what price. These covered entities do not know if they can buy these orphan drugs... DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 10 RIN 0906-AA94 Exclusion of Orphan Drugs for... Prices of Drugs Purchased by Covered Entities.'' Section 340B implemented a drug pricing program by which...

  14. 75 FR 69591 - Medicaid Program; Withdrawal of Determination of Average Manufacturer Price, Multiple Source Drug...

    Science.gov (United States)

    2010-11-15

    ..., Multiple Source Drug Definition, and Upper Limits for Multiple Source Drugs AGENCY: Centers for Medicare... withdrawing the definition of ``multiple source drug'' as it was revised in the ``Medicaid Program; Multiple Source Drug Definition'' final rule published in the October 7, 2008 Federal Register. DATES: Effective...

  15. Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers.

    Science.gov (United States)

    van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

    2018-03-01

    Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer's perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = -0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1-3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.

  16. Clinician impression versus prescription drug monitoring program criteria in the assessment of drug-seeking behavior in the emergency department.

    Science.gov (United States)

    Weiner, Scott G; Griggs, Christopher A; Mitchell, Patricia M; Langlois, Breanne K; Friedman, Franklin D; Moore, Rebecca L; Lin, Shuo Cheng; Nelson, Kerrie P; Feldman, James A

    2013-10-01

    We compare emergency provider impression of drug-seeking behavior with objective criteria from a state prescription drug monitoring program, assess change in opioid pain reliever prescribing after prescription drug monitoring program review, and examine clinical factors associated with suspected drug-seeking behavior. This was a prospective observational study of emergency providers assessing a convenience sample of patients aged 18 to 64 years who presented to either of 2 academic medical centers with chief complaint of back pain, dental pain, or headache. Drug-seeking behavior was objectively defined as present when a patient had greater than or equal to 4 opioid prescriptions by greater than or equal to 4 providers in the 12 months before emergency department evaluation. Emergency providers completed data forms recording their impression of the likelihood of drug-seeking behavior, patient characteristics, and plan for prescribing pre- and post-prescription drug monitoring program review. Descriptive statistics were generated. We calculated agreement between emergency provider impression of drug-seeking behavior and prescription drug monitoring program definition, and sensitivity, specificity, and positive predictive value of emergency provider impression, using prescription drug monitoring program criteria as the criterion standard. A multivariate logistic regression analysis was conducted to determine clinical factors associated with drug-seeking behavior. Thirty-eight emergency providers with prescription drug monitoring program access participated. There were 544 patient visits entered into the study from June 2011 to January 2013. There was fair agreement between emergency provider impression of drug-seeking behavior and prescription drug monitoring program (κ=0.30). Emergency providers had sensitivity 63.2% (95% confidence interval [CI] 54.8% to 71.7%), specificity 72.7% (95% CI 68.4% to 77.0%), and positive predictive value 41.2% (95% CI 34.4% to 48

  17. MARKETING PREDICTIONS IN ANTI-DRUG SOCIAL PROGRAMS: USE OF CAUSAL METHODS IN THE STUDY AND PREVENTION OF DRUG ABUSE

    Directory of Open Access Journals (Sweden)

    Serban Corina

    2010-12-01

    Full Text Available Drug use is one of the major challenges that todays society faces; its effects are felt at the level of various social, professional and age categories. Over 50 non-profit organizations are involved in the development of anti-drug social programs in Romania. Their role is to improve the degree of awareness of the target population concerning the risks associated with drug use, but also to steer consumers towards healthy areas, beneficial to their future. This paper aims to detail the issue of drug use in Romania, by making predictions based on the evolution of this phenomenon during the next five years. The obtained results have revealed the necessity to increase the number of programs preventing drug use, aswell as the need to continue social programs that have proved effective in previous years.

  18. 522 Postmarket Surveillance Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 522 Postmarket Surveillance Studies Program encompasses design, tracking, oversight, and review responsibilities for studies mandated under section 522 of the...

  19. [Role of the National Poliovirus Laboratory for the Program of eradication and poliomyelitis surveillance].

    Science.gov (United States)

    Trallero, Gloria; Cabrerizo, María; Avellón, Ana

    2013-01-01

    The Spanish acute flaccid paralysis surveillance network is coordinated by the National Poliovirus Laboratory (NPL), which, since 1998, carries out polioviruses (PV) and other enteroviruses detected characterization by cell culture and molecular techniques. A total of 110,725 (70046+40679) samples were studied between 1998-2012 and enteroviruses were detected in 8% of these. Among these enteroviruses 241 PV were characterized as PV Sabin-like, except samples belong to an imported poliomyelitis case, all of which were characterised as vaccine derived PV type 2. The NPL has carried out the serotyping and the intratypic differentiation of all the isolated PV in Spain of any syndrome. It is shown that wild PV has not circulated in our country during the 15 years studied and that has led to the signing of the Act of the "eradication of poliomyelitis in Spain" by WHO in 2001, and the /"certification of the eradication of wild PV free for European countries" on 21 June 2002. Currently only 3 countries have endemic transmission of wild PV (Pakistan, Afghanistan and Nigeria). Until a complete worldwide eradication, was achieved, Spain will actively continue to participate in the maintenance of the poliomyelitis eradication infrastructure by monitoring and vaccination as well as the wild PV containment plan to avoid the spread of wild PV.

  20. DRUG COURTS: Better DOJ Data Collection and Evaluation Efforts Needed to Measure Impact of Drug Court Programs

    National Research Council Canada - National Science Library

    2002-01-01

    .... Under this concept, in exchange for the possibility of dismissed charges or reduced sentences, defendants are diverted to drug court programs in various ways and at various stages in the judicial process...

  1. The effectiveness of a health-surveillance program for caisson saturation divers in a tunnel-boring machine: a microbiological survey

    NARCIS (Netherlands)

    van Rees Vellinga, T. P.; Sterk, W.; van Dijk, F. J. H.

    2010-01-01

    The purpose of this field study is to report and evaluate the implementation of a health surveillance program we developed to monitor the microbiological load for saturation divers, including preventive and therapeutic interventions. We extended the DMAC protocol for Saturation Diving Chamber

  2. Components production and assemble of the irradiation capsule of the Surveillance Program of Materials of the nuclear power plant of Laguna Verde

    International Nuclear Information System (INIS)

    Medrano, A.

    2009-01-01

    To predict the effects of the neutrons radiation and the thermal environment about the mechanical properties of the reactor vessel materials of the nuclear power plant of Laguna Verde, a surveillance program is implemented according to the outlines settled by Astm E185-02 -Standard practice for design of surveillance programs for light-water moderated nuclear power reactor vessels-. This program includes the installation of three irradiation capsules of similar materials to those of the reactor vessels, these samples are test tubes for mechanical practices of impact and tension. In the National Institute of Nuclear Research and due to the infrastructure as well as of the actual human resources of the Pilot Plant of Nuclear Fuel Assembles Production it was possible to realize the materials rebuilding extracted in 2005 of Unit 2 of nuclear power plant of Laguna Verde as well as the production, assemble and reassignment of the irradiation capsule made in 2006. At the present time the surveillance materials extracted in 2008 of Unit 1 of the nuclear power plant of Laguna Verde are reconstituting and the components are manufactured for the assembles of the irradiation capsule that will be reinstalled in the reactor vessel in 2010. The purpose of the present work is to describe the necessary components as well as its disposition during the assembles of the irradiation capsule for the surveillance program of the reactors vessel of the nuclear power plant of Laguna Verde. (Author)

  3. Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals

    Directory of Open Access Journals (Sweden)

    Madeline Carpinelli Wallack

    2012-01-01

    Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

  4. Stockpiling anti-viral drugs for a pandemic: the role of Manufacturer Reserve Programs.

    Science.gov (United States)

    Harrington, Joseph E; Hsu, Edbert B

    2010-05-01

    To promote stockpiling of anti-viral drugs by non-government organizations such as hospitals, drug manufacturers have introduced Manufacturer Reserve Programs which, for an annual fee, provide the right to buy in the event of a severe outbreak of influenza. We show that these programs enhance drug manufacturer profits but could either increase or decrease the amount of pre-pandemic stockpiling of anti-viral drugs.

  5. Quality assurance program for surveillance of fast reactor mixed oxide fuel analytical chemistry

    International Nuclear Information System (INIS)

    Rein, J.E.; Zeigler, R.K.; Waterbury, G.R.; McClung, W.E.; Praetorius, P.R.; Delvin, W.L.

    1976-01-01

    An effective quality assurance program for the chemical analysis of nuclear fuel is essential to assure that the fuel will meet the strict chemical specifications required for optimum reactor performance. Such a program has been in operation since 1972 for the fuels manufactured for the Fast Flux Test Facility. This program, through the use of common quality control and calibration standards, has consistently provided high levels of agreement among laboratories in all areas of analysis. The paper presented gives a summary of the chemical specifications for the fuel and source material, an outline of the requirements for laboratory qualifications and the preparation of calibration and quality control materials, general administration details of the plan, and examples where the program has been useful in solving laboratory problems

  6. Waterborne Release Monitoring and Surveillance Programs at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A.

    1999-03-26

    This report documents the liquid release environmental compliance programs currently in place at the Savannah river Site (SRS). Included are descriptions of stream monitoring programs, which measure chemical parameters and radionuclides in site streams and the Savannah river and test representative biological communities within the streams for chemical and radiological uptake. This report also explains the field sampling and analytical capabilities that are available at SRS during both normal and emergency conditions.

  7. Waterborne Release Monitoring and Surveillance Programs at the Savannah River Site

    International Nuclear Information System (INIS)

    Blanchard, A.

    1999-01-01

    This report documents the liquid release environmental compliance programs currently in place at the Savannah river Site (SRS). Included are descriptions of stream monitoring programs, which measure chemical parameters and radionuclides in site streams and the Savannah river and test representative biological communities within the streams for chemical and radiological uptake. This report also explains the field sampling and analytical capabilities that are available at SRS during both normal and emergency conditions

  8. A trial of a job-specific workers' health surveillance program for construction workers: study protocol.

    Science.gov (United States)

    Boschman, Julitta S; van der Molen, Henk F; van Duivenbooden, Cor; Sluiter, Judith K; Frings-Dresen, Monique H W

    2011-09-29

    Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians. The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement. This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job

  9. A trial of a job-specific workers' health surveillance program for construction workers: study protocol

    Directory of Open Access Journals (Sweden)

    Sluiter Judith K

    2011-09-01

    Full Text Available Abstract Background Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians. Methods/Design The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS group (n = 206 with that of a control (WHS group (n = 206. The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement. Discussion This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the

  10. Retinoblastoma incidence patterns in the US Surveillance, Epidemiology, and End Results program.

    Science.gov (United States)

    Wong, Jeannette R; Tucker, Margaret A; Kleinerman, Ruth A; Devesa, Susan S

    2014-04-01

    IMPORTANCE Several studies have found no temporal or demographic differences in the incidence of retinoblastoma except for age at diagnosis, whereas other studies have reported variations in incidence by sex and race/ethnicity. OBJECTIVE To examine updated US retinoblastoma incidence patterns by sex, age at diagnosis, laterality, race/ethnicity, and year of diagnosis. DESIGN, SETTING, AND PARTICIPANTS The Surveillance, Epidemiology, and End Results (SEER) databases were examined for retinoblastoma incidence patterns by demographic and tumor characteristics. We studied 721 children in SEER 18 registries, 659 in SEER 13 registries, and 675 in SEER 9 registries. MAIN OUTCOMES AND MEASURES Incidence rates, incidence rate ratios (IRRs), and annual percent changes in rates. RESULTS During 2000-2009 in SEER 18, there was a significant excess of total retinoblastoma among boys compared with girls (IRR, 1.18; 95% CI, 1.02 to 1.36), in contrast to earlier reports of a female predominance. Bilateral retinoblastoma among white Hispanic boys was significantly elevated relative to white non-Hispanic boys (IRR, 1.81; 95% CI, 1.22 to 2.79) and white Hispanic girls (IRR, 1.75; 95% CI, 1.11 to 2.91) because of less rapid decreases in bilateral rates since the 1990s among white Hispanic boys than among the other groups. Retinoblastoma rates among white non-Hispanics decreased significantly since 1992 among those younger than 1 year and since 1998 among those with bilateral disease. CONCLUSIONS AND RELEVANCE Although changes in the availability of prenatal screening practices for retinoblastoma may have contributed to these incidence patterns, further research is necessary to determine their actual effect on the changing incidence of retinoblastoma in the US population. In addition, consistent with other cancers, an excess of retinoblastoma diagnosed in boys suggests a potential effect of sex on cancer origin.

  11. Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

    Science.gov (United States)

    Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

    2001-01-01

    Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

  12. Scale up of a Plasmodium falciparum elimination program and surveillance system in Kayin State, Myanmar [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Daniel M. Parker

    2017-10-01

    Full Text Available Background: Myanmar has one of the largest malaria burdens in Southeast Asia. Along the border with Thailand, Plasmodium falciparum parasites are increasingly showing reduced sensitivity to artemisinin combination therapies. Given that there are no current alternative treatment therapies, one proposed solution to the threat of untreatable P. falciparum malaria is to eliminate the parasite from the region. Several small-scale elimination projects have been piloted along the Myanmar-Thailand border. Following their success, this operational research aimed to scale up the elimination to a broad area of Eastern Kayin State, Myanmar. Methods: The project relied on geographic reconnaissance and a geographic information system, community engagement, generalized access to community-based early diagnosis and treatment, near real-time epidemiological surveillance, cross sectional malaria prevalence surveys and targeted mass drug administration in villages with high prevalence of P. falciparum malaria. Molecular markers of drug resistance were also monitored in individuals with symptomatic and asymptomatic infections. Discussion: This project illustrates the establishment of an elimination project and operational research in a remote, rural area encompassing several armed groups, multiple political organizations and a near-absent health care infrastructure. The establishment of the project relied on a strong rapport with the target community, on-the-ground knowledge (through geographic surveys and community engagement, rapid decision making and an approach that was flexible enough to quickly adapt to a complex landscape. The elimination project is ongoing, now over three years in operation, and assessment of the impact of this operational research will follow. This project has relevance not only for other malaria elimination projects but also for operational research aimed at eliminating other diseases.

  13. Prognostic factors for survival in patients with Ewing's sarcoma using the surveillance, epidemiology, and end results (SEER) program database.

    Science.gov (United States)

    Duchman, Kyle R; Gao, Yubo; Miller, Benjamin J

    2015-04-01

    The current study aims to determine cause-specific survival in patients with Ewing's sarcoma while reporting clinical risk factors for survival. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify patients with osseous Ewing's sarcoma from 1991 to 2010. Patient, tumor, and socioeconomic variables were analyzed to determine prognostic factors for survival. There were 1163 patients with Ewing's sarcoma identified in the SEER Program database. The 10-year cause-specific survival for patients with non-metastatic disease at diagnosis was 66.8% and 28.1% for patients with metastatic disease. Black patients demonstrated reduced survival at 10 years with an increased frequency of metastatic disease at diagnosis as compared to patients of other race, while Hispanic patients more frequently presented with tumor size>10cm. Univariate analysis revealed that metastatic disease at presentation, tumor size>10cm, axial tumor location, patient age≥20 years, black race, and male sex were associated with decreased cause-specific survival at 10 years. Metastatic disease at presentation, axial tumor location, tumor size>10cm, and age≥20 years remained significant in the multivariate analysis. Patients with Ewing's sarcoma have decreased cause-specific survival at 10 years when metastatic at presentation, axial tumor location, tumor size>10cm, and patient age≥20 years. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Mark of the reconstitution process of the surveillance program of the CLV; Calificacion del proceso de reconstitucion del programa de vigilancia de CLV

    Energy Technology Data Exchange (ETDEWEB)

    Romero, J.; Hernandez, R.; Fernandez, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)]. e-mail: jrc@nuclear.inin.mx

    2006-07-01

    surveillance program of the reactor vessel of the nucleo electric central of Mexico it evaluates the mechanical state of the vessel, for it are had surveillance capsules with a series of witness test tubes, subjected to a similar or major neutron flux to that of the vessel. The objective is to evaluate in advance the embrittlement grade of the vessel in its design life. However the number of capsules with the witness test tubes it is only for the design life of the plant and at the moment the nucleo electric plants negotiate an extension of life of these, until for 20 years or more, of there the importance of this witness material that stores the information of the damage accumulated by irradiation. This material requires to be taken advantage after being rehearsed and the normative one settles down as obligatory to qualify the rebuilding process to obtain other 'new' Charpy test tubes that are again introduced in the reactor, reusing this material, as much for the surveillance program as for the extension of the plant life. In this work the qualification of the welding process by 'Stud Welding' for the rebuilding of Charpy test tubes of the surveillance program of the BWR reactor Unit 2 of the Laguna Verde Nucleo electric plant, Veracruz, Mexico is described. (Author)

  15. Site surveillance and maintenance program for Palos Park: Report for 1987

    International Nuclear Information System (INIS)

    Golchert, N.W.

    1988-04-01

    The results of the environmental monitoring program conducted at Site A/Plot M in the Palos Park Forest Preserve area for CY 1987 are presented. The monitoring program is the ongoing remedial action that resulted from the original radiological characterization of the site. This study had determined that hydrogen-3 (as tritiated water) migrated from the burial ground and was present in two nearby hand-pumped picnic wells. The current program consists of sample collection and analysis of air, surface and subsurface water, and bottom sediment. The results of the analyses are used to (1) determine the migration pathway of water from the burial ground (Plot M) to hand-pumped picnic wells, (2) establish if buried radionuclides other than hydrogen-3 have migrated, and (3) generally characterize the radiological environment of the area. The program was designed to study the migration of non-radiological hazardous waste constituents that may have been buried with the radioactive waste. This was done by analyzing borehole water samples for selected heavy metals and organic compounds and analyzing quarterly water samples from the Red Gate Woods picnic well for inorganic constituents. Hydrogen-3 in the Red Gate Woods picnic well continued to show the same pattern of elevated levels in the winter and low concentrations in the summer, but the magnitude of the current winter peak was significantly less than in earlier years. 16 refs., 6 figs., 15 tabs

  16. Head Injury Secondary to Suspected Child Maltreatment: Results of a Prospective Canadian National Surveillance Program

    Science.gov (United States)

    Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy

    2011-01-01

    Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…

  17. Principales resultados del sistema cubano de Farmacovigilancia en el año 2003 Main results of the Cuban System of Drug Surveillance in 2003

    Directory of Open Access Journals (Sweden)

    Francisco Debesa García

    2004-12-01

    Full Text Available Se describe el funcionamiento y principales resultados del sistema cubano de Farmacovigilancia durante el 2003 en todos los niveles de salud de Cuba. Durante 12 meses, los casos se identificaron mediante el sistema de notificación voluntaria de sospecha de reacciones adversas a medicamentos. Se recibieron en la Unidad Nacional Coordinadora de Farmacovilancia 12 601 notificaciones de reacciones adversas medicamentosas (RAM que contenían 25 348 sospechas de RAM, para una tasa de notificación de 1 119 reportes x 1 000 000 de habitantes. El 66 % de las RAM correspondió al sexo femenino y el 34 % al masculino. En cuanto al nivel de asistencia, la atención primaria es la que más notifica con 83,5 %. Fueron resultados alentadores que en este año la relación de reacciones leves con respecto a las moderadas y graves resultó del 55,3/44,7 %, que continúa con un balance bastante bueno en relación con el reporte por severidad. Se reportaron 54 reacciones con desenlace fatal, para el 0,2 %. Las notificaciones recibidas en nuestro unidad permitieron cuantificar y caracterizar las RAM, teniendo además un gran valor para generar alertas y vigilar la seguridad de los medicamentos que circulan en nuestro país.The functioning and the main results of the Cuban Drug Surveillance System at all the health levels, in 2003, are described. During 12 months, the cases were identified by the volunteer notification system of suspicion of adverse drug reactions. 12 601 notifications of adverse drug reactions (DAR containing 25 348 DAR suspicions were received at the National Coordinating Unit of Drug Surveillance for a notification rate of 1 119 reports x 1 000 000 inhabitants. 66 % of the ADRs corresponded to females and 34 % to males. As regards the assistance level, the primary care level notifies the most with 83.5 %. It was considered as encouraging the fact that the relation of mild adverse reactions with respect to the moderate and severe was 55.3 %/44

  18. European Surveillance Network for Influenza in Pigs: Surveillance Programs, Diagnostic Tools and Swine Influenza Virus Subtypes Identified in 14 European Countries from 2010 to 2013

    DEFF Research Database (Denmark)

    Simon, Gaelle; Larsen, Lars Erik; Duerrwald, Ralf

    2014-01-01

    : avian-like swine H1N1 (53.6%), human-like reassortant swine H1N2 (13%) and human-like reassortant swine H3N2 (9.1%), as well as pandemic A/H1N1 2009 (H1N1pdm) virus (10.3%). Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence....... For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some......Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs) circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs...

  19. Review of the Methods to Obtain Paediatric Drug Safety Information: Spontaneous Reporting and Healthcare Databases, Active Surveillance Programmes, Systematic Reviews and Meta-analyses

    Science.gov (United States)

    Gentili, Marta; Pozzi, Marco; Peeters, Gabrielle; Radice, Sonia; Carnovale, Carla

    2018-02-06

    Knowledge of drugs safety collected during the pre-marketing phase is inevitably limited because the randomized clinical trials (RCTs) are rarely designed to evaluate safety. The small and selective groups of enrolled individuals and the limited duration of trials may hamper the ability to characterize fully the safety profiles of drugs. Additionally, information about rare adverse drug reactions (ADRs) in special groups is often incomplete or not available for most of the drugs commonly used in the daily clinical practice. In the paediatric setting several highimpact safety issues have emerged. Hence, in recent years, there has been a call for improved post-marketing pharmacoepidemiological studies, in which cohorts of patients are monitored for sufficient time in order to determine the precise risk-benefit ratio. In this review, we discuss the current available strategies enhancing the post-marketing monitoring activities of the drugs in the paediatric setting and define criteria whereby they can provide valuable information to improve the management of therapy in daily clinical practice including both safety and efficacy aspects. The strategies we cover include the signal detection using international pharmacovigilance and/or healthcare databases, the promotion of active surveillance initiatives which can generate complete, informative data sets for the signal detection and systematic review/meta-analysis. Together, these methods provide a comprehensive picture of causality and risk improving the management of therapy in a paediatric setting and they should be considered as a unique tool to be integrated with post-marketing activities. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  20. Recommendations to the NRC for review criteria for alternative methods of low-level radioactive waste disposal: Environmental monitoring and surveillance programs

    International Nuclear Information System (INIS)

    Denham, D.H.; Stenner, R.D.; Eddy, P.A.; Jaquish, R.E.; Ramsdell, J.V. Jr.

    1988-07-01

    Licensing of a facility for low-level radioactive waste disposal requires the review of the environmental monitoring and surveillance programs. A set of review criteria is recommended for the US Nuclear Regulatory Commission (NRC) staff to use in each monitoring phase---preoperational, operational, and post operational---for evaluating radiological and selected nonradiological parameters in proposed environmental monitoring and surveillance programs at low-level waste disposal facilities. Applicable regulations, industry standards, and technical guidance on low-level radioactive waste are noted throughout the document. In the preoperational phase, the applicant must demonstrate that the environmental monitoring program identifies radiation levels and radionuclide concentrations at the site and also provides adequate basic data on the disposal site. Data recording and statistical analyses for this phase are addressed

  1. The Family and Federal Drug Abuse Policies--Programs: Toward Making the Invisible Family Visible.

    Science.gov (United States)

    Clayton, Richard R.

