Fun on the farm: evaluation of a lesson to teach students about the spread of infection on school farm visits.

Directory of Open Access Journals (Sweden)

Meredith K D Hawking

Full Text Available BACKGROUND: School visits to farms are a positive educational experience but pose risks due to the spread of zoonotic infections. A lesson plan to raise awareness about microbes on the farm and preventative behaviours was developed in response to the Griffin Investigation into the E. coli outbreak associated with Godstone Farm in 2009. This study evaluated the effectiveness of the delivery of the lesson plan in increasing knowledge about the spread of infection on the farm, amongst school students. METHODS: Two hundred and twenty-five 9-11 year old students from seven junior schools in England participated. Two hundred and ten students filled in identical questionnaires covering microbes, hand hygiene, and farm hygiene before and after the lesson. Statistical analysis assessed knowledge change using difference in percentage correct answers. RESULTS: Significant knowledge improvement was observed for all sections. In the 'Farm Hygiene' section, girls and boys demonstrated 18% (p<0.001 and 11% (p<0.001 improvement, respectively (girls vs. boys p<0.004. As girls had lower baseline knowledge the greater percentage improvement resulted in similar post intervention knowledge scores between genders (girls 80%, boys 83%. CONCLUSIONS: The lesson plan was successful at increasing awareness of microbes on the farm and infection prevention measures and should be used by teachers in preparation for a farm visit.

Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

International Nuclear Information System (INIS)

Klonaris, Chris; Katsargyris, Athanasios; Matthaiou, Alexandros; Giannopoulos, Athanasios; Tsigris, Chris; Papadopouli, Katerina; Tsiodras, Sotiris; Bastounis, Elias

2007-01-01

A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated

The lessons of SARS in Hong Kong.

Science.gov (United States)

Lai, Thomas Sik To; Yu, Wai Cho

2010-02-01

Severe acute respiratory syndrome (SARS) is a novel coronavirus infection which broke out in Hong Kong in March 2003. Princess Margaret Hospital was designated to manage this new, mysterious and serious disease. Healthcare workers had to work under extremely stressful and often risky conditions to care for patients. Despite manpower and equipment reinforcements, staff infection occurred as a result of bodily exhaustion, working in an unfamiliar environment and lapses in infection control. Patients suffered even more, not only due to physical discomfort, but also because of the fear of isolation and death away from family and friends. Health authorities learnt their lessons in the outbreak and formulated emergency plans for future infectious disease epidemics. The healthcare infrastructure has been examined and upgraded with regard to intensive care capacity, infection control measures, professional training, manpower deployment, staff facilities, and stockpiling of drugs and personal protective equipment.

A Lesson about the Circular Flow. Active Learning Lessons. Economics International.

Science.gov (United States)

Landfried, Janet

This lesson plan was developed through "Economics International," an international program to help build economic education infrastructures in the emerging market economies. It provides a lesson description; appropriate grade level; economic concepts; content standards and benchmarks; related subjects; instructional objectives; time…

The rise of Zika infection and microcephaly: what can we learn from a public health emergency?

Science.gov (United States)

McCloskey, B; Endericks, T

2017-09-01

To consider why Zika was declared a Public Health Emergency of International Concern (PHEIC), why it stopped being one and what we can learn from this for the future. This paper reviews the sequence of events and evidence base for the decision to declare Zika a PHEIC, the global response to this, the challenges in maintaining an evidence-based approach to outbreak response and identifies learning outcomes. Evidence review, all published articles in reputable UK and international journals were identified. The association between Zika virus infection and congenital malformations including microcephaly became a PHEIC on 1st February 2016 and was declared to be no longer an emergency in November 2016. This shaped the global response led by WHO in the first global emergency since Ebola in West Africa. The response to Zika highlights important issues and lessons for future outbreaks that might pose an international risk. Particular challenges arose in trying to maintain an evidence-based approach to public risk communication when the evidence is unclear or still evolving. The Zika incident also demonstrates the importance of public health practitioners and agencies understanding the political context in which outbreaks must be managed and understanding the competing factors that shape the political response. Copyright © 2017 The Royal Society for Public Health. All rights reserved.

Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

Science.gov (United States)

Fu, Chuanxi; Wang, Shengyong

2016-04-12

The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module II. Human Systems and Patient Assessment.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

This instructor's lesson plan guide on human systems and patient assessment is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Four units are presented: (1) medical terminology, which covers some common prefixes and suffixes and the use of the medical dictionary; (2) an overview of the…

Emergency operating procedures improvement based on the lesson learned from the Fukushima Daiichi accident

Energy Technology Data Exchange (ETDEWEB)

Wu, Wen-Hsiung, E-mail: whwu1127@aec.gov.tw [Atomic Energy Council, 2F., No. 80, Sec.1, Chenggong Rd., Yonghe Dist., New Taipei City 234, Taiwan (China); Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Sec. 2, Guangfu Rd., Hsinchu City 300, Taiwan (China); Liao, Lih-Yih, E-mail: lyliao@iner.gov.tw [Institute of Nuclear Energy Research, Atomic Energy Council, No. 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 325, Taiwan (China)

