WorldWideScience

Sample records for eliminating polio requires

  1. The Estimated Health and Economic Benefits of Three Decades of Polio Elimination Efforts in India.

    Science.gov (United States)

    Nandi, Arindam; Barter, Devra M; Prinja, Shankar; John, T Jacob

    2016-08-07

    In March 2014, India, the country with historically the highest burden of polio, was declared polio free, with no reported cases since January 2011. We estimate the health and economic benefits of polio elimination in India with the oral polio vaccine (OPV) during 1982-2012. Based on a pre-vaccine incidence rate, we estimate the counterfactual burden of polio in the hypothetical absence of the national polio elimination program in India. We attribute differences in outcomes between the actual (adjusted for under-reporting) and hypothetical counterfactual scenarios in our model to the national polio program. We measure health benefits as averted polio incidence, deaths, and disability adjusted life years (DALYs). We consider two methods to measure economic benefits: the value of statistical life approach, and equating one DALY to the Gross National Income (GNI) per capita. We estimate that the National Program against Polio averted 3.94 million (95% confidence interval [CI]: 3.89-3.99 million) paralytic polio cases, 393,918 polio deaths (95% CI: 388,897- 398,939), and 1.48 billion DALYs (95% CI: 1.46-1.50 billion). We also estimate that the program contributed to a $1.71 trillion (INR 76.91 trillion) gain (95% CI: $1.69-$1.73 trillion [INR 75.93-77.89 trillion]) in economic productivity between 1982 and 2012 in our base case analysis. Using the GNI and DALY method, the economic gain from the program is estimated to be $1.11 trillion (INR 50.13 trillion) (95% CI: $1.10-$1.13 trillion [INR 49.50-50.76 trillion]) over the same period. India accrued large health and economic benefits from investing in polio elimination efforts. Other programs to control/eliminate more vaccine-preventable diseases are likely to contribute to large health and economic benefits in India.

  2. Transitioning Lessons Learned and Assets of the Global Polio Eradication Initiative to Global and Regional Measles and Rubella Elimination.

    Science.gov (United States)

    Kretsinger, Katrina; Strebel, Peter; Kezaala, Robert; Goodson, James L

    2017-07-01

    The Global Polio Eradication Initiative has built an extensive infrastructure with capabilities and resources that should be transitioned to measles and rubella elimination efforts. Measles continues to be a major cause of child mortality globally, and rubella continues to be the leading infectious cause of birth defects. Measles and rubella eradication is feasible and cost saving. The obvious similarities in strategies between polio elimination and measles and rubella elimination include the use of an extensive surveillance and laboratory network, outbreak preparedness and response, extensive communications and social mobilization networks, and the need for periodic supplementary immunization activities. Polio staff and resources are already connected with those of measles and rubella, and transitioning existing capabilities to measles and rubella elimination efforts allows for optimized use of resources and the best opportunity to incorporate important lessons learned from polio eradication, and polio resources are concentrated in the countries with the highest burden of measles and rubella. Measles and rubella elimination strategies rely heavily on achieving and maintaining high vaccination coverage through the routine immunization activity infrastructure, thus creating synergies with immunization systems approaches, in what is termed a "diagonal approach." © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  3. Polio Vaccine

    Science.gov (United States)

    ... IBS) Home Family Health Infants and Toddlers Polio Vaccine Polio Vaccine Share Print What is polio? Poliomyelitis (polio) is ... each year. Fortunately, the use of the polio vaccine has made the disease very rare in most ...

  4. Polio (For Parents)

    Science.gov (United States)

    ... who came in contact with a recently immunized child might become immune, too. The problem with OPV was that, in very rare cases, paralytic polio could develop either in immunized children or in those who came in contact with them. Since 1979 (when wild polio was eliminated in the United States), the ...

  5. Polio and Prevention

    Science.gov (United States)

    ... Photo Collections Videos Polio Today → Polio + Prevention Polio + Prevention Polio and prevention Polio is a crippling and ... a child for life. Learn more about polio + prevention The Virus The Vaccines The Communities Related resources ...

  6. Polio and Post-Polio Syndrome

    Science.gov (United States)

    ... who've had polio develop post-polio syndrome (PPS) years later. Symptoms include tiredness, new muscle weakness, ... There is no way to prevent or cure PPS. The polio vaccine has wiped out polio in ...

  7. [Polio, late effects and post-polio].

    Science.gov (United States)

    Kay, Lise

    2014-10-20

    Approximately 7,000 Danes are still living with sequelae after surviving an acute polio infection. Late effects of polio include deformities, arthrosis and overloaded muscles. In the long run polio patients are at risk of having a further decrease of muscle function and a wide variety of other symptoms, a condition called post-polio syndrome (PPS). Treatment of PPS is in general symptomatic. Recently it has been shown that treatment with intravenous immunoglobulin may have an effect on pain, tiredness and walking distance. Patients with prior polio have an increase in morbidity and mortality, and may be more sensitive to a variety of medicine.

  8. Post-Polio Syndrome

    Science.gov (United States)

    ... had paralytic polio. Accurate statistics do not exist today, as a percentage of polio survivors have died ... up Meeting Now That You Are Funded Small Business Grants Overview Areas of Interest Budget Information Grant ...

  9. Non-Polio Enterovirus

    Science.gov (United States)

    ... Photos Related Links Water-related Hygiene Viral Conjunctivitis Hand, Foot, and Mouth Disease Viral Meningitis What is Polio? About Non-Polio ... illness... Related Links Water-related Hygiene Viral Conjunctivitis Hand, Foot, and Mouth Disease Viral Meningitis What is Polio? File Formats Help: ...

  10. ERADIKASI POLIO DAN IPV (INACTIVATED POLIO VACCINE

    Directory of Open Access Journals (Sweden)

    Gendrowahyuhono Gendrowahyuhono

    2012-09-01

    Full Text Available In the year 1988, World Health Organization (WHO claims that polio viruses should be eradicated after year 2000. However, until year 2010 the world have not been free from polio viruses circulation. So many effort had been achieved and it is estimated that the world will be free from polio virus after the year 2013. Control of poliomyelitis in Indonesia has been commenced since 1982 with routine immunization of polio program and the National Immunization Days (NID has been commenced since 1995,1996,2005 and 2006. When the world is free from polio virus, WHO suggests several alternative effort to maintain the world free from polio viruses : I stop the OPV (Oral Polio Vaccine and no polio immunization, 2 stop OPV and stock pile mOPV (monovalent OPV, 3 use OPV and IPV (Inactivated Polio Vaccine in a certain times, 4 use IPV only in a certain times. IPV has been used routinely in develop countries but has not been used in the developing countries. Several studies in development countries has been conducted, but had not been done in the developing countries. Indonesia collaboration with WHO has conducted the study of IPV in Yogyakarta Province since year 2002 until year 2010. The overall aim of the study is to compile the necessary data that will inform global and national decision-making regarding future polio immunization policies for the OPV cessation era. The data generated from the study will be particularly important to make decisions regarding optimal IPV use in developing tropical countries. It is unlikely that this data can be assembled through other means than through this study. The tentative result of the study shows that OPV immunization coverage in the year 2004 is 99% in four district and 93 % in the Yogyakarta city. Environment surveillance shows that there are 65.7% polio virus detected from 137 sewage samples pre IPV swich, and 4.8% polio virus detected from 83 sewage samples post IPV swich. Survey polio antibody serologis shows

  11. Crippling Violence: Conflict and Incident Polio in Afghanistan.

    Directory of Open Access Journals (Sweden)

    Alison Norris

    Full Text Available Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404.The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

  12. Polio and Post-Polio Syndrome - Multiple Languages

    Science.gov (United States)

    ... Home → Multiple Languages → All Health Topics → Polio and Post-Polio Syndrome URL of this page: https://medlineplus.gov/languages/ ... XYZ List of All Topics All Polio and Post-Polio Syndrome - Multiple Languages To use the sharing features on ...

  13. Late Effects of Polio: An Overview

    Science.gov (United States)

    ... Polio Wellness Retreats For Health Professionals The Late Effects of Polio: An Overview FRENCH | GERMAN | PORTUGUESE POLIOMYELITIS ( ... largest and most inclusive category is called Late Effects of Polio or Polio Sequelae and is defined ...

  14. polio eradication in nigeria

    African Journals Online (AJOL)

    cumulative total of 302 as at Jan 2004), ... have further resulted in the previous cancellation of polio-vaccination campaigns in several key Northern. Nigeria states. The outcome ... eradicate the sufferings, paralysis and death associated with the ...

  15. Polio Eradication Initiative (PEl) Emergency Plan: A Panacea for ...

    African Journals Online (AJOL)

    Methods A review of related and available literature was conducted on the subject matter using the Google search engine, Google Scholar, and PubMed using the key words polio; eradication; Nigeria; and Global Polio Eradication Initiative. Result Much progress has been made towards achieving the required coverage ...

  16. polio supplementary immunization campaign evaluation

    African Journals Online (AJOL)

    2013-08-20

    Aug 20, 2013 ... Introduction. Although there are no confirmed polio cases in South. Sudan since June 2009, vital indicators for polio eradication activities are not satisfactory [1.]. Hence, the recent huge polio outbreak in Somalia, Kenya and Ethiopia demanded a safety net SNIDs for four States, including Upper Nile.

  17. Workshop on Program for Elimination of Requirements Marginal to Safety: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Dey, M. [Nuclear Regulatory Commission, Washington, DC (United States). Div. of Safety Issue Resolution; Arsenault, F.; Patterson, M.; Gaal, M. [SCIENTECH, Inc., Rockville, MD (United States)

    1993-09-01

    These are the proceedings of the Public Workshop on the US Nuclear Regulatory Commission`s Program for Elimination of Requirements Marginal to Safety. The workshop was held at the Holiday Inn, Bethesda, on April 27 and 28, 1993. The purpose of the workshop was to provide an opportunity for public and industry input to the program. The workshop addressed the institutionalization of the program to review regulations with the purpose of eliminating those that are marginal. The objective is to avoid the dilution of safety efforts. One session was devoted to discussion of the framework for a performance-based regulatory approach. In addition, panelists and attendees discussed scope, schedules and status of specific regulatory items: containment leakage testing requirements, fire protection requirements, requirements for environmental qualification of electrical equipment, requests for information under 10CFR50.54(f), requirements for combustible gas control systems, and quality assurance requirements.

  18. Workshop on Program for Elimination of Requirements Marginal to Safety: Proceedings

    International Nuclear Information System (INIS)

    Dey, M.

    1993-09-01

    These are the proceedings of the Public Workshop on the US Nuclear Regulatory Commission's Program for Elimination of Requirements Marginal to Safety. The workshop was held at the Holiday Inn, Bethesda, on April 27 and 28, 1993. The purpose of the workshop was to provide an opportunity for public and industry input to the program. The workshop addressed the institutionalization of the program to review regulations with the purpose of eliminating those that are marginal. The objective is to avoid the dilution of safety efforts. One session was devoted to discussion of the framework for a performance-based regulatory approach. In addition, panelists and attendees discussed scope, schedules and status of specific regulatory items: containment leakage testing requirements, fire protection requirements, requirements for environmental qualification of electrical equipment, requests for information under 10CFR50.54(f), requirements for combustible gas control systems, and quality assurance requirements

  19. 75 FR 30395 - Stakeholder Input; National Pollutant Discharge Elimination System (NPDES) Permit Requirements...

    Science.gov (United States)

    2010-06-01

    ..., the elderly and those with weakened immune systems, can be at a higher risk of illness from exposure... municipal collection systems including satellite portions. 4. What is the appropriate role of NPDES permits... Pollutant Discharge Elimination System (NPDES) Permit Requirements for Municipal Sanitary Sewer Collection...

  20. Polio survivors perceptions of a multi-disciplinary rehabilitation programme.

    Science.gov (United States)

    Atwal, Anita; Duncan, Helen; Queally, Claire; Cedar, S H

    2017-10-03

    Post-polio syndrome refers to a late complication of the poliovirus infection. Management of post-polio syndrome is complex due to the extensive symptomology. European and United Kingdom guidelines have advised the use of rehabilitation programmes to manage post-polio syndrome. There is a paucity of research in relation to the effectiveness of rehabilitation interventions. The objective of this study is to explore polio survivor's perceptions of an in-patient multi-disciplinary rehabilitation programme. Semi-structured interviews of community dwelling polio survivors who attended in-patient rehabilitation programme in the United Kingdom. Thematic analysis was used to describe and interpret interview data. Participants' experiences were influenced by past experiences of polio and their self-concept. Participants generally had a positive experience and valued being with other polio survivors. Positive strategies, such as pacing and reflection changed their mind-sets into their lives after the programme, though they still faced challenges in daily living. Some participants supported others with post-polio syndrome after completing the programme. Our research identified that participants experienced long term positive benefits from attending a rehabilitation programme. Strategies that users found helpful that explored the effectiveness of interventions to manage polio are not cited within a Cochrane review. If we are to recognise the lived experience and service user empowerment within a model of co- production it is essential that patient preferences are evaluated and used as evidence to justify service provision. Further research is required with polio survivors to explore how best rehabilitation programmes can adopt the principles of co-production. Implications for Rehabilitation The patients' expertise and lived experience must be at the centre of a rehabilitation programme. Strategies such as pacing and reflection are perceived as important strategies to enable

  1. Post-Polio Health International including International Ventilator Users Network

    Science.gov (United States)

    ... on the Late Effects ... Late Effects of Polio Post-Polio Syndrome (PPS) About Acute Polio Major Topics of Interest ... about the LATE EFFECTS OF POLIO? What is Post-Polio Syndrome? Ask Dr. Maynard Promoting Positive Solutions by Rhoda ...

  2. Medical certification reduces the number of children requiring allergen elimination diets for school lunches.

    Science.gov (United States)

    Korematsu, Seigo; Toyokuni, Kenji; Handa, Yousuke; Gotoh, Chika; Wasada, Rieko; Kato, Rie; Kawano, Nanae; Ikeuchi, Mayo; Okamoto, Tomoko; Kiriya, Maki; Takahashi, Mizuho; Takano, Tomoyuki; Haigo, Atsuhiko

    2017-04-01

    Following the increase in the number of children with food allergies, support systems are now required for school lunches, but a large-scale factual investigation has not been carried out. We evaluated the features of elimination diet due to food allergy and the support system in kindergartens and schools. A prefecture-based questionnaire survey regarding measures for food allergies in school lunches of all kindergartens, public elementary schools, and public junior high schools (631 facilities) was conducted in Oita Prefecture, Japan. The recovery rate of the questionnaire was 99.5%, which included 106,008 students in total. A total of 1,562 children (1.5%) required elimination diets. The rate of children on elimination diets in kindergartens and elementary/junior high schools that required medical certification by a physician was 1.2% (324 among 27,761 children), which was significantly lower than the 1.8% of children (1,227 among 68,576 students) on elimination diets at the request of guardians without the need for medical certification ( p schools said that they would contact guardians if symptoms were observed after accidental ingestion, while a low 8.1% stated that they provided support to children themselves, including the administration of adrenaline auto-injectors. Medical certification reduces the number of children requiring elimination diets, but it has not been adequately implemented. Furthermore, waiting to contact guardians after symptoms are observed may lead to the delayed treatment of anaphylaxis. Cooperation between physicians and teachers is desired to avoid the overdiagnosis and undertreatment of children with food allergies.

  3. Introduction of Sequential Inactivated Polio Vaccine–Oral Polio Vaccine Schedule for Routine Infant Immunization in Brazil’s National Immunization Program

    Science.gov (United States)

    Domingues, Carla Magda Allan S.; de Fátima Pereira, Sirlene; Marreiros, Ana Carolina Cunha; Menezes, Nair; Flannery, Brendan

    2015-01-01

    In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. PMID:25316829

  4. Australia's polio risk.

    Science.gov (United States)

    Martin, Nicolee; Paterson, Beverley J; Durrheim, David N

    2014-06-30

    Australia, like all polio-free countries and regions, remains at risk of a wild poliovirus importation until polio is eradicated globally. The most probable route of importation will be through a traveller arriving in Australia either by air or sea from a polio-endemic or re-infected country. While the overall risk of an imported wild poliovirus infection leading to transmission within Australia is assessed as being low, some areas of the country have been identified as at increased risk. Local areas with relatively high arrivals from polio endemic countries, areas of low vaccination coverage and the potential for transmission to occur when these 2 factors are combined, were identified by this review as Australia's main polio risk. The risk of an importation event leading to locally acquired cases is mitigated by generally high polio vaccination coverage in Australia. This high coverage extends to residents of the Torres Strait Islands who are in close proximity to Papua New Guinea, a country identified as at high risk of poliovirus transmission should an importation occur. In 2012, all states and territories had vaccination coverage of greater than 90% at 1 year of age and all exceeded 93% at 2 years of age. Population immunity to wild poliovirus type 1, which remains the major cause of paralysis globally, has been estimated at 82%. This is sufficient to prevent outbreaks of this type in Australia. Of the 211 eligible non-polio acute flaccid paralysis (AFP) cases classified between 2008 and 2011, 91% (193) were vaccinated against polio at least once. High quality surveillance for AFP, which is supplemented by sentinel enterovirus and environmental surveillance activities, gives confidence that an imported case would be detected and appropriate public health action would ensue. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for

  5. Long-term evaluation of mucosal and systemic immunity and protection conferred by different polio booster vaccines.

    Science.gov (United States)

    Xiao, Yuhong; Daniell, Henry

    2017-09-25

    Oral polio vaccine (OPV) and Inactivated Polio Vaccine (IPV) have distinct advantages and limitations. IPV does not provide mucosal immunity and introduction of IPV to mitigate consequences of circulating vaccine-derived polio virus from OPV has very limited effect on transmission and OPV campaigns are essential for interrupting wild polio virus transmission, even in developed countries with a high coverage of IPV and protected sewer systems. The problem is magnified in many countries with limited resources. Requirement of refrigeration for storage and transportation for both IPV and OPV is also a major challenge in developing countries. Therefore, we present here long-term studies on comparison of a plant-based booster vaccine, which is free of virus and cold chain with IPV boosters and provide data on mucosal and systemic immunity and protection conferred by neutralizing antibodies. Mice were primed subcutaneously with IPV and boosted orally with lyophilized plant cells containing 1μg or 25μg polio viral protein 1 (VP1), once a month for three months or a single booster one year after the first prime. Our results show that VP1-IgG1 titers in single or double dose IPV dropped to background levels after one year of immunization. This decrease correlated with >50% reduction in seropositivity in double dose and cells expressing VP1 can be stored without losing efficacy, eliminating cold chain. Virus-free, cold-chain free vaccine is ready for further clinical development. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. World Health Organization Guidelines for Containment of Poliovirus Following Type-Specific Polio Eradication - Worldwide, 2015.

    Science.gov (United States)

    Previsani, Nicoletta; Tangermann, Rudolph H; Tallis, Graham; Jafari, Hamid S

    2015-08-28

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world.

  7. Using real data and process knowledge to eliminate excessive NESHAP programmatic requirements

    Energy Technology Data Exchange (ETDEWEB)

    Culp, T.A. [Sandia National Labs. (United States); Hylko, J.M. [Roy F. Weston, Inc. (United States)

    1998-12-31

    In 1989, the Environmental Protection Agency (EPA) promulgated Title 40 of the Code of Federal Regulations, Part 61, Subpart H, (NESHAP-40 CFR 61, Subpart H) to address radionuclide air emissions from US Department of Energy (DOE) facilities. The purpose of this paper is to identify the primary radionuclide source term contributors and use this information to eliminate excessive NESHAP programmatic requirements associated with modeling and reporting radionuclide emission sources contributing to the maximum exposed individual (MEI). Resources were made available to SNL for compliance activities associated with implementing a new NESHAP regulation. The requirements of 40 CFR 61, Subpart H were intended to limit the potential dose to members of the public resulting from radionuclide emissions from DOE facilities. However, it was difficult to envision the true impression and implications of a new regulation without actual operating experience. By acquiring a greater understanding of its potential radionuclide source term, including monitoring and reporting requirements, SNL was able to allocate resources according to those radionuclide emission sources contributing the majority of the effective dose equivalent (EDE) to the MEI. Furthermore, because resources required to maintain compliance activities after implementation are often subject to reduction, this reevaluation to eliminate excessive NESHAP programmatic requirements also demonstrates how compliance programs should be reviewed and updated annually. Moreover, as operational experience is acquired, decisions should be based on real data and process knowledge rather than relying on conservative assumptions that tend to overestimate the EDE to the MEI.

  8. Hurdles to the global antipolio campaign in Pakistan: an outline of the current status and future prospects to achieve a polio free world.

    Science.gov (United States)

    Khan, Tariq; Qazi, Javaria

    2013-08-01

    The Global Polio Eradication Initiative to eradicate polio completely by the year 2000 has been successful, except for three endemic and some non-endemic countries. Pakistan, one of the three endemic polio reservoirs, is posing a serious threat to the success of the initiative. Currently, the expanded programme on immunisation has been geared to win the race over polio virus in Pakistan. After the remarkable decrease in polio cases from 198 in 2011 to only 58 in 2012, Pakistan seemed to be at the verge of success. However, hurdles continue to retard the campaign. The war against terrorism, misconceptions about polio vaccine, religious misinterpretations, frustration among vaccinators, lack of awareness, social considerations, natural calamities, inaccessibility, and inefficient vaccines and so on are continually rupturing the foundations of the worldwide initiative in the country. Weak health management is found at the hub of majority of the challenges. Stricter policies, well managed and supervised plans and strategic actions, risk analysis and enhanced communication may help giving the final punch to polio virus in the country. Analysis suggested that there is some literature available on the challenges to polio elimination, yet there is not a single publication up to date that considers all the possible hurdles in a single manuscript. This paper sorts out the breaches that hamper the goal of eliminating polio from Pakistan. We have evaluated all the possible barriers and explained them with a perspective that will help develop area specific strategies against polio virus and thus eradicate polio virus from the world.

  9. Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms.

    Science.gov (United States)

    On, Arzu Yağız; Sungur, Ulaş

    2016-01-01

    Post-polio syndrome (PPS) is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG) evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient's self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Seventy-six of the patients (65.5%) met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42%) limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013). Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.

  10. Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms

    Directory of Open Access Journals (Sweden)

    Arzu Yagiz On

    2016-01-01

    Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.

  11. 34 CFR 403.13 - What are the personnel requirements regarding the elimination of sex discrimination and sex...

    Science.gov (United States)

    2010-07-01

    ... elimination of sex discrimination and sex stereotyping? 403.13 Section 403.13 Education Regulations of the... Planning Responsibilities? § 403.13 What are the personnel requirements regarding the elimination of sex discrimination and sex stereotyping? (a) A State that desires to participate in the State Vocational and Applied...

  12. Next Generation Inactivated Polio Vaccine Manufacturing to Support Post Polio-Eradication Biosafety Goals

    NARCIS (Netherlands)

    Thomassen, Y.E.; Oever, van 't A.G.; Oijen, van M.G.C.T.; Wijffels, R.H.; Pol, van der L.A.; Bakker, W.A.M.

    2013-01-01

    Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using

  13. Applying the Concept of Peptide Uniqueness to Anti-Polio Vaccination.

    Science.gov (United States)

    Kanduc, Darja; Fasano, Candida; Capone, Giovanni; Pesce Delfino, Antonella; Calabrò, Michele; Polimeno, Lorenzo

    2015-01-01

    Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1) have zero percent of identity to human proteins, (2) are potentially endowed with an immunologic potential, and (3) are highly conserved among poliovirus strains. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.

  14. Applying the Concept of Peptide Uniqueness to Anti-Polio Vaccination

    Directory of Open Access Journals (Sweden)

    Darja Kanduc

    2015-01-01

    Full Text Available Background. Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. Objective. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Methods. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1 have zero percent of identity to human proteins, (2 are potentially endowed with an immunologic potential, and (3 are highly conserved among poliovirus strains. Results. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Conclusion. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.

  15. The polio endgame: rationale behind the change in immunisation.

    Science.gov (United States)

    Garon, Julie; Patel, Manish

    2017-04-01

    The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Model Penyebaran Penyakit Polio Dengan Pengaruh Vaksinasi

    Directory of Open Access Journals (Sweden)

    RR Laila Ma’rifatun

    2013-04-01

    Full Text Available Polio (Poliomielitis is an infectious disease caused by the polio virus. This disease attacks the entire body (including the muscles and nerves and can lead to muscle weakness that is permanent, paralysis or death. This paper will discuss on the influence of vaccination against polio disease spread in the human population that settled in the form of mathematical modeling.

  17. Rotary's PolioPlus Program: Lessons Learned, Transition Planning, and Legacy.

    Science.gov (United States)

    Sever, John L; McGovern, Michael; Scott, Robert; Pandak, Carol; Edwards, Amy; Goodstone, David

    2017-07-01

    Hundreds of thousands of Rotary volunteers have provided support for polio eradication activities and continue to this day by making financial contributions to the Rotary PolioPlus program, participating in national immunization days, assisting with surveillance, working on local, national, and international advocacy programs for polio eradication, assisting at immunization posts and clinics, and mobilizing their communities for immunization activities (including poliovirus and other vaccines) and other health benefits. Rotary has contributed more than $1.61 billion for the global eradication of polio and has committed to provide an additional $35 million each year until 2018 (all dollar amounts represent US dollars). Its unwavering commitment to eradicate polio has been vital to the success of the program. Rotary is providing additional support for routine immunization and healthcare. When polio is finally gone, we will have the knowledge from the lessons learned with PolioPlus, such as the value of direct involvement by local Rotarians, the program for emergency funding, innovative tactics, and additional approaches for tackling other global issues, even those beyond public health. Rotary has already transitioned its grants program to include 6 areas of focus: disease prevention and treatment, water and sanitation, maternal and child health, basic education and literacy, economic and community development, and peace and conflict prevention/resolution. Funding for these grants in 2015-2016 was $71 million. The legacy of the polio program will be the complete eradication of poliovirus and the elimination of polio for all time. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  18. A simple procedure eliminating multiple optimization steps required in developing multiplex PCR reactions

    Energy Technology Data Exchange (ETDEWEB)

    Grondin, V.; Roskey, M.; Klinger, K.; Shuber, T. [Integrated Genetics, Framingham, MA (United States)

    1994-09-01

    The PCR technique is one of the most powerful tools in modern molecular genetics and has achieved widespread use in the analysis of genetic diseases. Typically, a region of interest is amplified from genomic DNA or cDNA and examined by various methods of analysis for mutations or polymorphisms. In cases of small genes and transcripts, amplification of single, small regions of DNA are sufficient for analysis. However, when analyzing large genes and transcripts, multiple PCRs may be required to identify the specific mutation or polymorphism of interest. Ever since it has been shown that PCR could simultaneously amplify multiple loci in the human dystrophin gene, multiplex PCR has been established as a general technique. The properities of multiplex PCR make it a useful tool and preferable to simultaneous uniplex PCR in many instances. However, the steps for developing a multiplex PCR can be laborious, with significant difficulty in achieving equimolar amounts of several different amplicons. We have developed a simple method of primer design that has enabled us to eliminate a number of the standard optimization steps required in developing a multiplex PCR. Sequence-specific oligonucleotide pairs were synthesized for the simultaneous amplification of multiple exons within the CFTR gene. A common non-complementary 20 nucleotide sequence was attached to each primer, thus creating a mixture of primer pairs all containing a universal primer sequence. Multiplex PCR reactions were carried out containing target DNA, a mixture of several chimeric primer pairs and primers complementary to only the universal portion of the chimeric primers. Following optimization of conditions for the universal primer, limited optimization was needed for successful multiplex PCR. In contrast, significant optimization of the PCR conditions were needed when pairs of sequence specific primers were used together without the universal sequence.

  19. Determinants of health disparities: The perennial struggle against polio in Nigeria

    Directory of Open Access Journals (Sweden)

    Nosayaba Osazuwa-Peters

    2011-01-01

    Full Text Available Polio remains a global public health issue, and even though it has been eradicated from most countries of the world, countries like Nigeria, the largest black nation on earth, threatens the dream of total eradication of polio from the surface of the earth. Transmission of wild polio virus has never been eliminated in Nigeria, but even worse is the number of countries, both in Sub-Saharan Africa and all over the world that has become re-infected by polio virus strains from Northern Nigeria in recent past. Although a lot has been documented about the Nigerian polio struggle, one aspect that has received little attention on this issue is ethnic and geographic disparities between the Southern and the Northern parts of Nigeria. Understanding these disparities involved in polio virus transmission in Nigeria, as well as the social determinants of health prevalent in Northern Nigeria will help government and other stakeholders and policy makers to synergize their efforts in the fight against this perennial scourge.

  20. PERAN LABORATORIUM DALAM MENUNJANG ERADIKASI POLIO

    Directory of Open Access Journals (Sweden)

    Gendro Wahyuhono

    2012-09-01

    Full Text Available Pada sidang tanggal 28 Mei 1988 telah diadopsi resolusi WHA (World Health Assembly dan menugaskan WHO untuk melaksanakan pemberantasan virus polio dari dunia menjelang tahun 2000. Keberhasilan dari rencana tersebut di atas akan sangat bergantung pada banyak faktor dari Pengembangan Program Imunisasi (PPI yang ada. Hal yang paling penting adalah peningkatan cakupan imunisasi dan peningkatan surveillons. Khusus penyakit polio, kegiatan surveillons sangat bergantung pada pelayanan laboratorium. Ketergantungan ini makin meningkat dengan makin berkurangnya kasus poliomyelitis. Di suatu daerah, di mana kasus polio sudah sangat jarang ditemukan maka setiap kasus lumpuh layuh pada anak balita harus diperiksa laboratorium secara lengkap dan sempurna. Tulisan ini memuat beberapa bahasan tentang virus polio, patogenesis, cara penularan, imunitas, dan pencegahannya dengan imunisasi. Jaringan laboratorium mengenai tingkat eradikasi polio, peran dan fungsi laboratorium. Cara pengumpulan spesimen, cara penyimpanan dan pengirimannya.   Kata kunci: Polio, Laboratorium, Eradikasi

  1. WHO Polio Eradication Program: Problems and Solutions

    Directory of Open Access Journals (Sweden)

    S. M. Kharit

    2016-01-01

    Full Text Available In 2013 WHO re-evaluated its main goals of the polio eradication program. A modernization program was accepted with regard to the National vaccination calendars worldwide which includes a step-by-step refusal from the living polio vaccine (OPV and a total transition to the inactivated polio vaccine (IPV starting in 2019. Because of the total eradication of the polio type 2 virus, as an intermediate step the 3-valence OPV was substituted with the 2-valence OPV, which does not contain the type 2 polio virus, in April 2016. The aim of the article is to present the history of polio prevention and to state the reasons for the adoption of 3rd edition of the Global Polio Eradication Initiative. The new approaches were defined for eradication of wild polio virus type 1 and vaccine related strains. A new strategy for global switch to inactivated polio vaccine by 2019 was suggested.

  2. Studies on the potency of oral polio vaccine using RD cell line and ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-11-16

    Nov 16, 2009 ... Oral polio vaccine (OPV) proved to be superior in administration eliminating the need of sterile syringes and making the vaccine more suitable for mass vaccination campaigns. Poliovirus is heat sensitive in nature, and thus OPV is stored at low temperature (frozen). The growth medium containing.

  3. Budget impact of polio immunization strategy for India: introduction of one dose of inactivated poliomyelitis vaccine and reductions in supplemental polio immunization.

    Science.gov (United States)

    Khan, M M; Sharma, S; Tripathi, B; Alvarez, F P

    2017-01-01

    . Introduction of three doses of IPV with the existing polio immunization schedule will increase the budget requirement by $102 million but replacing OPV doses with IPV will increase the budget by about $59 million. Discontinuation of supplemental OPV immunization with replacement of OPV by IPV will reduce the Government of India's (GOI) polio immunization budget by $99 million. Although the overall cost of polio programme will decline with the adoption of IEAG's recommendations, state-level costs will vary widely. In states like Kerala, Karnataka, Uttar Pradesh and Andhra Pradesh, cost of polio immunization will increase while in Punjab and Jharkhand the costs will remain more or less constant. Significant cost reductions will happen in states with high intensity of supplemental polio immunizations (Bihar, Haryana and Delhi). The cost of procuring polio vaccines will more than double from $20 million to about $47 million requiring allocation of additional foreign exchanges. In some states (like Bihar), the decline in polio-related employment will be very high requiring reallocation of personnel from polio to other programmes. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Change of strategy is required for malaria elimination: a case study in Purworejo District, Central Java Province, Indonesia.

    Science.gov (United States)

    Murhandarwati, E Elsa Herdiana; Fuad, Anis; Sulistyawati; Wijayanti, Mahardika Agus; Bia, Michael Badi; Widartono, Barandi Sapta; Kuswantoro; Lobo, Neil F; Supargiyono; Hawley, William A

    2015-08-16

    Malaria has been targeted for elimination from Indonesia by 2030, with varying timelines for specific geographical areas based on disease endemicity. The regional deadline for malaria elimination for Java island, given the steady decrease of malaria cases, was the end of 2015. Purworejo District, a malaria-endemic area in Java with an annual parasite incidence (API) of 0.05 per 1,000 population in 2009, aims to enter this elimination stage. This study documents factors that affect incidence and spatial distribution of malaria in Purworejo, such as geomorphology, topography, health system issues, and identifies potential constraints and challenges to achieve the elimination stage, such as inter-districts coordination, decentralization policy and allocation of financial resources for the programme. Historical malaria data from 2007 to 2011 were collected through secondary data, in-depth interviews and focus group discussions during study year (2010-2011). Malaria cases were mapped using the village-centroid shape file to visualize its distribution with geomorphologic characteristics overlay and spatial distribution of malaria. API in each village in Purworejo and its surrounding districts from 2007 to 2011 was stratified into high, middle or low case incidence to show the spatiotemporal mapping pattern. The spatiotemporal pattern of malaria cases in Purworejo and the adjacent districts demonstrate repeated concentrated occurrences of malaria in specific areas from 2007 to 2011. District health system issues, i.e., suboptimal coordination between primary care and referral systems, suboptimal inter-district collaboration for malaria surveillance, decentralization policy and the lack of resources, especially district budget allocations for the malaria programme, were major constraints for programme sustainability. A new malaria elimination approach that fits the local disease transmission, intervention and political system is required. These changes include timely

  5. Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016.

    Science.gov (United States)

    Freidl, Gudrun S; Tostmann, Alma; Curvers, Moud; Ruijs, Wilhelmina L M; Smits, Gaby; Schepp, Rutger; Duizer, Erwin; Boland, Greet; de Melker, Hester; van der Klis, Fiona R M; Hautvast, Jeannine L A; Veldhuijzen, Irene K

    2018-03-14

    Asylum seekers are a vulnerable population for contracting infectious diseases. Outbreaks occur among children and adults. In the Netherlands, asylum seeker children are offered vaccination according to the National Immunization Program. Little is known about protection against vaccine-preventable diseases (VPD) in adult asylum seekers. In this 2016 study, we assessed the immunity of adult asylum seekers against nine VPD to identify groups that might benefit from additional vaccinations. We invited asylum seekers from Syria, Iran, Iraq, Afghanistan, Eritrea and Ethiopia to participate in a serosurvey. Participants provided informed consent and a blood sample, and completed a questionnaire. We measured prevalence of protective antibodies to measles, mumps, rubella, varicella, diphtheria, tetanus, polio type 1-3 and hepatitis A and B, stratified them by country of origin and age groups. The median age of the 622 participants was 28 years (interquartile range: 23-35), 81% were male and 48% originated from Syria. Overall, seroprotection was 88% for measles (range between countries: 83-93%), 91% for mumps (81-95%), 94% for rubella (84-98%), 96% for varicella (92-98%), 82% for diphtheria (65-88%), 98% for tetanus (86-100%), 91% (88-94%) for polio type 1, 95% (90-98%) for polio type 2, 82% (76-86%) for polio type 3, 84% (54-100%) for hepatitis A and 27% for hepatitis B (anti-HBs; 8-42%). Our results indicate insufficient protection against certain VPD in some subgroups. For all countries except Eritrea, measles seroprotection was below the 95% threshold required for elimination. Measles seroprevalence was lowest among adults younger than 25 years. In comparison, seroprevalence in the Dutch general population was 96% in 2006/07. The results of this study can help prioritizing vaccination of susceptible subgroups of adult asylum seekers, in general and in outbreak situations. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. 2. Review of the Oral Polio

    African Journals Online (AJOL)

    Esem

    of children below five years in Toluca, Mexico . This strategy serves as the foundation of today's global polio eradication initiative. The call for global eradication of ... year 2000 against six diseases: diphtheria, tetanus, whooping cough, tuberculosis, measles, and polio. During 1997, 82% children were fully immunized - a.

  7. [Poliomyelitis and the post-polio syndrome].

    Science.gov (United States)

    Dénes, Z; Varga, M

    2001-07-15

    In developed countries as well as in Hungary polio virus related disease disappeared completely due to the extensive administering of vaccine. As a result, young and middle-aged doctors have no experience of encountering acute polio virus infection but instead they meet its resultant impairments and disabilities. Persons who had suffered the onset of poliomyelitis 3 or 4 decades earlier, may to develop a new set of symptoms and functional declines. The criteria for post-polio syndrome were identified and its impairments and disabilities were described. It is only within the last decade that the adaptive changes in muscular tissue, insufficiently compensed denervation, together with the effects of physiotherapy, have become better known. The aim of this paper is to review the present situation concerning the struggle for keeping the polio virus in check, to give a short summary of the post-polio syndrome and to draw attention to the importance of rehabilitation.

  8. Is EU/EEA population protected against polio?

    NARCIS (Netherlands)

    Nijsten, D.R.E.; Carrilo-Santisteve, P.; Miglietta, A.; Ruitenberg, E.J.; Lopalco, P.L.

    2015-01-01

    The WHO European Region has been declared polio-free since 2002. By 2010, inactivated polio vaccine (IPV) was the only polio vaccine in use in the EU/EEA for the primary vaccination of children. A systematic review of the literature on polio seroprevalence studies, complemented by the analysis of

  9. Awareness of pulse polio immunisation.

    Science.gov (United States)

    Gomber, S; Taneja, D K; Mohan, K

    1996-01-01

    Mass polio immunisation campaign was launched in the national capital territory of Delhi with 2 doses of polio vaccine to be administered to children upto 3 years of age on October and December 4, 1994 respectively. Massive information, education & communication (IEC) efforts through mass media and interpersonal communication preceded the dates of the campaign. A study to assess the awareness of general population was carried out by interviewing 225 adult residents of Delhi using a structured questionnaire. These were drawn by two stage stratified random sampling. Zonewise assembly segments in the first stage and census enumeration blocks in the second stage formed the sampling frame. The study, carried out 3 days prior to date of administration of first dose of oral polio, revealed that 60.4% of population was aware of the programme being launched and 31.6% about aim of the programme. None of the respondents were aware of all the specific parameters put together correctly viz., objective, immunisation days, age group & immunisation status of children. The higher level of awareness was directly proportional to the level of education. The overwhelming success of the programme was indicated by immunisation of > 90% children upto 3 years of age all over Delhi in the first phase of the programme. The key to success of the programme despite low awareness is explained on the basis of unflinching efforts put in by vaccine centre level committees, integrated child development scheme (ICDS) and urban basic service (UBS) functionaries in mobilising people to reach various vaccination centres. Other states planning to launch such mass campaigns should pay attention to social mobilisation in addition to IEC efforts for successful completion of the programme.

  10. 77 FR 34315 - National Pollutant Discharge Elimination System-Proposed Regulations to Establish Requirements...

    Science.gov (United States)

    2012-06-11

    ... ensuring that fewer aquatic organisms such as fish and shellfish are killed by cooling water intake... Requirements for Cooling Water Intake Structures at Existing Facilities; Notice of Data Availability Related to... Data Availability. SUMMARY: On April 20, 2011, EPA published proposed standards for cooling water...

  11. A law of removing radon by ventilation and air requirement calculation for eliminating radon daughters in uranium mines

    International Nuclear Information System (INIS)

    Wu Gang

    1988-06-01

    In accordance with testing data of removing radon and its daughters by ventilation from shrinkage and filling stopes of uranium mines, a law of removing radon by ventilation from the stopes is analyzed and summed. According to the decay law of radon and its daughters, an accumulation equation of potential alpha energy from radon daughters is presented with hyperbolic regression equation. the calculating formulae of ventilation flow are derived from the accumulation equation for eliminating radon daughters in inlet flow with or without contamination. It has been proved that the amount of ventilation air calcuated could meet the requirements of radiation safety rationally and economically

  12. Polio

    Science.gov (United States)

    ... and more ... Mayo Clinic Health Letter Medical Products Population Health and Wellness ... in parts of Asia and Africa. The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect ...

  13. [The history of polio in Sweden - from infantile paralysis to polio vaccine].

    Science.gov (United States)

    Axelsson, Per

    2004-01-01

    Although other epidemics declined due to improved hygiene and sanitation, legislation, and vaccination, polio epidemics appeared in Sweden in 1881 and at the turn of the 20th century the disease became and annual feature in the Swedish epidemiological pattern. Due to the vaccination starting in 1957 epidemics ceased to exist in Sweden around 1965. This article deals with the history polio epidemics in Sweden, 1880-1965 and gives a brief description of: the demographical influence of polio, how did the medical authorities investigate and try to combat it, and the different comprehensions of how polio affected its victims.A study of polio incidence in Sweden at the national level during 1905-1962 reveals that the disease caused major epidemics in 1911-1913 and 1953. At the beginning of the 20th century polio primarily attacked children up to 10 years of age, and at the end of the period victims were represented in all age groups, but mainly in the ages 20-39. Due to its enigmatic appearance, polio was not considered as an epidemic infectious disease during the 19th century. Sweden's early epidemics enabled Swedish medical science to act and together with American research institutes it acquired a leading role in international medical research on the disease. In the 1955 Jonas Salk produced the first successful vaccine against polio but also Sweden developed its own vaccine, different in choice of methods and materials from the widely used Salk-vaccine.

  14. The global introduction of inactivated polio vaccine can circumvent the oral polio vaccine paradox

    NARCIS (Netherlands)

    Heinsbroek, E.; Ruitenberg, E.J.

    2010-01-01

    This literature review identifies the factors that influence the decision to introduce inactivated polio vaccine (IPV) in developing countries as opposed to the policy of vaccine cessation. Attenuated viruses in the oral polio vaccine (OPV) can replicate, revert to neurovirulence and become

  15. Poliomyelitis and its elimination in Cuba: an historical overview.

    Science.gov (United States)

    Beldarraín, Enrique

    2013-04-01

    Polio was first detected in Cuba in the late 19th century among residents of the US community on the Isla de Pinos (Isle of Pines, now Isle of Youth), apparently introduced through migration from the USA. The first outbreak was reported in 1906 on the Isle, with the first epidemic reported in the former province of Las Villas in 1909. The epidemics subsequently intensified, by 1934 becoming periodic every four to five years, and accompanied by high morbidity, mortality and crippling sequelae, primarily among children. To review and analyze the history of polio and its control in Cuba, from the disease's first appearance in 1898 until WHO/PAHO certification of elimination in 1994. The historiological method was used; archival documents, medical records, and available polio morbidity and mortality statistics from the Ministry of Public Health's National Statistics Division before 1959 and from 1959 through 2000 were reviewed. Crude morbidity and mortality rates were calculated using population estimates at mid-period. Reports and scientific publications describing polio vaccination campaigns and their results were also reviewed, and key informants were interviewed. After initial introduction of polio in Cuba, five major epidemics occurred between 1932 and 1958: in 1934 (434 cases, 82 deaths); 1942 (494 cases, 58 deaths); 1946 (239 cases, 33 deaths), 1952 (492 cases, 15 deaths) and 1955 (267 cases, 8 deaths). Between 1957 and 1961 the disease's endemicity reached epidemic levels, with the last outbreak occurring in 1961, with 342 cases, 30% of them in children aged >4 years. In 1962, Cuba launched a nationwide polio vaccination campaign, the first of annual campaigns thereafter carried out in the framework of a coherent national program aimed at polio elimination. Using the Sabin oral vaccine and targeting the entire pediatric population in a single time period, five million doses were administered in the first campaign, reaching 87.5% of the target population aged 1

  16. Diplomacy and the polio immunization boycott in Northern Nigeria.

    Science.gov (United States)

    Kaufmann, Judith R; Feldbaum, Harley

    2009-01-01

    The boycott of polio vaccination in three Northern Nigerian states in 2003 created a global health crisis that was political in origin. This paper traces the diplomatic actions that were taken by the Global Polio Eradication Initiative, the United Nations, and the U.S. government, to restart polio vaccination and resolve the crisis. The polio vaccination boycott in Northern Nigeria provides a useful case study of the practice of global health diplomacy.

  17. Polio eradication efforts in regions of geopolitical strife: the Boko ...

    African Journals Online (AJOL)

    Polio eradication efforts in regions of geopolitical strife: the Boko Haram threat to efforts in sub-Saharan Africa. ... Targets of Boko Haram aggression in these zones include violence against polio workers, disruption of polio immunization campaigns, with consequent reduced access to health care and immunization.

  18. CIRCUMSTANCES AND CONSEQUENCES OF FALLS IN POLIO SURVIVORS

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-01-01

    Objectives: Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. Methods: A survey was conducted among 376 polio

  19. [Post-polio syndrome - a case report].

    Science.gov (United States)

    Pastuszak, Żanna; Tomczykiewicz, Kazimierz; Stępień, Adam

    2015-07-01

    Post-polio syndrome occurs 30-40 years after polio virus infection. The main symptoms of PPS are slowly progressive muscle limbs paresis with muscle atrophy, joints pain, paresthesia. In 90% of patients the main symptom is fatigue that leads to physical and mental activity deterioration. The cause of disease remains unknown. Probably it is an effect of motoneurons damage during acute virus polio infection, their overloading and degeneration of remaining ones. In this study we described a case of man who developed PPS 36 years after Heine-Medin disease. The main symptom was intensification of right limb paresis and muscle atrophy. In electromyography there were damage features of muscle clinically affected and unaffected. Changes in lifestyle made possible to continue occupational activity. © 2015 MEDPRESS.

  20. Campaign to kick polio out of Africa.

    Science.gov (United States)

    Letore, D

    1998-12-01

    This article discusses the goal of eradicating poliomyelitis (polio) in Africa by the year 2000. Polio is a crippling disease that paralyzes hundreds of thousands of children yearly. Polio was endemic in Africa during the 1970s. Today, polio is confined to sub-Saharan Africa and, specifically, to the Congo, Ethiopia, Nigeria, Somalia, and the Sudan. Considerable progress is evident. Full eradication is necessary because of the ease with which the virus is transmitted. The World Health Organization (WHO) set the goal of eradication by the year 2000 at a 1988 assembly meeting. The Plan of Action for a Global Polio Eradication Initiative was approved in 1989. The WHO Regional Committee for Africa adopted the resolution and urged again in 1995 for vigorous implementation. The Organization of African Unity endorsed the initiative in 1996. South African President Mandela led a region-wide mobilization campaign to increase public awareness of the initiative. Since 1997, leading players from the African Football Confederation have participated in awareness campaigns by spreading the message through a variety of channels. The initiative includes routine immunization complemented by the National Immunization Days (NIDs), training at the local level, surveillance, and door-to-door campaigns. The initiative must assure functioning systems of cold storage of vaccines and must continue to educate communities about the importance of routine immunization. There must be a strong laboratory network for isolating the 3 types of the virus. NIDs will be scheduled for 1999 in countries with civil conflict. The polio model is useful for other disease eradication campaigns.

  1. Eliminating armaments

    International Nuclear Information System (INIS)

    Adams, R.

    1998-01-01

    The end of Cold War induced optimistic projections concerning disarmament, elimination of nuclear weapons, elimination of massive inequities - poverty, hatred, racism. All these goals should be achieved simultaneously, but little has been achieved so far

  2. New Strains Intended for the Production of Inactivated Polio Vaccine at Low-Containment After Eradication.

    Science.gov (United States)

    Knowlson, Sarah; Burlison, John; Giles, Elaine; Fox, Helen; Macadam, Andrew J; Minor, Philip D

    2015-12-01

    Poliomyelitis has nearly been eradicated through the efforts of the World Health Organization's Global Eradication Initiative raising questions on containment of the virus after it has been eliminated in the wild. Most manufacture of inactivated polio vaccines currently requires the growth of large amounts of highly virulent poliovirus, and release from a production facility after eradication could be disastrous; WHO have therefore recommended the use of the attenuated Sabin strains for production as a safer option although it is recognised that they can revert to a transmissible paralytic form. We have exploited the understanding of the molecular virology of the Sabin vaccine strains to design viruses that are extremely genetically stable and hyperattenuated. The viruses are based on the type 3 Sabin vaccine strain and have been genetically modified in domain V of the 5' non-coding region by changing base pairs to produce a cassette into which capsid regions of other serotypes have been introduced. The viruses give satisfactory yields of antigenically and immunogenically correct viruses in culture, are without measurable neurovirulence and fail to infect non-human primates under conditions where the Sabin strains will do so.

  3. Treating fatigue in post-polio syndrome

    NARCIS (Netherlands)

    Koopman, F.S.

    2016-01-01

    The general aim of this thesis was to expand the knowledge on treatment of fatigue in post-polio syndrome (PPS). It was demonstrated that fatigue is severe and persistent in this population due to both physical and psychologic factors. These factors can potentially be modified, which may provide an

  4. Experiences from polio supplementary immunization activities in ...

    African Journals Online (AJOL)

    Conclusion: The State achieved high polio vaccination coverage through the SIAs, but coverage through routine immunization was low. Adopting proper planning and supervision, financial and political support, community involvement, improved vaccine logistics, and other measures utilized during the SIAs could help to ...

  5. Survey of young patients with polio and a foreign background at a Swedish post-polio outpatient clinic.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2016-10-01

    Nowadays, polio survivors aged under 60 years are non-native Swedes which pose new aspects and challenges to a post-polio outpatient clinic. To analyze the medical data, walking aids, occupational, and family situation in non-native polio survivors aged less than 60 years at a Swedish post-polio outpatient clinic. Retrospective data analysis. Data were retrieved from medical records at the post-polio outpatient clinic. Actual age, age at acute polio infection, walking capacity, pain, concomitant diseases, working and family situation, and ethnical origin were analyzed. Data are presented in numbers and percentage. 153 patients were included. Mean age was 45 (17-60) years, and mean age at acute polio infection was 2 (0-12) years. Paresis of the lower extremities was the most common disability. 10 % were wheelchair dependent. Pain occurred in 70 % with a mean intensity of 55 measured with the visual analog scale. Hypertension was the most common concomitant disease. Half of the polio survivors were working at least part time, and roughly half were singles. Data were comparable with data earlier published in Swedish native polio survivors. Non-native polio survivors aged under 60 years showed similarities in age at acute polio infection, paresis, prevalence, and intensity of pain when compared with native Swedish polio survivors. They were, however, younger, and were less often working and married/cohabitants than native Swedish polio survivors. The results of this study underline the importance of social and vocational rehabilitation tailoring rehabilitation suitable for polio survivors with a foreign background.

  6. Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

    Science.gov (United States)

    Kamadjeu, Raoul; Gathenji, Caroline

    2017-01-01

    In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone. The outbreak response required timely exchange of information between the outbreak response coordination unit (in Nairobi) and local staff located in multiple locations inside the country. The need to track and timely respond to information requests, to satisfy the information/data needs of polio partners and to track key outbreak response performance indicators dictated the need to urgently set up an online dashboard. The Somalia Polio Room dashboard provided a graphical display of the polio outbreak data to track progress and inform decision making. The system was designed using free and open sources components and seamlessly integrated existing polio surveillance data for real time monitoring of key outbreak response performance indicators. In this article, we describe the design and operation of an electronic dashboard for disease surveillance in an outbreak situation and used the lessons learned to propose key design considerations and functional requirements for online electronic dashboards for disease outbreak response.

  7. 78 FR 12951 - TRICARE; Elimination of the Non-Availability Statement (NAS) Requirement for Non-Emergency...

    Science.gov (United States)

    2013-02-26

    ... care for TRICARE Standard beneficiaries is separate and distinct from the ongoing right of first refusal for specialty services requested by a civilian provider under TRICARE Prime, if the services are... mental health services may be provided. This final rule does not eliminate the right of first refusal or...

  8. Site requirements and kinetics of immune-dependent elimination of intravascularly administered lung stage schistosomula in mice immunized with highly irradiated cercariae of Schistosoma mansoni

    International Nuclear Information System (INIS)

    Mangold, B.L.; Dean, D.A.; Coulson, P.S.; Wilson, R.A.

    1986-01-01

    Experiments were performed to compare the migration and survival of 75Se-labeled schistosomes, introduced by percutaneous cercarial exposure or by intravascular administration of 7-day-old lung stage schistosomula, in control and irradiated cercaria-immunized mice. Schistosomula were intravascularly introduced into the lungs, systemic organs and liver by injection via the femoral vein (FV), left ventricle (LV), and superior mesenteric vein (SMV), respectively. The fate of challenge larvae was examined by autoradiography of host tissues and by recovery of adult worms. It was found that both normal and immune elimination were site-dependent. In control mice 45%-60% of cercarial penetrants and lung schistosomula injected into the FV and LV were recoverable as adult worms, while a significantly greater number (70%-85%) were recoverable when lung schistosomula were injected into the SMV. In immunized mice, parasites introduced as either cercariae or FV-injected schistosomula were both highly sensitive to immune elimination. LV-injected schistosomula were also sensitive but to a slightly lesser degree. In contrast, schistosomula placed directly in the liver by SMV injection were totally insensitive to immune elimination. It was concluded that elimination of schistosomula in irradiated cercaria-immunized mice occurs in the lungs and/or in the systemic organs, but not in the liver. Also, it was concluded that immune elimination is not a rapid process, since more than 7 days were required after intravascular challenge for the development of demonstrable differences between control and immunized mice

  9. Next generation inactivated polio vaccine manufacturing to support post polio-eradication biosafety goals.

    Directory of Open Access Journals (Sweden)

    Yvonne E Thomassen

    Full Text Available Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin poliovirus strains (sIPV was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals.

  10. Perbandingan Manfaat Vaksin Oral Polio 1 (Monovalen) dengan Vaksin Oral Polio Trivalen Terhadap Transmisi Virus Polio 1 dalam Upaya Mengatasi Kejadian Luar Biasa Polio 1 di Indonesia Tahun 2005: ditinjau melalui respons imun dan keamanannya

    OpenAIRE

    Kusnandi Rusmil

    2016-01-01

    Latar belakang. Indonesia menggunakan trivalent oral polio vaccine (tOPV) sejak tahun 1977 dan sejak tahun 1995 tidak pernah ditemukan lagi kasus poliomelitis. Pada Maret 2005 terjadi kejadian luar biasa (KLB) polio yang meluas ke seluruh pulau Jawa dan Sumatera. Berdasarkan pengalaman negara yang berhasil mengatasi KLB, penggunaan monovalent oral polio vaccine (mOPV) sesuai penyebab KLB memberikan hasil lebih cepat dibandingkan tOPV. Tujuan. Melihat manfaat pemberian mOPV1 dibandingkan de...

  11. [Post-polio syndrome. Part II. Therapeutic management].

    Science.gov (United States)

    Matyja, Ewa

    2012-01-01

    The care of patients with post-polio syndrome ought to be carried out by a multidisciplinary team of specialists, including medical professionals, specialists of rehabilitation, psychologists and social workers. Many therapeutic strategies might be employed to reduce the late effects of polio. Today, the management of post-polio syndrome is based on non-pharmacological intervention, including lifestyle modification, decrease of physical activity, rest periods during the day and an individually tailored training program.

  12. Eradikasi Dan Babak Akhir Polio: Peran Tenaga Kesehatan Indonesia

    OpenAIRE

    Hartono Gunardi

    2016-01-01

    Poliomielitis adalah penyakit menular yangditandai dengan kelumpuhan akibat kerusakanmotor neuron di kornu anterior sumsum tulangbelakang; disebabkan oleh tiga serotipe virus polioyaitu serotipe 1 (brunhilde), serotipe 2 (lansig) danserotipe 3 (leon).1 Poliomielitis ditularkan secarafekal-oral atau oral-oral.Sebelum vaksin polio ditemukan, semua anakyang terinfeksi virus polio dan sekitar 1 dari 200anak yang terinfeksi akan menderita kelumpuhan.Setelah ditemukan vaksin polio inaktivasi (IPV,s...

  13. Eradikasi dan Babak Akhir Polio: Peran Tenaga Kesehatan Indonesia

    OpenAIRE

    Hartono Gunardi

    2017-01-01

    Poliomielitis adalah penyakit menular yangditandai dengan kelumpuhan akibat kerusakanmotor neuron di kornu anterior sumsum tulangbelakang; disebabkan oleh tiga serotipe virus polioyaitu serotipe 1 (brunhilde), serotipe 2 (lansig) danserotipe 3 (leon).1 Poliomielitis ditularkan secarafekal-oral atau oral-oral.Sebelum vaksin polio ditemukan, semua anakyang terinfeksi virus polio dan sekitar 1 dari 200anak yang terinfeksi akan menderita kelumpuhan.Setelah ditemukan vaksin polio inaktivasi (IPV,...

  14. [Polio paralytic. New problems: postpolio syndrome].

    Science.gov (United States)

    Esteban, Jesús

    2013-01-01

    In 1875 M. Raymond described a progressive muscle wasting and weakness in 3 individuals survivors of childhood acute poliomyelitis. Jean-Martin Charcot suggested that the initial injury should let these guys neurons more sensitive to develop posterior spinal diseases and new weakness was the result of overuse of the affected muscles. In 1979, after the publication of the description given by a 57 year old patient on motor difficulties that developed after suffering of polio in childhood, there was a very significant increase of comments of other individuals with similar symptoms, reaching wedged in the 80s the term of post-polio syndrome. The term is reserved for describing the development of new neurological symptoms, especially for the development of muscle weakness, muscle atrophy and new muscle fatigue not explained by other medical causes, and appear after more than 15 years of infection acute. Is estimated to affect 20 to 85% of individuals with a history of polio in childhood. In 2000 first described the diagnostic criteria. This syndrome determines a change in the functional abilities. Its pathogenesis is unknown, may be associated with aging. It could also be due to an inflammatory persistent or be influenced by genetic factors. There is no effective drug treatment, so I can only recommend symptomatic and moderate muscle training.

  15. Pharyngolaryngeal manifestations of post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Biase, Noemi Grigoletto De

    2011-10-01

    Full Text Available Introduction: The post-polio syndrome (PPS is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute. Objective: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations. Case Report: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms. Final comments: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

  16. Survey of post polio syndrome in Tehran

    Directory of Open Access Journals (Sweden)

    Talebian S

    2009-04-01

    Full Text Available "nBackground: The long-term effects of poliomyelitis are known in many of countries. In despite of one accrue title for these signs and symptoms; there are similarity aspects in patients' problems. In the signs of explained, absence of strength and endurance, musculoskeletal difficulties, respiratory dysfunction, sleep disorders are more generalized. Prevalence of post polio syndrome (PPS is aim of this study. "nMethods: 150 subjects with history of poliomyelitis (80 male and 70 female in Tehran city contributes in this study and complete question forms. "nResults: Muscle pain was reported in 88% of subjects. Thigh muscle weakness was at 42/28%, also muscle spasm indicated at 66%. Recurrent falling of subjects appeared in 74/7%. Early fatigue reported 86%. Above five signs selected for PPS. In this study 85 subjects had four signs of above criteria or 56.66% of subjects had PPS. "nConclusion:  Depended of evaluation and observation there is post polio syndrome in Tehran. Recommended for physical therapy of post polio syndrome attend to stages of progression of this syndrome. In aim to this procedure, physical treatment of these patients must limit to muscle fatigue and also severe physical and exercise activities must be reduce, also some mild aerobic activities without fatigue can be useful.