    1979-01-01

    Notes why the family is not considered in drug policy and programing and asserts that existing conditions demand conscious consideration of the family in efforts of federal drug agencies. Data show changing parameters of drug use-abuse. A research and prevention agenda that integrates the family is presented. (Author/BEF)

  2. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

  3. Ski and snowboard school programs: Injury surveillance and risk factors for grade-specific injury.

    Science.gov (United States)

    Sran, R; Djerboua, M; Romanow, N; Mitra, T; Russell, K; White, K; Goulet, C; Emery, C; Hagel, B

    2018-05-01

    The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Drug usage guidelines, Part 3: assessment of acceptance of the program.

    Science.gov (United States)

    Patry, R A; Huber, S L; Rice, G; Hudson, H D; Godwin, H N

    1985-04-01

    The Drug Usage Guidelines (DUG) program, as perceived by the members of the P & T Committee and by physicians who had prepared and submitted DUGs, was demonstrated to be an effective method for evaluating drugs for formulary inclusion. The majority of P & T members felt that the DUG program had strengthened the drug review process without being too tedious or preventing the addition of valuable drugs to the formulary. Sixty-eight percent of physicians who had submitted a DUG expressed the opinion that it served as a vehicle for providing educational information on rational therapeutics. A majority of respondents stated that they would recommend the DUG program to other hospitals.

  5. Designing an Effective Prevention Program: Principles Underlying the Rand Smoking and Drug Prevention Experiment.

    Science.gov (United States)

    Ellickson, Phyllis L.

    This paper describes the Project ALERT program (Adolescent Learning Experiences in Resistance Training) which was established by the Rand Corporation to prevent smoking and drug use among seventh graders. The program is based on the social influence model of drug use initiation. Curriculum features are described including motivation to resist and…

  6. 75 FR 38422 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-07-02

    ... 2105-AD84 Procedures for Transportation Workplace Drug and Alcohol Testing Programs AGENCY: Office of..., 2011. DATES: This rule is effective July 2, 2010. FOR FURTHER INFORMATION CONTACT: For program issues... Federal Regulations, as follows: PART 40--PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING...

  7. National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

    Science.gov (United States)

    Coates, Ralph J.; Pérez, Alejandro; Baer, Atar; Zhou, Hong; English, Roseanne; Coletta, Michael; Dey, Achintya

    2016-01-01

    Objective We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP). Methods We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting 15 data with all ED visits in all 50 states and Washington, DC. Results Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented. Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. PMID:26883318

  8. A distinctive avian assemblage (Aves: Passeriformes in Western Darién, Panama is uncovered through a disease surveillance program

    Directory of Open Access Journals (Sweden)

    Matthew J. Miller

    2014-08-01

    Full Text Available Basic knowledge about the distribution of flora and fauna is lacking for most tropical areas. Improving our knowledge of the tropical biota will help address contemporary global problems, including emerging tropical diseases. Less appreciated is the role that applied studies can have in improving our understanding of basic biological patterns and processes in the tropics. Here, I describe a novel avifauna assemblage uncovered in Western Darién province in the Republic of Panama that was uncovered during a vector-borne disease surveillance program. I compared the passerine bird species composition at 16 sites using records from recent ornithological expeditions sponsored by the Smithsonian Tropical Research Institute in Central and Eastern Panama. Based on the results of a Mantel test, geographic distance did not correlate with pairwise distinctiveness of sites. Instead, based on an index of distinctiveness modified from the Chao-Jaccard index, most sites were more or less similarly distinctive, with one site, Aruza Abajo, significantly more distinctive than the rest. I found that the distinctiveness of this site was due not only to the presence of several rare and range-restricted taxa, but also to the absence of taxa that are common elsewhere. This finding provides more evidence of high species composition turnover (beta-diversity in the Panamanian biota, which appears to be driven by a combination of soil and climate differences over narrow distances. Rev. Biol. Trop. 62 (2: 711-717. Epub 2014 June 01.

  9. Gas generation over plutonium oxides in the 94-1 shelf-life surveillance program

    International Nuclear Information System (INIS)

    Berg, J.M.; Harradine, D.M.; Hill, D.D.; McFarlan, James T.; Padilla, D.D.; Prenger, F. Coyne; Veirs, D.K.; Worl, L.A.

    2002-01-01

    The Department of Energy (DOE) is embarking upon a program to store large quantities of plutonium-bearing materials for up to fifty years. The Los Alamos National Laboratory Shelf Life Project was established to bound the behavior of plutonium-bearing material meeting the DOE 3013 Standard. The shelf life study monitors temperature, pressure and gas composition over oxide materials in a limited number of large-scale 3013 inner containers and in many small-scale containers. For the large-scale study, baseline plutonium oxides, oxides exposed to high-humidity atmospheres, and oxides containing chloride salt impurities are planned. The first large-scale container represents a baseline and contains dry plutonium oxide prepared according to the 3013 Standard. This container has been observed for pressure, temperature and gas compositional changes for less than a year. Results indicate that no detectable changes in pressure and gas composition are observed.

  10. Plenary III–04: Responses to Drug Costs: Year Three of the Medicare Part D Program

    OpenAIRE

    Fung, Vicki; Reed, Mary; Hsu, John

    2010-01-01

    Background/Aims: Many Medicare Part D beneficiaries face substantial prescription drug cost-sharing. In the first year of the program, many beneficiaries reported substantial drug use changes in response to the coverage gap. In response, an increasing number of plans offer generic drug coverage during the gap. We compared responses to Part D costs among beneficiaries with generic-only gap coverage and full gap coverage in 2008, the third year of the Part D program.

  11. Quali-quantitative analysis of best selling drugs from pharmacy, street market and traditional herbal medicine: a pilot study of market surveillance in Senegal.

    Science.gov (United States)

    Pichini, Simona; Rotolo, Maria Concetta; Bellotti, Pasquale; Minutillo, Adele; Mastrobattista, Luisa; Pacifici, Roberta

    2015-02-01

    A pilot study of market surveillance in Senegal has been performed analyzing best selling drugs from an official pharmacy and a street market in two principal cities of Senegal and some traditional preparations from herbal medicine from the same market. A simple and rapid gas chromatography method with mass spectrometry detection has been applied after a liquid-liquid extraction of pharmaceutical products and traditional preparations at acidic, neutral and basic pH with chloroform-isopropanol (9:1, v/v). The assay was validated in the range from 10mg to 250 mg/g powder preparations with good determination coefficients (r(2)≥ 0.99) for the calibration curves. At three concentrations spanning the linear dynamic ranges of the calibration curves, mean recoveries of substances under investigation were always higher than 90% and intra-assay and inter-assay precision and accuracy were always better than 15%. The four best selling drugs purchased from a Dakar local pharmacy exactly contained the amount of active principles reported in the respective labels while the best selling drugs freely purchased from Kaolack market contained an amount of active ingredients lower than that declared on the label. No pharmacological active compound, but salicylic acid was found in one of the traditional herbal preparations. This pilot study showed that whereas official drugs sold in pharmacies at prices accessible for a very few portion of the population contained the amount of active principles as reported in the labels, those from street market bought by the majority of population contained an amount of active ingredients lower than that declared on the label and finally traditional herbal preparations seldom contain pharmacological active principles. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Comprehensive Legislative Reform to Protect the Integrity of the 340B Drug Discount Program.

    Science.gov (United States)

    Zeta, Lowell M

    2015-01-01

    The 40B Drug Discount Program (340B Program) is a federally facilitated program that requires drug manufacturers to provide steep discounts on outpatient prescription drugs to qualifying safety net health care providers. The federal program is intended as a safeguard to ensure access to affordable drugs to the indigeut. However, over the last two decades safety net health care providers have exploited financial incentives under the 340B Program at the expense of drug manufacturers and patients, including the most needy and vulnerable populations-they are committed to serve. Although the federal government has been applauded for increasing effortsto combat health care fraud and abuse including recovering $3.3 billion in 2014, federal officials and the general public have paid markedly less attention to pervasive abuse of the 340B Program. In 2014, drug purchases of 340B-designated drugs totaled $7 billion and are expected to increase to $12 billion: by 2016 as a result of the expansion of the program under the Affordable Care Act. The 340B Program has completely lost its way, and comprehensive legislation is necessary to realign the program with its intent.

  13. Annual summary report of the decontamination and decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1991

    International Nuclear Information System (INIS)

    Ford, M.K.; Holder, L. Jr.

    1991-09-01

    The Surplus Facilities Management Program and Defense Facilities Decommissioning Program were established at Oak Ridge National Laboratory (ORNL) in 1976 in order to provide collective management of all surplus sites under ORNL control on the Oak Ridge Reservation. Some 34 facilities, classified into 3 civilian-related and 8 defense-related projects, are currently managed by the recently integrated Decontamination and Decommissioning Program. Support includes (1) surveillance and maintenance (S ampersand M) planning, (2) routine S ampersand M, and (3) special maintenance projects. This report documents routine S ampersand M, special projects, and special maintenance performed on these facilities for the period of October 1990 through September 1991

  14. Molecular surveillance of drug resistance through imported isolates of Plasmodium falciparum in Europe

    DEFF Research Database (Denmark)

    Jelinek, Tomas; Peyerl-Hoffmann, Gabriele; Mühlberger, Nikolai

    2002-01-01

    and chloroquine. The screening results were used to map the prevalence of mutations and, thus, levels of potential drug resistance in endemic areas world-wide. RESULTS: 337 isolates have been tested so far. Prevalence of mutations that are associated with resistance to chloroquine on the pfcrt and pfmdr genes...

  15. Surveillance program for former PCB-exposed workers of a transformer and capacitor recycling company, family members, employees of surrounding companies, and area residents--executive summary.

    Science.gov (United States)

    Kraus, Thomas; Gube, Monika; Lang, Jessica; Esser, Andre; Sturm, Walter; Fimm, Bruno; Willmes, Klaus; Neulen, Joseph; Baron, Jens Malte; Merk, Hans; Schettgen, Thomas; Konrad, Kerstin; Deisz, Sabine; Rink, Lothar; Hagmann, Michael; Fillies, Birgit; Zschiesche, Wolfgang; Wittsiepe, Jürgen; Wilhelm, Michael

    2012-01-01

    In a German company polychlorinated biphenyls (PCB)-containing transformers and capacitors were recycled on a large scale. Human biomonitoring revealed a high PCB body burden in workers of the recycling company, in surrounding locations of this plant, in companies in the neighborhood of this plant, and in family members of these employees. In order to clarify whether possible adverse health effects occurred or may occur in the future, a prospective surveillance program was initiated. After an extensive literature search, an interdisciplinary group of experts developed a surveillance program based on current knowledge with respect to possible adverse health effects that might occur in the recycling process of transformers and capacitors. Exposure to various hazardous substances (PCB, polychlorinated dibenzo-p-dioxins and dibenzo-furans [PCDD/F], metals, solvents) was considered. Criteria derived from human biomonitoring results of PCB were used for admission to the program. Participants in the surveillance program are first informed about risks and aims of the program. Subsequently, physicians started a detailed documentation of participants' general and occupational history, with their complaints, diseases, and nutritional habits, as well as information regarding their living areas, by means of a standardized questionnaire. In addition, separate examinations were performed to detect possible neurological, immunological, (neuro)psychological, hormonal, and skin effects. Moreover, DNA exposure as assessed by the comet assay and antioxidative status were determined. The program will be offered at yearly intervals for 3 years, and then at 5 and 10 years after program onset. Until now the program has proved to be feasible, and acceptance among workers and their families has been high. Based on the results, criteria will be developed to define adverse health effects that might be attributable to a hazardous substance exposure.

  16. Using data from a nationally representative nutrition surveillance system to assess trends and influence nutrition programs and policy

    Directory of Open Access Journals (Sweden)

    Nasima Akhter

    2010-02-01

    Full Text Available The Nutritional Surveillance Project (NSP* of Helen Keller International (HKI, Bangladesh, implemented in partnership with the Government of Bangladesh’s (GOB Institute of Public Health Nutrition (IPHN from 1990 until 2006, is among the longest running surveillance systems; and was implemented with an overall goal to monitor nutrition and health status of children and mothers in Bangladesh. From 1990-1997, NSP data collection included rural and urban poor populations of disaster prone areas of Bangladesh. Since 1998, it evolved into a nationally representative nutrition surveillance system in rural Bangladesh and also continued assessing trends of malnutrition in urban poor areas. Over the 16 year period, the NSP produced plethora of information that was packaged and shared as bulletins, in peer reviewed journal articles, as presentations at conferences, seminars, workshops. The NSP had a flexible framework that allowed it to assess trends and underlying factors of malnutrition, monitor and evaluate selected programs and conduct special studies related to current and emerging issues. NSP findings were available to contribute to program development and supported policy discussions in-country and internationally. The NSP continuously highlighted the importance of monitoring, which is not only an indispensible element for a successful program, but also helps prioritization and decision making to maximize utilization of limited resources for developing countries burdened with numerous problems to address. The NSP provides an example of a technically sound surveillance system with rapid turnover of data and findings, which is imperative to successful program planning, policy formulation and tracking progress toward developmental goals.Le projet Nutritional Surveillance Project (NSP* de l’association Helen Keller International (HKI, mis en œuvre au Bangladesh en partenariat avec l’Institute of Public Health Nutrition (IPHN,

  17. The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market.

    Science.gov (United States)

    Donado-Godoy, P; Castellanos, R; León, M; Arevalo, A; Clavijo, V; Bernal, J; León, D; Tafur, M A; Byrne, B A; Smith, W A; Perez-Gutierrez, E

    2015-04-01

    The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets. © 2015 Blackwell Verlag GmbH.

  18. Introduction to surveillance studies

    CERN Document Server

    Petersen, JK

    2012-01-01

    Introduction & OverviewIntroduction Brief History of Surveillance Technologies & TechniquesOptical SurveillanceAerial Surveillance Audio Surveillance Radio-Wave SurveillanceGlobal Positioning Systems Sensors Computers & the Internet Data Cards Biochemical Surveillance Animal Surveillance Biometrics Genetics Practical ConsiderationsPrevalence of Surveillance Effectiveness of Surveillance Freedom & Privacy IssuesConstitutional Freedoms Privacy Safeguards & Intrusions ResourcesReferences Glossary Index

  19. Drug use prevention: factors associated with program implementation in Brazilian urban schools.

    Science.gov (United States)

    Pereira, Ana Paula Dias; Sanchez, Zila M

    2018-03-07

    A school is a learning environment that contributes to the construction of personal values, beliefs, habits and lifestyles, provide convenient settings for the implementation of drug use prevention programs targeting adolescents, who are the population group at highest risk of initiating drug use. The objective of the present study was to investigate the prevalence of factors associated with implementing drug use prevention programs in Brazilian public and private middle and high urban schools. The present population-based cross-sectional survey was conducted with a probability sample of 1151 school administrators stratified by the 5 Brazilian administrative divisions, in 2014. A close-ended, self-reported online questionnaire was used. Logistic regression analysis was used to identify factors associated with implementing drug use prevention programs in schools. A total of 51.1% of the schools had adopted drug use prevention programs. The factors associated with program implementation were as follows: belonging to the public school network; having a library; development of activities targeting sexuality; development of "Health at School Program" activities; offering extracurricular activities; and having an administrator that participated in training courses on drugs. The adoption of drug use prevention practices in Brazilian schools may be expanded with greater orchestration of schools through specialized training of administrators and teachers, expansion of the School Health Program and concomitant development of the schools' structural and curricular attributes.

  20. Carbapenem non-susceptible enterobacteriaceae in Quebec, Canada: results of a laboratory surveillance program (2010-2012.

    Directory of Open Access Journals (Sweden)

    Brigitte Lefebvre

    Full Text Available The emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE represent a major public health concern because these bacteria are usually extensively resistant to most antibiotics. In order to evaluate their dissemination in Quebec, a surveillance program was introduced in 2010. We report the molecular and epidemiological profiles of CPE isolates collected. Between August 2010 and December 2012, a total of 742 non-duplicate isolates non-susceptible to carbapenems were analysed. AmpC β-lactamase and metallo-β-lactamase production were detected by Etest and carbapenemase production by the modified Hodge test (MHT. Antibiotic susceptibility profiles were determined using broth microdilution or Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC strains was analyzed by pulsed-field gel electrophoresis (PFGE. The presence of genes encoding carbapenemases as well as other β-lactamases was detected using PCR. Of the 742 isolates tested, 169 (22.8% were CPE. Of these 169 isolates, 151 (89.3% harboured a blaKPC gene while the remaining isolates carried blaSME (n = 9, blaOXA-48 (n = 5, blaNDM (n = 3, and blaNMC (n = 1 genes. Among the 93 KPC strains presenting with a unique pattern (unique PFGE pattern and/or unique antibiotics susceptibility profile, 99% were resistant to ertapenem, 95% to imipenem, 87% to meropenem, 97% to aztreonam, 31% to colistin and 2% to tigecycline. In 19 patients, 2 to 5 KPC strains from different species or with a different PFGE pattern were isolated. CPE strains were present in the province of Quebec with the majority of strains harbouring KPC. Alternately, SME, OXA-48 and NMC containing strains were rarely found.

  1. An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

    Science.gov (United States)

    van Empelen, Pepijn; Kok, Gerjo; Schaalma, Herman P; Bartholomew, L Kay

    2003-10-01

    This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

  2. December 1993 National Drunk and Drugged Driving (3D) Prevention Month: Program Planner.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This program planner's kit is based on the experiences of the first 12 years of the National Drunk and Drugged Driving (3D) Prevention Month program and provides practical advice to help readers plan activities for this year's campaign. Included in the kit is a background and resource guide that explains the background and goals of the program and…

  3. 77 FR 39194 - Combined Drug and Alcohol Testing Programs

    Science.gov (United States)

    2012-07-02

    .... Revise paragraph (c)(5) and redesignate it as (c)(6); Sec. 120.115 Employee Assistance Program (EAP... assistance program (EAP). Finally, this rulemaking would make it clear that the agency's practice of... of the training given to both supervisors and employees in their employee assistance programs...

  4. 78 FR 41999 - Combined Drug and Alcohol Testing Programs

    Science.gov (United States)

    2013-07-15

    ...)(5) and (c)(6). The revisions read as follows: Sec. 120.115 Employee Assistance Program (EAP... of employees, must be documented as part of each employer's employee assistance program. 4. It makes... documentation of the training given to both supervisors and employees in their employee assistance programs...

  5. The surveillance error grid.

    Science.gov (United States)

    Klonoff, David C; Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B; Kirkman, M Sue; Kovatchev, Boris

    2014-07-01

    Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to

  6. Development, implementation and management of a drug testing program in the workplace

    Energy Technology Data Exchange (ETDEWEB)

    Burtis, C.A.

    1990-01-01

    To combat the rising use of drugs in the workplace many American companies have implemented drug testing programs and are testing employees and job applicants for use of illegal drugs. In addition, on September 15, 1986, Executive Order No.12564 was issued by President Reagan, which requires all federal agencies to develop programs and policies, one of the goals of which is to achieve a drug-free federal workplace. Included in this Executive Order is the requirement that federal agencies implement drug testing has become a prevalent practice as a means to detect and deter drug use in the workplace. Before a drug testing program is implemented, it is imperative that policies and procedures are developed that (1) ensure the accuracy of test results, (2) protect the validity and integrity of the specimen, (3) guarantee due process, and (4) maintain confidentiality. To make certain that these prerequisites were met in the government drug testing programs, the US Department of Health and Human Services (HHS) was directed to develop technical and scientific guidelines for conducting such programs. 15 refs., 1 fig., 2 tabs.

  7. Systematic review of reporting rates of adverse events following immunization: an international comparison of post-marketing surveillance programs with reference to China.

    Science.gov (United States)

    Guo, Biao; Page, Andrew; Wang, Huaqing; Taylor, Richard; McIntyre, Peter

    2013-01-11

    China is the most populous country in the world, with an annual birth cohort of approximately 16 million, requiring an average of 500 million vaccine doses administered annually. In China, over 30 domestic and less than 10 overseas vaccine manufacturers supply over 60 licensed vaccine products, representing a growing vaccine market mainly due to recent additions to the national immunization schedule, but data on post-marketing surveillance for adverse events following immunization (AEFI) are sparse. To compare reporting rates for various categories of AEFI from China with other routine post-marketing surveillance programs internationally. Systematic review of published studies reporting rates of AEFI by vaccine, category of reaction and age from post-marketing surveillance systems in English and Chinese languages. Overall AEFI reporting rates (all vaccines, all ages) in Chinese studies were consistent with those from similar international studies elsewhere, but there was substantial heterogeneity in regional reporting rates in China (range 2.3-37.8/100,000 doses). The highest AEFI reporting rates were for diphtheria-tetanus-pertussis whole-cell (DTwP) and acellular (DTaP) vaccines (range 3.3-181.1/100,000 doses for DTwP; range 3.5-92.6/100,000 doses for DTaP), with higher median rates for DTwP than DTaP, and higher than expected rates for DTaP vaccine. Similar higher rates for DTwP and DTaP containing vaccines, and relatively lower rates for vaccines against hepatitis B virus, poliovirus, and Japanese encephalitis virus were found in China and elsewhere in the world. Overall AEFI reporting rates in China were consistent with similar post-marketing surveillance systems in other countries. Sources of regional heterogeneity in AEFI reporting rates, and their relationships to differing vaccine manufacturers versus differing surveillance practices, require further exploration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Surveillance Culture

    DEFF Research Database (Denmark)

    2017-01-01

    What does it mean to live in a world full of surveillance? In this documentary film, we take a look at everyday life in Denmark and how surveillance technologies and practices influence our norms and social behaviour. Researched and directed by Btihaj Ajana and Anders Albrechtslund....

  9. Analysis to evaluate predictors of fiberboard aging to guide surveillance sampling for the 9975 life extension program

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Elizabeth J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Daugherty, William L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Hackney, Elizabeth R. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-05-09

    During surveillance of the 9975 shipping package at the Savannah River Site K-Area Complex, several package dimensions are recorded. The analysis described in this report shows that, based on the current data analysis, two of these measurements, Upper Assembly Outer Diameter (UAOD) and Upper Assembly Inside Height (UAIH), do not have statistically significant aging trends regardless of wattage levels. In contrast, this analysis indicates that the measurement of Air Shield Gap (ASGap) does show a significant increase with age. It appears that the increase is greater for high wattage containers, but this result is dominated by two measurements from high-wattage containers. For all three indicators, additional high-wattage, older containers need to be examined before any definitive conclusions can be reached. In addition, the current analysis indicates that ASGap measurements for low and medium wattage containers are increasing slowly over time. To reduce uncertainties and better capture the aging trend for these containers, additional low and medium wattage older containers should also be examined. Based on this analysis, surveillance guidance is to augment surveillance containers resulting from 3013 surveillance with 9975-focused sampling that targets older, high wattage containers and also includes some older, low and medium wattage containers. This focused sampling began in 2015 and will continue in 2016. The UAOD, UAIH and ASGap data are highly variable. It is possible that additional factors such as seasonal variation and packaging site location might reduce variability and be useful for focusing surveillance and predicting aging.

  10. [Extrapyramidal toxicity caused by metoclopramide and clebopride: study of voluntary notifications of adverse effects to the Spanish Drug Surveillance System].

    Science.gov (United States)

    Cuena Boy, R; Maciá Martínez, M A

    1998-03-31

    To clarify if there is any basis for the hypothesis that Clebopride leads to more extrapyramidal reactions than Metoclopramide. Observational, longitudinal, retrospective and comparative study of two series of cases. The entire Spanish healthcare system. Those notified to the Spanish Drug watch system as possibly having suffered an adverse reaction to Metoclopramide (n = 98) or Clebopride (n = 123) between 1/1/1990 and 10/6/1997. None. 84.3% of suspected adverse reactions to Clebopride and 51.6% of those to Metoclopramide had a non-hospital precedence (P Clebopride, there was extrapyramidal toxicity (P = 0.021). There is a basis for the hypothesis that Clebopride causes more extrapyramidal reactions than Metoclopramide. It was reasonable to realize a study based on this hypothesis.