  17. Post-polio syndrome: renaissance of poliomyelitis?

    Directory of Open Access Journals (Sweden)

    Claudio Andre Barbosa de Lira

    2009-03-01

    Full Text Available Poliomyelitis is an acute and infectious viral disease, transmitted primarily through oral-fecal contact or directly, person to person. Approximately 90% of the individuals infected by the polio virus do not present symptoms; however, the affected individuals can show a variety of symptoms if the virus reaches the bloodstream. In up to 2% of cases, the virus reaches the central nervous system  preferably infecting and destroying the motor neurons, resulting in muscular weakness and acute flaccid paralysis. Despite the expressive reduction in the number of cases, many people live with the consequences of the acute illness, thus representing a burden to the public healthcare systems. Many of these people present new manifestations as signs and symptoms that are called post-polio syndrome. It can be defined and characterized by new neuromuscular symptoms, which occur at least 15 years after a period of clinical and functional stability in patients with previous history of symptomatic poliomyelitis. The signs and symptoms characterizing the post-polio syndrome include new muscular weakness, muscular fatigue and atrophy, pain in joints and muscles, sleep disorders, intolerance to cold, respiratory and swallowing difficulties, and recent weight gain. Therefore, the aim of this review is to present the physiological changes caused by the new manifestation of symptoms in individuals with poliomyelitis.

  18. Sailing in Uncharted Waters: Carefully Navigating the Polio Endgame.

    Directory of Open Access Journals (Sweden)

    Elizabeth Miller

    2016-10-01

    Full Text Available In a Perspective linked to the research article by Isobel Blake and colleagues, Elizabeth Miller and T. Jacob John discuss the path towards global polio eradication and the challenges, strategies, and necessary precautions around oral polio vaccine cessation.

  19. Polio Eradication Initiative (PEl) Emergency Plan: A Panacea for ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    and surmount the intractable problem of sub- optimal vaccine coverage which has remained a critical bottleneck in the successful eradication of the polio virus in Nigeria. It becomes pertinent therefore, to appraise this latest effort to avoid a recurrence of failure in subsequent polio eradication programs. METHODS. A review ...

  20. Epidemiology and Distribution of Polio Induced Deformities in ...

    African Journals Online (AJOL)

    Background: Poliomyelitis has remained endemic in Nigeria despite the efforts made by governments to eradicate the disease. The deformities arising from poliomyelitis (polio) make the establishment of rehabilitation centres a public health priority. Objective: To study the epidemiology, nature and distribution of polio ...

  1. Post-Polio Directory 2014: Post-Polio Clinics, Health Professionals, Support Groups

    Science.gov (United States)

    ... com http://DynamicBracingSolutions.net Progressive Medical Helen A. Kent, BS, RRT 2720 Loker Ave W Ste P ... 760-686-5813, j_hueftle@yahoo.com Sierra Hills Post-Polio Syndrome Group Auburn Barbara Childress: babc2003@ ...

  2. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark

    DEFF Research Database (Denmark)

    Sørup, Signe; Stensballe, Lone G; Krause, Tyra Grove

    2016-01-01

    with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods.  A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses...

  3. Eradikasi dan Babak Akhir Polio: Peran Tenaga Kesehatan Indonesia

    Directory of Open Access Journals (Sweden)

    Hartono Gunardi

    2017-01-01

    Full Text Available Poliomielitis adalah penyakit menular yangditandai dengan kelumpuhan akibat kerusakanmotor neuron di kornu anterior sumsum tulangbelakang; disebabkan oleh tiga serotipe virus polioyaitu serotipe 1 (brunhilde, serotipe 2 (lansig danserotipe 3 (leon.1 Poliomielitis ditularkan secarafekal-oral atau oral-oral.Sebelum vaksin polio ditemukan, semua anakyang terinfeksi virus polio dan sekitar 1 dari 200anak yang terinfeksi akan menderita kelumpuhan.Setelah ditemukan vaksin polio inaktivasi (IPV,salk pada tahun 1955, vaksin polio oral monovalen(mOPV, sabin tahun 1961 dan vaksin polio oraltrivalen (tOPV pada tahun 1963, program imunisasipolio berlangsung di seluruh dunia. Vaksin IPVdiganti dengan tOPV karena pemberiannyamudah, lebih unggul dalam merangsang kekebalanmukosa usus, dan lebih murah. Vaksin tOPV masukdalam Program Pengembangan Imunisasi/PPI diIndonesia sejak tahun 1978. Normal 0 false false false IN X-NONE X-NONE Prevalence and risk factors of post-polio syndrome in a cohort of polio survivors.

    Science.gov (United States)

    Ragonese, Paolo; Fierro, Brigida; Salemi, Giuseppe; Randisi, Giovanna; Buffa, Daniela; D'Amelio, Marco; Aloisio, Antonella; Savettieri, Giovanni

    2005-09-15

    To investigate frequency and associated factors of post polio syndrome (PPS) in an Italian cohort of people with prior poliomyelitis. We screened subjects admitted for poliomyelitis at the paediatric hospital of the University of Palermo during the time frame 1945-1960. Patients who developed PPS were identified through a structured questionnaire and a neurologic examination. PPS diagnosis was made according to specified diagnostic criteria. Frequency of PPS was calculated in the selected cohort of polio survivors. The association with the investigated risk factors (sex, age at onset of polio, extension and severity of polio, education, associated diseases, cigarette smoking, trauma, polio vaccination) was analysed by the calculation of the odds ratio. Forty-eight participants met the adopted diagnostic criteria for PPS, giving a prevalence of 31.0%. The prevalence rate was significantly higher in women than in men (p=0.02). Logistic regression analyses revealed a significant inverse association with onset of poliomyelitis at over 12 months of age (OR 0.33; CI 0.14-0.79) a higher degree of education (OR 0.20; CI 0.07-0.79), and a significant association with the presence of other diseases (OR 9.86; CI 3.69-26.34). In our survey one-third of patients with prior poliomyelitis had PPS. Higher age at onset of poliomyelitis is inversely associated with PPS. The association with other diseases may indicate that a chronic physical stress, particularly in already weak motor units, can contribute to the development of signs and symptoms of PPS. Our results also suggest the impact of socio-economic conditions on the risk of PPS.

  4. Operational requirements for avoidance and eventual elimination of Gz-induced loss of consciousness (G-LOC) in flight.

    Science.gov (United States)

    Wood, E

    1993-02-01

    Fifty years of more or less active research experiences concerning the cardiovascular, respiratory, and neurologic dynamics of G-LOC carried out in healthy humans, both on centrifuges and in flight, have convinced me that on the basis of the physiology involved and because of the risk of the very high cost in pilot lives and their planes due to G-LOC, three operational requirements should be adopted as follows. Operational Requirement I. A noninvasive continuous on-line, real-time recording of arterial pulsations at brain level should be a mandatory requirement for every human centrifuge exposure to Gz accelerations that carry an appreciable likelihood of loss of vision and/or consciousness. A similar system should be a mandatory requirement for every pilot when performing high G air-to-air or air-to-ground combat maneuvers both in training and in actual combat conditions. Operational Requirement II. A physiological G-LOC forewarning system based on arterial pulsations at head level coupled with a last-resort automatic plane recovery system should be installed in all advanced fighter aircraft. Operational Requirement III. Because of the inherent biomedical hazards associated with very high Gz protection and the risk of G-LOC when in conventional upright or partially supinated positions, an automatic 9 Gz or greater activated timer, G-LOC avoidance system should be installed in advanced fighter aircraft. This system should be set to activate an auditory G-LOC forewarning signal when a Gz level of more than 9 is maintained for 3 seconds, i.e., a period less than the cerebral anoxic reserve time. Failure of pilot response, that is, maintenance of Gz levels of greater than 9 for more than 4 seconds following this forewarning signal (i.e., a total sustained very high period of 6-7 seconds, a period equal to the average human cerebral anoxic reserve time), then activates a follow-on automatic plane recovery system.

  5. Polio survivors' perceptions of the meaning of quality of life and strategies used to promote participation in everyday activities.

    Science.gov (United States)

    Atwal, Anita; Spiliotopoulou, Georgia; Coleman, Caron; Harding, Kate; Quirke, Caroline; Smith, Nicole; Osseiran, Zeina; Plastow, Nicola; Wilson, Lesley

    2015-10-01

    The term 'post-polio syndrome' (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life. Research in this area has focused upon health status rather than its effect on quality of life. To gain an in-depth understanding of the meaning of quality of life for polio survivors and to determine the type of strategies that are used by people with PPS and the support that they consider as important to facilitate participation in everyday life activities that have an impact on their quality of life. Six focus groups were conducted with 51 participants from two regions in England. Data were audio-taped and analysed using thematic analysis. Our research found that polio survivors used terms used to describe quality of life which could be associated with that of happiness. Our research has identified resolvable factors that influence quality of life namely inaccessible environments, attitudes of health-care professionals and societal attitudes. Polio survivors have tried alternative therapies, chiefly acupuncture and massage, and found them to be effective in enhancing their quality of life. It is suggested that health-care professionals should consider factors which influence happiness and implement a person-centred approach with the views of the polio survivor being listened to. The three factors that influenced quality of life could be resolved by health-care professionals and by society. With regard to strategies used, we suggest that polio survivors should have access to the treatments that they perceive as important, although further research is required to design optimal interventions for this client group. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  6. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors.

    Science.gov (United States)

    Nam, Ki Yeun; Lee, SeungYeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-02-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional physical measurements and tests. Of the 317 respondents, 68.5% reported at least one fall in the past year. Of the fallers, 42.5% experienced at least one fall during one month. Most falls occurred during ambulation (76.6%), outside (75.2%) and by slipping down (29.7%). Of fallers, 45% reported any injuries caused by falls, and 23.3% reported fractures specifically. Female sex, old age, low bone mineral density, the presence of symptoms related to post-polio syndrome (PPS), poor balance confidence, short physical performance battery and weak muscle strength of knee extensor were not significantly associated with falls. Only leg-length discrepancy using spine-malleolar distance (SMD) was a significant factor associated with falls among Korean polio survivors. Our findings suggest that malalignment between the paralytic and non-paralytic limb length should be addressed in polio survivors for preventing falls.

  7. The Public Health Legacy of Polio Eradication in Africa.

    Science.gov (United States)

    Craig, Allen S; Haydarov, Rustam; O'Malley, Helena; Galway, Michael; Dao, Halima; Ngongo, Ngashi; Baranyikwa, Marie Therese; Naqvi, Savita; Abid, Nima S; Pandak, Carol; Edwards, Amy

    2017-07-01

    The legacy of polio in Africa goes far beyond the tragedies of millions of children with permanent paralysis. It has a positive side, which includes the many well-trained polio staff who have vaccinated children, conducted surveillance, tested stool specimens in the laboratories, engaged with communities, and taken care of polio patients. This legacy also includes support for routine immunization services and vaccine introductions and campaigns for other diseases. As polio funding declines, it is time to take stock of the resources made available with polio funding in Africa and begin to find ways to keep some of the talented staff, infrastructure, and systems in place to work on new public health challenges. The partnerships that helped support polio eradication will need to consider funding to maintain and to strengthen routine immunization services and other maternal, neonatal, and child health programs in Africa that have benefitted from the polio eradication infrastructure. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  8. Unusual MRI Findings in a Polio Survivor

    Directory of Open Access Journals (Sweden)

    Masaaki Sakamoto

    2016-01-01

    Full Text Available A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors.

  9. Polio, terror and the immunological worldview.

    Science.gov (United States)

    Peckham, Robert

    2018-02-01

    This paper adopts a socio-historical perspective to explore when, how and why the eradication of poliomyelitis has become politicised to the extent that health workers and security personnel are targeted in drive-by shootings. Discussions of the polio crisis in Afghanistan and Pakistan have tended to focus on Taliban suspicions of a US-led public health intervention and the denunciation of 'modernity' by Islamic 'extremists'. In contrast, this paper considers a broader history of indigenous hostility and resistance to colonial immunisation on the subcontinent, suggesting how interconnected public health and political crises today have reactivated the past and created a continuity between events. The paper explores how the biomedical threat posed by polio has become intertwined with military and governmental discourses premised on the 'preemptive strike'. Here, the paper tracks the connections between biological immunity and a postcolonial politics that posits an immunological rationale for politico-military interventions. The paper concludes by reflecting on the consequences for global public health of this entanglement of infectious disease with terror.

  10. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2006-01-01

    The goals of this project were: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  11. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2002-01-01

    The goals of this project are: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  12. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2004-01-01

    The goals of this project are: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  13. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2003-01-01

    The goals of this project are: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age matched control population and 2...

  14. Review of the Oral Polio Vaccineimmunization Coverage with ...

    African Journals Online (AJOL)

    routine and supplemental) in Zambia from 2000 to 2009, with the view of identifying opportunities for system strengthening, given that routine immunization is the “bed rock” for polio eradication. Design: A retrospective descriptive analysis design ...

  15. Post-polio syndrome and rehabilitation.

    Science.gov (United States)

    Tiffreau, V; Rapin, A; Serafi, R; Percebois-Macadré, L; Supper, C; Jolly, D; Boyer, F-C

    2010-02-01

    Post-polio syndrome (PPS) is the commonly affected term to describe the symptoms that may develop many years after acute paralytic poliomyelitis. The etiology of PPS is still unclear. An overuse of enlarged motor units is suspected causing denervation again due to distal degeneration of axons. Metabolic and functional changes has been described in muscle fibers of partially denervated muscles. Nevertheless, submaximal aerobic training and low intensity muscular strengthening have shown positive effects on muscular strength and cardiorespiratory system in patients affected by PPS. Aquatic therapy has a positive impact on pain and muscle function. In patients with severe fatigue, it is recommended to adapt the daily exercise routine to their specific case. 2009 Elsevier Masson SAS. All rights reserved.

  16. [General anesthesia for a patient with post-polio syndrome].

    Science.gov (United States)

    Sonobe, Shota; Imashuku, Yasuhiko; Inamori, Masayuki; Yabuta, Koichi; Hashimura, Toshiya; Kura, Masahiro; Otada, Hideki

    2013-08-01

    We gave anesthesia for a patient with post-polio syndrome undergoing laparoscopic sigmoid colectomy. She is a 68-year-old woman and had been diagnosed as post-polio syndrome since she was 55 years of age. Before the operation, paralysis was observed in her right leg. After inducing anesthesia using propofol, muscle relaxation was obtained by rocuronium bromide for intubation. Remifentanil was used during the operation, and good pain relief was obtained by iv-PCA (fentanyl) after operation.

  17. [Post-polio syndrome. Part I. The "legacy" of forgotten disease, challenges for professionals and polio survivors].

    Science.gov (United States)

    Matyja, Ewa

    2012-01-01

    The outcome of paralytic polio was believed to be a stable neurological state. Now, it is established that polio has an additional, slowly progressive phase, called post-polio syndrome (PPS) that develops 30-40 years after the acute poliomyelitis in 25-80% of paralytic and about 40% of nonparalytic polio survivors. The clinical symptoms are nonspecific and usually include muscle weakness, fatigue and muscle or joint pain. Some patients suffer from muscular atrophy, respiratory insufficiency, dysphagia, sleep disturbances or cold intolerance. The etiopathogenesis of PPS is unclear and many factors, such as dysfunction of the surviving motor units, aging, defects of neuromuscular transmission, persistence of viral infection and immunological mechanisms, are considered.

  18. Deconstructing social resistance to pulse polio campaign in two North Indian districts.

    Science.gov (United States)

    Chaturvedi, Sanjay; Dasgupta, Rajib; Adhish, Vivek; Ganguly, Kalyan K; Rai, Sanjay; Sushant, Leena; Srabasti, S; Arora, Narendra K

    2009-11-01

    To gain an insight into the phenomenon of social resistance and rumors against pulse polio campaign. Qualitative, community-based investigation, mapping perceptions of various stakeholders through in-depth interviews (IDIs), focus group discussions (FGDs), non-formal interactions and observations. Moradabad and JP Nagar districts of Uttar Pradesh. IDIs (providers 33, mothers 33, community leaders 10); FGDs (providers 4, mothers 8) and non-formal interactions (156) with community leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. A distinct machination of social resistance and rumors against oral polio vaccine during supplementary immunization activities (SIA) was observed in some minority dominated areas. The pattern can be understood through a model that emerged through qualitative evidence. Inspite of all this, most parents in minority areas supported the SIAs. Only a few clusters from extremely marginalized sections continued to evade SIAs, with an endemic pattern. Through social osmosis, these rumors reached majority community as well and some parents were affected. However, in such cases, the resistance was sporadic and transient. While the programs focus was on microbiological issues, the obstacles to polio eradication lie in the endemicity of social (and/or cultural) resistance in some pockets, leading to clustering of perpetually unimmunized children - inspite of good coverage of SIAs at macro level. This may sustain low levels of wild poliovirus transmission, and there can be exceptions to the robustness of the pulse approach. A micro level involvement of volunteers from marginalized pockets of minorities might be able to minimize or eliminate this resistance.

  19. Estimation after classification using lot quality assurance sampling: corrections for curtailed sampling with application to evaluating polio vaccination campaigns.

    Science.gov (United States)

    Olives, Casey; Valadez, Joseph J; Pagano, Marcello

    2014-03-01

    To assess the bias incurred when curtailment of Lot Quality Assurance Sampling (LQAS) is ignored, to present unbiased estimators, to consider the impact of cluster sampling by simulation and to apply our method to published polio immunization data from Nigeria. We present estimators of coverage when using two kinds of curtailed LQAS strategies: semicurtailed and curtailed. We study the proposed estimators with independent and clustered data using three field-tested LQAS designs for assessing polio vaccination coverage, with samples of size 60 and decision rules of 9, 21 and 33, and compare them to biased maximum likelihood estimators. Lastly, we present estimates of polio vaccination coverage from previously published data in 20 local government authorities (LGAs) from five Nigerian states. Simulations illustrate substantial bias if one ignores the curtailed sampling design. Proposed estimators show no bias. Clustering does not affect the bias of these estimators. Across simulations, standard errors show signs of inflation as clustering increases. Neither sampling strategy nor LQAS design influences estimates of polio vaccination coverage in 20 Nigerian LGAs. When coverage is low, semicurtailed LQAS strategies considerably reduces the sample size required to make a decision. Curtailed LQAS designs further reduce the sample size when coverage is high. Results presented dispel the misconception that curtailed LQAS data are unsuitable for estimation. These findings augment the utility of LQAS as a tool for monitoring vaccination efforts by demonstrating that unbiased estimation using curtailed designs is not only possible but these designs also reduce the sample size. © 2014 John Wiley & Sons Ltd.

  1. Assessment of cold-chain maintenance in vaccine carriers during Pulse Polio National Immunization Day in a rural block of India.

    Science.gov (United States)

    Pakhare, Abhijit P; Bali, Surya; Pawar, Radhakishan B; Lokhande, Ganesh S

    2014-01-01

    India was certified polio free on 27 March 2014. Supplementary immunization activities, in the form of national immunization days, is one of the core strategies for eradication, where oral polio vaccine is administered to children aged under 5 years throughout the country. Oral polio vaccine is heat sensitive and requires maintenance of a stringent cold chain. Therefore, vaccine carriers with ice packs are used in the Pulse Polio Immunization (PPI) programme. This study assessed whether the cold chain is maintained during National Immunization Day in Beed district. A cross-sectional study was conducted at six randomly selected booths, one each from six primary health centres in Georai block of Beed district in Maharashtra. Electronic data loggers, configured to measure half-hourly temperatures, were kept in vaccine carriers throughout the day of PPI. The vaccine carrier temperature was below 8 °C at all six booths; minimum temperature recorded was -9.5 °C, while the maximum was 4.5 °C. The vaccine vial monitor did not reach discard point in any booth. A vaccine carrier with four ice packs very effectively maintains the cold chain required for oral polio vaccine.

  2. Polio vaccines: WHO position paper, March 2016-recommendations.

    Science.gov (United States)

    World Health Organization

    2017-03-01

    This article presents the World Health Organization's (WHO) recommendations on the use of polio vaccine excerpted from the WHO position paper on polio vaccines - March 2016, published in the Weekly Epidemiological Record [1]. This position paper on polio vaccines replaces the 2014 WHO position paper [2]. The position paper summarizes the WHO position on the introduction of at least one dose of inactivated polio vaccine (IPV) into routine immunization schedules as a strategy to mitigate the potential risk of re-emergence of type 2 polio following the withdrawal of Sabin type 2 strains from oral polio vaccine (OPV) [3]. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This position paper reflects the global switch from trivalent to bivalent OPV which took place in April 2016. Recommendations on the use of polio vaccines have been discussed on multiple occasions by SAGE, most recently in October 2016; evidence presented at these meetings can be accessed at: http://www.who.int/immunization/sage/previous/en/index.html. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Post-polio eradication: vaccination strategies and options for India

    Directory of Open Access Journals (Sweden)

    Jayakrishnan Thayyil

    2014-11-01

    Full Text Available In 1988, the World Health Organization (WHO resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV. The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.

  4. Post-polio syndrome. Cases report and review of literature.

    Science.gov (United States)

    Pastuszak, Żanna; Stępień, Adam; Tomczykiewicz, Kazimierz; Piusińska-Macoch, Renata; Galbarczyk, Dariusz; Rolewska, Agnieszka

    It is estimated that around 15 million people survived polio infection worldwide since early twentieth century. In 1950 effective vaccination was used for first time. Since that time number of affected people decreased. The last epidemic of Haine-Medine disease in Poland was in 1950s. Another rare cases of infections were observed till 1970s. About at least 15 years after polio virus infection, slowly progressive muscle limbs paresis with muscle atrophy, joints pain, paresthesia were observed in polio survivors. That constellation of symptoms was called post-polio syndrome (PPS). PPS frequency among people after paralytic and nonparalytic polio infectious is ranged from 30% to 80%. Fatigue that leads to physical and mental activity deterioration is another important symptom that is observed in 90% of patients with PPS. Etiology of disease remains elusive. Probably it is an effect of spine frontal horns motoneurons damage during acute virus polio infection that leads to overloading and degeneration of remaining ones. The most important risk factors of PPS are female sex and respiratory symptoms during acute polio infection. Electromyography is an important part of PPS diagnostic process. Electrophysiological abnormalities are seen in clinically affected and unaffected muscles. The most frequent are fasciculations and fibrillations during rest activity, extension of motor unit area, time duration and amplitude. In this study we described three cases of people who developed PPS years after Haine-Medine disease and correlation between their EMG results and clinical status. We also analyzed electromyography results both after one month since first PPS signs occurred as well as after few years. Presentation of dynamic changes in EMG was the most important aim of that study. Copyright © 2017. Published by Elsevier Urban & Partner Sp. z o.o.

  5. Immunity to polio, measles and rubella in women of child-bearing age and estimated congenital rubella syndrome incidence, Cambodia, 2012.

    Science.gov (United States)

    Mao, B; Chheng, K; Wannemuehler, K; Vynnycky, E; Buth, S; Soeung, S C; Reef, S; Weldon, W; Quick, L; Gregory, C J

    2015-07-01

    Significant gaps in immunity to polio, measles, and rubella may exist in adults in Cambodia and threaten vaccine-preventable disease (VPD) elimination and control goals, despite high childhood vaccination coverage. We conducted a nationwide serological survey during November-December 2012 of 2154 women aged 15-39 years to assess immunity to polio, measles, and rubella and to estimate congenital rubella syndrome (CRS) incidence. Measles and rubella antibodies were detected by IgG ELISA and polio antibodies by microneutralization testing. Age-structured catalytic models were fitted to rubella serological data to predict CRS cases. Overall, 29.8% of women lacked immunity to at least one poliovirus (PV); seroprevalence to PV1, PV2 and PV3 was 85.9%, 93.4% and 83.3%, respectively. Rubella and measles antibody seroprevalence was 73.3% and 95.9%, respectively. In the 15-19 years age group, 48.2% [95% confidence interval (CI) 42.4-54.1] were susceptible to either PV1 or PV3, and 40.3% (95% CI 33.0-47.5) to rubella virus. Based on rubella antibody seroprevalence, we estimate that >600 infants are born with CRS in Cambodia annually. Significant numbers of Cambodian women are still susceptible to polio and rubella, especially those aged 15-19 years, emphasizing the need to include adults in VPD surveillance and a potential role for vaccination strategies targeted at adults.

  6. Post-polio syndrome and risk factors in korean polio survivors: a baseline survey by telephone interview.

    Science.gov (United States)

    Bang, Hyun; Suh, Jee Hyun; Lee, Seung Yeol; Kim, Keewon; Yang, Eun Joo; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Oh, Min-Gyun; Kim, Jeong-Hwan; Lee, Sam-Gyu; Lim, Jae-Young

    2014-10-01

    To obtain information on the socioeconomic, medical, and functional status of polio survivors, and to use these results as the preliminary data for establishing the middle-aged cohort of polio survivors. The subjects were recruited based on the medical records of multiple hospitals and centers. They were assessed through a structured questionnaire over the phone. Post-poliomyelitis syndrome (PPS) was identified according to the specified diagnostic criteria. Differences between polio survivors with or without PPS were evaluated, and the risk factors for PPS were analyzed by the odds ratio (OR). Majority of polio survivors were middle-aged and mean age was 51.2±8.3 years. A total of 188 out of 313 polio survivors met the adopted criteria for PPS based on the symptoms, yielding a prevalence of 61.6%. Mean interval between acute poliomyelitis and the development of PPS was 38.5±11.6 years. Female gender (OR 1.82; confidence interval [CI] 1.09-3.06), the age at onset of poliomyelitis (OR 1.75; CI 1.05-2.94), the use of orthoses or walking aids (OR 2.46; CI 1.44-4.20), and the history of medical treatment for paralysis, pain or gait disturbance (OR 2.62; CI 1.52-4.51) represented independent risk factors for PPS. We found that the majority of Korean polio survivors entered middle age with many medical, functional, and social problems. Female gender, early age of onset of poliomyelitis, the use of orthoses or walking aids, and the history of medical treatment for paralysis, pain or gait disturbance were identified as the significant risk factors for PPS. A comprehensive and multidisciplinary plan should be prepared to manage polio survivors considering their need for health care services and the risk factors for late effects, such as PPS.

  7. Polio immunization in Pakistan: ethical issues and challenges.

    Science.gov (United States)

    Basharat, Sarah; Shaikh, Babar Tasneem

    2017-01-01

    Immunization should be considered a basic human right to health and well-being. It is everybody's business, and it is everybody's responsibility: the individual, the community, the health system and the state. This paper attempts to review some of the literature that highlights the ethical and religious concerns surrounding polio vaccination and what approaches may be used to counter the problems faced in Pakistan. This paper is developed through a literature review on public health and polio in Pakistan, consulting local, regional and globally published peer reviewed articles focussing on religion, culture, ethics and public health. Human behaviour, including the utilization and acceptability of healthcare services, is greatly influenced by religious beliefs and dogmas. Immunization, specifically for the purpose of polio eradication, has been a topic under focus and in the news in Pakistan. The government is doing its best through a variety of interventions to increase access, inform the public and increase vaccination rates. Nevertheless, the country still faces a huge challenge from certain stern pockets of uncompromising populations who resist and refuse vaccination. Beliefs, practices and cultural norms overshadow public health priorities and ethics. Understanding of the context, therefore, is critical to determine the social hindrances in polio eradication and strategize thereon. Having programmatic, system-wide, socio-cultural and of course ethical dimensions, the policy makers and the programme managers in Pakistan must attempt to address the multitude of challenges to polio vaccination, whereby the plan of action developed within the ethical norms could potentially lead to an ultimate success.

  8. Repetitive transcranial magnetic stimulation in treatment of post polio syndrome.

    Science.gov (United States)

    Pastuszak, Żanna; Piusińska-Macoch, Renata; Stępień, Adam; Czernicki, Zbigniew

    2017-11-05

    Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome. To describe a case of patient diagnosed with post polio syndrome who was treated with rTMS stimulation with a good effect. Patient had rTMS stimulation of left prefrontal cortex twice a week for an eight weeks. Patient's health status was evaluated before treatment, after last rTMS session and after three months from the end of the treatment. Improvement of fatigue score, mood disturbances and motor functions was observed after treatment. rTMS can be an effective method in treatment of post polio syndrome but further studies with larger group need to be done to confirm that data. Copyright © 2017. Published by Elsevier Urban & Partner Sp. z o.o.

  9. Post polio syndrome: fatigued patients a specific subgroup?

    Science.gov (United States)

    Östlund, Gunilla; Wahlin, Åke; Sunnerhagen, Katharina S; Borg, Kristian

    2011-01-01

    To examine the characteristics of fatigued and non-fatigued post-polio patients and to define potential subgroups across the fatigue continuum. Multi-centre study. A total of 143 post-polio patients were subdivided on the basis of percentile distribution into a fatigue group, a intermediate group, and a non-fatigue group, using the Multi Fatigue Inventory 20 general fatigue ratings. Data on background, quality of life, fatigue and pain were collected. Descriptive statistics and correlations in each group and analysis of variance and χ2 for group comparisons were performed. Non-linear regressions were employed to evaluate differences in the strength of associations between physical and mental fatigue, on the one hand, and vitality on the other. The fatigued group was younger, had shorter polio duration, more pain, higher body mass index, lower quality of life and was more physically and mentally fatigued. A higher proportion of this group had contracted polio after 1956 and was under 65 years of age. Mental fatigue had a relatively higher explanatory value than physical fatigue for differences in vitality in the fatigued group, whereas reversed patterns were seen in the other groups. Fatigued post-polio patients can be considered as a subgroup.

  10. Tracking progress toward global polio eradication, 2010-2011.

    Science.gov (United States)

    2012-04-20

    In January 2012, polio eradication was declared a "programmatic emergency for global public health" by the Executive Board of the World Health Organization (WHO). Since the Global Polio Eradication Initiative (GPEI) began in 1988, progress has been tracked by surveillance of acute flaccid paralysis (AFP) cases and testing of linked stool specimens for polioviruses (PVs) in WHO-accredited Global Polio Laboratory Network (GPLN) laboratories, complemented by sewage testing (environmental surveillance) in selected areas. Monitoring AFP surveillance quality at national and subnational administrative levels using standard performance indicators identifies potential gaps where PV circulation might go undetected; monitoring specimen transport and laboratory reporting timeliness identifies areas where reporting delays could lead to late response, permitting ongoing transmission. This report provides an assessment of 2010-2011 performance indicators for AFP surveillance at national and subnational levels in polio-affected countries and laboratory reporting at the regional level, updated from 2009-2010. Overall, 16 (62%) of 26 countries with circulating wild PV (WPV) met national AFP surveillance indicator targets during both 2010 and 2011. All three countries with reestablished WPV transmission and 16 of 19 countries with WPV outbreaks had substantial proportions (>20%) of their respective populations living in areas with underperforming surveillance during 2010 or 2011. Targets for timely reporting of PV isolation and type characterization results were met in three of six WHO regions in 2010 and five regions in 2011. To achieve polio eradication, efforts are needed to improve AFP surveillance and laboratory performance.

  11. Prevalence of post-polio syndrome based on a cross-sectional survey in Kitakyushu, Japan.

    Science.gov (United States)

    Takemura, Jin; Saeki, Satoru; Hachisuka, Kenji; Aritome, Keinosuke

    2004-01-01

    To determine the number of polio survivors living in Kitakyushu, Japan, and the prevalence of post-polio syndrome. Cross-sectional survey in Kitakyushu. A total of 342 possible polio survivors were selected from the list of physically disabled persons' certificates administered by the Department of Health and Welfare, Kitakyushu City Government. A self-administered questionnaire concerning the diagnosis, paralysis, limitation in daily living, and use of adaptive devices was mailed to the 342 possible polio survivors. By confirmation of the diagnosis, 241 of the 342 turned out to be polio survivors, and the number of polio survivors per population of 100,000 amounted to 24.1. Of the polio survivors, 85% complained of new health problems such as difficulty in climbing stairs, muscle weakness, difficulty in walking, or fatigue. According to Halstead's criteria, 180 polio survivors suffered from post-polio syndrome, and the prevalence of post-polio syndrome in Kitakyushu was 18.0 per population of 100,000. This survey revealed the number of polio survivors, and the prevalence of post-polio syndrome in Kitakyushu, Japan.

  12. Did the call for boycott by the Catholic bishops affect the polio ...

    African Journals Online (AJOL)

    Introduction: Polio eradication is now feasible after removal of Nigeria from the list of endemic countries and global reduction of cases of wild polio virus in 2015 by more than 80%. However, all countries must remain focused to achieve eradication. In August 2015, the Catholic bishops in Kenya called for boycott of a polio ...

  13. Extended acclimatization is required to eliminate stress effects of periodic blood-sampling procedures on vasoactive hormones and blood volume in beagle dogs.

    Science.gov (United States)

    Slaughter, M R; Birmingham, J M; Patel, B; Whelan, G A; Krebs-Brown, A J; Hockings, P D; Osborne, J A

    2002-10-01

    Important in all experimental animal studies is the need to control stress stimuli associated with environmental change and experimental procedures. As the stress response involves alterations in levels of vasoactive hormones, ensuing changes in cardiovascular parameters may confound experimental outcomes. Accordingly, we evaluated the duration required for dogs (n = 4) to acclimatized to frequent blood sampling that involved different procedures. On each sampling occasion during a 6-week period, dogs were removed from their pen to a laboratory area and blood was collected either by venepuncture (days 2, 15, 34, 41) for plasma renin activity (PRA), epinephrine (EPI), norepinephrine, aldosterone, insulin, and atrial natriuretic peptide, or by cannulation (dogs restrained in slings; days 1, 8, 14, 22, 30, 33, 37, 40) for determination of haematocrit (HCT) alone (days 1 to 22) or HCT with plasma volume (PV; days 30 to 40). PRA was higher on days 2 and 15 compared with days 34 and 41 and had decreased by up to 48% by the end of the study (day 41 vs day 15; mean/SEM: 1.18/0.27 vs 2.88/0.79 ng ANG I/ml/h, respectively). EPI showed a time-related decrease from days 2 to 34, during which mean values had decreased by 51% (mean/SEM: 279/29 vs 134/20.9 pg/ml for days 2 and 34, respectively), but appeared stable from then on. None of the other hormones showed any significant variability throughout the course of the study. HCT was relatively variable between days 1 to 22 but stabilized from day 30, after which all mean values were approximately 6% lower than those between days 1 and 8. We conclude that an acclimatization period of at least 4 weeks is required to eliminate stress-related effects in dogs associated with periodic blood sampling.

  14. Polio Endgame: Lessons Learned From the Immunization Systems Management Group.

    Science.gov (United States)

    Zipursky, Simona; Vandelaer, Jos; Brooks, Alan; Dietz, Vance; Kachra, Tasleem; Farrell, Margaret; Ottosen, Ann; Sever, John L; Zaffran, Michel J

    2017-07-01

    The Immunization Systems Management Group (IMG) was established to coordinate and oversee objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018, namely, (1) introduction of ≥1 dose of inactivated poliovirus vaccine in all 126 countries using oral poliovirus vaccine (OPV) only as of 2012, (2) full withdrawal of OPV, starting with the withdrawal of its type 2 component, and (3) using polio assets to strengthen immunization systems in 10 priority countries. The IMG's inclusive, transparent, and partnership-focused approach proved an effective means of leveraging the comparative and complementary strengths of each IMG member agency. This article outlines 10 key factors behind the IMG's success, providing a potential set of guiding principles for the establishment and implementation of other interagency collaborations and initiatives beyond the polio sphere. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  15. Rapid assessment as an evaluation tool for polio national ...

    African Journals Online (AJOL)

    Rapid assessment as an evaluation tool for polio national immunisation days in Brong Ahafo region, Ghana. ... TM Akande, M Eshetu, G Bonsu ... Conclusion: Rapid assessment is a valuable tool for evaluation of NIDs; it enables timely intervention in covering missed children and helps in careful interpretation of the usual ...

  16. Submaximal exercise capacity and maximal power output in polio subjects

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Sargeant, A. J.; de Visser, M.; Lankhorst, G. J.; de Jong, B. A.

    2001-01-01

    OBJECTIVES: To compare the submaximal exercise capacity of polio subjects with postpoliomyelitis syndrome (PPS) and without (non-PPS) with that of healthy control subjects, to investigate the relationship of this capacity with maximal short-term power and quadriceps strength, and to evaluate

  17. Polio Outbreak Response in Ethiopia | Mesfin | East African Medical ...

    African Journals Online (AJOL)

    Background: Ethiopia had been polio-free for almost four years until December 2004. However, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of Sudan. In response, the country has attempted to document the ...

  18. National immunisation days for polio eradication in Uganda: Did ...

    African Journals Online (AJOL)

    Methods: NIDs for polio eradication commenced in Uganda in 1996. Two rounds, one month apart are implemented yearly. During the second round of 1998 NlDs, cards were introduced nationally and vitamin supplementation was introduced in 24 of the 45 districts. We compared NIDs coverage before and after NIDs cards ...

  19. Quadriceps muscle strength and voluntary activation after polio

    NARCIS (Netherlands)

    Beelen, Anita; Nollet, Frans; de Visser, Marianne; de Jong, Bareld A.; Lankhorst, Gustaaf J.; Sargeant, Anthony J.

    2003-01-01

    Quadriceps strength, maximal anatomical cross-sectional area (CSA), maximal voluntary activation (MVA), and maximal relaxation rate (MRR) were studied in 48 subjects with a past history of polio, 26 with and 22 without postpoliomyelitis syndrome (PPS), and in 13 control subjects. It was also

  20. Eradication of disease - The case study of polio | Schoub | South ...

    African Journals Online (AJOL)

    Eradication of disease - The case study of polio. BD Schoub. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  1. Aerobic exercise capacity in post-polio syndrome

    NARCIS (Netherlands)

    Voorn, E.L.

    2015-01-01

    The aim of this thesis was to expand the body of knowledge on the diminished aerobic capacity of individuals with post-polio syndrome (PPS). The studies described in this thesis were based on the assumption that, besides a reduced muscle mass, deconditioning contributes to the severely diminished

  2. Resistance of polio to its eradication in Pakistan

    Directory of Open Access Journals (Sweden)

    Sher Zunaira

    2011-10-01

    Full Text Available Abstract Background This study is based on EPI (Expanded Program on Immunization immunization surveys and surveillance of polio, its challenges in immunization and the way forward to overcome these challenges. Methods Several Government documents, survey reports and unpublished program documents were studied and online search was made to find information on EPI Pakistan. SPSS 16 and Microsoft Excel 2007 were used for the statistical analysis. Results Immunization against polio is higher in urban areas as compared to rural areas. Marked variation in vaccination has been observed in different provinces of Pakistan in the last decade. Secondly 10-20% of the children who have received their first dose of trivalent polio vaccine were deprived of their 2nd and 3rd dose because of poor performance of EPI and Lack of information about immunization. Conclusion In spite of numerous successes, such as the addition of new vaccines and raising immunization to over 100% in some areas, EPI is still struggling to reach its polio eradication goals. Inadequate service delivery, lack of information about immunization and limited number of vaccinators were found to be the key reason for poor performance of immunization and for large number of cases reported each year due to the deficiency of second and third booster dose.

  3. [Viral contamination of polio vaccines in context of antivaccination mythology].

    Science.gov (United States)

    Mats, A N; Kuz'mina, M N; Cheprasova, E V

    2010-01-01

    Analysis of publications about real and suggested contamination of polio vaccines produced in 1950s and 1960s with simian viruses--SV40 and SIV--is performed. Factual data are discussed and antivaccination fictions about calamitous consequences of really occurred contamination with SV40 and concocted contamination with SIV are refuted.

  4. rapid assessment of polio virus antibodies prevalence amongst ...

    African Journals Online (AJOL)

    RAPID ASSESSMENT OF POLIO VIRUS ANTIBODIES. PREVALENCE AMONGST CHILDREN IN KANO STATE, NORTH. WEST NIGERIA. 1Yusuf Kabir Mawashi⃰, Jatau David Edward±, Olonotola Steve±, Yakubu Edward±, Suleiman Abubakar Babangida±, Nuhu Adamu⃰, Zubairu. Gaiyya±, Yahaya, Aminu El- Ladanⱡ.

  5. Assessing the impact of the Lebanese National Polio Immunization Campaign using a population-based computational model

    Directory of Open Access Journals (Sweden)

    Ali Alawieh

    2017-11-01

    Full Text Available Abstract Background After the re-introduction of poliovirus to Syria in 2013, Lebanon was considered at high transmission risk due to its proximity to Syria and the high number of Syrian refugees. However, after a large-scale national immunization initiative, Lebanon was able to prevent a potential outbreak of polio among nationals and refugees. In this work, we used a computational individual-simulation model to assess the risk of poliovirus threat to Lebanon prior and after the immunization campaign and to quantitatively assess the healthcare impact of the campaign and the required standards that need to be maintained nationally to prevent a future outbreak. Methods Acute poliomyelitis surveillance in Lebanon was along with the design and coverage rate of the recent national polio immunization campaign were reviewed from the records of the Lebanese Ministry of Public Health. Lebanese population demographics including Syrian and Palestinian refugees were reviewed to design individual-based models that predicts the consequences of polio spread to Lebanon and evaluate the outcome of immunization campaigns. The model takes into account geographic, demographic and health-related features. Results Our simulations confirmed the high risk of polio outbreaks in Lebanon within 10 days of case introduction prior to the immunization campaign, and showed that the current immunization campaign significantly reduced the speed of the infection in the event poliomyelitis cases enter the country. A minimum of 90% national immunization coverage was found to be required to prevent exponential propagation of potential transmission. Conclusions Both surveillance and immunization efforts should be maintained at high standards in Lebanon and other countries in the area to detect and limit any potential outbreak. The use of computational population simulation models can provide a quantitative approach to assess the impact of immunization campaigns and the burden of

  6. Assessing the impact of the Lebanese National Polio Immunization Campaign using a population-based computational model.

    Science.gov (United States)

    Alawieh, Ali; Sabra, Zahraa; Langley, E Farris; Bizri, Abdul Rahman; Hamadeh, Randa; Zaraket, Fadi A

    2017-11-25

    After the re-introduction of poliovirus to Syria in 2013, Lebanon was considered at high transmission risk due to its proximity to Syria and the high number of Syrian refugees. However, after a large-scale national immunization initiative, Lebanon was able to prevent a potential outbreak of polio among nationals and refugees. In this work, we used a computational individual-simulation model to assess the risk of poliovirus threat to Lebanon prior and after the immunization campaign and to quantitatively assess the healthcare impact of the campaign and the required standards that need to be maintained nationally to prevent a future outbreak. Acute poliomyelitis surveillance in Lebanon was along with the design and coverage rate of the recent national polio immunization campaign were reviewed from the records of the Lebanese Ministry of Public Health. Lebanese population demographics including Syrian and Palestinian refugees were reviewed to design individual-based models that predicts the consequences of polio spread to Lebanon and evaluate the outcome of immunization campaigns. The model takes into account geographic, demographic and health-related features. Our simulations confirmed the high risk of polio outbreaks in Lebanon within 10 days of case introduction prior to the immunization campaign, and showed that the current immunization campaign significantly reduced the speed of the infection in the event poliomyelitis cases enter the country. A minimum of 90% national immunization coverage was found to be required to prevent exponential propagation of potential transmission. Both surveillance and immunization efforts should be maintained at high standards in Lebanon and other countries in the area to detect and limit any potential outbreak. The use of computational population simulation models can provide a quantitative approach to assess the impact of immunization campaigns and the burden of infectious diseases even in the context of population migration.

  7. Optimal vaccine stockpile design for an eradicated disease: application to polio.

    Science.gov (United States)

    Tebbens, Radboud J Duintjer; Pallansch, Mark A; Alexander, James P; Thompson, Kimberly M

    2010-06-11

    Eradication of a disease promises significant health and financial benefits. Preserving those benefits, hopefully in perpetuity, requires preparing for the possibility that the causal agent could re-emerge (unintentionally or intentionally). In the case of a vaccine-preventable disease, creation and planning for the use of a vaccine stockpile becomes a primary concern. Doing so requires consideration of the dynamics at different levels, including the stockpile supply chain and transmission of the causal agent. This paper develops a mathematical framework for determining the optimal management of a vaccine stockpile over time. We apply the framework to the polio vaccine stockpile for the post-eradication era and present examples of solutions to one possible framing of the optimization problem. We use the framework to discuss issues relevant to the development and use of the polio vaccine stockpile, including capacity constraints, production and filling delays, risks associated with the stockpile, dynamics and uncertainty of vaccine needs, issues of funding, location, and serotype dependent behavior, and the implications of likely changes over time that might occur. This framework serves as a helpful context for discussions and analyses related to the process of designing and maintaining a stockpile for an eradicated disease. (c) 2010 Elsevier Ltd. All rights reserved.

  8. Mathematical modelling of lymphatic filariasis elimination programmes in India: Required duration of mass drug administration and post-treatment level of infection indicators

    NARCIS (Netherlands)

    Jambulingam, P. (Purushothaman); S.V. Subramanian; S.J. de Vlas (Sake); Vinubala, C. (Chellasamy); W.A. Stolk (Wilma)

    2016-01-01

    textabstractBackground: India has made great progress towards the elimination of lymphatic filariasis. By 2015, most endemic districts had completed at least five annual rounds of mass drug administration (MDA). The next challenge is to determine when MDA can be stopped. We performed a simulation

  9. The Cutter incident and the development of a Swedish polio vaccine, 1952-1957

    OpenAIRE

    Axelsson, Per

    2012-01-01

    The creation of two different vaccines to eradicate polio stands out as one of modern science most important accomplishments. The current article examines Swedish polio vaccine research, the vaccination campaign and especially how the Cutter incident came to affect Swedish Science, scientists and society in the 1950s. Sweden is one of the few countries that came to produce its own inactivated polio vaccine (IPV) in the 1950s, a type of vaccine they never abandoned. This article highlights the...

  10. Understanding vaccine hesitancy in polio eradication in northern Nigeria.

    Science.gov (United States)

    Taylor, Sebastian; Khan, Mahmud; Muhammad, Ado; Akpala, Okey; van Strien, Marit; Morry, Chris; Feek, Warren; Ogden, Ellyn

    2017-11-07

    Vaccine hesitancy constitutes a major threat to the Global Polio Eradication Initiative (GPEI), and to further expansion of routine immunisation. Understanding hesitancy, leading in some cases to refusal, is vital to the success of GPEI. Re-emergence of circulating wild poliovirus in northern Nigeria in mid-2016, after 24months polio-free, gives urgency to this. But it is equally important to protect and sustain the global gains available through routine immunisation in a time of rising scepticism and potential rejection of specific vaccines or immunisation more generally. This study is based on a purposive sampling survey of 1653 households in high- and low-performing rural, semiurban and urban areas of three high-risk states of northern Nigeria in 2013-14 (Sokoto, Kano and Bauchi). The survey sought to understand factors at household and community level associated with propensity to refuse polio vaccine. Wealth, female education and knowledge of vaccines were associated with lower propensity to refuse oral polio vaccine (OPV) among rural households. But higher risk of refusal among wealthier, more literate urban household rendered these findings ambiguous. Ethnic and religious identity did not appear to be associated with risk of OPV refusal. Risk of vaccine refusal was highly clustered among households within a small sub-group of sampled settlements. Contrary to expectations, households in these settlements reported higher levels of expectation of government as service provider, but at the same time lesser confidence in the efficacy of their relations with government. Results suggest that strategies to address the micro-political dimension of vaccination - expanding community-level engagement, strengthening the role of local government in public health, and enhancing public participation of women - should be effective in reducing non-compliance, asan important set of strategies complementary to conventional didactic/educational approaches and working through

  11. Analysis of sleep characteristics in post-polio syndrome patients.

    Science.gov (United States)

    Silva, Tatiana Mesquita E; Moreira, Gustavo Antonio; Quadros, Abrahão Augusto Juviniano; Pradella-Hallinan, Márcia; Tufik, Sergio; Oliveira, Acary Souza Bulle

    2010-08-01

    The main post-polio syndrome (PPS) symptoms are new weakness, new atrophy, fatigue, pain and sleep disturbances. Polysomnography is the gold standard for sleep analysis. To analyze sleep patterns in PPS patients. Sixty patients (mean age 46.8+/-11.3 years) at the Federal University of São Paulo (UNIFESP/EPM) complaining of sleep disturbances were evaluated by means of polysomnography, performed at the Sleep Institute. Sleep efficiency was lower due to high sleep latency and arousal index. The apnea and hypopnea index (AHI) and the periodic limb movements (PLM) index were higher. Sleep architecture was also impaired. There were no abnormalities of oxygen saturation, carbon dioxide levels, respiratory rate or heart rate. New post-polio sleep disturbances were isolated symptoms. It appears that these symptoms were not due to post-polio features, but rather, that they were due to dysfunction of the surviving motor neurons in the brainstem. Abnormal dopamine production, which is responsible for many sleep-related breathing disorders and abnormal movements, may also have been implicated in the present findings.

  12. Fetal damage after accidental polio vaccination of an immune mother.

    Science.gov (United States)

    Burton, A E; Robinson, E T; Harper, W F; Bell, E J; Boyd, J F

    1984-07-01

    Irreparable damage to the anterior horn cells of the cervical and thoracic cord was found in a 20-week-old fetus whose mother was immune to poliomyelitis before conceiving but who was inadvertently given oral polio vaccine at 18 weeks gestation. Polio neutralizing antibody titres in sera, taken before and after pregnancy, were identical and were at levels normally regarded as providing protection. Unsuccessful attempts were made to isolate poliovirus from extracts of fetal brain, lung, liver and placenta. Fluorescent antibody tests were performed on various levels of the central nervous system and on the left and right extensor forearm muscles. Specific positive fluorescence to poliovirus 2 and 3 antigens was detected at dorsal spinal cord level only. One positive result was seen with Coxsackie A9 antiserum and fresh guinea-pig complement in the inflammatory cells in the right extensor forearm muscles.This experience, as yet unexplained, underlines the importance of ensuring that women are not pregnant prior to oral polio vaccination.

  13. Report: U.S. Chemical Safety and Hazard Investigation Board Complied With Reporting Requirements of the Improper Payments Elimination and Recovery Act

    Science.gov (United States)

    Report #13-P-0177, March 12, 2013. CSB is fully compliant with the reporting requirements of IPERA, which require all agencies to periodically review all programs and activities that may be susceptible to significant improper payments.

  14. Perceived health in a population based sample of victims of the 1956 polio epidemic in the Netherlands

    NARCIS (Netherlands)

    Nollet, F.; Ivanyi, B.; Beelen, A.; de Haan, R. J.; Lankhorst, G. J.; de Visser, M.

    2002-01-01

    Objective: To investigate perceived health and its relation to residual paresis from polio, late onset neuromuscular symptoms following poliomyelitis (LSP), and sex, in a population based sample of polio survivors. Methods: 350 subjects traced from the notification records of the Dutch 1956 polio

  15. Studies on the potency of oral polio vaccine using RD cell line and ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-11-16

    Nov 16, 2009 ... The potency of vaccines was tested using the Karber's Formula. Key words: Oral polio vaccine, rhabdomyosarcoma, thermostability, potency. INTRODUCTION. Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the faecal-oral ...

  16. Psoriasis sparing the polio-affected limb: Is it merely the koebner phenomenon?

    Directory of Open Access Journals (Sweden)

    B C Ravikumar

    2014-01-01

    Full Text Available Psoriasis being a common skin condition, atypical forms and unusual localizations of this disease are quite frequently seen. However, psoriasis sparing a polio-affected limb is extremely rare. We report a case of an adult male, who presented with psoriasis distributed all over the body but with almost complete sparing of the polio-affected left lower limb.

  17. Ankle-foot orthoses that restrict dorsiflexion improve walking in polio survivors with calf muscle weakness

    NARCIS (Netherlands)

    Ploeger, Hilde E.; Bus, Sicco A.; Brehm, Merel-Anne; Nollet, Frans

    2014-01-01

    In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We

  18. The March of Dimes and Polio: Lessons in Vaccine Advocacy for Health Educators

    Science.gov (United States)

    Larsen, Dawn

    2012-01-01

    The polio vaccine became available in 1955, due almost entirely to the efforts of the March of Dimes. In 1921, Franklin Roosevelt gave a public face to polio and mounted a campaign to prevent it, establishing the National Foundation for Infantile Paralysis in 1938. During the Depression, U.S. citizens were asked to contribute one dime. Entertainer…

  19. Pathophysiology of muscular changes in post-polio syndrome and consequences for physical mobility

    NARCIS (Netherlands)

    Bickerstaffe, A.

    2016-01-01

    A large proportion of the estimated 10-20 million polio survivors worldwide can be expected to experience symptoms of further neuromuscular decline for many decades to come as they develop post-polio syndrome (PPS). Chapter 1 in Section A contains an overview of the insights into PPS as they stood

  20. Childhood mortality after oral polio immunisation campaign in Guinea-Bissau

    DEFF Research Database (Denmark)

    Aaby, Peter; Hedegaard, Kathryn; Sodemann, Morten

    2005-01-01

    Though previous studies have suggested a non-specific beneficial effect of oral polio vaccine (OPV), there has been no evaluation of the mortality impact of national polio immunization days. On the other hand, studies examining the effect of OPV and diphtheria-tetanus-pertussis (DTP) vaccines, wh...

  1. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan.

    Science.gov (United States)

    Obregón, Rafael; Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-08-01

    Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.

  2. Post Polio Paralysis: A Clarion Call For Surgical Re-Awakening ...

    African Journals Online (AJOL)

    Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be rehabilitated to ambulate erect by reconstructive operations, use of orthosis and physiotherapy. This study assesses the problems of post polio paralysis, rehabilitative interventions and calls for a surgical reawakening in this regard.

  3. Improving polio vaccination during supplementary campaigns at areas of mass transit in India

    Directory of Open Access Journals (Sweden)

    Bahl Sunil

    2010-05-01

    Full Text Available Abstract Background In India, children who are traveling during mass immunization campaigns for polio represent a substantial component of the total target population. These children are not easily accessible to health workers and may thus not receive vaccine. Vaccination activities at mass transit sites (such as major intersections, bus depots and train stations, can increase the proportion of children vaccinated but the effectiveness of these activities, and factors associated with their success, have not been rigorously evaluated. Methods We assessed data from polio vaccination activities in Jyotiba Phule Nagar district, Uttar Pradesh, India, conducted in June 2006. We used trends in the vaccination results from the June activities to plan the timing, locations, and human resource requirements for transit vaccination activities in two out of the seven blocks in the district for the July 2006 supplementary immunization activity (SIA. In July, similar data was collected and for the first time vaccination teams also recorded the proportion of children encountered each day who were vaccinated (a new monitoring system. Results In June, out of the 360,937 total children vaccinated, 34,643 (9.6% received vaccinations at mass transit sites. In the July SIA, after implementation of a number of changes based on the June monitoring data, 36,475 children were vaccinated at transit sites (a 5.3% increase. Transit site vaccinations in July increased in the two intervention blocks from 18,194 to 21,588 (18.7% and decreased from 16,449 to 14,887 (9.5% in the five other blocks. The new monitoring system showed the proportion of unvaccinated children at street intersection transit sites in the July campaign decreased from 24% (1,784/7,405 at the start of the campaign to 3% (143/5,057 by the end of the SIA, consistent with findings from the more labor-intensive post-vaccination coverage surveys routinely performed by the program. Conclusions Analysis of

  4. Twenty-Eight Years of Poliovirus Replication in an Immunodeficient Individual: Impact on the Global Polio Eradication Initiative.

    Directory of Open Access Journals (Sweden)

    Glynis Dunn

    2015-08-01

    Full Text Available There are currently huge efforts by the World Health Organization and partners to complete global polio eradication. With the significant decline in poliomyelitis cases due to wild poliovirus in recent years, rare cases related to the use of live-attenuated oral polio vaccine assume greater importance. Poliovirus strains in the oral vaccine are known to quickly revert to neurovirulent phenotype following replication in humans after immunisation. These strains can transmit from person to person leading to poliomyelitis outbreaks and can replicate for long periods of time in immunodeficient individuals leading to paralysis or chronic infection, with currently no effective treatment to stop excretion from these patients. Here, we describe an individual who has been excreting type 2 vaccine-derived poliovirus for twenty eight years as estimated by the molecular clock established with VP1 capsid gene nucleotide sequences of serial isolates. This represents by far the longest period of excretion described from such a patient who is the only identified individual known to be excreting highly evolved vaccine-derived poliovirus at present. Using a range of in vivo and in vitro assays we show that the viruses are very virulent, antigenically drifted and excreted at high titre suggesting that such chronic excreters pose an obvious risk to the eradication programme. Our results in virus neutralization assays with human sera and immunisation-challenge experiments using transgenic mice expressing the human poliovirus receptor indicate that while maintaining high immunisation coverage will likely confer protection against paralytic disease caused by these viruses, significant changes in immunisation strategies might be required to effectively stop their occurrence and potential widespread transmission. Eventually, new stable live-attenuated polio vaccines with no risk of reversion might be required to respond to any poliovirus isolation in the post

  5. Twenty-Eight Years of Poliovirus Replication in an Immunodeficient Individual: Impact on the Global Polio Eradication Initiative

    Science.gov (United States)

    Dunn, Glynis; Klapsa, Dimitra; Wilton, Thomas; Stone, Lindsay; Minor, Philip D.; Martin, Javier

    2015-01-01

    There are currently huge efforts by the World Health Organization and partners to complete global polio eradication. With the significant decline in poliomyelitis cases due to wild poliovirus in recent years, rare cases related to the use of live-attenuated oral polio vaccine assume greater importance. Poliovirus strains in the oral vaccine are known to quickly revert to neurovirulent phenotype following replication in humans after immunisation. These strains can transmit from person to person leading to poliomyelitis outbreaks and can replicate for long periods of time in immunodeficient individuals leading to paralysis or chronic infection, with currently no effective treatment to stop excretion from these patients. Here, we describe an individual who has been excreting type 2 vaccine-derived poliovirus for twenty eight years as estimated by the molecular clock established with VP1 capsid gene nucleotide sequences of serial isolates. This represents by far the longest period of excretion described from such a patient who is the only identified individual known to be excreting highly evolved vaccine-derived poliovirus at present. Using a range of in vivo and in vitro assays we show that the viruses are very virulent, antigenically drifted and excreted at high titre suggesting that such chronic excreters pose an obvious risk to the eradication programme. Our results in virus neutralization assays with human sera and immunisation-challenge experiments using transgenic mice expressing the human poliovirus receptor indicate that while maintaining high immunisation coverage will likely confer protection against paralytic disease caused by these viruses, significant changes in immunisation strategies might be required to effectively stop their occurrence and potential widespread transmission. Eventually, new stable live-attenuated polio vaccines with no risk of reversion might be required to respond to any poliovirus isolation in the post-eradication era. PMID:26313548

  6. Violence, insecurity, and the risk of polio: A systematic analysis.

    Directory of Open Access Journals (Sweden)

    Kia Guarino

    Full Text Available Since the introduction of polio vaccines in the 1950's and 60's, eradication of poliovirus from the world has been technically feasible. Progress towards this goal, however, has been uneven and influenced by social and political factors that challenge the implementation of robust immunization programs. While violence and insecurity are often cited as barriers to eradication, current global risk models are largely based on virologic and immunologic indicators measured at national levels. In this manuscript, we quantify the relevance of indicators of violence and insecurity on the risk of polio spread.Using logistic regression models and public data sources, we evaluate the relationship between measures of violence and instability and the location of poliomyelitis cases between 2006 and 2015 at the country-level, both individually and after controlling for more proximal determinants of disease, such as nearby circulating poliovirus and vaccination rates. We found that increases in a country's Fragile States Index (FSI and Global Peace Index (GPI, aggregate indicators of violence and instability, were associated with the occurrence of poliovirus cases in the subsequent year (p< 0.01, even after controlling for established risk factors. These effects of violence and insecurity must be mediated through immunity and exposure to poliovirus, coarse measures of which are included in our model. This also implies that in our study, and in risk models in general, the interpretation depends on the quality and granularity of available data.National virologic and immunologic indicators understate the risk of poliovirus spread in areas with violence and insecurity, and the inclusion of such factors improves precision. In addition, the link between violence and incidence of disease highlights the broader challenge of implementing health interventions in conflict areas. We discuss practical implications of this work in understanding and measuring the risks to

  7. USCIS Backlog Elimination

    Data.gov (United States)

    Department of Homeland Security — USCIS is streamlining the way immigration benefits are delivered. By working smarter and eliminating redundancies, USCIS is bringing a business model to government....

  8. Expansion of syndromic vaccine preventable disease surveillance to include bacterial meningitis and Japanese encephalitis: evaluation of adapting polio and measles laboratory networks in Bangladesh, China and India, 2007-2008.

    Science.gov (United States)

    Cavallaro, Kathleen F; Sandhu, Hardeep S; Hyde, Terri B; Johnson, Barbara W; Fischer, Marc; Mayer, Leonard W; Clark, Thomas A; Pallansch, Mark A; Yin, Zundong; Zuo, Shuyan; Hadler, Stephen C; Diorditsa, Serguey; Hasan, A S M Mainul; Bose, Anindya S; Dietz, Vance

    2015-02-25

    Surveillance for acute flaccid paralysis with laboratory confirmation has been a key strategy in the global polio eradication initiative, and the laboratory platform established for polio testing has been expanded in many countries to include surveillance for cases of febrile rash illness to identify measles and rubella cases. Vaccine-preventable disease surveillance is essential to detect outbreaks, define disease burden, guide vaccination strategies and assess immunization impact. Vaccines now exist to prevent Japanese encephalitis (JE) and some etiologies of bacterial meningitis. We evaluated the feasibility of expanding polio-measles surveillance and laboratory networks to detect bacterial meningitis and JE, using surveillance for acute meningitis-encephalitis syndrome in Bangladesh and China and acute encephalitis syndrome in India. We developed nine syndromic surveillance performance indicators based on international surveillance guidelines and calculated scores using supervisory visit reports, annual reports, and case-based surveillance data. Scores, variable by country and targeted disease, were highest for the presence of national guidelines, sustainability, training, availability of JE laboratory resources, and effectiveness of using polio-measles networks for JE surveillance. Scores for effectiveness of building on polio-measles networks for bacterial meningitis surveillance and specimen referral were the lowest, because of differences in specimens and techniques. Polio-measles surveillance and laboratory networks provided useful infrastructure for establishing syndromic surveillance and building capacity for JE diagnosis, but were less applicable for bacterial meningitis. Laboratory-supported surveillance for vaccine-preventable bacterial diseases will require substantial technical and financial support to enhance local diagnostic capacity. Published by Elsevier Ltd.

  9. Knowledge attitude practice study on pulse polio immunization in Mangalore, Dakshina Kannada district, Karnataka.

    Science.gov (United States)

    Joseph, Nitin; Subba, S H; Shashidhar, Kotian M

    2011-06-01

    Government of India launched PPI in 1995 to eradicate polio by the end of 2000. Despite this 733 cases were reported last year alone. There is a need to understand the reason behind high number of cases being reported even after so many years of programme implementation. This study was therefore conducted to assess knowledge of people about polio and PPI, their attitude and practice towards PPI. This cross sectional study was done in Mangalore city of Karnataka. Only houses having under five children were taken for the study. Data was collected by interviewing any adult member of the household using a pretested questionnaire. Out of 100 participants 99 were literates but only 11 knew the correct mode of transmission of polio. Twenty seven had misconception that polio is a curable disease. Only 40 participants knew that polio drops can be given to children even with mild illnesses. Few (2%) participants felt that PPI causes vaccine overdose and 8 participants thought PPI to be a substitute for routine immunization. This study identified few important misconceptions associated with polio and PPI. This needs to be addressed by large scale awareness campaigns in order to eradicate polio in the near future.

  10. TANGGAP KEBAL ANAK-ANAK TERHADAP 2 DOSIS VAKSIN POLIO DI JAKARTA

    Directory of Open Access Journals (Sweden)

    Gendrowahyuhono Gendrowahyuhono

    2012-09-01

    Full Text Available Antibody response to two doses of oral polio vaccine was studied in children of Kebayoran Baru district, Jakarta. Trivalent liquid oral polio vaccine containing 105.6 to 106.1 TCID50 per dose was used ana vaccination was carried out twice with one month interval to 75 children of3 - 36 months of age. Another group of 94 children from the same district were unvaccinated for control. Serum neutralization test against 100 TCID50 polio virus, to measure antibody strength, was carried out on monkey kidney cell cultures in microplates. Identification of isolated virus is done also in monkey kidney cell culture, using virus neutralization technique in microplate, against 30 Units antibody of polio type 1, type 2 and type 3. The result showed that 80 % of vaccinated children developed antibody against three types of polio after they received 2 doses of oral polio vaccine; 96.7 % against type 1,88 % against type 2 and 64.7 % against type 3. Out of 75 specimens from vaccinated children; polio virus could be isolated from 15 specimens, while from no one specimen could be isolated Coxsackie and Echo virus. The significant of this findings are discussed and should be considered as a simpler alternative method to vaccinate children.

  11. Preformulation study of highly purified inactivated polio vaccine, serotype 3.

    Science.gov (United States)

    Qi, Wei; Zeng, Yuhong; Orgel, Scott; Francon, Alain; Kim, Jae Hyun; Randolph, Theodore W; Carpenter, John F; Middaugh, C Russell

    2014-01-01

    To improve the effectiveness of the polio vaccination campaign, improvements in the thermal stability of the vaccine are being investigated. Here, inactivated polio vaccine, serotype 3 (IPV3) was characterized via a number of biophysical techniques. The size was characterized by transmission electronic microscopy and light scattering. The capsid protein conformation was evaluated by intrinsic fluorescence and circular dichroism (CD), and the D-antigen content by enzyme-linked immunosorbent assay (ELISA). The pH thermal stability of IPV3 (pH 3.0-8.0; 10°C-87.5°C) was evaluated by fluorescence, CD, and static light scattering. The transition temperatures reflect the responses, respectively, of tertiary structure, secondary structure, and size to applied thermal stress. The data were summarized as empirical phase diagrams, and the most stable conditions were found to be pH 7.0 with temperature lower than 40°C. CD detected a higher transition temperature for capsid protein than that for RNA. The effects of certain excipients on IPV3 thermal stability and antigen content were evaluated. The results of their effects, based on intrinsic fluorescence and ELISA, were in good agreement, suggesting the feasibility of applying intrinsic fluorescence as a high-throughput tool for formulation development. The study improves the understanding of IPV3 thermal stability, and provides a starting point for future formulation development of IPV3 and other serotypes. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

  12. High incidence of osteoporosis and fractures in an aging post-polio population.

    LENUS (Irish Health Repository)

    Mohammad, Ausaf F

    2009-01-01

    Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.

  13. Elimination of aluminum adjuvants.

    Science.gov (United States)

    Hem, Stanley L

    2002-05-31

    In vitro dissolution experiments although perhaps not at typical body concentrations and temperatures demonstrated that the alpha-hydroxycarboxylic acids present in interstitial fluid (citric acid, lactic acid, and malic acid) are capable of dissolving aluminum-containing adjuvants. Amorphous aluminum phosphate adjuvant dissolved more rapidly than crystalline aluminum hydroxide adjuvant. Intramuscular administration in New Zealand White rabbits of aluminum phosphate and aluminum hydroxide adjuvants, which were labelled with 26Al, revealed that 26Al was present in the first blood sample (1 h) for both adjuvants. The area under the blood level curve for 28 days indicated that three times more aluminum was absorbed from aluminum phosphate adjuvant than aluminum hydroxide adjuvant. In vivo studies using 26Al-labelled adjuvants are relatively safe because accelerator mass spectrometry (AMS) can quantify quantities of 26Al as small as 10(-17) g. A similar study in humans would require a whole-body exposure of 0.7 microSv per year compared to the natural background exposure of 3000 microSv per year. The in vitro dissolution and in vivo absorption studies indicate that aluminum-containing adjuvants which are administered intramuscularly are dissolved by alpha-hydroxycarboxylic acids in interstitial fluid, absorbed into the blood, distributed to tissues, and eliminated in the urine.

  14. Quantas manobras são necessárias para abolir o nistagmo na vertigem posicional paroxística benigna? The number of procedures required to eliminate positioning nystagmus in benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Ricardo Schaffeln Dorigueto

    2005-12-01

    selected according to each combination of canalithiasis or cupulolithiasis with semicircular canal involvement. Patients were treated by means of canalith repositioning procedures repeated weekly until the elimination of the positioning nystagmus. Analysis of Variance was used to verify differences between the variables. RESULTS: An average of 2.13 procedures (from 1 to 8 was needed to eliminate the positioning nystagmus. Canalithiasis required an average of 1.53 procedures, while cupulolithiasis needed 2.92 procedures (p=0.0002. An average of two procedures was needed to eliminate the positioning nystagmus in cases with posterior canal involvement, 2.39 procedures in cases with anterior canal involvement and 2.07 procedures in cases with lateral canal involvement (p=0.5213. CONCLUSIONS: From one to eight weekly canalith repositioning procedures were needed, with an average of two, to eliminate positioning nystagmus in benign paroxysmal positional vertigo. Cupulolithiasis requires a greater number of procedures than canalithiasis to eliminate positioning nystagmus. Semicircular canal involvement didn't influence the number of therapeutic maneuvers.

  15. [A battle won: the elimination of poliomyelitis in Cuba].

    Science.gov (United States)

    Chaple, Enrique Beldarraín

    2015-01-01

    Poliomyelitis was introduced in Cuba in the late nineteenth century by American residents in Isla de Pinos. The first epidemics occurred in 1906 and 1909 and increased in intensity between 1930 and 1958. The scope of the paper is to reconstruct the history of the disease and its epidemics in Cuba prior to 1961, the first National Polio Vaccination Campaign (1962) and its results, as well as analyze the ongoing annual vaccination campaigns through to certified elimination of the disease (1994). The logical historical method was used and archival documents and statistics from the Ministry of Health on morbidity and mortality through 2000 were reviewed. Gross morbidity and mortality rates were calculated and interviews with key figures were conducted.

  16. Hypothesis elimination on a quantum computer

    OpenAIRE

    Soklakov, Andrei N.; Schack, Ruediger

    2004-01-01

    Hypothesis elimination is a special case of Bayesian updating, where each piece of new data rules out a set of prior hypotheses. We describe how to use Grover's algorithm to perform hypothesis elimination for a class of probability distributions encoded on a register of qubits, and establish a lower bound on the required computational resources.

  17. Viral Aetiology of Acute Flaccid Paralysis Surveillance Cases, before and after Vaccine Policy Change from Oral Polio Vaccine to Inactivated Polio Vaccine

    Directory of Open Access Journals (Sweden)

    T. S. Saraswathy Subramaniam

    2014-01-01

    Full Text Available Since 1992, surveillance for acute flaccid paralysis (AFP cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV. Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period.

  18. Disability and functional assessment in former polio patients with and without postpolio syndrome

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Prins, M.H.; Sargeant, A.J.; Lankhorst, G.J.; de Jong, B.A.; de Visser, M.

    1999-01-01

    Objectives: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. Design: Cross- sectional survey;

  19. Repeater F-waves are signs of motor unit pathology in polio survivors.

    Science.gov (United States)

    Hachisuka, Akiko; Komori, Tetsuo; Abe, Tatsuya; Hachisuka, Kenji

    2015-05-01

    The purpose of this study was to determine whether F-waves reveal electrophysiological features of anterior horn cells in polio survivors. Forty-three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F-waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE). A significant increase in abnormally stereotyped ("repeater") F-waves and a reduction of F-wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F-waves had a negative correlation with MUNE. These trends in F-wave persistence and repeater F-waves after motor unit loss are characteristic findings in polio survivors. Repeater F-waves are a sign of motor unit pathology. © 2014 The Authors. Muscle & Nerve Published by Wiley Periodicals, Inc.

  20. Incompatibility of lyophilized inactivated polio vaccine with liquid pentavalent whole-cell-pertussis-containing vaccine

    NARCIS (Netherlands)

    Kraan, H.; Have, Ten R.; Maas, van der L.; Kersten, G.F.A.; Amorij, J.P.

    2016-01-01

    A hexavalent vaccine containing diphtheria toxoid, tetanus toxoid, whole cell pertussis, Haemophilius influenza type B, hepatitis B and inactivated polio vaccine (IPV) may: (i) increase the efficiency of vaccination campaigns, (ii) reduce the number of injections thereby reducing needlestick

  1. Between East and West: polio vaccination across the Iron Curtain in Cold War Hungary.

    Science.gov (United States)

    Vargha, Dora

    2014-01-01

    In 1950s Hungary, with an economy and infrastructure still devastated from World War II and facing further hardships, thousands of children became permanently disabled and many died in the severe polio epidemic that shook the globe. The relatively new communist regime invested significantly in solving the public health crisis, initially importing a vaccine from the West and later turning to the East for a new solution. Through the history of polio vaccination in Hungary, this article shows how Cold War politics shaped vaccine evaluation and implementation in the 1950s. On the one hand, the threat of polio created a safe place for hitherto unprecedented, open cooperation among governments and scientific communities on the two sides of the Iron Curtain. On the other hand, Cold War rhetoric influenced scientific evaluation of vaccines, choices of disease prevention, and ultimately the eradication of polio.

  2. Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

    Science.gov (United States)

    Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C

    2016-03-01

    As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities.

  3. Routine immunization - do people know about it? A study among caretakers of children attending pulse polio immunization in east Delhi

    Directory of Open Access Journals (Sweden)

    Sharma Rahul

    2008-01-01

    Full Text Available Research question: Do caretakers of children under five years have sufficient knowledge regarding routine immunization (RI? Objective: To assess the knowledge about RI among caretakers of young children. Settings: Pulse polio immunization centres in East Delhi. Study design: Cross-sectional study. Participants: Six hundred and eighty-two caretakers accompanying children under 5 years to pulse polio booths in November 2006. Study tool: Pre-tested semi-open-ended questionnaire. Statistical analysis: Proportions, Chi-square test. Results: The proportions of respondents who had awareness about different aspects of RI, such as weekday of RI (37.0%, age group for RI (49.1%, number of visits required in the first year of life (27.0%, were all low. When asked to name the four diseases covered under the RI program in Delhi, only 268 (39.3% could name at least three. The education level of respondents was strongly associated with their knowledge about RI. Conclusion: The need of the hour is to make RI a ′felt need′ of the community. Making caretakers more aware about RI is a vital step in achieving this goal.

  4. Surveillance for polio eradication: current status and lessons learnt--India, 1999.

    Science.gov (United States)

    Banerjee, K; Bandyopadhyay, S; Hlady, W G; Sarkar, S; Andrus, J K

    2000-01-01

    With the launch of the Universal Immunisation Programme in India in 1985, childhood immunisation was provided to children in all districts of the country in a phased manner by 1990. Surveillance for vaccine preventable diseases (VPD) including polio was started at the same time with monthly reporting from the districts to the Ministry of Health and Family Welfare (MOHFW), Government of India (GOI). In 1995, the Pulse Polio Immunisation (PPI) campaign was launched with the objective of polio eradication. Prior to 1997, surveillance for polio was directed at finding clinical polio cases by passive reporting from health facilities. There was no active surveillance for all cases of acute flaccid paralysis (AFP). In 1996, a scheme for the surveillance of AFP was drawn up. With the support of the Danish and US governments and Rotary International, 59 surveillance medical officers (SMOs) were hired, trained, and posted throughout the country in October 1997 to establish active surveillance of AFP. The number of SMOs was increased to 108 in August 1999. The SMOs along with their government counterparts established 10,069 reporting units nationwide by the end of November 1999 reporting weekly the occurrence of AFP cases to the district, state, and national levels; timely case investigation and collection of stool specimens from AFP cases; linkages to support the polio laboratory network; and extensive training of government counterparts. Data reported to the national level is analysed and put on an internet website which is updated every two weeks. Annualised rates of reported non-polio AFP have increased from 0.22 per 100,000 children aged < 15 years in 1997 to 1.57 in 1999. The number of polio cases associated with isolation of wild poliovirus decreased from 1404 in the third trimester of 1998 to 664 in the third trimester of 1999, yet widespread transmission of wild polioviruses persists throughout the country.

  5. Knowledge, attitude and practice of polio prevention among people in Khyber pakhtunkhwa

    International Nuclear Information System (INIS)

    Mehmood, T.; Babar, A.

    2014-01-01

    To assess the knowledge, attitude and practice of Polio among people in Khyber PakhtunKhwa and to recommend measures in order to improve the awareness of disease. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was conducted at CMH Nowshera, CMH Mardan and Kohat General Hospital from March to June 2013. Subjects and Methods: Persons presenting for consultation to tertiary care hospitals at medical reception rooms were approached by convenience sampling. Structured questionnaire was developed and data was collected by interviews. Results: The findings of the study revealed that out of 296 persons participated in study 57.4% were males while 42.2% were females. They were residents of Mardan, Nowshera, Kohat and Swabi districts of Khyber Pakhtukhwa. Persons who believed that vaccine is prohibited in religion were 13.9%, 81.1% persons knew about Polio disease and 84.5% persons believed that disease could be prevented by giving vaccines to children. Persons who gave vaccine to their children were 88.9% and 66.9% also knew the schedule of the vaccine. Pressure groups which included tribal elders stopped 19.3% people from giving vaccine to their children and for 11.1% persons the facility of giving vaccine was not available. Persons who believed that Polio can cause infertility were 11.5% and 20.9% believed that Polio vaccine cannot prevent Polio disease. Persons who have seen patient of Polio were 38.9% and 88.5 % persons wanted to eradicate disease from Pakistan. Conclusion: The results of the study revealed that people have adequate knowledge about Polio and wanted to eradicate it from Pakistan by participating in vaccination activities but still there are few people who believe that Polio vaccine cannot prevent disease resulting in failure to adminster vaccine for their children. (author)

  6. Polio Crisis in Costa Rica: Lessons Learned and Achievements

    Directory of Open Access Journals (Sweden)

    Gioconda Vargas-Morúa

    2015-05-01

    Full Text Available This presentation shows some of the consequences of the polio crisis in Costa Rica during the 1950’s, in order to preserve certain attitudes of Costa Ricans back then that are worth remembering: simplicity, solidarity and gratefulness. Hand in hand with highly service-oriented men and women, the country overcame the crisis and built one of the most iconic hospitals in Costa Rica: the National Children’s Hospital. It is worth rescuing the lessons learned and applying them to current times. This historical text was created based on the stories told by people who lived during the times of the crisis, on a 1956 notebook, on documents from the National Archive and the National Health and Social Security Library (BINASSS, for its name in Spanish, the Costa Rican Social Security System (CCSS, for its name in Spanish, Dr. Rodolfo Álvaro Murillo, and San Juan de Dios Hospital.  National and international newspapers were also reviewed. The consulted material confirms how the work of Costa Ricans, led by committed and service-oriented individuals, allowed for the construction of the National Children’s Hospital to take place -an institution that has served the Costa Rican people for fifty years. Costa Ricans also succeeded in eradicating polio long before several other countries around the world. The reactions of people in the 1950’s are lessons of solidarity and humanity that should not be forgotten; they should be remembered in order to value team work over individual work and make sure, no matter what our role in society is, to always stand by common well-being, as mid-century Costa Ricans did by overcoming their personal limitations and acting for the benefit of society.

  7. Eliminating NVA Requirements & Improving the Inspection System

    Science.gov (United States)

    2011-01-27

    Wg ISPR Blood Pgm QA JTAC Stan/Eval Formal Joint Comm AAAHC SCI Security Pgm Review Pathologists WII Ed & Dev Inter vent. Servi ces FDA Pubs...his/her tour  Balanced mix of scheduled & no-notice inspections  Units will be inspected for Readiness and Compliance every 24 months  Readiness...a whole  IG Team Chiefs drive team effectiveness, are the most visible direct representatives of MAJCOM CCs & should be selected by CIP or a board

  8. Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Ryan, Michael J; Smith, Philip; Mahamud, Abdirahman; Farag, Noha; Haithami, Salah; Sharaf, Magdi; Jorba, Jaume C; Ehrhardt, Derek

    2017-03-03

    As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs). † Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.

  9. Risk factors for post-polio syndrome among an Italian population: a case-control study.

    Science.gov (United States)

    Bertolasi, Laura; Acler, Michele; dall'Ora, Elisa; Gajofatto, Alberto; Frasson, Emma; Tocco, Pierluigi; Turri, Mara; Ferlisi, Monica; Fiorini, Michele; Pimazzoni, Fabiana; Squintani, Giovanna; Martini, Millo; Danzi, Bruno; Monaco, Salvatore

    2012-12-01

    Post-polio syndrome (PPS) is a clinical syndrome of new weakness, fatigue and musculoskeletal pain occurring in a variable proportion of polio survivors decades after acute disease. To date, several risk factors for PPS development have been reported, although the etiology of this disorder remains elusive. Using a case-control design, we aimed to assess risk indicators for PPS in a group of Italian polio survivors. Subjects with prior poliomyelitis attending the rehabilitation hospital of Malcesine, Italy, were the target population. Patients with PPS, diagnosed according to the European Federation of Neurological Societies criteria, served as cases, while patients not meeting diagnostic criteria for PPS were used as controls. All subjects were assessed through a structured questionnaire made of 82 questions and neurological examination. The association with investigated risk factors (sex, age at polio onset, age at onset of symptoms, extension and severity of polio, employment) was analyzed by the calculation of the odds ratio. A total of 161 out of 391 eligible patients met the adopted diagnostic criteria for PPS, giving a frequency of 41.2%. Symptoms most frequently complained by PPS patients were loss of muscle strength, loss of resistance, loss of muscle volume and generalized fatigue. Female gender, the presence of respiratory disturbance during the acute phase of polio and the use of orthoses and aids during the recovery and stabilization represented independent risk factors for PPS in the studied population.

  10. Exceptional Financial Support for Introduction of Inactivated Polio Vaccine in Middle-Income Countries.

    Science.gov (United States)

    Blankenhorn, Anne-Line; Cernuschi, Tania; Zaffran, Michel J

    2017-07-01

    In May 2012, the World Health Assembly declared the completion of poliovirus eradication a programmatic emergency for global public health and called for a comprehensive polio endgame strategy. The Polio Eradication and Endgame Strategic Plan 2013-2018 was developed in response to this call and demands that all countries using Oral Polio Vaccine (OPV) only introduce at least 1 dose of Inactivated Polio Vaccine (IPV) into routine immunization schedules by the end of 2015. In November 2013, the Board of Gavi (the Vaccine Alliance) approved the provision of support for IPV introduction in the 72 Gavi-eligible countries. Following analytical work and stakeholder consultations, the IPV Immunization Systems Management Group (IMG) presented a proposal to provide exceptional financial support for IPV introduction to additional OPV-only using countries not eligible for Gavi support and that would otherwise not be able to mobilize the necessary financial resources within the Polio Eradication and Endgame Strategic Plan timelines. In June 2014, the Polio Oversight Board (POB) agreed to make available a maximum envelope of US $45 million toward supporting countries not eligible for Gavi funding. This article describes the design of the funding mechanism that was developed, its implementation and the lessons learned through this process. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  11. [Oral polio vaccine in infants does not interfere in detection of enterovirus in blood].

    Science.gov (United States)

    González, Marcela; Sandoval, Carmen; Valenzuela, Patricia; Montecinos, Luisa; Martínez, Constanza; Godoy, Paula; Abarca, Katia

    2013-12-01

    There is not known if a viraemia post-oral polio vaccine (OPV) is detectable by modern molecular techniques. Such viraemia could affect the performance of the real time-polymerase chain reaction (PCR) for non polio enterovirus (EV) detection, technique of growing clinical use for the study of febrile infants. To determine viraemia post-first dose of OPV in healthy infants, by molecular techniques. 50 infants less than three months without previous VPO were randomized in 5 groups: a control group with pre-vaccination blood sample (BS), group 1 BS at day 2, group 2 BS at day 4, group 3, BS at day 6 and group 4, BS at day 8 post-vaccination. Conventional and specific PCR for poliovirus and real time PCR for non polio EV were performed in BS and in OPV samples. No genetic material of poliovirus was detected in any infant, while in 9 of them (18%) non polio EV was identified. Real time PCR for EV did not amplify poliovirus from OPV samples. Results suggest that no post VPO viraemia detectable by molecular methods exists. Considering that real time PCR for EV does not allow to identify polio virus, no false positives of the test are expected as a result of a recent VPO vaccination. We documented presence of non polio EV in blood of healthy asymptomatic infants.

  12. Reducing resistance to polio immunisation with free health camps and Bluetooth messaging: An update from Kaduna, Northern, Nigeria.

    Science.gov (United States)

    Birukila, Gerida; Babale, Sufiyan M; Epstein, Helen; Gugong, Victor; Anger, Robert; Corkum, Melissa; Jehoshaphat Nebanat, Albarka; Musoke, Fredrick; Alabi, Olaniran

    2017-01-01

    Since 1997, the Global Polio Eradication Initiative has sponsored regular door-to-door polio immunisation campaigns in northern Nigeria. On 30 July 2015, the country was finally declared poliofree, a hard won success. At various times, polio eradication has been threatened by rumours and community tensions. For example, in 2003, local Imams, traditional leaders and politicians declared a polio campaign boycott, due to the concerns about the safety of the polio vaccine. Although the campaigns resumed in 2004, many parents continued to refuse vaccination because of the persistence of rumours of vaccine contamination, and anger about the poor state of health services for conditions other than polio. To address this, UNICEF and Nigerian Government partners piloted two interventions: (1) mobile 'health camps' to provide ambulatory care for conditions other than polio and (2) an audiovisual clip about vaccine safety and other health issues, shareable on multimedia mobile phones via Bluetooth pairing. The mobile phone survey found that Bluetooth compatible messages could rapidly spread behavioural health messages in low-literacy communities. The health camps roughly doubled polio vaccine uptake in the urban ward where it was piloted. This suggests that polio eradication would have been accelerated by improving primary health care services.

  13. The risk of type 2 oral polio vaccine use in post-cessation outbreak response.

    Science.gov (United States)

    McCarthy, Kevin A; Chabot-Couture, Guillaume; Famulare, Michael; Lyons, Hil M; Mercer, Laina D

    2017-10-04

    Wild type 2 poliovirus was last observed in 1999. The Sabin-strain oral polio vaccine type 2 (OPV2) was critical to eradication, but it is known to revert to a neurovirulent phenotype, causing vaccine-associated paralytic poliomyelitis. OPV2 is also transmissible and can establish circulating lineages, called circulating vaccine-derived polioviruses (cVDPVs), which can also cause paralytic outbreaks. Thus, in April 2016, OPV2 was removed from immunization activities worldwide. Interrupting transmission of cVDPV2 lineages that survive cessation will require OPV2 in outbreak response, which risks seeding new cVDPVs. This potential cascade of outbreak responses seeding VDPVs, necessitating further outbreak responses, presents a critical risk to the OPV2 cessation effort. The EMOD individual-based disease transmission model was used to investigate OPV2 use in outbreak response post-cessation in West African populations. A hypothetical outbreak response in northwest Nigeria is modeled, and a cVDPV2 lineage is considered established if the Sabin strain escapes the response region and continues circulating 9 months post-response. The probability of this event was investigated in a variety of possible scenarios. Under a broad range of scenarios, the probability that widespread OPV2 use in outbreak response (~2 million doses) establishes new cVDPV2 lineages in this model may exceed 50% as soon as 18 months or as late as 4 years post-cessation. The risk of a cycle in which outbreak responses seed new cVDPV2 lineages suggests that OPV2 use should be managed carefully as time from cessation increases. It is unclear whether this risk can be mitigated in the long term, as mucosal immunity against type 2 poliovirus declines globally. Therefore, current programmatic strategies should aim to minimize the possibility that continued OPV2 use will be necessary in future years: conducting rapid and aggressive outbreak responses where cVDPV2 lineages are discovered, maintaining high

  14. Minding Rachlin's Eliminative Materialism

    Science.gov (United States)

    McDowell, J. J.

    2012-01-01

    Rachlin's teleological behaviorism eliminates the first-person ontology of conscious experience by identifying mental states with extended patterns of behavior, and thereby maintains the materialist ontology of science. An alternate view, informed by brain-based and externalist philosophies of mind, is shown also to maintain the materialist…

  15. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

    Science.gov (United States)

    Voorn, Eric L; Koopman, Fieke S; Brehm, Merel A; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H L; Nollet, Frans

    2016-01-01

    To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22) or usual care (n = 22). Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve). The attendance rate was high (median 89%). None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT) most of the time. Muscle function did not improve in the exercise group. Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead. Netherlands National Trial Register NTR1371.

  16. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Eric L Voorn

    Full Text Available To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function.A process evaluation using data from an RCT.Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22 or usual care (n = 22.Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve.The attendance rate was high (median 89%. None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT most of the time. Muscle function did not improve in the exercise group.Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead.Netherlands National Trial Register NTR1371.

  17. Cut elimination in multifocused linear logic

    DEFF Research Database (Denmark)

    Guenot, Nicolas; Brock-Nannestad, Taus

    2015-01-01

    We study cut elimination for a multifocused variant of full linear logic in the sequent calculus. The multifocused normal form of proofs yields problems that do not appear in a standard focused system, related to the constraints in grouping rule instances in focusing phases. We show that cut...... elimination can be performed in a sensible way even though the proof requires some specific lemmas to deal with multifocusing phases, and discuss the difficulties arising with cut elimination when considering normal forms of proofs in linear logic....

  18. The critical role of acute flaccid paralysis surveillance in the Global Polio Eradication Initiative.

    Science.gov (United States)

    Tangermann, Rudolf H; Lamoureux, Christine; Tallis, Graham; Goel, Ajay

    2017-05-01

    Acute flaccid paralysis (AFP) surveillance is a key strategy used by the Global Polio Eradication Initiative (GPEI) to measure progress towards reaching the global eradication goal. Supported by a global polio laboratory network, AFP surveillance is conducted in 179 of 194 WHO member states. Active surveillance visits to priority health facilities are used to assure all children <15 years with AFP are detected, followed by stool specimen collection and testing for poliovirus in WHO-accredited polio laboratories. The quality of AFP surveillance is regularly monitored with standardized surveillance quality indicators. In highest risk countries and areas, the sensitivity of AFP surveillance is enhanced by environmental surveillance (testing of sewage samples). Genetic sequencing of detected poliovirus isolates yields programmatically important information on polio transmission pathways. AFP surveillance is one of the most valuable assets of the GPEI, with the potential to serve as a platform to build integrated disease surveillance systems. Continued support to maintain AFP surveillance systems will be essential, to reliably monitor the completion of global polio eradication, and to assure that a key resource for building surveillance capacity is transitioned post-eradication to support other health priorities. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Impact of pain on quality of life in patients with post-polio syndrome.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2013-02-01

    Post-polio syndrome is a neurological disorder occurring several years after an acute polio infection. The main symptoms are increased muscular weakness and atrophy, fatigue and pain. Pain is present more often in younger individuals and in females and, according to the visual analogue scale (VAS), the intensity of pain is relatively high. The aim of the present study was to analyse the impact of pain on quality of life in patients with post-polio syndrome. Transversal study. Patients with post-polio syndrome underwent a thorough neurological and general examination. They were interviewed about the presence and intensity of pain during the previous 3 months, then completed the quality of life inventory Short-Form 36 (SF-36), which included questions about pain during the previous 4 weeks, and rated their pain intensity during the previous 24 h according to the VAS. Seventy-seven of the patients (68%) experienced pain at the examination. Pain was found to have a significant impact on the SF-36 subdomains Vitality and General health. A correlation was found between pain during the previous 3 months, the previous 4 weeks, and the previous 24 h. Pain is common in patients with post-polio syndrome. Although patients have a high mean VAS score the pain only affects quality of life for Vitality and General Health, but not for other physical and mental domains.

  20. [Socio-medical profile of post-polio syndrome patients in center east of Tunisia].

    Science.gov (United States)

    Zorgati, Asma; Maaref, Khaled; Naouar, Nader; Zaoui, Afif; Ghannouchi, Slaheddine

    2014-01-01

    The diagnosis of the post polio syndrome is purely clinic. It occurs few decade after poliomyelitis. It associates recent appearance or progressive worsening of muscular weakness, pain, muscular fatigue or atrophy. It remains not recognized in Tunisia. of our study is to identify the socio-medical profile of the postpolio population in the Tunisian east central region through a check of the risk factors and the clinical characteristics of these patients. Descriptive study analyzing 32 files (medical expertise) of post polio syndrome patients The risk factors of post polio syndrome such us female gender, obesity, low educational level, early age of poliomyelitis appearance and the importance of physical effort at work, were observed in our study and are in agreement with the literature data. Average delay of post polio syndrome occurrence was 40 years. Most Disturbing symptom was the muscular pain. All our patients indicated negative impact on their everyday life and their work. They all asked for their right for incapacity or long-term disease beside the National health insurance fund (CNAM). Recognition of patients affected by the Post polio syndrome and their social and medical needs are necessary.

  1. Polio Patients in Northern Italy, a 50 Year Follow-up.

    Science.gov (United States)

    Bertolasi, L; Danese, A; Monaco, S; Turri, M; Borg, K; Werhagen, L

    2016-01-01

    Poliomyelitis was before the immunization an important medical problem. Nowadays polio prior patients (PP) suffer from polio sequelae or have developed post-polio-syndrome (PPS) with increasing paresis, pain and fatigue. To analyze the medical situation 50 years after acute polio. The degree of paresis was compared between the recovery 1952-1961 and 2012.The prevalence of patients fulfilling the criteria for PPS was estimated. The study was performed in Italy. Included were PP with rehabilitation after acute polio 1952-1961 and in 2012. During the years PP underwent yearly evaluation. A thorough neurological examination was performed in 2012. A telephone interview with questions concerning pain, paresis, fatigue, walking aids and concomitant diseases was performed in 2012. The patients were divided in two groups, if they fulfilled the criteria for PPS or not. Included were 67(94%) patients receiving rehabilitation after acute poliomyelitis and 2012. 78% were walkers, half of the PPS used wheelchair. Eight out of ten suffered from pain. Four out of ten fulfilled the PPS criteria. Pain was slightly more common in PPS. Female gender, fatigue and wheelchair dependency were significantly more common in PPS while pain was common in both groups.

  2. Effect of intravenous immunoglobulin on pain in patients with post-polio syndrome.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2011-11-01

    Pain is a common symptom that affects quality of life in patients with post-polio syndrome. An increase in cytokine in the cerebrospinal fluid suggests that inflammation is pathophysiologically important in post-polio syndrome. Intravenous immunoglobulin might therefore be a therapeutic option. The aim of this study was to analyse the effect of intravenous immunoglobulin treatment on pain in post-polio syndrome. An uncontrolled clinical study. Patients with post-polio syndrome and pain (n = 45) underwent a neurological examination and were interviewed about pain before and 6 months after treatment with intravenous immunoglobulin. Pain intensity was measured on a visual analogue scale. The pain was classified according to the International Association for the Study of Pain criteria as neuropathic when it occurred in an area with decreased sensibility, or nociceptive when signs of inflammation and/or painful joints movements were present. After treatment 31/45 (69%) patients were improved, with a mean visual analogue scale decrease from 53 to 42 (p = 0.001). Eighteen patients (40%) had a decrease of 20 or more points on the visual analogue scale. The effect of treatment did not differ regarding age, gender and severity of disability. Two-thirds of 45 patients with post-polio syndrome and pain reported a decrease on the visual analogue scale for pain after treatment with intravenous immunoglobulin, and 40% reported a decrease of 20 or more points on the visual analogue scale.

  3. Factors Associated with Reduced Quality of Life in Polio Survivors in Korea.

    Science.gov (United States)

    Yang, Eun Joo; Lee, Seung Yeol; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2015-01-01

    The purpose of this study is to assess health-related quality of life in polio survivors (PS) compared with that in the general population in Korea. Polio survivors (n = 120) from outpatient clinics at two hospitals, healthy controls (HC, n = 121) and members of the general population with activity limitations (AL, n = 121) recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions). The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI) and Short Physical Performance Battery (SPPB) were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.

  4. Factors Associated with Reduced Quality of Life in Polio Survivors in Korea.

    Directory of Open Access Journals (Sweden)

    Eun Joo Yang

    Full Text Available The purpose of this study is to assess health-related quality of life in polio survivors (PS compared with that in the general population in Korea. Polio survivors (n = 120 from outpatient clinics at two hospitals, healthy controls (HC, n = 121 and members of the general population with activity limitations (AL, n = 121 recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions. The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI and Short Physical Performance Battery (SPPB were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.

  5. Wild and vaccine-derived poliovirus circulation, and implications for polio eradication.

    Science.gov (United States)

    Lopalco, P L

    2017-02-01

    Polio cases due to wild virus are reported by only three countries in the world. Poliovirus type 2 has been globally eradicated and the last detection of poliovirus type 3 dates to November 2012. Poliovirus type 1 remains the only circulating wild strain; between January and September 2016 it caused 26 cases (nine in Afghanistan, 14 in Pakistan, three in Nigeria). The use of oral polio vaccine (OPV) has been the key to success in the eradication effort. However, paradoxically, moving towards global polio eradication, the burden caused by vaccine-derived polioviruses (VDPVs) becomes increasingly important. In this paper circulation of both wild virus and VDPVs is reviewed and implications for the polio eradication endgame are discussed. Between April and May 2016 OPV2 cessation has been implemented globally, in a coordinated switch from trivalent OPV to bivalent OPV. In order to decrease the risk for cVDPV2 re-emergence inactivated polio vaccine (IPV) has been introduced in the routine vaccine schedule of all countries. The likelihood of re-emergence of cVDPVs should markedly decrease with time after OPV cessation, but silent circulation of polioviruses cannot be ruled out even a long time after cessation. For this reason, immunity levels against polioviruses should be kept as high as possible in the population by the use of IPV, and both clinical and environmental surveillance should be maintained at a high level.

  6. Currents issues in cardiorespiratory care of patients with post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Marco Orsini

    2016-07-01

    Full Text Available ABSTRACT Post-polio syndrome (PPS is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

  7. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    2012-11-26

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.  Created: 11/26/2012 by Division of HIV/AIDS Prevention.   Date Released: 11/26/2012.

  8. Polio and Nobel prizes: looking back 50 years.

    Science.gov (United States)

    Norrby, Erling; Prusiner, Stanley B

    2007-05-01

    In 1954, John Enders, Thomas Weller, and Frederick Robbins were awarded the Nobel Prize in Physiology or Medicine "for their discovery of the ability of poliomyelitis viruses to grow in cultures of various types of tissue."5370 This discovery provided for the first time opportunities to produce both inactivated and live polio vaccines. By searching previously sealed Nobel Committee archives, we were able to review the deliberations that led to the award. It appears that Sven Gard, who was Professor of Virus Research at the Karolinska Institute and an adjunct member of the Nobel Committee at the time, played a major role in the events leading to the awarding of the Prize. It appears that Gard persuaded the College of Teachers at the Institute to decide not to follow the recommendation by their Nobel Committee to give the Prize to Vincent du Vigneaud. Another peculiar feature of the 1954 Prize is that Weller and Robbins were included based on only two nominations submitted for the first time that year. In his speech at the Nobel Prize ceremony, Gard mentioned the importance of the discovery for the future production of vaccines, but emphasized the implications of this work for growing many different, medically important viruses. We can only speculate on why later nominations highlighting the contributions of scientists such as Jonas Salk, Hilary Koprowski, and Albert Sabin in the development of poliovirus vaccines have not been recognized by a Nobel Prize.

  9. The polio eradication effort has been a great success--let's finish it and replace it with something even better.

    NARCIS (Netherlands)

    Kimman, Tjeerd G; Boot, Hein J

    2006-01-01

    The polio eradication campaign has greatly reduced the effects of this disease, but many new challenges have emerged. These challenges include the occurrence of polio outbreaks caused by wild-type polioviruses or circulating vaccine-derived polioviruses (cVDPVs) in areas where vaccination coverage

  10. Modelling Risk to US Military Populations from Stopping Blanket Mandatory Polio Vaccination (Open Access Publisher’s Version)

    Science.gov (United States)

    2017-09-14

    Research Article Modelling Risk to US Military Populations from Stopping Blanket Mandatory Polio Vaccination Colleen Burgess,1,2 Andrew Burgess,2 and...routinely vaccinated with inactivated poliovirus vaccine (IPV), supplemented based upon deployment circumstances. Given residual protection from...childhood vaccination , risk-based vaccination may sufficiently protect troops from polio transmission. Methods.This analysis employed a mathematical system

  11. EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force

    NARCIS (Netherlands)

    Farbu, E.; Gilhus, N. E.; Barnes, M. P.; Borg, K.; de Visser, M.; Driessen, A.; Howard, R.; Nollet, F.; Opara, J.; Stalberg, E.

    2006-01-01

    Post-polio syndrome (PPS) is characterized by new or increased muscular weakness, atrophy, muscle pain and fatigue several years after acute polio. The aim of the article is to prepare diagnostic criteria for PPS, and to evaluate the existing evidence for therapeutic interventions. The Medline,

  12. Polio eradication efforts in regions of geopolitical strife: the Boko Haram threat to efforts in sub-Saharan Africa.

    Science.gov (United States)

    Bigna, Jean Joel R

    2016-06-01

    The World Health Organization aims to eradicate wild poliovirus worldwide by the end of 2018. Cameroon and Nigeria, neighboring countries, have been affected by the terrorist and militant activities of the Islamist sect Boko Haram. Impacted regions are mainly the far North of Cameroon and Northern Nigeria. Targets of Boko Haram aggression in these zones include violence against polio workers, disruption of polio immunization campaigns, with consequent reduced access to health care and immunization. In addition to this significant problem, Northern Nigeria has historically seen rejection of polio virus vaccine initiatives. It remains to know how health systems can continue operations against polio in areas where Boko Haram operates. If appropriate measures are not urgently taken, it will be not possible to meet the 2018 goal of polio virus eradication. The response should include specialized immunization activities in conflict zones, will engagement of leaders. Countries should also explore immunization activities by soldiers and military personnel.

  13. Life purpose: effect on functional decline and quality of life in polio survivors.

    Science.gov (United States)

    Harrison, Tracie C; Stuifbergen, Alexa K

    2006-01-01

    This article explores the protective effects that finding a purpose in life has on the level of physical and mental impairment and overall quality of life. Results were gathered from a national sample of 2,153 polio survivors. Although the combined social and physical experience of living with the disabling effects of polio has been associated with accelerated aging due to an increased allostatic load, finding a purpose in life may diminish these effects. The findings of this study indicate that purpose in life is associated with less perceived decline in health. Moreover, purpose in life is predictive of better quality of life despite levels of physical and mental impairment. Rehabilitation nurses should consider ways to help persons with polio maintain activities and interests that promote their sense of purpose in life.

  14. The Perception of Physical Activity in Ambulatory Persons with Late Effects of Polio: A Qualitative Study.

    Science.gov (United States)

    Winberg, Cecilia; Carlsson, Gunilla; Brogårdh, Christina; Lexell, Jan

    2017-01-01

    Maintaining regular physical activity (PA) can be challenging for persons with late effects of polio. This qualitative study of ambulatory persons with late effects of polio explored their perceptions of PA, as well as facilitators of and barriers to PA. Semistructured interviews were conducted with 15 persons and analyzed with content analysis using the International Classification of Functioning, Disability and Health (ICF) as a framework. The participants described positive perceptions of PA and its health benefits. PA was used to prevent further decline in functioning, and the type and frequency of activities had changed over time. Past experiences and personal characteristics impacted PA. Support from close relatives, knowledgeable health care professionals, mobility devices, and accessible environments facilitated PA, whereas impairments, inaccessible environments, and cold weather were the main barriers. To perform PA regularly, persons with late effects of polio may benefit from individualized advice based on their disability and personal and environmental factors.

  15. A Cross-Sectional Survey of Healthcare Workers on the Knowledge and Attitudes towards Polio Vaccination in Pakistan.

    Directory of Open Access Journals (Sweden)

    Muhammad Umair Khan

    Full Text Available Pakistan accounts for 85.2% of the total polio cases reported worldwide. Healthcare workers (HCWs are an integral part of immunization campaigns and source of education for the general public. This study aimed to assess the knowledge and attitudes towards polio vaccination among HCWs providing immunisation and education to general public in Quetta and Peshawar divisions of Pakistan.A cross-sectional survey of 490 HCWs was conducted in two major referral public teaching hospitals of Quetta and Peshawar divisions. During February to April, 2015, a random sample of 490 HCWs was invited to participate in this study. Knowledge and attitudes were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and logistic regression analyses were used to express the results.A total of 468 participants responded to the questionnaire, giving a response rate of 95.5%. Overall, participants demonstrated good knowledge and positive attitudes towards polio vaccination. The mean knowledge score of HCWs about polio was 13.42 ± 2.39 (based on 18 knowledge questions while the mean attitude score was 28.75 ± 5.5 (based on 9 attitudes statements. Knowledge gaps were identified about the incubation period of poliovirus (19.5%, management issues (31.9%, use of polio vaccine in mild illnesses (34.7% and the consequences of the polio virus (36.9%. The majority of participants agreed that all children should be vaccinated for polio (95.1%, while reservations were noted about the need of a booster (38.9%, and sterility issues associated with polio vaccines (43.6%. Internet (n = 167, 37% and Posters (n = 158, 35% were the main sources used by HCWs to educate themselves about polio.Participants in this study had good knowledge and positive attitudes towards polio vaccination. Although the data are indicative of gaps in the knowledge of HCWs, the findings may not be generalized to other hospitals in Pakistan.

  16. Polio Eradication Initiative contribution in strengthening immunization and integrated disease surveillance data management in WHO African region, 2014.

    Science.gov (United States)

    Poy, Alain; Minkoulou, Etienne; Shaba, Keith; Yahaya, Ali; Gaturuku, Peter; Dadja, Landoh; Okeibunor, Joseph; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The PEI Programme in the WHO African region invested in recruitment of qualified staff in data management, developing data management system and standards operating systems since the revamp of the Polio Eradication Initiative in 1997 to cater for data management support needs in the Region. This support went beyond polio and was expanded to routine immunization and integrated surveillance of priority diseases. But the impact of the polio data management support to other programmes such as routine immunization and disease surveillance has not yet been fully documented. This is what this article seeks to demonstrate. We reviewed how Polio data management area of work evolved progressively along with the expansion of the data management team capacity and the evolution of the data management systems from initiation of the AFP case-based to routine immunization, other case based disease surveillance and Supplementary immunization activities. IDSR has improved the data availability with support from IST Polio funded data managers who were collecting them from countries. The data management system developed by the polio team was used by countries to record information related to not only polio SIAs but also for other interventions. From the time when routine immunization data started to be part of polio data management team responsibility, the number of reports received went from around 4000 the first year (2005) to >30,000 the second year and to >47,000 in 2014. Polio data management has helped to improve the overall VPD, IDSR and routine data management as well as emergency response in the Region. As we approach the polio end game, the African Region would benefit in using the already set infrastructure for other public health initiative in the Region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Elevated blood lipids are uncommon in patients with post-polio syndrome--a cross sectional study.

    Science.gov (United States)

    Melin, Eva; Kahan, Thomas; Borg, Kristian

    2015-04-29

    The post-polio syndrome occurs in people who previously have had poliomyelitis. After the initial recovery, new or increasing neurologic symptoms occur. Inflammation and dyslipidaemia may play an important role in the development of atherosclerotic complications, for example myocardial infarction and angina pectoris. Previous studies on cardiovascular risk factors in the post-polio syndrome have found a higher prevalence of hypertension, ischemic heart disease, hyperlipidaemia, and stroke in these patients. The present study was undertaken in order to evaluate whether post-polio patients have elevated lipid values, and if blood lipid abnormalities could be correlated to signs of inflammation. Cross-sectional study of 89 consecutive post-polio patients, (53 women, mean age 65 years) from the Post-Polio Outpatient Clinic, Danderyd University Hospital, Stockholm, Sweden. The lipid profiles of post-polio patients were compared to age and sex matched reference values from two earlier studies. Statistical analyses were performed by the Student's t-test, and linear regression analyses were assessed by Pearson's correlation coefficient. Mean total cholesterol levels (5.7 mmol/L) were low or normal in post-polio patients, whereas low density lipoprotein levels (3.6 mmol/L) were normal, and high density lipoprotein (1.5 mmol/L) and triglycerides (1.4 mmol/L) lower than reference values. The prevalence of diabetes (7%), hypertension (38%), concomitant cardiovascular disease, (including angina pectoris, myocardial infarction, heart failure, atrial fibrillation and stroke) (7%), and calculated 10 year risk of coronary heart disease according to Framingham risk score algorithm (8%) was not increased in post-polio patients. Compared to reference populations, post-polio patients in Sweden appear to have low or normal total cholesterol and low density lipoprotein levels, whereas high density lipoprotein and triglyceride levels are low. Hence, a possible persisting inflammatory

  18. Retrospective cost-effectiveness analyses for polio vaccination in the United States.

    Science.gov (United States)

    Thompson, Kimberly M; Tebbens, Radboud J Duintjer

    2006-12-01

    The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost-effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately US dollars 35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately US dollars 1.4 billion (1955 net present value, or US dollars 6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately US dollars 180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost-saving public health program. Observed changes in the cost-effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost-effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of

  19. Communications, Immunization, and Polio Vaccines: Lessons From a Global Perspective on Generating Political Will, Informing Decision-Making and Planning, and Engaging Local Support.

    Science.gov (United States)

    Menning, Lisa; Garg, Gaurav; Pokharel, Deepa; Thrush, Elizabeth; Farrell, Margaret; Kodio, Frederic Kunjbe; Veira, Chantal Laroche; Wanyoike, Sarah; Malik, Suleman; Patel, Manish; Rosenbauer, Oliver

    2017-07-01

    The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018-to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs-set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children's Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when

  20. Risks: diagnosing and eliminating

    Directory of Open Access Journals (Sweden)

    Yuriy A. Tikhomirov

    2016-01-01

    Full Text Available Objective to develop conceptual theoretical and legal provisions and scientific recommendations on the identification analysis and elimination of risk. Methods universal dialectic method of cognition as well as scientific and private research methods based on it. Results the system was researched of risks diagnostics in the legal sphere and mechanism of influencing the quotrisk situationsquot and their consequences damage to the environment and harm to society. The concept of risk in the legal sphere was formulated the author39s classification of risks in the legal sphere is presented. The rules of analysis evaluation and prevention of risks and the model risk management framework are elaborated. Scientific novelty the mechanism for the identification analysis and elimination of risk has been developed and introduced into scientific circulation the author has proposed the classification and types of risks the reasons and the conditions promoting the risk occurrence. Practical significance the provisions and conclusions of the article can be used in the scientific lawmaking and lawenforcement activity as well as in the educational process of higher educational establishments. nbsp

  1. Mass media effect on vaccines uptake during silent polio outbreak.

    Science.gov (United States)

    Sagy, Iftach; Novack, Victor; Gdalevich, Michael; Greenberg, Dan

    2018-03-14

    During 2013, isolation of a wild type 1 poliovirus from routine sewage sample in Israel, led to a national OPV campaign. During this period, there was a constant cover of the outbreak by the mass media. To investigate the association of media exposure and OPV and non-OPV vaccines uptake during the 2013 silent polio outbreak in Israel. We received data on daily immunization rates during the outbreak period from the Ministry of Health (MoH). We conducted a multivariable time trend analysis to assess the association between daily media exposure and vaccines uptake. Analysis was stratified by ethnicity and socio-economic status (SES). During the MoH supplemental immunization activity, 138,799 OPV vaccines were given. There was a significant association between media exposure and OPV uptake, most prominent in a lag of 3-5 days from the exposure among Jews (R.R 1.79C.I 95% 1.32-2.41) and high SES subgroups (R.R 1.71C.I 95% 1.27-2.30). These subgroups also showed increased non-OPV uptake in a lag of 3-5 days from the media exposure, in all vaccines except for MMR. Lower SES and non-Jewish subgroups did not demonstrate the same association. Our findings expand the understanding of public behaviour during outbreaks. The public response shows high variability within specific subgroups. These findings highlight the importance of tailored communication strategies for each subgroup. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Why have the majority of recent polio cases occurred in countries affected by Islamist militancy? A historical comparative analysis of the political determinants of polio in Nigeria, Somalia, Pakistan, Afghanistan and Syria.

    Science.gov (United States)

    Kennedy, Jonathan

    2016-01-01

    This article aims to understand why the last few areas where polio remains are affected by armed conflicts involving militant organizations that use Islam to legitimize their activities. The first section critically analyses the argument that Muslims' animosity towards polio vaccination programmes is a consequence of their irrational, backward, anti-Western theology. This argument is depoliticizing, ahistorical and orientalist. Moreover, it does not explain why Islamist militant groups' attitudes to polio vaccination campaigns vary between countries. The second section analyses official documents, newspaper articles, interviews and historical and ethnographic accounts to understand the relationship between Islamist militant groups and polio in five countries - Nigeria, Somalia, Pakistan, Afghanistan and Syria - that account for 95% of the world's polio cases since 2012. I demonstrate that specific political grievances related to the postcolonial state and/or foreign military intervention help to explain variations in militant groups' attitudes to polio vaccination programmes. The paper concludes by considering the policy implications of the analysis. Improved access for polio vaccinators is not predicated on military victory against the militants but securing support of de facto political leaders. This can be achieved by developing a better understanding of the specific sociopolitical contexts in which immunization programmes operate.

  3. How Drone Strikes and a Fake Vaccination Program Have Inhibited Polio Eradication in Pakistan: An Analysis of National Level Data.

    Science.gov (United States)

    Kennedy, Jonathan

    2017-10-01

    This article investigates whether the United States' counterinsurgency operations have inhibited polio eradication efforts in northwestern Pakistan, the world's last major reservoir of polio. Anecdotal evidence suggests that militants disrupt polio vaccination programs because of suspicions that campaigns are a cover for gathering intelligence on Central Intelligence Agency (CIA) drone targets. This paper analyzes national-level quantitative data to test this argument. Between 2004 and 2012, the number of polio cases in Pakistan closely mirrored the number of drone strikes. But from 2013 onward, polio cases increased while drone strikes fell. This can be explained by the CIA's use of a fake immunization campaign in a failed attempt to obtain the DNA of Osama bin Laden's relatives prior to his assassination in 2011. This seemingly vindicated militants' suspicions that vaccination programs were a cover for espionage. Militants consequently intensified their disruption of immunization campaigns, resulting in an increase in polio cases in Pakistan, as well as in Afghanistan, Syria, and Iraq. For politicians and military planners, drones are attractive because they are said to harm fewer civilians than conventional methods of warfare. However, this paper demonstrates that drone strikes had negative effects on the well-being of civilians in Pakistan and further afield because they undermined global efforts to eradicate polio.

  4. Disability and functional assessment in former polio patients with and without postpolio syndrome

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Prins, M. H.; de Visser, M.; Sargeant, A. J.; Lankhorst, G. J.; de Jong, B. A.

    1999-01-01

    OBJECTIVES: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. DESIGN: Cross-sectional survey;

  5. Does oral polio vaccine at birth affect the size of the thymus?

    DEFF Research Database (Denmark)

    Eriksen, Helle Brander; Lund, Najaaraq; Biering-Sørensen, Sofie

    2014-01-01

    BACKGROUND: There is increasing evidence that vaccines have an effect on general mortality which goes beyond specific disease protection. Oral polio vaccine (OPV) is widely used in low-income countries, but in observational studies in Guinea-Bissau we observed that not receiving OPV at birth...

  6. Gait patterns in association with underlying impairments in polio survivors with calf muscle weakness

    NARCIS (Netherlands)

    Ploeger, Hilde E.; Bus, Sicco A.; Nollet, Frans; Brehm, Merel-Anne

    2017-01-01

    The objective was to identify gait patterns in polio survivors with calf muscle weakness and associate them to underlying lower extremity impairments, which are expected to help in the search for an optimal orthosis. Unilaterally affected patients underwent barefoot 3D-gait analyses. Gait pattern

  7. Inactivated polio vaccination using a microneedle patch is immunogenic in the rhesus macaque.

    Science.gov (United States)

    Edens, Chris; Dybdahl-Sissoko, Naomi C; Weldon, William C; Oberste, M Steven; Prausnitz, Mark R

    2015-09-08

    The phased replacement of oral polio vaccine (OPV) with inactivated polio vaccine (IPV) is expected to significantly complicate mass vaccination campaigns, which are an important component of the global polio eradication endgame strategy. To simplify mass vaccination with IPV, we developed microneedle patches that are easy to administer, have a small package size, generate no sharps waste and are inexpensive to manufacture. When administered to rhesus macaques, neutralizing antibody titers were equivalent among monkeys vaccinated using microneedle patches and conventional intramuscular injection for IPV types 1 and 2. Serologic response to IPV type 3 vaccination was weaker after microneedle patch vaccination compared to intramuscular injection; however, we suspect the administered type 3 dose was lower due to a flawed pre-production IPV type 3 analytical method. IPV vaccination using microneedle patches was well tolerated by the monkeys. We conclude that IPV vaccination using a microneedle patch is immunogenic in rhesus macaques and may offer a simpler method of IPV vaccination of people to facilitate polio eradication. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Physical activity in persons with late effects of polio: a descriptive study.

    Science.gov (United States)

    Winberg, Cecilia; Flansbjer, Ulla-Britt; Carlsson, Gunilla; Rimmer, James; Lexell, Jan

    2014-07-01

    To promote a healthy and active lifestyle there is a need to increase our knowledge of the level of physical activity (PA) among people with late effects of polio. To examine PA in people with late effects of polio and to assess the relationship between PA, life satisfaction and various sociodemographic factors. PA was assessed in 81 persons with late effects of polio using the Physical Activity and Disability Survey (PADS) and by a pedometer. Life satisfaction was assessed with the Life Satisfaction Questionnaire (LiSat-11). The amount of PA varied considerably but on average the participants were physically active almost 3 h per day, mostly in household activities. The mean value of the pedometer counts was 6212 steps per day (SD = 3208). Sixty-nine percent of the participants rated themselves as satisfied with life as a whole. The sum of PADS was positively and significantly related to the number of steps (r = 0.39, p polio are physically active, but much of the activities are performed as part of their household activities and not as traditional exercise. The relationship between PA, life satisfaction and age further supports the general contention that an active lifestyle is an important factor for perceived well-being among older people. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Relationship of depression and medications on incidence of falls among people with late effects of polio.

    Science.gov (United States)

    Da Silva, Carolyn P; Zuckerman, Bianca; Olkin, Rhoda

    2017-05-01

    The purpose of this study was to determine if falls in polio survivors, with or without post-polio syndrome (PPS), are related to number of medications taken, use of anti-depressant or psychoactive medications, or self-report of depression. A survey was sent to 300 members of a regional polio support group, asking them to document their fall history, medications used, and the presence of depression. Depression was measured by self-report and with the Geriatric Depression Scale, short form (GDS-15). One hundred and seventy-two usable surveys were returned with 146 of those completing the medication list. Sixty-two percent reported at least one fall in the past year. The multiple logistic regression was significant (p = 0.023), and it indicated depression to be a significant predictor (p = 0.012) of falls in polio survivors with and without PPS. The number of total medications or anti-depressant or psychoactive medications used was not related to fall incidence. Routine screening and treatment for depression may be one aspect of fall prevention which can be implemented through primary care.