  11. Extent of Drug Coverage across Generic Drug Discount Programs offered by Community Pharmacies: A look at five Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Harshali K. Patel, MS

    2012-01-01

    Full Text Available Background: Chronic conditions are expensive to treat because of the ongoing prescription cost burden. Generic drug discount programs (GDDPs that offer generics at discounted price may prove beneficial to reduce pharmacy costs for the same.Objective: The objective of this study was to assess the extent to which GDDPs provide drug coverage for five common chronic conditions.Methods: A content analyses of preexisting information was conducted. Extent of coverage based on top 200 generic drugs prescribed during 2008 for the treatment of chronic conditions such as hypertension, mental disorders, arthritis, pulmonary/respiratory conditions, and diabetes were identified. Commonly prescribed medications for these diseases were identified using published peer reviewed clinical guidelines. List of drugs covered under a GDDP for stores, Wal-Mart, Walgreens, CVS, Kroger, HEB, Target, and Randalls were obtained and compared to assess drug coverage by retail dollar sales and sales volume. Descriptive statistics and frequency/percentage of coverage were reported using SAS 9.2.Results: GDDPs covered the highest number of drugs for hypertension (21-27 across different GDDPs and the least (3-5 across different GDDPs for pulmonary/respiratory conditions. Arthritis (5-11, mental disorders (6-11 and diabetes (5-7 had similar coverage. When compared to the top 200 drugs by retail dollars spent during 2008, hypertension (68%-87% and diabetes (63%-88% had the highest coverage followed by respiratory conditions (30%-50%, arthritis (22%-48%, and mental disorders (21%-38%. Similar result was obtained when GDDP coverage was compared with the top 200 generic drugs by sales volume, where diabetes (63-88% and hypertension (57%-74% had the highest coverage and mental disorders remained the lowest (23%-37%.Conclusion/Implications: Drug coverage in GDDPs varied by pharmacies across the five common chronic conditions evaluated which may limit accessibility of these programs for

  12. Enhanced HIV-1 surveillance using molecular epidemiology to study and monitor HIV-1 outbreaks among intravenous drug users (IDUs) in Athens and Bucharest.

    Science.gov (United States)

    Paraskevis, Dimitrios; Paraschiv, Simona; Sypsa, Vana; Nikolopoulos, Georgios; Tsiara, Chryssa; Magiorkinis, Gkikas; Psichogiou, Mina; Flampouris, Andreas; Mardarescu, Mariana; Niculescu, Iulia; Batan, Ionelia; Malliori, Meni; Otelea, Dan; Hatzakis, Angelos

    2015-10-01

    A significant increase in HIV-1 diagnoses was reported among Injecting Drug Users (IDUs) in the Athens (17-fold) and Bucharest (9-fold) metropolitan areas starting 2011. Molecular analyses were conducted on HIV-1 sequences from IDUs comprising 51% and 20% of the diagnosed cases among IDUs during 2011-2013 for Greece and Romania, respectively. Phylodynamic analyses were performed using the newly developed birth-death serial skyline model which allows estimating of important epidemiological parameters, as implemented in BEAST programme. Most infections (>90%) occurred within four and three IDU local transmission networks in Athens and Bucharest, respectively. For all Romanian clusters, the viral strains originated from local circulating strains, whereas in Athens, the local strains seeded only two of the four sub-outbreaks. Birth-death skyline plots suggest a more explosive nature for sub-outbreaks in Bucharest than in Athens. In Athens, two sub-outbreaks had been controlled (Re1.0) and two had been controlled (Re<1.0). The lead times were shorter for the outbreak in Athens than in Bucharest. Enhanced molecular surveillance proved useful to gain information about the origin, causal pathways, dispersal patterns and transmission dynamics of the outbreaks that can be useful in a public health setting. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

    Science.gov (United States)

    Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

    2003-01-01

    Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

  14. What Will Happen if . . . A Programmed Instruction Course on Drugs and Their Effects.

    Science.gov (United States)

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    Developed by the National Institute of Mental Health, this booklet offers a programed instruction course on drugs and their effects. The purpose of the text is to learn about specific drugs which are currently being used and abused by a large group of people in our society. Narcotics, stimulants, depressants, hallucinogens, and marihuana are…

  15. 43 CFR 43.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What must I include in my drug-free awareness program? 43.215 Section 43.215 Public Lands: Interior Office of the Secretary of the Interior GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than Individuals § 43.215 What must I...

  16. 29 CFR 1472.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 1472.215 Section 1472.215 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than Individuals § 1472.215...

  17. Directory of Academic Institutions and Organizations Offering Drug, Alcohol, and Employee Assistance Program Educational Resources.

    Science.gov (United States)

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    This directory lists academic institutions, State offices of alcohol and drug abuse, and national organizations which offer drug, alcohol, and employee assistance program (EAP) educational resources. A matrix format is used. Entries include name, address, telephone number, and contact person. A dot appears directly under column headings which are…

  18. Supporting surveillance capacity for antimicrobial resistance: Laboratory capacity strengthening for drug resistant infections in low and middle income countries [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Anna C. Seale

    2017-09-01

    Full Text Available Development of antimicrobial resistance (AMR threatens our ability to treat common and life threatening infections. Identifying the emergence of AMR requires strengthening of surveillance for AMR, particularly in low and middle-income countries (LMICs where the burden of infection is highest and health systems are least able to respond. This work aimed, through a combination of desk-based investigation, discussion with colleagues worldwide, and visits to three contrasting countries (Ethiopia, Malawi and Vietnam, to map and compare existing models and surveillance systems for AMR, to examine what worked and what did not work. Current capacity for AMR surveillance varies in LMICs, but and systems in development are focussed on laboratory surveillance. This approach limits understanding of AMR and the extent to which laboratory results can inform local, national and international public health policy. An integrated model, combining clinical, laboratory and demographic surveillance in sentinel sites is more informative and costs for clinical and demographic surveillance are proportionally much lower. The speed and extent to which AMR surveillance can be strengthened depends on the functioning of the health system, and the resources available. Where there is existing laboratory capacity, it may be possible to develop 5-20 sentinel sites with a long term view of establishing comprehensive surveillance; but where health systems are weaker and laboratory infrastructure less developed, available expertise and resources may limit this to 1-2 sentinel sites. Prioritising core functions, such as automated blood cultures, reduces investment at each site. Expertise to support AMR surveillance in LMICs may come from a variety of international, or national, institutions. It is important that these organisations collaborate to support the health systems on which AMR surveillance is built, as well as improving technical capacity specifically relating to AMR

  19. Restructuring rehabilitation for women: programs for the female drug addict.

    Science.gov (United States)

    Doyle, K M; Quinones, M A; Tracy, G; Young, D; Hughes, J

    1977-12-01

    Two residential therapeutic communities for female addicts--one coeducational and the other all female--encountered serious problems shortly after their formation. The authors found that the male and female staff of the coeducational program had quite different perceptions of the purposes and characteristics of the women's part of the program. In both programs the female staff held such strongly ambivalent feeling toward their roles as women and authority figures that they had difficulty functioning effectively. The authors suggest the need for research that will identify the female addict's special needs, and a restructuring of programs to meet those needs. Further, training programs for female staff must enable them to distinguish between their own ideals and their clients' needs.

  20. [Drug Addiction Self-Help Recovery scale (DASH-scale): an approach to the measurement of recovery from drug addiction in self-help program among drug addicts].

    Science.gov (United States)

    Shimane, Takuya; Misago, Chizuru

    2004-12-01

    The purpose of the study was to develop a scale for measuring the recovery in self-help program for drug addicts. Our study sites were fourteen self-help groups for drug addicts called "DARC: Drug Addiction Rehabilitation Center". DARC activities were based on Narcotics Anonymous types of self-help program. The 25-items DASH-scale questionnaire was developed using data, which were obtained through in-depth interview among DARC staff. A cross-sectional study among recovering addicts participating in "DARC" activities was implemented from Jan 2004 to Feb 2004. 164 subjects were responded to our questionnaire. Factor analysis was carried out and items with weaker or split loadings were removed. Factor analysis of DASH-scale results produced a surprisingly clean four-factor solution. 19-items were left to form the final DASH-scale; regular life-style (6 items), acceptance of drug addiction (5 items), sympathy with member (5 items), reborn (3 items). The internal consistency (Cronbach's Alpha) of these scales was very high (0.87). Low but significant concurrent correlations were observed between the DASH-scale and the Rosenberg Self-Esteem Scale (0.22), Purpose in Life Test (0.35). Discriminant validity of the DASH-scale was supported by significant increase with exposed period of self-help program. Evidence supports the DASH-scale was possible to measure recovery in self-help program.

  1. The Incidence and Prevalence of Systemic Lupus Erythematosus in New York County (Manhattan), New York: The Manhattan Lupus Surveillance Program.

    Science.gov (United States)

    Izmirly, Peter M; Wan, Isabella; Sahl, Sara; Buyon, Jill P; Belmont, H Michael; Salmon, Jane E; Askanase, Anca; Bathon, Joan M; Geraldino-Pardilla, Laura; Ali, Yousaf; Ginzler, Ellen M; Putterman, Chaim; Gordon, Caroline; Helmick, Charles G; Parton, Hilary

    2017-10-01

    The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry designed to determine the prevalence of systemic lupus erythematosus (SLE) in 2007 and the incidence from 2007 to 2009 among residents of New York County (Manhattan), New York, and to characterize cases by race/ethnicity, including Asians and Hispanics, for whom data are lacking. We identified possible SLE cases from hospital records, rheumatologist records, and administrative databases. Cases were defined according to the American College of Rheumatology (ACR) classification criteria, the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria, or the treating rheumatologist's diagnosis. Rates among Manhattan residents were age-standardized, and capture-recapture analyses were conducted to assess case underascertainment. By the ACR definition, the age-standardized prevalence and incidence rates of SLE were 62.2 and 4.6 per 100,000 person-years, respectively. Rates were ∼9 times higher in women than in men for prevalence (107.4 versus 12.5) and incidence (7.9 versus 1.0). Compared with non-Hispanic white women (64.3), prevalence was higher among non-Hispanic black (210.9), Hispanic (138.3), and non-Hispanic Asian (91.2) women. Incidence rates were higher among non-Hispanic black women (15.7) compared with non-Hispanic Asian (6.6), Hispanic (6.5), and non-Hispanic white (6.5) women. Capture-recapture adjustment increased the prevalence and incidence rates (75.9 and 6.0, respectively). Alternate SLE definitions without capture-recapture adjustment revealed higher age-standardized prevalence and incidence rates (73.8 and 6.2, respectively, by the SLICC definition and 72.6 and 5.0 by the rheumatologist definition) than the ACR definition, with similar patterns by sex and race/ethnicity. The MLSP confirms findings from other registries on disparities by sex and race/ethnicity, provides new estimates among Asians and Hispanics, and provides estimates using the

  2. Characteristics of plasmids in multi-drug-resistant Enterobacteriaceae isolated during prospective surveillance of a newly opened hospital in Iraq.

    Directory of Open Access Journals (Sweden)

    Xiao-Zhe Huang

    Full Text Available BACKGROUND: Gram-negative multidrug-resistant (MDR bacteria are major causes of nosocomial infections, and antibiotic resistance in these organisms is often plasmid mediated. Data are scarce pertaining to molecular mechanisms of antibiotic resistance in resource constrained areas such as Iraq. METHODOLOGY/PRINCIPAL FINDINGS: In this study, all MDR Enterobacteriaceae (n = 38 and randomly selected non-MDR counterparts (n = 41 isolated from patients, healthcare workers and environmental surfaces in a newly opened hospital in Iraq were investigated to characterize plasmids found in these isolates and determine their contribution to antibiotic resistance. Our results demonstrated that MDR E. coli and K. pneumoniae isolates harbored significantly more (≥ 3 plasmids compared to their non-MDR counterparts, which carried ≤ 2 plasmids (p<0.01. Various large plasmids (~52 to 100 kb from representative isolates were confirmed to contain multiple resistance genes by DNA microarray analysis. Aminoglycoside (acc, aadA, aph, strA/B, and ksgA, β-lactam (bla(TEM1, bla(AMPC, bla(CTX-M-15, bla(OXA-1, bla(VIM-2 and bla(SHV, sulfamethoxazole/trimethoprim (sul/dfr, tetracycline (tet and chloramphenicol (cat resistance genes were detected on these plasmids. Additionally, multiple plasmids carrying multiple antibiotic resistance genes were found in the same host strain. Genetic transfer-associated genes were identified on the plasmids from both MDR and non-MDR isolates. Seven plasmid replicon types (FII, FIA, FIB, B/O, K, I1 and N were detected in the isolates, while globally disseminated IncA/C and IncHI1 plasmids were not detected in these isolates. CONCLUSIONS/SIGNIFICANCE: This is the first report of the characteristics of the plasmids found in Enterobacteriaceae isolated following the opening of a new hospital in Iraq. The information provided here furthers our understanding of the mechanisms of drug resistance in this specific region and their evolutionary

  3. Surveillance Pleasures

    DEFF Research Database (Denmark)

    Albrechtslund, Anders

    The notorious intensification and digitalization of surveillance technologies and practices in today’s society has brought about numerous changes. These changes have been widely noticed, described and discussed across many academic disciplines. However, the contexts of entertainment, play...

  4. Studies and development of essential systems in the surveillance program, life extension potential of the vessel and master curve in nuclear power plants

    International Nuclear Information System (INIS)

    Romero C, J.; Hernandez C, R.; Rocamontes A, M.; Perez R, N.

    2010-01-01

    The nuclear power plants owners should demonstrate that the effects of the embrittlement by neutronic radiation do not commit the structural integrity of the pressure vessel of the nuclear reactors, so much under conditions of routine operation as below an accident postulate. In consequence, in Mexico surveillance programs of the vessels of the nuclear power plant of Laguna Verde exist, in which three surveillance capsules are have by reactor. A surveillance capsule is composed by a support and between six and eight containers for test tubes and dosemeters. The containers for test tubes are of two types: rectangular container for Charpy V test tubes and cylindrical container for tension test tubes. These test tubes are subject to a same or bigger neutronic flow that of the vessel, being representative witness of the mechanical conditions of the vessel. The objective of to assay the test tubes to impact is to evaluate the embrittlement grade of the vessel beforehand during its useful life of operation, as well as to determinate the running of the ductile-fragile transition temperature in function of the time. (Author)

  5. Surface Environmental Surveillance Procedures Manual

    International Nuclear Information System (INIS)

    Hanf, Robert W.; Poston, Ted M.

    2000-01-01

    Shows and explains certain procedures needed for surface environmental surveillance. Hanford Site environmental surveillance is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE) under the Surface Environmental Surveillance Project (SESP). The basic requirements for site surveillance are set fourth in DOE Order 5400.1, General Environmental Protection Program Requirements. Guidance for the SESP is provided in DOE Order 5484.1, Environmental Protection, Safety, and Health Protection Information Reporting Requirements and DOE Order 5400.5, Radiation Protection of the Public and Environment. Guidelines for environmental surveillance activities are provided in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance. An environmental monitoring plan for the Hanford Site is outlined in DOE/RL 91-50 Rev. 2, Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office. Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual. Personnel training requirements are documented in SESP-TP-01 Rev.2, Surface Environmental Surveillance Project Training Program.

  6. An Experimental Trial of Adaptive Programming in Drug Court: Outcomes at 6, 12 and 18 Months.

    Science.gov (United States)

    Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Harron, Ashley

    2014-06-01

    Test whether an adaptive program improves outcomes in drug court by adjusting the schedule of court hearings and clinical case-management sessions pursuant to a priori performance criteria. Consenting participants in a misdemeanor drug court were randomly assigned to the adaptive program (n = 62) or to a baseline-matching condition (n = 63) in which they attended court hearings based on the results of a criminal risk assessment. Outcome measures were re-arrest rates at 18 months post-entry to the drug court and urine drug test results and structured interview results at 6 and 12 months post-entry. Although previously published analyses revealed significantly fewer positive drug tests for participants in the adaptive condition during the first 18 weeks of drug court, current analyses indicate the effects converged during the ensuing year. Between-group differences in new arrest rates, urine drug test results and self-reported psychosocial problems were small and non-statistically significant at 6, 12 and 18 months post-entry. A non-significant trend (p = .10) suggests there may have been a small residual impact (Cramer's ν = .15) on new misdemeanor arrests after 18 months. Adaptive programming shows promise for enhancing short-term outcomes in drug courts; however, additional efforts are needed to extend the effects beyond the first 4 to 6 months of enrollment.

  7. The Prevalence of Transmitted Drug Resistance in Newly Diagnosed HIV-Infected Individuals in Croatia: The Role of Transmission Clusters of Men Who Have Sex with Men Carrying the T215S Surveillance Drug Resistance Mutation

    Science.gov (United States)

    Grgic, Ivana; Lunar, Maja M.; Poljak, Mario; Vince, Adriana; Vrakela, Ivana Baca; Planinic, Ana; Seme, Katja; Begovac, Josip

    2013-01-01

    Abstract The aim of this study was to determine the prevalence of transmitted drug resistance (TDR) in newly diagnosed and treatment-naive HIV-infected patients from Croatia and evaluate a possible contribution of transmission clusters to the spread of resistant virus. The study enrolled treatment-naive HIV-infected patients that entered clinical care at the Croatian Reference Center for HIV/AIDS between 2006 and 2008. The protease gene and a part of the reverse transcriptase gene of the HIV-1 genome were sequenced by using the Trugene HIV-1 Genotyping System. The prevalence of transmitted drug resistance was analyzed by using the surveillance drug resistance mutations (SDRM) list recommended by the WHO in 2009. We report findings for 118 of 180 eligible patients (65.6% coverage). SDRM were detected in 26 of 118 patients (22.0%) who were infected with subtype B and belonged mostly to the men having sex with men (MSM). The majority of patients with primary resistance carried SDRM associated with resistance to nucleoside analogues reverse transcriptase inhibitors (NRTIs, 23 of 118 patients, 19.5%). The most frequently found NRTI SDRM was T215S (17 of 118 patients, 14.4%). SDRM associated with resistance to nonnucleoside reverse transcriptase inhibitors were detected in three (2.5%) patients and primary resistance to protease inhibitors was not detected. Non-B subtypes were detected in 13/118 patients (11%). A total of 12 transmission pairs and eight distinct transmission clusters were identified with the largest cluster harboring sequences from 19 patients; among them all but two were carrying the T215S mutation. This study showed a high prevalence of TDR in newly diagnosed MSM from Croatia and is an important contribution concerning the relationship between local transmission clusters and the spread of resistant virus. PMID:22906365

  8. Legal drug content in music video programs shown on Australian television on saturday mornings.

    Science.gov (United States)

    Johnson, Rebecca; Croager, Emma; Pratt, Iain S; Khoo, Natalie

    2013-01-01

    To examine the extent to which legal drug references (alcohol and tobacco) are present in the music video clips shown on two music video programs broadcast in Australia on Saturday mornings. Further, to examine the music genres in which the references appeared and the dominant messages associated with the references. Music video clips shown on the music video programs 'Rage' (ABC TV) and [V] 'Music Video Chart' (Channel [V]) were viewed over 8 weeks from August 2011 to October 2011 and the number of clips containing verbal and/or visual drug references in each program was counted. The songs were classified by genre and the dominant messages associated with drug references were also classified and analysed. A considerable proportion of music videos (approximately one-third) contained drug references. Alcohol featured in 95% of the music videos that contained drug references. References to alcohol generally associated it with fun and humour, and alcohol and tobacco were both overwhelmingly presented in contexts that encouraged, rather than discouraged, their use. In Australia, Saturday morning is generally considered a children's television viewing timeslot, and several broadcaster Codes of Practice dictate that programs shown on Saturday mornings must be appropriate for viewing by audiences of all ages. Despite this, our findings show that music video programs aired on Saturday mornings contain a considerable level of drug-related content.

  9. Factors associated with the implementation of programs for drug abuse prevention in schools

    Directory of Open Access Journals (Sweden)

    Ana Paula Dias Pereira

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. METHODS Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. RESULTS We found that 42.5% (95%CI 36.1–49.1 of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. CONCLUSIONS The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school.

  10. Evaluating an In-School Drug Prevention Program for At-Risk Youth.

    Science.gov (United States)

    DeWit, David J.; Steep, Barbara; Silverman, Gloria; Stevens-Lavigne, Andrea; Ellis, Kathy; Smythe, Cindy; Rye, Barbara J.; Braun, Kathy; Wood, Eileen

    2000-01-01

    A drug prevention program involving 167 at-risk students in grades 8-10 at 9 Ontario schools resulted in reduced use of and less supportive attitudes toward alcohol, cannabis, tobacco, and tranquilizers. Program success is attributed to high attendance and retention, community health professionals' participation, comprehensive approach, strong…

  11. Designing a risk-based surveillance program for Mycobacterium avium ssp. paratuberculosis in Norwegian dairy herds using multivariate statistical process control analysis.

    Science.gov (United States)

    Whist, A C; Liland, K H; Jonsson, M E; Sæbø, S; Sviland, S; Østerås, O; Norström, M; Hopp, P

    2014-11-01

    Surveillance programs for animal diseases are critical to early disease detection and risk estimation and to documenting a population's disease status at a given time. The aim of this study was to describe a risk-based surveillance program for detecting Mycobacterium avium ssp. paratuberculosis (MAP) infection in Norwegian dairy cattle. The included risk factors for detecting MAP were purchase of cattle, combined cattle and goat farming, and location of the cattle farm in counties containing goats with MAP. The risk indicators included production data [culling of animals >3 yr of age, carcass conformation of animals >3 yr of age, milk production decrease in older lactating cows (lactations 3, 4, and 5)], and clinical data (diarrhea, enteritis, or both, in animals >3 yr of age). Except for combined cattle and goat farming and cattle farm location, all data were collected at the cow level and summarized at the herd level. Predefined risk factors and risk indicators were extracted from different national databases and combined in a multivariate statistical process control to obtain a risk assessment for each herd. The ordinary Hotelling's T(2) statistic was applied as a multivariate, standardized measure of difference between the current observed state and the average state of the risk factors for a given herd. To make the analysis more robust and adapt it to the slowly developing nature of MAP, monthly risk calculations were based on data accumulated during a 24-mo period. Monitoring of these variables was performed to identify outliers that may indicate deviance in one or more of the underlying processes. The highest-ranked herds were scattered all over Norway and clustered in high-density dairy cattle farm areas. The resulting rankings of herds are being used in the national surveillance program for MAP in 2014 to increase the sensitivity of the ongoing surveillance program in which 5 fecal samples for bacteriological examination are collected from 25 dairy herds

  12. An Evaluation of Immediate Outcomes and Fidelity of a Drug Abuse Prevention Program in Continuation High Schools: Project towards No Drug Abuse (TND)

    Science.gov (United States)

    Lisha, Nadra E.; Sun, Ping; Rohrbach, Louise A.; Spruijt-Metz, Donna; Unger, Jennifer B.; Sussman, Steve

    2012-01-01

    The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n = 1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational…

  13. Using Elite Athletes to Promote Drug Abstinence: Evaluation of a Single-Session School-Based Drug Use Prevention Program Delivered by Junior Hockey Players

    Science.gov (United States)

    Wong, Jennifer

    2016-01-01

    School-based substance use prevention programs are a common method to approaching drug use in youths. Project SOS is a single-session drug prevention program developed by police officers and delivered by elite junior hockey players to students in grades 6 and 7. The current study evaluates the effects of Project SOS at achieving its objectives of…

  14. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Required elements of an anti-drug use and alcohol... and alcohol misuse program. An anti-drug use and alcohol misuse program shall include the following: (a) A statement describing the employer's policy on prohibited drug use and alcohol misuse in the...