  10. Reliability of contractile properties of the knee extensor muscles in individuals with post-polio syndrome

    NARCIS (Netherlands)

    Voorn, Eric L.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Nollet, Frans; Gerrits, Karin H. L.

    2014-01-01

    To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS) and 18 age-matched healthy individuals. Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with

  11. Change in physical mobility over 10 years in post-polio syndrome

    NARCIS (Netherlands)

    Bickerstaffe, A.; Beelen, A.; Nollet, F.

    2015-01-01

    Post-polio syndrome is characterised by progressive muscle weakness and other symptoms which can limit physical mobility. We assessed the rate of decline in mobility over 10 years in relation to strength decline; and investigated potential predictors for the rate of decline of walking capacity, a

  12. Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J.; Nollet, Frans; van Dijk, Johannes P.

    2015-01-01

    We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were

  13. Disability in a 4-year follow-up study of people with post-polio syndrome.

    Science.gov (United States)

    Willén, Carin; Thorén-Jönsson, Anna-Lisa; Grimby, Gunnar; Sunnerhagen, Katharina Stibrant

    2007-03-01

    To evaluate changes over time in a clinically based cohort of individuals with post-polio syndrome. A prospective longitudinal study. A total of 106 individuals with poliomyelitis sequelae were included in the study. They were self-referred or had been referred to the post-polio clinic. After 4 years subjects were called for a follow-up and underwent the same measurements as at the initial assessment. The following measurements were conducted at both the initial assessment, and the follow-up: questionnaires including Nottingham Health Profile, muscle strength and walking speed. Minor changes in disability during a 4-year period were shown. A significant reduction in muscle strength was only seen for 60 degrees flexion in the left leg and for right and left dorsal flexion. No change could be seen in the total Nottingham Health Profile score. The minor changes in disability found in this study are an indication that we still do not know which subjects are at risk for deterioration. It is difficult to say whether the small changes over time shown in this study are associated with support from the polio clinic or are an expression of the natural history of the syndrome. However, it is hoped that support from the polio clinic may result in self-selected lifestyle changes, which may positively influence the development of symptoms and functional capacity.

  14. Fatigue resistance of the knee extensor muscles is not reduced in post-polio syndrome

    NARCIS (Netherlands)

    Voorn, E.L.; Beelen, A.; Gerrits, K.H.L.; Nollet, F.; de Haan, A.

    2013-01-01

    The present study investigated whether intrinsic fatigability of the muscle fibers is reduced in patients with post-polio syndrome (PPS). This may contribute to the muscle fatigue complaints reported by patients with PPS. For this purpose, we assessed contractile properties and fatigue resistance of

  15. Loss of motor unit size and quadriceps strength over 10 years in post-polio syndrome

    NARCIS (Netherlands)

    Bickerstaffe, A.; van Dijk, J. P.; Beelen, A.; Zwarts, M. J.; Nollet, F.

    2014-01-01

    To investigate whether strength decline in post-polio syndrome (PPS) results from excessive distal axonal degeneration of enlarged motor units. We assessed changes over 10 years in isometric quadriceps strength, mean motor unit action potential (MUAP) size, root mean squared (RMS) amplitude, and

  16. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Voorn, Eric L.; Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; de Haan, Arnold; Gerrits, Karin H. L.; Nollet, Frans

    2016-01-01

    To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS) on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function. A process evaluation using data from an RCT. Forty-four severely fatigued

  17. Studies on the potency of oral polio vaccine using RD cell line and ...

    African Journals Online (AJOL)

    Studies on the potency of oral polio vaccine using RD cell line and evaluation of growth using different serum concentration and volume of media. ... The culture flasks containing different volumes of growth medium with 10% serum concentration such as 8, 9, 10, 11 and 12 ml were added to a series of culture flasks. All the ...

  18. Oral Polio Vaccine Influences the Immune Response to BCG Vaccination. A Natural Experiment

    DEFF Research Database (Denmark)

    Sartono, E.; Lisse, I.M.; Terveer, E.M.

    2010-01-01

    Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...

  19. Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment

    DEFF Research Database (Denmark)

    Sartono, Erliyani; Lisse, Ida M; Terveer, Elisabeth M

    2010-01-01

    BACKGROUND: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...

  20. Restless legs syndrome in post-polio syndrome: a series of 10 patients with demographic, clinical and laboratorial findings.

    Science.gov (United States)

    Marin, Luis F; Carvalho, Luciane B C; Prado, Lucila B F; Quadros, Abrahao A J; Oliveira, Acary S; Prado, Gilmar F

    2011-08-01

    Few studies have described the occurrence of restless legs syndrome in post-polio syndrome. We studied 10 consecutive patients with post-polio syndrome and symptoms of restless legs syndrome. We look at demographic, clinical and laboratorial data. A remarkable finding was the concomitant onset of symptoms of both diseases, suggesting a possible underlying mechanism. Severity of restless legs symptoms was moderate to very severe. Epidemiological studies with larger samples are needed to better establish the relationship and the incidence of restless legs syndrome in post-polio syndrome. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. [Musculoskeletal symptoms in patients with post-polio syndrome].

    Science.gov (United States)

    Balzien, B; Hofner, B; Harlander-Weikert, E; Frommelt, P; Bork, H; Forst, R; Fujak, A

    2014-06-01

    The prevalence of the post-polio syndrome (PPS) is in estimated 50 % of persons with established poliomyelitis with a subsequently stable phase of at least 15 years. The basic mechanism is a loss of motoneuron cells in the spinal cord resulting in muscle weakness and fatigue. In addition pain, cold intolerance and a loss of stamina are frequently reported. There are few studies focusing on the orthopaedic symptoms in the PPS. This study should support the health-care professionals to the address the needs of PPS patients. A questionnaire was developed to collect data on patients who have been diagnosed by a neurologist as fulfilling the criteria of a PPS. It consists of two parts. In the first part, general patient data are collected. In the second part, details of health, pain, and activities of daily living are collected at two points in time: the time of the stable phase immediately after the acute phase of the disease and the phase after the PPS diagnosis. The questionnaires were sent to patients with a diagnosis of PPS. A total of 124 questionnaires were analysed (male: 45, female: 79). Parts of the data were used to calculate a score. It was hypothesised that the score would demonstrate a higher load of orthopaedic symptoms in the PPS phase. The results show that the phase after poliomyelitis (stable phase vs. PPS phase) was associated with significantly different sum score relating to the orthopaedic impairments. The score in the stable phase is on average 18.6 units lower than that in the post-PPS diagnosis phase (p < 0.001). The hypothesis that in the PPS phase the load of orthopaedic symptoms is increased is confirmed by our data. The "loss of functioning in the upper extremity" is also significantly associated with the score (p = 0.004). At the time the survey was taken, patients reveal a high level of musculoskeletal impairments and disabilities after PPS than during the stable phase with regard to general health as well as pain status and

  2. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame.

    Directory of Open Access Journals (Sweden)

    Margarita Pons-Salort

    2016-07-01

    Full Text Available Reversion and spread of vaccine-derived poliovirus (VDPV to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs. Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2 in April 2016. Supplementary immunisation activities (SIAs with trivalent OPV (tOPV in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2. Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]. We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population

  3. Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication program.

    Directory of Open Access Journals (Sweden)

    Rashid S Hussain

    Full Text Available Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.This study is limited by the manual coding of the

  4. Elimination of Constraints from Feature Trees

    NARCIS (Netherlands)

    van den Broek, P.M.; Galvao, I.; Noppen, J.A.R.

    2008-01-01

    We present an algorithm which eliminates constraints from a feature model whose feature diagram is a tree and whose constraints are "requires" or "excludes" constraints. The algorithm constructs a feature tree which has the same semantics as the original feature model. The computational complexity

  5. Eliminating Rabies in Estonia

    Science.gov (United States)

    Cliquet, Florence; Robardet, Emmanuelle; Must, Kylli; Laine, Marjana; Peik, Katrin; Picard-Meyer, Evelyne; Guiot, Anne-Laure; Niin, Enel

    2012-01-01

    The compulsory vaccination of pets, the recommended vaccination of farm animals in grazing areas and the extermination of stray animals did not succeed in eliminating rabies in Estonia because the virus was maintained in two main wildlife reservoirs, foxes and raccoon dogs. These two species became a priority target therefore in order to control rabies. Supported by the European Community, successive oral vaccination (OV) campaigns were conducted twice a year using Rabigen® SAG2 baits, beginning in autumn 2005 in North Estonia. They were then extended to the whole territory from spring 2006. Following the vaccination campaigns, the incidence of rabies cases dramatically decreased, with 266 cases in 2005, 114 in 2006, four in 2007 and three in 2008. Since March 2008, no rabies cases have been detected in Estonia other than three cases reported in summer 2009 and one case in January 2011, all in areas close to the South-Eastern border with Russia. The bait uptake was satisfactory, with tetracycline positivity rates ranging from 85% to 93% in foxes and from 82% to 88% in raccoon dogs. Immunisation rates evaluated by ELISA ranged from 34% to 55% in foxes and from 38% to 55% in raccoon dogs. The rabies situation in Estonia was compared to that of the other two Baltic States, Latvia and Lithuania. Despite regular OV campaigns conducted throughout their territory since 2006, and an improvement in the epidemiological situation, rabies has still not been eradicated in these countries. An analysis of the number of baits distributed and the funding allocated by the European Commission showed that the strategy for rabies control is more cost-effective in Estonia than in Latvia and Lithuania. PMID:22393461

  6. Gait characteristics and influence of fatigue during the 6-minute walk test in patients with post-polio syndrome.

    Science.gov (United States)

    Vreede, Katarina Skough; Henriksson, Jan; Borg, Kristian; Henriksson, Marketta

    2013-09-01

    To evaluate gait in patients with post-polio syndrome, using the 6-minute walk test (6MWT) combined with three-dimensional kinematic analysis. Descriptive study. Eighteen patients and 11 healthy controls. Kinematic data were obtained during a 6MWT by a Vicon motion capture system. Distance, heart rate, leg tiredness, dyspnoea and exertion were also recorded. Patients with post-polio syndrome showed larger increases in leg tiredness (p post-polio syndrome, and this was reflected in the kinematic data. Walking speed was negatively correlated with the increased hip flexion, but not with the ankle plantar-flexion at foot-off in the patients with post-polio syndrome. The three-dimensional results underscore the importance of hip function in this patient group.

  7. Local resistance to the global eradication of polio: newspaper coverage of the 2003-2004 vaccination stoppage in northern Nigeria.

    Science.gov (United States)

    Olufowote, James Olumide

    2011-12-01

    Successful global health initiatives are executed on the recognition that globalization involves simultaneous pulls between global unification and fragmentation. This article responds to the need for more understanding of the role of fragmentation in global health initiatives through analyses of 52 northern Nigerian newspaper reports of the 2003-2004 northern Nigerian stoppage of the Global Polio Eradication Initiative. By 2009 the stoppage had resulted in an epidemic in Nigeria and polio importations in 20 previously polio-free countries. Findings pointed to beliefs in contemporary forms of Western control and abuse through global organizations (nongovernmental organizations and for-profits), understandings of the "philanthropy" of the West and global organizations as self-serving and malevolent, and doubts about the polio vaccine product.

  8. From intense rejection to advocacy: how Muslim clerics were engaged in a polio eradication initiative in Northern Nigeria.

    Directory of Open Access Journals (Sweden)

    Sani-Gwarzo Nasir

    2014-08-01

    Full Text Available Gambo Aliyu and colleagues describe an approach to eradicating polio in Northern Nigeria by engaging Muslim clerics in influencing community perceptions. Please see later in the article for the Editors' Summary.

  9. Post-Polio Syndrome as a Model for Musculo-Tendinous Overuse Syndromes in Military and Civilian Populations

    National Research Council Canada - National Science Library

    Keenan, Mary

    1999-01-01

    .... The muscle weakness experienced by many polio survivors puts this population in a unique position to serve as an accelerated model for the same weakness-overuse-injury cycle experienced by military recruits...

  10. [Inactivated poliovirus vaccines: an inevitable choice for eliminating poliomyelitis].

    Science.gov (United States)

    Vidor, J D; Jean-Denis, Shu

    2016-12-06

    The inactivated poliovirus vaccine (IPV) is a very old tool in the fight against poliomyelitis. Though supplanted by oral poliovirus vaccine (OPV) in the 1960s and 1970s, the IPV has now become an inevitable choice because of the increasingly recognized risks associated with continuous use of OPVs. Following the pioneering work of Jonas Salk, who established key principles for the IPV, considerable experience has accumulated over the years. This work has led to modern Salk IPV-containing vaccines, based on the use of inactivated wildtype polioviruses, which have been deployed for routine use in many countries. Very good protection against paralysis is achieved with IPV through the presence of circulating antibodies able to neutralize virus infectivity toward motor neurons. In addition, with IPV, a variable degree of protection against mucosal infection (and therefore transmission) through mucosal antibodies and immune cells is achieved, depending on previous exposure of subjects to wildtype or vaccine polioviruses. The use of an IPV-followed-by-OPV sequential immunization schedule has the potential advantage of eliminating the vaccine-associated paralytic poliomyelitis (VAPP) risk, while limiting the risks of vaccine-derived poliovirus (VDPVs). Sabin strain-derived IPVs are new tools, only recently beginning to be deployed, and data are being generated to document their performance. IPVs will play an irreplaceable role in global eradication of polio.

  11. Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

    Science.gov (United States)

    Haskew, John; Kenyi, Veronica; William, Juma; Alum, Rebecca; Puri, Anu; Mostafa, Yehia; Davis, Robert

    2015-01-01

    Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting. Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district). Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting. Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall) during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place. Pre-campaign community education

  12. Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

    Directory of Open Access Journals (Sweden)

    John Haskew

    Full Text Available Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting.Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district. Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting.Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place

  13. Extracting transmission networks from phylogeographic data for epidemic and endemic diseases: Ebola virus in Sierra Leone, 2009 H1N1 pandemic influenza and polio in Nigeria.

    Science.gov (United States)

    Famulare, Michael; Hu, Hao

    2015-03-01

    Phylogeography improves our understanding of spatial epidemiology. However, application to practical problems requires choices among computational tools to balance statistical rigor, computational complexity, sensitivity to sampling strategy and interpretability. We introduce a fast, heuristic algorithm to reconstruct partially-observed transmission networks (POTN) that combines features of phylogenetic and transmission tree approaches. We compare the transmission network generated by POTN with existing algorithms (BEAST and SeqTrack), and discuss the benefits and challenges of phylogeographic analysis on examples of epidemic and endemic diseases: Ebola virus, H1N1 pandemic influenza and polio. For the 2014 Sierra Leone Ebola virus outbreak and the 2009 H1N1 outbreak, all three methods provide similarly plausible transmission histories but differ in detail. For polio in northern Nigeria, we discuss performance trade-offs between the POTN and discrete phylogeography in BEAST and conclude that spatial history reconstruction is limited by under-sampling. POTN is complementary to available tools on densely-sampled data, fails gracefully on under-sampled data and is scalable to accommodate larger datasets. We provide further evidence for the utility of phylogeography for understanding transmission networks of rapidly evolving epidemics. We propose simple heuristic criteria to identify how sampling rates and disease dynamics interact to determine fundamental limitations of phylogeographic inference. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  14. Effects of polio eradication activities on routine immunization: lessons from the 2013 outbreak response in Somali region of Ethiopia.

    Science.gov (United States)

    Tafesse, Belete; Tekle, Ephrem; Wondwossen, Liya; Bogale, Mengistu; Fiona, Braka; Nsubuga, Peter; Tomas, Karengera; Kassahun, Aron; Kathleen, Gallagher; Teka, Aschalew

    2017-01-01

    Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state. We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Somali regional state. All data and technical reports of the 15 rounds of polio SIAs from June 2013 through June 2015 and routine immunization coverages for DPT-Hib-HepB 3 and measles were observed. More than 93% of the SIAs were having administrative coverage above 95%. The trend of routine immunization for the two antigens, over the five years (2011 through 2015) did not show a consistent pattern against the number of SIAs. Documentations showed qualitative positive impacts of the SIAs strengthening the routine immunization during all courses of the campaigns. The quantitative impact of polio SIAs on routine immunization remained not so impressive in this study. Clear planning, data consistencies and completeness issues need to be cleared for the impact assessment in quantitative terms, in polio legacy planning as well as for the introduction of injectable polio vaccine through the routine immunization.

  15. Denial, Oblivion and New Fears: Poliomyelitis and the Post-Polio Syndrome in the Spanish and Portuguese Press (1995-2009

    Directory of Open Access Journals (Sweden)

    Juan Antonio Rodriguez-Sanchez

    2015-06-01

    Full Text Available Polio disappeared in the Iberian Peninsula at the end of the eighties. That promoted the disappearance in the medias agenda and the oblivion of people living with polios sequaleae. The consequence was that polio was forgotten in the public agenda. We explore the change in the social perception of polio in the Iberian Peninsula through content analysis (agenda setting and framing of four newspapers with a large circulation (the Spanish El Pais and El Mundo, and the Portuguese Jornal de Noticias and Publico, between 1995 and 2009. Polio was linked to poverty and ignorance in distant countries, susceptible to cooperation activities. It was only considered an issue when it was perceived as a threat to the West, linked to health crises or giving it a metaphorical sense. Thus, post-polio syndrome was invisible in the Portuguese case and weakly represented in Spain by the patient associations.

  16. Characterization of group B coxsackieviruses isolated from non-polio acute flaccid paralysis patients in Pakistan: vital assessment before polio eradication.

    Science.gov (United States)

    Angez, M; Shaukat, S; Zahra, R; Alam, M M; Sharif, S; Khurshid, A; Arshad, Y; Suleman, M; Mujtaba, G; Zaidi, S S Z

    2017-09-01

    Pakistan is at the verge of polio eradication but isolation of non-polio enteroviruses (NPEVs) from acute flaccid paralysis (AFP) cases may result in serious or even fatal outcome. Many enteroviruses share similar symptoms and epidemiology as is the case with poliovirus and coxsackievirus (CV). The present study was designed to genetically characterize coxsackievirus B (CV-B) serotypes isolated from non-polio acute flaccid paralytic children, as well as to understand their probable role in paralysis. A total of 63 (20·1%) out of 313 stool samples during 2013 were found positive for NPEVs in rhabdomyosarcoma cells. Only 24 (38·0%) NPEVs were typed as CV-B by microneutralization assay and were further characterized by sequencing of the viral protein 1 (VP1) gene. Molecular phylogenetic analyses classified the study strains into six coxsackievirus B serotypes (coxsackievirus B1 to B6) with their respective prototype strains with evidence of epidemiological linkage and distinct clusters. Moreover, four major differences were found within the amino acid sequences of BC-loop in VP1 of CV-B strains. In conclusion, this study presented the molecular evolutionary genetic overview and distinct phylogenetic pattern of CV-B isolates from AFP cases in Pakistan, and explored the possible link between CV-B infections and AFP cases. Furthermore, our data reveal that these viruses might contribute to the incidence of paralysis in population and there is need of time to establish an enterovirus surveillance system for better understanding of epidemiological and virological characteristics of NPEV infections associated with AFP cases in the country.

  17. Use of Dedicated Mobile Teams and Polio Volunteer Community Mobilizers to Increase Access to Zero-Dose Oral Poliovirus Vaccine and Routine Childhood Immunizations in Settlements at High Risk for Polio Transmission in Northern Nigeria.

    Science.gov (United States)

    Ongwae, Kennedy M; Bawa, Samuel B; Shuaib, Faisal; Braka, Fiona; Corkum, Melissa; Isa, Hammanyero K

    2017-07-01

    The Polio Eradication Initiative in Nigeria, which started >20 years ago, faced many challenges, including initial denial, resistance from communities, and prolonged regional safety concerns. These challenges led into the structuring of the response including the development of the National Emergency Action Plan, improved partner coordination and government engagement, and the establishment of a Polio Emergency Operations Centre. Although monthly supplementary immunization activities (SIAs) continued, the targeting of settlements at high risk for polio transmission with routine immunization (RI) and other selected primary healthcare (PHC) services using dedicated mobile teams and volunteer community mobilizers (VCMs) became a key strategy for interrupting polio transmission in the high-risk areas. These efforts could have contributed to the wild poliovirus-free 2-year period between 24 July 2014 and 11 August 2016, when 2 cases of the virus were reported from Borno State, Northern Nigeria. A narrative analysis of polio-related program and other official documents was conducted to identify the relevant human resources and their role in the Polio Eradication Initiative and in RI. The data used in the article was obtained from United Nations Children's Fund (UNICEF) and World Health Organization project reports and a draft evaluation report of the dedicated mobile teams approach in Northern Nigeria. The data from 6 of the states that commenced the provision of polio, RI, and other selected PHC services using the dedicated mobile teams approach in 2014 showed an overall increase in the percentage of children aged 12-23 months in the settlements at high risk for polio transmission with a RI card seen, from 23% to 56%, and an overall increase in fully immunized children aged 12-23 months, from 19% to 55%. The number of newborns given the first dose of oral poliovirus vaccine (OPV) according to the RI schedule and the number of children given zero-dose OPV with the

  18. Analysis of long-standing nociceptive and neuropathic pain in patients with post-polio syndrome.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2010-06-01

    The purpose of this study was to analyze pain, both nociceptive and neuropathic, in patients with post-polio syndrome (PPS) and relate the pain to age at the initial polio infection, age at examination, to gender and disability. The study was conducted in a university hospital department. Patients with PPS were interviewed at their regular visits about pain, its character, intensity and localization. A clinical examination, including a thorough neurological examination, was performed. Data included age at time of polio infection, age at time of examination and gender. Pain intensity was measured with the VAS-scale and walking capability by the WISCI-scale. One hundred sixty-three (88 women, 75 men) patients were included in the study. Pain was present in 109 (67%). Pain was more frequently reported by women (82%) than by men (49%). 96 patients experienced nociceptive pain, 10 patients both neuropathic and nociceptive pain and three experienced pure neuropathic pain. Half of the patients with pain experienced pain in more than one body region. When neuropathic pain was present, another additional neurological disorder was diagnosed. Pain was more often found in younger patients (around 70%) than in older patients (around 50%). In summary pain is common in patients with PPS and most patients experienced nociceptive pain. Women have pain more often than men. Older patients experience pain more seldom than younger patients. Age at time of primary polio infection is important for the development of pain. When neuropathic pain is present, it is important to proceed with neurological examination to find an adequate diagnosis.

  19. Effect of Multiple Simultaneous Vaccines on Polio Seroresponse and Associated Health Outcomes

    Science.gov (United States)

    2015-01-01

    including histories of devas- tating outbreaks of influenza, group A streptococcus , adenovirus, and meningococcal disease. Whether administered...with a higher proportion of polio seroconversions than the ɛ group (95% vs. 58%, respectively, p < 0.01). Analysis of the ɛ subgroup...between the roups was very similar. In particular, the baseline of ≥1:1448 was ound in 8% in the ɛ group and 7% in the >4 group . A logistic

  20. Childhood mortality after oral polio immunisation campaign in Guinea-Bissau

    DEFF Research Database (Denmark)

    Aaby, Peter; Hedegaard, Kathryn; Sodemann, Morten

    2005-01-01

    for the 6103 children less than 5 years of age in the Bandim Health Project's study area in Guinea-Bissau. Survival was ascertained through regular surveillance from March 1998 until the beginning of the war on June 7, 1998, the end of 1998, or the end of 1999, respectively. The child register was linked...... was not significant for all children under 5 years of age (mortality ratio (MR)=0.46 (0.18-1.15)). However, oral polio vaccination was associated with a beneficial effect for children under 6 months of age at the time of the campaign, the mortality ratio being 0.09 (95% CI 0.01-0.85) in the 3 months before the war.......28-0.69)) and no effect of oral polio vaccine was measurable in this age group. The effect of polio vaccine among children less than 6 months of age could be due to selection bias but might also represent a non-specific beneficial immune stimulation and there is nothing to suggest that OPV might have a negative effect...

  1. Multidimensional fatigue inventory and post-polio syndrome - a Rasch analysis.

    Science.gov (United States)

    Dencker, Anna; Sunnerhagen, Katharina S; Taft, Charles; Lundgren-Nilsson, Åsa

    2015-02-12

    Fatigue is a common symptom in post-polio syndrome (PPS) and can have a substantial impact on patients. There is a need for validated questionnaires to assess fatigue in PPS for use in clinical practice and research. The aim with this study was to assess the validity and reliability of the Swedish version of Multidimensional Fatigue Inventory (MFI-20) in patients with PPS using the Rasch model. A total of 231 patients diagnosed with PPS completed the Swedish MFI-20 questionnaire at post-polio out-patient clinics in Sweden. The mean age of participants was 62 years and 61% were females. Data were tested against assumptions of the Rasch measurement model (i.e. unidimensionality of the scale, good item fit, independency of items and absence of differential item functioning). Reliability was tested with the person separation index (PSI). A transformation of the ordinal total scale scores into an interval scale for use in parametric analysis was performed. Dummy cases with minimum and maximum scoring were used for the transformation table to achieve interval scores between 20 and 100, which are comprehensive limits for the MFI-20 scale. An initial Rasch analysis of the full scale with 20 items showed misfit to the Rasch model (p post-polio syndrome. The Rasch transformed total scores can be used for parametric statistical analyses in future clinical studies.

  2. Dysphagia and dysphonia among persons with post-polio syndrome - a challenge in neurorehabilitation.

    Science.gov (United States)

    Söderholm, S; Lehtinen, A; Valtonen, K; Ylinen, A

    2010-11-01

    To study the occurrence of dysphagia and dysphonia in persons with post-polio syndrome admitted into the centre for neurological rehabilitation in Finland. Fifty-one persons with post-polio syndrome who were rehabilitated at Käpylä Rehabilitation Centre, Helsinki, Finland, in 2003-2004 were interviewed on problems with swallowing and voice production. Pulmonary function testing and grip strength measurement were performed. A clinical assessment of oral motor and laryngeal functions was carried out for those who reported daily problems with voice production or swallowing. Fifteen persons (29.4%) reported daily problems with swallowing or voice production. In the clinical assessment, the most commonly observed deficits in swallowing included decreased pharyngeal transit (n = 13) and the food catching in the throat (n = 4). The disturbance of co-ordination of breathing and voice production was seen in 12 persons. There were no significant differences in any of the potential predictors between the groups. Professionals need to be aware of the routine evaluation of dysphagia and dysphonia in patients with post-polio syndrome. Copyright © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard.

  3. Change in physical mobility over 10 years in post-polio syndrome.

    Science.gov (United States)

    Bickerstaffe, A; Beelen, A; Nollet, F

    2015-03-01

    Post-polio syndrome is characterised by progressive muscle weakness and other symptoms which can limit physical mobility. We assessed the rate of decline in mobility over 10 years in relation to strength decline; and investigated potential predictors for the rate of decline of walking capacity, a measure of mobility, in 48 patients with post-polio syndrome and proven quadriceps dysfunction at baseline. Average walking capacity and self-reported physical mobility declined over 10 years, by 6 and 14%, respectively. Concomitantly people lost an average of 15% of isometric quadriceps strength. Significantly more people used walking aids offering greater support at follow-up. Notably, there was much individual variation, with 18% of participants losing a substantial amount of walking capacity (27% decline) and concomitant self-reported physical mobility (38% decline). Loss of quadriceps strength only explained a small proportion of the variance of the decline in walking capacity (R = 11%) and the rate of decline could not be predicted from baseline values for strength, walking capacity, self-reported physical mobility or basic demographics. The individual variability, yet lack of predictive factors, underscores the need for personally tailored care based on actual functional decline in patients with post-polio syndrome. Copyright © 2014. Published by Elsevier B.V.

  4. ROLE OF MEDICAL REHABILITATION TREATMENT IN POST-POLIO SYNDROME – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    DOGARU Gabriela

    2015-05-01

    Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation [1]. The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.

  5. Comparison of two 6-minute walk tests to assess walking capacity in polio survivors.

    Science.gov (United States)

    Brehm, Merel-Anne; Verduijn, Suzan; Bon, Jurgen; Bredt, Nicoline; Nollet, Frans

    2017-11-21

    To compare walking dynamics and test-retest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed. Observational study. Thirty-three polio survivors, able to walk ≥ 150 m. On the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed. The mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); pwalked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively. Both the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

  6. Estimating the risk of re-emergence after stopping polio vaccination

    Directory of Open Access Journals (Sweden)

    Akira eSasaki

    2012-05-01

    Full Text Available Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactive polio vaccine (IPV is extensively used after the termination of live vaccination.

  7. 10 CFR 61.21 - Elimination of repetition.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Elimination of repetition. 61.21 Section 61.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.21 Elimination of repetition. In its application, the applicant may incorporate by reference...

  8. Remediation Technologies Eliminate Contaminants

    Science.gov (United States)

    2012-01-01

    groundwater tainted by chlorinated solvents once used to clean rocket engine components. The award-winning innovation (Spinoff 2010) is now NASA s most licensed technology to date. PCBs in paint presented a new challenge. Removing the launch stand for recycling proved a difficult operation; the toxic paint had to be fully stripped from the steel structure, a lengthy and costly process that required the stripped paint to be treated before disposal. Noting the lack of efficient, environmentally friendly options for dealing with PCBs, Quinn and her colleagues developed the Activated Metal Treatment System (AMTS). AMTS is a paste consisting of a solvent solution containing microscale particles of activated zero-valent metal. When applied to a painted surface, the paste extracts and degrades the PCBs into benign byproducts while leaving the paint on the structure. This provides a superior alternative to other methods for PCB remediation, such as stripping the paint or incinerating the structure, which prevents reuse and can release volatized PCBs into the air. Since its development, AMTS has proven to be a valuable solution for removing PCBs from paint, caulking, and various insulation and filler materials in older buildings, naval ships, and former munitions facilities where the presence of PCBs interferes with methods for removing trace explosive materials. Miles of potentially toxic caulking join sections of runways at airports. Any of these materials installed before 1979 potentially contain PCBs, Quinn says. "This is not just a NASA problem," she says. "It s a global problem."

  9. Defense Logistics Agency Revenue Eliminations

    National Research Council Canada - National Science Library

    1996-01-01

    The issue of revenue eliminations was identified during our work on the Defense Logistics Agency portion of the Audit of Revenue Accounts in the FY 1996 Financial Statements of the Defense Business Operations Fund...

  10. Proportional counter end effects eliminator

    International Nuclear Information System (INIS)

    Meekins, J.F.

    1976-01-01

    An improved gas-filled proportional counter which includes a resistor network connected between the anode and cathode at the ends of the counter in order to eliminate ''end effects'' is described. 3 Claims, 2 Drawing Figures

  11. Elimination of Onchocerciasis from Mexico

    Science.gov (United States)

    Rodríguez-Pérez, Mario A.; Fernández-Santos, Nadia A.; Orozco-Algarra, María E.; Rodríguez-Atanacio, José A.; Domínguez-Vázquez, Alfredo; Rodríguez-Morales, Kristel B.; Real-Najarro, Olga; Prado-Velasco, Francisco G.; Cupp, Eddie W.; Richards, Frank O.; Hassan, Hassan K.; González-Roldán, Jesús F.; Kuri-Morales, Pablo A.; Unnasch, Thomas R.

    2015-01-01

    Background Mexico is one of the six countries formerly endemic for onchocerciasis in Latin America. Transmission has been interrupted in the three endemic foci of that country and mass drug distribution has ceased. Three years after mass drug distribution ended, post-treatment surveillance (PTS) surveys were undertaken which employed entomological indicators to check for transmission recrudescence. Methodology/Principal findings In-depth entomologic assessments were performed in 18 communities in the three endemic foci of Mexico. None of the 108,212 Simulium ochraceum s.l. collected from the three foci were found to contain parasite DNA when tested by polymerase chain reaction-enzyme-linked immunosorbent assay (PCR-ELISA), resulting in a maximum upper bound of the 95% confidence interval (95%-ULCI) of the infective rate in the vectors of 0.035/2,000 flies examined. This is an order of magnitude below the threshold of a 95%-ULCI of less than one infective fly per 2,000 flies tested, the current entomological criterion for interruption of transmission developed by the international community. The point estimate of seasonal transmission potential (STP) was zero, and the upper bound of the 95% confidence interval for the STP ranged from 1.2 to 1.7 L3/person/season in the different foci. This value is below all previous estimates for the minimum transmission potential required to maintain the parasite population. Conclusions/Significance The results from the in-depth entomological post treatment surveillance surveys strongly suggest that transmission has not resumed in the three foci of Mexico during the three years since the last distribution of ivermectin occurred; it was concluded that transmission remains undetectable without intervention, and Onchocerca volvulus has been eliminated from Mexico. PMID:26161558

  12. Elimination of Onchocerciasis from Mexico.

    Directory of Open Access Journals (Sweden)

    Mario A Rodríguez-Pérez

    Full Text Available Mexico is one of the six countries formerly endemic for onchocerciasis in Latin America. Transmission has been interrupted in the three endemic foci of that country and mass drug distribution has ceased. Three years after mass drug distribution ended, post-treatment surveillance (PTS surveys were undertaken which employed entomological indicators to check for transmission recrudescence.In-depth entomologic assessments were performed in 18 communities in the three endemic foci of Mexico. None of the 108,212 Simulium ochraceum s.l. collected from the three foci were found to contain parasite DNA when tested by polymerase chain reaction-enzyme-linked immunosorbent assay (PCR-ELISA, resulting in a maximum upper bound of the 95% confidence interval (95%-ULCI of the infective rate in the vectors of 0.035/2,000 flies examined. This is an order of magnitude below the threshold of a 95%-ULCI of less than one infective fly per 2,000 flies tested, the current entomological criterion for interruption of transmission developed by the international community. The point estimate of seasonal transmission potential (STP was zero, and the upper bound of the 95% confidence interval for the STP ranged from 1.2 to 1.7 L3/person/season in the different foci. This value is below all previous estimates for the minimum transmission potential required to maintain the parasite population.The results from the in-depth entomological post treatment surveillance surveys strongly suggest that transmission has not resumed in the three foci of Mexico during the three years since the last distribution of ivermectin occurred; it was concluded that transmission remains undetectable without intervention, and Onchocerca volvulus has been eliminated from Mexico.

  13. Cognitive behavioural therapy for reducing fatigue in post-polio syndrome and in facioscapulohumeral dystrophy: A comparison.

    Science.gov (United States)

    Koopman, Fieke S; Brehm, Merel A; Beelen, Anita; Voet, Nicole; Bleijenberg, Gijs; Geurts, Alexander; Nollet, Frans

    2017-07-07

    Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. To compare fatigue-related cognitions between patients with post-polio syndrome and facio-scapulohumeral dystrophy. Patients with post-polio syndrome (n = 21) and facioscapulohumeral dystrophy (n = 24) allocated to a cognitive behavioural therapy intervention in 2 identical trials. Assessed cognitions included: sense of control over fatigue; catastrophizing; acceptance; focusing on fatigue; and perceived social support. Group differences in cognitions (independent t-tests or Mann-Whitney U tests) and group differences in the association of cognitions with fatigue (linear regression models) were studied. No differences in cognitions were found between the 2 groups (p > 0.18). Furthermore, there were no cognition-by-group interaction effects, except for "perceived social support", for which a different association with fatigue was found between the 2 groups (p = 0.01). However, univariate models revealed no associations per group. Fatigue-related cognitions in severely fatigued patients with post-polio syndrome are not clearly different from that in facioscapulohumeral dystrophy. Thus, the lack of efficacy of cognitive behavioural therapy in post-polio syndrome cannot be attributed to unique cognitive characteristics of this population.

  14. Cognitive behavioural therapy for reducing fatigue in post-polio syndrome and in facioscapulohumeral dystrophy: A comparison

    Directory of Open Access Journals (Sweden)

    Fieke S. Koopman

    2017-06-01

    Full Text Available Background: Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. Objective: To compare fatigue-related cognitions between patients with post-polio syndrome and facio-scapulohumeral dystrophy. Subjects: Patients with post-polio syndrome (n = 21 and facioscapulohumeral dystrophy (n = 24 allocated to a cognitive behavioural therapy intervention in 2 identical trials. Methods: Assessed cognitions included: sense of control over fatigue; catastrophizing; acceptance; focusing on fatigue; and perceived social support. Group differences in cognitions (independent t-tests or Mann–Whitney U tests and group differences in the association of cognitions with fatigue (linear regression models were studied. Results: No differences in cognitions were found between the 2 groups (p > 0.18. Furthermore, there were no cognition-by-group interaction effects, except for “perceived social support”, for which a different association with fatigue was found between the 2 groups (p = 0.01. However, univariate models revealed no associations per group. Conclusion: Fatigue-related cognitions in severely fatigued patients with post-polio syndrome are not clearly different from that in facioscapulohumeral dystrophy. Thus, the lack of efficacy of cognitive behavioural therapy in post-polio syndrome cannot be attributed to unique cognitive characteristics of this population.

  15. Transcranial direct current stimulation (tDCS) for sleep disturbances and fatigue in patients with post-polio syndrome.

    Science.gov (United States)

    Acler, Michele; Bocci, Tommaso; Valenti, Diana; Turri, Mara; Priori, Alberto; Bertolasi, Laura

    2013-01-01

    Post-polio syndrome develops about 20-40 years after acute paralytic poliomyelitis, and manifests with progressively deteriorating muscle strength and endurance. Here, we assessed whether transcranial direct current stimulation (tDCS) improves sleep and fatigue symptoms in patients with post-polio syndrome. We enrolled 32 patients with a diagnosis of post-polio syndrome. tDCS (1.5 mA, 15 min) was delivered by a direct current stimulator connected to three electrodes: two anodal electrodes on the scalp over the right and left pre-motor cortex and the other above the left shoulder (cathode). 16 patients received anodal tDCS and the remainder sham tDCS. We evaluated changes induced by tDCS (daily for five days a week, for three weeks) on clinical scales (Short Form Health Survey [SF-36], Piper Fatigue Scale [PFS], Fatigue Severity Scale [FSS], 101-Point Numerical Rating [PNR-101], Hamilton Rating Scale for Depression [HRSD], Pittsburgh Sleep Quality Index [PSQI]) at baseline (T0) and three weeks later (T1). At T1 SF-36 sub-items physical functioning, role physical, vitality, social functioning and role emotional improved significantly more in patients who received tDCS (p post-polio syndrome. tDCS could be a non-invasive and valuable new tool for managing post-polio patients.

  16. Health promotion: From malaria control to elimination | Groepe ...

    African Journals Online (AJOL)

    Here we reflect on the achievement of some of the diverse activities that have brought malaria under control, highlight key challenges and propose specific health promotion interventions required to move South Africa's malaria programme from control to elimination.

  17. Late onset polio sequelae: disabilities and handicaps in a population-based cohort of the 1956 poliomyelitis outbreak in The Netherlands

    NARCIS (Netherlands)

    Ivanyi, B.; Nollet, F.; Redekop, W. K.; de Haan, R.; Wohlgemuht, M.; van Wijngaarden, J. K.; de Visser, M.

    1999-01-01

    OBJECTIVE: To investigate the prevalence of new neuromuscular symptoms, disabilities, and handicaps in a group of polio survivors. DESIGN: A self-constructed health questionnaire about neuromuscular complaints and disability and handicap levels during the stable period after recovery from polio and

  18. Late onset polio sequelae : Disabilities and handicaps in a population-based cohort of the 1956 poliomyelitis outbreak in The Netherlands

    NARCIS (Netherlands)

    Ivanyi, Barbara; Nollet, E; Redekop, WK; De Haan, R; Wohlgemuht, M; van Wijngaarden, JK; de Visser, Marianne

    Objective: To investigate the prevalence of new neuromuscular symptoms, disabilities, and handicaps in a group of polio survivors. Design: A self-constructed health questionnaire about neuromuscular complaints and disability and handicap levels during the stable period after recovery from polio and

  19. Measuring Physical and Cognitive Fatigue in People With Post-Polio Syndrome: Development of the Neurological Fatigue Index for Post-Polio Syndrome (NFI-PP).

    Science.gov (United States)

    Young, Carolyn A; Wong, Samantha M; Quincey, Anne-Marie C; Tennant, Alan

    2018-02-01

    Fatigue in post-polio syndrome (PPS) has been shown to affect quality of life adversely. There is currently no disease-specific measure of fatigue for PPS. To develop a scale to measure fatigue in PPS that meets rigorous psychometric standards. Qualitative followed by validation and test-retest studies. Polio clinic followed by national questionnaire studies. A total of 45 participants from polio clinic for qualitative; 319 participants from clinic or self-referral for validation study, of whom 87 completed the retest questionnaire. Draft questionnaire items on PPS fatigue were derived from transcripts of qualitative interviews. After cognitive debriefing, the draft measure was administered by mail along with comparator questionnaires to a new sample. Draft PPS fatigue measure, Fatigue Severity Scale, and visual analog scale for fatigue. Analysis of 271 of 319 (85%) questionnaires identified a 2-factor solution (RMSEA 0.058). For the physical subscale, a 20-item scale showed good fit (χ 2 P = .189), strict unidimensionality (t-test 5.17%), and reliability 0.91. For the cognitive subscale, a 7-item scale showed excellent fit (χ 2 P = .917), strict unidimensionality (t-test 5.2%), and reliability 0.89. Evidence of a "difficulty factor" emerged also supporting a total score that showed good fit (χ 2 P = .151), strict unidimensionality (t-test 0.4%), and reliability consistent with group use at 0.73. Test-retest correlations for all scales were greater than 0.85. Standard error of measurement on metric ranges was 5.4 for total, 2.9 for physical, and 1.69 for cognitive domains. With the latent estimate of the total score transformed to a 0-100 scale, the mean score was 49.5 (SD 6.9). Spearman correlations with the Fatigue Severity Scale and visual analog scale were 0.60 and 0.55, respectively. A patient-derived Neurological Fatigue Index for PPS, with physical and cognitive subscales and a total score, has demonstrated good reliability, appropriate concurrent

  20. The global cost of eliminating avoidable blindness

    Directory of Open Access Journals (Sweden)

    Kirsten L Armstrong

    2012-01-01

    Full Text Available Aims : To complete an initial estimate of the global cost of eliminating avoidable blindness, including the investment required to build ongoing primary and secondary health care systems, as well as to eliminate the ′backlog′ of avoidable blindness. This analysis also seeks to understand and articulate where key data limitations lie. Materials and Methods : Data were collected in line with a global estimation approach, including separate costing frameworks for the primary and secondary care sectors, and the treatment of backlog. Results : The global direct health cost to eliminate avoidable blindness over a 10-year period from 2011 to 2020 is estimated at $632 billion per year (2009 US$. As countries already spend $592 billion per annum on eye health, this represents additional investment of $397.8 billion over 10 years, which is $40 billion per year or $5.80 per person for each year between 2010 and 2020. This is concentrated in high-income nations, which require 68% of the investment but comprise 16% of the world′s inhabitants. For all other regions, the additional investment required is $127 billion. Conclusions : This costing estimate has identified that low- and middle-income countries require less than half the additional investment compared with high-income nations. Low- and middle-income countries comprise the greater investment proportion in secondary care whereas high-income countries require the majority of investment into the primary sector. However, there is a need to improve sector data. Investment in better data will have positive flow-on effects for the eye health sector.

  1. The global cost of eliminating avoidable blindness

    Science.gov (United States)

    Armstrong, Kirsten L; Jovic, Martin; Vo-Phuoc, Jennifer L; Thorpe, Jeremy G; Doolan, Brian L

    2012-01-01

    Aims: To complete an initial estimate of the global cost of eliminating avoidable blindness, including the investment required to build ongoing primary and secondary health care systems, as well as to eliminate the ‘backlog’ of avoidable blindness. This analysis also seeks to understand and articulate where key data limitations lie. Materials and Methods: Data were collected in line with a global estimation approach, including separate costing frameworks for the primary and secondary care sectors, and the treatment of backlog. Results: The global direct health cost to eliminate avoidable blindness over a 10-year period from 2011 to 2020 is estimated at $632 billion per year (2009 US$). As countries already spend $592 billion per annum on eye health, this represents additional investment of $397.8 billion over 10 years, which is $40 billion per year or $5.80 per person for each year between 2010 and 2020. This is concentrated in high-income nations, which require 68% of the investment but comprise 16% of the world's inhabitants. For all other regions, the additional investment required is $127 billion. Conclusions: This costing estimate has identified that low- and middle-income countries require less than half the additional investment compared with high-income nations. Low- and middle-income countries comprise the greater investment proportion in secondary care whereas high-income countries require the majority of investment into the primary sector. However, there is a need to improve sector data. Investment in better data will have positive flow-on effects for the eye health sector. PMID:22944763

  2. Elimination of salmonella from animal glandular products.

    Science.gov (United States)

    De Fiebre, C W; Burck, K T; Feldman, D

    1969-03-01

    Methods for the elimination of salmonellae from selected powdered pharmaceuticals of animal glandular origin were studied. Terminal heat treatment under carefully controlled conditions was effective for pancreatin-a powder containing proteolytic, amylolytic, and lipolytic enzymes prepared from hog pancreas glands. Use of this method resulted in a significant reduction in the number of salmonella-positive batches and also reduced the testing procedures required to confirm the absence of viable salmonellae among the majority of samples tested. Powders such as stomach substance and thyroid, in which the biological activity is not enzyme in nature, were treated successfully with acidified organic solvents. Other methods were investigated but were not suitable because of a deleterious effect on the biological activity or physical properties of the product or an inability to effect salmonella elimination.

  3. Elimination of Salmonellae from Animal Glandular Products

    Science.gov (United States)

    De Fiebre, Conrad W.; Burck, Kenneth T.; Feldman, David

    1969-01-01

    Methods for the elimination of salmonellae from selected powdered pharmaceuticals of animal glandular origin were studied. Terminal heat treatment under carefully controlled conditions was effective for pancreatin—a powder containing proteolytic, amylolytic, and lipolytic enzymes prepared from hog pancreas glands. Use of this method resulted in a significant reduction in the number of salmonella-positive batches and also reduced the testing procedures required to confirm the absence of viable salmonellae among the majority of samples tested. Powders such as stomach substance and thyroid, in which the biological activity is not enzyme in nature, were treated successfully with acidified organic solvents. Other methods were investigated but were not suitable because of a deleterious effect on the biological activity or physical properties of the product or an inability to effect salmonella elimination. PMID:5780395

  4. Muscle strength is only a weak to moderate predictor of gait performance in persons with late effects of polio.

    Science.gov (United States)

    Flansbjer, Ulla-Britt; Brogårdh, Christina; Lexell, Jan

    2013-01-01

    To assess muscle strength in the knee extensors, knee flexors and ankle dorsiflexors in persons with late effects of polio, and determine how much muscle strength, gender, age and BMI are related to gait performance. Ninety community-dwelling ambulant persons (47 men and 43 women; mean age 64 years SD 8) with late effects of polio participated. Isokinetic concentric knee extensor and flexor muscle strength was measured at 60°/s and ankle dorsiflexor muscle strength at 30°/s. Gait performance was assessed by the Timed "Up & Go", the Comfortable and Fast Gait Speed tests, and the 6-Minute Walk test. There were significant correlations between knee extensor and flexor muscle strength and gait performance (p polio, but the strength of the relationships indicates that other factors are also important.

  5. Reaching the unreached with polio vaccine and other child survival interventions through partnership with military in Angola.

    Science.gov (United States)

    Fekadu, Lemma; Okeibunor, Joseph; Nsubuga, Peter; Kipela, Jean Marie; Mkanda, Pascal; Mihigo, Richard

    2016-10-10

    Growing conflict and insecurity played a major role in precipitating polio outbreaks in the Horn of Africa and the Middle East. In Angola, the early post-conflict situation was characterized by the presence of many inaccessible zones and districts due to insecurity and poor infrastructure. Partnership with the Angolan Army health service (AAHS) was one of the innovative strategies that the Polio Eradication Initiative (PEI) introduced into the country to support the polio vaccination campaigns in insecure and hard to reach zones. Before embarking on creating a partnership with Angolan military it was essential to make high-level advocacy with top military decision makers to engage the leadership in the process for better and sustainable support to the strategy. The principal supports provided by the AAHS were the administration of oral polio vaccine, vitamin A, deworming agents, social mobilization, monitoring campaign quality, and surveillance. Distribution of logistics using military vehicles and helicopters to hard to reach and insecure zones was also part of the support. Using this partnership it was possible to reach a significant number of children in insecure and hard to reach areas with polio vaccine and other child survival interventions. The military partnership also contributed in increasing the demand and addressing rejection for the polio vaccine. Military is a potentially productive force that can be used for any development activities in any country. The Angolan experience has demonstrated that it is possible to form a partnership with the military for basic health intervention activities with little training and investment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Update on current and emerging treatment options for post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Elisabeth Farbu

    2010-07-01

    Full Text Available Elisabeth Farbu Neurocenter and National Competence Center for Movement Disorders, Stavanger University Hospital, Stavanger, NorwayAbstract: Post-polio syndrome (PPS refers to the clinical deterioration experienced by many polio survivors several decades after their acute illness. The symptoms are new muscle weakness, decreased muscle endurance, fatigue, muscle pain, joint pain, cold intolerance, and this typical clinical entity is reported from different parts of the world. The pathophysiology behind PPS is not fully understood, but a combination of distal degeneration of enlarged motor units caused by increased metabolic demands and the normal aging process, in addition to inflammatory mechanisms, are thought to be involved. There is no diagnostic test for PPS, and the diagnosis is based on a proper clinical workup where all other possible explanations for the new symptoms are ruled out. The basic principle of management of PPS lies in physical activity, individually tailored training programs, and lifestyle modification. Muscle weakness and muscle pain may be helped with specific training programs, in which training in warm water seems to be particularly helpful. Properly fitted orthoses can improve the biomechanical movement pattern and be energy-saving. Fatigue can be relieved with lifestyle changes, assistive devices, and training programs. Respiratory insufficiency can be controlled with noninvasive respiratory aids including biphasic positive pressure ventilators. Pharmacologic agents like prednisone, amantadine, pyridostigmine, and coenzyme Q10 are of no benefit in PPS. Intravenous immunoglobulin (IVIG has been tried in three studies, all having positive results. IVIG could probably be a therapeutic alternative, but the potential benefit is modest, and some important questions are still unanswered, in particular to which patients this treatment is useful, the dose, and the therapeutic interval.Keywords: polio, survivors, fatigue, aging

  7. Engineering Enhanced Vaccine Cell Lines To Eradicate Vaccine-Preventable Diseases: the Polio End Game.

    Science.gov (United States)

    van der Sanden, Sabine M G; Wu, Weilin; Dybdahl-Sissoko, Naomi; Weldon, William C; Brooks, Paula; O'Donnell, Jason; Jones, Les P; Brown, Cedric; Tompkins, S Mark; Oberste, M Steven; Karpilow, Jon; Tripp, Ralph A

    2016-02-15

    Vaccine manufacturing costs prevent a significant portion of the world's population from accessing protection from vaccine-preventable diseases. To enhance vaccine production at reduced costs, a genome-wide RNA interference (RNAi) screen was performed to identify gene knockdown events that enhanced poliovirus replication. Primary screen hits were validated in a Vero vaccine manufacturing cell line using attenuated and wild-type poliovirus strains. Multiple single and dual gene silencing events increased poliovirus titers >20-fold and >50-fold, respectively. Host gene knockdown events did not affect virus antigenicity, and clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9-mediated knockout of the top candidates dramatically improved viral vaccine strain production. Interestingly, silencing of several genes that enhanced poliovirus replication also enhanced replication of enterovirus 71, a clinically relevant virus to which vaccines are being targeted. The discovery that host gene modulation can markedly increase virus vaccine production dramatically alters mammalian cell-based vaccine manufacturing possibilities and should facilitate polio eradication using the inactivated poliovirus vaccine. Using a genome-wide RNAi screen, a collection of host virus resistance genes was identified that, upon silencing, increased poliovirus and enterovirus 71 production by from 10-fold to >50-fold in a Vero vaccine manufacturing cell line. This report provides novel insights into enterovirus-host interactions and describes an approach to developing the next generation of vaccine manufacturing through engineered vaccine cell lines. The results show that specific gene silencing and knockout events can enhance viral titers of both attenuated (Sabin strain) and wild-type polioviruses, a finding that should greatly facilitate global implementation of inactivated polio vaccine as well as further reduce costs for live-attenuated oral polio vaccines. This work

  8. Polio immunization policy in Mexico: economic assessment of current practice and future alternatives.

    Science.gov (United States)

    Mascareñas, A; Salinas, J; Tasset-Tisseau, A; Mascareñas, C; Khan, M M

    2005-06-01

    The World Health Organization recommends that all children aged less than 5 years should be vaccinated against polio through intensive immunization programmes as well as routine immunization. A national immunization week (NIW) was held in February 2002 in the Monterrey district of Mexico. A prospective micro-costing study was conducted to measure the total cost to the state of the NIW, the cost profile, and the ratio of cost per immunization contact to cost per dose of oral polio vaccine (OPV), and to compare OPV and inactive polio vaccine (IPV) in economic terms. Two scenarios were used as the basis for calculation. The cost of volunteers was excluded from the "lower-cost scenario" and included in the "upper-cost scenario". The total cost of the NIW was USD 100,454 for the lower-cost scenario and USD 156,614 for the upper-cost scenario. The major part of the costs was personnel costs (67.30 and 77.53% of the total costs in the lower- and upper-cost scenario, respectively). The ratio of cost per immunization contact to cost per dose of OPV was 6.45 for the lower-cost scenario and 10.05 for the upper-cost scenario. Changing from the current OPV-based intensive and routine schedule to a sequential IPV-OPV routine schedule would save USD 14.52 per vaccinated child, and changing to a full IPV routine schedule would save USD 9.41 per vaccinated child.

  9. Patients with Primary Immunodeficiencies Are a Reservoir of Poliovirus and a Risk to Polio Eradication

    Directory of Open Access Journals (Sweden)

    Asghar Aghamohammadi

    2017-06-01

    Full Text Available Immunodeficiency-associated vaccine-derived polioviruses (iVDPVs have been isolated from primary immunodeficiency (PID patients exposed to oral poliovirus vaccine (OPV. Patients may excrete poliovirus strains for months or years; the excreted viruses are frequently highly divergent from the parental OPV and have been shown to be as neurovirulent as wild virus. Thus, these patients represent a potential reservoir for transmission of neurovirulent polioviruses in the post-eradication era. In support of WHO recommendations to better estimate the prevalence of poliovirus excreters among PIDs and characterize genetic evolution of these strains, 635 patients including 570 with primary antibody deficiencies and 65 combined immunodeficiencies were studied from 13 OPV-using countries. Two stool samples were collected over 4 days, tested for enterovirus, and the poliovirus positive samples were sequenced. Thirteen patients (2% excreted polioviruses, most for less than 2 months following identification of infection. Five (0.8% were classified as iVDPVs (only in combined immunodeficiencies and mostly poliovirus serotype 2. Non-polio enteroviruses were detected in 30 patients (4.7%. Patients with combined immunodeficiencies had increased risk of delayed poliovirus clearance compared to primary antibody deficiencies. Usually, iVDPV was detected in subjects with combined immunodeficiencies in a short period of time after OPV exposure, most for less than 6 months. Surveillance for poliovirus excretion among PID patients should be reinforced until polio eradication is certified and the use of OPV is stopped. Survival rates among PID patients are improving in lower and middle income countries, and iVDPV excreters are identified more frequently. Antivirals or enhanced immunotherapies presently in development represent the only potential means to manage the treatment of prolonged excreters and the risk they present to the polio endgame.

  10. And they shall walk: ideal versus reality in polio rehabilitation in the United States

    Directory of Open Access Journals (Sweden)

    Wilson, Daniel J.

    2009-06-01

    Full Text Available This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

    En este artículo se analiza la importancia que tiene la recuperación de la capacidad de andar para los especialistas en rehabilitación y los pacientes de polio en los Estados Unidos. La polio iba a menudo acompañada de parálisis o de una grave debilitación de las piernas en aquellas personas que contraían la enfermedad. El recuperar la capacidad de andar era por lo tanto un importante factor indicativo de la recuperación de la enfermedad. Sin embargo, el andar significaba algo más que la simple acción física. El recuperar la movilidad significaba simbólicamente que uno dejaba de ser un minusválido y que volvía a ser una persona normal. Esta postura la compartían tanto los especialistas en rehabilitación como los pacientes. Este artículo analiza esta actitud y los valores culturales derivados de la misma, a través de un estudio sobre los esfuerzos llevados a cabo por un grupo seleccionado de supervivientes de polio para aprender a andar de nuevo así como de un análisis de la literatura sobre la rehabilitaci

  11. Measles elimination: progress and challenges.

    Science.gov (United States)

    Cutts, F T; Henao-Restrepo, A; Olivé, J M

    1999-10-29

    The accelerating progress in reducing measles incidence and mortality in many parts of the world has led to calls for its global eradication during the next 10-15 years. Three regions have established goals of elimination of indigenous transmission of measles. The strategy used in the Americas of a mass 'catchup' campaign of children 9 months to 15 years of age, high coverage through routine vaccination of infants, intensive surveillance and follow-up campaigns to prevent excessive build-up of susceptibles has had great success in reducing measles transmission close to zero. However, while these developments are impressive, much remains to be done to reduce measles-associated mortality in western and central Africa, where less than half of children are currently receiving measles vaccine and half a million children die from measles each year. The obstacles to global measles eradication are perceived to be predominantly political and financial. There are also technical questions, however. These include the refinement of measles elimination strategies in the light of recent outbreaks in the Americas; the implications of the HIV epidemic for measles elimination, issues around injection safety, and concerns about the possibility that secondary vaccine failures will contribute in sustaining transmission in highly vaccinated populations. The global priorities are to improve measles control in low income countries, increase awareness among industrialized countries of the importance of measles, and conduct studies to answer the technical questions about measles elimination strategies.

  12. Quality of life for post-polio syndrome: a patient derived, Rasch standard scale.

    Science.gov (United States)

    Young, Carolyn A; Quincey, Anne-Marie C; Wong, Samantha M; Tennant, Alan

    2018-03-01

    To design a disease-specific quality of life (QoL) questionnaire for people with post-polio syndrome (PPS). Qualitative interviews were conducted with 45 people with PPS to identify themes and derive potential items reflecting impact upon QoL. After cognitive debriefing, these were made into a questionnaire pack along with comparative questionnaires and posted to 319 patients. The 271 (85%) returned questionnaires were subjected to exploratory factor analysis (EFA) and Rasch analysis. A 25 item scale, the post-polio quality of life scale (PP-QoL), showed good fit to the Rasch model (conditional chi-square p = 0.156), unidimensionality (% t-tests 2.0: CI 0.7-3.8), and Cronbach's alpha of 0.87. With the latent estimate transformed to a 0-100 scale, the mean score was 56.9 (SD 18.5) with only 3.3% of respondents at the floor or ceiling of the scale. Test-retest reliability showed an intraclass correlation coefficient (ICC) (2.1) of 0.916, and correlation of 0.85. The disease-specific PP-QoL demonstrated excellent reliability, appropriate concurrent validity, and satisfied the standards of the Rasch model. It enables examination of the impact of health status upon perceived QoL, and the impact of rehabilitation interventions. The scale is freely available for academic or not-for-profit users to improve research in this neglected, disabling condition. Implications for Rehabilitation In post-polio syndrome (PPS), existing work examines aspects of health-related quality of life (HRQoL), such as activity limitations. A disease-specific QoL measure would enable researchers to model the impact of health status, such as fatigue or mobility restrictions, upon QoL in PPS. The post-polio quality of life scale (PP-QoL) is based on the patients' lived experience, meets Rasch standards and is free for use for academic and not-for-profit researchers. The raw score is reliable for individual use in clinical settings, and interval scale transformation is available for parametric

  13. The immunological effects of oral polio vaccine provided with BCG vaccine at birth

    DEFF Research Database (Denmark)

    Jensen, Kristoffer Jarlov; Karkov, Hanne Sophie; Lund, Najaaraq

    2014-01-01

    BACKGROUND: Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based...... BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen...