  15. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  16. 78 FR 102 - Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device...

    Science.gov (United States)

    2013-01-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1056] Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device Submissions; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

  17. Validación de un programa de vigilancia de infecciones nosocomiales Validation of a nosocomial infections surveillance program

    Directory of Open Access Journals (Sweden)

    M. Sigfrido Rangel-Frausto

    1999-01-01

    Full Text Available OBJETIVO. Validar el programa de vigilancia de infecciones nosocomiales y conocer la morbilidad y la mortalidad. MATERIAL Y MÉTODOS. Un médico especialmente capacitado, realizó vigilancia intensiva de todos los pacientes admitidos en el hospital. Los casos de infección fueron discutidos con otros dos médicos y el resultado se comparó con la vigilancia rutinaria. Se incluyó a todos los pacientes hospitalizados del 11 de julio al 12 de agosto de 1995, que no tenían un proceso infeccioso activo o que no manifestaban un periodo de incubación a su ingreso. Se siguieron diariamente y se registraron datos de: edad, sexo y padecimiento de ingreso. Se recabó información sobre tratamiento antimicrobiano, microrganismo aislado y susceptibilidad. Se evaluó el estado clínico final y se estimó el tiempo de estancia hospitalaria. RESULTADOS. De 429 pacientes, 45 desarrollaron infección nosocomial (casos y 384 no lo hicieron (controles. La incidencia de infecciones nosocomiales fue de 10.48/100. La sensibilidad y la especificidad del programa fueron de 93.3 y 98.7%, respectivamente. La mortalidad en los infectados fue de 11.11%, y en el grupo de los no infectados, de 2.4%. El promedio de estancia hospitalaria fue de 20 y 11 días, para infectados y no infectados, respectivamente (pOBJECTIVES. To validate the nosocomial infections surveillance system, establish its impact in morbi-mortality. MATERIAL AND METHODS. Surveillance of every single patient admited during a one month period was done by one of us (DMG. Each posibile case was discussed with two other hospital epidemiologists (SPLR, MSRF. This intensive surveillance was compared against the routinely surveillance performed by the nurses. We included all hospitalized patients between 11th July and 12th of August according to CDC (Atlanta, GA nosocomial infections definitions. Patients were followed everyday and information about age, gender, underlying diagnosis, microorganisms responsible

  18. Drug and alcohol abuse: the bases for employee assistance programs in the nuclear-utility industry

    Energy Technology Data Exchange (ETDEWEB)

    Radford, L.R.; Rankin, W.L.; Barnes, V.; McGuire, M.V.; Hope, A.M.

    1983-07-01

    This report describes the nature, prevalence, and trends of drug and alcohol abuse among members of the US adult population and among personnel in non-nuclear industries. Analogous data specific to the nuclear utility industry are not available, so these data were gathered in order to provide a basis for regulatory planning. The nature, prevalence, and trend inforamtion was gathered using a computerized literature, telephone discussions with experts, and interviews with employee assistance program representatives from the Seattle area. This report also evaluates the possible impacts that drugs and alcohol might have on nuclear-related job performance, based on currently available nuclear utility job descriptions and on the scientific literature regarding the impairing effects of drugs and alcohol on human performance. Employee assistance programs, which can be used to minimize or eliminate job performance decrements resulting from drug or alcohol abuse, are also discussed.

  19. The effectiveness of a health-surveillance program for caisson saturation divers in a tunnel-boring machine: a microbiological survey.

    Science.gov (United States)

    Van Rees Vellinga, T P; Sterk, W; Van Dijk, F J H

    2010-01-01

    The purpose of this field study is to report and evaluate the implementation of a health surveillance program we developed to monitor the microbiological load for saturation divers, including preventive and therapeutic interventions. We extended the DMAC protocol for Saturation Diving Chamber Hygiene and added some components: ear inspections, swabs and environmental swabs every third day. The implementation was evaluated by analyzing the results of the activities. In a pre-saturation dive check we examined a total of 17 divers. Here we present the data from all seven saturation phases, collected over a period of 1.5 years. In every saturation phase we have found pathogenic bacteria or fungi in divers and in the environment, but more in some periods than in others. We did not observe any serious infection that required a diver to abort his stay in the living chamber. This health surveillance program has demonstrated the potential value of an early warning system to prevent problems. The bacterial load found in divers and in the environment was clearly visible. Prevention could be improved by more consistent implementation of the protocol. Fortunately, the infections had no serious consequences for the health of the workers or for the continuation of the work process.

  20. Public involvement in environmental surveillance at Hanford

    International Nuclear Information System (INIS)

    Hanf, R.W. Jr.; Patton, G.W.; Woodruff, R.K.; Poston, T.M.

    1994-08-01

    Environmental surveillance at the Hanford Site began during the mid-1940s following the construction and start-up of the nation's first plutonium production reactor. Over the past approximately 45 years, surveillance operations on and off the Site have continued, with virtually all sampling being conducted by Hanford Site workers. Recently, the US Department of Energy Richland Operations Office directed that public involvement in Hanford environmental surveillance operations be initiated. Accordingly, three special radiological air monitoring stations were constructed offsite, near hanford's perimeter. Each station is managed and operated by two local school teaches. These three stations are the beginning of a community-operated environmental surveillance program that will ultimately involve the public in most surveillance operations around the Site. The program was designed to stimulate interest in Hanford environmental surveillance operations, and to help the public better understand surveillance results. The program has also been used to enhance educational opportunities at local schools

  1. An Online Drug Abuse Prevention Program for Adolescent Girls: Posttest and 1-Year Outcomes.

    Science.gov (United States)

    Schwinn, Traci M; Schinke, Steven P; Hopkins, Jessica; Keller, Bryan; Liu, Xiang

    2018-03-01

    Early adolescent girls' rates of drug use have matched, and in some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session, gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early adolescent girls.

  2. Efficacy evaluation of the school program Unplugged for drug use prevention among Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Zila M. Sanchez

    2016-11-01

    Full Text Available Abstract Background Most Brazilian schools do not have a continuous program for drug use prevention and do not conduct culturally adapted activities for that purpose. This study evaluated the impact of the Unplugged program on drug use prevention among children and adolescents in public middle schools of Brazil. Methods A non-randomized controlled trial was conducted in 2013 with 2185 students in 16 public schools from 3 Brazilian cities. The intervention group attended 12 weekly classes of the Unplugged program for drug use prevention, and the control group did not attend to any school prevention programs in the same year. Multilevel analyses were used to evaluate temporal and between group changes in the consumption of each drug. Results The study suggested that there was no evidence that Unplugged effected 11- to 12-year-old students. However, the program seemed to stimulate a decrease in recent marijuana use (transition from use to non-use in 85.7% of intervention cases and 28.6% of control cases, OR = 17.5, p = 0.039 among 13- to 15-year-old students. In addition, students in this age range who received the Unplugged program had similar drug consumption levels to those observed before the program began. However, students in the control group presented a significant tendency to increase marijuana use and binge drinking. Conclusions This study adds to the evidence of program efficacy among Brazilian middle school students by presenting marginal effects on binge drinking and marijuana use. An 18-month randomized controlled trial is recommended for a future study.

  3. Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

    NARCIS (Netherlands)

    Blok, C. de; Schilp, J.; Wagner, C.

    2013-01-01

    Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

  4. Annual summary report on surveillance and maintenance activities of the surplus contaminated facilities program at Oak Ridge National Laboratory for period ending September 30, 1991

    International Nuclear Information System (INIS)

    Cannon, T.R.; Ford, M.K.; Holder, L. Jr.

    1991-09-01

    The Surplus Contaminated Facilities Program (SCFP) was established at the Oak Ridge National Laboratory (ORNL) in 1985 to provide support for inactive contaminated facilities that were largely abandoned by the programs which they formerly served. This support provides for routine surveillance and maintenance (S ampersand M) and special projects beyond a routine nature when such actions are needed to ensure adequate protection of personnel or the environment. The facilities included in the program had been used for research, technology development, isotope production and processing, and waste management. Support for facilities in the SCFP has previously been provided by the Department of Energy's (DOE's) Office of Energy Research: Multiprogram Energy Laboratories -- Facilities Support (ERKG) because of multiprogram use of the facilities or because of the landlord responsibility of Energy Research. Recently, an integrated Decontamination and Decommissioning (D ampersand D) program within the DOE Office of Environmental Restoration and Waste Management has been established to collectively manage the former Surplus Facilities Management Program, Defense D ampersand D Program, and the KG-funded, ORNL-originated SCFP. This report gives an overview of the S ampersand M planning, routine S ampersand M, and special maintenance project activities which have occurred at the SCFP facilities during the 1991 Fiscal Year

  5. Annual summary report of the Decontamination and Decommissioning surveillance and maintenance program at Oak Ridge National Laboratory for period ending September 30, 1992

    International Nuclear Information System (INIS)

    Ford, M.K.; Holder, L. Jr.

    1992-09-01

    The Oak Ridge National Laboratory (ORNL) Decontamination and Decommissioning (D ampersand D) Program is part of the Department of Energy (DOE) Environmental Restoration D ampersand D Program and has continued to provide surveillance and maintenance (S ampersand M) support for 34 surplus facilities. The objectives are (1) to ensure adequate containment of residual radioactive materials remaining in the facilities, (2) to provide safety and security controls to minimize the potential hazards to on-site personnel and to the general public, and (3) to manage the facilities in the most cost-effective manner while awaiting decommissioning. This support has included work in three principal areas: (1) S ampersand M planning, (2) routine S ampersand M, and (3) special projects designed to correct serious facility deficiencies beyond the scope of routine maintenance

  6. Public/private partnerships for prescription drug coverage: policy formulation and outcomes in Quebec's universal drug insurance program, with comparisons to the Medicare prescription drug program in the United States.

    Science.gov (United States)

    Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Palley, Howard A; Martin, Elisabeth

    2007-09-01

    In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA.

  7. The results of the surveillance specimen program performed in the RPVs NPP V-2 in Jaslovske Bohunice

    Energy Technology Data Exchange (ETDEWEB)

    Kupca, L; Beno, P [Vyskumny Ustav Jadrovych Elektrarni, Trnava (Slovakia); Cepeek, S [Atomova Elektraren Bohunice, Jaslovske Bohunice (Slovakia); Tomasich, M [Slovak Nuclear Society, Bratislava (Slovakia)

    1994-12-31

    After a description of the mechanical and chemical characteristics of the materials (steels, welded joints) used in the pressure vessels of the WWER-440 V-213 type, the present status of the Bohunice NPP Unit 3 and 4 pressure vessel embrittlement assessment programme is presented: neutron flux monitoring and calculations, detector accuracy, irradiation temperature monitoring, reactor core fuel loading calculation, materials, number and types of surveillance specimens, specimen testing. Results are given for 5 years of irradiation: mechanical properties, transition temperatures, lifetime evaluation. 4 refs., 13 figs., 6 tabs.

  8. Influenza surveillance

    Directory of Open Access Journals (Sweden)

    Karolina Bednarska

    2016-04-01

    Full Text Available Influenza surveillance was established in 1947. From this moment WHO (World Health Organization has been coordinating international cooperation, with a goal of monitoring influenza virus activity, effective diagnostic of the circulating viruses and informing society about epidemics or pandemics, as well as about emergence of new subtypes of influenza virus type A. Influenza surveillance is an important task, because it enables people to prepare themselves for battle with the virus that is constantly mutating, what leads to circulation of new and often more virulent strains of influenza in human population. As vaccination is the most effective method of fighting the virus, one of the major tasks of GISRS is developing an optimal antigenic composition of the vaccine for the current epidemic season. European Influenza Surveillance Network (EISN has also developed over the years. EISN is running integrated epidemiological and virological influenza surveillance, to provide appropriate data to public health experts in member countries, to enable them undertaking relevant activities based on the current information about influenza activity. In close cooperation with GISRS and EISN are National Influenza Centres - national institutions designated by the Ministry of Health in each country.

  9. Surveillance Angels

    NARCIS (Netherlands)

    Rothkrantz, L.J.M.

    2014-01-01

    The use of sensor networks has been proposed for military surveillance and environmental monitoring applications. Those systems are composed of a heterogeneous set of sensors to observe the environment. In centralised systems the observed data will be conveyed to the control room to process the

  10. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

    Directory of Open Access Journals (Sweden)

    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  11. Access to Investigational Drugs: FDA Expanded Access Programs or “Right‐to‐Try” Legislation?

    Science.gov (United States)

    Berglund, Jelena P.; Weatherwax, Kevin; Gerber, David E.; Adamo, Joan E.

    2015-01-01

    Abstract Purpose The Food and Drug Administration Expanded Access (EA) program and “Right‐to‐Try” legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. Methods FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. Results The FDA EA program includes Single Patient‐Investigational New Drug (SP‐IND), Emergency SP‐IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. “Right‐to‐Try” legislation bypasses some of these steps, but provides no regulatory or safety oversight. Conclusion The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP‐IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. PMID:25588691

  12. Access to Investigational Drugs: FDA Expanded Access Programs or "Right-to-Try" Legislation?

    Science.gov (United States)

    Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E

    2015-10-01

    The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.

  13. Development of a metrics dashboard for monitoring involvement in the 340B Drug Pricing Program.

    Science.gov (United States)

    Karralli, Rusol; Tipton, Joyce; Dumitru, Doina; Scholz, Lisa; Masilamani, Santhi

    2015-09-01

    An electronic tool to support hospital organizations in monitoring and addressing financial and compliance challenges related to participation in the 340B Drug Pricing Program is described. In recent years there has been heightened congressional and regulatory scrutiny of the federal 340B program, which provides discounted drug prices on Medicaid-covered drugs to safety net hospitals and other 340B-eligible healthcare organizations, or "covered entities." Historically, the 340B program has lacked a metrics-driven reporting framework to help covered entities capture the value of 340B program involvement, community benefits provided to underserved populations, and costs associated with compliance with 340B eligibility requirements. As part of an initiative by a large health system to optimize its 340B program utilization and regulatory compliance efforts, a team of pharmacists led the development of an electronic dashboard tool to help monitor 340B program activities at the system's 340B-eligible facilities. After soliciting input from an array of internal and external 340B program stakeholders, the team designed the dashboard and associated data-entry tools to facilitate the capture and analysis of 340B program-related data in four domains: cost savings and revenue, program maintenance costs, community benefits, and compliance. A large health system enhanced its ability to evaluate and monitor 340B program-related activities through the use of a dashboard tool capturing key metrics on cost savings achieved, maintenance costs, and other aspects of program involvement. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  14. Scaffold hopping in drug discovery using inductive logic programming.

    Science.gov (United States)

    Tsunoyama, Kazuhisa; Amini, Ata; Sternberg, Michael J E; Muggleton, Stephen H

    2008-05-01

    In chemoinformatics, searching for compounds which are structurally diverse and share a biological activity is called scaffold hopping. Scaffold hopping is important since it can be used to obtain alternative structures when the compound under development has unexpected side-effects. Pharmaceutical companies use scaffold hopping when they wish to circumvent prior patents for targets of interest. We propose a new method for scaffold hopping using inductive logic programming (ILP). ILP uses the observed spatial relationships between pharmacophore types in pretested active and inactive compounds and learns human-readable rules describing the diverse structures of active compounds. The ILP-based scaffold hopping method is compared to two previous algorithms (chemically advanced template search, CATS, and CATS3D) on 10 data sets with diverse scaffolds. The comparison shows that the ILP-based method is significantly better than random selection while the other two algorithms are not. In addition, the ILP-based method retrieves new active scaffolds which were not found by CATS and CATS3D. The results show that the ILP-based method is at least as good as the other methods in this study. ILP produces human-readable rules, which makes it possible to identify the three-dimensional features that lead to scaffold hopping. A minor variant of a rule learnt by ILP for scaffold hopping was subsequently found to cover an inhibitor identified by an independent study. This provides a successful result in a blind trial of the effectiveness of ILP to generate rules for scaffold hopping. We conclude that ILP provides a valuable new approach for scaffold hopping.

  15. Break-even analysis of costs for controlling Toxoplasma gondii infections in slaughter pigs via a serological surveillance program in the Netherlands.

    Science.gov (United States)

    van Asseldonk, M; van Wagenberg, C P A; Wisselink, H J

    2017-03-01

    Toxoplasma gondii (T. gondii) is a food safety hazard which causes a substantial human disease burden and cost-of-illness. Infected pig meat is a common source of toxoplasmosis. A break-even analysis was conducted to estimate the point for which the intervention cost at fattening pig farms equaled the cost of averted human disease burden and cost-of-illness minus the costs of a T. gondii surveillance program. The surveillance program comprised serological testing of blood samples taken at slaughter. Break-even points were determined given alternative levels of the effectiveness of the intervention program (10% up to 90% in steps of 10%), the value of an averted DALY (20,000, 50,000 and 80,000 Euro), and threshold of sample prevalence for a farm to be under intervention (5% up to 50% out of 20 samples in steps of 5%). Since test characteristics are a determining factor in the break-even analysis, and literature is inconclusive concerning sensitivity (se) and specificity (sp) of the serological test kit used, two alternative sets of assumptions were analysed. The estimated maximum costs of an intervention if only benefits for domestic consumers were accounted amounted approximately 2981 Euro (se=98.9% and sp=92.7%) versus 4389 Euro (se=65.2% and sp=97.4%) per year per fattening pig farm under intervention assuming an effectiveness of 50%, 50,000 Euro per averted DALY and threshold T. gondii sample prevalence of 5% for a farm to be under intervention. Since almost 80% of the gross domestic production is exported corresponding break-even values increased up to 12,034 Euro and 18,366 Euro if benefits for consumers abroad were included as well. Empirical research to strengthen the knowledge about the efficacy of a farm intervention measures is recommended. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Crypto and empire: the contradictions of counter-surveillance advocacy

    NARCIS (Netherlands)

    Gürses, S.; Kundnani, A.; Van Hoboken, J.

    2016-01-01

    Since Edward Snowden’s revelations of US and UK surveillance programs, privacy advocates, progressive security engineers, and policy makers have been seeking to win majority support for countering surveillance. The problem is framed as the replacement of targeted surveillance with mass surveillance

  17. Philadelphia's community based drug abuse program: broader medical and social concepts.

    Science.gov (United States)

    Schut, J

    1975-06-01

    The rehabilitation of drug dependent people has undergone drastic changes since first attempts were made to curb the abuse of illegal drugs. The isolated law-enforcement model proved to be of no use in this area. So, too, the medical model, the psychological model and the public health model proved disappointingly low in their results. During the last ten years, a so-called "metabolic replacement model" has had its upsurge, creating a controversy still under discussion. The Drug Abuse Rehabilitation Programs of the West Philadelphia Community Mental Health Consortium, Inc. have been in the forefront with its treatment models. Established in 1968 as a purely methadone maintenance program, it has evolved into becoming a model, applying community mental health principles. This paper will explore this model further, describing the mechanics of its changes. From a municipal hospital-based methadone dispensing station, the program has developed into a multi-modality project. Three decentralized drug-free outpatient services are located in the midst of the community where the drug abuse problem is more accute. Outreach is emphasized and case-funding is applied. A possibly unique river-front motel was just acquired for the development of a community-based treatment modality. The 94 rooms were converted into a first-floor alcoholism program which also has a "highway safety program" and an intermediate care facility for alcoholics. The second floor of this facility contains outpatient services for the treatment of drug addicts, including a methadone maintenance program, counselling, family therapy and group therapy. The place where most of the emphasis has been placed is the Work Rehabilitation Center (a novel approach whereby patients will spend up to six hours in "partial hospitalization"). Clients will be tested for vocational aptitude and four workshops will be developed on the premises - carpentry, automotive, electricity and clerical. A huge cafeteria with a semi

  18. 75 FR 13009 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-03-18

    ... DEPARTMENT OF TRANSPORTATION Office of the Secretary 49 CFR Part 40 [Docket DOT-OST-2008-0088] RIN OST 2105-AD84 Procedures for Transportation Workplace Drug and Alcohol Testing Programs Correction In rule document 2010-3731 beginning on page 8528 in the issue of Thursday, February 25, 2010, make the...

  19. An Assessment of Prison-Based Drug Treatment; Texas' In-Prison Therapeutic Community Program.

    Science.gov (United States)

    Knight, Kevin; Simpson, D. Dwayne; Chatham, Lois R.; Camacho, L. Mabel

    1997-01-01

    Provides an overview of a comprehensive, prison-based treatment assessment, including a six-month follow-up study. Results show that 80% of the inmates referred to the program graduated. Graduates demonstrated marked reductions in criminal and drug-use activity and had lower relapse and recidivism rates when compared to other parolees. (RJM)

  20. Program Administrator's Handbook. Strategies for Preventing Alcohol and Other Drug Problems. The College Series.

    Science.gov (United States)

    CSR, Inc., Washington, DC.

    This handbook is for administrators of programs in higher education settings which deal with alcohol and other drug (AOD) related problems. Chapter 1, "Defining the Problem, Issues, and Trends" examines the problem from various perspectives and presents the latest statistics on the extent of AOD use on campuses, specific problems affecting…

  1. 75 FR 8524 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-02-25

    ... 2105-AD67 Procedures for Transportation Workplace Drug and Alcohol Testing Programs AGENCY: Office of... IFR to mitigate this conflict between the DOT rules and what we view as beneficial State laws by.... It merely eliminated a conflict that would have precluded parties from complying with certain State...

  2. FACTORS AFFECTING THE RELEASE RATE OF A HIGHLY SOLUBLE DRUG FROM A PROGRAMMED RELEASE MEGALOPOROUS SYSTEM

    NARCIS (Netherlands)

    VANDERVEEN, C; MENGER, NR; LERK, CF

    The present study reports on the successful incorporation of a highly soluble drug, procaine HCl, in a programmed-release megaloporous system. This solid two-phase system is composed of housing phase matrix granules (HMG), controlling liquid penetration into the system, and of restraining phase

  3. 77 FR 60318 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs: 6-acetylmorphine (6-AM...

    Science.gov (United States)

    2012-10-03

    ... 2105-AE14 Procedures for Transportation Workplace Drug and Alcohol Testing Programs: 6-acetylmorphine... 12866 and Regulatory Flexibility Act This Final Rule is not significant for purposes of Executive Order... certify, under the Regulatory Flexibility Act, that this rule does not have a significant economic impact...

  4. 75 FR 8526 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-02-25

    ... 2105-AD64 Procedures for Transportation Workplace Drug and Alcohol Testing Programs AGENCY: Office of... required method. However, in response to comments requesting additional flexibility in testing methods, the... may increase flexibility and lower costs for employers who choose to use them over more expensive...

  5. 75 FR 8528 - Procedures for Transportation Workplace Drug and Alcohol Testing Programs

    Science.gov (United States)

    2010-02-25

    ... OST 2105-AD84 Procedures for Transportation Workplace Drug and Alcohol Testing Programs AGENCY: Office... of small entities, for purposes of the Regulatory Flexibility Act. The Department makes these... necessary for the Department to conduct a regulatory evaluation or Regulatory Flexibility Analysis for this...

  6. 76 FR 14001 - Office of Safe and Drug-Free Schools Discretionary Grant Programs

    Science.gov (United States)

    2011-03-15

    .... 2005; 62(6) 593-602. These challenges--crime, early drug and alcohol abuse, anxiety, aggressive or... Programs): Grants to Reduce Alcohol Abuse (CFDA No. 84.184A). Grants for the Integration of Schools and... abuse and mental health crises that affect AI/AN students. DATES: We must receive your comments on or...

  7. 76 FR 63017 - Medicare Program; Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug...

    Science.gov (United States)

    2011-10-11

    ... (Sec. 423.2300) b. Definitions (Sec. 423.2305) (1) Applicable Beneficiary (2) Applicable Drug (3... marketing, including agent/broker training; payments to MA organizations based on quality ratings; standards... program; payment rules for non-contract health care providers; extending current network adequacy...

  8. School-Based Drug Abuse Prevention Programs in High School Students

    Science.gov (United States)

    Sharma, Manoj; Branscum, Paul

    2013-01-01

    Drug abuse, or substance abuse, is a substantial public health problem in the United States, particularly among high school students. The purpose of this article was to review school-based programs implemented in high schools for substance abuse prevention and to suggest recommendations for future interventions. Included were English language…

  9. Rinderpest surveillance

    International Nuclear Information System (INIS)

    2003-01-01

    Rinderpest is probably the most lethal virus disease of cattle and buffalo and can destroy whole populations; damaging economies; undermining food security and ruining the livelihood of farmers and pastoralists. The disease can be eradicated by vaccination and control of livestock movement. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division to provide advice, training and materials to thirteen states through the 'Support for Rinderpest Surveillance in West Asia' project. (IAEA)

  10. Health surveillance

    International Nuclear Information System (INIS)

    1981-01-01

    The Code includes a number of requirements for the health surveillance of employees associated with the mining and milling of radioactive ores. This guideline is particularly directed at determining the level of fitness of employees and prospective employees, detecting any symptom which might contraindicate exposure to the environment encountered in mine/mill situations, examination of any employee who may have been exposed to radiation in excess of defined limits and the accumulation and provision of data on the health of employees

  11. Annual summary report of the Decontamination and Decommissioning Surveillance and Maintenance Program at Oak Ridge National Laboratory for period ending September 30, 1993

    International Nuclear Information System (INIS)

    1993-11-01

    The Oak Ridge National Laboratory (ORNL) Decontamination and Decommissioning (D ampersand D) Program has continued to provide surveillance and maintenance (S ampersand M) support for 34 surplus facilities. The objectives are to (1) ensure adequate containment of residual radioactive materials remaining in the facilities, (2) provide safety and security controls to minimize the potential hazards to on-site personnel and the general public, and (3) manage the facilities in the most cost-effective manner while awaiting decommissioning. This support has included work in three principal areas: (1) S ampersand M planning, (2) routine S ampersand M, and (3) special projects designed to correct serious facility deficiencies beyond the scope of routine maintenance

  12. Impact of a change in surveillance definition on performance assessment of a catheter-associated urinary tract infection prevention program at a tertiary care medical center.

    Science.gov (United States)

    Sopirala, Madhuri M; Syed, Asma; Jandarov, Roman; Lewis, Margaret

    2018-03-16

    In January 2015, the Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) changed the definition of catheter-associated urinary tract infection (CAUTI). We evaluated the outcomes of a robust CAUTI prevention program when we performed surveillance using the old definition (before 2015) versus the new definition (after 2015). This is the first study to evaluate how the change in CDC/NHSN definitions affected the outcomes of a CAUTI reduction program. Baseline was from January 2012 to September 2014; the intervention period was from October 2014 to February 2016. Staff nurses were trained to be liaisons of infection prevention (Link Nurses) with clearly defined CAUTI prevention goals and with ongoing monthly activities. CAUTI incidence per 1000 catheter days was compared between the baseline and intervention periods, using the 2 definitions. With the new definition, CAUTIs decreased by 33%, from 2.69 to 1.81 cases per 1000 catheter days (incidence rate ratio [IRR] = 0.67; 95% confidence interval [CI]: 0.48-0.93; P definition, CAUTIs increased by 12%, from 3.38 to 3.80 cases per 1000 catheter days (IRR = 1.12; 95% CI: 0.88-1.43; P = .348). We aggressively targeted CAUTI prevention, but a reduction was observed only with the new definition. Our findings stress the importance of having a reasonably accurate surveillance definition to monitor infection prevention initiatives. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening: a monocenter study in Germany.

    Science.gov (United States)

    Vetter, Lisa; Keller, Monika; Bruckner, Thomas; Golatta, Michael; Eismann, Sabine; Evers, Christina; Dikow, Nicola; Sohn, Christof; Heil, Jörg; Schott, Sarah

    2016-04-01

    Breast cancer (BC) is the leading cancer among women worldwide and in 5-10 % of cases is of hereditary origin, mainly due to BRCA1/2 mutations. Therefore, the German Consortium for Familial Breast and Ovarian Cancer (HBOC) with its 15 specialized academic centers offers families at high risk for familial/hereditary cancer a multimodal breast cancer surveillance program (MBCS) with regular breast MRI, mammography, ultrasound, and palpation. So far, we know a lot about the psychological effects of genetic testing, but we know little about risk-correlated adherence to MBCS or prophylactic surgery over time. The aim of this study was to investigate counselees' adherence to recommendations for MBCS in order to adjust the care supply and define predictors for incompliance. All counselees, who attended HBOC consultation at the University Hospital Heidelberg between July 01, 2009 and July 01, 2011 were eligible to participate. A tripartite questionnaire containing sociodemographic information, psychological parameters, behavioral questions, and medical data collection from the German consortium were used. A high participation rate was achieved among the study population, with 72 % returning the questionnaire. This study showed a rate of 59 % of full-adherers to the MBCS. Significant predictors for partial or full adherence were having children (p = 0.0221), younger daughters (p = 0.01795), a higher awareness of the topic HBOC (p = 0.01795, p breast cancer risk (p breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening-a monocenter study in Germany.

  14. The Andrews’ Principles of Risk, Need, and Responsivity as Applied in Drug Abuse Treatment Programs: Meta-Analysis of Crime and Drug Use Outcomes

    Science.gov (United States)

    Prendergast, Michael L.; Pearson, Frank S.; Podus, Deborah; Hamilton, Zachary K.; Greenwell, Lisa

    2013-01-01

    Objectives The purpose of the present meta-analysis was to answer the question: Can the Andrews principles of risk, needs, and responsivity, originally developed for programs that treat offenders, be extended to programs that treat drug abusers? Methods Drawing from a dataset that included 243 independent comparisons, we conducted random-effects meta-regression and ANOVA-analog meta-analyses to test the Andrews principles by averaging crime and drug use outcomes over a diverse set of programs for drug abuse problems. Results For crime outcomes, in the meta-regressions the point estimates for each of the principles were substantial, consistent with previous studies of the Andrews principles. There was also a substantial point estimate for programs exhibiting a greater number of the principles. However, almost all of the 95% confidence intervals included the zero point. For drug use outcomes, in the meta-regressions the point estimates for each of the principles was approximately zero; however, the point estimate for programs exhibiting a greater number of the principles was somewhat positive. All of the estimates for the drug use principles had confidence intervals that included the zero point. Conclusions This study supports previous findings from primary research studies targeting the Andrews principles that those principles are effective in reducing crime outcomes, here in meta-analytic research focused on drug treatment programs. By contrast, programs that follow the principles appear to have very little effect on drug use outcomes. Primary research studies that experimentally test the Andrews principles in drug treatment programs are recommended. PMID:24058325

  15. 49 CFR 40.323 - May program participants release drug or alcohol test information in connection with legal...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false May program participants release drug or alcohol... the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING... information pertaining to an employee's drug or alcohol test without the employee's consent in certain legal...

  16. 77 FR 63837 - Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical...

    Science.gov (United States)

    2012-10-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1056] Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device Submissions; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...

  17. Elements of quality assurance in environmental surveillance

    International Nuclear Information System (INIS)

    Johnson, L.J.

    1975-01-01

    Qualities of an environmental surveillance program requiring control or assurance are reviewed. Requirements of accuracy, reproducibility, sensitivity, acceptability, and time and cost effectiveness are qualities discussed. The controls applicable to sample collection, handling, chemical analysis, measurement and data presentation are identified and discussed as they pertain to environmental monitoring. Quality assurance program recommendations for developing and reporting environmental surveillance data are provided

  18. Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts.

    Science.gov (United States)

    Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro

    2015-05-01

    In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.

  19. Dual and multi-stimuli responsive polymeric nanoparticles for programmed site-specific drug delivery.

    Science.gov (United States)

    Cheng, Ru; Meng, Fenghua; Deng, Chao; Klok, Harm-Anton; Zhong, Zhiyuan

    2013-05-01

    In the past decades, polymeric nanoparticles have emerged as a most promising and viable technology platform for targeted and controlled drug delivery. As vehicles, ideal nanoparticles are obliged to possess high drug loading levels, deliver drug to the specific pathological site and/or target cells without drug leakage on the way, while rapidly unload drug at the site of action. To this end, various "intelligent" polymeric nanoparticles that release drugs in response to an internal or external stimulus such as pH, redox, temperature, magnetic and light have been actively pursued. These stimuli-responsive nanoparticles have demonstrated, though to varying degrees, improved in vitro and/or in vivo drug release profiles. In an effort to further improve drug release performances, novel dual and multi-stimuli responsive polymeric nanoparticles that respond to a combination of two or more signals such as pH/temperature, pH/redox, pH/magnetic field, temperature/reduction, double pH, pH and diols, temperature/magnetic field, temperature/enzyme, temperature/pH/redox, temperature/pH/magnetic, pH/redox/magnetic, temperature/redox/guest molecules, and temperature/pH/guest molecules have recently been developed. Notably, these combined responses take place either simultaneously at the pathological site or in a sequential manner from nanoparticle preparation, nanoparticle transporting pathways, to cellular compartments. These dual and multi-stimuli responsive polymeric nanoparticles have shown unprecedented control over drug delivery and release leading to superior in vitro and/or in vivo anti-cancer efficacy. With programmed site-specific drug delivery feature, dual and multi-stimuli responsive nanoparticulate drug formulations have tremendous potential for targeted cancer therapy. In this review paper, we highlight the recent exciting developments in dual and multi-stimuli responsive polymeric nanoparticles for precision drug delivery applications, with a particular focus

  20. 49 CFR 655.11 - Requirement to establish an anti-drug use and alcohol misuse program.

    Science.gov (United States)

    2010-10-01

    ... use and alcohol misuse program. Each employer shall establish an anti-drug use and alcohol misuse... 49 Transportation 7 2010-10-01 2010-10-01 false Requirement to establish an anti-drug use and alcohol misuse program. 655.11 Section 655.11 Transportation Other Regulations Relating to Transportation...

  1. Multiparametric Magnetic-Resonance to Confirm Eligibility to an Active Surveillance Program for Low-Risk Prostate Cancer: Intermediate Time Results of a Third Referral High Volume Centre Active Surveillance Protocol.

    Science.gov (United States)

    Luzzago, Stefano; Musi, Gennaro; Catellani, Michele; Russo, Andrea; Di Trapani, Ettore; Mistretta, Francesco Alessandro; Bianchi, Roberto; Cozzi, Gabriele; Conti, Andrea; Pricolo, Paola; Ferro, Matteo; Matei, Deliu-Victor; Mirone, Vincenzo; Petralia, Giuseppe; de Cobelli, Ottavio

    2018-05-07

    To evaluate the role of confirmatory multiparametric magnetic resonance imaging (mpMRI) of the prostate at the time of Active Surveillance (AS) enrollment to reduce disease misclassification. From 2012 to 2016, 383 patients with low-risk disease respecting Prostate Cancer Research International AS criteria underwent confirmatory 1.5-T mpMRI. AS was proposed to patients with Prostate Imaging and Report and Data System (PI-RADS) score ≤3 and no extraprostatic extension (EPE), whereas patients with PI-RADS score ≥4 and/or EPE were treated actively. Kaplan-Meier analyses quantified progression-free survival (PFS) in patients enrolled in the AS program. Logistic regression analyses tested the association between confirmatory mpMRI and clinically significant prostate cancer (csPCa) at radical prostatectomy (RP). Diagnostic performance of mpMRI was calculated in patients submitted to immediate RP. PFS rate was 99, 90 and 86% at 1, 2 and 3 years respectively. At multivariable analysis, PI-RADS 3, PI-RADS 4, PI-RADS 5 and EPE increased the probability of having csPCa at immediate RP (PI-RADS 3 [OR] 1.2, p = 0.26; PI-RADS 4 [OR] 5.1, p = 0.02; PI-RADS 5 [OR] 6.7; p = 0.009; EPE [OR] 11.8, p < 0.001). Confirmatory mpMRI showed sensibility, specificity, positive predictive value and negative predictive value of 85, 55, 68 and 76% respectively. MpMRI at the time of AS enrollment reduces the misclassification rate of csPCa. We suggest to perform target biopsies in patients with PI-RADS score 3 and 4 lesions. © 2018 S. Karger AG, Basel.

  2. Visual interface for the automation of the instrumented pendulum of Charpy tests used in the surveillance program of reactors vessel of nuclear power plants

    International Nuclear Information System (INIS)

    Rojas S, A.S.; Sainz M, E.; Ruiz E, J.A.

    2004-01-01

    Inside the Programs of Surveillance of the nuclear power stations periodic information is required on the state that keep the materials with those that builds the vessel of the reactor. This information is obtained through some samples or test tubes that are introduced inside the core of the reactor and it is observed if its physical characteristics remain after having been subjected to the radiation changes and temperature. The rehearsal with the instrumented Charpy pendulum offers information on the behavior of fracture dynamics of a material. In the National Institute of Nuclear Research (ININ) it has an instrumented Charpy pendulum. The operation of this instrument is manual, having inconveniences to carry out rehearsals with radioactive material, handling of high and low temperatures, to fulfill the normative ones for the realization of the rehearsals, etc. In this work the development of a computational program is presented (virtual instrument), for the automation of the instrumented pendulum. The system has modules like: Card of data acquisition, signal processing, positioning system, tempered system, pneumatic system, compute programs like it is the visual interface for the operation of the instrumented Charpy pendulum and the acquisition of impact signals. This system shows that given the characteristics of the nuclear industry with radioactive environments, the virtual instrumentation and the automation of processes can contribute to diminish the risks to the personnel occupationally exposed. (Author)

  3. Multiple drug cost containment policies in Michigan's Medicaid program saved money overall, although some increased costs.

    Science.gov (United States)

    Kibicho, Jennifer; Pinkerton, Steven D

    2012-04-01

    Michigan's Medicaid program implemented four cost containment policies--preferred drug lists, joint and multistate purchasing arrangements, and maximum allowable cost--during 2002-04. The goal was to control growth of drug spending for beneficiaries who were enrolled in both Medicaid and Medicare and taking antihypertensive or antihyperlipidemic prescription drugs. We analyzed the impact of each policy while holding the effect of all other policies constant. Preferred drug lists increased both preferred and generic drugs' market share and reduced daily cost--the cost per day for each prescription provided to a beneficiary. In contrast, the maximum allowable cost policy increased daily cost and was the only policy that did not generate cost savings. The joint and multistate arrangements did not affect daily cost. Despite these policy trade-offs, the cumulative effect was a 10 percent decrease in daily cost and a total cost savings of $46,195 per year. Our findings suggest that policy makers need to evaluate the impact of multiple policies aimed at restraining drug spending, and further evaluate the policy trade-offs, to ensure that scarce public dollars achieve the greatest return for money spent.

  4. Development of the plant life management technology for RPV steels [ - Current status of surveillance test specimen reconstitution program -

    International Nuclear Information System (INIS)

    Kazunobu, Sakamoto; Eliichiro, Otsuka; Yoshiaki, Oka; Kosei, Taguchi; Michiyoshi, Yamamoto

    2001-01-01

    In order to develop the reconstitution technology to standardize surveillance test specimen reconstitution practices to deal with the extended service life of reactor pressure vessels, the Japan Power Engineering and Inspection Corporation (JAPEIC) has been carried out the project entrusted by the Ministry of International Trade and Industry (MITI). We focus on a correlation between the reduction of absorbed energy and the interaction of the heat affected zone (HAZ) and the plastic zone, to establish applicable reconstitution conditions for Charpy specimens. The relationship between the plastic zone width and the absorbed energy has been obtained by estimating the plastic zone width from the hardness distribution of the Charpy specimens. Impact tests of reconstituted specimens with 10 mm-length insert using the surface activated joining method were performed and the test results were compared to those obtained by the standard specimens. By comparing the length of insert material to the sum of HAZ width and plastic zone width, it is clear that the interaction causes the reduction of the absorbed energy. Hence, the applicable conditions of reconstituted Charpy specimens could be assessed by comparing the insert length to the sum of HAZ width and plastic zone width. Moreover the effects of the possible deviations from the standard shape and size specimens for the reconstituted specimens were studied. (authors)

  5. Analysis of the particular spill characteristics observed by the Belgian aerial surveillance program during the Tricolor incident

    International Nuclear Information System (INIS)

    Price, M.

    2004-01-01

    This presentation described the Tricolor oil spill incident, the remote sensing equipment used to monitor the spill, the observed spill characteristics and the flight data assessment. The spill occurred on December 14, 2002 following a collision between the carrier Tricolor and the container vessel Kariba in French waters in the Zone of Joint Responsibility, close to the Belgian and English borders. The Tricolor sank and 3 more vessels collided with the wreck in the five weeks following the collision, spilling several 100 tons of mostly heavy fuel oil into the sea. The remote sensing equipment aboard Belgian surveillance aircraft noted that freshly spilled oil formed a network of widespread dark oil trails surrounded by light oil fractions. The spill volumes were estimated to be high because of the large extent of the polluted area. Nine months following the spill, the emulsified oil trails had a density close to that of seawater. It was assumed that a cold and thick emulsion had formed and became trapped inside the wreck. Upon release, the emulsion could submerse and resurface. The incident demonstrated that early stage oil sample analysis could help interpret slick behaviour by means of remote sensing. 9 refs., 3 tabs., 1 fig

  6. Increasing compliance with mass drug administration programs for lymphatic filariasis in India through education and lymphedema management programs.

    Directory of Open Access Journals (Sweden)

    Paul T Cantey

    2010-06-01

    Full Text Available Nearly 45% of people living at risk for lymphatic filariasis (LF worldwide live in India. India has faced challenges obtaining the needed levels of compliance with its mass drug administration (MDA program to interrupt LF transmission, which utilizes diethylcarbamazine (DEC or DEC plus albendazole. Previously identified predictors of and barriers to compliance with the MDA program were used to refine a pre-MDA educational campaign. The objectives of this study were to assess the impact of these refinements and of a lymphedema morbidity management program on MDA compliance.A randomized, 30-cluster survey was performed in each of 3 areas: the community-based pre-MDA education plus community-based lymphedema management education (Com-MDA+LM area, the community-based pre-MDA education (Com-MDA area, and the Indian standard pre-MDA education (MDA-only area. Compliance with the MDA program was 90.2% in Com-MDA+LM, 75.0% in Com-MDA, and 52.9% in the MDA-only areas (p<0.0001. Identified barriers to adherence included: 1 fear of side effects and 2 lack of recognition of one's personal benefit from adherence. Multivariable predictors of adherence amenable to educational intervention were: 1 knowing about the MDA in advance of its occurrence, 2 knowing everyone is at risk for LF, 3 knowing that the MDA was for LF, and 4 knowing at least one component of the lymphedema management techniques taught in the lymphedema management program.This study confirmed previously identified predictors of and barriers to compliance with India's MDA program for LF. More importantly, it showed that targeting these predictors and barriers in a timely and clear pre-MDA educational campaign can increase compliance with MDA programs, and it demonstrated, for the first time, that lymphedema management programs may also increase compliance with MDA programs.

  7. Nutritional surveillance.

    Science.gov (United States)

    Mason, J B; Mitchell, J T

    1983-01-01

    The concept of nutritional surveillance is derived from disease surveillance, and means "to watch over nutrition, in order to make decisions that lead to improvements in nutrition in populations". Three distinct objectives have been defined for surveillance systems, primarily in relation to problems of malnutrition in developing countries: to aid long-term planning in health and development; to provide input for programme management and evaluation; and to give timely warning of the need for intervention to prevent critical deteriorations in food consumption. Decisions affecting nutrition are made at various administrative levels, and the uses of different types of nutritional surveillance information can be related to national policies, development programmes, public health and nutrition programmes, and timely warning and intervention programmes. The information should answer specific questions, for example concerning the nutritional status and trends of particular population groups.Defining the uses and users of the information is the first essential step in designing a system; this is illustrated with reference to agricultural and rural development planning, the health sector, and nutrition and social welfare programmes. The most usual data outputs are nutritional outcome indicators (e.g., prevalence of malnutrition among preschool children), disaggregated by descriptive or classifying variables, of which the commonest is simply administrative area. Often, additional "status" indicators, such as quality of housing or water supply, are presented at the same time. On the other hand, timely warning requires earlier indicators of the possibility of nutritional deterioration, and agricultural indicators are often the most appropriate.DATA COME FROM TWO MAIN TYPES OF SOURCE: administrative (e.g., clinics and schools) and household sample surveys. Each source has its own advantages and disadvantages: for example, administrative data often already exist, and can be

  8. The impact of state-level nutrition-education program funding on BMI: evidence from the behavioral risk factor surveillance system.

    Science.gov (United States)

    McGeary, Kerry Anne

    2013-04-01

    Currently, there is insufficient evidence regarding which policies will improve nutrition, reduce BMI levels and the prevalence of obesity and overweight nationwide. This preliminary study investigates the impact of a nutrition-education policy relative to price policy as a means to reduce BMI in the United States (US). Model estimations use pooled cross-sectional data at the individual-level from the Centers for Disease Control's (CDC), Behavioral Risk Factor Surveillance System (BRFSS), state-level food prices from the American Chamber of Commerce Research Association (ACCRA) and funding for state-specific nutrition-education programs from the United States Department of Agriculture (USDA) from 1992 to 2006. The total number of observations for the study is 2,249,713 over 15 years. During this period, federal funding for state-specific nutrition-education programs rose from approximately $660 thousand for seven states to nearly $248 million for all fifty-two states. In 2011, federal funding for nutrition-education programs reached $375 million. After controlling for state-fixed effects, year effects and state specific linear and quadratic time trends, we find that nutrition education spending has the intended effect on BMI, obese and overweight in aggregate. However, we find heterogeneity as individuals from certain, but not all, income and education levels respond to nutrition-education funding. The results regarding nutrition-education programs suggest that large scale funding of nutrition-education programs may improve BMI levels and reduce obesity and overweight. However, more study is required to determine if these funds are able make the requisite dietary improvements that may ultimately improve BMI for individuals from low income and education-levels. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. The "Clubs against Drugs" program in Stockholm, Sweden: two cross-sectional surveys examining drug use among staff at licensed premises

    Directory of Open Access Journals (Sweden)

    Gripenberg Abdon Johanna

    2011-02-01

    Full Text Available Abstract Background The objective of this study is to examine self-reported drug use among staff at licensed premises, types of drugs used, attitudes towards drugs, and observed drug use among guests. Results are presented from two measurement points (in 2001 and 2007/08. This study was carried out within the framework of the "Clubs against Drugs" program, which is a community-based multi-component intervention targeting licensed premises in Stockholm, Sweden. Methods Two cross-sectional surveys were conducted, the first in 2001 and the second in 2007/08. Staff at licensed premises attending server training were asked to participate in the anonymous survey. A survey was administered in a classroom setting and consisted of four sections: 1 demographics, 2 respondents' own drug use experience, 3 respondents' attitudes towards drug use, and 4 observed drug use among guests at licensed premises. Results Data were collected from 446 staff in 2001 and 677 staff in 2007/08. The four most commonly used drugs among staff were cannabis, cocaine, amphetamine, and ecstasy. The highest rates of drug use were reported by staff in the two youngest age groups, i.e., those younger than 25 and those between the ages of 25 and 29. In 2007/08 staff reported significantly lower rates of drug use than staff in 2001. Last year drug use for the sample in 2007/08 was 19% compared to 27% for the 2001 sample. While drug-using staff compared to non drug-using staff reported more observations of drug use among guests, they were less inclined to intervene. Overall, staff reported restrictive attitudes towards drugs. Conclusions The prevalence of life-time and last year drug use among staff at licensed premises is high compared to the general population in Sweden. Lower rates of self-reported drug use among staff were reported in 2007/08. The results of this study highlight that staff at licensed premises represent an important target population in club drug prevention

  10. Decrease in Staphylococcus aureus colonization and hospital-acquired infection in a medical intensive care unit after institution of an active surveillance and decolonization program.