  14. Impact of an Intervention to Use a Measles, Rubella, and Polio Mass Vaccination Campaign to Strengthen Routine Immunization Services in Nepal.

    Science.gov (United States)

    Wallace, Aaron S; Bohara, Rajendra; Stewart, Steven; Subedi, Giri; Anand, Abhijeet; Burnett, Eleanor; Giri, Jagat; Shrestha, Jagat; Gurau, Suraj; Dixit, Sameer; Rajbhandari, Rajesh; Schluter, W William

    2017-07-01

    The potential to strengthen routine immunization (RI) services through supplementary immunization activities (SIAs) is an important benefit of global measles and rubella elimination and polio eradication strategies. However, little evidence exists on how best to use SIAs to strengthen RI. As part the 2012 Nepal measles-rubella and polio SIA, we developed an intervention package designed to improve RI processes and evaluated its effect on specific RI process measures. The intervention package was incorporated into existing SIA activities and materials to improve healthcare providers' RI knowledge and practices throughout Nepal. In 1 region (Central Region) we surveyed the same 100 randomly selected health facilities before and after the SIA and evaluated the following RI process measures: vaccine safety, RI planning, RI service delivery, vaccine supply chain, and RI data recording practices. Data collection included observations of vaccination sessions, interviews with the primary healthcare provider who administered vaccines at each facility, and administrative record reviews. Pair-matched analytical methods were used to determine whether statistically significant changes in the selected RI process measures occurred over time. After the SIA, significant positive changes were measured in healthcare provider knowledge of adverse events following immunization (11% increase), availability of RI microplans (+17%) and maps (+12%), and awareness of how long a reconstituted measles vial can be used before it must be discarded (+14%). For the SIA, 42% of providers created an SIA high-risk villages list, and >50% incorporated this information into RI outreach session site planning. Significant negative changes occurred in correct knowledge of measles vaccination contraindications (-11%), correct definition for a measles outbreak (-21%), and how to treat a child with a severe adverse event following immunization (-10%). Twenty percent of providers reported cancelling ≥1 RI

  15. Cancer risks: Strategies for elimination

    International Nuclear Information System (INIS)

    Bannasch, P.

    1987-01-01

    This book deals with the possibilities for identifying and eliminating cancer risk factors. The current state of knowledge on the detection, assessment and elimination of chemical, physical (radiation), and biological (viruses) risk factors are comprehensively presented in 15 contributions. Chemical risk factors resulting from smoking and environmental contamination are given special attention. The coverage of cancer risks by radiation includes some of the consequences of the Chernobyl disaster. Finally, the discussion of the possible risks that certain viruses hold for cancer in man is intended to further the development of vaccinations against these viral infections. The information is directed not only at specialists, but also at a wider interested audience. Its primary aim is to convey established findings that are already being used for cancer prevention. Furthermore, the book aims to promote more intense research in the field of primary cancer prevention. Contents: General aspects; chemical carcinogens: Risk assessment; chemical carcinogens: Primary prevention; physical carcinogens - Oncogenic viruses and subject index

  16. Vacina contra poliomielite: um novo paradigma Polio vaccines: a new paradigma

    Directory of Open Access Journals (Sweden)

    Lucia Ferro Bricks

    2007-06-01

    , from January 2000 to December 2006. DATA SYNTHESIS: Acknowledgement of vaccine-associated paralysis and oral vaccine-derived circulating viruses’ paralysis shall certainly require discontinuation of oral vaccination for poliomyelitis use in a short time. After eradication of the wild viruses, oral vaccination for poliomyelitis should be discontinued, preferably in a synchronized manner in all the countries. After termination of vaccination programs, people will become susceptible again to poliomyelitis virus and disease outbreaks caused by wild viruses may occur (accidental escape from laboratories or bioterrorism. In countries already using inactivated poliovirus vaccine, it is unlikely that vaccination will be interrupted. Countries that currently use exclusively oral poliovirus vaccine will have to rely on epidemiological surveillance and on oral vaccine inventories to control potential polio outbreaks. If the oral poliovirus vaccine is reintroduced in those populations, there will be again a risk for vaccine-associated paralysis and oral vaccine-derived circulating viruses’ that may spread rapidly to other regions and to nearby countries. CONCLUSIONS: Inactivated poliovirus vaccine introduction in the routine Brazilian vaccination calendar should be programmed as well as acquisition of technology for inactivated poliovirus vaccine production since the latter is currently insufficient to cover global demand.

  17. Cold-Chain Adaptability During Introduction of Inactivated Polio Vaccine in Bangladesh, 2015.

    Science.gov (United States)

    Billah, Mallick M; Zaman, K; Estivariz, Concepcion F; Snider, Cynthia J; Anand, Abhijeet; Hampton, Lee M; Bari, Tajul I A; Russell, Kevin L; Chai, Shua J

    2017-07-01

    Introduction of inactivated polio vaccine creates challenges in maintaining the cold chain for vaccine storage and distribution. We evaluated the cold chain in 23 health facilities and 36 outreach vaccination sessions in 8 districts and cities of Bangladesh, using purposive sampling during August-October 2015. We interviewed immunization and cold-chain staff, assessed equipment, and recorded temperatures during vaccine storage and transportation. All health facilities had functioning refrigerators, and 96% had freezers. Temperature monitors were observed in all refrigerators and freezers but in only 14 of 66 vaccine transporters (21%). Recorders detected temperatures >8°C for >60 minutes in 5 of 23 refrigerators (22%), 3 of 6 cold boxes (50%) transporting vaccines from national to subnational depots, and 8 of 48 vaccine carriers (17%) used in outreach vaccination sites. Temperatures cold boxes (21%) transporting vaccine from subnational depots to health facilities and 14 of 48 vaccine carriers (29%). Bangladesh has substantial cold-chain storage and transportation capacity after inactivated polio vaccine introduction, but temperature fluctuations during vaccine transport could cause vaccine potency loss that could go undetected. Bangladesh and other countries should strive to ensure consistent and sufficient cold-chain storage and monitor the cold chain during vaccine transportation at all levels. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  18. Struggling to be part of Swedish society: Strategies used by immigrants with late effects of polio.

    Science.gov (United States)

    Santos Tavares Silva, Iolanda; Thorén-Jönsson, Anna-Lisa

    2015-01-01

    To explore and describe strategies in daily occupations among immigrants with late effects of polio. The strategies were explored by interviews with 12 immigrants from Eastern Africa with late effects of polio. Sampling and data analysis was carried out according to grounded theory. The participants struggled for occupational participation and normality in an effort to participate in, and be part of, society. The study identified 14 strategies used by the immigrants in their daily occupations. The strategies can be presented in the following four categories: managing physical capacity; promoting occupational performance; strategies for gaining respect; and preparing the ground for one's existence. The participants struggled to find a balance between physical capacity and meaningful occupations, conception of their own and others' norms and values, and living conditions in Swedish society. The strategies were related to the participants' will to manage daily occupations, maintain social relationships, and be part of society. The strategies revealed that the participants strive to participate in occupations and society. This study reinforces the importance of occupation for immigrants with disability. The results highlight the need for adequate health care and rehabilitation but should also alert other social institutions.

  19. [Post-polio syndrome: a review of its clinical characteristics and treatment].

    Science.gov (United States)

    Bouza, C; Amate, J M

    Post-polio syndrome (PPS) is recognised as a clinical syndrome that causes the late, progressive functional impairment suffered by survivors of an acute episode of poliomyelitis. The importance of PPS is acknowledged by increasingly wider sectors of the population and health care sectors; nevertheless, few reports have been published about its epidemiology or its clinical characteristics and treatment. To review the current scientific evidence available on the clinical manifestations, risk factors, prevalence, diagnosis and recommendations for treatment of PPS. We conducted a review of the medical literature in the MEDLINE database. The search was restricted to studies conducted in humans that had been published as complete works in English and/or Spanish up to December 2004. PPS is recognised as being a specific neurological syndrome that appears several decades after the acute episode of polio; it exacerbates the motor sequelae already present in these patients and reduces their functional capacity to a point where it affects their activities of daily living. Its causation has still not been clearly identified and it constitutes a process that is difficult to diagnose and manage. In addition, no specific treatment has been developed for this condition to date. Nevertheless, the psychological and functional impact it has on its victims and the possibility of bringing about a significant improvement in the symptoms call for a greater effort by professionals to identify the clinical needs imposed by the syndrome and to break down some of the health care barriers that currently exist.

  20. Support for children identified with acute flaccid paralysis under the global polio eradication programme in Uttar Pradesh, India: a qualitative study

    Directory of Open Access Journals (Sweden)

    Yotsu Rie R

    2012-03-01

    Full Text Available Abstract Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17, with non-polio AFP (9, healthcare providers (40, and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21 were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with

  1. Effect of carbon-composite knee-ankle-foot orthoses on walking efficiency and gait in former polio patients

    NARCIS (Netherlands)

    Brehm, Merel-Anne; Beelen, Anita; Doorenbosch, Caroline A. M.; Harlaar, Jaap; Nollet, Frans

    2007-01-01

    Objective: To investigate the effects of total-contact fitted carbon-composite knee-ankle-foot orthoses (KAFOs) on energy cost of walking in patients with former polio who normally wear a conventional leather/metal KAFO or plastic/metal KAFO. Design: A prospective uncontrolled study with a multiple

  2. Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy

    NARCIS (Netherlands)

    Bakker, Minne; Schipper, Karen; Koopman, Fieke S.; Nollet, Frans; Abma, Tineke A.

    2016-01-01

    Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or

  3. Cognitive behavioural therapy for reducing fatigue in post-polio syndrome and in facioscapulohumeral dystrophy: A comparison

    NARCIS (Netherlands)

    Koopman, F.S.; Brehm, M.A.; Beelen, A.; Voet, N.; Bleijenberg, G.; Geurts, A.C.; Nollet, F.

    2017-01-01

    BACKGROUND: Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. OBJECTIVE: To compare fatigue-related cognitions between

  4. Cognitive behavioural therapy for reducing fatigue in post-polio syndrome and in facioscapulohumeral dystrophy: A comparison

    NARCIS (Netherlands)

    Koopman, Fieke S.; Brehm, Merel A.; Beelen, Anita; Voet, Nicole; Bleijenberg, Gijs; Geurts, Alexander; Nollet, Frans

    2017-01-01

    Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. To compare fatigue-related cognitions between patients with

  5. Elevated plasma inflammatory mediators in post-polio syndrome: No association with long-term functional decline

    NARCIS (Netherlands)

    Bickerstaffe, A.; Beelen, A.; Lutter, R.; Nollet, F.

    2015-01-01

    A key feature of post-polio syndrome (PPS) is progressive loss of muscle strength. In other chronic diseases systemic inflammation has been linked to muscle wasting. In this study plasma TNF-α, IL-6, IL-8, and leptin levels were significantly increased in PPS-patients compared to healthy controls.

  6. [Study on the immunization status and its influencing factors among workers from the polio network laboratories in China].

    Science.gov (United States)

    Guo, Y S; Wang, J Q; Xu, C; Liu, Y N; He, X H; Wei, Q

    2017-06-10

    Objective: To Investigate the immune status and influencing factors of provincial polio network laboratory (PNL) workers in China so as to provide evidence for the development of related strategies to protect personnel working at the PNLs. Methods: All the practitioners from the PNLs at the provincial centers for disease control, were selected as objects for this study, from October to December, 2016, under a questionnaire survey. Information on status of immunity and influencing factors was collected, with SAS software, trend chi-square used for statistics analysis. Results: A total of 77 workers were involved in this survey, with 60 (78 % ) of them completed the polio-based immune program but the rest 17 (22 % ) remained records unclear. 66 people (about 86 % ) remembered clearly that they had received vaccination when engaging in the polio-lab work, but the rest 11 (14 % ) with only partial vaccination records. We also noticed that the Influencing factors realted to vaccination status were: age ( χ (2)=2.48, P employment ( P <0.000 1), education ( χ (2)=0.74, P =0.46) and gender ( χ (2)=0.46, P =0.50). Conclusion: Immune status of the Chinese provincial PNL practitioners appeared fairly good as 86 % of all the workers had received polio-related vaccination, with 41 % of them completed a 3-time inoculation program, when started working in this field.

  7. The Introduction of Diphtheria-Tetanus-Pertussis and Oral Polio Vaccine Among Young Infants in an Urban African Community

    DEFF Research Database (Denmark)

    Mogensen, Søren Wengel; Andersen, Andreas; Rodrigues, Amabelia

    2017-01-01

    Background We examined the introduction of diphtheria-tetanus-pertussis (DTP) and oral polio vaccine (OPV) in an urban community in Guinea-Bissau in the early 1980s. Methods The child population had been followed with 3-monthly nutritional weighing sessions since 1978. From June 1981 DTP and OPV ...

  8. Listening to the rumours: what the northern Nigeria polio vaccine boycott can tell us ten years on.

    Science.gov (United States)

    Ghinai, Isaac; Willott, Chris; Dadari, Ibrahim; Larson, Heidi J

    2013-01-01

    In 2003 five northern Nigerian states boycotted the oral polio vaccine due to fears that it was unsafe. Though the international responses have been scrutinised in the literature, this paper argues that lessons still need to be learnt from the boycott: that the origins and continuation of the boycott were due to specific local factors. We focus mainly on Kano state, which initiated the boycotts and continued to reject immunisations for the longest period, to provide a focused analysis of the internal dynamics and complex multifaceted causes of the boycott. We argue that the delay in resolving the year-long boycott was largely due to the spread of rumours at local levels, which were intensified by the outspoken involvement of high-profile individuals whose views were misunderstood or underestimated. We use sociological concepts to analyse why these men gained influence amongst northern Nigerian communities. This study has implications on contemporary policy: refusals still challenge the Global Polio Eradication Initiative; and polio remains endemic to Nigeria (Nigeria accounted for over half of global cases in 2012). This paper sheds light on how this problem may be tackled with the ultimate aim of vaccinating more children and eradicating polio.

  9. Outcomes of polio eradication activities in Uttar Pradesh, India: the Social Mobilization Network (SM Net and Core Group Polio Project (CGPP

    Directory of Open Access Journals (Sweden)

    Singh Vibha

    2011-05-01

    Full Text Available Abstract Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE statistical method to account for Intra-cluster Correlation (ICC, and used 'Quasi-likelihood under the independence model criterion (QIC' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with

  10. Men With Late Effects of Polio Decline More Than Women in Lower Limb Muscle Strength: A 4-Year Longitudinal Study.

    Science.gov (United States)

    Flansbjer, Ulla-Britt; Brogårdh, Christina; Horstmann, Vibeke; Lexell, Jan

    2015-11-01

    In persons with prior paralytic poliomyelitis, progressive muscle weakness can occur after a stable period of at least 15 years. Knowledge is limited about which factors influence changes in lower limb muscle strength in these persons. To assess changes in lower limb muscle strength annually over 4 years in persons with late effects of polio and to identify prognostic factors for changes in muscle strength. A prospective, longitudinal study. University hospital outpatient program. Fifty-two ambulant persons (mean age ± standard deviation: 64 ± 6 years) with verified late effects of polio. Mixed linear models were used to analyze changes in muscle strength and to identify determinants among the following covariates: gender, age, age at acute polio infection, time with late effects of polio, body mass index, and estimated baseline muscle weakness. Knee extensor and flexor and ankle dorsiflexor muscle strength were measured annually with a Biodex dynamometer. The men (n = 28) had significant linear change over time for all knee muscle strength measurements, from -1.4% (P lower limb to -4.2% (P lower limb, and for 2 ankle dorsiflexor muscle strength measurements (-3.3%-1.4% per year [P strength over time. Over 4 years, men had a greater decline in muscle strength than did women, but the rate of decline did not accelerate. This finding indicates that gender could be a contributing factor to the progressive decline in muscle strength in persons with late effects of polio. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  11. World witnesses a tumultuous year while India reports an eventful decade in the long story of polio eradication

    Directory of Open Access Journals (Sweden)

    Sanjay Chaturvedi

    2014-01-01

    Full Text Available With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1 in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3 and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV. Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV to up-scaled routine immunization (RI, switch from trivalent oral polio vaccine (tOPV to bivalent oral polio vaccine (bOPV in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs, tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of ′right to say no′, on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

  12. World Witnesses a Tumultuous Year while India Reports an Eventful Decade in the Long Story of Polio Eradication.

    Science.gov (United States)

    Chaturvedi, Sanjay

    2014-04-01

    With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1) in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3) and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV). Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV) to up-scaled routine immunization (RI), switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs), tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of 'right to say no', on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

  13. Neuromuscular NMDA Receptors Modulate Developmental Synapse Elimination.

    Science.gov (United States)

    Personius, Kirkwood E; Slusher, Barbara S; Udin, Susan B

    2016-08-24

    At birth, each mammalian skeletal muscle fiber is innervated by multiple motor neurons, but in a few weeks, all but one of those axons retracts (Redfern, 1970) and differential activity between inputs controls this phenomenon (Personius and Balice-Gordon, 2001; Sanes and Lichtman, 2001; Personius et al., 2007; Favero et al., 2012). Acetylcholine, the primary neuromuscular transmitter, has long been presumed to mediate this activity-dependent process (O'Brien et al., 1978), but glutamatergic transmission also occurs at the neuromuscular junction (Berger et al., 1995; Grozdanovic and Gossrau, 1998; Mays et al., 2009). To test the role of neuromuscular NMDA receptors, we assessed their contribution to muscle calcium fluxes in mice and tested whether they influence removal of excess innervation at the end plate. Developmental synapse pruning was slowed by reduction of NMDA receptor activation or expression and by reduction of glutamate production. Conversely, pruning is accelerated by application of exogenous NMDA. We also found that NMDA induced increased muscle calcium only during the first 2 postnatal weeks. Therefore, neuromuscular NMDA receptors play previously unsuspected roles in neuromuscular activity and synaptic pruning during development. In normal adult muscle, each muscle fiber is innervated by a single axon, but at birth, fibers are multiply innervated. Elimination of excess connections requires neural activity; because the neuromuscular junction (NMJ) is a cholinergic synapse, acetylcholine has been assumed to be the critical mediator of activity. However, glutamate receptors are also expressed at the NMJ. We found that axon removal in mice is slowed by pharmacological and molecular manipulations that decrease signaling through neuromuscular NMDA receptors, whereas application of exogenous NMDA at the NMJ accelerates synapse elimination and increases muscle calcium levels during the first 2 postnatal weeks. Therefore, neuromuscular NMDA receptors play

  14. Frequency of isolation of polioviruses and non polio enteroviruses from patients with acute flaccid paralysis, enterovirus infection and children from groups at risk

    Directory of Open Access Journals (Sweden)

    N. I. Romanenkova

    2012-01-01

    Full Text Available The article describes the frequency of isolation of polioviruses and non polio enteroviruses from different categories of the investigated children. The percentage of detection of polioviruses from the patients with acute flaccid paralysis was lower than that from the children from groups at risk. Among the patients with the enterovirus infection the polioviruses were rarely revealed. The frequency of isolation of non polio enteroviruses from these patients was significantly higher than that from the other categories of investigated persons. The improvement of poliomyelitis surveillance and the reinforcement of virological surveillance of children from groups at risk and those with enterovirus infection will provide the important data for Global Polio Eradication Initiative and the maintenance of polio free status of the Russian Federation.

  15. Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J; Nollet, Frans; van Dijk, Johannes P

    2015-01-01

    We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were measured in 48 patients with PPS and 12 healthy controls. Patients with PPS had significantly higher echo intensity and lower muscle thickness than healthy controls. In patients, both echo intensity and muscle thickness were associated independently with muscle strength. A combined measure of echo intensity and muscle thickness was more strongly related to muscle strength than either parameter alone. Quantitative ultrasound distinguishes healthy muscles from those affected by PPS, and measures of muscle quality and quantity are associated with muscle strength. Hence, ultrasound could be a useful tool for assessing disease severity and monitoring changes resulting from disease progression or clinical intervention in patients with PPS. © 2014 Wiley Periodicals, Inc.

  16. Currents issues in cardiorespiratory care of patients with post-polio syndrome.

    Science.gov (United States)

    Orsini, Marco; Lopes, Agnaldo J; Guimarães, Fernando S; Freitas, Marcos R G; Nascimento, Osvaldo J M; Anna, Mauricio de Sant'; Moreira, Pedro; Fiorelli, Stenio; Ferreira, Ana Carolina A F; Pupe, Camila; Bastos, Victor H V; Pessoa, Bruno; Nogueira, Carlos B; Schmidt, Beny; Souza, Olivia G; Davidovich, Eduardo R; Oliveira, Acary S B; Ribeiro, Pedro

    2016-07-01

    A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

  17. Femoral neck pseudoarthrosis in a polio patient treated with closed reduction and cell therapy

    Directory of Open Access Journals (Sweden)

    M.A. Codesido

    2017-04-01

    Full Text Available Poliomyelitis disease affects the anterior horns cells of the spinal cord and certain motor nuclei of the brain stem. Paralysis type is flaccid and asymmetrical and result in muscular imbalance.Due to this, in case of having a hip muscles involvement, degenerative or posttraumatic, total hip arthroplasty is normally contraindicated because of the excessive risk of hip dislocation. In cases of subcapital femoral neck fractures the femoral head vascularization is a main concern, and in cases of neglected fracture with pseudoarthrosis the vascular status to the head must be investigated prior to further decisions.We report the case of a femoral neck fracture non-union after a missed femoral neck fracture in a polio affected leg treated with cannulated screws and percutaneous autologous injection of processed total nuclear cells (TNC mixed with putty demineralized bone matrix. Keywords: Pseudoarthrosis, Poliomyelitis, Cell therapy, Femoral neck

  18. Polio vaccines, SV40 and human tumours, an update on false positive and false negative results.

    Science.gov (United States)

    Elmishad, A G; Bocchetta, M; Pass, H I; Carbone, M

    2006-01-01

    Simian virus 40 (SV40) has been detected in different human tumours in numerous laboratories. The detection of SV40 in human tumours has been linked to the administration of SV40-contaminated polio vaccines from 1954 until 1963. Many of these reports linked SV40 to human mesothelioma. Some studies have failed to detect SV40 in human tumours and this has caused a controversy. Here we review the current literature. Moreover, we present evidence showing how differences in the sensitivities of methodologies can lead to a very different interpretation of the same study. The same 20 mesothelioma specimens all tested negative, 2/20 tested positive or 7/20 tested positive for SV40 Tag by simply changing the detection method on the same immuno-precipitation/western blot membranes. These results provide a simple explanation for some of the apparent discordant results reported in the literature.

  19. Elimination Problems in Infants and Children

    Science.gov (United States)

    ... Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea Ear Problems Elimination Problems Elimination Problems in Infants and Children Eye Problems Facial Swelling Feeding Problems in Infants ...

  20. Restless legs syndrome is highly prevalent in patients with post-polio syndrome.

    Science.gov (United States)

    Marin, Luis Fabiano; Carvalho, Luciane B C; Prado, Lucila B F; Oliveira, Acary S B; Prado, Gilmar F

    2017-09-01

    Few studies have quantified the prevalence of restless legs syndrome (RLS) in patients with post-polio syndrome (PPS). Our objective was to assess the prevalence and severity of RLS in patients with PPS and to examine the demographic characteristics of this population. This was a cross-sectional study conducted from April 2010 to May 2012 at the outpatient Neuromuscular Disorders clinic of Universidade Federal de São Paulo, São Paulo, Brazil. We evaluated 119 patients with PPS, consecutively recruited, and investigated for RLS based on the diagnostic criteria established by the International Restless Legs Syndrome Study Group (IRLSSG). Patients were evaluated with the Brazilian version of the IRLSSG severity scale. The prevalence of RLS was 36% (n = 43; 32 women and 11 men). The ages at onset of RLS (median = 41 years) and PPS (median = 41 years) were concurrent, and the correlation between onset of symptoms of RLS and onset of symptoms of PPS was positive and very strong (Spearman r = 0.93, p = 0.01). The median RLS severity was 23 (range, 20-28). Low educational achievement and depression were predictive of RLS development. In the largest population of patients with PPS studied to date, our results indicate a high prevalence of RLS, marked disease severity, and concomitant onset of both conditions in many patients with PPS. Further studies are needed to elucidate a possible pathophysiologic mechanism linking these two conditions. We suggest that all post-polio patients with sensory and motor complaints in the legs be investigated for RLS. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Rasch analysis of the WHOQOL-BREF in post polio syndrome.

    Science.gov (United States)

    Pomeroy, Ian M; Tennant, Alan; Young, Carolyn A

    2013-09-01

    The World Health Organisation quality of life abbreviated scale (WHOQOL-BREF) was developed as a measure of quality of life across 4 separate health domains; physical health, psychological, social relationships and environment. This study evaluated the validity of the WHOQOL-BREF in post-polio syndrome by testing it for fit against the Rasch model. The scale was posted to 319 volunteers, 271 (85%) completed the scale with a mean age of 66.7 years (standard deviation 8.15); 64% were female. The social relationships domain fitted the Rasch model (χ2 p = 0.19) but reliability was low (α = 0.69) and there were insufficient items to test the assumption of unidimensionality. Solutions were derived for physical health (p = 0.45, t-test = 1.5%, α = 0.67), psychological (p = 0.19, t-test = 4.9%, α = 0.78) and environment domains (p = 0.48, t-test = 6.0% - lower confidence interval 3.4%, α = 0.80) by accounting for local dependence and to cancel out differential item functioning. An overall measure of quality of life, which combined all 4 domains was validated (p = 0.80, t-test = 4.6%, α = 0.81). A transformation table for this total score is provided. The 4 domains of the WHOQOL-BREF provide valid measures of quality of life in post-polio syndrome. The summed score was more reliable and better targeted and can be used as an ordinal estimate of quality of life.

  2. Isolation of sabin-like polioviruses from wastewater in a country using inactivated polio vaccine.

    Science.gov (United States)

    Zurbriggen, Sebastian; Tobler, Kurt; Abril, Carlos; Diedrich, Sabine; Ackermann, Mathias; Pallansch, Mark A; Metzler, Alfred

    2008-09-01

    From 2001 to 2004, Switzerland switched from routine vaccination with oral polio vaccine (OPV) to inactivated polio vaccine (IPV), using both vaccines in the intervening period. Since IPV is less effective at inducing mucosal immunity than OPV, this change might allow imported poliovirus to circulate undetected more easily in an increasingly IPV-immunized population. Environmental monitoring is a recognized tool for identifying polioviruses in a community. To look for evidence of poliovirus circulation following cessation of OPV use, two sewage treatment plants located in the Zurich area were sampled from 2004 to 2006. Following virus isolation using either RD or L20B cells, enteroviruses and polioviruses were identified by reverse transcription-PCR. A total of 20 out of 174 wastewater samples were positive for 62 Sabin-like isolates. One isolate from each poliovirus-positive sample was analyzed in more detail. Sequencing the complete viral protein 1 (VP1) capsid coding region, as well as intratypic differentiation (ITD), identified 3 Sabin type 1, 13 Sabin type 2, and 4 Sabin type 3 strains. One serotype 1 strain showed a discordant result in the ITD. Three-quarters of the strains showed mutations within the 5' untranslated region and VP1, known to be associated with reversion to virulence. Moreover, three strains showed heterotypic recombination (S2/S1 and S3/S2/S3). The low number of synonymous mutations and the partial temperature sensitivity are not consistent with extended circulation of these Sabin virus strains. Nevertheless, the continuous introduction of polioviruses into the community emphasizes the necessity for uninterrupted child vaccination to maintain high herd immunity.

  3. Effectiveness of oral polio vaccination against paralytic poliomyelitis: a matched case-control study in Somalia.

    Science.gov (United States)

    Mahamud, Abdirahman; Kamadjeu, Raoul; Webeck, Jenna; Mbaeyi, Chukwuma; Baranyikwa, Marie Therese; Birungi, Julianne; Nurbile, Yassin; Ehrhardt, Derek; Shukla, Hemant; Chatterjee, Anirban; Mulugeta, Abraham

    2014-11-01

    After the last case of type 1 wild poliovirus (WPV1) was reported in 2007, Somalia experienced another outbreak of WPV1 (189 cases) in 2013. We conducted a retrospective, matched case-control study to evaluate the vaccine effectiveness (VE) of oral polio vaccine (OPV). We retrieved information from the Somalia Surveillance Database. A case was defined as any case of acute flaccid paralysis (AFP) with virological confirmation of WPV1. We selected two groups of controls for each case: non-polio AFP cases ("NPAFP controls") matched to WPV1 cases by age, date of onset of paralysis and region; and asymptomatic "neighborhood controls," matched by age. Using conditional logistic regression, we estimated the VE of OPV as (1-odds ratio)×100. We matched 99 WPV cases with 99 NPAFP controls and 134 WPV1 cases with 268 neighborhood controls. Using NPAFP controls, the overall VE was 70% (95% confidence interval [CI], 37-86), 59% (2-83) among 1-3 dose recipients, 77% (95% CI, 46-91) among ≥4 dose recipients. In neighborhood controls, the overall VE was 95% (95% CI, 84-98), 92% (72-98) among 1-3 dose recipients, and 97% (89-99) among ≥4 dose recipients. When the analysis was limited to cases and controls ≤24 months old, the overall VE in NPAFP and neighborhood controls was 95% (95% CI, 65-99) and 97% (95% CI, 76-100), respectively. Among individuals who were fully vaccinated with OPV, vaccination was effective at preventing WPV1 in Somalia. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Formal algorithmic elimination for PDEs

    CERN Document Server

    Robertz, Daniel

    2014-01-01

    Investigating the correspondence between systems of partial differential equations and their analytic solutions using a formal approach, this monograph presents algorithms to determine the set of analytic solutions of such a system and conversely to find differential equations whose set of solutions coincides with a given parametrized set of analytic functions. After giving a detailed introduction to Janet bases and Thomas decomposition, the problem of finding an implicit description of certain sets of analytic functions in terms of differential equations is addressed. Effective methods of varying generality are developed to solve the differential elimination problems that arise in this context. In particular, it is demonstrated how the symbolic solution of partial differential equations profits from the study of the implicitization problem. For instance, certain families of exact solutions of the Navier-Stokes equations can be computed.

  5. Towards the Elimination of Hepatitis C in the United States.

    Science.gov (United States)

    Saab, Sammy; Le, Long; Saggi, Satvir; Sundaram, Vinay; Tong, Myron

    2017-11-27

    The emergence of effective direct-acting antiviral (DAA) agents has reignited discussion over hepatitis C elimination potential in the United States. Eliminating hepatitis C will require a critical examination regarding technical feasibility, economic considerations, and social/political attention. Tremendous advancement has been made in recent years with the availability of sensitive diagnostic tests and highly effective DAAs capable of achieving sustained viral response (SVR) in more than 95% of patients. Eliminating hepatitis C requires escalating existing surveillance networks to identify and respond to new epidemics. Basic prevention strategies such as community based outreach and education, testing and counseling, clean syringe and needle exchange programs, safe injection sites, opioid substitution therapies, and mental health services must be scaled up and adapted to target high risk groups. Although costs of DAAs have raised budget concerns for hepatitis C elimination, studies have shown that eliminating hepatitis C will produce a savings of up to 6.5 billion USD annually along with other intangible benefits such as work productivity and quality of life. Simulation economic models and meta-analyses suggest that all adults should be screened for hepatitis C, but special efforts must focus on high risk populations. There is growing recognition that social and political factors are at least as important as technical feasibility and economic considerations. Due to lack of promotion and public awareness, HCV elimination efforts continue to receive inadequate funding. Social stigma continues to impede meaningful policy changes. Eliminating hepatitis C from the U.S. is possible but it will require a sustained national commitment and strong political leadership. This article is protected by copyright. All rights reserved. © 2017 by the American Association for the Study of Liver Diseases.

  6. Social media as a platform for health-related public debates and discussions: the Polio vaccine on Facebook.

    Science.gov (United States)

    Orr, Daniela; Baram-Tsabari, Ayelet; Landsman, Keren

    2016-01-01

    Social media can act as an important platform for debating, discussing, and disseminating information about vaccines. Our objectives were to map and describe the roles played by web-based mainstream media and social media as platforms for vaccination-related public debates and discussions during the Polio crisis in Israel in 2013: where and how did the public debate and discuss the issue, and how can these debates and discussions be characterized? Polio-related coverage was collected from May 28 to October 31, 2013, from seven online Hebrew media platforms and the Facebook groups discussing the Polio vaccination were mapped and described. In addition, 2,289 items from the Facebook group "Parents talk about Polio vaccination" were analyzed for socio-demographic and thematic characteristics. The traditional media mainly echoed formal voices from the Ministry of Health. The comments on the Facebook vaccination opposition groups could be divided into four groups: comments with individualistic perceptions, comments that expressed concerns about the safety of the OPV, comments that expressed distrust in the Ministry of Health, and comments denying Polio as a disease. In the Facebook group "Parents talk about the Polio vaccination", an active group with various participants, 321 commentators submitted 2289 comments, with 64 % of the comments written by women. Most (92 %) people involved were parents. The comments were both personal (referring to specific situations) and general in nature (referring to symptoms or wide implications). A few (13 %) of the commentators were physicians ( n  = 44), who were responsible for 909 (40 %) of the items in the sample. Half the doctors and 6 % of the non-doctors wrote over 10 items each. This Facebook group formed a unique platform where unmediated debates and discussions between the public and medical experts took place. The comments on the social media, as well as the socio-demographic profiles of the commentators, suggest

  7. The extent of using mobility assistive devices can partly explain fatigue among persons with late effects of polio - a retrospective registry study in Sweden.

    Science.gov (United States)

    Santos Tavares Silva, I; Sunnerhagen, K S; Willén, C; Ottenvall Hammar, I

    2016-11-18

    Fatigue is reported as one of the most disabling symptoms and is common among persons living with late effects of polio. Although fatigue has been studied in the context of people living with late effects of polio, there is a lack of knowledge concerning the association of fatigue and variables of importance for participation in daily life. Therefore, the aim of this study was to explore possible factors associated with fatigue among persons with late effects of polio in Sweden. This retrospective registry study consisted of 89 persons with late effects of polio living in Sweden. Fatigue was measured with the Multidimensional Fatigue Inventory (MFI-20) scale, Swedish version. Pearson's correlation coefficient was used to analyse the correlation between the factors and fatigue, and a multiple linear regression was carried out to explore factors for fatigue. Fatigue statistically significantly correlated with age (r = 0.234, p polio, and the model partly explained 14% of the variation of fatigue. Fatigue could partly be explained by the extent of using mobility assistive devices and age. Healthcare professionals should provide and demonstrate the importance of assistive devices to ensure management of fatigue in persons living with late effects of polio.

  8. ‘Do not eat those apples; they’ve been on the ground!’: polio epidemics and preventive measures, Sweden 1880s-1940s

    Directory of Open Access Journals (Sweden)

    Axelsson, Per

    2009-06-01

    Full Text Available This article will address how Swedish scientists, physicians and public health officers tried to combat the polio epidemics in the pre-vaccine era. It shows that once polio was considered as an epidemic disease the preventive measures used were based on the hindrance of other infectious diseases. It also illustrates how epidemiological and laboratory studies to some degree affected the thoughts of how polio should be prevented, and that Swedish ideas and experiences differed from those put forward in the USA.

    Este artículo trata sobre cómo los científicos, médicos y funcionarios de la sanidad pública de Suecia intentaron combatir la epidemia de la polio en la era anterior a la vacuna y expone que en cuanto la polio fue considerada como una epidemia, las medidas preventivas que se aplicaron se basaban en las de otras enfermedades contagiosas. También ilustra en qué medida los estudios epidemiológicos y los análisis de laboratorio influyeron en la manera de prevenir la polio y también demuestra que las opiniones y experiencias en Suecia eran diferentes a las de los Estados Unidos.

  9. Test Bias and the Elimination of Racism

    Science.gov (United States)

    Sedlacek, William E.

    1977-01-01

    Three types of test bias are discussed: content bias, atmosphere bias, and use bias. Use bias is considered the most important. Tests reflect the bias in society, and eliminating test bias means eliminating racism and sexism in society. A six-stage model to eliminate racism and sexism is presented. (Author)

  10. Costs and financial feasibility of malaria elimination

    Science.gov (United States)

    Sabot, Oliver; Cohen, Justin M; Hsiang, Michelle S; Kahn, James G; Basu, Suprotik; Tang, Linhua; Zheng, Bin; Gao, Qi; Zou, Linda; Tatarsky, Allison; Aboobakar, Shahina; Usas, Jennifer; Barrett, Scott; Cohen, Jessica L; Jamison, Dean T; Feachem, Richard GA

    2010-01-01

    Summary The marginal costs and benefits of converting malaria programmes from a control to an elimination goal are central to strategic decisions, but empirical evidence is scarce. We present a conceptual framework to assess the economics of elimination and analyse a central component of that framework—potential short-term to medium-term financial savings. After a review that showed a dearth of existing evidence, the net present value of elimination in five sites was calculated and compared with effective control. The probability that elimination would be cost-saving over 50 years ranged from 0% to 42%, with only one site achieving cost-savings in the base case. These findings show that financial savings should not be a primary rationale for elimination, but that elimination might still be a worthy investment if total benefits are sufficient to outweigh marginal costs. Robust research into these elimination benefits is urgently needed. PMID:21035839

  11. Quality of life in Swedish patients with post-polio syndrome with a focus on age and sex.

    Science.gov (United States)

    Jung, Tae-Du; Broman, Lisbet; Stibrant-Sunnerhagen, Katharina; Gonzalez, Henrik; Borg, Kristian

    2014-06-01

    To investigate the health-related quality of life (QOL) in Swedish patients with post-polio syndrome (PPS), with a focus on sex and age. A total of 364 patients were recruited from five Swedish post-polio clinics. Analysis was carried out using SF-36 and data were compared with those of a normal population. QOL was significantly lower in PPS patients for all eight subdomains and the two main scores (physical compound score and mental compound score) when compared with the controls. Male patients had a significantly higher QOL than female patients for all subdomains and also for mental compound score and physical compound score, a phenomenon also observed in the normal population. There was a decrease in QOL in the physical domains and an increase in vitality with age. PPS decreases health-related QOL in both sexes, more in female patients. QOL for physical domains decreases whereas vitality increases with age in both sexes.

  12. Determinants of Falls and Fear of Falling in Ambulatory Persons With Late Effects of Polio.

    Science.gov (United States)

    Brogårdh, Christina; Flansbjer, Ulla-Britt; Lexell, Jan

    2017-05-01

    Falls and fear of falling (FOF) are common in persons with late effects of polio, but there is limited knowledge of associated factors. To determine how knee muscle strength, dynamic balance, and gait performance (adjusted for gender, age, and body mass index) are associated with falls and FOF in persons with late effects of polio. A cross-sectional study. A university hospital outpatient clinic. Eighty-one ambulatory persons with verified late effects of polio (43 men; mean age 67 years). Number of falls the past year, Falls Efficacy Scale-International to assess FOF, a Biodex dynamometer to measure knee muscle strength, the Timed Up & Go test to assess dynamic balance, and the 6-Minute Walk test to assess gait performance. Univariate and multivariate logistic regression analyses were used for falls (categorical data) and linear regression analyses for FOF (continuous data) as dependent variables. Fifty-nine percent reported at least 1 fall during the past year, and 79% experienced FOF. Reduced knee muscle strength in the more affected limb and gait performance were determinants of falls. An increase of 10 Nm in knee flexor and knee extensor strength reduced the odds ratio between 0.70 and 0.83 (P = .01), and an increase of 100 m in 6-Minute Walk test reduced the odds ratio to 0.41 (P = .001). All factors were determinants of FOF; reduced knee muscle strength in the more and less affected limbs explained 17%-25% of the variance in FOF, dynamic balance 30%, and gait performance 41%. Gender, age, and body mass index only marginally influenced the results. Reduced gait performance, knee muscle strength, and dynamic balance are to a varying degree determinants of falls and FOF in ambulatory persons with late effects of polio. Future studies need to evaluate whether rehabilitation programs targeting these factors can reduce falls and FOF in this population. IV. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All

  13. Surveillance and laboratory detection for non-polio enteroviruses in the European Union/European Economic Area, 2016.

    Science.gov (United States)

    Harvala, Heli; Jasir, Aftab; Penttinen, Pasi; Pastore Celentano, Lucia; Greco, Donato; Broberg, Eeva

    2017-11-01

    Enteroviruses (EVs) cause severe outbreaks of respiratory and neurological disease as illustrated by EV-D68 and EV-A71 outbreaks, respectively. We have mapped European laboratory capacity for identification and characterisation of non-polio EVs to improve preparedness to respond to (re)-emerging EVs linked to severe disease. An online questionnaire on non-polio EV surveillance and laboratory detection was submitted to all 30 European Union (EU)/European Economic Area (EEA) countries. Twenty-nine countries responded; 26 conducted laboratory-based non-polio EV surveillance, and 24 included neurological infections in their surveillance. Eleven countries have established specific surveillance for EV-D68 via sentinel influenza surveillance (n = 7), typing EV-positive respiratory samples (n = 10) and/or acute flaccid paralysis surveillance (n = 5). Of 26 countries performing non-polio EV characterisation/typing, 10 further characterised culture-positive EV isolates, whereas the remainder typed PCR-positive but culture-negative samples. Although 19 countries have introduced sequence-based EV typing, seven still rely entirely on virus isolation. Based on 2015 data, six countries typed over 300 specimens mostly by sequencing, whereas 11 countries characterised under 50 EV-positive samples. EV surveillance activity varied between EU/EEA countries, and did not always specifically target patients with neurological and/or respiratory infections. Introduction of sequence-based typing methods is needed throughout the EU/EEA to enhance laboratory capacity for the detection of EVs.

  14. Evaluating cessation of the type 2 oral polio vaccine by modeling pre- and post-cessation detection rates.

    Science.gov (United States)

    Kroiss, Steve J; Famulare, Michael; Lyons, Hil; McCarthy, Kevin A; Mercer, Laina D; Chabot-Couture, Guillaume

    2017-10-09

    The globally synchronized removal of the attenuated Sabin type 2 strain from the oral polio vaccine (OPV) in April 2016 marked a major change in polio vaccination policy. This change will provide a significant reduction in the burden of vaccine-associated paralytic polio (VAPP), but may increase the risk of circulating vaccine-derived poliovirus (cVDPV2) outbreaks during the transition period. This risk can be monitored by tracking the disappearance of Sabin-like type 2 (SL2) using data from the polio surveillance system. We studied SL2 prevalence in 17 countries in Africa and Asia, from 2010 to 2016 using acute flaccid paralysis surveillance data. We modeled the peak and decay of SL2 prevalence following mass vaccination events using a beta-binomial model for the detection rate, and a Ricker function for the temporal dependence. We found type 2 circulated the longest of all serotypes after a vaccination campaign, but that SL2 prevalence returned to baseline levels in approximately 50days. Post-cessation model predictions identified 19 anomalous SL2 detections outside of model predictions in Afghanistan, India, Nigeria, Pakistan, and western Africa. Our models established benchmarks for the duration of SL2 detection after OPV2 cessation. As predicted, SL2 detection rates have plummeted, except in Nigeria where OPV2 use continued for some time in response to recent cVDPV2 detections. However, the anomalous SL2 detections suggest specific areas that merit enhanced monitoring for signs of cVDPV2 outbreaks. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Environmental surveillance of poliovirus and non-polio enterovirus in urban sewage in Dakar, Senegal (2007-2013)

    OpenAIRE

    Ndiaye, Abdou Kader; Diop, Pape Amadou Mbathio; Diop, Ousmane Madiagne

    2014-01-01

    Introduction Global poliomyelitis eradication initiative relies on (i) laboratory based surveillance of acute flaccid surveillance (AFP) to monitor the circulation of wild poliovirus in a population, and (ii) vaccination to prevent its diffusion. However, as poliovirus can survive in the environment namely in sewage, environmental surveillance (ES) is of growing importance as the eradication target is close. This study aimed to assess polioviruses and non polio enteroviruses circulation in se...

  16. Impact of national immunization days on polio-related knowledge and practice of urban women in Bangladesh.

    Science.gov (United States)

    Quaiyum, M A; Tuñon, C; Hel Baqui, A; Quayyum, Z; Khatun, J

    1997-12-01

    Bangladesh began to hold National Immunization Days (NIDs) from 1995 as part of the country's goal to eradicate poliomyelitis by the turn of the century. The NIDs brought together government agencies, the media, voluntary organisations and individual volunteers in social mobilization and service delivery activities. This paper assesses the impact of the first two polio NIDs in terms of the immunization coverage and change in knowledge about the disease among women living in Dhaka city, the capital of the country. Data were collected through pre- and post-NID cross-sectional surveys in a sample of one area of Dhaka city which included slum and non-slum households. Knowledge data were collected from 525 women with at least one child aged less than five years. The oral polio vaccine (OPV) coverage during NIDs was obtained from 720 children. Knowledge of polio as a vaccine preventable disease increased after NIDs among both slum and non-slum women. The knowledge gap between the two groups was significantly reduced. Field workers, who regularly visit women at their homes to promote health and family planning services, were the main source of information for the slum women while television was cited as the most important source of information by non-slum women. The study revealed that 88% of children under five years received at least one dose of oral polio vaccine (OPV) during NIDs, and 67% received two stipulated doses with no significant differences between slum (65%) and non-slum (69%) groups. In addition, 68% of the children contacted during the NIDs were given vitamin A supplementation. The study suggests that strategies like NID can be effectively used to tap into community resources and to generate political commitments for health programmes.

  17. Implementation of a Systematic Accountability Framework in 2014 to Improve the Performance of the Nigerian Polio Program.

    Science.gov (United States)

    Tegegne, Sisay G; MKanda, Pascal; Yehualashet, Yared G; Erbeto, Tesfaye B; Touray, Kebba; Nsubuga, Peter; Banda, Richard; Vaz, Rui G

    2016-05-01

    An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)-Nigeria polio program staff, as well as the program itself. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Data on administrative actions and process indicators from quarters 2-4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework. © 2016 World Health Organization; licensee Oxford Journals.

  18. Post-poliomyelitis syndrome: case report Síndrome pós-polio: relato de caso

    Directory of Open Access Journals (Sweden)

    Marco Antonio Orsini Neves

    2007-06-01

    Full Text Available The post-polio syndrome (PPS is an entity characterized for an episode of muscular weakness and/or abnormal muscular fatigue in individuals that had presented acute polio years before. We report the case of PPS in a patient, 40 years, that thirty-five years after had had paralytic poliomyelitis, developed new symptoms of fatigue, muscular atrophy, dyspnea, difficulties in deambulation and muscular and joint pain. The electromyographic findings revealed injuried neurons of the anterior horn of the marrow and reinnervation after muscular tests.A síndrome pós-polio (SPP é entidade caracterizada por um episódio de fraqueza muscular e/ou fadiga muscular anormal em indivíduos que apresentaram poliomielite aguda anos antes. Relatamos o caso de SPP em um paciente, 40 anos, que trinta e cinco anos após haver tido poliomielite paralítica, desenvolveu novos sintomas de fadiga, atrofia muscular, dispnéia, dificuldades na deambulação e dores articulares e musculares. Os achados eletromiográficos revelaram acometimento dos neurônios da ponta anterior da medula e reinervação após a realização de testes musculares.

  19. Environmental surveillance of poliovirus and non-polio enterovirus in urban sewage in Dakar, Senegal (2007-2013).

    Science.gov (United States)

    Ndiaye, Abdou Kader; Diop, Pape Amadou Mbathio; Diop, Ousmane Madiagne

    2014-01-01

    Global poliomyelitis eradication initiative relies on (i) laboratory based surveillance of acute flaccid surveillance (AFP) to monitor the circulation of wild poliovirus in a population, and (ii) vaccination to prevent its diffusion. However, as poliovirus can survive in the environment namely in sewage, environmental surveillance (ES) is of growing importance as the eradication target is close. This study aimed to assess polioviruses and non polio enteroviruses circulation in sewage drains covering a significant population of Dakar. From April 2007 to May 2013, 271 specimens of raw sewage were collected using the grab method in 6 neighborhoods of Dakar. Samples were processed to extract and concentrate viruses using polyethylene glycol and Dextran (two-phase separation method). Isolation of enteroviruses was attempted in RD, L20B and Hep2 cell lines. Polioviruses were identified by RT-PCR and Elisa. Non Polio Enteroviruses (NPEVs) were identified by RT-PCR and microneutralisation tests. Polioviruses and NPEVs were respectively detected in 34,3% and 42,8% sewage samples. No wild poliovirus neither circulating vaccine-derived Poliovirus (cVDPV) was detected. Neutralization assays have identified 49 non polio enteroviruses that were subsequently classified in 13 serotypes belonging to HEV-A (22, 4%), HEV-B (12, 24%), HEV-C (26, 53%) and HEV-D (6, 12%) species. This study is the first documentation of enteroviruses environmental detection in Senegal. It shows the usefulness of environmental surveillance for indirect monitoring of the circulation and distribution of enteroviruses in the community.

  20. Detecting and eliminating slippery footwear.

    Science.gov (United States)

    Jones, C; Manning, D P; Bruce, M

    1995-02-01

    A recently developed walking traction test has proved to be a reliable and rapid method of measuring coefficient of friction (c.o.f.) of floor surfaces and footwear, and is a suitable method for ranking the grip of footwear solings on slippery floors. This paper describes four new experiments in which footwear samples were ranked. The first experiment compared mean rank orders on water wet (wet) and oily surfaces of seven flat solings. Spearman's rank correlation coefficient rs was 0·893, P test methods. The test surfaces were oily stainless steel plates cut from the same sheet. Rank orders of the three test methods were significantly similar. Kendall's coefficient of concordance w = 8·68, P < 0·001. In another experiment samples of commercially available footwear were issued to factory workers and recalled for c.o.f. measurements at intervals. Their rank orders on wet and oily surfaces were not statistically similar but when wet surface results obtained at 4 months, were compared with those at 10 months, rank orders were significant; rs = 0·994, P < 0·01. Also on oily surfaces, rank orders of two measurements were significant, rs = 0·982, P <0·01. Although most experiments have revealed significant correlations between footwear samples on wet and oily surfaces there are examples where a soling performs well on wet surfaces but is at the lower end of rank order on oily surfaces. It is concluded that rank orders on wet, oily and icy surfaces should be calculated but also it is necessary to examine rank orders on each surface-lubricant combination, by comparing results obtained at intervals during the useful lives of the solings. In future, samples at the lower end of the rank orders of c.o.f. will be eliminated from the varieties available to workers.

  1. Minimizing or eliminating refueling of nuclear reactor

    Science.gov (United States)

    Doncals, Richard A.; Paik, Nam-Chin; Andre, Sandra V.; Porter, Charles A.; Rathbun, Roy W.; Schwallie, Ambrose L.; Petras, Diane S.

    1989-01-01

    Demand for refueling of a liquid metal fast nuclear reactor having a life of 30 years is eliminated or reduced to intervals of at least 10 years by operating the reactor at a low linear-power density, typically 2.5 kw/ft of fuel rod, rather than 7.5 or 15 kw/ft, which is the prior art practice. So that power of the same magnitude as for prior art reactors is produced, the volume of the core is increased. In addition, the height of the core and it diameter are dimensioned so that the ratio of the height to the diameter approximates 1 to the extent practicable considering the requirement of control and that the pressure drop in the coolant shall not be excessive. The surface area of a cylinder of given volume is a minimum if the ratio of the height to the diameter is 1. By minimizing the surface area, the leakage of neutrons is reduced. By reducing the linear-power density, increasing core volume, reducing fissile enrichment and optimizing core geometry, internal-core breeding of fissionable fuel is substantially enhanced. As a result, core operational life, limited by control worth requirements and fuel burnup capability, is extended up to 30 years of continuous power operation.

  2. International controls and the elimination of nuclear weapons

    International Nuclear Information System (INIS)

    Shea, T.

    1997-01-01

    The elimination of nuclear weapons will require success in three interrelated efforts: stopping the proliferation of nuclear weapons by states through indigenous programs; preventing the illicit acquisition o warheads, components or essential materials by states, sub-national organizations or individuals; and halting further production and eliminating existing nuclear weapons in acknowledged nuclear-weapon-states and in other states that may now possess such weapons. The elimination of nuclear weapons is a challenge for regional and global security and perhaps more than any other security issue, a matter of most appropriate for collective control measures. The most significant issues concerning control are related to proliferation and peaceful uses of plutonium and highly enriched uranium. The IAEA has a special role, tasks and responsibilities concerning verification of non-proliferation, plutonium management, illegal trafficking of plutonium and/or highly enriched uranium, production cut-off of fissile material

  3. Psychological resilience and depressive symptoms in older adults diagnosed with post-polio syndrome.

    Science.gov (United States)

    Pierini, Diana; Stuifbergen, Alexa K

    2010-01-01

    Depression is a serious comorbidity in people with disabilities; however, few studies have focused on depressive symptoms in older adults with post-polio syndrome (PPS). This study used a resilience conceptual framework that focused on patient psychosocial strengths to investigate the relationship between psychological resilience factors (e.g., acceptance, self-efficacy, personal resources, interpersonal relationships, self-rated health, spiritual growth, stress management) and depressive symptoms in a large sample (N = 630) of people older than 65 years who were diagnosed with PPS. Forty percent of the sample scored > or = 10 on the Center for Epidemiologic Studies Short Depression Scale (CES-D10), which is a higher percentage than what has been previously cited in other studies; however, 53% of the sample had good or excellent self-rated health, suggesting psychological resilience. Depression scores were regressed on seven selected resilience factors after controlling for functional limitations. Four of the seven variables accounted for 30% of the variance in depressive symptoms, with spiritual growth representing the main predictor (beta = -.26). The implications for rehabilitation nurses in developing a patient-strengths perspective in the assessment and counseling of older adults with PPS are discussed.

  4. Reliability of contractile properties of the knee extensor muscles in individuals with post-polio syndrome.

    Directory of Open Access Journals (Sweden)

    Eric L Voorn

    Full Text Available To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS and 18 age-matched healthy individuals.Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with the use of a fixed dynamometer. Reliability was determined for fatigue resistance, rate of torque development (MRTD, and early and late relaxation time (RT50 and RT25, using the intraclass correlation coefficient (ICC and standard error of measurement (SEM, expressed as % of the mean.In both groups, reliability for fatigue resistance was good, with high ICCs (>0.90 and small SEM values (PPS: 7.1%, healthy individuals: 7.0%. Reliability for contractile speed indices varied, with the best values found for RT50 (ICCs>0.82, SEM values <2.8%. We found no systematic differences between test and retest occasions, except for RT50 in healthy subjects (p = 0.016.In PPS and healthy individuals, the reliability of fatigue resistance, as obtained from electrically evoked contractions is high. The reliability of contractile speed is only moderate, except for RT50 in PPS, demonstrating high reliability.This was the first study to examine the reliability of electrically evoked contractile properties in individuals with PPS. Our results demonstrate its potential to study mechanisms underlying muscle fatigue in PPS and to evaluate changes in contractile properties over time in response to interventions or from natural course.

  5. Assessing Inactivated Polio Vaccine Introduction and Utilization in Kano State, Nigeria, April-November 2015.

    Science.gov (United States)

    Osadebe, Lynda U; MacNeil, Adam; Elmousaad, Hashim; Davis, Lora; Idris, Jibrin M; Haladu, Suleiman A; Adeoye, Olorunsogo B; Nguku, Patrick; Aliu-Mamudu, Uneratu; Hassan, Elizabeth; Vertefeuille, John; Bloland, Peter

    2017-07-01

    Kano State, Nigeria, introduced inactivated polio vaccine (IPV) into its routine immunization (RI) schedule in March 2015 and was the pilot site for an RI data module for the National Health Management Information System (NHMIS). We determined factors impacting IPV introduction and the value of the RI module on monitoring new vaccine introduction. Two assessment approaches were used: (1) analysis of IPV vaccinations reported in NHMIS, and (2) survey of 20 local government areas (LGAs) and 60 associated health facilities (HF). By April 2015, 66% of LGAs had at least 20% of HFs administering IPV, by June all LGAs had HFs administering IPV and by July, 91% of the HFs in Kano reported administering IPV. Among surveyed staff, most rated training and implementation as successful. Among HFs, 97% had updated RI reporting tools, although only 50% had updated microplans. Challenges among HFs included: IPV shortages (20%), hesitancy to administer 2 injectable vaccines (28%), lack of knowledge on multi-dose vial policy (30%) and age of IPV administration (8%). The introduction of IPV was largely successful in Kano and the RI module was effective in monitoring progress, although certain gaps were noted, which should be used to inform plans for future vaccine introductions. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  6. Immunoglobulin treatment in post-polio syndrome: Identification of responders and non-responders.

    Science.gov (United States)

    Östlund, Gunilla; Broman, Lisbet; Werhagen, Lars; Borg, Kristian

    2015-09-01

    To define and characterize responders and non-responders in a group of 124 patients with post-polio syndrome who received a single treatment with intravenous immunoglobulin. Open trial, prospective follow-up study. Clinical examination and data from medical records. Short Form 36 (SF-36), Physical Activity Scale for the Elderly (PASE) and visual analogue scale (VAS) measured quality of life, physical activity and intensity of pain, respectively. Data were obtained before treatment and at 6-month follow-up. Two responder groups were identified with the outcome SF-36 Vitality and 3 with Bodily pain, respectively. Forty-five percent were positive-responders, identified before treatment by reduced physical function, muscle atrophy in the lower extremities, higher levels of fatigue and pain, and a VAS pain score above 20. Negative-responders were identified by good physical function and mental health, lesser muscle atrophy in the lower extremities, and low levels of fatigue and pain. Intravenous immunoglobulin is a biological intervention, and therefore it is important to be able to identify responders and non-responders. In order to maximize a positive outcome it is suggested that patients with a high level of fatigue and/or pain and reduced physical function are selected.

  7. Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome.

    Science.gov (United States)

    Viana, Celiana Figueiredo; Pradella-Hallinan, Márcia; Quadros, Abrahão Augusto Juviniano; Marin, Luis Fabiano; Oliveira, Acary Souza Bulle

    2013-07-01

    It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP) and with post-polio syndrome (PPS), and correlate it with parameters of sleep and the circadian cycle. Thirty patients, 17 female (56.7%), participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years), and 19 had PPS (mean age±standard deviation of 46.4±5.6 years). Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS.

  8. Respiratory failure in a patient with antecedent poliomyelitis: amyotrophic lateral sclerosis or post-polio syndrome?

    Science.gov (United States)

    Terao, Shin-ichi; Miura, Naofumi; Noda, Aiji; Yoshida, Mari; Hashizume, Yoshio; Ikeda, Hiroshi; Sobue, Gen

    2006-10-01

    We report a 69-year-old man who developed paralytic poliomyelitis in childhood and then decades later suffered from fatal respiratory failure. Six months before this event, he had progressive weight loss and shortness of breath. He had severe muscular atrophy of the entire right leg as a sequela of the paralytic poliomyelitis. He showed mild weakness of the facial muscle and tongue, dysarthria, and severe muscle atrophy from the neck to proximal upper extremities and trunk, but no obvious pyramidal signs. Electromyogram revealed neurogenic changes in the right leg, and in the paraspinal, sternocleidomastoid, and lingual muscles. There was a slight increase in central motor conduction time from the motor cortex to the lumbar anterior horn. Pulmonary function showed restrictive ventilation dysfunction, which was the eventual cause of death. Some neuropathological features were suggestive of amyotrophic lateral sclerosis (ALS), namely Bunina bodies. In patients with a history of paralytic poliomyelitis who present after a long stable period with advanced fatal respiratory failure, one may consider not only respiratory impairment from post-polio syndrome but also the onset of ALS.

  9. Loss of motor unit size and quadriceps strength over 10 years in post-polio syndrome.

    Science.gov (United States)

    Bickerstaffe, A; van Dijk, J P; Beelen, A; Zwarts, M J; Nollet, F

    2014-06-01

    To investigate whether strength decline in post-polio syndrome (PPS) results from excessive distal axonal degeneration of enlarged motor units. We assessed changes over 10 years in isometric quadriceps strength, mean motor unit action potential (MUAP) size, root mean squared (RMS) amplitude, and level of interference (LOI) in 47 patients with PPS and 12 healthy controls, using high density surface EMG. At baseline, all patients had symptomatic quadriceps dysfunction, evidenced by transmission defects on single-fibre EMG. MU size and strength declined significantly by 20% and 15%, respectively in patients with PPS. Those with the largest initial MU sizes exhibited the greatest losses of mean MU size (27%) and proportional decreases in quadriceps strength (23%). Initial strength, change in LOI and change in RMS amplitude together explained 35% of the variability in strength changes in patients. MU size of controls did not change, although they lost 29% strength. MU size and strength declined concomitantly in a homogeneous cohort of patients with PPS and quadriceps dysfunction. This long term follow-up study provides evidence that size diminution of enlarged MUs combined with a reduced number of active MUs contributes to the gradual strength decline in PPS. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Psychological Resilience and Depressive Symptoms in Older Adults Diagnosed with Post-polio Syndrome

    Science.gov (United States)

    Pierini, Diana; Stuifbergen, Alexa

    2012-01-01

    Depression is a serious co-morbidity in persons with disability, yet few studies have focused on depressive symptoms in persons aging with post-polio syndrome (PPS). We used a resilience conceptual framework that focused on patient psychosocial strengths to investigate the relationship between psychological resilience factors (acceptance, self-efficacy, personal resources, interpersonal relationships, self-rated health, spiritual growth, and stress management) and depressive symptoms in a large sample (n = 630) of persons over age 65 who were diagnosed with PPS. A higher percentage (40%) of the sample scored ≥ 10 on the CES-D 10 than was previously cited in other studies; however, 53% of the sample had good or excellent self-rated health, suggesting psychological resilience. Depression scores were regressed on seven selected resilience factors after controlling for functional limitations. Four of the seven variables accounted for 30% of the variance in depressive symptoms with spiritual growth representing the main predictor (β = −.26). The implications for rehabilitation nurses in developing a patient-strengths perspective in the assessment and counseling of individuals aging with PPS are discussed. PMID:20681392

  11. Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Celiana Figueiredo Viana

    2013-07-01

    Full Text Available Objective It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP and with post-polio syndrome (PPS, and correlate it with parameters of sleep and the circadian cycle. Methods Thirty patients, 17 female (56.7%, participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years, and 19 had PPS (mean age±standard deviation of 46.4±5.6 years. Results Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. Conclusion Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS.

  12. Reliability of contractile properties of the knee extensor muscles in individuals with post-polio syndrome.

    Science.gov (United States)

    Voorn, Eric L; Brehm, Merel A; Beelen, Anita; de Haan, Arnold; Nollet, Frans; Gerrits, Karin H L

    2014-01-01

    To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS) and 18 age-matched healthy individuals. Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with the use of a fixed dynamometer. Reliability was determined for fatigue resistance, rate of torque development (MRTD), and early and late relaxation time (RT50 and RT25), using the intraclass correlation coefficient (ICC) and standard error of measurement (SEM, expressed as % of the mean). In both groups, reliability for fatigue resistance was good, with high ICCs (>0.90) and small SEM values (PPS: 7.1%, healthy individuals: 7.0%). Reliability for contractile speed indices varied, with the best values found for RT50 (ICCs>0.82, SEM values <2.8%). We found no systematic differences between test and retest occasions, except for RT50 in healthy subjects (p = 0.016). In PPS and healthy individuals, the reliability of fatigue resistance, as obtained from electrically evoked contractions is high. The reliability of contractile speed is only moderate, except for RT50 in PPS, demonstrating high reliability. This was the first study to examine the reliability of electrically evoked contractile properties in individuals with PPS. Our results demonstrate its potential to study mechanisms underlying muscle fatigue in PPS and to evaluate changes in contractile properties over time in response to interventions or from natural course.

  13. Wearable Monitoring Devices for Assistive Technology: Case Studies in Post-Polio Syndrome

    Directory of Open Access Journals (Sweden)

    Giuseppe Andreoni

    2014-01-01

    Full Text Available The correct choice and customization of an orthosis are crucial to obtain the best comfort and efficiency. This study explored the feasibility of a multivariate quantitative assessment of the functional efficiency of lower limb orthosis through a novel wearable system. Gait basographic parameters and energetic indexes were analysed during a Six-Minute Walking Test (6-MWT through a cost-effective, non-invasive polygraph device, with a multichannel wireless transmission, that carried out electro-cardiograph (ECG; impedance-cardiograph (ICG; and lower-limb accelerations detection. Four subjects affected by Post-Polio Syndrome (PPS were recruited. The wearable device and the semi-automatic post-processing software provided a novel set of objective data to assess the overall efficiency of the patient-orthosis system. Despite the small number of examined subjects, the results obtained with this new approach encourage the application of the method thus enlarging the dataset to validate this promising protocol and measuring system in supporting clinical decisions and out of a laboratory environment.

  14. Fatigue resistance of the knee extensor muscles is not reduced in post-polio syndrome.

    Science.gov (United States)

    Voorn, Eric L; Beelen, Anita; Gerrits, Karin H L; Nollet, Frans; de Haan, Arnold

    2013-11-01

    The present study investigated whether intrinsic fatigability of the muscle fibers is reduced in patients with post-polio syndrome (PPS). This may contribute to the muscle fatigue complaints reported by patients with PPS. For this purpose, we assessed contractile properties and fatigue resistance of the knee extensor muscles using repeated isometric electrically evoked contractions in 38 patients with PPS and 19 age-matched healthy subjects. To determine whether any difference in fatigue resistance between both groups could be attributed to differences in aerobic capacity of the muscle fibers, 9 patients with PPS and 11 healthy subjects performed the same protocol under arterial occlusion. Results showed that fatigue resistance of patients with PPS was comparable to that in controls, both in the situation with intact circulation and with occluded blood flow. Together, our findings suggest that there are no differences in contractile properties and aerobic muscle capacity that may account for the increased muscle fatigue perceived in PPS. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Surveillance to Track Progress Toward Polio Eradication - Worldwide, 2016-2017.

    Science.gov (United States)

    Gardner, Tracie J; Diop, Ousmane M; Jorba, Jaume; Chavan, Smita; Ahmed, Jamal; Anand, Abhijeet

    2018-04-13

    Global efforts to eradicate polio began in 1988, and four of the six World Health Organization (WHO) regions currently have achieved poliofree certification. Within the remaining two regions with endemic poliomyelitis (African and Eastern Mediterranean), Afghanistan, Nigeria, and Pakistan have never interrupted transmission of wild poliovirus (WPV). The primary means of detecting poliovirus transmission is surveillance for acute flaccid paralysis (AFP) among children aged surveillance is supplemented by environmental surveillance for polioviruses in sewage from selected locations. Genomic sequencing of isolated polioviruses enables the mapping of transmission by time and place, assessment of potential gaps in surveillance, and identification of the emergence of VDPVs (3). This report presents poliovirus surveillance data from 2016-2017, with particular focus on six countries in the Eastern Mediterranean Region (EMR) and 20 countries in the African Region (AFR) that reported WPV or circulating VDPVs (cVDPVs) during 2011-2017. Included in the 20 AFR countries are the three most affected by the 2014-2015 Ebola virus disease (Ebola) outbreak (Guinea, Liberia, and Sierra Leone), even though only one (Guinea) reported WPV or cVDPVs during the surveillance period. During 2017, a total of 14 (70%) of the 20 AFR countries and five (83%) of the six EMR countries met both surveillance quality indicators at the national level; however, provincial-level variation was seen. Surveillance strengthening activities are needed in specific countries of these regions to provide evidence supporting ultimate certification of the interruption of poliovirus circulation.

  16. Evaluation of Radiosensitivity of HeLa Cells Infected with Polio Virus Irradiated by Co 60

    Directory of Open Access Journals (Sweden)

    F Seif

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: The main purpose of radiotherapy is exposing enough doses of radiation to tumor tissue and protecting the normal tissues around it. Tumor dose for each session in radiotherapy will be considered based on radiosensitivity of the tissues. The presence of viral diseases in tumoral area can affect the radiosensitivity of cells. This study aimed to evaluate the radiosensitivity of Hela cells infected with poliomyelitis virus irradiated by Co 60. Materials & Methods: In this study, the radiosensitivity of HeLa cells, with or without the viral infection, after gamma radiation of cobalt 60, was assessed. Results: Results of comparison of the radisensitivity of infected and uninfected cells indicates that after 2 Gy irradiation by Co 60, polio infection in low, moderate and high virus load, increases the cell death by 20-30%, 30-40% and 70-90% respectively. Conclusion : Radiosensitivity of tumoral cells increase when they are infected with viral agents. Results of this study showed that non cancer diseases should be considered when prescribing dose fraction in radiotherapy of cancers.

  17. Using Predictive Evaluation to Design, Evaluate, and Improve Training for Polio Volunteers.

    Science.gov (United States)

    Traicoff, Denise A; Basarab, Dave; Ehrhardt, Derek T; Brown, Sandi; Celaya, Martin; Jarvis, Dennis; Howze, Elizabeth H

    2018-03-01

    Predictive Evaluation (PE) uses a four-step process to predict results then designs and evaluates a training intervention accordingly. In 2012, the Sustainable Management Development Program (SMDP) at the Centers for Disease Control and Prevention used PE to train Stop Transmission of Polio (STOP) program volunteers. Stakeholders defined specific beliefs and practices that volunteers should demonstrate. These predictions and adult learning practices were used to design a curriculum to train four cohorts. At the end of each workshop, volunteers completed a beliefs survey and wrote goals for intended actions. The goals were analyzed for acceptability based on four PE criteria. The percentage of acceptable goals and the beliefs survey results were used to define the quality of the workshop. A postassignment adoption evaluation was conducted for two cohorts, using an online survey and telephone or in-person structured interviews. The results were compared with the end of workshop findings. The percentage of acceptable goals across the four cohorts ranged from 49% to 85%. In the adoption evaluation of two cohorts, 88% and 94% of respondents reported achieving or making significant progress toward their goal. A comparison of beliefs survey responses across the four cohorts indicated consistencies in beliefs that aligned with stakeholders' predictions. Goal statements that participants write at the end of a workshop provide data to evaluate training quality. Beliefs surveys surface attitudes that could help or hinder workplace performance. The PE approach provides an innovative framework for health worker training and evaluation that emphasizes performance.

  18. REMOTE INTERVENTION TOWER ELIMINATION SYSTEM

    International Nuclear Information System (INIS)

    Dave Murnane; Renauld Washington

    2002-01-01

    This Topical Report is presented to satisfy reporting requirements in the Statement of work section J.5 page 120 per Department of Energy contract DE-AC26-01NT41093. The project does not contain any imperial research data. This report describes the assembly of Commercial off the shelf (COTS) items configured in a unique manner to represent new and innovative technology in the service of size reduction and material handling at DOE sites, to assist in the DandD effort currently underway at the designated DOE Facilities

  19. Immunization. Safety and Use of Polio Vaccines. Briefing Report to the Chairman, Subcommittee on Natural Resources, Agriculture Research and Environment, Committee on Science, Space, and Technology, House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report presents information on the status of the safety and use of polio vaccines in the United States. Topics discussed include: (1) the role of the Food and Drug Administration (FDA) in processing an inactivated polio vaccine license application; (2) the steps the federal government has taken to improve the safety of the vaccine; (3) the…

  20. Tardive dyskinesia: eliminated, forgotten, or overshadowed?

    Science.gov (United States)

    Remington, Gary

    2007-03-01

    The present review focuses on atypical antipsychotics and tardive dyskinesia. We have known for many years that clozapine has a diminished risk of tardive dyskinesia compared with typical antipsychotics. The last decade has seen the introduction of a number of other atypical antipsychotics, allowing us to begin evaluating whether they too share this attribute. In addition, the opportunity to use these drugs as first-line treatment permits a more precise means of establishing risk. While longer-term data are required, the limited evidence available clearly indicates that the atypical antipsychotics have a decreased liability of tardive dyskinesia, approximately 1% compared with 5% for typical agents annually. Like clozapine, the other atypical antipsychotics also demonstrate antidyskinetic properties in individuals with preexisting tardive dyskinesia. The underlying mechanisms remain unclear, and without such information it is not possible to say what clinical conditions, if any, might diminish or even eliminate these advantages. An update is provided regarding the atypical antipsychotics and tardive dyskinesia. This information is critical in our decision-making regarding choice of antipsychotic and optimal use in the clinical setting.

  1. Elimination of mercury in health care facilities.

    Science.gov (United States)

    2000-03-01

    Mercury is a persistent, bioaccumulative toxin that has been linked to numerous health effects in humans and wildlife. It is a potent neurotoxin that may also harm the brain, kidneys, and lungs. Unborn children and young infants are at particular risk for brain damage from mercury exposure. Hospitals' use of mercury in chemical solutions, thermometers, blood pressure gauges, batteries, and fluorescent lamps makes these facilities large contributors to the overall emission of mercury into the environment. Most hospitals recognize the dangers of mercury. In a recent survey, four out of five hospitals stated that they have policies in place to eliminate the use of mercury-containing products. Sixty-two percent of them require vendors to disclose the presence of mercury in chemicals that the hospitals purchase. Only 12 percent distribute mercury-containing thermometers to new parents. Ninety-two percent teach their employees about the health and environmental effects of mercury, and 46 percent teach all employees how to clean up mercury spills. However, the same study showed that many hospitals have not implemented their policies. Forty-two percent were not aware whether they still purchased items containing mercury. In addition, 49 percent still purchase mercury thermometers, 44 percent purchase mercury gastrointestinal diagnostic equipment, and 64 percent still purchase mercury lab thermometers.

  2. Ultrasound Guided Carpal Tunnel Release Using Dynamic Expansion of the Transverse Safe Zone in a Patient with Post-Polio Syndrome: A Case Report.

    Science.gov (United States)

    Henning, Troy; Lueders, Daniel; Chang, Kate; Yang, Lynda

    2018-03-05

    The prevalence of carpal tunnel syndrome(CTS) in patients that suffer from post-polio syndrome occurs at a rate of 22%.[1] Irrespective of those with CTS, 74% of post-polio patients weight bear through their arms for ambulation or transfers.[1] As open carpal tunnel release is performed along the weight bearing region of the wrist, their functional independence may be altered while recovering. This case demonstrates that ultrasound guided carpal tunnel release(USCTR) was successfully performed in a patient with post-polio syndrome allowing him to immediately weight bear through his hands after the procedure so he could recover at home. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  3. Elimination of Kala-Azar from the Southeast Asia Region.

    Science.gov (United States)

    Bhattacharya, Sujit K; Dash, Aditya Prasad

    2017-04-01

    AbstractVisceral leishmaniasis (VL), popularly known as kala-azar, is essentially a disease of poverty. Kala-azar is caused by a parasite, Leishmania donovani . Recent review indicates that worldwide 98 countries are endemic for kala-azar. Approximately 0.2-0.4 million new VL cases occur each year worldwide. More than 90% of global VL cases occur in Bangladesh, Brazil, Ethiopia, India, South Sudan, and Sudan. This trend is slowly changing due to the progress in kala-azar elimination in southeast Asia, where Bangladesh has reported an average of some 600 new cases in 2014-2015. With the advancement in our knowledge about the disease and development of tools to diagnose and treat VL, it was considered that elimination of kala-azar was possible from India, Nepal, and Bangladesh. The three countries signed a memorandum of understanding in 2005 for collaboration. Miltefosine is the first ever oral drug developed to treat VL, which was later replaced by lipid amphotericin B. The main components of the strategy are early diagnosis using rK39 strip test and complete treatment utilizing miltefosine for 28 days. Dichlorodiphenyltrichloroethane or pyrethroids were deployed for vector control. There was much to be desired for better performance of the vector control activity. Pharmacovigilance and monitoring of drug resistance were the weakest part of the program. In the post-elimination phase, surveillance reinforced by active case finding will of a crucial factor for sustainability of the elimination. A strong political will is required to ensure elimination of kala-azar from the Indian subcontinent and its sustainability in the post-elimination phase.

  4. Identifying Malaria Transmission Foci for Elimination Using Human Mobility Data.

    Science.gov (United States)

    Ruktanonchai, Nick W; DeLeenheer, Patrick; Tatem, Andrew J; Alegana, Victor A; Caughlin, T Trevor; Zu Erbach-Schoenberg, Elisabeth; Lourenço, Christopher; Ruktanonchai, Corrine W; Smith, David L

    2016-04-01

    Humans move frequently and tend to carry parasites among areas with endemic malaria and into areas where local transmission is unsustainable. Human-mediated parasite mobility can thus sustain parasite populations in areas where they would otherwise be absent. Data describing human mobility and malaria epidemiology can help classify landscapes into parasite demographic sources and sinks, ecological concepts that have parallels in malaria control discussions of transmission foci. By linking transmission to parasite flow, it is possible to stratify landscapes for malaria control and elimination, as sources are disproportionately important to the regional persistence of malaria parasites. Here, we identify putative malaria sources and sinks for pre-elimination Namibia using malaria parasite rate (PR) maps and call data records from mobile phones, using a steady-state analysis of a malaria transmission model to infer where infections most likely occurred. We also examined how the landscape of transmission and burden changed from the pre-elimination setting by comparing the location and extent of predicted pre-elimination transmission foci with modeled incidence for 2009. This comparison suggests that while transmission was spatially focal pre-elimination, the spatial distribution of cases changed as burden declined. The changing spatial distribution of burden could be due to importation, with cases focused around importation hotspots, or due to heterogeneous application of elimination effort. While this framework is an important step towards understanding progressive changes in malaria distribution and the role of subnational transmission dynamics in a policy-relevant way, future work should account for international parasite movement, utilize real time surveillance data, and relax the steady state assumption required by the presented model.

  5. Evaluation and comparison of Hela, Hep2C and Vero cell lines sensitivity to polio vaccinal virus using micro and macro vaccine potency tests

    Directory of Open Access Journals (Sweden)

    Soleimani, S.,

    2012-11-01

    Full Text Available Poliomyelitis, an acute viral infectious disease caused by poliovirus, still remains a public health problem in developing countries. Despite the global effort to eradicate polio, continuing the polio immunization with a potent and safe vaccine is essential. For accurate vaccine evaluation, three types of cell lines including Hela, Hep2C and Vero were evaluated and compared using two methods of polio vaccine potency tests (micro & macro. For cells comparison, five different batches from polio vaccines were tested and to develop the test, five variables including viruses, cells, serum, media and Co2 were studied. For validation, the titer of which has been well established as a working reference preparation (WRP was applied to control the accuracy and reproducibility of the testing system. Multiple comparisons were performed by analysis of variance (ANOVA followed by Tokey HDS and LSD. No significant differences were found between the potency of vaccine batches and between macro and micro methods. Reduction in cells sensitivity and potency of vaccines was found with increasing passage number. Significant differences were found between the sensitivity of the cell lines. The highest potency of polio vaccines was obtained using Hela cells (GMT in macro and micro test = 10 6.35; Hep2C cells were afterwards (GMT in macro= 10 6.01 and in micro test= 10 5.94; Vero cells were lowest (GMT in macro= 10 5.78 and in micro test= 10 5.72. So, the sensitivity and accuracy of the potency test for evaluation of the polio vaccine in immunization program in Iran will be assured using the Hela cell line with low passage number in macro and micro methods.

  6. Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.

    Science.gov (United States)

    Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte; Ibsen, Rikke; Kjellberg, Jakob; Jennum, Poul

    2016-06-01

    Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system.

  7. 75 FR 7546 - Foreign Trade Regulations (FTR): Eliminate the Social Security Number (SSN) as an Identification...

    Science.gov (United States)

    2010-02-22

    ...-AA48 Foreign Trade Regulations (FTR): Eliminate the Social Security Number (SSN) as an Identification... Trade Regulations (FTR) to eliminate the requirement to report a Social Security Number (SSN) as an identification number when registering to file and filing electronic export information in the Automated Export...

  8. Sliding Control with Chattering Elimination for Hydraulic Drives

    DEFF Research Database (Denmark)

    Schmidt, Lasse; Andersen, Torben Ole; Pedersen, Henrik C.

    2012-01-01

    This paper presents the development of a sliding mode control scheme with chattering elimination, generally applicable for position tracking control of electro-hydraulic valve-cylinder drives. The proposed control scheme requires only common data sheet information, no knowledge on load characteri......This paper presents the development of a sliding mode control scheme with chattering elimination, generally applicable for position tracking control of electro-hydraulic valve-cylinder drives. The proposed control scheme requires only common data sheet information, no knowledge on load...... characteristics, and employs piston- and valve spool positions- and load- and supply pressure feedback. The main target is to overcome problems with linear controllers deteriorating performance due to the inherent nonlinear nature of such systems. In order to accomplish this task, an integral sliding mode...

  9. Human movement data for malaria control and elimination strategic planning.

    Science.gov (United States)

    Pindolia, Deepa K; Garcia, Andres J; Wesolowski, Amy; Smith, David L; Buckee, Caroline O; Noor, Abdisalan M; Snow, Robert W; Tatem, Andrew J

    2012-06-18

    Recent increases in funding for malaria control have led to the reduction in transmission in many malaria endemic countries, prompting the national control programmes of 36 malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of malaria through HPM. Strategic control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging malaria movement patterns and building control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal malaria protection and other factors that modify malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum malaria infection movements.

  10. Post-polio syndrome, spinal cord injury and statin myopathy: double trouble or incorrect diagnosis? Two case reports.

    Science.gov (United States)

    Werhagen, Lars; Borg, Kristian

    2011-07-01

    To discuss the importance of a thorough clinical examination and evaluation of symptoms in upper and lower motor neurone lesions. Case report. Post-polio outpatient clinic, Danderyds University Hospital, Stockholm, Sweden. We describe here two patients with a past history of poliomyelitis, who were experiencing increasing muscular weakness. Clinical evaluation led to diagnoses of spinal cord injury and statin myopathy, respectively. In order to make a correct diagnosis it is essential to distinguish between lower and upper motor neurone lesions. In the case of a lower motor neurone disorder a neurophysiological examination is necessary for a correct diagnosis, and is a prerequisite for adequate treatment and rehabilitation.

  11. Elevated plasma inflammatory mediators in post-polio syndrome: No association with long-term functional decline.

    Science.gov (United States)

    Bickerstaffe, A; Beelen, A; Lutter, R; Nollet, F

    2015-12-15

    A key feature of post-polio syndrome (PPS) is progressive loss of muscle strength. In other chronic diseases systemic inflammation has been linked to muscle wasting. In this study plasma TNF-α, IL-6, IL-8, and leptin levels were significantly increased in PPS-patients compared to healthy controls. There was however no association between these raised systemic levels of inflammatory mediators and long-term decline in quadriceps strength or other clinical parameters. In conclusion, there is evidence for systemic inflammation in PPS, yet the relationship with clinical deterioration remains tenuous. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Expresión en escherichia coli de un peptido perteneciente a la proteina vp1 del virus del polio

    Directory of Open Access Journals (Sweden)

    Myriam Sánchez de Gómez

    2010-07-01

    Full Text Available Una secuencia sintética de 49 pb codificante para un péptido de la cubierta del virus del Polio se clonó en el vector de fusión pEZZ8, basado en el gen de la proteína A del Staphylococcus aureus. La expresión se hizo en Escherichia coli y la proteína de fusión se recuperó en el sobrenadante. Se purificó mediante cromatografía de afinidad con IgG Sepharosa y se identificó por medio de electroforesis en presencia de SDS.

  13. [Evaluation of the lifetime of nail markings during polio vaccinations in Chad].

    Science.gov (United States)

    Quoc Cuong, Huong; Schlumberger, Martin; Garba Tchang, Salomon; Ould Cheikh, Dah; Savès, Marianne; Mallah, Barah; Demtilo Attilo, Jacques; Ngangro Mosurel, Ndeikoundam; Gamatié, Youssouf

    2010-01-01

    SID (Supplemental Immunization Days) is a special strategy intended to accelerate eradication of poliomyelitis in countries where it is still endemic (India, Afghanistan, and Pakistan in Asia, and Nigeria in Africa). This strategy is also applied in Nigeria's neighbours (Cameroon, Chad, Niger and Benin). Since the poliomyelitis virus was imported from Nigeria in 2001, Chad has reported cases of poliomyelitis every year. After 30 SIDs in Chad and the inaccurate or false attribution of side-effects to polio vaccines, some groups persistently refuse polio vaccination. To ascertain the true coverage of SID, the Ministry of Health and several partners (WHO, UNICEF and Rotary) conduct external coverage evaluations, to identify the under-vaccinated areas where population may be refusing immunization. The nails of the children receiving vaccinations are marked with indelible ink and those markings are the best indicator of the area's actual SID coverage. When coverage investigators arrive and propose vaccination to all children not immunized during SID, mothers who wish to refuse vaccination may claim that the children's markings disappeared after a few days, due to bathing. WHO experts have found that markings applied to their own nails with the WHO-recommended markers persist a few weeks, but others suggested that the markings may disappear much faster among children living in a traditional tropical environment. Until now, the lifetime of these markings has not been tested among children in Africa. To determine the lifetime of the fingernail markings after SID and factors that influence this lifetime in children young than 5 years old in Chad. This prospective cohort study of 200 children (aged 0 to 59 months) took place from March to May 2009 in Milezi, a health zone north of Ndjamena, the capital of Chad, in central Africa. These children received nail markings on their left little finger with an indelible marker pen provided by WHO. The finger was monitored for 35

  14. Enterovirus no polio de casos con parálisis residual. Colombia, 1992-1995

    Directory of Open Access Journals (Sweden)

    Dioselina Peláez

    1999-06-01

    Full Text Available Las parálisis fláccidas agudas (PFA tienen una amplia variedad de orígenes y de agentes causales: físicos, fisiopatológicos, tóxicos e infecciosos. Entre estos últimos, el virus salvaje (silvestre de la poliomielitis y el enterovirus 71 (EV71, parecen ser los agentes virales más frecuentes. Habiendo eliminado el poliovirus salvaje autóctono como agente causal de enfermedad paralítica en Colombia desde junio de 1991 y teniendo aislamientos de virus no polio en el 20,8% del total de casos de PFA notificados anualmente, quisimos conocer el papel que juegan los enterovirus en la incidencia de parálisis fláccida aguda y la dinámica de circulación y distribución de los mismos en Colombia. Se revisó la base de datos de los casos notificados al Programa de Erradicación de la Poliomielitis en Colombia entre el 1"" de enero de 1992 y el 31 de diciembre de 1995, al cual se notificaron 856 casos sospechosos de niños menores de 15 años, y se escogieron 69 casos para el estudio pero se recuperaron 57 aislamientos virales por reinoculación en células RD y Hep-2C. Estos se identificaron mediante neutralización con mezclas de antisueros de Lim & Benyesh-Melnick (LBM.Todos ellos fueron sometidos a caracterización molecular mediante reacción en cadena de la polimerasa -PCR-, utilizando iniciadores complementarios a la regiónVP1 del genoma viral, seguida del análisis de secuencia de nucleótidos de los fragmentos amplificados por PCR. La identificación final del serotipo se realizó por comparación de nucleótidos en auto assemblery el análisis descriptivo de los datos. No se estableció circulación mayor de ningún serotipo específico en región geográfica alguna del país. Tampoco hubo asociación causal a ninguna patología característica con ninguno de los enterovirus aislados. Se describe el hallazgo de EV71 en un caso de PFA con diagnóstico clínico de síndrome de Guillain-Barré. La descripción de 22 serotipos diferentes

  15. Water isotope effect on the thermostability of a polio viral RNA hairpin: A metadynamics study

    Science.gov (United States)

    Pathak, Arup K.; Bandyopadhyay, Tusar

    2017-04-01

    Oral polio vaccine is considered to be the most thermolabile of all the common childhood vaccines. Despite heavy water (D2O) having been known for a long time to stabilise attenuated viral RNA against thermodegradation, the molecular underpinnings of its mechanism of action are still lacking. Whereas, understanding the basis of D2O action is an important step that might reform the way other thermolabile drugs are stored and could possibly minimize the cold chain problem. Here using a combination of parallel tempering and well-tempered metadynamics simulation in light water (H2O) and in D2O, we have fully described the free energy surface associated with the folding/unfolding of a RNA hairpin containing a non-canonical basepair motif, which is conserved within the 3'-untranslated region of poliovirus-like enteroviruses. Simulations reveal that in heavy water (D2O) there is a considerable increase of the stability of the folded basin as monitored through an intramolecular hydrogen bond (HB), size, shape, and flexibility of RNA structures. This translates into a higher melting temperature in D2O by 41 K when compared with light water (H2O). We have explored the hydration dynamics of the RNA, hydration shell around the RNA surface, and spatial dependence of RNA-solvent collective HB dynamics in the two water systems. Simulation in heavy water clearly showed that D2O strengthens the HB network in the solvent, lengthens inter-residue water-bridge lifetime, and weakens dynamical coupling of the hairpin to its solvation environment, which enhances the rigidity of solvent exposed sites of the native configurations. The results might suggest that like other added osmoprotectants, D2O can act as a thermostabilizer when used as a solvent.

  16. Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment.

    Science.gov (United States)

    Sartono, Erliyani; Lisse, Ida M; Terveer, Elisabeth M; van de Sande, Paula J M; Whittle, Hilton; Fisker, Ane B; Roth, Adam; Aaby, Peter; Yazdanbakhsh, Maria; Benn, Christine S

    2010-05-21

    Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG only. At age 6 weeks, the in vitro cytokine response to purified protein derivate (PPD) of M. Tuberculosis was reduced in LBW and NBW infants who had received OPV with BCG. In a pooled analysis receiving OPV with BCG at birth was associated with significantly lower IL-13 (p = 0.041) and IFN-gamma (p = 0.004) and a tendency for lower IL-10 (p = 0.054) in response to PPD. Furthermore, OPV was associated with reduced in vivo response to PPD at age 2 months, the prevalence ratio (PR) of having a PPD reaction being 0.75 (0.58-0.98), p = 0.033, and with a tendency for reduced likelihood of having a BCG scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05), p = 0.012. This study is the first to address the consequences for the immune response to BCG of simultaneous administration with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine.

  17. Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment.

    Directory of Open Access Journals (Sweden)

    Erliyani Sartono

    Full Text Available BACKGROUND: Oral polio vaccine (OPV is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW and normal-birth-weight (NBW infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. METHODS AND FINDINGS: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG only. At age 6 weeks, the in vitro cytokine response to purified protein derivate (PPD of M. Tuberculosis was reduced in LBW and NBW infants who had received OPV with BCG. In a pooled analysis receiving OPV with BCG at birth was associated with significantly lower IL-13 (p = 0.041 and IFN-gamma (p = 0.004 and a tendency for lower IL-10 (p = 0.054 in response to PPD. Furthermore, OPV was associated with reduced in vivo response to PPD at age 2 months, the prevalence ratio (PR of having a PPD reaction being 0.75 (0.58-0.98, p = 0.033, and with a tendency for reduced likelihood of having a BCG scar (0.95 (0.91-1.00, p = 0.057. Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05, p = 0.012. CONCLUSIONS: This study is the first to address the consequences for the immune response to BCG of simultaneous administration with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine.

  18. Elimination of variables in simple laser equations

    Energy Technology Data Exchange (ETDEWEB)

    Ning, C.Z.; Haken, H. (Stuttgart Univ. (Germany). Inst. fuer Theoretische Physik)

    1992-08-01

    The usual way of obtaining rate equations (RE) and a single equation for the field amplitude (EFA) from the semiclassical laser equations (Lorentz-Haken model) is reexamined by undertaking a systematic elimination procedure developed in synergetics. The RE and EFA are justified in the case 1 ({gamma}{sub perpendicular} {sub to}>> {gamma}{sub parallel}, {kappa}) and case 2 ({gamma}{sub perpendicular} {sub to}, {gamma}{sub parallel}>>{kappa}), respectively. We show that, because the eliminated variable happens to contain a considerable contribution from an unstable mode, the usual elimination technique in the case 3 ({gamma}{sub perpendicular} {sub to}, {kappa}>>{gamma}{sub parallel}) leads to an inconsistency. As important by-products we obtain the RE and EFA for arbitrary cavity relaxation constant ({kappa}). Some remarks are given on the direct elimination technique in the non-diagonal representation in the study of instabilities. (orig.).

  19. A framework for assessing the feasibility of malaria elimination

    Directory of Open Access Journals (Sweden)

    Cohen Jessica

    2010-11-01

    Full Text Available Abstract The recent scale-up of malaria interventions, the ensuing reductions in the malaria burden, and reinvigorated discussions about global eradication have led many countries to consider malaria elimination as an alternative to maintaining control measures indefinitely. Evidence-based guidance to help countries weigh their options is thus urgently needed. A quantitative feasibility assessment that balances the epidemiological situation in a region, the strength of the public health system, the resource constraints, and the status of malaria control in neighboring areas can serve as the basis for robust, long-term strategic planning. Such a malaria elimination feasibility assessment was recently prepared for the Minister of Health in Zanzibar. Based on the Zanzibar experience, a framework is proposed along three axes that assess the technical requirements to achieve and maintain elimination, the operational capacity of the malaria programme and the public health system to meet those requirements, and the feasibility of funding the necessary programmes over time. Key quantitative and qualitative metrics related to each component of the assessment are described here along with the process of collecting data and interpreting the results. Although further field testing, validation, and methodological improvements will be required to ensure applicability in different epidemiological settings, the result is a flexible, rational methodology for weighing different strategic options that can be applied in a variety of contexts to establish data-driven strategic plans.

  20. Elimination diets in the management of eosinophilic esophagitis

    Directory of Open Access Journals (Sweden)

    Wechsler JB

    2014-05-01

    Full Text Available Joshua B Wechsler, Sally Schwartz, Katie Amsden, Amir F Kagalwalla Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, IL, USA Abstract: Eosinophilic esophagitis, an increasingly recognized chronic inflammatory disorder isolated to the esophagus, is triggered by an abnormal allergic response to dietary antigens. Current treatment includes swallowed topical steroids and dietary modification, which aim to resolve symptoms and prevent long-term complications such as formation of strictures. The dietary approach has become more widely accepted because long-term steroid therapy is associated with potential risks. Dietary treatment includes elemental and elimination diets. An exclusive elemental diet, which requires replacement of all intact protein with amino acid-based formula, offers the best response of all available therapies, with remission in up to 96% of subjects proving it to be superior to all other available therapies including topical steroids. However, compliance with this approach is challenging because of poor taste and monotony. The high cost of formula and the associated psychosocial problems are additional drawbacks of this approach. Empiric and allergy test-directed elimination diets have gained popularity given that elimination of a limited number of foods is much easier and as such is more readily acceptable. There is a growing body of literature supporting this type of therapy in both children and adults. This paper reviews the evidence for all types of dietary therapy in eosinophilic esophagitis. Keywords: eosinophilic esophagitis, dietary therapy, empiric elimination, elemental, allergy test-directed

  1. Fabrication techniques to eliminate postweld heat treatment

    International Nuclear Information System (INIS)

    Lochhead, J.C.

    1978-01-01

    Postweld heat treatments to reduce residual stresses (stress relief operations) have been a common practice in the pressure vessel industry for a large number of years. A suitable heat treatment operation can, in particular for low alloy steels, have additional beneficial effects, i.e. a reduction in peak hardness values in the heat-affected zone, an improvement in weld metal properties, and a lowering of the adverse effects of the welding process on the mechanical properties of the parent material adjacent to the weld metal. However, continuing studies in the field of brittle fracture, improved parent materials, and more sophisticated nondestructive testing techniques have led to the elimination of such a practice in ever-increasing thickness ranges and types of material. For instance, the recently issued BS 5500 compared with BS 1113 (1969) lifts the thickness limit requiring stress relief in certain circumstances from 19 to 35mm for C steels. With respect to materials the CEGB has stated that as a result of successful operational experience it will no longer be necessary to postweld heat treat butt welds in 2 1/4 Cr-1Mo tubes of certain dimensions. Despite this trend, over a period of years a number of instances have arisen where, because of some factor, postweld heat treatment, although perhaps desirable, is not possible. This Paper describes several such examples. It must be noted that the examples quoted consist of relatively important and major items. It has been necessary within the confines of this Paper to condense the reports. It is hoped that no significant factors have been omitted. (author)

  2. [The frequency of detection of non-polio enteroviruses in foul and fecal waste waters, water and some food products].

    Science.gov (United States)

    Sergevnin, V I; Tryasolobova, M A; Kudrevatykh, E V; Kuzovnikova, E Z

    2016-01-01

    In the Perm Territory from 2010 to 2014 155 samples offoul andfecal waste waters, 293 samples of surface water, 827 samples of supply net water, and 57 vegetable and fruit water-washes were examined for the RNA enterovirus agent with the use of polymerase chain reaction (PCR) method. In parallel 155 wastewater samples, 20 samples of surface water, and 4 samples of supply net water were examined for non-polio enterovirus agent with the use of virological methods. In the samples of foul waste waters the RNA enterovirus agent was detected in 74.8 ± 3.4%, and nonpolio enterovirus agent - in 65.1 ± 3.8%. In the samples of surface water the RNA enterovirus agent was detected in 2.3 ± 0.8%; in the area offoul and fecal waste waters the non-polio enterovirus agent was detected in 20.0 ± 4.4% in the process of virological investigation of RNA-positive water samples. In supply net water the RNA enterovirus agent was detected in 0.8 ± 0.3 %, on the surface of vegetables, fruits, and grapes - in 10.5 ± 3.9 %.

  3. Fine structure of changes produced in cultured cells sampled at specified intervals during a single growth cycle of polio virus.

    Science.gov (United States)

    KALLMAN, F; WILLIAMS, R C; DULBECCO, R; VOGT, M

    1958-05-25

    Primary suspended cultures of rhesus monkey kidney cells were infected with poliomyelitis virus, type 1 (Brunhilde strain). The release of virus from these cells over a one-step growth curve was correlated with their change in fine structure, as seen in the electron microscope. Most of the cells were infected nearly simultaneously, and morphological changes developed in the cells were sufficiently synchronous to be classified into three stages. The earliest change (stage I) became visible at a time when virus release into the culture fluid begins, some 3 hours after adsorption. Accentuation of the abnormal characteristics soon occurs, at 4 to 7 hours after adsorption, and results in stage II. Stage III represents the appearance of cells after their rate of virus release had passed its maximum, and probably the abnormal morphology of these cells reflects non-specific physiological damage. There seems to be consistency between the previously described cellular changes as seen under the light microscope and the finer scale changes reported here. Cytoplasmic bodies, called U bodies, were seen in large number at the time when the virus release was the most rapid (stage II). While these bodies are not of proper size to be considered polio virus, they seem to be specifically related to the infection. No evidence was found for the presence of particles that could even be presumptively identified with those of polio virus.

  4. Body elimination attitude family resemblance in Kuwait.

    Science.gov (United States)

    Al-Fayez, Ghenaim; Awadalla, Abdelwahid; Arikawa, Hiroko; Templer, Donald I; Hutton, Shane

    2009-12-01

    The purpose of the present study was to determine the family resemblance of attitude toward body elimination in Kuwaiti participants. This study was conceptualized in the context of the theories of moral development, importance of cleanliness in the Muslim religion, cross-cultural differences in personal hygiene practices, previous research reporting an association between family attitudes and body elimination attitude, and health implications. The 24-item Likert-type format Body Elimination Attitude Scale-Revised was administered to 277 Kuwaiti high school students and 437 of their parents. Females scored higher, indicating greater disgust, than the males. Moreover, sons' body elimination attitude correlated more strongly with fathers' attitude (r = .85) than with that of the mothers (r = .64). Daughters' attitude was similarly associated with the fathers' (r = .89) and the mothers' attitude (r = .86). The high correlations were discussed within the context of Kuwait having a collectivistic culture with authoritarian parenting style. The higher adolescent correlations, and in particular the boys' correlation with fathers than with mothers, was explained in terms of the more dominant role of the Muslim father in the family. Public health and future research implications were suggested. A theoretical formulation was advanced in which "ideal" body elimination attitude is relative rather than absolute, and is a function of one's life circumstances, one's occupation, one's culture and subculture, and the society that one lives in.

  5. Martian Atmospheric Pressure Static Charge Elimination Tool

    Science.gov (United States)

    Johansen, Michael R.

    2014-01-01

    A Martian pressure static charge elimination tool is currently in development in the Electrostatics and Surface Physics Laboratory (ESPL) at NASA's Kennedy Space Center. In standard Earth atmosphere conditions, static charge can be neutralized from an insulating surface using air ionizers. These air ionizers generate ions through corona breakdown. The Martian atmosphere is 7 Torr of mostly carbon dioxide, which makes it inherently difficult to use similar methods as those used for standard atmosphere static elimination tools. An initial prototype has been developed to show feasibility of static charge elimination at low pressure, using corona discharge. A needle point and thin wire loop are used as the corona generating electrodes. A photo of the test apparatus is shown below. Positive and negative high voltage pulses are sent to the needle point. This creates positive and negative ions that can be used for static charge neutralization. In a preliminary test, a floating metal plate was charged to approximately 600 volts under Martian atmospheric conditions. The static elimination tool was enabled and the voltage on the metal plate dropped rapidly to -100 volts. This test data is displayed below. Optimization is necessary to improve the electrostatic balance of the static elimination tool.

  6. Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: A qualitative study

    Directory of Open Access Journals (Sweden)

    Christina Brogårdh

    2017-08-01

    Full Text Available Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-to-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years with late effects of polio. Results: Analysis resulted in one main theme, “Everyday life is a challenge to avoid the consequences of falls”, and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problem-focused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.

  7. The virus and the vaccine: the true story of a cancer-causing monkey virus, contaminated polio vaccine, and the millions of Americans exposed

    National Research Council Canada - National Science Library

    Bookchin, Debbie; Schumacher, Jim

    2004-01-01

    .... But the story of the vaccine has a dark side, one that has never been fully told before... Between 1954 and 1963, close to 98 million Americans received polio vaccinations contaminated with a carcinogenic monkey virus, now known as SV40...

  8. Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

    Science.gov (United States)

    Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

    2017-07-01

    To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  9. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Murray Deirdre

    2012-12-01

    Full Text Available Abstract Background Many Polio survivors have reduced mobility, pain and fatigue, which make access to conventional forms of aerobic exercise difficult. Inactivity leads to increased risk of health problems, many of which are prevalent among Polio survivors. Aerobic exercise programmes in Polio survivors should utilise stable muscle groups and should be designed to minimise exacerbation of pain and fatigue. A home-based arm ergometry aerobic exercise programme may represent an affordable and accessible exercise modality, incorporating exercise prescription principles in this group. Methods/design This is a prospective, single blinded, randomised controlled trial. There are two arms; exercise intervention using arm ergometers and control. Polio survivors meeting eligibility criteria will be recruited and randomly allocated to intervention or control groups. Participants allocated to the intervention group will receive a small arm ergometer and a polar heart rate monitor. They will carry out a home-based moderate intensity (50-70% HRMax aerobic exercise programme for eight weeks, following instruction by the treating physiotherapist. Assessments will occur at baseline and after eight weeks and will include tests of physical fitness, activity, energy cost of walking, fatigue and quality of life. Clinically feasible assessment tools including the Six Minute Arm Test, the Physical Activity Scale for People with Physical Disabilities questionnaire, the Physiological Cost Index, Fatigue Severity Scale and the SF-36v2 will be utilised. Discussion The efficacy of a home-based arm ergometry programme in Polio survivors will be examined. No previous trial has examined such a programme using a wide range of outcome measures pertinent to Polio survivors. This study will provide new information on the impact of arm ergometry on physical fitness, activity, body composition, fatigue, pain, muscle strength, and health related quality of life. Also, the study

  10. Costs of eliminating malaria and the impact of the global fund in 34 countries.

    Directory of Open Access Journals (Sweden)

    Brittany Zelman

    Full Text Available International financing for malaria increased more than 18-fold between 2000 and 2011; the largest source came from The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund. Countries have made substantial progress, but achieving elimination requires sustained finances to interrupt transmission and prevent reintroduction. Since 2011, global financing for malaria has declined, fueling concerns that further progress will be impeded, especially for current malaria-eliminating countries that may face resurgent malaria if programs are disrupted.This study aims to 1 assess past total and Global Fund funding to the 34 current malaria-eliminating countries, and 2 estimate their future funding needs to achieve malaria elimination and prevent reintroduction through 2030.Historical funding is assessed against trends in country-level malaria annual parasite incidences (APIs and income per capita. Following Kizewski et al. (2007, program costs to eliminate malaria and prevent reintroduction through 2030 are estimated using a deterministic model. The cost parameters are tailored to a package of interventions aimed at malaria elimination and prevention of reintroduction.The majority of Global Fund-supported countries experiencing increases in total funding from 2005 to 2010 coincided with reductions in malaria APIs and also overall GNI per capita average annual growth. The total amount of projected funding needed for the current malaria-eliminating countries to achieve elimination and prevent reintroduction through 2030 is approximately US$8.5 billion, or about $1.84 per person at risk per year (PPY (ranging from $2.51 PPY in 2014 to $1.43 PPY in 2030.Although external donor funding, particularly from the Global Fund, has been key for many malaria-eliminating countries, sustained and sufficient financing is critical for furthering global malaria elimination. Projected cost estimates for elimination provide policymakers with an indication of the

  11. Costs of Eliminating Malaria and the Impact of the Global Fund in 34 Countries

    Science.gov (United States)

    Zelman, Brittany; Kiszewski, Anthony; Cotter, Chris; Liu, Jenny

    2014-01-01

    Background International financing for malaria increased more than 18-fold between 2000 and 2011; the largest source came from The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). Countries have made substantial progress, but achieving elimination requires sustained finances to interrupt transmission and prevent reintroduction. Since 2011, global financing for malaria has declined, fueling concerns that further progress will be impeded, especially for current malaria-eliminating countries that may face resurgent malaria if programs are disrupted. Objectives This study aims to 1) assess past total and Global Fund funding to the 34 current malaria-eliminating countries, and 2) estimate their future funding needs to achieve malaria elimination and prevent reintroduction through 2030. Methods Historical funding is assessed against trends in country-level malaria annual parasite incidences (APIs) and income per capita. Following Kizewski et al. (2007), program costs to eliminate malaria and prevent reintroduction through 2030 are estimated using a deterministic model. The cost parameters are tailored to a package of interventions aimed at malaria elimination and prevention of reintroduction. Results The majority of Global Fund-supported countries experiencing increases in total funding from 2005 to 2010 coincided with reductions in malaria APIs and also overall GNI per capita average annual growth. The total amount of projected funding needed for the current malaria-eliminating countries to achieve elimination and prevent reintroduction through 2030 is approximately US$8.5 billion, or about $1.84 per person at risk per year (PPY) (ranging from $2.51 PPY in 2014 to $1.43 PPY in 2030). Conclusions Although external donor funding, particularly from the Global Fund, has been key for many malaria-eliminating countries, sustained and sufficient financing is critical for furthering global malaria elimination. Projected cost estimates for elimination provide

  12. Restless legs syndrome and post polio syndrome: a case-control study.

    Science.gov (United States)

    Romigi, A; Pierantozzi, M; Placidi, F; Evangelista, E; Albanese, M; Liguori, C; Nazzaro, M; Risina, B U; Simonelli, V; Izzi, F; Mercuri, N B; Desiato, M T

    2015-03-01

    The aim was to investigate the prevalence of restless legs syndrome (RLS), fatigue and daytime sleepiness in a large cohort of patients affected by post polio syndrome (PPS) and their impact on patient health-related quality of life (HRQoL) compared with healthy subjects. PPS patients were evaluated by means of the Stanford Sleepiness Scale and the Fatigue Severity Scale (FSS). The Short Form Health Survey (SF-36) questionnaire was utilized to assess HRQoL in PPS. RLS was diagnosed when standard criteria were met. Age and sex matched healthy controls were recruited amongst spouses or friends of PPS subjects. A total of 66 PPS patients and 80 healthy controls were enrolled in the study. A significantly higher prevalence of RLS (P < 0.0005; odds ratio 21.5; 95% confidence interval 8.17-57) was found in PPS patients (PPS/RLS+ 63.6%) than in healthy controls (7.5%). The FSS score was higher in PPS/RLS+ than in PPS/RLS- patients (P = 0.03). A significant decrease of SF-36 scores, including the physical function (P = 0.001), physical role (P = 0.0001) and bodily pain (P = 0.03) domains, was found in PPS/RLS+ versus PPS/RLS- patients. Finally, it was found that PPS/RLS+ showed a significant correlation between International Restless Legs Scale score and FSS (P < 0.0001), as well as between International Restless Legs Scale score and most of the SF-36 items (physical role P = 0.0018, general health P = 0.0009, vitality P = 0.0022, social functioning P = 0.002, role emotional P = 0.0019, and mental health P = 0.0003). Our findings demonstrate a high prevalence of RLS in PPS, and that RLS occurrence may significantly influence the HRQoL and fatigue of PPS patients. A hypothetical link between neuroanatomical and inflammatory mechanisms in RLS and PPS is suggested. © 2014 EAN.

  13. Elimination of Ideas and Professional Socialisation

    DEFF Research Database (Denmark)

    Gravengaard, Gitte; Rimestad, Lene

    2012-01-01

    . Our aim is to study how this building of expertise takes place at meetings with a particular focus on the decision-making process concerning ideas for new news stories. In order to do this, we perform linguistic analysis of news production practices, as we investigate how the journalists' ideas......This article investigates and interprets social and cultural production and reproduction as we turn our attention to an important part of routinised practice in the newsroom: the early newsroom meetings. These meetings are essential sites for the building of the craft ethos and professional vision...... for potential news stories are eliminated by the editor at the daily newsroom meetings. The elimination of ideas for news stories are not just eliminations; they are also corrections of culturally undesirable behaviour producing and reproducing the proper perception of an important object of knowledge...

  14. Ten years left to eliminate blinding trachoma

    Directory of Open Access Journals (Sweden)

    Haddad D.

    2010-09-01

    Full Text Available n 1997, the World Health Organization formed the Global Alliance to Eliminate Blinding Trachoma by 2020 (GET 2020, a coalition of governmental, non-governmental, research, and pharmaceutical partners. In 1998, the World Health Assembly urged member states to map blinding trachoma in endemic areas, implement the SAFE strategy (which stands for surgery for trichiasis, antibiotics, facial-cleanliness and environmental change, such as clean water and latrines and collaborate with the global alliance in its work to eliminate blinding trachoma.

  15. Did the call for boycott by the Catholic bishops affect the polio vaccination coverage in Kenya in 2015? A cross-sectional study.

    Science.gov (United States)

    Njeru, Ian; Ajack, Yusuf; Muitherero, Charles; Onyango, Dickens; Musyoka, Johnny; Onuekusi, Iheoma; Kioko, Jackson; Muraguri, Nicholas; Davis, Robert

    2016-01-01

    Polio eradication is now feasible after removal of Nigeria from the list of endemic countries and global reduction of cases of wild polio virus in 2015 by more than 80%. However, all countries must remain focused to achieve eradication. In August 2015, the Catholic bishops in Kenya called for boycott of a polio vaccination campaign citing safety concerns with the polio vaccine. We conducted a survey to establish if the coverage was affected by the boycott. A cross sectional survey was conducted in all the 32 counties that participated in the campaign. A total of 90,157 children and 37,732 parents/guardians were sampled to determine the vaccination coverage and reasons for missed vaccination. The national vaccination coverage was 93% compared to 94% in the November 2014 campaign. The proportion of parents/guardians that belonged to Catholic Church was 31% compared to 7% of the children who were missed. Reasons for missed vaccination included house not being visited (44%), children not being at home at time of visit (38%), refusal by parents (12%), children being as leep (1%), and various other reasons (5%). Compared to the November 2014 campaign, the proportion of children who were not vaccinated due to parent's refusal significantly increased from 6% to 12% in August 2015. The call for boycott did not affect the campaign significantly. However, if the call for boycott is repeated in future it could have some significant negative implication to polio eradication. It is therefore important to ensure that any vaccine safety issues are addressed accordingly.

  16. Strategy elimination in games with interaction structures

    NARCIS (Netherlands)

    Witzel, A.; Apt, K.R.; Zvesper, J.A.

    2009-01-01

    We study games in the presence of an interaction structure, which allows players to communicate their preferences, assuming that each player initially only knows his own preferences. We study the outcomes of iterated elimination of strictly dominated strategies (IESDS) that can be obtained in any

  17. Eliminating transducer distortion in acoustic measurements

    DEFF Research Database (Denmark)

    Agerkvist, Finn T.; Torras Rosell, Antoni; McWalter, Richard Ian

    2014-01-01

    This paper investigates the in uence of nonlinear components that contaminate the linear response of acoustic transducer, and presents a method for eliminating the in uence of nonlinearities in acoustic measurements. The method is evaluated on simulated as well as experimental data, and is shown ...

  18. Gram-Schmidt Orthogonalization by Gauss Elimination.

    Science.gov (United States)

    Pursell, Lyle; Trimble, S. Y.

    1991-01-01

    Described is the hand-calculation method for the orthogonalization of a given set of vectors through the integration of Gaussian elimination with existing algorithms. Although not numerically preferable, this method adds increased precision as well as organization to the solution process. (JJK)

  19. Accelerating to Zero: Strategies to Eliminate Malaria in the Peruvian Amazon

    Science.gov (United States)

    Quispe, Antonio M.; Llanos-Cuentas, Alejandro; Rodriguez, Hugo; Clendenes, Martin; Cabezas, Cesar; Leon, Luis M.; Chuquiyauri, Raul; Moreno, Marta; Kaslow, David C.; Grogl, Max; Herrera, Sócrates; Magill, Alan J.; Kosek, Margaret; Vinetz, Joseph M.; Lescano, Andres G.; Gotuzzo, Eduardo

    2016-01-01

    In February 2014, the Malaria Elimination Working Group, in partnership with the Peruvian Ministry of Health (MoH), hosted its first international conference on malaria elimination in Iquitos, Peru. The 2-day meeting gathered 85 malaria experts, including 18 international panelists, 23 stakeholders from different malaria-endemic regions of Peru, and 11 MoH authorities. The main outcome was consensus that implementing a malaria elimination project in the Amazon region is achievable, but would require: 1) a comprehensive strategic plan, 2) the altering of current programmatic guidelines from control toward elimination by including symptomatic as well as asymptomatic individuals for antimalarial therapy and transmission-blocking interventions, and 3) the prioritization of community-based active case detection with proper rapid diagnostic tests to interrupt transmission. Elimination efforts must involve key stakeholders and experts at every level of government and include integrated research activities to evaluate, implement, and tailor sustainable interventions appropriate to the region.

  20. Transmission dynamics and prospects for the elimination of canine rabies.

    Directory of Open Access Journals (Sweden)

    Katie Hampson

    2009-03-01

    Full Text Available Rabies has been eliminated from domestic dog populations in Western Europe and North America, but continues to kill many thousands of people throughout Africa and Asia every year. A quantitative understanding of transmission dynamics in domestic dog populations provides critical information to assess whether global elimination of canine rabies is possible. We report extensive observations of individual rabid animals in Tanzania and generate a uniquely detailed analysis of transmission biology, which explains important epidemiological features, including the level of variation in epidemic trajectories. We found that the basic reproductive number for rabies, R0, is very low in our study area in rural Africa (approximately 1.2 and throughout its historic global range (<2. This finding provides strong support for the feasibility of controlling endemic canine rabies by vaccination, even near wildlife areas with large wild carnivore populations. However, we show that rapid turnover of domestic dog populations has been a major obstacle to successful control in developing countries, thus regular pulse vaccinations will be required to maintain population-level immunity between campaigns. Nonetheless our analyses suggest that with sustained, international commitment, global elimination of rabies from domestic dog populations, the most dangerous vector to humans, is a realistic goal.

  1. [Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning].

    Science.gov (United States)

    Garip, Yesim; Eser, Filiz; Bodur, Hatice; Baskan, Bedriye; Sivas, Filiz; Yilmaz, Ozlem

    2015-02-07

    To determine the impact of postpolio-syndrome on quality of life in polio survivors. Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Total manual muscle testing score was 26.19±13.24 (median: 29) in postpolio-syndrome group and 30.08±8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  2. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning

    Directory of Open Access Journals (Sweden)

    Yesim Garip

    Full Text Available ABSTRACT Objective: To determine the impact of postpolio-syndrome on quality of life in polio survivors. Methods: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Results: Total manual muscle testing score was 26.19 ± 13.24 (median: 29 in postpolio-syndrome group and 30.08 ± 8.9 (median: 32 in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Conclusions: Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life.

  3. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning.

    Science.gov (United States)

    Garip, Yesim; Eser, Filiz; Bodur, Hatice; Baskan, Bedriye; Sivas, Filiz; Yilmaz, Ozlem

    To determine the impact of postpolio-syndrome on quality of life in polio survivors. Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Total manual muscle testing score was 26.19±13.24 (median: 29) in postpolio-syndrome group and 30.08±8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  4. Correlation between vaccine coverage against polio and circulation and genetic evolution of the poliovirus strains isolated in Romania in the framework of the global polio eradication strategy.

    Science.gov (United States)

    Băicuş, Anda; Persu, Ana; Popescu, Maria; Penciu, Alina; Stavri, Simona; Soare, Alina; Grecu, Nicolae; Szmal, Camelia; Oprişan, Gabriela

    2009-01-01

    Until 2008 in Romania poliomyelitis has been controlled by predominantly using trivalent oral poliovirus vaccine (TOPV). The alternative vaccination schedule (formalin inactivated poliovirus vaccine IPV/OPV) has been implemented starting September 2008 and at the begining of 2009 was decided only vaccination with IPV. Between 1995-2006 the risk of the vaccine-associated paralytic poliomyelitis (VAPP) decreased with an average of less than 2 VAPP cases/year and no VAPP case between 2007 - September 2009. Begining with 2007 the number of the poliovirus strains isolated was less. All 9 poliovirus strains (PV) isolated between 2007-2009 and investigated by RT-PCR-RFLP in VP1-2A and VP3-VP1 coding regions showed Sabin-like profiles, and only one strain poliovirus type 3 showed Sabin 2-like profile by RFLP in 3D coding ARN polymerase region. The study about the seroprevalence of antibodies against poliovirus types in serum samples from the acute flaccid paralysis (AFP), facial paralysis (FP) cases showed that the seroprevalence of antibodies against types 1 and 2 Sabin strains was higher (>90%) than for type 3 Sabin strains (average 85%). It was confirmed the necessity of maintaining a proper vaccine coverage in population, after the switch in the vaccination strategy in Romania until all threats of poliovirus are eliminated globally.