    Science.gov (United States)

    Fraser, Thomas G; Fatica, Cynthia; Scarpelli, Michele; Arroliga, Alejandro C; Guzman, Jorge; Shrestha, Nabin K; Hixson, Eric; Rosenblatt, Miriam; Gordon, Steven M; Procop, Gary W

    2010-08-01

    To evaluate the effects of an active surveillance program for Staphylococcus aureus linked to a decolonization protocol on the incidence of healthcare-associated infection and new nasal colonization due to S. aureus. Retrospective quasi-experimental study. An 18-bed medical intensive care unit at a tertiary care center in Cleveland, Ohio. From January 1, 2006, through December 31, 2007, all patients in the medical intensive care unit were screened for S. aureus nasal carriage at admission and weekly thereafter. During the preintervention period, January 1 through September 30, 2006, only surveillance occurred. During the intervention period, January 1 through December 31, 2007, S. aureus carriers received mupirocin intranasally. Beginning in February 2007, carriers also received chlorhexidine gluconate baths. During the preintervention period, 604 (73.7%) of 819 patients were screened for S. aureus nasal carriage, yielding 248 prevalent carriers (30.3%). During the intervention period, 752 (78.3%) of 960 patients were screened, yielding 276 carriers (28.8%). The incidence of S. aureus carriage decreased from 25 cases in 3,982 patient-days (6.28 cases per 1,000 patient-days) before intervention to 18 cases in 5,415 patient-days (3.32 cases per 1,000 patient-days) (P=.04; relative risk [RR], 0.53 [95% confidence interval {CI}, 0.28-0.97]) and from 9.57 to 4.77 cases per 1,000 at-risk patient-days (P=.02; RR, 0.50 [95% CI, 0.27-0.91]). The incidence of S. aureus hospital-acquired bloodstream infection during the 2 periods was 2.01 and 1.11 cases per 1,000 patient-days, respectively (P=.28). The incidence of S. aureus ventilator-associated pneumonia decreased from 1.51 to 0.18 cases per 1,000 patient-days (P=.03; RR, 0.12 [95% CI, 0.01-0.83]). The total incidence of S. aureus hospital-acquired infection decreased from 3.52 to 1.29 cases per 1,000 patient-days (P=.03; RR, 0.37 [95% CI, 0.14-0.90]). Active surveillance for S. aureus nasal carriage combined with

  11. Rapid surveillance for health events following a mass meningococcal B vaccine program in a university setting: A Canadian Immunization Research Network study.

    Science.gov (United States)

    Langley, J M; MacDougall, D M; Halperin, B A; Swain, A; Halperin, S A; Top, K A; McNeil, S A; MacKinnon-Cameron, D; Marty, K; De Serres, G; Dubé, E; Bettinger, J A

    2016-07-25

    An outbreak of Neisseria meningitidis serotype B infection occurred at a small residential university; public health announced an organizational vaccination program with the 4-component Meningococcal B (4CMenB) vaccine (Bexsero(TM), Novartis/GlaxoSmithKline Inc.) several days later. Since there were limited published data on reactogenicity of 4CMenB in persons over 17years of age, this study sought to conduct rapid surveillance of health events in vaccinees and controls using an online survey. Vaccine uptake was 84.7% for dose 1 (2967/3500) and 70% (2456/3500) for dose 2; the survey response rates were 33.0% (987/2967) and 18.7% (459/2456) in dose 1 and dose 1 recipients respectively, and 12% in unvaccinated individuals (63/533). Most students were 20-29years of age (vaccinees, 64.0%; controls, 74.0). A new health problem or worsening of an existing health problem was reported by 30.0% and 30.3% of vaccine recipients after doses 1 and 2 respectively; and by 15.9% of controls. These health problems interfered with the ability to perform normal activities in most vaccinees reporting these events (74.7% post dose 1; 62.6% post dose 2), and in 60% of controls. The health problems led to a health care provider visit (including emergency room) in 12.8% and 14.4% of vaccinees post doses 1 and 2, respectively and in 40% of controls. The most common reactions in vaccinees were injection site reactions (20.6% post dose 1, 16.1% post dose 20 and non-specific systemic complaints (22.6% post dose 1, 17.6% post dose 2). No hospitalizations were reported. An online surveillance program during an emergency meningococcal B vaccine program was successfully implemented, and detected higher rates of health events in vaccinees compared to controls, and high rates of both vaccinees and controls seeking medical attention. The types of adverse events reported by young adult vaccinees were consistent with those previously. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Health surveillance of radiological work

    International Nuclear Information System (INIS)

    Pauw, H.; Vliet, J.V.D.; Zuidema, H.

    1988-01-01

    Shielding x-ray devices and issuing film badges to radiological workers in 1936 can be considered the start of radiological protection in the Philips enterprises in the Netherlands. Shielding and equipment were constantly improved based upon the dosimetry results of the filmbadges. The problem of radioactive waste led to the foundation of a central Philips committee for radiological protection in 1956, which in 1960 also issued an internal license system in order to regulate the proper precautions to be taken : workplace design and layout, technological provisions and working procedures. An evaluation of all radiological work in 1971 learnt that a stricter health surveillance program was needed to follow up the precautions issued by the license. On one hand a health surveillance program was established and on the other hand all types of radiological work were classified. In this way an obligatory and optimal health surveillance program was issued for each type of radiological work

  13. Special Supplemental Nutrition Program for Women, Infants, and Children participation and infants' growth and health: a multisite surveillance study.

    Science.gov (United States)

    Black, Maureen M; Cutts, Diana B; Frank, Deborah A; Geppert, Joni; Skalicky, Anne; Levenson, Suzette; Casey, Patrick H; Berkowitz, Carol; Zaldivar, Nieves; Cook, John T; Meyers, Alan F; Herren, Tim

    2004-07-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is the largest food supplement program in the United States, serving almost 7 500 000 participants in 2002. Because the program is a grant program, rather than an entitlement program, Congress is not mandated to allocate funds to serve all eligible participants. Little is known about the effects of WIC on infant growth, health, and food security. To examine associations between WIC participation and indicators of underweight, overweight, length, caregiver-perceived health, and household food security among infants 95th percentile, varied from 7% to 9% and did not differ among the 3 groups but were higher than the 5% expected from national growth charts. Rates of food insecurity were consistent with national data for minority households with children. Families that did not receive WIC assistance because of access problems had higher rates of food insecurity (28%) than did WIC participants (23%), although differences were not significant after covariate control. Caregivers who did not perceive a need for WIC services had more economic and personal resources than did WIC participants and were less likely to be food-insecure, but there were no differences in infants' weight-for-age, perceived health, or overweight between families that did not perceive a need for WIC services and those that received WIC assistance. Infants participation. Health care providers should promote WIC utilization for eligible families and advocate that WIC receive support to reduce waiting lists and eliminate barriers that interfere with access.

  14. Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation.

    Science.gov (United States)

    Beitel, Mark; Oberleitner, Lindsay; Muthulingam, Dharushana; Oberleitner, David; Madden, Lynn M; Marcus, Ruthanne; Eller, Anthony; Bono, Madeline H; Barry, Declan T

    2018-03-09

    Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.

  15. Vigilancia de la resistencia a los fármacos antituberculosos en Cuba, 2000-2009 Surveillance of resistance to antitubercular drugs in Cuba, 2000-2009

    Directory of Open Access Journals (Sweden)

    Ernesto Montoro

    2011-12-01

    Full Text Available OBJETIVO: Determinar la prevalencia de la resistencia a los fármacos antituberculosos en Cuba en el decenio 2000-2009. MÉTODOS: Se realizó un estudio prospectivo longitudinal. El universo de trabajo estuvo constituido por un total de 2 285 aislamientos de Mycobacterium tuberculosis obtenidos de todo el país en el período comprendido entre el 1 de enero de 2000 y el 31 de diciembre de 2009. Se empleó el método de las proporciones en medio Löwenstein-Jensen con los fármacos de primera línea: isoniazida, estreptomicina, etambutol y rifampicina. RESULTADOS: La resistencia entre los casos nuevos y los pacientes con antecedente de tratamiento previo fue de 8,5% y 37,0%, respectivamente; para estas mismas categorías de caso, la multirresistencia fue de 0,4% y 8,8%, respectivamente. CONCLUSIONES: El presente estudio muestra baja prevalencia de cepas multirresistentes en Cuba. Estos resultados reflejan los avances logrados por el programa nacional de control, que trabaja en la actualidad hacia la eliminación de la tuberculosis como problema de salud pública en el país.OBJECTIVE: Determine the prevalence of resistance to antitubercular drugs in Cuba in the 2000-2009 decade. METHODS: A prospective longitudinal study was conducted. The sample group consisted of 2  285 Mycobacterium tuberculosis isolates obtained from throughout the country in the period from 1 January 2000 to 31 December 2009. The proportion method was used in Löwenstein-Jensen media with the first-line drugs: isoniazid, streptomycin, ethambutol, and rifampicin. RESULTS: In the new cases and patients with a history of previous treatment, resistance was 8.5% and 37.0%, respectively. In these case categories, multidrug resistance was 0.4% and 8.8%, respectively. CONCLUSIONS: This study shows low prevalence of multidrug-resistant strains in Cuba. The results reflect the progress made by the national control program, which is currently working on the elimination of

  16. Programmatic Impact of 5 Years of Mortality Surveillance of New York City Homeless Populations

    Science.gov (United States)

    Marder, Dova; Begier, Elizabeth; Gutkovich, Alexander; Mos, Robert; Griffin, Angela; Zimmerman, Regina; Madsen, Ann

    2013-01-01

    A homeless mortality surveillance system identifies emerging trends in the health of the homeless population and provides this information to key stakeholders in a timely and ongoing manner to effect evidence-based, programmatic change. We describe the first 5 years of the New York City homeless mortality surveillance system and, for the first time in peer-reviewed literature, illustrate the impact of key elements of sustained surveillance (i.e., timely dissemination of aggregate mortality data and real-time sharing of information on individual homeless decedents) on the programs of New York City’s Department of Homeless Services. These key elements had a positive impact on the department’s programs that target sleep-related infant deaths and hypothermia, drug overdose, and alcohol-related deaths among homeless persons. PMID:24148068

  17. Surveillance and Critical Theory

    Directory of Open Access Journals (Sweden)

    Christian Fuchs

    2015-09-01

    Full Text Available In this comment, the author reflects on surveillance from a critical theory approach, his involvement in surveillance research and projects, and the status of the study of surveillance. The comment ascertains a lack of critical thinking about surveillance, questions the existence of something called “surveillance studies” as opposed to a critical theory of society, and reflects on issues such as Edward Snowden’s revelations, and Foucault and Marx in the context of surveillance.

  18. Effectiveness of the universal prevention program 'Healthy School and Drugs': study protocol of a randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, M.; Overbeek, G.J.; Kleinjan, M.; Vermulst, A.; Monshouwer, K.; Lammers, J.; Vollebergh, W.A.M.; Engels, R.C.M.E.

    2010-01-01

    Background: Substance use is highly prevalent among Dutch adolescents. The Healthy School and Drugs program is a nationally implemented school-based prevention program aimed at reducing early and excessive substance use among adolescents. Although the program's effectiveness was tested in a

  19. Effectiveness of the universal prevention program 'Healthy School and Drugs': Study protocol of a randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, M.; Overbeek, G.J.; Kleinjan, M.; Vermulst, A.A.; Monshouwer, K.; Lammers, J.; Vollebergh, W.A.M.; Engels, R.C.M.E.

    2010-01-01

    Background: Substance use is highly prevalent among Dutch adolescents. The Healthy School and Drugs program is a nationally implemented school-based prevention program aimed at reducing early and excessive substance use among adolescents. Although the program's effectiveness was tested in a

  20. Sports medicine and drug control programs of the U.S. Olympic Committee.

    Science.gov (United States)

    Clarke, K S

    1984-05-01

    The Amateur Sports Act of 1978 reconstituted the U.S. Olympic Committee ( USOC ), giving it new responsibilities and opportunities as a unifying force in amateur sports, including sports medicine. Sports medicine is the sum of attentions that promote and protect the health of the active person. Olympic sports medicine includes attention to the needs of both the elite athlete and the developing athlete. In some instances the attentions are the same; in others they are not. Those in Olympic sports medicine must thereby reduce the increasing array of general concepts and issues to the applicable specifics of the respective occasion, sport, and individual. The USOC Sports Medicine Program is guided by a 15-person volunteer Sports Medicine Council and implemented by a core Sports Medicine Division staff. Services are provided at the Olympic training centers in Colorado Springs and Lake Placid and extended through a budding network of colleagues in the field to clusters of athletes across the nations. Organizationally , the Division is composed of departments of biomechanics, sports physiology, clinical services, and educational services. Special projects are developed as warranted to provide focal attention to sports psychology, nutrition, chronobiology, vision enhancement, and drug control. The USOC Drug Control Program was born at the 1983 Pan American Games in Caracas after a long gestation period. Drug education in sports has been a frequent activity for the past 20 yr. sometimes focusing on illicit drugs (e.g., marijuana and cocaine) and sometimes on sports performance drugs (e.g., amphetamines and anabolic steroids).(ABSTRACT TRUNCATED AT 250 WORDS)

  1. SAVY-4000 Field Surveillance Plan Update for 2017

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Elizabeth J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stone, Timothy Amos [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Smith, Paul Herrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reeves, Kirk Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Veirs, Douglas Kirk [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Prochnow, David Adrian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-03-20

    The Packaging Surveillance Program section of the Department of Energy (DOE) Manual 441.1-­1, Nuclear Material Packaging Manual (DOE 2008), requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.”This 2017 update reflects changes to the surveillance plan resulting from surveillance findings as documented in Reeves et al. 2016. These findings include observations of corrosion in SAVY and Hagan containers and the indication (in one SAVY container) of possible filter membrane thermal degradation. This surveillance plan update documents the rationale for selecting surveillance containers, specifies the containers for 2017 surveillance, and identifies a minimum set of containers for 2018 surveillance. This update contains important changes to the previous surveillance plans.

  2. Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

    Science.gov (United States)

    Fraser, Melissa A; Grooms, Dustin R; Guskiewicz, Kevin M; Kerr, Zachary Y

    2017-07-01

    Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.   Descriptive epidemiology study.   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.   Collegiate student-athletes participating in 11 sports.   Ball-contact-injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).   Ball-contact-injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although

  3. Coding completeness and quality of relative survival-related variables in the National Program of Cancer Registries Cancer Surveillance System, 1995-2008.

    Science.gov (United States)

    Wilson, Reda J; O'Neil, M E; Ntekop, E; Zhang, Kevin; Ren, Y

    2014-01-01

    Calculating accurate estimates of cancer survival is important for various analyses of cancer patient care and prognosis. Current US survival rates are estimated based on data from the National Cancer Institute's (NCI's) Surveillance, Epidemiology, and End RESULTS (SEER) program, covering approximately 28 percent of the US population. The National Program of Cancer Registries (NPCR) covers about 96 percent of the US population. Using a population-based database with greater US population coverage to calculate survival rates at the national, state, and regional levels can further enhance the effective monitoring of cancer patient care and prognosis in the United States. The first step is to establish the coding completeness and coding quality of the NPCR data needed for calculating survival rates and conducting related validation analyses. Using data from the NPCR-Cancer Surveillance System (CSS) from 1995 through 2008, we assessed coding completeness and quality on 26 data elements that are needed to calculate cancer relative survival estimates and conduct related analyses. Data elements evaluated consisted of demographic, follow-up, prognostic, and cancer identification variables. Analyses were performed showing trends of these variables by diagnostic year, state of residence at diagnosis, and cancer site. Mean overall percent coding completeness by each NPCR central cancer registry averaged across all data elements and diagnosis years ranged from 92.3 percent to 100 percent. RESULTS showing the mean percent coding completeness for the relative survival-related variables in NPCR data are presented. All data elements but 1 have a mean coding completeness greater than 90 percent as was the mean completeness by data item group type. Statistically significant differences in coding completeness were found in the ICD revision number, cause of death, vital status, and date of last contact variables when comparing diagnosis years. The majority of data items had a coding

  4. Comparing Black and White Drug Offenders: Implications for Racial Disparities in Criminal Justice and Reentry Policy and Programming.

    Science.gov (United States)

    Rosenberg, Alana; Groves, Allison K; Blankenship, Kim M

    2017-01-01

    Despite knowledge of racial bias for drug-related criminal justice involvement and its collateral consequences, we know less about differences between Black and White drug offenders. We compare 243 Blacks and White non-violent drug offenders in New Haven, CT for demographic characteristics, substance use, and re-entry services accessed. Blacks were significantly more likely to have sales and possession charges, significantly more likely to prefer marijuana, a less addictive drug, and significantly less likely to report having severe drug problems. For both races, drug treatment was the most common service accessed through supervision. These comparisons suggest different reasons for committing drug-related crimes and thus, different reentry programming needs. While drug treatment is critical for all who need it, for racial justice, we must also intervene to address other needs of offenders, such as poverty alleviation and employment opportunities.

  5. Firm- and drug-specific patterns of generic drug payments by US medicaid programs: 1991-2008.

    Science.gov (United States)

    Kelton, Christina M L; Chang, Lenisa V; Guo, Jeff J; Yu, Yan; Berry, Edmund A; Bian, Boyang; Heaton, Pamela C

    2014-04-01

    The entry of generic drugs into markets previously monopolized by patented, branded drugs often represents large potential savings for healthcare payers in the USA. Our objectives were to describe and explain the trends in drug reimbursement by public Medicaid programmes post-generic entry for as many drug markets and for as long a time period as possible. The data were the Medicaid State Drug Utilization Data maintained by the Centers for Medicare and Medicaid Services. Quarterly utilization and expenditure data from 1991 to 2008 were extracted for 83 drugs, produced by 229 firms, that experienced initial generic entry between 1992 and 2004. A relative 'price' for a specific drug, firm and quarter was constructed as Medicaid reimbursement per unit (e.g. tablet, capsule or vial) divided by average reimbursement per unit for the branded drug the year before entry. Fixed-effects models controlling for time-, firm- and drug-specific differences were estimated to explain reimbursement. Twelve quarters after generic entry, 18 % of drugs had average per-unit reimbursement less than 50 % of the original branded-drug reimbursement. For each additional firm manufacturing the drug, reimbursement per unit, relative to the pre-generic-entry branded-drug reimbursement, was estimated to fall by 17 (p < 0.01) and 3 (p < 0.01) percentage points for generic and branded-drug companies, respectively. Each additional quarter post-generic entry brought a 2 (p < 0.01) percentage point drop in relative reimbursement. State Medicaid programmes generally have been able to obtain relief from high drug prices following patent expirations for many branded-drug medications by adjusting reimbursement following the expanded competition in the pharmaceutical market.

  6. An experiential program to reduce AIDS risk among female sex partners of injection-drug users.

    Science.gov (United States)

    Rhodes, F; Wolitski, R J; Thornton-Johnson, S

    1992-11-01

    This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.

  7. Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

    Directory of Open Access Journals (Sweden)

    Richard M. Reisman

    2009-01-01

    Full Text Available Context The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs on prescription opioid abuse admissions. Design and Setting A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set in 14 states with PDMPs (intervention group and 36 states without PDMPs (control group for the period 1997–2003. Results From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001. PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063. A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785. Conclusions PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

  8. Generic drug discount programs: are prescriptions being submitted for pharmacy benefit adjudication?

    Science.gov (United States)

    Tungol, Alexandra; Starner, Catherine I; Gunderson, Brent W; Schafer, Jeremy A; Qiu, Yang; Gleason, Patrick P

    2012-01-01

      In 2006, pharmacies began offering select generic prescription drugs at discount prices (e.g., $4 for a 30-day supply) through nonmembership and membership programs. As part of the contract in membership generic drug discount programs, the member agrees to forgo submission of the claim to the insurance company. Claims not submitted for insurance adjudication may result in incomplete pharmacy benefit manager (PBM) and health plan data, which could negatively influence adherence reporting and clinical programs. To address potentially missing claims data, the Centers for Medicare Medicaid Services (CMS) encourages Medicare Part D sponsors to incentivize network pharmacies to submit claims directly to the plan for drugs dispensed outside of a member's Part D benefit, unless a member refuses. The extent of PBM and health plan claims capture loss due to generic drug discount programs is unknown. To identify changes in levothyroxine utilizers' prescription claims capture rate following the advent of generic drug discount membership and nonmembership programs. This retrospective concurrent cohort study used claims data from 3.5 million commercially insured members enrolled in health plans located in the central and southern United States with Prime Therapeutics pharmacy benefit coverage. Members were required to be 18 years or older and younger than 60 years as of January 1, 2006, and continuously enrolled from January 1, 2006, through December 31, 2010. Members utilizing generic levothyroxine for at least 120 days during January 1, 2006, through June 30, 2006 (baseline period) from the same pharmacy group with supply on July 1, 2006, were placed into 1 of 3 pharmacy groups: (1) nonmembership (Walmart, Sam's Club, Target, Kroger, City Market, and King Soopers pharmacies), (2) membership (Walgreens, CVS, Albertsons, and Savon pharmacies), or (3) the reference group of all other pharmacies. The index date was defined as July 1, 2006. The levothyroxine claim providing

  9. Did We Get Our Money’s Worth? Bridging Economic and Behavioral Measures of Program Success in Adolescent Drug Prevention

    Directory of Open Access Journals (Sweden)

    Lawrence M. Scheier

    2013-11-01

    Full Text Available The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of “cost efficiency”. The languages and methods of each respective discipline don’t necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy.

  10. Did we get our money's worth? Bridging economic and behavioral measures of program success in adolescent drug prevention.

    Science.gov (United States)

    Griffith, Kevin N; Scheier, Lawrence M

    2013-11-08

    The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of "cost efficiency". The languages and methods of each respective discipline don't necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy.

  11. Did We Get Our Money’s Worth? Bridging Economic and Behavioral Measures of Program Success in Adolescent Drug Prevention

    Science.gov (United States)

    Griffith, Kevin N.; Scheier, Lawrence M.

    2013-01-01

    The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of “cost efficiency”. The languages and methods of each respective discipline don’t necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy. PMID:24217178

  12. GSFC Supplier Surveillance

    Science.gov (United States)

    Kelly, Michael P.

    2011-01-01

    Topics covered include: Develop Program/Project Quality Assurance Surveillance Plans The work activities performed by the developer and/or his suppliers are subject to evaluation and audit by government-designated representatives. CSO supports project by selecting on-site supplier representative s by one of several methods: (1) a Defense Contract Management Agency (DCMA) person via a Letter Of Delegation (LOD), (2) an independent assurance contractor (IAC) via a contract Audits, Assessments, and Assurance (A3) Contract Code 300 Mission Assurance Support Contract (MASC)

  13. Use of a simplified pathways model to improve the environmental surveillance program at the radioactive waste management complex of the Idaho National Engineering Laboratory (INEL)

    International Nuclear Information System (INIS)

    Case, M.J.; Rope, S.K.