  5. Noise Elimination Study for a Single Station Magnetotelluric Data

    Science.gov (United States)

    Şengül, Ebru; Uǧur Ulugergerli, Emin; Göktaş, Hilal

    2010-05-01

    Five components of the natural electromagnetic field relating to underground conductivity distribution on Earth are measured as a time series in the Magnetotelluric (MT) method. E (Ex, Ey) and H (Hx, Hy, Hz) components of the electromagnetic field suffers from noise contamination. The noise, in general, can be classified as random and systematic noise. Random noise disrupts the pattern of data such as sudden signal peaks and/or step structures called impulsive effect. This type of noise usually is dominant in some parts of the time series. The sources of random noise vary; some of the sources are instrumental problems and atmospheric events. On the other hand, systematic noise occurs at certain frequencies and is added to the data. Industrial activities cause such type of the noise and can corrupt all the data set. The estimation of the impedance tensor from single-station MT data is subject to this study. The proposed method uses statistical approaches focused on the noise elimination techniques. Noise elimination from MT time series is very important particularly to achieve repeatable impedance values using single station MT data. The conventional impedance estimation technique requires solution of a linear equation system (E = ZH) based on Gaussian statistical model which requires the noise of electric channels should obey Gaussian distribution and magnetic channels should be noise free. In fact, measured data never provides this ideal condition. Therefore, noise elimination techniques are very important step in data processing works in MT method. Random noise such as spikes makes deviations in impedance values, resistivity and phase curves. Random noise should be eliminated to correct of these deviations in the data. For this purpose firstly, all data are divided into time windows. Each window consists of 512 values. After that, spikes are removed and missing data are regenerated by using interpolation technique for each window in time domain. Then, data are

  6. Lot quality assurance sampling to monitor supplemental immunization activity quality: an essential tool for improving performance in polio endemic countries.

    Science.gov (United States)

    Brown, Alexandra E; Okayasu, Hiromasa; Nzioki, Michael M; Wadood, Mufti Z; Chabot-Couture, Guillaume; Quddus, Arshad; Walker, George; Sutter, Roland W

    2014-11-01

    Monitoring the quality of supplementary immunization activities (SIAs) is a key tool for polio eradication. Regular monitoring data, however, are often unreliable, showing high coverage levels in virtually all areas, including those with ongoing virus circulation. To address this challenge, lot quality assurance sampling (LQAS) was introduced in 2009 as an additional tool to monitor SIA quality. Now used in 8 countries, LQAS provides a number of programmatic benefits: identifying areas of weak coverage quality with statistical reliability, differentiating areas of varying coverage with greater precision, and allowing for trend analysis of campaign quality. LQAS also accommodates changes to survey format, interpretation thresholds, evaluations of sample size, and data collection through mobile phones to improve timeliness of reporting and allow for visualization of campaign quality. LQAS becomes increasingly important to address remaining gaps in SIA quality and help focus resources on high-risk areas to prevent the continued transmission of wild poliovirus. © Crown copyright 2014.

  7. [An autopsy case of progressive generalized muscle atrophy over 14 years due to post-polio syndrome].

    Science.gov (United States)

    Oki, Ryosuke; Uchino, Akiko; Izumi, Yuishin; Ogawa, Hirohisa; Murayama, Shigeo; Kaji, Ryuji

    2016-01-01

    We report the case of a 72-year-old man who had contracted acute paralytic poliomyelitis in his childhood. Thereafter, he had suffered from paresis involving the left lower limb, with no relapse or progression of the disease. He began noticing slowly progressive muscle weakness and atrophy in the upper and lower extremities in his 60s. At the age of 72, muscle weakness developed rapidly, and he demonstrated dyspnea on exertion and dysphagia. He died after about 14 years from the onset of muscle weakness symptoms. Autopsy findings demonstrated motoneuron loss and glial scars not only in the plaque-like lesions in the anterior horns, which were sequelae of old poliomyelitis, but also throughout the spine. No Bunina bodies, TDP-43, and ubiquitin inclusions were found. Post-polio syndrome is rarely fatal due to rapid progressive dyspnea and dysphagia. Thus, the pathological findings in the patient are considered to be related to the development of muscle weakness.

  8. Flexion Osteotomy in Genu Recurvatum Following Post-Polio Syndrome: Use of an Old Technique in a New Condition

    Directory of Open Access Journals (Sweden)

    Abolfazle Bagherifard

    2017-05-01

    Full Text Available Introduction Post-polio syndrome (PPS can have devastating functional effects on the walking ability of patients decades after the acute disease. Genu recurvatum, as a consequence of PPS, is one such disability which can be treated through different measures. Case Presentation A 43-year-old woman with a history of supracondylar extension osteotomy of the left femur at the age of 22 was admitted to our hospital for a flexion contracture of the left knee due to poliomyelitis. She was able to walk without assistance for 20 years after the osteotomy until one year ago, when she started to experience progressive genu recurvatum. In the clinical and laboratory workup, she was diagnosed with PPS. Accordingly, we decided to perform supracondylar flexion osteotomy. Conclusions Supracondylar flexion osteotomy in patients with genu recurvatum, as a consequence of PPS, is a valuable treatment, which can relieve the patients' dependence on walking aids and improve their symptoms.

  9. [The International Classification of Diseases, the Family of International Classifications, the ICD-11, and post-polio syndrome].

    Science.gov (United States)

    Laurenti, Ruy; Nubila, Heloisa Brunow Ventura Di; Quadros, Abrahão Augusto Joviniano; Conde, Mônica Tilli Reis Pessoa; Oliveira, Acary Souza Bulle

    2013-09-01

    The first International Classification of Diseases (ICD) was approved in 1893 and since then it has been periodically reviewed. The last, 10th revision (ICD-10), was approved in 1989. Since 1989, it was possible to update from ICD revisions, which did not happen before. The next revision (ICD-11) would probably be published in 2015. In 1989, mechanisms were established to update ICD-10, through the creation of the Morbidity Reference Group (MbRG) in 1997 and the Update and Revision Committee (URC) in 2000. The Morbidity Reference Group (MbRG) was created in 2007 to discuss in more detail the issues to update morbidity. A specific code in ICD was not included in the revision of ICD-10 in 1989 for the post-polio syndrome (PPS). However, the ICD new code G14 for PPS was included in ICD-10 since 2010.

  10. [Polio vaccination and stool screening in German reception centers for asylum seekers, November 2013-January 2014 : What was implemented?].

    Science.gov (United States)

    Zeitlmann, Nadine; George, Maja; Falkenhorst, Gerhard

    2016-05-01

    Following the polio outbreak in Syria and the rising number of Syrian asylum seekers in Germany in 2013, the Robert Koch Institute recommended - within the context of existing vaccination recommendations for asylum seekers - on 01/11/2013 to prioritize polio vaccination of Syrian asylum seekers and stool screening in a target group of Syrian asylum seekers aged less than three years. The article evaluates the implementation of this recommendation in German asylum seeker reception centres (RC) to gain further knowledge on the vaccination practices in RCs and to identify opportunities for improving future recommendations. The electronic questionnaire was sent by email to all German RCs, asking for general information on the RC, existing vaccination efforts, the main obstacles for implementation of the recommendations, the number of incoming and vaccinated asylum seekers, and asylum seekers screened for poliovirus in the period from 01/11/2013 to 31/01/2014. The RCs rated the feasibility of the recommendation and the provided multilingual information material. All of the 20 identified RCs responded. During the study period, 33.874 asylum seekers arrived in the RCs. Of those with available information about possession of a vaccination record, on average 1.6 % did have one. All RCs offered timely vaccination to Syrian asylum seekers younger than three years. In this target group, eight RC achieved vaccination coverages of ≥ 80 %. Stool screening coverage was ≥ 80 % in five of 19 RCs. Eleven RCs rated the recommendation as very well/well implementable. Staff shortages and language barriers were mentioned as the main implementation obstacles. Similar future recommendations for asylum seekers in RCs should be accompanied by informational material in additional languages. Staff shortages hampering implementation could be overcome through collaborations with non-governmental organizations.

  11. National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials

    Directory of Open Access Journals (Sweden)

    Andreas Andersen

    2018-02-01

    Full Text Available BackgroundA recent WHO review concluded that live BCG and measles vaccine (MV may have beneficial non-specific effects (NSEs reducing mortality from non-targeted diseases. NSEs of oral polio vaccine (OPV were not examined. If OPV vaccination campaigns reduce the mortality rate, it would suggest beneficial NSEs.SettingBetween 2002 and 2014, Guinea-Bissau had 15 general OPV campaigns and other campaigns with OPV plus vitamin A supplementation (VAS, VAS-only, MV, and H1N1 vaccine. In this period, we conducted seven randomized controlled trials (RCTs with mortality as main outcome.MethodsWithin these RCTs, we assessed whether the mortality rate was lower after-campaign than before-campaign. We used Cox models with age as underlying time and further adjusted for low birth-weight, season and time trend in mortality. We calculated the adjusted mortality rate ratio (MRR for after-campaign vs before-campaign.ResultsThe mortality rate was lower after OPV-only campaigns than before, the MRR being 0.81 (95% CI = 0.68–0.95. With each additional dose of campaign-OPV the mortality rate declined further (MRR = 0.87 (95% CI: 0.79–0.96 per dose (test for trend, p = 0.005. No other type of campaign had similar beneficial effects. Depending on initial age and with follow-up to 3 years of age, the number needed to treat with campaign-OPV-only to save one life was between 68 and 230 children.ConclusionBissau had no case of polio infection so the results suggest that campaign-OPV has beneficial NSEs. Discontinuation of OPV-campaigns in low-income countries may affect general child mortality levels negatively.

  12. Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants.

    Science.gov (United States)

    Taniuchi, Mami; Platts-Mills, James A; Begum, Sharmin; Uddin, Md Jashim; Sobuz, Shihab U; Liu, Jie; Kirkpatrick, Beth D; Colgate, E Ross; Carmolli, Marya P; Dickson, Dorothy M; Nayak, Uma; Haque, Rashidul; Petri, William A; Houpt, Eric R

    2016-06-08

    Oral polio vaccine (OPV) and rotavirus vaccine (RV) exhibit poorer performance in low-income settings compared to high-income settings. Prior studies have suggested an inhibitory effect of concurrent non-polio enterovirus (NPEV) infection, but the impact of other enteric infections has not been comprehensively evaluated. In urban Bangladesh, we tested stools for a broad range of enteric viruses, bacteria, parasites, and fungi by quantitative PCR from infants at weeks 6 and 10 of life, coincident with the first OPV and RV administration respectively, and examined the association between enteropathogen quantity and subsequent OPV serum neutralizing titers, serum rotavirus IgA, and rotavirus diarrhea. Campylobacter and enterovirus (EV) quantity at the time of administration of the first dose of OPV was associated with lower OPV1-2 serum neutralizing titers, while enterovirus quantity was also associated with diminished rotavirus IgA (-0.08 change in log titer per tenfold increase in quantity; P=0.037), failure to seroconvert (OR 0.78, 95% CI: 0.64-0.96; P=0.022), and breakthrough rotavirus diarrhea (OR 1.34, 95% CI: 1.05-1.71; P=0.020) after adjusting for potential confounders. These associations were not observed for Sabin strain poliovirus quantity. In this broad survey of enteropathogens and oral vaccine performance we find a particular association between EV carriage, particularly NPEV, and OPV immunogenicity and RV protection. Strategies to reduce EV infections may improve oral vaccine responses. ClinicalTrials.gov Identifier: NCT01375647. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Eliminative behaviour of dairy cows at pasture

    DEFF Research Database (Denmark)

    Whistance, Lindsay Kay; Sinclair, Liam A.; Arney, David Richard

    2011-01-01

    Despite a strong avoidance of grazing near dung patches, cattle have traditionally been considered not to avoid bodily contact with faeces, regardless of any risk of disease. Little is understood of the behaviour of pasture-kept dairy cows at the time of defaecation and therefore, the eliminative...... behaviour of 40 Holstein-Friesian cows was observed at pasture for6 heach day between morning and afternoon milking for a total of24 h. Lying (l), standing (s) and walking (w) behaviours were recorded pre, during and post-elimination. Sequences of 3–6 changes in these behaviours were recorded if expressed...... observed events (uppercase letters denote behaviour during defaecation). In all recorded events, 383 stood and 54 walked whilst defaecating (P

  14. Assessment of the Status of Measles Elimination in the United States, 2001-2014.

    Science.gov (United States)

    Gastañaduy, Paul A; Paul, Prabasaj; Fiebelkorn, Amy Parker; Redd, Susan B; Lopman, Ben A; Gambhir, Manoj; Wallace, Gregory S

    2017-04-01

    We assessed the status of measles elimination in the United States using outbreak notification data. Measles transmissibility was assessed by estimation of the reproduction number, R, the average number of secondary cases per infection, using 4 methods; elimination requires maintaining R at measles transmission is maintained in the United States. A suggested increase in measles transmissibility since elimination warrants continued monitoring and emphasizes the importance of high measles vaccination coverage throughout the population. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  15. Hitting Hotspots: Spatial Targeting of Malaria for Control and Elimination

    NARCIS (Netherlands)

    Bousema, T.; Griffin, J.T.; Sauerwein, R.W.; Smith, D.L.; Churcher, T.S.; Takken, W.; Ghani, A.; Drakeley, C.; Gosling, R.

    2012-01-01

    Current malaria elimination guidelines are based on the concept that malaria transmission becomes heterogeneous in the later phases of malaria elimination [1]. In the pre-elimination and elimination phases, interventions have to be targeted to entire villages or towns with higher malaria incidence

  16. How absolute is zero? An evaluation of historical and current definitions of malaria elimination.

    Science.gov (United States)

    Cohen, Justin M; Moonen, Bruno; Snow, Robert W; Smith, David L

    2010-07-22

    Decisions to eliminate malaria from all or part of a country involve a complex set of factors, and this complexity is compounded by ambiguity surrounding some of the key terminology, most notably "control" and "elimination." It is impossible to forecast resource and operational requirements accurately if endpoints have not been defined clearly, yet even during the Global Malaria Eradication Program, debate raged over the precise definition of "eradication." Analogous deliberations regarding the meaning of "elimination" and "control" are basically nonexistent today despite these terms' core importance to programme planning. To advance the contemporary debate about these issues, this paper presents a historical review of commonly used terms, including control, elimination, and eradication, to help contextualize current understanding of these concepts. The review has been supported by analysis of the underlying mathematical concepts on which these definitions are based through simple branching process models that describe the proliferation of malaria cases following importation. Through this analysis, the importance of pragmatic definitions that are useful for providing malaria control and elimination programmes with a practical set of strategic milestones is emphasized, and it is argued that current conceptions of elimination in particular fail to achieve these requirements. To provide all countries with precise targets, new conceptual definitions are suggested to more precisely describe the old goals of "control" - here more exactly named "controlled low-endemic malaria" - and "elimination." Additionally, it is argued that a third state, called "controlled non-endemic malaria," is required to describe the epidemiological condition in which endemic transmission has been interrupted, but malaria resulting from onwards transmission from imported infections continues to occur at a sufficiently high level that elimination has not been achieved. Finally, guidelines are

  17. Case investigation and reactive case detection for malaria elimination in northern Senegal

    OpenAIRE

    Littrell, Megan; Sow, Gnagna Dieng; Ngom, Algaye; Ba, Mady; Mboup, Balla Mbacke; Dieye, Yakou; Mutombo, Boniface; Earle, Duncan; Steketee, Richard W

    2013-01-01

    Background Given progress in malaria control in recent years, many control programmes in sub-Saharan Africa will soon be required to strengthen systems for surveillance in order to further drive transmission to zero. Yet few practical experiences are available to guide control programmes in designing surveillance system components in low transmission, pre-elimination, and elimination phases. Methods A malaria case investigation programme was piloted for 12?weeks in 2012 in Richard Toll distri...

  18. Frequency of apnea, bradycardia, and desaturations following first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B immunization in hospitalized preterm infants.

    Science.gov (United States)

    Lee, Jackie; Robinson, Joan L; Spady, Donald W

    2006-06-19

    Adverse cardiorespiratory events including apnea, bradycardia, and desaturations have been described following administration of the first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B (DTP-IPV-Hib) immunization to preterm infants. The effect of the recent substitution of acellular pertussis vaccine for whole cell pertussis vaccine on the frequency of these events requires further study. Infants with gestational age of apnea, bradycardia, and/or desaturations (ABD) and the treatment required for these episodes in the 72 hours prior to and 72 hours post-immunization (for the immunized cohort) or at the same post-natal age (for controls) was recorded. Thirty-four infants who received DTP-IPV-Hib with whole cell pertussis vaccine, 90 infants who received DTP-IPV-Hib with acellular pertussis vaccine, and 124 control infants were entered in the study. Fifty-six immunized infants (45.1%) and 36 control infants (29.0%) had a resurgence of or increased ABD in the 72 hours post-immunization in the immunized infants and at the same post-natal age in the controls with an adjusted odds ratio for immunized infants of 2.41 (95% CI 1.29,4.51) as compared to control infants. The incidence of an increase in adverse cardiorespiratory events post-immunization was the same in infants receiving whole cell or acellular pertussis vaccine (44.1% versus 45.6%). Eighteen immunized infants (14.5%) and 51 control infants (41.1%) had a reduction in ABD in the 72 hours post- immunization or at the equivalent postnatal age in controls for an odds ratio of 0.175 (95%CI 0.08, 0.39). The need for therapy of ABD in the immunized infants was not statistically different from the control infants. Lower weight at the time of immunization was a risk factor for a resurgence of or increased ABD post-immunization. Birth weight, gestational age, postnatal age or sex were not risk factors. There is an increase in adverse cardiorespiratory events following the first dose of DTP

  19. Standby-Loss Elimination in Server Power Supply

    Directory of Open Access Journals (Sweden)

    Jong-Woo Kim

    2017-07-01

    Full Text Available In a server power system, a standby converter is required in order to provide the standby output, monitor the system’s status, and communicate with the server power system. Since these functions are always required, losses from the standby converter are produced even though the system operates in normal mode. For these reasons, the losses deteriorate the total efficiency of the system. In this paper, a new structure is proposed to eliminate the losses from the standby converter of a server power supply. The key feature of the proposed structure is that the main direct current (DC/DC converter substitutes all of the output power of the standby converter, and the standby converter is turned off in normal mode. With the proposed structure, the losses from the standby converter can be eliminated in normal mode, and this leads to a higher efficiency in overall load conditions. Although the structure has been proposed in the previous work, very important issues such as a steady state analysis, the transient responses, and how to control the standby converter are not discussed. This paper presents these issues further. The feasibility of the proposed structure has been verified with 400 V link voltage, 12 V/62.5 A main output, and a 12 V/2.1 A standby output server power system.

  20. Characteristics of wild polio virus outbreak investigation and response in Ethiopia in 2013-2014: implications for prevention of outbreaks due to importations.

    Science.gov (United States)

    Tegegne, Ayesheshem Ademe; Braka, Fiona; Shebeshi, Meseret Eshetu; Aregay, Aron Kassahun; Beyene, Berhane; Mersha, Amare Mengistu; Ademe, Mohammed; Muhyadin, Abdulahi; Jima, Dadi; Wyessa, Abyot Bekele

    2018-01-05

    Ethiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004-2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned. The data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP). In 2013, a WPV1 outbreak was confirmed following importation in Dollo zone of the Somali region, which affected three Woredas (Warder, Geladi and Bokh). Between July 10, 2013, and January 5, 2014, there were 10 children paralyzed due to WPV1 infection. The majorities (7 of 10) were male and below 5 years of age, and 7 of 10 cases was not vaccinated, and 72% (92/129) of Child" approach, including periodic routine immunization intensification and supplemental immunization activities.

  1. Sex-differential effect on infant mortality of oral polio vaccine administered with BCG at birth in Guinea-Bissau. A natural experiment

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Fisker, Ane Baerent; Rodrigues, Amabelia

    2008-01-01

    BACKGROUND: The policy to provide oral polio vaccine (OPV) at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS) at birth in Guinea-Bissau, OPV was not availa......-differential effect on mortality. Poliovirus is almost eradicated and OPV at birth contributes little to herd immunity. A randomised study of the effect of OPV at birth on overall mortality in both sexes is warranted.......BACKGROUND: The policy to provide oral polio vaccine (OPV) at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS) at birth in Guinea-Bissau, OPV...

  2. The effect of prophylaxis with chloroquine and proguanil on delayed-type hypersensitivity and antibody production following vaccination with diphtheria, tetanus, polio, and pneumococcal vaccines

    DEFF Research Database (Denmark)

    Gyhrs, A; Pedersen, B K; Bygbjerg, I

    1991-01-01

    with seven delayed-type common antigens (Multitest) and 2) humoral immunity by measurement of specific antibody response to vaccination. Sixty healthy young individuals were randomized into four groups and given 1) no treatment (controls), 2) chloroquine diphosphate (500 mg/week), 3) chloroquine diphosphate...... dosages, does not induce any detectable suppression of delayed-type hypersensitivity or vaccination responses to diphtheria, tetanus, polio, or pneumococcal polysaccharide antigens....... (1,000 mg/week), or 4) proguanil hydrochloride (200 mg/day) for six weeks. Skin testing was performed on days 0 and 28. Vaccinations with diphtheria, tetanus, polio, and pneumococcal polysaccharide antigen vaccines were performed on day 28, and the presence of specific antibodies was determined...

  3. The effect of prophylaxis with chloroquine and proguanil on delayed-type hypersensitivity and antibody production following vaccination with diphtheria, tetanus, polio, and pneumococcal vaccines

    DEFF Research Database (Denmark)

    Gyhrs, A; Pedersen, B K; Bygbjerg, I

    1991-01-01

    (1,000 mg/week), or 4) proguanil hydrochloride (200 mg/day) for six weeks. Skin testing was performed on days 0 and 28. Vaccinations with diphtheria, tetanus, polio, and pneumococcal polysaccharide antigen vaccines were performed on day 28, and the presence of specific antibodies was determined...... on days 0, 28, and 42. The skin tests induced a significant increase in skin reactive areas from day 0 to day 28 in all groups. Furthermore, the skin test induced an increase in the level of specific IgG for diphtheria and tetanus, but had no effect on antibodies to antigens not included in the skin test...... dosages, does not induce any detectable suppression of delayed-type hypersensitivity or vaccination responses to diphtheria, tetanus, polio, or pneumococcal polysaccharide antigens....

  4. Basil O'Connor, the National Foundation for Infantile Paralysis and the Reorganization of Polio Research in the United States, 1935-41.

    Science.gov (United States)

    Wilson, Daniel J

    2015-07-01

    The costs associated with polio research in the late 1920s were high, while sources for research funding remained scarce. This began to change in the early 1930s with the creation of three private philanthropies that would form the basis of a system to fund polio research adequately: the International Committee for the Study of Infantile Paralysis (1928), The President's Birthday Ball Commission (1934), and the National Foundation for Infantile Paralysis (1938). This article explores how these three organizations shaped the process for directing funds to polio research. Beginning with the International Committee, all three philanthropies used medical advisory committees as vehicles for the review of proposals for research. The National Foundation adopted many of the policies and procedures of the earlier organizations, drawing on the experiences, misfortunes, and successes of its predecessors. The National Foundation also relied on some of the same personnel, although the microbiologist and writer Paul de Kruif, who was an influential figure in the early years, was gradually pushed out. This essay explores the establishment of the medical advisory committees of the National Foundation and reveals how by 1941 under leadership of Basil O'Connor and Dr. Thomas Rivers they developed a systematic and readily legitimated process for directing funding. By 1941, the NFIP had in place the fund-raising capacity to underwrite the scientific research that would ultimately produce two successful polio vaccines in the next twenty years. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. An evaluation of community perspectives and contributing factors to missed children during an oral polio vaccination campaign--Katsina State, Nigeria.

    Science.gov (United States)

    Michael, Charles A; Ashenafi, Samra; Ogbuanu, Ikechukwu U; Ohuabunwo, Chima; Sule, Adamu; Corkum, Melissa; Mackay, Susan; Storms, Aaron D; Achari, Panchanan; Biya, Oladayo; Nguku, Patrick; Newberry, David; Bwaka, Ado; Mahoney, Frank

    2014-11-01

    Unvaccinated children contribute to accumulation of susceptible persons and the continued transmission of wild poliovirus in Nigeria. In September 2012, the Expert Review Committee (ERC) on Polio Eradication and Routine Immunization in Nigeria recommended that social research be conducted to better understand why children are missed during supplementary immunization activities (SIAs), also known as "immunization plus days (IPDs)" in Nigeria. Immediately following the SIA in October 2012, polio eradication partners and the government of Nigeria conducted a study to assess why children are missed. We used semistructured questionnaires and focus group discussions in 1 rural and 1 urban local government area (LGA) of Katsina State. Participants reported that 61% of the children were not vaccinated because of poor vaccination team performance: either the teams did not visit the homes (25%) or the children were reported absent and not revisited (36%). This lack of access to vaccine was more frequently reported by respondents from scattered/nomadic communities (85%). In 1 out of 4 respondents (25%), refusal was the main reason their child was not vaccinated. The majority of respondents reported they would have consented to their children being vaccinated if the vaccine had been offered. Poor vaccination team performance is a major contributor to missed children during IPD campaigns. Addressing such operational deficiencies will help close the polio immunity gap and eradicate polio from Nigeria. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. Reducing allergic symptoms through eliminating subgingival plaque

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2008-12-01

    Full Text Available Background: Elimination of subgingival plaque for prevention and treatment of periodontal diseases through scaling is a routine procedure. It is also well-known that periodontal disease is related to systemic diseases. Nevertheless, the idea how scaling procedures also able to reduce allergic symptoms i.e. eczema and asthma, is not easily accepted, because it is contradictory to the “hygiene hypothesis”. However, since allergic symptoms also depend on variable factors such as genetic, environmental and infection factors; every possible effort to eliminate or avoid from these factors had to be considered. Subgingival plaque is a source of infection, especially the Gram-negative bacteria that produced endotoxin (lipopolysaccharides, LPS, a potential stimulator of immunocompetent cells, which may also related to allergy, such as mast cells and basophils. In addition, it also triggers the “neurogenic switching” mechanism which may be initiated from chronic gingivitis. Objective: This case report may explain the possible connection between subgingival plaque and allergy based on evidence-based cases. Case: Two adult siblings who suffered from chronic gingivitis also showed different manifestations of allergy that were allergic dermatitis and asthma for years. They were also undergone unsuccessful medical treatment for years. Oral and topical corticosteroids were taken for dermatitis and inhalation for asthma. Case Management: Patients were conducted deep scaling procedures, allergic symptoms gradually diminished in days even though without usual medications. Conclusion: Concerning to the effectiveness of scaling procedures which concomitantly eliminate subgingival plaque in allergic patients, it concluded that this concept is logical. Nevertheless, further verification and collaborated study with allergic expert should be done.

  7. Heuristic Drift Elimination for Personnel Tracking Systems

    Science.gov (United States)

    Borenstein, Johann; Ojeda, Lauro

    This paper pertains to the reduction of the effects of measurement errors in rate gyros used for tracking, recording, or monitoring the position of persons walking indoors. In such applications, bias drift and other gyro errors can degrade accuracy within minutes. To overcome this problem we developed the Heuristic Drift Elimination (HDE) method, that effectively corrects bias drift and other slow-changing errors. HDE works by making assumptions about walking in structured, indoor environments. The paper explains the heuristic assumptions and the HDE method, and shows experimental results. In typical applications, HDE maintains near-zero heading errors in walks of unlimited duration.

  8. Redundancy Elimination in DTN via ACK Mechanism

    Directory of Open Access Journals (Sweden)

    Xiqing Zhang

    2015-08-01

    Full Text Available The traditional routing protocols for delay tolerant networks (DTN usually take the strategy of spreading multiple copies of one message to the networks. When one copy reaches destination, the transmission of other copies not only waste the bandwidth but also deprive other messages of the opportunities for transmission. This paper brings up a mechanism to eliminate the redundant copies. By adding an acknowledge field to the packet header to delete redundant copies, it can degrade the network overhead while improve the delivery ratio. Simulation results confirm that the proposed method can improve the performance of epidemic and Spray and Wait routing protocol.

  9. Elimination of Chagas disease transmission: perspectives.

    Science.gov (United States)

    Dias, João Carlos Pinto

    2009-07-01

    One hundred years after its discovery by Carlos Chagas, American trypanosomiasis, or Chagas disease, remains an epidemiologic challenge. Neither a vaccine nor an ideal specific treatment is available for most chronic cases. Therefore, the current strategy for countering Chagas disease consists of preventive actions against the vector and transfusion-transmitted disease. Here, the present challenges, including congenital and oral transmission of Trypanosoma cruzi infections, as well as the future potential for Chagas disease elimination are discussed in light of the current epidemiological picture. Finally, a list of challenging open questions is presented about Chagas disease control, patient management, programme planning and priority definitions faced by researchers and politicians.

  10. Heterogeneity in the spread and control of infectious disease: consequences for the elimination of canine rabies

    Science.gov (United States)

    Ferguson, Elaine A.; Hampson, Katie; Cleaveland, Sarah; Consunji, Ramona; Deray, Raffy; Friar, John; Haydon, Daniel T.; Jimenez, Joji; Pancipane, Marlon; Townsend, Sunny E.

    2015-01-01

    Understanding the factors influencing vaccination campaign effectiveness is vital in designing efficient disease elimination programmes. We investigated the importance of spatial heterogeneity in vaccination coverage and human-mediated dog movements for the elimination of endemic canine rabies by mass dog vaccination in Region VI of the Philippines (Western Visayas). Household survey data was used to parameterise a spatially-explicit rabies transmission model with realistic dog movement and vaccination coverage scenarios, assuming a basic reproduction number for rabies drawn from the literature. This showed that heterogeneous vaccination reduces elimination prospects relative to homogeneous vaccination at the same overall level. Had the three vaccination campaigns completed in Region VI in 2010–2012 been homogeneous, they would have eliminated rabies with high probability. However, given the observed heterogeneity, three further campaigns may be required to achieve elimination with probability 0.95. We recommend that heterogeneity be reduced in future campaigns through targeted efforts in low coverage areas, even at the expense of reduced coverage in previously high coverage areas. Reported human-mediated dog movements did not reduce elimination probability, so expending limited resources on restricting dog movements is unnecessary in this endemic setting. Enhanced surveillance will be necessary post-elimination, however, given the reintroduction risk from long-distance dog movements. PMID:26667267

  11. Heterogeneity in the spread and control of infectious disease: consequences for the elimination of canine rabies

    Science.gov (United States)

    Ferguson, Elaine A.; Hampson, Katie; Cleaveland, Sarah; Consunji, Ramona; Deray, Raffy; Friar, John; Haydon, Daniel T.; Jimenez, Joji; Pancipane, Marlon; Townsend, Sunny E.

    2015-12-01

    Understanding the factors influencing vaccination campaign effectiveness is vital in designing efficient disease elimination programmes. We investigated the importance of spatial heterogeneity in vaccination coverage and human-mediated dog movements for the elimination of endemic canine rabies by mass dog vaccination in Region VI of the Philippines (Western Visayas). Household survey data was used to parameterise a spatially-explicit rabies transmission model with realistic dog movement and vaccination coverage scenarios, assuming a basic reproduction number for rabies drawn from the literature. This showed that heterogeneous vaccination reduces elimination prospects relative to homogeneous vaccination at the same overall level. Had the three vaccination campaigns completed in Region VI in 2010-2012 been homogeneous, they would have eliminated rabies with high probability. However, given the observed heterogeneity, three further campaigns may be required to achieve elimination with probability 0.95. We recommend that heterogeneity be reduced in future campaigns through targeted efforts in low coverage areas, even at the expense of reduced coverage in previously high coverage areas. Reported human-mediated dog movements did not reduce elimination probability, so expending limited resources on restricting dog movements is unnecessary in this endemic setting. Enhanced surveillance will be necessary post-elimination, however, given the reintroduction risk from long-distance dog movements.

  12. Una enfermedad lejana: la información sobre poliomielitis y síndrome post-polio en la prensa hispanolusa, 1995-2009

    Directory of Open Access Journals (Sweden)

    Juan Antonio Rodríguez Sánchez

    2015-09-01

    Full Text Available Se explora el cambio en la percepción social de la polio en la Península Ibérica a través del análisis de contenidos, entre 1995 y 2009, de dos periódicos de gran tirada. La desaparición en la agenda periodística de la polio y de las personas que viven con sus secuelas influyó en el olvido de la misma en la agenda pública. La poliomielitis se vinculó a la pobreza y la ignorancia en países lejanos, susceptibles de acciones de cooperación, siendo objeto de atención solo cuando es percibida como amenaza para Occidente, vinculada a crisis sanitarias o en un sentido metafórico. Así, el síndrome post-polio fue invisibilizado en el caso portugués y débilmente representado en España por el movimiento asociativo.

  13. Placing Human Behavior at the Center of the Fight to Eradicate Polio: Lessons Learned and Their Application to Other Life-Saving Interventions.

    Science.gov (United States)

    Guirguis, Sherine; Obregon, Rafael; Coleman, Michael; Hickler, Benjamin; SteelFisher, Gillian

    2017-07-01

    Today, acceptance of oral polio vaccine is the highest ever. Reaching this level of acceptance has depended on decades of engaging with communities, building trust amid extraordinary social contexts, and responding to the complex variables that trigger behavioral and social change. Drawing on both the successes and setbacks in the 28 years of the Global Polio Eradication Initiative (GPEI), this article articulates what happened when the GPEI began to pay more attention to the dynamics of human and social behavior change. Three particular lessons for other health and immunization programs can be drawn from the experience of GPEI: change begins from within (ie, success needs institutional recognition of the importance of human behavior), good data are not enough for good decision-making, and health workers are important agents of behavior change. These lessons should be harnessed and put into practice to build demand and trust for the last stages of polio eradication, as well as for other life-saving health interventions. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  14. Uso universal da vacina inativada contra poliomielite Universal use of inactivated polio vaccine

    Directory of Open Access Journals (Sweden)

    Luiza Helena Falleiros Carvalho

    2006-07-01

    terms of worldwide eradication and the World Health Organization.s (WHO proposals in this transition period between global eradication and the post-eradication period. SOURCES OF DATA: Data for the period from 1955 to 2005 were searched in MEDLINE, LILACS, The Web, Doctor's Guide, WHO website and Pan American Health Organization (PAHO website and text book. SUMMARY OF THE FINDINGS: In 1988, the WHO established the goal of eradicating the disease and interrupting transmission of the wild virus globally. Since then, there has been a dramatic decline of the disease, although in 2005 there were still some countries considered endemic and others where polio returned on account of imported viruses. The vaccines used worldwide are the classical tOPV and IPV, and in this eradication process, the use of mOPV vaccines has been encouraged in places where only one type of poliovirus circulates. In addition to spreading the virus in the community, the OPV vaccines may, however, cause paralyses by reversal of the neurovirulence process. CONCLUSIONS: For a world free of poliomyelitis disease, it would be necessary to interrupt circulation of the virus, which will only be possible if the OPV virus were to be discontinued, in accordance with the WHO proposals for this transition period and the post-eradication period.

  15. The elimination of Chagas' disease from Brazil.

    Science.gov (United States)

    Massad, E

    2008-09-01

    On 9 June 2006 the Pan American Health Organization (PAHO) presented the Minister of Health of Brazil with the International Elimination of Transmission of Chagas' Disease Certificate. This act was the culmination of an intensive process that began in 1991 with the Southern Cone Initiative, a joint agreement between the governments of Argentina, Bolivia, Brazil, Chile, Paraguay, Uruguay and Peru, to control Chagas' disease by the elimination of the main vector, Triatoma infestans. This initiative has been highly successful and the prevalence area of the vector diminished rapidly in the last years. As a consequence, the current seroprevalence in children aged between 0 and 5 years is of the order of 10(-5), a clear indication that transmission, if it is occurring, is only accidental. In this review I calculate the basic reproduction number, R0, for Chagas' disease and demonstrate that its relatively low value (1.25) explains why vectorial transmission was interrupted relatively easily. In addition, I used a mathematical model to forecast how long the remaining cases of the disease, as well as the additional vertically transmitted cases will last.

  16. Elimination of Lymphatic Filariasis in Southern India

    Directory of Open Access Journals (Sweden)

    Sanjay Pattanshetty

    2010-12-01

    Full Text Available BackgroundLymphatic filariasis is an important public health problem in India. Inspite of National filarial control programme (NFCP being in place for lymphatic filariasis (LF elimination, several important issues need to be addressed. There is uncertainty about the coverage and compliance to treatment in order to achieve elimination. Method A community based cross-sectional study was conducted as per the National Vector Borne Disease Control Programme (NVBDCP directions. The study included survey of 200 households of Dakshina Kannada District, South India where the Mass drug administration (MDA program was conducted. The main objective of the study was to assess the coverage and compliance to MDA. ResultsOut of the total 1050 eligible people, 876 (83% received the DEC tablets; so, the coverage was 83%. Among those who received the tablets, only 777 (88.7% received the adequate dose and only 670 (76.8% people actually consumed the tablets. Hence, compliance rate was only 76.8%.ConclusionThe planning and implementation of MDA programme needs to be strengthened by efficient micro planning, inter sectoral co-ordination and motivating the community to participate in the MDA programme.

  17. The elimination of fox rabies from Europe: determinants of success and lessons for the future

    Science.gov (United States)

    Freuling, Conrad M.; Hampson, Katie; Selhorst, Thomas; Schröder, Ronald; Meslin, Francois X.; Mettenleiter, Thomas C.; Müller, Thomas

    2013-01-01

    Despite perceived challenges to controlling an infectious disease in wildlife, oral rabies vaccination (ORV) of foxes has proved a remarkably successful tool and a prime example of a sophisticated strategy to eliminate disease from wildlife reservoirs. During the past three decades, the implementation of ORV programmes in 24 countries has led to the elimination of fox-mediated rabies from vast areas of Western and Central Europe. In this study, we evaluated the efficiency of 22 European ORV programmes between 1978 and 2010. During this period an area of almost 1.9 million km² was targeted at least once with vaccine baits, with control taking between 5 and 26 years depending upon the country. We examined factors influencing effort required both to control and eliminate fox rabies as well as cost-related issues of these programmes. The proportion of land area ever affected by rabies and an index capturing the size and overlap of successive ORV campaigns were identified as factors having statistically significant effects on the number of campaigns required to both control and eliminate rabies. Repeat comprehensive campaigns that are wholly overlapping much more rapidly eliminate infection and are less costly in the long term. Disproportionally greater effort is required in the final phase of an ORV programme, with a median of 11 additional campaigns required to eliminate disease once incidence has been reduced by 90 per cent. If successive ORV campaigns span the entire affected area, rabies will be eliminated more rapidly than if campaigns are implemented in a less comprehensive manner, therefore reducing ORV expenditure in the longer term. These findings should help improve the planning and implementation of ORV programmes, and facilitate future decision-making by veterinary authorities and policy-makers. PMID:23798690

  18. Schistosomiasis elimination strategies and potential role of a vaccine in achieving global health goals.

    Science.gov (United States)

    Mo, Annie X; Agosti, Jan M; Walson, Judd L; Hall, B Fenton; Gordon, Lance

    2014-01-01

    In March 2013, the National Institute of Allergy and Infectious Diseases and the Bill and Melinda Gates Foundation co-sponsored a meeting entitled "Schistosomiasis Elimination Strategy and Potential Role of a Vaccine in Achieving Global Health Goals" to discuss the potential role of schistosomiasis vaccines and other tools in the context of schistosomiasis control and elimination strategies. It was concluded that although schistosomiasis elimination in some focal areas may be achievable through current mass drug administration programs, global control and elimination will face several significant scientific and operational challenges, and will require an integrated approach with other, additional interventions. These challenges include vector (snail) control; environmental modification; water, sanitation, and hygiene; and other future innovative tools such as vaccines. Defining a clear product development plan that reflects a vaccine strategy as complementary to the existing control programs to combat different forms of schistosomiasis will be important to develop a vaccine effectively.

  19. Cut Elimination, Identity Elimination, and Interpolation in Super-Belnap Logics

    Czech Academy of Sciences Publication Activity Database

    Přenosil, Adam

    2017-01-01

    Roč. 105, č. 6 (2017), s. 1255-1289 ISSN 0039-3215 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 689176 - SYSMICS Institutional support: RVO:67985807 Keywords : Super-Belnap logics * Dunn–Belnap logic * Logic of Paradox * Strong Kleene logic * Exactly True Logic * Gentzen calculus * Cut elimination * Identity elimination * Interpolation Subject RIV: BA - General Mathematics OBOR OECD: Computer sciences, information science, bioinformathics (hardware development to be 2.2, social aspect to be 5.8) Impact factor: 0.589, year: 2016

  20. Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases: A systematic review and implications for polio eradication

    Science.gov (United States)

    Guo, Jean; Bolivar-Wagers, Sara; Srinivas, Nivedita; Holubar, Marisa; Maldonado, Yvonne

    2017-01-01

    Background Vaccine-derived polioviruses (VDPVs), strains of poliovirus mutated from the oral polio vaccine, pose a challenge to global polio eradication. Immunodeficiency-related vaccine-derived polioviruses (iVDPVs) are a type of VDPV which may serve as sources of poliovirus reintroduction after the eradication of wild-type poliovirus. This review is a comprehensive update of confirmed iVDPV cases published in the scientific literature from 1962 to 2012, and describes clinically relevant trends in reported iVDPV cases worldwide. Methods We conducted a systematic review of published iVDPV case reports from January 1960 to November 2012 from four databases. We included cases in which the patient had a primary immunodeficiency, and the vaccine virus isolated from the patient either met the sequencing definition of VDPV (>1% divergence for serotypes 1 and 3 and >0.6% for serotype 2) and/or was previously reported as an iVDPV by the World Health Organization. Results We identified 68 iVDPV cases in 49 manuscripts reported from 25 countries and the Palestinian territories. 62% of case patients were male, 78% presented clinically with acute flaccid paralysis, and 65% were iVDPV2. 57% of cases occurred in patients with predominantly antibody immunodeficiencies, and the overall all-cause mortality rate was greater than 60%. The median age at case detection was 1.4 years [IQR: 0.8, 4.5] and the median duration of shedding was 1.3 years [IQR: 0.7, 2.2]. We identified a poliovirus genome VP1 region mutation rate of 0.72% per year and a higher median percent divergence for iVDPV1 cases. More cases were reported from high income countries, which also had a larger age variation and different distribution of immunodeficiencies compared to upper and lower middle-income countries. Conclusion Our study describes the incidence and characteristics of global iVDPV cases reported in the literature in the past five decades. It also highlights the regional and economic disparities of

  1. Preventive measures to eliminate asbestos-related diseases in singapore.

    Science.gov (United States)

    Lim, John Wah; Koh, David; Khim, Judy Sng Gek; Le, Giang Vinh; Takahashi, Ken

    2011-09-01

    The incidence of asbestos-related diseases (ARD) has increased in the last four decades. In view of the historical use of asbestos in Singapore since the country started banning it in phases in 1989 and the long latency of the disease, the incidence of ARD can be expected to increase further. As occupational exposure to asbestos still occurs, preventive measures to eliminate ARD continue to be required to protect the health of both workers and the public from asbestos exposure. The majority of occupational exposures to asbestos at present occur during the removal of old buildings. Preventive measures have been utilized by different government ministries and agencies in eliminating ARD in Singapore over the past 40 years. These measures have included the enforcement of legislation, substitution with safer materials, and engineering controls during asbestos removal as well as improvements in personal hygiene and the use of personal protective equipment. The existing Workman's Compensation System for ARD should be further refined, given that is currently stipulates that claims for asbestosis and malignant mesothelioma be made within 36 and 12 months after ceasing employment.

  2. Preventive Measures to Eliminate Asbestos-Related Diseases in Singapore

    Directory of Open Access Journals (Sweden)

    John Wah Lim

    2011-09-01

    Full Text Available The incidence of asbestos-related diseases (ARD has increased in the last four decades. In view of the historical use of asbestos in Singapore since the country started banning it in phases in 1989 and the long latency of the disease, the incidence of ARD can be expected to increase further. As occupational exposure to asbestos still occurs, preventive measures to eliminate ARD continue to be required to protect the health of both workers and the public from asbestos exposure. The majority of occupational exposures to asbestos at present occur during the removal of old buildings. Preventive measures have been utilized by different government ministries and agencies in eliminating ARD in Singapore over the past 40 years. These measures have included the enforcement of legislation, substitution with safer materials, and engineering controls during asbestos removal as well as improvements in personal hygiene and the use of personal protective equipment. The existing Workman’s Compensation System for ARD should be further refined, given that is currently stipulates that claims for asbestosis and malignant mesothelioma be made within 36 and 12 months after ceasing employment.

  3. QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms.

    Science.gov (United States)

    Zwartjes, Ardjan; Havinga, Paul J M; Smit, Gerard J M; Hurink, Johann L

    2016-10-01

    In this work, we introduce QUEST (QUantile Estimation after Supervised Training), an adaptive classification algorithm for Wireless Sensor Networks (WSNs) that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

  4. QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms

    Directory of Open Access Journals (Sweden)

    Ardjan Zwartjes

    2016-10-01

    Full Text Available In this work, we introduce QUEST (QUantile Estimation after Supervised Training, an adaptive classification algorithm for Wireless Sensor Networks (WSNs that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

  5. Towards lab-on-a-chip diagnostics for malaria elimination.

    Science.gov (United States)

    Kolluri, N; Klapperich, C M; Cabodi, M

    2017-12-19

    Malaria continues to be one of the most devastating diseases impacting global health. Although there have been significant reductions in global malaria incidence and mortality rates over the past 17 years, the disease remains endemic throughout the world, especially in low- and middle-income countries. The World Health Organization has put forth ambitious milestones moving toward a world free of malaria as part of the United Nations Millennium Goals. Mass screening and treatment of symptomatic and asymptomatic malaria infections in endemic regions is integral to these goals and requires diagnostics that are both sensitive and affordable. Lab-on-a-chip technologies provide a path toward sensitive, portable, and affordable diagnostic platforms. Here, we review and compare currently-available and emerging lab-on-a-chip diagnostic approaches in three categories: (1) protein-based tests, (2) nucleic acid tests, and (3) cell-based detection. For each category, we highlight the opportunities and challenges in diagnostics development for malaria elimination, and comment on their applicability to different phases of elimination strategies.

  6. For a convention for nuclear weapon elimination

    International Nuclear Information System (INIS)

    2008-03-01

    This document contains two texts linked with the project of an international convention for the elimination of nuclear weapons (the text of this project has been sent to the UN General Secretary and is part of an international campaign to abolish nuclear weapons, ICAN). These two texts are contributions presented in London at the Global Summit for a Nuclear Weapon-free World. The first one calls into question the deterrence principle and the idea of a nuclear weapon-based security. It calls for different forms of action to promote a nuclear weapon-free world. The second text stresses the role and the responsibility of states with nuclear weapons in nuclear disarmament and in the reinforcement of the nuclear non proliferation treaty (NPT)

  7. Adaptive elimination of synchronization in coupled oscillator

    International Nuclear Information System (INIS)

    Zhou, Shijie; Lin, Wei; Ji, Peng; Feng, Jianfeng; Zhou, Qing; Kurths, Jürgen

    2017-01-01

    We present here an adaptive control scheme with a feedback delay to achieve elimination of synchronization in a large population of coupled and synchronized oscillators. We validate the feasibility of this scheme not only in the coupled Kuramoto’s oscillators with a unimodal or bimodal distribution of natural frequency, but also in two representative models of neuronal networks, namely, the FitzHugh–Nagumo spiking oscillators and the Hindmarsh–Rose bursting oscillators. More significantly, we analytically illustrate the feasibility of the proposed scheme with a feedback delay and reveal how the exact topological form of the bimodal natural frequency distribution influences the scheme performance. We anticipate that our developed scheme will deepen the understanding and refinement of those controllers, e.g. techniques of deep brain stimulation, which have been implemented in remedying some synchronization-induced mental disorders including Parkinson disease and epilepsy. (paper)

  8. Lean for Government: Eliminating the Seven Wastes

    Science.gov (United States)

    Shepherd, Christena C.

    2012-01-01

    With shrinking budgets and a slow economy, it is becoming increasingly important for all government agencies to become more efficient. Citizens expect and deserve efficient and effective services from federal, state and local government agencies. One of the best methods to improve efficiency and eliminate waste is to institute the business process improvement methodologies known collectively as Lean; however, with reduced budgets, it may not be possible to train everyone in Lean or to engage the services of a trained consultant. It is possible, however, to raise awareness of the "Seven Wastes" of Lean in each employee, and encourage them to identify areas for improvement. Management commitment is vital to the success of these initiatives, and it is also important to develop the right metrics that will track the success of these changes.

  9. RESULTS of the "ELIMINATING NOISE" campaign

    CERN Multimedia

    SC Unit

    2008-01-01

    From 4 to 6 August, CERN’s nurses conducted a screening campaign entitled "Eliminating noise". This campaign was especially aimed at young people exposed to noise during their leisure hours (playing in a band, listening to MP3 players, attending concerts, etc.). In all, 166 people attended the Infirmary, where they were able to receive personalised advice, documentation and, above all, a hearing test (audiogram). While the high attendance of people in the younger age category (18-30) was a success, their audiogram data were a cause for concern, with 24.5% showing abnormal results, hearing deficiencies which, we should remind you, are irreversible. It should be noted that such conditions are almost exclusively caused by noise exposure in a non-professional environment (leisure activities, music, etc.). This latest campaign confirms the harmful effects of noise on people’s hearing due to the absence or insufficiency of protective equipment during music-related activities; this further unde...

  10. RESULTS of the "ELIMINATING NOISE" campaign

    CERN Multimedia

    SC Unit

    2008-01-01

    From 4 to 6 August, CERN’s nurses conducted a screening campaign entitled "Eliminating noise". This campaign was especially aimed at young people exposed to noise during their leisure hours (playing in a band, listening to MP3 players, attending concerts, etc.). In all, 166 people attended the infirmary, where they were able to receive personalised advice, documentation and, above all, a hearing test (audiogram). While the high attendance of people in the younger age category (18-30) was a success, their audiogram data were a cause for concern, with 24.5% showing abnormal results, hearing deficiencies which, we should remind you, are irreversible. It should be noted that such conditions are almost exclusively caused by noise exposure in a non-professional environment (leisure activities, music, etc.). This latest campaign confirms the harmful effects of noise on people’s hearing due to the absence or insufficiency of protective equipment during music-related activities; this further unde...

  11. Cell competition: how to eliminate your neighbours

    Science.gov (United States)

    Amoyel, Marc; Bach, Erika A.

    2014-01-01

    A conventional view of development is that cells cooperate to build an organism. However, based on studies of Drosophila, it has been known for years that viable cells can be eliminated by their neighbours through a process termed cell competition. New studies in mammals have revealed that this process is universal and that many factors and mechanisms are conserved. During cell competition, cells with lower translation rates or those with lower levels of proteins involved in signal transduction, polarity and cellular growth can survive in a homogenous environment but are killed when surrounded by cells of higher fitness. Here, we discuss recent advances in the field as well as the mechanistic steps involved in this phenomenon, which have shed light on how and why cell competition exists in developing and adult organisms. PMID:24550108

  12. Adaptive elimination of synchronization in coupled oscillator

    Science.gov (United States)

    Zhou, Shijie; Ji, Peng; Zhou, Qing; Feng, Jianfeng; Kurths, Jürgen; Lin, Wei

    2017-08-01

    We present here an adaptive control scheme with a feedback delay to achieve elimination of synchronization in a large population of coupled and synchronized oscillators. We validate the feasibility of this scheme not only in the coupled Kuramoto’s oscillators with a unimodal or bimodal distribution of natural frequency, but also in two representative models of neuronal networks, namely, the FitzHugh-Nagumo spiking oscillators and the Hindmarsh-Rose bursting oscillators. More significantly, we analytically illustrate the feasibility of the proposed scheme with a feedback delay and reveal how the exact topological form of the bimodal natural frequency distribution influences the scheme performance. We anticipate that our developed scheme will deepen the understanding and refinement of those controllers, e.g. techniques of deep brain stimulation, which have been implemented in remedying some synchronization-induced mental disorders including Parkinson disease and epilepsy.

  13. Renal lactate elimination is maintained during moderate exercise in humans

    DEFF Research Database (Denmark)

    Volianitis, Stefanos; Dawson, Ellen A; Dalsgaard, Mads

    2012-01-01

    Reduced hepatic lactate elimination initiates blood lactate accumulation during incremental exercise. In this study, we wished to determine whether renal lactate elimination contributes to the initiation of blood lactate accumulation. The renal arterial-to-venous (a-v) lactate difference...... ischaemia, and renal lactate elimination is maintained. Thus, kidney lactate elimination is unlikely to contribute to the initial blood lactate accumulation during progressive exercise....

  14. Malaria vaccines and their potential role in the elimination of malaria

    Directory of Open Access Journals (Sweden)

    Greenwood Brian M

    2008-12-01

    Full Text Available Abstract Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination, now being considered seriously in some epidemiological situations, requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. The feature of the life-cycles of human malarias that presents the greatest challenge to an elimination programme is the persistence of parasites as asymptomatic infections. These are an important source from which transmission to mosquitoes can occur. Consequently, an elimination strategy requires a community-based approach covering all individuals and not just those who are susceptible to clinical malaria. The progress that has been made in development of candidate malaria vaccines is reviewed. It is unlikely that many of these will have the efficacy required for complete elimination of parasites, though they may have an important role to play as part of future integrated control programmes. Vaccines for elimination must have a high level of efficacy in order to stop transmission to mosquitoes. This might be achieved with some pre-erythrocytic stage candidate vaccines or by targeting the sexual stages directly with transmission-blocking vaccines. An expanded malaria vaccine programme with such objectives is now a priority.

  15. A change in humidification system can eliminate endotracheal tube occlusion.

    Science.gov (United States)

    Doyle, Alex; Joshi, Manasi; Frank, Peter; Craven, Thomas; Moondi, Parvez; Young, Peter

    2011-12-01

    Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Eliminating the phrase "elective abortion": why language matters.

    Science.gov (United States)

    Janiak, Elizabeth; Goldberg, Alisa B

    2016-02-01

    The phrase "elective abortion" is often used to describe induced abortions performed for reasons other than a direct, immediate threat to maternal physical health. We argue that the term "elective abortion" is variably defined, misrepresents the complexity and multiplicity of indications for abortion and perpetuates stigma. In practice, restricting access to abortion at the legal, regulatory or institutional level based on subjective perceptions of patient need constrains health care providers' ability to act according to their best clinical judgments and limits patient access to care. The phrase "elective abortion" should be eliminated from scientific and medical discourse to prevent further damage to the public understanding of the variety of indications for which women require expeditious and equitable access to induced abortion. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Attitude and subjective wellbeing of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria.

    Science.gov (United States)

    Umeh, Gregory C; Nomhwange, Terna Ignatius; Shamang, Anthony F; Zakari, Furera; Musa, Audu I; Dogo, Paul M; Gugong, Victor; Iliyasu, Neyu

    2018-02-08

    Attitude and subjective well-being are important factors in mothers accepting or rejecting Oral Polio Vaccine (OPV) supplemental immunization. The purpose of the study was to determine the role of mothers' attitude and subjective wellbeing on non-compliance to OPV supplemental immunization in Northern Nigeria. The study utilized a cross-sectional design to assess attitude and subjective well-being of mothers using previously validated VACSATC (Vaccine Safety, Attitudes, Training and Communication-10 items) & SUBI (Subjective Well-being Inventory-40 items) measures. A total of 396 participants (equal number of non-compliant and compliant mothers) from 94 non-compliant settlements were interviewed, after informed consent. T-test was run to assess difference in mean scores between the non-compliant and compliant mothers on VACSATC and SUBI measures. The research showed a significant difference in mean scores between the non-compliant and compliant groups on VACSATC measure of mothers' attitude (M = 18.9 non-compliant, compared to 26.5 compliant; p subjective well-being, the study showed there was no significant difference in the mean scores of the SUBI measure (M = 77.4 non-compliant, compared to 78.0 compliant; p > 0.05). The research has shown that negative attitude is more commonly present in non-compliant mothers and may be a factor in vaccine refusal in Northern Nigeria.

  18. On the Importance of Elimination Heuristics in Lazy Propagation

    DEFF Research Database (Denmark)

    Madsen, Anders Læsø; Butz, Cory J.

    2012-01-01

    elimination orders on-line. This paper considers the importance of elimination heuristics in LP when using Variable Elimination (VE) as the message and single marginal computation algorithm. It considers well-known cost measures for selecting the next variable to eliminate and a new cost measure....... The empirical evaluation examines dierent heuristics as well as sequences of cost measures, and was conducted on real-world and randomly generated Bayesian networks. The results show that for most cases performance is robust relative to the cost measure used and in some cases the elimination heuristic can have...

  19. Time to symptom improvement using elimination diets in non-IgE-mediated gastrointestinal food allergies.

    Science.gov (United States)

    Lozinsky, Adriana Chebar; Meyer, Rosan; De Koker, Claire; Dziubak, Robert; Godwin, Heather; Reeve, Kate; Dominguez Ortega, Gloria; Shah, Neil

    2015-08-01

    The prevalence of food allergy has increased in recent decades, and there is paucity of data on time to symptom improvement using elimination diets in non-Immunoglobulin E (IgE)-mediated food allergies. We therefore aimed to assess the time required to improvement of symptoms using a symptom questionnaire for children with non-IgE-mediated food allergies on an elimination diet. A prospective observational study was performed on patients with non-IgE-mediated gastrointestinal food allergies on an elimination diet, who completed a questionnaire that includes nine evidence-based food allergic symptoms before and after the exclusion diet. The questionnaire measured symptoms individually from 0 (no symptom) to 5 (most severe) and collectively from 0 to 45. Children were only enrolled in the study if collectively symptoms improved with the dietary elimination within 4 or 8 weeks. Data from 131 patients were analysed including 90 boys with a median age of 21 months [IQR: 7 to 66]. Based on the symptom questionnaire, 129 patients (98.4%) improved after 4-week elimination diet and only two patients improved after 8 weeks. A statistically significant difference before and after commencing the elimination diet was seen in all nine recorded symptoms (all p < 0.001), and in the median of overall score (p < 0.001). This is the first study attempting to establish time to improve after commencing the diet elimination. Almost all children in this study improved within 4 weeks of following the elimination diet, under dietary supervision. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Malaria vaccine: a step toward elimination.

    Science.gov (United States)

    Jindal, Harashish; Bhatt, Bhumika; Malik, Jagbir S; Sk, Shashikantha; Mehta, Bharti

    2014-01-01

    Malaria has long been recognized as a public health problem. At the community level, vector control, and antimalarial medicines are the main means for reducing incidence, morbidity, and mortality of malaria. A vaccine not only would bring streamlining in the prevention of morbidity and mortality from malaria but also would be more accessible if integrated with Expanded Programme of Immunization (EPI). Globally, an estimated 3.4 billion people are at risk of malaria. Most cases (80%) and deaths (90%) occurred in Africa, and most deaths (77%) are in children under 5 years of age. An effective vaccine has long been envisaged as a valuable addition to the available tools for malaria control. Although research toward the development of malaria vaccines has been pursued since the 1960s, there are no licensed malaria vaccines. The RTS,S/AS01 vaccine, which targets P. falciparum, has reached phase 3 clinical trials and results are promising. Malaria Vaccine Technology Road Map 2013 has envisaged the world aiming for a licensed vaccine by 2030 that would reduce malaria cases by 75% and be capable of eliminating malaria. It will not only fill the gaps of today's interventions but also be a cost-effective method of decreasing morbidity and mortality from malaria.

  1. Method of eliminating radioactive substances in atmosphere

    International Nuclear Information System (INIS)

    Hashimoto, Tadayuki.

    1981-01-01

    Purpose: To eliminate natural radioactive substance (in particular, gases 222 Rn) in the atmosphere. Method: Air removed with dusts of greater than several μ in a filter is introduced into a mixer using a blower. In the blower, super-heated steams at 120 - 200 0 C and the airs are mixed together. Then, the air mixture is introduced into a cooler and cooled to room temperature -50 0 C to condensate water. Subsequently, the cooled air mixture is passed through an activated carbon adsorption device (6 - 12 mesh, air passing speed less than 4 cm/sec. and activated carbon layer thickness 50 - 100 cm) to adsorb 222 Rn. Finally, the air passed through the activated carbon adsorption device is introduced to an ultrafilter for collecting fine particles (asbesto filter, glass filter, etc.) to collect fine particles of activated carbon, lead, bismuth, etc. (decaying products of gaseous 222 Rn). Liquid issued from the mixer and the cooler are discharged by way of drain pipes. (Ikeda, J.)