    1985-01-01

    Systems analysis, including a simple pathways model based on first-order kinetics, is a useful way to design or improve environmental monitoring networks. This method allows investigators and administrators to consider interactions that may be occurring in the system and provides guidance in determining the need to collect data on various system components and processes. A simplified pathways model of radionuclide movement from low-level waste and transuranic waste buried at the Radioactive Waste Management Complex was developed (1) to identify critical pathways that should be monitored and (2) to identify key input parameters that need investigation by special studies. The model was modified from the Savannah River Laboratory DOSTOMAN code. Site-specific data were used in the model, if available. Physical and biological pathways include airborne and waterborne transport of surface soil, subsurface migration to the aquifer, waste container degradation, plant uptake, small mammal burrowing, and a few simplified food chain pathways. The model was run using a set of radionuclides determined to be significant in terms of relative hazard. Critical transport pathways which should be monitored were selected based on relative influence on model results. Key input parameters were identified for possible special studies by evaluating the sensitivity of model response to the parameters used to define transport pathways. A description of the approaches used and the guidance recommended to improve the environmental surveillance program are presented in this paper. 5 references, 1 figure, 2 tables

  14. Instrumentation of a Charpy-pendulum. Additional data obtained from it and its application to nuclear reactor pressure vessels surveillance programs

    International Nuclear Information System (INIS)

    Chomik, Enrique P.; Dhers, Horacio; Iorio, Antonio F.; Ciriani, Dario F.

    1999-01-01

    Charpy test gives information about a material dynamic fracture behavior. In a plain Charpy test, this information is the absorbed energy during fracture of the specimen, lateral deformation and the percentage of ductile fracture of the specimen. These parameters can then be used for the determination of the material response to a dynamic applied load, and are used at present to determine the brittle-ductile transition temperature of a material. However, there is a lot of additional information that can be obtained from a Charpy test, which is vital for the case of surveillance programs of nuclear power plants, where it is necessary to get the most available information from the specimens to be tested, because each one of them was irradiated for many years under temperature and neutronic flux conditions similar to that of the internal surface of the reactor pressure vessel, which converts these specimens in unique and very expensive ones. This additional information can be obtained from the curve that determines the evolution of the applied force to the specimen throughout the time involved in its fracture. It was possible to instrument a Charpy pendulum at a fraction of the cost necessary to buy an instrumentation package like the ones available in the market, and since the instrumentation equipment obtained is easy to transport. It has the additional advantage that can be used to instrument any other pendulum replacing only the hammer of the pendulum with a instrumented one for that pendulum. (author)

  15. Risk of leukemia associated with the first course of cancer treatment: an analysis of the Surveillance, Epidemiology, and End Results Program experience

    International Nuclear Information System (INIS)

    Curtis, R.E.; Hankey, B.F.; Myers, M.H.; Young, J.L. Jr.

    1984-01-01

    The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973-80 (average follow-up . 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leukemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy [relative risk (RR) . 4.5, 95% confidence interval (Cl) . 3.1-6.3]. Significant ANLL excesses were observed following chemotherapy for breast cancer (RR . 8.1), ovarian cancer (RR . 22.2), and multiple myeloma (RR . 9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR . 2.5, 95% Cl . 1.8-3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR . 4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR . 2.2)

  16. Surveillance of the North-Eastern Atlantic dumpsite for low-level radioactive waste. The Swiss oceanographic research program 'PROSPER'. Progress report

    International Nuclear Information System (INIS)

    Nyffeler, F.; Ruch, P.; Hanselmann, K.

    1984-08-01

    This report describes the results of the research undertaken within the CRESP program by the Swiss group PROSPER, for the surveillance of the current dumpsite for low-level radioactive waste in the North-Eastern Atlantic. About 100 nephelometric profiles obtained during three cruises in the vicinity of the site provide a sound basis for the description of the benthic nepheloid layer structure. Statistical analyses show that the last 1000 m of water above the bottom are influenced by resuspension processes or by lateral advection of particles detached from the surrounding relief. A mapping performed over a large area (200 x 200 km) confirms the accumulation of particles in topographic lows. Geochemical analysis of suspended matter and surficial sediment has been carried out in order to compare their elemental composition, and to determine the classes of particles which are more likely to be resuspended. The discrepancy between BNL and local sediment composition suggests that advective transport or resuspension of older bottom sediment, exposed following slumping from the hill slopes, could act in addition to the local resuspension of recent sediment. (author)

  17. The incidence of nosocomial infection in the Intensive Care Unit, Hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999.

    Science.gov (United States)

    Rozaidi, S W; Sukro, J; Dan, A

    2001-06-01

    CU-acquired nosocomial infection (NI) remains one of the major causes of ICU mortality. This study presents the incidence of ICU-acquired nosocomial infection in ICU HUKM for the years 1998 and 1999, as part of the ongoing ICU-acquired nosocomial infection surveillance program. The overall incidence was 23%. The main types of NI was lower respiratory tract infection (15.3%), primary bacteraemia (8.1%), ventilator associated pneumonia (5.4%), urinary tract infection (2.0%), skin infection (1.6%) central venous catheter sepsis (1.2%) and surgical skin infection (0.8%). The overall culture positive nosocomial infection rate was only 12.1%, majority from the lungs (12.6%), blood (7.3%), skin swabs (2.0%), and urine (1.6%). The main gram-negative organism cultured was Acinetobacter sp. (19%) and Staph. aureus (8.5%) was the gram-positive organism. The overall ICU mortality rate was 27.5% of which 60.9% of patients who died were attributed directly to sepsis.

  18. Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico.

    Science.gov (United States)

    Arredondo, J; Strathdee, S A; Cepeda, J; Abramovitz, D; Artamonova, I; Clairgue, E; Bustamante, E; Mittal, M L; Rocha, T; Bañuelos, A; Olivarria, H O; Morales, M; Rangel, G; Magis, C; Beletsky, L

    2017-11-08

    Mexico's 2009 "narcomenudeo reform" decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP) improved officers' drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge. Pre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar's tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers' ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform. Of 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001) in their technical understanding of syringe possession (56 to 91%) and drug amounts decriminalized, including marijuana (9 to 52%), heroin (8 to 71%), and methamphetamine (7 to 70%). The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96%) (p < 0.001), marijuana (16 to 91%), heroin (11 to 91%), and methamphetamine (11 to 89%). In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4-3.2) and decriminalization for heroin (aOR 2.7, 95% CI 1.3-4.3), methamphetamine (aOR 2.2, 95% CI 1.4-3.2), and marijuana (aOR 2.5, 95% CI 1.6-4). Drug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating formal laws to policing practice. To close such gaps, PEP initiatives

  19. Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico

    Directory of Open Access Journals (Sweden)

    J. Arredondo

    2017-11-01

    Full Text Available Abstract Background Mexico’s 2009 “narcomenudeo reform” decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP improved officers’ drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge. Methods Pre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar’s tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers’ ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform. Results Of 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001 in their technical understanding of syringe possession (56 to 91% and drug amounts decriminalized, including marijuana (9 to 52%, heroin (8 to 71%, and methamphetamine (7 to 70%. The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96% (p < 0.001, marijuana (16 to 91%, heroin (11 to 91%, and methamphetamine (11 to 89%. In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4–3.2 and decriminalization for heroin (aOR 2.7, 95% CI 1.3–4.3, methamphetamine (aOR 2.2, 95% CI 1.4–3.2, and marijuana (aOR 2.5, 95% CI 1.6–4. Conclusions Drug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating

  20. Parent Engagement in Youth Drug Prevention in Chinese Families: Advancement in Program Development and Evaluation

    Directory of Open Access Journals (Sweden)

    Sandra K. M. Tsang

    2011-01-01

    Full Text Available The escalating youth drug abuse problem in Hong Kong has attracted intense attention from the government, schools, and youth service professionals. Most preventive efforts have focused directly on positive youth development, very often through school programs delivered to secondary school students. There have been limited efforts to engage parents even though it is obvious that the family is actually the primary context of children and youth development. This paper will assert the importance of parental engagement in youth drug-prevention work, discuss some barriers in such parental involvement, present some promising local attempts and their strengths and limitations, and propose that sustained efforts are needed to build up theory-driven and evidence-based resources for Chinese communities on the subject.

  1. Financial incentives for generic drugs: case study on a reimbursement program

    Directory of Open Access Journals (Sweden)

    Marcos Inocencio

    2010-06-01

    Full Text Available Objective: To discuss the use of financial incentives in choice of medication and to assess the economic results concerning the use of financial incentives to promote the use of genetic medication in lieu of reference drugs in a company with a reimbursement program. Methods: A case study was carried out in a large supermarket. The data was obtained in the company responsible for managing medication. The study reached 83,625 users between August 2005 and July 2007. The data was submitted to regressions in order to analyze trends and hypothesis tests to assess differences in medication consumption. The results were compared with general data regarding medication consumption of five other organizations and also with data about the national consumption of generic medication in Brazil. Results: The use of financial incentives to replace brand medications for generics, in the company studied, increased the consumption of generic drugs without reducing the company expenses with the reimbursement programs. Conclusions: This study show the occurrence of unplanned results (increase in the consumption of medications and the positive consequences of the reimbursement program concerning access to medication.

  2. A disease of frozen feelings: ethically working on emotional worlds in a Russian Orthodox Church drug rehabilitation program

    NARCIS (Netherlands)

    Zigon, J.

    2010-01-01

    In a Russian Orthodox Church drug rehabilitation program in St. Petersburg, drug addiction was often described as a disease of frozen feelings. This image suggests that rehabilitation is a process of thawing emotional worlds and, thus, allows the emotions to flow once again. In this article I argue

  3. Prescription Monitoring Program Trends Among Individuals Arrested in Maine for Trafficking Prescription Drugs in 2014.

    Science.gov (United States)

    McCall, Kenneth; Nichols, Stephanie D; Holt, Christina; Ochs, Leslie; Cattabriga, Gary; Tu, Chunhao

    2016-06-01

    To evaluate controlled substance prescribing trends available in the Maine Prescription Monitoring Program (PMP) among individuals arrested for prescription drug "trafficking." The demographic characteristics of the individuals who had matching prescription records in the PMP within 90 days of the arrest were identified. A population-based, retrospective cohort study using data from the Maine Diversion Alert Program (DAP) and the Maine PMP. The study population consisted of persons arrested for trafficking prescription drugs in Maine during the 2014 calendar year from January 1 to December 31. There were 594 trafficking arrests reported by the Maine DAP in 2014. The study population consisted of the 235 persons (40%) with arrests involving controlled prescription medications. The mean age of these persons was 33 years (range 18-77 yrs), and 156 (66%) were male. Arrests involved 154 prescription opioids (65%), seven stimulants (3%), seven benzodiazepines (3%), and 77 unspecified controlled prescription drugs (33%). A minority of individuals (n=57, 24%) had a prescription record in the PMP that matched the substance involved in the arrest. Only one person with matching PMP and arrest records utilized ≥ 5 prescribers, while none used ≥ 5 pharmacies within 90 days before the arrest. Payment methods for matching prescriptions were commercial insurance (n=28, 49%), Medicaid (n=19, 33%), Medicare (n=5, 9%), and cash (n=5, 9%). The majority (76%) of persons arrested for prescription drug trafficking did not have PMP records and did not directly obtain the diverted medication from a licensed pharmacy. Traditional red flags, like cash payment and using multiple prescribers or pharmacies, were uncommon. Therefore, arrest records for diversion and PMPs are distinct and complementary tools for identifying individuals at risk for substance misuse. © 2016 Pharmacotherapy Publications, Inc.

  4. Prevalence of rotavirus genotypes in children younger than 5 years of age before the introduction of a universal rotavirus vaccination program: report of rotavirus surveillance in Turkey.

    Directory of Open Access Journals (Sweden)

    Riza Durmaz

    Full Text Available BACKGROUND: Group A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program. METHODS: Rotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR. RESULTS: RT-PCR found rotavirus RNA in 1644 (78.2% of the samples tested. The highest rate of rotavirus positivity (38.7% was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%. A total of eight different G types, six different P types, and 42 different G-P combinations were obtained. Four common G types (G1, G2, G3, and G9 and two common P types (P[8] and P[4] accounted for 95.1% and 98.8% of the strains, respectively. G9P[8] was the most common G/P combination found in 40.5% of the strains followed by G1P[8] (21.6%, G2P[8] (9.3%, G2P[4] (6.5%, G3P[8] (3.5%, and finally, G4P[8] (3.4%. These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%. CONCLUSION: The majority of the strains analyzed belonged to the G1-G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country.

  5. Prevalence of Rotavirus Genotypes in Children Younger than 5 Years of Age before the Introduction of a Universal Rotavirus Vaccination Program: Report of Rotavirus Surveillance in Turkey

    Science.gov (United States)

    Durmaz, Riza; Kalaycioglu, Atila Taner; Acar, Sumeyra; Bakkaloglu, Zekiye; Karagoz, Alper; Korukluoglu, Gulay; Ertek, Mustafa; Torunoglu, Mehmet Ali

    2014-01-01

    Background Group A rotaviruses are the most common causative agent of acute gastroenteritis among children less than 5 years of age throughout the world. This sentinel surveillance study was aimed to obtain baseline data on the rotavirus G and P genotypes across Turkey before the introduction of a universal rotavirus vaccination program. Methods Rotavirus antigen-positive samples were collected from 2102 children less than 5 years of age who attended hospitals participating in the Turkish Rotavirus Surveillance Network. Rotavirus antigen was detected in the laboratories of participating hospitals by commercial serological tests such as latex agglutination, immunochromatographic test or enzyme immunoassay. Rotavirus G and P genotypes were determined by reverse transcription polymerase chain reaction (RT-PCR) using consensus primers detecting the VP7 and VP4 genes, followed by semi-nested type-specific multiplex PCR. Results RT-PCR found rotavirus RNA in 1644 (78.2%) of the samples tested. The highest rate of rotavirus positivity (38.7%) was observed among children in the 13 to 24 month age group, followed by children in the age group of 25 to 36 months (28.3%). A total of eight different G types, six different P types, and 42 different G–P combinations were obtained. Four common G types (G1, G2, G3, and G9) and two common P types (P[8] and P[4]) accounted for 95.1% and 98.8% of the strains, respectively. G9P[8] was the most common G/P combination found in 40.5% of the strains followed by G1P[8] (21.6%), G2P[8] (9.3%), G2P[4] (6.5%), G3P[8] (3.5%), and finally, G4P[8] (3.4%). These six common genotypes included 83.7% of the strains tested in this study. The rate of uncommon genotypes was 14%. Conclusion The majority of the strains analyzed belonged to the G1–G4 and G9 genotypes, suggesting high coverage of current rotavirus vaccines. This study also demonstrates a dramatic increase in G9 genotype across the country. PMID:25437502

  6. Who is Surveilling Whom?

    DEFF Research Database (Denmark)

    Mortensen, Mette

    2014-01-01

    This article concerns the particular form of counter-surveillance termed “sousveillance”, which aims to turn surveillance at the institutions responsible for surveillance. Drawing on the theoretical perspectives “mediatization” and “aerial surveillance,” the article studies WikiLeaks’ publication...

  7. Surveillance guidelines for smallpox vaccine (vaccinia) adverse reactions.

    Science.gov (United States)

    Casey, Christine; Vellozzi, Claudia; Mootrey, Gina T; Chapman, Louisa E; McCauley, Mary; Roper, Martha H; Damon, Inger; Swerdlow, David L

    2006-02-03

    CDC and the U.S. Food and Drug Administration rely on state and local health departments, health-care providers, and the public to report the occurrence of adverse events after vaccination to the Vaccine Adverse Event Reporting System. With such data, trends can be accurately monitored, unusual occurrences of adverse events can be detected, and the safety of vaccination intervention activities can be evaluated. On January 24, 2003, the U.S. Department of Health and Human Services (DHHS) implemented a preparedness program in which smallpox (vaccinia) vaccine was administered to federal, state, and local volunteers who might be first responders during a biologic terrorism event. As part of the DHHS Smallpox Preparedness and Response Program, CDC in consultation with experts, established surveillance case definitions for adverse events after smallpox vaccination. Adverse reactions after smallpox vaccination identified during the 1960s surveillance activities were classified on the basis of clinical description and included eczema vaccinatum; fetal vaccinia; generalized vaccinia; accidental autoinoculation, nonocular; ocular vaccinia; progressive vaccinia; erythema multiforme major; postvaccinial encephalitis or encephalomyelitis; and pyogenic infection of the vaccination site. This report provides uniform criteria used for the surveillance case definition and classification for these previously recognized adverse reactions used during the DHHS Smallpox Preparedness and Response Program. Inadvertent inoculation was changed to more precisely describe this event as inadvertent autoinoculation and contact transmission, nonocular and ocular vaccinia. Pyogenic infection also was renamed superinfection of the vaccination site or regional lymph nodes. Finally, case definitions were developed for a new cardiac adverse reaction (myo/pericarditis) and for a cardiac adverse event (dilated cardiomyopathy) and are included in this report. The smallpox vaccine surveillance case

  8. High effectiveness of self-help programs after drug addiction therapy

    Directory of Open Access Journals (Sweden)

    Kristensen Øistein

    2006-08-01

    Full Text Available Abstract Background The self-help groups Alcoholics Anonymous (AA and Narcotics Anonymous (NA are very well established. AA and NA employ a 12-step program and are found in most large cities around the world. Although many have argued that these organizations are valuable, substantial scepticism remains as to whether they are actually effective. Few treatment facilities give clear recommendations to facilitate participation, and the use of these groups has been disputed. The purpose of this study was to examine whether the use of self-help groups after addiction treatment is associated with higher rates of abstinence. Methods One hundred and fourteen patients, 59 with alcohol dependency and 55 with multiple drug dependency, who started in self-help groups after addiction treatment, were examined two years later using a questionnaire. Return rate was 66%. Six (5% of the patients were dead. Results Intention-to-treat-analysis showed that 38% still participated in self-help programs two years after treatment. Among the regular participants, 81% had been abstinent over the previous 6 months, compared with only 26% of the non-participants. Logistic regression analysis showed OR = 12.6, 95% CI (4.1–38.3, p Conclusion The study has several methodological problems; in particular, correlation does not necessarily indicate causality. These problems are discussed and we conclude that the probability of a positive effect is sufficient to recommend participation in self-help groups as a supplement to drug addiction treatment. Previous publication This article is based on a study originally published in Norwegian: Kristensen O, Vederhus JK: Self-help programs in drug addiction therapy. Tidsskr Nor Laegeforen 2005, 125:2798–2801.

  9. Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity.

    Science.gov (United States)

    Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne

    2008-01-18

    Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as

  10. Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity

    Directory of Open Access Journals (Sweden)

    Fagan Abigail A

    2008-01-01

    Full Text Available Abstract Background Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. Methods This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Results Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers, ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence. Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage. Student behavior and use of interactive teaching techniques (quality of delivery were positively related. No variables were related to student participation (student responsiveness. Conclusion Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that

  11. A linear programming computational framework integrates phosphor-proteomics and prior knowledge to predict drug efficacy.

    Science.gov (United States)

    Ji, Zhiwei; Wang, Bing; Yan, Ke; Dong, Ligang; Meng, Guanmin; Shi, Lei

    2017-12-21

    In recent years, the integration of 'omics' technologies, high performance computation, and mathematical modeling of biological processes marks that the systems biology has started to fundamentally impact the way of approaching drug discovery. The LINCS public data warehouse provides detailed information about cell responses with various genetic and environmental stressors. It can be greatly helpful in developing new drugs and therapeutics, as well as improving the situations of lacking effective drugs, drug resistance and relapse in cancer therapies, etc. In this study, we developed a Ternary status based Integer Linear Programming (TILP) method to infer cell-specific signaling pathway network and predict compounds' treatment efficacy. The novelty of our study is that phosphor-proteomic data and prior knowledge are combined for modeling and optimizing the signaling network. To test the power of our approach, a generic pathway network was constructed for a human breast cancer cell line MCF7; and the TILP model was used to infer MCF7-specific pathways with a set of phosphor-proteomic data collected from ten representative small molecule chemical compounds (most of them were studied in breast cancer treatment). Cross-validation indicated that the MCF7-specific pathway network inferred by TILP were reliable predicting a compound's efficacy. Finally, we applied TILP to re-optimize the inferred cell-specific pathways and predict the outcomes of five small compounds (carmustine, doxorubicin, GW-8510, daunorubicin, and verapamil), which were rarely used in clinic for breast cancer. In the simulation, the proposed approach facilitates us to identify a compound's treatment efficacy qualitatively and quantitatively, and the cross validation analysis indicated good accuracy in predicting effects of five compounds. In summary, the TILP model is useful for discovering new drugs for clinic use, and also elucidating the potential mechanisms of a compound to targets.

  12. 75 FR 74063 - Supplemental Funding Under the Food and Drug Administration's Convener of Active Medical Product...

    Science.gov (United States)

    2010-11-30

    ... the program expansion including the availability of appropriate staff and sufficient funding. 4. The...] Supplemental Funding Under the Food and Drug Administration's Convener of Active Medical Product Surveillance... expansion of its Conference Cooperative Agreement Program (U13), awarded to the Engelberg Center for Health...

  13. The evolution of the matrix metalloproteinase inhibitor drug discovery program at abbott laboratories.

    Science.gov (United States)

    Wada, Carol K

    2004-01-01

    Matrix metalloproteinases (MMPs) have been implicated in several pathologies. At Abbott Laboratories, the matrix metalloproteinases inhibitor drug discovery program has focused on the discovery of a potent, selective, orally bioavailable MMP inhibitor for the treatment of cancer. The program evolved from early succinate-based inhibitors to utilizing in-house technology such as SAR by NMR to develop a novel class of biaryl hydroxamate MMP inhibitors. The metabolic instability of the biaryl hydroxamates led to the discovery of a new class of N-formylhydroxylamine (retrohydroxamate) biaryl ethers, exemplified by ABT-770 (16). Toxicity issues with this pre-clinical candidate led to the discovery of another novel class of retrohydroxamate MMP inhibitors, the phenoxyphenyl sulfones such as ABT-518 (19j). ABT-518 is a potent, orally bioavailable, selective inhibitor of MMP-2 and 9 over MMP-1 that has been evaluated in Phase I clinical trials in cancer patients.

  14. Results from 15years of quality surveillance for a National Indigenous Point-of-Care Testing Program for diabetes.

    Science.gov (United States)

    Shephard, Mark; Shephard, Anne; McAteer, Bridgit; Regnier, Tamika; Barancek, Kristina

    2017-12-01

    Diabetes is a major health problem for Australia's Aboriginal and Torres Strait Islander peoples. Point-of-care testing for haemoglobin A1c (HbA1c) has been the cornerstone of a long-standing program (QAAMS) to manage glycaemic control in Indigenous people with diabetes and recently, to diagnose diabetes. The QAAMS quality management framework includes monthly testing of quality control (QC) and external quality assurance (EQA) samples. Key performance indicators of quality include imprecision (coefficient of variation [CV%]) and percentage acceptable results. This paper reports on the past 15years of quality testing in QAAMS and examines the performance of HbA1c POC testing at the 6.5% cut-off recommended for diagnosis. The total number of HbA1c EQA results submitted from 2002 to 2016 was 29,093. The median imprecision for EQA testing by QAAMS device operators averaged 2.81% (SD 0.50; range 2.2 to 3.9%) from 2002 to 2016 and 2.44% (SD 0.22; range 2.2 to 2.9%) from 2009 to 2016. No significant difference was observed between the median imprecision achieved in QAAMS and by Australasian laboratories from 2002 to 2016 (p=0.05; two-tailed paired t-test) and from 2009 to 2016 (p=0.17; two-tailed paired t-test). For QC testing from 2009 to 2016, imprecision averaged 2.5% and 3.0% for the two levels of QC tested. Percentage acceptable results averaged 90% for QA testing from 2002 to 2016 and 96% for QC testing from 2009 to 2016. The DCA Vantage was able to measure a patient and an EQA sample with an HbA1c value close to 6.5% both accurately and precisely. HbA1c POC testing in QAAMS has remained analytically sound, matched the quality achieved by Australasian laboratories and met profession-derived analytical goals for 15years. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Prediction of drug-related cardiac adverse effects in humans--B: use of QSAR programs for early detection of drug-induced cardiac toxicities.

    Science.gov (United States)

    Frid, Anna A; Matthews, Edwin J

    2010-04-01

    This report describes the use of three quantitative structure-activity relationship (QSAR) programs to predict drug-related cardiac adverse effects (AEs), BioEpisteme, MC4PC, and Leadscope Predictive Data Miner. QSAR models were constructed for 9 cardiac AE clusters affecting Purkinje nerve fibers (arrhythmia, bradycardia, conduction disorder, electrocardiogram, palpitations, QT prolongation, rate rhythm composite, tachycardia, and Torsades de pointes) and 5 clusters affecting the heart muscle (coronary artery disorders, heart failure, myocardial disorders, myocardial infarction, and valve disorders). The models were based on a database of post-marketing AEs linked to 1632 chemical structures, and identical training data sets were configured for three QSAR programs. Model performance was optimized and shown to be affected by the ratio of the number of active to inactive drugs. Results revealed that the three programs were complementary and predictive performances using any single positive, consensus two positives, or consensus three positives were as follows, respectively: 70.7%, 91.7%, and 98.0% specificity; 74.7%, 47.2%, and 21.0% sensitivity; and 138.2, 206.3, and 144.2 chi(2). In addition, a prospective study using AE data from the U.S. Food and Drug Administration's (FDA's) MedWatch Program showed 82.4% specificity and 94.3% sensitivity. Furthermore, an external validation study of 18 drugs with serious cardiotoxicity not considered in the models had 88.9% sensitivity. Published by Elsevier Inc.

  16. Randomized Controlled Evaluation of the "Too Good for Drugs" Prevention Program: Impact on Adolescents at Different Risk Levels for Drug Use

    Science.gov (United States)

    Hall, Bruce W.; Bacon, Tina P.; Ferron, John M.

    2013-01-01

    Sixth graders participating in the "Too Good for Drugs" (TGFD) prevention program in comparison to 6th graders not participating show different results by student risk level. Sixth graders from 20 middle schools were randomly assigned to receive the intervention and those from 20 paired middle schools assigned to serve as controls (N =…

  17. Containment and Surveillance Equipment Compendium

    International Nuclear Information System (INIS)

    Luetters, F.O.

    1980-02-01

    The Containment and Surveillance Equipment Compendium contains information sections describing the application and status of seals, optical surveillance systems, and monitors for international safeguards systems. The Compendium is a collection of information on equipment in use (generally by the IAEA) or under development in the US in diverse programs being conducted at numerous facilities under different sponsors. The Compendium establishes a baseline for the status and applications of C/S equipment and is a tool to assist in the planning of future C/S hardware development activities. The Appendix contains design concepts which can be developed to meet future goals

  18. Best practices: an electronic drug alert program to improve safety in an accountable care environment.

    Science.gov (United States)

    Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

    2015-04-01

    The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

  19. Evolutionary ARMS Race: Antimalarial Resistance Molecular Surveillance.

    Science.gov (United States)

    Prosser, Christiane; Meyer, Wieland; Ellis, John; Lee, Rogan

    2018-04-01

    Molecular surveillance of antimalarial drug resistance markers has become an important part of resistance detection and containment. In the current climate of multidrug resistance, including resistance to the global front-line drug artemisinin, there is a consensus to upscale molecular surveillance. The most salient limitation to current surveillance efforts is that skill and infrastructure requirements preclude many regions. This includes sub-Saharan Africa, where Plasmodium falciparum is responsible for most of the global malaria disease burden. New molecular and data technologies have emerged with an emphasis on accessibility. These may allow surveillance to be conducted in broad settings where it is most needed, including at the primary healthcare level in endemic countries, and extending to the village health worker. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. An analysis of potential costs of adverse events based on Drug Programs in Poland. Pulmonology focus

    Directory of Open Access Journals (Sweden)

    Szkultecka-Debek Monika

    2014-06-01

    Full Text Available The project was performed within the Polish Society for Pharmacoeconomics (PTFE. The objective was to estimate the potential costs of treatment of side effects, which theoretically may occur as a result of treatment of selected diseases. We analyzed the Drug Programs financed by National Health Fund in Poland in 2012 and for the first analysis we selected those Programs where the same medicinal products were used. We based the adverse events selection on the Summary of Product Characteristics of the chosen products. We extracted all the potential adverse events defined as frequent and very frequent, grouping them according to therapeutic areas. This paper is related to the results in the pulmonology area. The events described as very common had an incidence of ≥ 1/10, and the common ones ≥ 1/100, <1/10. In order to identify the resources used, we performed a survey with the engagement of clinical experts. On the basis of the collected data we allocated direct costs incurred by the public payer. We used the costs valid in December 2013. The paper presents the estimated costs of treatment of side effects related to the pulmonology disease area. Taking into account the costs incurred by the NHF and the patient separately e calculated the total spending and the percentage of each component cost in detail. The treatment of adverse drug reactions generates a significant cost incurred by both the public payer and the patient.

  1. Aiding surveillance

    International Development Research Centre (IDRC) Digital Library (Canada)

    arashid

    8 See, for example, the work of the Center for Global Development, ..... toward social protection, cash transfer, or social safety net programs as effective tools for .... that the [MIS] will fit within the users' work environment and be useful to them.

  2. Reconciling the Multiple Objectives of Prison Diversion Programs for Drug Offenders: Evidence from Kansas' Senate Bill 123

    Science.gov (United States)

    Stemen, Don; Rengifo, Andres F.

    2011-01-01

    Background: In recent years, several states have created mandatory prison-diversion programs for felony drug possessors. These programs have both individual-level goals of reducing recidivism rates and system-level goals of reducing prison populations. Objective: This study examines the individual level and system level impact of Kansas' Senate…

  3. Ideology, Critique and Surveillance

    Directory of Open Access Journals (Sweden)

    Heidi Herzogenrath-Amelung

    2013-11-01

    Full Text Available The 2013 revelations concerning global surveillance programmes demonstrate in unprecedented clarity the need for Critical Theory of information and communication technologies (ICTs to address the mechanisms and implications of increasingly global, ubiquitous surveillance. This is all the more urgent because of the dominance of the “surveillance ideology” (the promise of security through surveillance that supports the political economy of surveillance. This paper asks which theoretical arguments and concepts can be useful for philosophically grounding a critique of this surveillance ideology. It begins by examining how the surveillance ideology works through language and introduces the concept of the ‘ideological packaging’ of ICTs to show how rhetoric surrounding the implementation of surveillance technologies reinforces the surveillance ideology. It then raises the problem of how ideology-critique can work if it relies on language itself and argues that Martin Heidegger’s philosophy can make a useful contribution to existing critical approaches to language.

  4. Drug treatment program patients' hepatitis C virus (HCV education needs and their use of available HCV education services

    Directory of Open Access Journals (Sweden)

    Osborne Andrew

    2007-03-01

    Full Text Available Abstract Background In spite of the disproportionate prevalence of hepatitis C virus (HCV infection among drug users, many remain uninformed or misinformed about the virus. Drug treatment programs are important sites of opportunity for providing HCV education to their patients, and many programs do, in fact, offer this education in a variety of formats. Little is known, however, about the level of HCV knowledge among drug treatment program patients, and the extent to which they utilize their programs' HCV education services. Methods Using data collected from patients (N = 280 in 14 U.S. drug treatment programs, we compared patients who reported that they never injected drugs (NIDUs with past or current drug injectors (IDUs concerning their knowledge about HCV, whether they used HCV education opportunities at their programs, and the facilitators and barriers to doing so. All of the programs were participating in a research project that was developing, implementing, and evaluating a staff training to provide HCV support to patients. Results Although IDUs scored higher on an HCV knowledge assessment than NIDUs, there were many gaps in HCV knowledge among both groups of patients. To address these knowledge gaps, all of the programs offered at least one form of HCV education: all offered 1:1 sessions with staff, 12 of the programs offered HCV education in a group format, and 11 of the programs offered this education through pamphlets/books. Only 60% of all of the participating patients used any of their programs' HCV education services, but those who did avail themselves of these HCV education opportunities generally assessed them positively. In all, many patients were unaware that HCV education was offered at their programs through individual sessions with staff, group meetings, and books/pamphlets, (42%, 49%, and 46% of the patients, respectively, and 22% were unaware that any HCV education opportunities existed. Conclusion Efforts especially need

  5. Patterns of HIV testing, drug use, and sexual behaviors in people who use drugs: findings from a community-based outreach program in Phnom Penh, Cambodia.

    Science.gov (United States)

    Mburu, Gitau; Ngin, Chanrith; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Yi, Siyan

    2017-12-05

    People who use drugs are an important priority for HIV programs. However, data related to their utilization of HIV services are limited. This paper reports patterns of HIV testing, drug use, and risk and service perception among people who use drugs. Study participants were receiving HIV and harm reduction services from a community-based program in Phnom Penh, comprised of itinerant peer-led outreach and static drop-in centers. This was a mixed-methods study conducted in 2014, comprising of a quantitative survey using a structured questionnaire, followed by two focus group discussions among a sub-sample of survey participants. Participants were recruited from hotspots in five HIV high-burden communes using a two-stage cluster sampling method. Quantitative descriptive analyses and qualitative thematic analyses were performed. This study included 151 people who use drugs with a mean age of 31.2 (SD = 6.5) years; 77.5% were male and 39.1% were married. The most common drugs used were methamphetamines (72.8%) and heroin (39.7%), and 38.0% injected drugs in the past 3 months. Overall, 83.3% had been tested for HIV in the past 6 months, of whom 62.5% had been tested by peers through community-based outreach. However, there were ongoing HIV risks: 37.3% were engaging in sex on drugs, only 35.6% used a condom at last sexual intercourse, and 10.8% had had a sexually transmitted infection in the last 6 months. Among people who reported injecting drugs in the past 3 months, 27.5% reported re-using needles/syringes. Almost half (46.5%) perceived themselves as being at lower risk of HIV compared to the general population. Qualitative results contextualized the findings of low perception of HIV risks and suggested that although services were often unavailable on weekends, at night, or during national holidays, peer-led community-based outreach was highly accepted. A peer-led community-based approach was effective in reaching people who use drugs with HIV and harm reduction

  6. Drug efficiency: a new concept to guide lead optimization programs towards the selection of better clinical candidates.

    Science.gov (United States)

    Braggio, Simone; Montanari, Dino; Rossi, Tino; Ratti, Emiliangelo

    2010-07-01

    As a result of their wide acceptance and conceptual simplicity, drug-like concepts are having a major influence on the drug discovery process, particularly in the selection of the 'optimal' absorption, distribution, metabolism, excretion and toxicity and physicochemical parameters space. While they have an undisputable value when assessing the potential of lead series or in evaluating inherent risk of a portfolio of drug candidates, they result much less useful in weighing up compounds for the selection of the best potential clinical candidate. We introduce the concept of drug efficiency as a new tool both to guide the drug discovery program teams during the lead optimization phase and to better assess the developability potential of a drug candidate.

  7. Antifungal susceptibilities of Candida, Cryptococcus neoformans and Aspergillus fumigatus from the Asia and Western Pacific region: data from the SENTRY antifungal surveillance program (2010-2012).

    Science.gov (United States)

    Pfaller, Michael A; Messer, Shawn A; Jones, Ronald N; Castanheira, Mariana

    2015-09-01

    The SENTRY Antifungal Surveillance Program monitors global susceptibility rates of newer and established antifungal agents. We report the in vitro activity of seven antifungal agents against 496 contemporary clinical isolates of yeasts and molds. The isolates were obtained from 20 laboratories in the Asia-Western Pacific (APAC) region during 2010 through 2012. Anidulafungin, caspofungin, micafungin, fluconazole, itraconazole, posaconazole and voriconazole were susceptibility tested using CLSI methods and species-specific interpretive criteria. Sequencing of fks hot spots was performed for echinocandin-resistant strains. Isolates included 13 species of Candida (n=460), 5 species of non-Candida yeasts (21), 5 species of Aspergillus (11) and 4 other molds. Echinocandin resistance was uncommon among eight species of Candida and was only detected in three isolates of Candida glabrata, two from Australia harboring mutations in fks1 (F625S) and fks2 (S663P). Resistance to the azoles was much more common and was observed among all species with the exception of Candida dubliniensis. Fluconazole resistance rates observed with C. glabrata (6.8%) was comparable to that seen with Candida parapsilosis (5.7%) and Candida tropicalis (3.6%). Cross resistance among the triazoles was seen with each of these three species. The mold-active azoles and the echinocandins were all active against isolates of Aspergillus fumigatus. Azole resistance was not detected among the isolates of Cryptococcus neoformans. Antifungal resistance is uncommon among isolates of fungi causing invasive fungal infections in the APAC region. As in other regions of the world, emerging resistance to the echinocandins among invasive isolates of C. glabrata bears close monitoring.

  8. 21 CFR 822.11 - What should I consider when designing my plan to conduct postmarket surveillance?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false What should I consider when designing my plan to conduct postmarket surveillance? 822.11 Section 822.11 Food and Drugs FOOD AND DRUG ADMINISTRATION... Surveillance Plan § 822.11 What should I consider when designing my plan to conduct postmarket surveillance...

  9. Consumption of antihypertensive drugs dispensed under the pharmacy benefit management program

    Directory of Open Access Journals (Sweden)

    Aline Pereira Rocha

    2011-12-01

    Full Text Available Pharmacy benefit management (PBM programs provide attractive discounts for drug purchase, a relevant measure to address costs, mainly of drugs for the treatment of chronic diseases. This study investigated whether PBM may be used as a tool to provide information about the use of antihypertensive medications when they are purchased. The profile of medicines taken to treat high blood pressure by large IT company employees and their dependents was evaluated from January to December 2009. The mean rate of drug boxes purchased to control hypertension was 9.4 ± 10.0 in 2009. Men purchased more drugs than women. The number of drugs purchased for the treatment of hypertension was lower than expected in all age groups except for individuals aged 54-58 and >59 years. Among men, the purchase of drugs to treat hypertension was higher than expected in the 24-28, 34-38 and 54-58 age groups. Among women, results matched expectations, except for the age group 34-38 years, in which purchase was lower than expected. Individuals in the age group 0-18 years were found to consume antihypertensive drugs. Although the PBM system may be used to identify drugs purchased by users, it does not ensure patient adherence to recommended drug treatment to control hypertension.O objetivo do Programa de Benefícios em Medicamentos (PBM é proporcionar descontos atraentes para aquisição de medicamentos, um fator relevante para o custo, principalmente no tratamento de doenças crônicas. O objetivo deste estudo é comprovar se o PBM pode ser utilizado como ferramenta para o fornecimento de informações sobre o consumo de medicamentos antihipertensivos através da aquisição dos mesmos. Foi realizada análise do perfil de medicamentos adquiridos para o tratamento de hipertensão arterial sistêmica por funcionários e seus dependentes de uma empresa de grande porte na área de tecnologia de informação (TI no período compreendido entre janeiro a dezembro de 2009. A taxa de

  10. Molecular surveillance for drug-resistant Plasmodium falciparum in clinical and subclinical populations from three border regions of Burma/Myanmar: cross-sectional data and a systematic review of resistance studies

    Science.gov (United States)

    2012-01-01

    health workers can contribute to molecular surveillance of drug resistance in remote areas of Myanmar. Marginal and displaced populations under-represented among previous resistance investigations can and should be included in resistance surveillance efforts, particularly once genetic markers of artemisinin-delayed parasite clearance are identified. Subclinical infections may contribute to the epidemiology of drug resistance, but determination of gene amplification from desiccated filter samples requires further validation when DNA concentration is low. PMID:22992214

  11. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    Science.gov (United States)

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

  12. Wallops Ship Surveillance System

    Science.gov (United States)

    Smith, Donna C.

    2011-01-01

    Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

  13. Factors associated with the implementation of programs for drug abuse prevention in schools.

    Science.gov (United States)

    Pereira, Ana Paula Dias; Paes, Ângela Tavares; Sanchez, Zila M

    2016-08-04

    To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. We found that 42.5% (95%CI 36.1-49.1) of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school. Analisar se características dos dirigentes, das escolas e do currículo escolar estão associadas à implantação de programas de prevenção ao uso de drogas nas escolas do ciclo fundamental II e médio. Estudo transversal, com amostra aleatória sistemática de 263 dirigentes escolares. Os dados foram coletados nos anos

  14. [Antiretroviral drug supply in Argentina: National Program to Combat Human Retroviruses, AIDS, and STDs].

    Science.gov (United States)

    Colautti, Marisel; Luppi, Irene; Salamano, Mercedes; Traverso, María Luz; Botta, Carina; Palchik, Valeria

    2009-01-01

    To evaluate the supply cycle of antiretroviral (ARV) drugs, overseen by the National Program to Combat Human Retroviruses, AIDS, and STDs, through its order fulfillment indicators, and to obtain input from supply chain stakeholders. A study was carried out from April-September 2005 in the pharmacies of two hospitals in Rosario, Argentina, involving both a quantitative analysis of indicators and secondary sources and a qualitative evaluation using semistructured interviews. The indicators reveal the impact that interruptions in ARV supply stream from the Program (central level) have and the overstocking that takes place at the pharmacies (local level) to manage the shortages. Changes in ARV treatment account for over 50% of the prescriptions. Fulfillments fall short of the reference value. The interviewees shared possible strategies for overcoming the communication gaps between levels, for building-up stock, for guaranteeing availability, and for shortening waiting times; reached informal agreements to deal with the lack of policies and the shortage of staff; acknowledged the challenges facing the jurisdictions (central, intermediate, and local/community); and recognized local efforts to improve management. These challenges could be the starting point for building teams to work on effectively decentralizing the entire supply chain and allowing the Program to fulfill its much-needed oversight role.

  15. Trends of Mycobacterium bovis Isolation and First-Line Anti-tuberculosis Drug Susceptibility Profile: A Fifteen-Year Laboratory-Based Surveillance.

    Science.gov (United States)

    Bobadilla-del Valle, Miriam; Torres-González, Pedro; Cervera-Hernández, Miguel Enrique; Martínez-Gamboa, Areli; Crabtree-Ramirez, Brenda; Chávez-Mazari, Bárbara; Ortiz-Conchi, Narciso; Rodríguez-Cruz, Luis; Cervantes-Sánchez, Axel; Gudiño-Enríquez, Tomasa; Cinta-Severo, Carmen; Sifuentes-Osornio, José; Ponce de León, Alfredo

    2015-09-01

    Mycobacterium tuberculosis causes the majority of tuberculosis (TB) cases in humans; however, in developing countries, human TB caused by M. bovis may be frequent but undetected. Human TB caused by M. bovis is considered a zoonosis; transmission is mainly through consumption of unpasteurized dairy products, and it is less frequently attributed to animal-to-human or human-to-human contact. We describe the trends of M. bovis isolation from human samples and first-line drug susceptibility during a 15-year period in a referral laboratory located in a tertiary care hospital in Mexico City. Data on mycobacterial isolates from human clinical samples were retrieved from the laboratory's database for the 2000-2014 period. Susceptibility to first-line drugs: rifampin, isoniazid, streptomycin (STR) and ethambutol was determined. We identified 1,165 isolates, 73.7% were M. tuberculosis and 26.2%, M. bovis. Among pulmonary samples, 16.6% were M. bovis. The proportion of M. bovis isolates significantly increased from 7.8% in 2000 to 28.4% in 2014 (X(2)trend, ptuberculosis isolates (10.9% vs.3.4%, ptuberculosis, respectively (p = 0.637). A rising trend of primary STR monoresistance was observed for both species (3.4% in 2000-2004 vs. 7.6% in 2010-2014; p = 0.02). There is a high prevalence and a rising trend of M. bovis isolates in our region. The proportion of pulmonary M. bovis isolates is higher than in previous reports. Additionally, we report high rates of primary anti-tuberculosis resistance and secondary MDR in both M. tuberculosis and M. bovis. This is one of the largest reports on drug susceptibility of M. bovis from human samples and shows a significant proportion of first-line anti-tuberculosis drug resistance.

  16. Trends of Mycobacterium bovis Isolation and First-Line Anti-tuberculosis Drug Susceptibility Profile: A Fifteen-Year Laboratory-Based Surveillance

    Science.gov (United States)

    Bobadilla-del Valle, Miriam; Torres-González, Pedro; Cervera-Hernández, Miguel Enrique; Martínez-Gamboa, Areli; Crabtree-Ramirez, Brenda; Chávez-Mazari, Bárbara; Ortiz-Conchi, Narciso; Rodríguez-Cruz, Luis; Cervantes-Sánchez, Axel; Gudiño-Enríquez, Tomasa; Cinta-Severo, Carmen; Sifuentes-Osornio, José; Ponce de León, Alfredo

    2015-01-01

    Background Mycobacterium tuberculosis causes the majority of tuberculosis (TB) cases in humans; however, in developing countries, human TB caused by M. bovis may be frequent but undetected. Human TB caused by M. bovis is considered a zoonosis; transmission is mainly through consumption of unpasteurized dairy products, and it is less frequently attributed to animal-to-human or human-to-human contact. We describe the trends of M. bovis isolation from human samples and first-line drug susceptibility during a 15-year period in a referral laboratory located in a tertiary care hospital in Mexico City. Methodology/Principal Findings Data on mycobacterial isolates from human clinical samples were retrieved from the laboratory’s database for the 2000–2014 period. Susceptibility to first-line drugs: rifampin, isoniazid, streptomycin (STR) and ethambutol was determined. We identified 1,165 isolates, 73.7% were M. tuberculosis and 26.2%, M. bovis. Among pulmonary samples, 16.6% were M. bovis. The proportion of M. bovis isolates significantly increased from 7.8% in 2000 to 28.4% in 2014 (X 2 trend, ptuberculosis isolates (10.9% vs.3.4%, ptuberculosis, respectively (p = 0.637). A rising trend of primary STR monoresistance was observed for both species (3.4% in 2000–2004 vs. 7.6% in 2010–2014; p = 0.02). Conclusions/Significance There is a high prevalence and a rising trend of M. bovis isolates in our region. The proportion of pulmonary M. bovis isolates is higher than in previous reports. Additionally, we report high rates of primary anti-tuberculosis resistance and secondary MDR in both M. tuberculosis and M. bovis. This is one of the largest reports on drug susceptibility of M. bovis from human samples and shows a significant proportion of first-line anti-tuberculosis drug resistance. PMID:26421930

  17. Is Project Towards No Drug Abuse (Project TND) an evidence-based drug and violence prevention program? A review and reappraisal of the evaluation studies.

    Science.gov (United States)

    Gorman, Dennis M

    2014-08-01

    This paper critically reviews the published evidence pertaining to Project Towards No Drug Abuse (Project TND). Publications from seven evaluation studies of Project TND are reviewed, and the results from these are discussed as related to the following outcomes: main effects on the use of cigarettes, alcohol and marijuana; main effects on the use of "hard drugs," defined in the evaluations as cocaine, hallucinogens, stimulants, inhalants, ecstasy and other drugs (e.g., depressants, PCP, steroids and heroin); subgroup and interaction analyses of drug use; and violence-related behaviors. Very few main effects have been found for cigarette, alcohol and marijuana use in the Project TND evaluations. While studies do report main effects for hard drug use, these findings are subject to numerous threats to validity and may be attributable to the data analyses employed. Similarly, while isolated subgroup and interaction effects were found for alcohol use among baseline nonusers and some violence-related behaviors in the early Project TND evaluations, these findings have not been replicated in more recent studies and may result from multiple comparisons between study conditions. In conclusion, there is little evidence to support the assertion that Project TND is an effective drug or violence prevention program. The broader implications of these findings for prevention science are discussed and suggestions are made as to how the quality of research