  2. Seasonal blood shortages can be eliminated.

    Science.gov (United States)

    Gilcher, Ronald O; McCombs, Suzanne

    2005-11-01

    This review is designed to help readers understand seasonal blood shortages and provide solutions through the use of technology that can increase the number of red blood cell units collected and the use of recruitment and marketing initiatives that appeal to the increasingly diverse donor base. Seasonal shortages are, in reality, mostly shortages of group O red blood cells and occur most commonly during midsummer and early winter. The shortages occur primarily from increased use of group O red blood cells at times of decreased donor availability. While reducing the disproportionate use of red cells will help, blood centers can more quickly reduce the seasonal deficits by using automated red cell technology to collect double red blood cell units; targeted marketing programs to provide effective messages; seasonal advertising campaigns; and recognition, benefits, and incentives to enhance the donor motivation donation threshold. A multi-level approach to increasing blood donations at difficult times of the year can ensure that donations are increased at a time when regular donor availability is decreased. Seasonal blood shortages can be eliminated by understanding the nature of the shortages, why and when they occur, and using more sophisticated recruitment and marketing strategies as well as automated collection technologies to enhance the blood supply.

  3. Elimination of excess molybdenum by cattle

    Energy Technology Data Exchange (ETDEWEB)

    Toelgyesi, G.; Elmoty, I.A.

    1967-01-01

    It was found that cattle would ingest spontaneously 5-15 g of molybdenum on one occasion. The uptake of this quantity caused but moderate loss of appetite and mild enteritis, both normalizing in one week. The occurrence of a severe acute molybdenum poisoning can be practically excluded, owing to refusal of the poisoned feed. Spontaneously ingested molybdenum caused on the first day a 30-100 fold rise of ruminal Mo-level, decreasing to the order of the normal value in about one week. But in the urine and faeces, Mo-level was at least 10 fold, in the blood and milk about 4 fold of the normal one, even one or two weeks after ingestion. During this period at least 90% of ingested Mo was eliminated with the faeces, urine and milk. One week after the ingestion of molybdenum, the rumen content showed no evidence on poisoning and no trace of molybdenum. Oral administration of ammonium molybdenate in an amount equivalent to 40 g molybdenum caused no fatality. In fact, cattle would never ingest spontaneously such a large dose.

  4. Reward eliminates retrieval-induced forgetting.

    Science.gov (United States)

    Imai, Hisato; Kim, Dongho; Sasaki, Yuka; Watanabe, Takeo

    2014-12-02

    Although it is well known that reward enhances learning and memory, how extensively such enhancement occurs remains unclear. To address this question, we examined how reward influences retrieval-induced forgetting (RIF) in which the retrieval of a nonpracticed item under the same category as a practiced item is worse than the retrieval of a nonpracticed item outside the category. Subjects were asked to try to encode category-exemplar pairs (e.g., FISH-salmon). Then, they were presented with a category name and a two-letter word stem (e.g., FISH-sa) and were asked to complete an encoded word (retrieval practice). For a correct response, apple juice was given as a reward in the reward condition and a beeping sound was presented in the no-reward condition. Finally, subjects were asked to report whether each exemplar had been presented in the first phase. RIF was replicated in the no-reward condition. However, in the reward condition, RIF was eliminated. These results suggest that reward enhances processing of retrieval of unpracticed members by mechanisms such as spreading activation within the same category, irrespective of whether items were practiced or not.

  5. Progress toward measles elimination in kyrgyzstan.

    Science.gov (United States)

    Suvanbekov, Akbar; Kitarova, Gulzhan; Reyer, Joshua A; Hamajima, Nobuyuki

    2015-02-01

    Measles is one of the most severe infectious diseases of childhood, and one of the major causes of mortali-ty, especially in developing countries. Despite rare measles outbreaks in recent years, Kyrgyzstan seeks to show its commitment towards the global anti-measles campaign. The aim of this article is to summarize the scattered information on the recent status of measles, valid surveillance system, and measles elimination strategies in Kyrgyzstan, based on sources that include non-confidential but usually inaccessible governmental data. Infor-mation was extracted from the reports to the Ministry of Health and documents on the national surveillance system, in addition to outbreak cases extracted from the Republican Infectious Diseases Hospital's archive. To tackle the worsening measles situation in Kyrgyzstan, the Ministry of Health established the Republican Center for Immunoprophylaxis in 1994. Measles related death, which was rampant up until 1992, has not been registered since 2000 due to improved routine vaccination coverage, increasing from 88% in 1994 to 97% and over in 1997. The national surveillance system was modernized thanks to the World Health Organization, helping to detect measles cases and prevent major outbreaks. The system identified 222 cases in the outbreak of 2011, and the case cards in the hospital provided the findings of 69 admitted cases (42 infants, 22 children aged 1 to 14 years, and 5 aged 15 years or over), including 32 severe cases. This article provides a whole view on measles in Kyrgyzstan, which would be useful to control measles worldwide.

  6. Mitochondrial reactive oxygen species production and elimination.

    Science.gov (United States)

    Nickel, Alexander; Kohlhaas, Michael; Maack, Christoph

    2014-08-01

    Reactive oxygen species (ROS) play an important role in cardiovascular diseases, and one important source for ROS are mitochondria. Emission of ROS from mitochondria is the net result of ROS production at the electron transport chain (ETC) and their elimination by antioxidative enzymes. Both of these processes are highly dependent on the mitochondrial redox state, which is dynamically altered under different physiological and pathological conditions. The concept of "redox-optimized ROS balance" integrates these aspects and implies that oxidative stress occurs when the optimal equilibrium of an intermediate redox state is disturbed towards either strong oxidation or reduction. Furthermore, mitochondria integrate ROS signals from other cellular sources, presumably through a process termed "ROS-induced ROS release" that involves mitochondrial ion channels. Here, we attempt to integrate these recent advances in our understanding of the control of mitochondrial ROS emission and develop a concept of how in heart failure, defects in ion handling can lead to mitochondrial oxidative stress. This article is part of a Special Issue entitled "Redox Signalling in the Cardiovascular System". Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Vital School Professionals Eliminated: Student Health, Career Preparation, Art Exposure Suffer. Executive Summary

    Science.gov (United States)

    Jackson, Victoria

    2016-01-01

    Until last year, Ohio had in place a rule requiring a minimum level of staffing for music, visual arts, physical education, counselors, librarians, nurses, social workers and visiting teachers. School districts had to have at least five of these eight positions for every 1,000 students. In March 2015, the State Board of Education eliminated this…

  8. 78 FR 65890 - National School Lunch Program and School Breakfast Program: Eliminating Applications Through...

    Science.gov (United States)

    2013-11-04

    ... Program: Eliminating Applications Through Community Eligibility as Required by the Healthy, Hunger-Free... through policy guidance following enactment of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA... potential issues surrounding the absence of individual free and reduced price data for other education...

  9. Closed-loop surface-related multiple elimination and its application to simultaneous data reconstruction

    NARCIS (Netherlands)

    Lopez Angarita, G.A.; Verschuur, D.J.

    2015-01-01

    Surface-related multiple elimination (SRME) is one of the most commonly used methods for suppressing surface multiples. However, to obtain an accurate surface multiple estimation, dense source and receiver sampling is required. The traditional approach to this problem is performing data

  10. Eliminating Hairy Cell Leukemia Minimal Residual Disease

    Science.gov (United States)

    In this trial, patients with hairy cell leukemia who have disease-related symptoms that require treatment will be randomly assigned to receive cladribine with either concurrent rituximab or rituximab at least 6 months after completing cladribine therapy.

  11. Immunogenicity and safety of combined adsorbed low-dose diphtheria, tetanus and inactivated poliovirus vaccine (REVAXIS®) versus combined diphtheria, tetanus and inactivated poliovirus vaccine (DT Polio®) given as a booster dose at 6 years of age

    Science.gov (United States)

    Gajdos, Vincent; Soubeyrand, Benoit; Vidor, Emmanuel; Richard, Patrick; Boyer, Julie; Sadorge, Christine

    2011-01-01

    This randomized, comparative, phase-IIIb study conducted in France aimed to demonstrate whether seroprotection against diphtheria, tetanus and poliomyelitis 1 month after a single dose of REVAXIS (low-dose diphtheria) is non-inferior to seroprotection 1 month after a single dose of DT Polio (standard-dose diphtheria), both vaccines being given as a second booster to healthy children at 6 years of age. Children were randomly assigned to receive a single intramuscular dose of REVAXIS or DT Polio. Primary endpoints were the 1-month post-booster seroprotection rates for diphtheria, tetanus and poliovirus type-1, -2 and -3 antigens. Secondary endpoints were immunogenicity and safety observations. Of 788 children screened, 760 were randomized: REVAXIS group, 384 children; DT Polio group, 376 children. No relevant difference in demographic characteristics at baseline was observed between REVAXIS and DT Polio groups. Noninferiority of REVAXIS compared with DT Polio for seroprotection was demonstrated against diphtheria (respectively 98.6% and 99.3%), tetanus (respectively 99.6% and 100%) and poliovirus antigens (100% for each types in both groups). No allergic reactions to REVAXIS were reported. A benefit/risk ratio in favor of REVAXIS was suggested by the trend towards a better tolerability of REVAXIS compared with DT Polio regarding the rate of severe solicited injection-site reactions. The results support the use of REVAXIS as a booster at 6 years of age in infants who previously received a three-dose primary series within the first 6 months of life and a first booster including diphtheria, tetanus and poliovirus vaccine(s) given before 2 years of age. PMID:21441781

  12. Treatment with L-citrulline in patients with post-polio syndrome: study protocol for a single-center, randomised, placebo-controlled, double-blind trial.

    Science.gov (United States)

    Schmidt, Simone; Gocheva, Vanya; Zumbrunn, Thomas; Rubino-Nacht, Daniela; Bonati, Ulrike; Fischer, Dirk; Hafner, Patricia

    2017-03-09

    Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute infection by the Poliomyelitis virus. Most often, patients who suffered from polio start to experience gradual new weakening in muscles, a gradual decrease in the size of muscles (muscle atrophy) and fatigue years after the acute illness. L-citrulline is known to change muscular metabolism synthesis by raising nitric oxide (NO) levels and increasing protein synthesis. This investigator-initiated, randomised, placebo-controlled, double-blind, trial aims to demonstrate that L-citrulline positively influences muscle function and increases muscular energy production in patients with PPS. Thirty ambulant PPS patients will be recruited in Switzerland. Patients will be randomly allocated to one of the two arms of the study (placebo:verum 1:1). After a 24-week run-in phase to observe natural disease history and progression, participants will be treated either with L-citrulline or placebo for 24 weeks. The primary endpoint is change in the 6-min Walking Distance Test. Secondary endpoints will include motor function measure, quantitative muscle force, quantitative muscle magnetic resonance imaging and magnetic resonance spectroscopy and serum biomarker laboratory analysis DISCUSSION: The aim of this phase IIa trial is to determine if treatment with L-citrulline shows a positive effect on clinical function and paraclinical biomarkers in PPS. If treatment with L-citrulline shows positive effects, this might represent a cost-efficient symptomatic therapy for PPS patients. ClinicalTrial.gov, ID: NCT02801071 . Registered on 6 June 2016.

  13. Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization.

    Science.gov (United States)

    Okeibunor, Joseph; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization METHODS: We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region. The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country. The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African

  14. The rehabilitation plan can support clients' active engagement and facilitate the process of change - experiences from people with late effects of polio participating in a rehabilitation programme.

    Science.gov (United States)

    Lexell, Eva Månsson; Lexell, Jan; Larsson-Lund, Maria

    2016-01-01

    To explore how the rehabilitation plan influences the rehabilitation process and its outcome in people with late effects of polio participating in an individualised goal-oriented interdisciplinary rehabilitation programme. Four women and two men with late effects of polio were interviewed before rehabilitation, at discharge, and at follow-up. Data were analysed according to the constant comparative method of grounded theory. The participants' experiences formed one core category: "The same starting point but different rehabilitation processes". Before rehabilitation, all participants experienced a similar starting point: Naïve understanding of rehabilitation. During rehabilitation, two separate processes followed. Four participants experienced their rehabilitation as being a mutually shared process that led to a process of change. They were actively engaged, using the rehabilitation plan, and working towards goals targeting a broad perspective of daily activities. The remaining two participants experienced their rehabilitation as a staff-directed process, with limited use of the rehabilitation plan, focusing on goals mainly related to body functions and self-care, not leading to any substantial changes. When clients experience that they develop a mutually shared rehabilitation process, based on a rehabilitation plan, they became more engaged in their rehabilitation and gained a better understanding of their participation during the process. Knowledge of the differences in how clients use the rehabilitation plan during the rehabilitation process can support their active engagement during rehabilitation. This, in turn, can promote a more holistic view among clients and professionals during the rehabilitation for people with late effects of polio. Implications for Rehabilitation Clients who experience a rehabilitation that is mutually shared with professionals, have a better understanding of their engagement during the rehabilitation process. When clients and

  15. From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province

    Directory of Open Access Journals (Sweden)

    Mushtaq Muhammad Umair

    2010-08-01

    Full Text Available Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI to ultimately provide evidence for designing future interventions. Methods A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. Results The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs, unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. Conclusion The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should

  16. From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province.

    Science.gov (United States)

    Mushtaq, Muhammad Umair; Shahid, Ubeera; Majrooh, Muhammad Ashraf; Shad, Mushtaq Ahmad; Siddiqui, Arif Mahmood; Akram, Javed

    2010-08-23

    The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI) to ultimately provide evidence for designing future interventions. A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts) and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs), unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should be considered in prioritizing future strategies.

  17. Civil war, contested sovereignty and the limits of global health partnerships: A case study of the Syrian polio outbreak in 2013.

    Science.gov (United States)

    Kennedy, Jonathan; Michailidou, Domna

    2017-06-01

    States and the World Health Organization (WHO), an international organization that is mandated to respect the sovereignty of its member states, are still the leading actors in global health. This paper explores how this discrepancy inhibits the ability of global health partnerships to implement programmes in conflict-affected areas that are under the de facto control of rebel organizations. We concentrate on a single crucial case, the polio outbreak in Syria in 2013, analysing a variety of qualitative data-twenty semi-structured interviews with key actors, official documents, and media reports-in order to investigate the events that preceded and followed this event. The WHO's mandate to respect the Syrian government's sovereignty inhibited its ability to prevent, identify and contain the outbreak because the Assad regime refused it permission to operate in rebel-controlled areas. The polio outbreak was identified and contained by organizations operating outside the United Nations (UN) system that disregarded the Syrian government's sovereignty claims and cooperated with the militants. Thus, we identify a serious problem with so-called global health partnerships in which nation states and international organizations remain key actors. Such initiatives function well in situations where there is a capable state that is concerned with the welfare of its citizens and has exclusivity of jurisdiction over its territory. But they can encounter difficulties in areas where rebels challenge the state's sovereignty. Although the response to the Syrian polio outbreak was ultimately effective, it was reactive, ad hoc, slow and relied on personnel who had little experience. Global health partnerships would be more effective in conflict-affected areas if they put in place proactive and institutionalized plans to implement their programmes in regions outside government control. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

  18. Would it be legally justified to impose vaccination in Israel? Examining the issue in light of the 2013 detection of polio in Israeli sewage.

    Science.gov (United States)

    Kamin-Friedman, Shelly

    2017-10-30

    The detection of wild poliovirus in Israeli sewage in May 2013 led the health authorities to decide that children who had been vaccinated with IPV would also be vaccinated with OPV. The decision sought to protect vulnerable Israeli individuals who were either not vaccinated with IPV or who suffered from an immune deficiency, to preserve Israel's status as a polio-free country, to prevent the virus' "exportation" into vulnerable polio-free countries, and to participate in the global efforts toward the eradication of polio. After a massive public persuasion campaign, 79% of the children born after 2004 were vaccinated as well as 69% of the children residing in central Israel. A 2014 State Comptroller Report stated that the Ministry of Health should draw conclusions from the low compliance rates in certain Israeli regions. The article seeks to examine the legal legitimacy of mandatory vaccination in the service of eradicating a contagious disease (as opposed to preventing a pandemic outbreak), which was one of the objectives in the 2013 Polio case. It more specifically relates to current Israeli law as well as to a hypothetical new public health law which would authorize health officials to oblige vaccination and enforce this through the use of criminal sanctions. Qualitative content analysis through the interpretation of court judgements, laws, legislative protocols, health ministry guidelines and documented discussions of the Advisory Committee on Infectious Diseases and Immunization. A mandatory vaccination backed by criminal sanctions in the service of the eradication of contagious diseases would probably be perceived as infringing on the constitutional right to autonomy to a greater extent than necessary according to Israeli law and case law precedents. There may be some added value inherent in a new public health law which would authorize health officials to oblige vaccination where nonrestrictive measures have been ineffective. However, the law should also

  19. The Role of National Immunization Technical Advisory Groups (NITAGs) in the Introduction of Inactivated Polio Vaccine: Experience of the Indonesia and Uganda NITAGs.

    Science.gov (United States)

    Ba-Nguz, Antoinette; Adjagba, Alex; Wisnu Hendrarto, Toto; Sewankambo, Nelson K; Nalwadda, Celia; Kisakye, Annette

    2017-07-01

    National Immunization Technical Advisory Groups (NITAGs) are established by national authorities to provide them with independent, bias-free, objective, and evidence-based advice on vaccines and immunization challenges. As of December 2015, 125 countries have reported having set up an NITAG. The Health Policy and Institutional Development Center at the Agence de Médecine Préventive, a World Health Organization (WHO) Collaborative Center for evidence-informed immunization, through its Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative project, provides assistance to low- and middle-income countries in the establishment and strengthening of their NITAGs. The Indonesian NITAG (ITAGI) was formed in December 2006 and Uganda's (UNITAG) was formed in November 2014. Both Uganda and Indonesia have introduced inactivated polio vaccine (IPV) as part of the Global Polio Eradication and Endgame Strategic Plan (the Endgame plan). The authors reflect on the process and the role played by NITAGs in the introduction of IPV in the routine immunization program and the lessons learned. This commentary is a reflection of the authors' experience on NITAG's role as observed in 2 particular local settings and applied to a global public health issue, the polio eradication Endgame plan. The reflection is backed up by the relevant (policy and technical) documents on polio eradication, along with minutes and reports from countries' ministries of health, immunization programs, WHO, and NITAGs. NITAGs are valuable tools for ministries of health to ensure sustainable, evidence-informed immunization policies that are trusted and accepted by their communities. Early engagement with NITAGs also ensures that the adoption of strategies addressing global public health threats at the country level reinforces the national immunization programs. On the other end, when NITAGs are proactive and forward-thinking, they can contribute to a smooth and effective

  20. Selective harmonic elimination of new family of multilevel inverters using genetic algorithms

    International Nuclear Information System (INIS)

    El-Naggar, Khaled; Abdelhamid, Tamer H.

    2008-01-01

    Selective harmonic elimination has been a widely researched alternative to traditional PWM techniques. This paper presents the selective harmonic elimination of a new family of multilevel inverters using genetic algorithms. The new topology has the advantage of a reduced number of devices compared to traditional configurations and can be extended to any number of levels. The presented system reduces both the implementation complexity and the computational time. The GA technique finds the optimal solution set of switching angles, if it exists, for each required harmonic profile. Both simulation results and experimental verification of the proposed inverter topology for different numbers of levels and different harmonic profiles are presented

  1. Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy.

    Science.gov (United States)

    Bakker, Minne; Schipper, Karen; Koopman, Fieke S; Nollet, Frans; Abma, Tineke A

    2016-02-10

    Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of the interventions from the perspectives of the patients and therapists. Qualitative data were collected through semi-structured interviews with 17 patients and 7 therapists. All participants were involved in the trial. A thematic analysis of the data was performed. Some patients experienced a short term enhanced endurance and a better use of energy during the day. However, in general patients did not experience a long lasting reduction of fatigue from the CBT or ET. Mainly patients of the CBT, but also some patients of the ET described an increase of self-esteem and self-acceptance. As a result, patients were sometimes better able to perform physical activities during the day. In contrast to the CBT, the ET was in general perceived by the patients as an intensive therapy, which was difficult to fit into their daily routine. Therapists of both the CBT and the ET struggled with a low intrinsic motivation of the patients in the study. This made it sometimes difficult for the therapists to follow the protocol. Confirming the negative quantitative study outcome, the qualitative results did not demonstrate lasting effects on fatigue. Patients did, however, experience some benefits on self-esteem and acceptance of the disease. This study showed that it is of great importance to work with feasible interventions; they should fit the patients' needs on a practical (fit into their daily routine) and mental (fit their need for support) level.

  2. The effect of mass vaccination campaigns against polio on the utilization of routine immunization services: A regression discontinuity design.

    Science.gov (United States)

    Helleringer, Stephane; Asuming, Patrick O; Abdelwahab, Jalaa

    2016-07-19

    In most low and middle-income countries (LMIC), vaccines are primarily distributed by routine immunization services (RI) at health facilities. Additional opportunities for vaccination are also provided through mass vaccination campaigns, conducted periodically as part of disease-specific initiatives. It is unclear whether these campaigns are detrimental to RI services, or wether they may stimulate the utilization of RI. Unobserved confounders and reverse causality have limited existing evaluations of the effects of mass vaccination campaigns on RI services. We explored the use of a regression discontinuity design (RDD) to measure these effects more precisely. This is a quasi-experimental method, which exploits random variations in birth dates to identify the causal effects of vaccination campaigns. We applied RDD to survey data on a nationwide vaccination campaign against Polio conducted in Bangladesh. We compared systematically the children born immediately before vs. after the vaccination campaign. These two groups had similar background characteristics, but differed by their exposure to the vaccination campaign. Contrary to previous studies, exposure to the campaign had positive effects on RI utilization. Children exposed to the campaign received between 0.296 and 0.469 additional doses of DPT vaccine by age 4months than unexposed children. RDD constitutes a promising tool to assess the effects of mass vaccination campaigns on RI services. It could be tested in additional settings, using larger and more precise datasets. It could also be extended to measure the effects of other disease-specific interventions on the functioning of health systems, in particular those that occur at a discrete point in time and/or include age-related eligibility criteria. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Frequency of apnea, bradycardia, and desaturations following first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B immunization in hospitalized preterm infants

    Directory of Open Access Journals (Sweden)

    Spady Donald W

    2006-06-01

    Full Text Available Abstract Background Adverse cardiorespiratory events including apnea, bradycardia, and desaturations have been described following administration of the first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B (DTP-IPV-Hib immunization to preterm infants. The effect of the recent substitution of acellular pertussis vaccine for whole cell pertussis vaccine on the frequency of these events requires further study. Methods Infants with gestational age of ≤ 32 weeks who received their first DTP-IPV-Hib immunization prior to discharge from two Edmonton Neonatal Intensive Care Units January 1, 1996 to November 30, 2000 were eligible for the study. Each immunized infant was matched by gestational age to one control infant. The number of episodes of apnea, bradycardia, and/or desaturations (ABD and the treatment required for these episodes in the 72 hours prior to and 72 hours post-immunization (for the immunized cohort or at the same post-natal age (for controls was recorded. Results Thirty-four infants who received DTP-IPV-Hib with whole cell pertussis vaccine, 90 infants who received DTP-IPV-Hib with acellular pertussis vaccine, and 124 control infants were entered in the study. Fifty-six immunized infants (45.1% and 36 control infants (29.0% had a resurgence of or increased ABD in the 72 hours post-immunization in the immunized infants and at the same post-natal age in the controls with an adjusted odds ratio for immunized infants of 2.41 (95% CI 1.29,4.51 as compared to control infants. The incidence of an increase in adverse cardiorespiratory events post-immunization was the same in infants receiving whole cell or acellular pertussis vaccine (44.1% versus 45.6%. Eighteen immunized infants (14.5% and 51 control infants (41.1% had a reduction in ABD in the 72 hours post- immunization or at the equivalent postnatal age in controls for an odds ratio of 0.175 (95%CI 0.08, 0.39. The need for therapy of ABD in the immunized

  4. Elimination of Potential Electrical Stress During EMC (CS01) Testing

    Science.gov (United States)

    Erickson, Kenneth P.; Whittlesey, Albert C.; Vorperian, Vatche

    2006-01-01

    This viewgraph presentation reviews possible ways to eliminate electrical stress during Electromagneticic Compatibility (EMC) testing. The presentation reviews tests that have had problems due to electrical stress. On December 5, 1995 Cassini Radar instrument failed a functional test in preparation for EMC conducted susceptibility (CSO 1 ) testing. The instrument power supply did not turn on as required, and failure occurred prior to injection of CS test stimulus. A investigation of the failure was conducted. A PSPICE simulation of Cassini Radar 30V line using the EMC test setup was performed; the result of the simulation was an oscillation on the 30V input of the power supply. In another case: on December 28, 1999 an oscillation occurred on the input power line of the SlRTF Infrared Array Camera (IRAC) while preparing to perform CSOI testing, Resulted in damage to flight hardware. Subsequent to failure, JPL provided GSFC history and corrective action from Cassini Radar CSOI test failure GSFC implemented the same corrective action as JPL, except that the value of the resistor connected across the isolation transformer primary winding is 2.5 ohms instead of 50 ohms. Three recommendations are made: (1) Make EMC test community aware of the problem and potential solutions by presenting papers at major environmental test conferences (2) Include warnings and safeguards in EMC test requirements and procedures (3) Try to convince EMC test equipment suppliers to design a CSOl test fixture similar to fixture shown in the diagram

  5. Managerial process improvement: a lean approach to eliminating medication delivery.

    Science.gov (United States)

    Hussain, Aftab; Stewart, LaShonda M; Rivers, Patrick A; Munchus, George

    2015-01-01

    Statistical evidence shows that medication errors are a major cause of injuries that concerns all health care oganizations. Despite all the efforts to improve the quality of care, the lack of understanding and inability of management to design a robust system that will strategically target those factors is a major cause of distress. The paper aims to discuss these issues. Achieving optimum organizational performance requires two key variables; work process factors and human performance factors. The approach is that healthcare administrators must take in account both variables in designing a strategy to reduce medication errors. However, strategies that will combat such phenomena require that managers and administrators understand the key factors that are causing medication delivery errors. The authors recommend that healthcare organizations implement the Toyota Production System (TPS) combined with human performance improvement (HPI) methodologies to eliminate medication delivery errors in hospitals. Despite all the efforts to improve the quality of care, there continues to be a lack of understanding and the ability of management to design a robust system that will strategically target those factors associated with medication errors. This paper proposes a solution to an ambiguous workflow process using the TPS combined with the HPI system.

  6. Quantum error prevention and leakage elimination for quantum dots

    Science.gov (United States)

    Pegahan, Saeed; Byrd, Mark S.; Reddy Chinni, Karthik

    2015-03-01

    Decoherence-free, or noiseless subsystems, are used to encode spin qubits in quantum dots in order to achieve universal quantum computing using only the exchange interaction. We investigate the use of dynamical decoupling controls for the purposes of eliminating leakage for a logical qubit encoded using three physical qubits. These leakage elimination operators (LEOs) can be used to eliminate all leakage errors using exchange interactions between the physical spin qubits. Depending on the encoding and the decoupling control, different types of errors can be eliminated. We show several different possible controls and the consequential noise reduction for different encodings as well as our general method for determining the effectiveness of these pulses.

  7. Demand and Financial Constraints in Eliminating Architectural and Technical Barriers for People with Disabilities in Poland

    Directory of Open Access Journals (Sweden)

    Maria Hełdak

    2018-01-01

    Full Text Available The purpose of the study is to analyse the availability of financial resources for people with disabilities and to assess the needs satisfaction level of the disabled in order to eliminate architectural and technical barriers in Poland. The research conducted among the disabled affected by physical disability indicates that mobility barriers and obstacles remain among the most important problems encountered by people with disabilities. The research has shown that the problem of barriers increases with age. The elimination of architectural barriers requires, each time, higher financial expenditure, whereas the elimination of technical barriers improves the life quality of people with disabilities at low financial outlays. The average funding in Poland amounted to PLN 827.53 in 2016, including the funding of EUR 1453.60 for the elimination of architectural barriers and approx. EUR 582 for the removal of technical barriers. The financial resources allocated for this purpose do not cover the actual needs of the people with disabilities. The analysis revealed that the demand for investment in the elimination of barriers is increasing with age, whereas the expenditure of the Polish state is decreasing.

  8. [Simulating measles and rubella elimination levels according to social stratification and interaction].

    Science.gov (United States)

    Hincapié-Palacio, Doracelly; Ospina-Giraldo, Juan; Gómez-Arias, Rubén D; Uyi-Afuwape, Anthony; Chowell-Puente, Gerardo

    2010-02-01

    The study was aimed at comparing measles and rubella disease elimination levels in a homogeneous and heterogeneous population according to socioeconomic status with interactions amongst low- and high-income individuals and diversity in the average number of contacts amongst them. Effective reproductive rate simulations were deduced from a susceptibleinfected- recovered (SIR) mathematical model according to different immunisation rates using measles (1980 and 2005) and rubella (1998 and 2005) incidence data from Latin-America and the Caribbean. Low- and high-income individuals' social interaction and their average number of contacts were analysed by bipartite random network analysis. MAPLE 12 (Maplesoft Inc, Ontario Canada) software was used for making the simulations. The progress made in eliminating both diseases between both periods of time was reproduced in the socially-homogeneous population. Measles (2005) would be eliminated in high- and low-income groups; however, it would only be achieved in rubella (2005) if there were a high immunity rate amongst the low-income group. If the average number of contacts were varied, then rubella would not be eliminated, even with a 95 % immunity rate. Monitoring the elimination level in diseases like measles and rubella requires that socio-economic status be considered as well as the population's interaction pattern. Special attention should be paid to communities having diversity in their average number of contacts occurring in confined spaces such as displaced communities, prisons, educational establishments, or hospitals.

  9. Modeling the impact and costs of semiannual mass drug administration for accelerated elimination of lymphatic filariasis.

    Directory of Open Access Journals (Sweden)

    Wilma A Stolk

    Full Text Available The Global Program to Eliminate Lymphatic Filariasis (LF has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.

  10. Financial and Economic Costs of the Elimination and Eradication of Onchocerciasis (River Blindness in Africa.

    Directory of Open Access Journals (Sweden)

    Young Eun Kim

    Full Text Available Onchocerciasis (river blindness is a parasitic disease transmitted by blackflies. Symptoms include severe itching, skin lesions, and vision impairment including blindness. More than 99% of all cases are concentrated in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly decreased morbidity, and the treatment goal is shifting from control to elimination in Africa.We estimated financial resources and societal opportunity costs associated with scaling up community-directed treatment with ivermectin and implementing surveillance and response systems in endemic African regions for alternative treatment goals--control, elimination, and eradication. We used a micro-costing approach that allows adjustment for time-variant resource utilization and for the heterogeneity in the demographic, epidemiological, and political situation.The elimination and eradication scenarios, which include scaling up treatments to hypo-endemic and operationally challenging areas at the latest by 2021 and implementing intensive surveillance, would allow savings of $1.5 billion and $1.6 billion over 2013-2045 as compared to the control scenario. Although the elimination and eradication scenarios would require higher surveillance costs ($215 million and $242 million than the control scenario ($47 million, intensive surveillance would enable treatments to be safely stopped earlier, thereby saving unnecessary costs for prolonged treatments as in the control scenario lacking such surveillance and response systems.The elimination and eradication of onchocerciasis are predicted to allow substantial cost-savings in the long run. To realize cost-savings, policymakers should keep empowering community volunteers, and pharmaceutical companies would need to continue drug donation. To sustain high surveillance costs required for elimination and eradication, endemic countries would need to enhance their domestic funding capacity

  11. Elimination of Redwater Formation from TNT Manufacture

    Science.gov (United States)

    2007-12-21

    particular problems regarding reactor configuration (e.g. fixed vs. fluidized bed ) and catalyst renewal. Also, certain of these catalysts have been...utilizing the advantages of these systems to best effect would require three discrete reactors - a heterogeneous (fixed/ fluidized bed ) reactor to introduce...second and recrystallization stages, direct escape to the surroundings would be prevented by trapping using granulated activated carbon. Likewise

  12. Lessons learnt to keep Europe polio-free: a review of outbreaks in the European Union, European Economic Area, and candidate countries, 1973 to 2013.

    Science.gov (United States)

    Derrough, Tarik; Salekeen, Alexandra

    2016-04-21

    Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage.

  13. Comparison of activity and fatigue of the respiratory muscles and pulmonary characteristics between post-polio patients and controls: A pilot study.

    Science.gov (United States)

    Shoseyov, David; Cohen-Kaufman, Tali; Schwartz, Isabella; Portnoy, Sigal

    2017-01-01

    To compare pulmonary function measures, maximal respiratory pressure and fatigue of respiratory muscles between patients with Post-Polio Syndrome (PPS) and controls. Cross-sectional study. Patients with PPS (N = 12; age 62.1±11.6 years) able to walk for 6 minutes without human assistance; age-matched controls with no history of polio or pulmonary dysfunction (N = 12; age 62.2±6.5 years). A body plethysmograph was used to quantify Residual Volume (RV), Total Lung Capacity (TLC), and Thoracic Gas Volume (TGV) etc. A manometer was used to measure Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure. A spirometer was used to measure Maximal Voluntary Ventilation (MVV). Surface electromyography (sEMG) recorded diaphragmatic muscle activity while performing MVV. The control group had significantly higher TGV and showed improvement in MIP following the effort (difference of 5.5±4.0cmH2O) while the PPS group showed deterioration in MIP (difference of -2.5±5.0cmH2O). Subjects with scoliosis had significantly higher RV/TLC values compared with subjects without scoliosis. The 25th frequency percentile of the sEMG signal acquired during MVV was reduced in the PPS group. Maximal respiratory pressure test and sEMG measurements may identify fatigue of respiratory muscles in patients with PPS. Early diagnosis of respiratory impairment may delay respiratory decline and future need of invasive respiratory aids.

  14. Tracking the polio virus down the Congo River: a case study on the use of Google Earth™ in public health planning and mapping

    Directory of Open Access Journals (Sweden)

    Kamadjeu Raoul

    2009-01-01

    Full Text Available Abstract Background The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth™ (GE is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps. Results The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response. Conclusion GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals.

  15. Stimulation of HIV-1-specific cytolytic T-lymphocytes facilitates elimination of latent viral reservoir after virus reactivation

    OpenAIRE

    Shan, Liang; Deng, Kai; Shroff, Neeta S.; Durand, Christine; Rabi, S. Alireza.; Yang, Hung-Chih; Zhang, Hao; Margolick, Joseph B.; Blankson, Joel N.; Siliciano, Robert F.

    2012-01-01

    Highly active antiretroviral therapy (HAART) suppresses HIV-1 replication but cannot eliminate the virus because HIV-1 establishes latent infection. Interruption of HAART leads to a rapid rebound of viremia. Life-long treatment is therefore required. Efforts to purge the latent reservoir have focused on reactivating latent proviruses without inducing global T-cell activation. However, the killing of the infected cells after virus reactivation, which is essential for elimination of the reservo...

  16. 77 FR 30871 - Implementing the Prison Rape Elimination Act

    Science.gov (United States)

    2012-05-23

    ...--Implementing the Prison Rape Elimination Act Proclamation 8823--Armed Forces Day, 2012 #0; #0; #0; Presidential... Prison Rape Elimination Act Memorandum for the Heads of Executive Departments and Agencies Sexual violence, against any victim, is an assault on human dignity and an affront to American values. The Prison...

  17. 29 CFR 452.61 - Elimination contests-local unions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Elimination contests-local unions. 452.61 Section 452.61 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR... AND DISCLOSURE ACT OF 1959 Nominations for Office § 452.61 Elimination contests—local unions. (a) A...

  18. New ways of working to support sustainable disease elimination

    Directory of Open Access Journals (Sweden)

    Geordie Woods

    2017-03-01

    Full Text Available How can we ensure that Neglected Tropical Diseases (NTDs are not just eliminated, but eliminated once and for all? This article explores the key role that water, sanitation and hygiene (WASH interventions can play and what partnerships, programs and policies can be adopted to help see the end of certain diseases for good.

  19. Gains and Pitfalls of Quantifier Elimination as a Teaching Tool

    Science.gov (United States)

    Oldenburg, Reinhard

    2015-01-01

    Quantifier Elimination is a procedure that allows simplification of logical formulas that contain quantifiers. Many mathematical concepts are defined in terms of quantifiers and especially in calculus their use has been identified as an obstacle in the learning process. The automatic deduction provided by quantifier elimination thus allows…

  20. 10 CFR 60.23 - Elimination of repetition.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Elimination of repetition. 60.23 Section 60.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Licenses License Applications § 60.23 Elimination of repetition. In its application, environmental...

  1. Dietary Therapy for Eosinophilic Esophagitis: Elimination and Reintroduction.

    Science.gov (United States)

    Kliewer, Kara L; Cassin, Alison M; Venter, Carina

    2017-12-14

    Eosinophilic esophagitis (EoE) is a food antigen-mediated disorder of the esophagus characterized by eosinophil predominant inflammation and symptoms of esophageal dysfunction. Dietary antigen elimination induces clinical and histological remission in patients with EoE. The most restrictive of elimination diets (the elemental diet) removes all possible food antigens while empiric elimination diets remove all (or a subset) of food antigens most commonly reported to cause esophageal eosinophilia and food allergies (milk, egg, wheat, soy, peanuts, tree nuts, fish, or legumes). Elimination diets are effective treatments for EoE but pose psychosocial and financial challenges to patients and consequently may impair quality of life. Foods that are commonly eliminated, especially milk, are also nutrient-dense and therefore their elimination may result in inadequate nutrient intake or deficiencies without careful diet planning to include nutritionally comparable and safe food substitutes. After remission is achieved with elimination diets, foods can be reintroduced sequentially to identify specific food triggers, but this reintroduction is not standardized. Food elimination and food reintroductions should consider the patient's lifestyle, nutrition needs, and skills and ideally be managed by a team with knowledge of eosinophilic gastrointestinal disorders and nutrition.

  2. Malaria elimination practices in rural community residents in ...

    African Journals Online (AJOL)

    Background: Rwanda is moving towards malaria pre-elimination phase by the year 2017 and the role of the community will be critical. However, there is limited information about community perspective of the malaria elimination strategy. A study was thus designed to explore that. Methods: A descriptive cross-sectional study ...

  3. Eliminating gender-based violence: learning from the widowhood ...

    African Journals Online (AJOL)

    Eliminating gender-based violence: learning from the widowhood practices elimination Initiative of a women organisation in Ozubulu, Anambra State of Nigeria. ... of violence, they were surprisingly also the perpetrators and astute enforcers of the practice, as well as those who vehemently opposed any form of change.

  4. Community transmission of type 2 poliovirus after cessation of trivalent oral polio vaccine in Bangladesh: an open-label cluster-randomised trial and modelling study.

    Science.gov (United States)

    Taniuchi, Mami; Famulare, Michael; Zaman, Khalequ; Uddin, Md Jashim; Upfill-Brown, Alexander M; Ahmed, Tahmina; Saha, Parimalendu; Haque, Rashidul; Bandyopadhyay, Ananda S; Modlin, John F; Platts-Mills, James A; Houpt, Eric R; Yunus, Mohammed; Petri, William A

    2017-10-01

    Trivalent oral polio vaccine (tOPV) was replaced worldwide from April, 2016, by bivalent types 1 and 3 oral polio vaccine (bOPV) and one dose of inactivated polio vaccine (IPV) where available. The risk of transmission of type 2 poliovirus or Sabin 2 virus on re-introduction or resurgence of type 2 poliovirus after this switch is not understood completely. We aimed to assess the risk of Sabin 2 transmission after a polio vaccination campaign with a monovalent type 2 oral polio vaccine (mOPV2). We did an open-label cluster-randomised trial in villages in the Matlab region of Bangladesh. We randomly allocated villages (clusters) to either: tOPV at age 6 weeks, 10 weeks, and 14 weeks; or bOPV at age 6 weeks, 10 weeks, and 14 weeks and either one dose of IPV at age 14 weeks or two doses of IPV at age 14 weeks and 18 weeks. After completion of enrolment, we implemented an mOPV2 vaccination campaign that targeted 40% of children younger than 5 years, regardless of enrolment status. The primary outcome was Sabin 2 incidence in the 10 weeks after the campaign in per-protocol infants who did not receive mOPV2, as assessed by faecal shedding of Sabin 2 by reverse transcriptase quantitative PCR (RT-qPCR). The effect of previous immunity on incidence was also investigated with a dynamical model of poliovirus transmission to observe prevalence and incidence of Sabin 2 virus. This trial is registered at ClinicalTrials.gov, number NCT02477046. Between April 30, 2015, and Jan 14, 2016, individuals from 67 villages were enrolled to the study. 22 villages (300 infants) were randomly assigned tOPV, 23 villages (310 infants) were allocated bOPV and one dose of IPV, and 22 villages (329 infants) were assigned bOPV and two doses of IPV. Faecal shedding of Sabin 2 in infants who did not receive the mOPV2 challenge did not differ between children immunised with bOPV and one or two doses of IPV and those who received tOPV (15 of 252 [6%] vs six of 122 [4%]; odds ratio [OR] 1·29, 95% CI 0

  5. Requirement Development Process and Tools

    Science.gov (United States)

    Bayt, Robert

    2017-01-01

    Requirements capture the system-level capabilities in a set of complete, necessary, clear, attainable, traceable, and verifiable statements of need. Requirements should not be unduly restrictive, but should set limits that eliminate items outside the boundaries drawn, encourage competition (or alternatives), and capture source and reason of requirement. If it is not needed by the customer, it is not a requirement. They establish the verification methods that will lead to product acceptance. These must be reproducible assessment methods.

  6. Problems of elimination of low emission

    Energy Technology Data Exchange (ETDEWEB)

    Stepniowski, A. [Municipal Gas Distribution Enterprise, Cracow (Poland)

    1995-12-31

    The Cracow Municipal Gas Distribution Enterprises is subordinated to the Carpathian Regional Gas Engineering Plant in Tarnow, which - in turn - is a part of Polish Oil Mining and Gas Engineering with its seat in Warsaw. The required quick development of power engineering in Poland needs harmonized development of all branches of power engineering, including the gas production and distribution industry which constitutes an element of technical infrastructure of Poland influencing the direction of development. After World War II, the gas engineering industry was transformed from a typical communal service to a big industrial structure which covers the entire territory of the state and has considerable technical and material measures at its disposal. Programming of the gas industry development ranges from development of installation of gas-supply arrangements for communal purposes including modification of local gas generators - to the development of gas transportation, storage and purification system. At present gas is taken from following sources: import, own natural gas deposits (high-methane content gas and high-nitrogen content gas within Polish Lowland); cokeries, and local gas generators. Gas sorts obtained in these sources have differentiated physico-chemical properties and they are distributed by three independent transmission systems assigned for high-methane natural gas, high-nitrogen natural gas, and coke-oven gas. Taking into consideration the forecast demand and potential capacity of natural gas production in Poland, the required import of natural gas is estimated.

  7. Anti-HBs levels in infants of hepatitis B carrier mothers after delayed active immunization with recombinant vaccine concomitant with DTP-polio vaccine: Is there need for a second dose of HBIg?

    NARCIS (Netherlands)

    P.M. Grosheide (Pia Maria); R. Del Canho (R.); M. Voogd (M.); R.A. Heijtink; S.W. Schalm (Solko)

    1994-01-01

    textabstractThe need for an additional dose of hepatitis B immune globulin (HBIg) was studied by comparing infants receiving 1 ml HBIg at birth followed by hepatitis B immunization, concomitant with DTP-polio vaccine, at 3, 4, 5 and 11 months (schedule E), with infants receiving the same schedule

  8. Neonatal vitamin A supplementation associated with a cluster of deaths and poor early growth in a randomised trial among low-birth-weight boys of vitamin A versus oral polio vaccine at birth

    DEFF Research Database (Denmark)

    Lund, Najaaraq; Biering-Sørensen, Sofie; Andersen, Andreas

    2014-01-01

    BACKGROUND: The effect of oral polio vaccine administered already at birth (OPV0) on child survival was not examined before being recommended in 1985. Observational data suggested that OPV0 was harmful for boys, and trials have shown that neonatal vitamin A supplementation (NVAS) at birth may...

  9. Why use of interventions targeting outdoor biting mosquitoes will be necessary to achieve malaria elimination

    Directory of Open Access Journals (Sweden)

    Nicodem James Govella

    2012-06-01

    Full Text Available By definition, elimination of malaria means permanent reduction to zero of locally incidence of infections. Achieving this goal among other reasons, it requires fully understanding on where and when persons are most exposed to malaria vectors as these are fundamental for targeting interventions to achieve maximum impact. While elimination can be possible in some settings with low malaria transmission intensity and dominated with late and indoor biting of vectors using Long Lasting Insecticidal Nets (LLIN and Indoor Residual Spraying (IRs, it’s difficult and even impossible in areas with high and where majority of human exposure to transmission occurs outside human dwellings. Recently in response to wide spread use of LLIN and IRS, human risk of exposure to transmission is increasingly spread across the entire night so that much of it occurs outdoors and before bed time. This modification of vector populations and behaviour has now been reported from across Africa, Asia and from the Solomon Islands. Historical evidence shows that even in areas with intervention coverage exceeding 90% of human population it was so hard to even push prevalence down below the pre elimination threshold of 1% being compromised mainly with the outdoor residual transmission. Malaria control experts must however continue to deliver interventions that tackle indoor transmission but considerable amount of resources that target mosquitoes outside of houses and outside of sleeping hours will therefore be required to sustain and go beyond existing levels of malaria control and achieve elimination.

  10. Tuberculosis 2015: burden, challenges and strategy for control and elimination

    Directory of Open Access Journals (Sweden)

    Mario Raviglione

    2016-06-01

    Full Text Available Tuberculosis (TB is a leading cause of morbidity and mortality worldwide, accounting for about 9.6 million new cases and 1.5 million deaths annually. The poorest and socially excluded groups carry the largest burden of disease, which makes it essential to properly address the social determinants of health through poverty reduction measures and targeted interventions on high-risk populations. The spread of multidrug-resistance TB requires special attention and highlights the need to foster research on TB diagnostics, new drugs and vaccines. Although many advances have been made in the fight against TB over the last twenty years, a lot is still needed to achieve global elimination. The new end-TB strategy that was first launched in 2014 by the World Health Organization, is fully in line with the seventeen Sustainable Development Goals that came into effect since January 2016 and sets ambitious goals for the post-2015 agenda. A 90% reduction in TB-related mortality and an 80% decline in TB incidence within 2030 as well as the abolition of catastrophic expenditures for TB-affected people are the main targets of this strategy. Strong government commitment and adequate financing from all countries together with community engagement and appropriate investments in research are necessary in order to reach these objectives.

  11. A Novel Algorithm of Surface Eliminating in Undersurface Optoacoustic Imaging

    Directory of Open Access Journals (Sweden)

    Zhulina Yulia V

    2004-01-01

    Full Text Available This paper analyzes the task of optoacoustic imaging of the objects located under the surface covering them. In this paper, we suggest the algorithm of the surface eliminating based on the fact that the intensity of the image as a function of the spatial point should change slowly inside the local objects, and will suffer a discontinuity of the spatial gradients on their boundaries. The algorithm forms the 2-dimensional curves along which the discontinuity of the signal derivatives is detected. Then, the algorithm divides the signal space into the areas along these curves. The signals inside the areas with the maximum level of the signal amplitudes and the maximal gradient absolute values on their edges are put equal to zero. The rest of the signals are used for the image restoration. This method permits to reconstruct the picture of the surface boundaries with a higher contrast than that of the surface detection technique based on the maximums of the received signals. This algorithm does not require any prior knowledge of the signals' statistics inside and outside the local objects. It may be used for reconstructing any images with the help of the signals representing the integral over the object's volume. Simulation and real data are also provided to validate the proposed method.

  12. Accurate and diverse recommendations via eliminating redundant correlations

    Energy Technology Data Exchange (ETDEWEB)

    Zhou Tao; Su Riqi; Liu Runran; Jiang Luoluo; Wang Binghong [Department of Modern Physics and Nonlinear Science Center, University of Science and Technology of China, Hefei Anhui 230026 (China); Zhang Yicheng [Department of Physics, University of Fribourg, Chemin du Musee 3, CH-1700 Fribourg (Switzerland)], E-mail: bhwang@ustc.edu.cn

    2009-12-15

    In this paper, based on a weighted projection of a bipartite user-object network, we introduce a personalized recommendation algorithm, called network-based inference (NBI), which has higher accuracy than the classical algorithm, namely collaborative filtering. In NBI, the correlation resulting from a specific attribute may be repeatedly counted in the cumulative recommendations from different objects. By considering the higher order correlations, we design an improved algorithm that can, to some extent, eliminate the redundant correlations. We test our algorithm on two benchmark data sets, MovieLens and Netflix. Compared with NBI, the algorithmic accuracy, measured by the ranking score, can be further improved by 23 per cent for MovieLens and 22 per cent for Netflix. The present algorithm can even outperform the Latent Dirichlet Allocation algorithm, which requires much longer computational time. Furthermore, most previous studies considered the algorithmic accuracy only; in this paper, we argue that the diversity and popularity, as two significant criteria of algorithmic performance, should also be taken into account. With more or less the same accuracy, an algorithm giving higher diversity and lower popularity is more favorable. Numerical results show that the present algorithm can outperform the standard one simultaneously in all five adopted metrics: lower ranking score and higher precision for accuracy, larger Hamming distance and lower intra-similarity for diversity, as well as smaller average degree for popularity.

  13. Accurate and diverse recommendations via eliminating redundant correlations

    Science.gov (United States)

    Zhou, Tao; Su, Ri-Qi; Liu, Run-Ran; Jiang, Luo-Luo; Wang, Bing-Hong; Zhang, Yi-Cheng

    2009-12-01

    In this paper, based on a weighted projection of a bipartite user-object network, we introduce a personalized recommendation algorithm, called network-based inference (NBI), which has higher accuracy than the classical algorithm, namely collaborative filtering. In NBI, the correlation resulting from a specific attribute may be repeatedly counted in the cumulative recommendations from different objects. By considering the higher order correlations, we design an improved algorithm that can, to some extent, eliminate the redundant correlations. We test our algorithm on two benchmark data sets, MovieLens and Netflix. Compared with NBI, the algorithmic accuracy, measured by the ranking score, can be further improved by 23 per cent for MovieLens and 22 per cent for Netflix. The present algorithm can even outperform the Latent Dirichlet Allocation algorithm, which requires much longer computational time. Furthermore, most previous studies considered the algorithmic accuracy only; in this paper, we argue that the diversity and popularity, as two significant criteria of algorithmic performance, should also be taken into account. With more or less the same accuracy, an algorithm giving higher diversity and lower popularity is more favorable. Numerical results show that the present algorithm can outperform the standard one simultaneously in all five adopted metrics: lower ranking score and higher precision for accuracy, larger Hamming distance and lower intra-similarity for diversity, as well as smaller average degree for popularity.

  14. Robust fuzzy logic stabilization with disturbance elimination.

    Science.gov (United States)

    Danapalasingam, Kumeresan A

    2014-01-01

    A robust fuzzy logic controller is proposed for stabilization and disturbance rejection in nonlinear control systems of a particular type. The dynamic feedback controller is designed as a combination of a control law that compensates for nonlinear terms in a control system and a dynamic fuzzy logic controller that addresses unknown model uncertainties and an unmeasured disturbance. Since it is challenging to derive a highly accurate mathematical model, the proposed controller requires only nominal functions of a control system. In this paper, a mathematical derivation is carried out to prove that the controller is able to achieve asymptotic stability by processing state measurements. Robustness here refers to the ability of the controller to asymptotically steer the state vector towards the origin in the presence of model uncertainties and a disturbance input. Simulation results of the robust fuzzy logic controller application in a magnetic levitation system demonstrate the feasibility of the control design.

  15. [Switzerland eliminates measles. National Strategy for the Elimination of Measles 2011-2015].

    Science.gov (United States)

    Koch, D; Richard, J-L; Hanhart, J; Eckert, T; Eigenmann Schüttel, S

    2013-09-01

    The measles virus circulates within Switzerland in an endemic way leading to sporadic outbreaks. The most recent outbreak occurred in 2011. It lasted 9 months and had 687 reported cases. This is in contrast to 2012 when there were 66 cases,corresponding to an incidence of 8 cases per million inhabitants. During 2008-2010, the average national vaccination coverage for one or two doses of measles vaccine amounted to 92 and 83 % for 2-year-olds, 95 and 85 % for 8-year-olds, and 95 and 85 % for 16-year-olds, respectively. To improve the national vaccination coverage, the Federal Council adopted the National Strategy for the Elimination of Measles 2011-2015 in 2011.The strategy was drawn up in a participative process led by the Federal Office for Public Health.The cantons as key partners were represented by the Conference of the Cantonal Directors for Public Health and the Association of Cantonal Health Officers. The strategy pursues the vision of eliminating measles in Switzerland in order to protect the population against measles and its complications, including all persons who may not be vaccinated for medical reasons. The strategy comprises six axes of intervention:(1)political engagement and support by all stakeholders, (2)a targeted ≥ 95 % two-dose vaccination coverage for all 2-year-olds, (3)easier access and incentives for the booster vaccination for everyone in the 2-year-old age group up to those born in 1964, (4)communication and promotion, (5)uniform national outbreak control, and (6)targeted surveillance.

  16. Eliminating the OUCH in OUtreaCH

    Science.gov (United States)

    Karsten, J. L.; Manduca, C. A.

    2004-12-01

    ``I'm a scientist who knows how to conduct research, not an expert in teaching pre-college students!'' is a common complaint within the scientific community in response to recent funding agency mandates that research proposals explicitly address education, public outreach or other broader impacts. Yet, these new requirements address several important goals - fostering public support for research funding in the Earth and Space sciences, recruiting the next generation of talented geoscientists in the face of declining student enrollments, and educating the citizenry for informed decision making and advocacy, chief among them. Further, the phrase ``broader impacts'' is not meant to be synonymous with outreach to pre-college students and teachers - agency program managers actually encourage many different types of activity for meeting these obligations. AGU and its Committee on Education and Human Resources (CEHR) are committed to offering an array of programs that facilitate our members' ability to meet these new education, outreach, and broader impacts criteria in support of the research enterprise. CEHR has an on-going need for scientists willing to speak about their research in Geophysical Information for Teacher (GIFT) Workshops, sponsored lectures at annual and regional conventions of the National Science Teachers Association, special symposia for minority high school students attending annual AGU meetings, and career planning workshops for students and early career investigators. More extensive involvement as meeting mentors for minority undergraduate and graduate students is available through AGU's partnership with the new MSPHDS initiative (A. Pyrtle, P.I.). A new AGU outreach web site now under development will make available scientist biographies and abstracts derived from recent scientific articles originally published in AGU journals, which have been rewritten for a public audience. This resource is expected to serve as an important vehicle for AGU members

  17. Optimising strategies for Plasmodium falciparum malaria elimination in Cambodia: primaquine, mass drug administration and artemisinin resistance.

    Directory of Open Access Journals (Sweden)

    Richard J Maude

    Full Text Available Malaria elimination requires a variety of approaches individually optimized for different transmission settings. A recent field study in an area of low seasonal transmission in South West Cambodia demonstrated dramatic reductions in malaria parasite prevalence following both mass drug administration (MDA and high treatment coverage of symptomatic patients with artemisinin-piperaquine plus primaquine. This study employed multiple combined strategies and it was unclear what contribution each made to the reductions in malaria.A mathematical model fitted to the trial results was used to assess the effects of the various components of these interventions, design optimal elimination strategies, and explore their interactions with artemisinin resistance, which has recently been discovered in Western Cambodia. The modelling indicated that most of the initial reduction of P. falciparum malaria resulted from MDA with artemisinin-piperaquine. The subsequent continued decline and near elimination resulted mainly from high coverage with artemisinin-piperaquine treatment. Both these strategies were more effective with the addition of primaquine. MDA with artemisinin combination therapy (ACT increased the proportion of artemisinin resistant infections, although much less than treatment of symptomatic cases with ACT, and this increase was slowed by adding primaquine. Artemisinin resistance reduced the effectiveness of interventions using ACT when the prevalence of resistance was very high. The main results were robust to assumptions about primaquine action, and immunity.The key messages of these modelling results for policy makers were: high coverage with ACT treatment can produce a long-term reduction in malaria whereas the impact of MDA is generally only short-term; primaquine enhances the effect of ACT in eliminating malaria and reduces the increase in proportion of artemisinin resistant infections; parasite prevalence is a better surveillance measure for

  18. Malaria elimination in Haiti by the year 2020: an achievable goal?

    Science.gov (United States)

    Boncy, Paul Jacques; Adrien, Paul; Lemoine, Jean Frantz; Existe, Alexandre; Henry, Patricia Jean; Raccurt, Christian; Brasseur, Philippe; Fenelon, Natael; Dame, John B; Okech, Bernard A; Kaljee, Linda; Baxa, Dwayne; Prieur, Eric; El Badry, Maha A; Tagliamonte, Massimiliano S; Mulligan, Connie J; Carter, Tamar E; Beau de Rochars, V Madsen; Lutz, Chelsea; Parke, Dana M; Zervos, Marcus J

    2015-06-05

    Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d'Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on "Elimination Strategies for Malaria in Haiti" on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of

  19. Progress toward measles elimination--Japan, 1999-2008.

    Science.gov (United States)

    2008-09-26

    In 2005, the Regional Committee of the World Health Organization (WHO) Western Pacific Region (WPR) set a target date of 2012 for measles elimination in all WPR member states. In Japan, measles control strategies have included 1) a nationwide public awareness campaign implemented in 2001 to promote timely vaccination with the first dose of measles-containing vaccine (MCV1) administered on or after age 12 months, and 2) a 2-dose MCV schedule with the second dose (MCV2) administered at age 5-6 years, adopted in 2006 in accordance with the recommended WPR measles elimination strategy. However, during 2007-2008, Japan experienced a large measles outbreak, which resulted in exportation of measles cases from Japan into countries where measles elimination had been achieved. This report describes the epidemiology of measles in Japan during 1999--2008 and approval of a National Measles Elimination Plan in December 2007 that includes recommendations for immunization strategies, case-based measles surveillance, and monitoring to ensure elimination of measles by 2012. Measles continues to be endemic in Japan, with most cases occurring in children before school entry, except for 2007 and 2008, when a shift to an older age group was observed. With implementation of the National Measles Elimination Plan, Japan is expected to make progress toward achieving the WPR measles elimination goal.

  20. Elimination of Helicobacter pylori under treatment with omeprazole.

    Science.gov (United States)

    Stolte, M; Bethke, B

    1990-06-01

    Biopsies from the stomachs (antrum and corpus) of 201 patients with peptic ulcers or reflux oesophagitis were retrospectively investigated for the effect of treatment with omeprazole on the elimination of Helicobacter pylori (HP) and on gastritis. Of 64 patients without gastritis two (3.1%) developed gastritis during treatment. Among 134 patients with HP gastritis undergoing treatment, 48 (35.8%) experienced no HP elimination, in 41 (30.6%) there was HP elimination from the antrum, but HP persistence in the corpus, while in 45 (33.6%) HP was eliminated from both antrum and corpus. HP elimination led to a reduction in the degree and activity of gastritis under omeprazole treatment. Only eight patients were examined after completion of treatment, and in three in whom HP had been eliminated, recolonization was found to have occurred. The disappearance of HP in Type A gastritis coupled with the fact that HP is highly sensitive to contamination with other bacteria--as observed in the laboratory--suggests that this now partially established elimination of HP under the strongly acid-inhibiting omeprazole therapy can be traced back to a bacterial overgrowth of the gastric mucosa.