2016-12-01

Highlights: • Discuss the problem of EOPs at the time of Fukushima accident to deal with the prolonged SBO. • Elaborate the potential risk accompanied with the emergency depressurization in the SBO. • Describe a special guideline to cope with Fukushima-like accidents and provide its technical basis. • Point out that Fukushima accident might have been prevented if improved EOPs had been used. • Propose key points and suggestions for improving the EOPs. - Abstract: One of the lessons learned from the Fukushima Daiichi accident is the emergency operating procedures (EOPs) have to be improved. The BWR Owners’ Group revised the emergency procedure guidelines and addressed the lesson learned from the Fukushima Daiichi accident in revision 3 in order to avoid loss of turbine-driven makeup water systems during reactor depressurization. However, the improvement deserves much more attention. The existing EOPs at the time of the accident may not be adequate enough for the prolonged station blackout condition, because resources required for performing the EOPs are vastly unavailable or gradually exhausted. The improved EOPs must not only permit early reactor pressure vessel depressurization, but also address the risk accompanied with the emergency depressurization. For this reason, Taiwan Power Company proposed the Ultimate Response Guideline (URG) to cope with Fukushima-like accidents. The main content of the URG is a two-stage depressurization strategy, namely the controlled depressurization and the emergency depressurization. The technical basis of the two-stage depressurization strategy was discussed in this paper. The effectiveness of the URG was verified by using TRAC/RELAP Advanced Computational Engine (TRACE). Besides, the emergency responses performed by Fukushima Daini nuclear power plant (Fukushima Daini NPP) were found to be very similar to the URG. The consequences of Fukushima Daini NPP somehow demonstrate that the URG is effective for Fukushima

Emergency operating procedures improvement based on the lesson learned from the Fukushima Daiichi accident

International Nuclear Information System (INIS)

Wu, Wen-Hsiung; Liao, Lih-Yih

2016-01-01

Highlights: • Discuss the problem of EOPs at the time of Fukushima accident to deal with the prolonged SBO. • Elaborate the potential risk accompanied with the emergency depressurization in the SBO. • Describe a special guideline to cope with Fukushima-like accidents and provide its technical basis. • Point out that Fukushima accident might have been prevented if improved EOPs had been used. • Propose key points and suggestions for improving the EOPs. - Abstract: One of the lessons learned from the Fukushima Daiichi accident is the emergency operating procedures (EOPs) have to be improved. The BWR Owners’ Group revised the emergency procedure guidelines and addressed the lesson learned from the Fukushima Daiichi accident in revision 3 in order to avoid loss of turbine-driven makeup water systems during reactor depressurization. However, the improvement deserves much more attention. The existing EOPs at the time of the accident may not be adequate enough for the prolonged station blackout condition, because resources required for performing the EOPs are vastly unavailable or gradually exhausted. The improved EOPs must not only permit early reactor pressure vessel depressurization, but also address the risk accompanied with the emergency depressurization. For this reason, Taiwan Power Company proposed the Ultimate Response Guideline (URG) to cope with Fukushima-like accidents. The main content of the URG is a two-stage depressurization strategy, namely the controlled depressurization and the emergency depressurization. The technical basis of the two-stage depressurization strategy was discussed in this paper. The effectiveness of the URG was verified by using TRAC/RELAP Advanced Computational Engine (TRACE). Besides, the emergency responses performed by Fukushima Daini nuclear power plant (Fukushima Daini NPP) were found to be very similar to the URG. The consequences of Fukushima Daini NPP somehow demonstrate that the URG is effective for Fukushima

Emerging Trend of Acinetobacter Nosocomial Infection in Northeast of Iran

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Samaneh Saed

2015-10-01

Full Text Available Background: Acinetobacter spp. emerged as an opportunistic pathogen for hospital-acquired infections. Recently, increasing antibiotic resistance among Acinetobacter spp. has worsened the problem. The aim of this study was to investigate  the  emerging  trend  of  infection  due  to Acinetobacter  in Ghaem University Hospital, Mashhad during 2006-2012.Methods: The demographic data and information about redisposing factors was collected. Appropriate bacteriological samples were collected and Acinetobacter spp. was isolated. Antibiotics susceptibility pattern of these isolates againstdifferent antimicrobials agents was determined.Results: Results confirmed that Acinetobacter spp. cause 20.9% of nosocomial infection during this period. The trend of Acinetobacter nosocomial infection was increasing and patients with risk factors such as COPD, bronchectasia, diabetes   mellitus   were   more   prone   to   infection.  There   was   significant association   between   these   infections   and   invasive   procedures   such   as catheterization, mechanical ventilation and broad-spectrum antibiotics usage. Conclusion:  Understanding  trends  in  causative  organisms  of  nosocomial infection can help us to better define our infection control policy.

Newly approved antibiotics and antibiotics reserved for resistant infections: Implications for emergency medicine.

Science.gov (United States)

Mazer-Amirshahi, Maryann; Pourmand, Ali; May, Larissa

2017-01-01

Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical. Increasing rates of antibiotic resistance, drug allergies, and antibiotic shortages further complicates the choice of antibiotics. Patients may have a history of prior resistant infections or culture data indicating that common first-line antibiotics used in the ED may be ineffective. In recent years, there have been several new antibiotic approvals as well as renewed interest in second and third line antibiotics because of the aforementioned concerns. In addition, several newly approved antibiotics have the advantage of being administered once weekly or even as a single infusion, which has the potential to decrease hospitalizations and healthcare costs. This article reviews newly approved antibiotics and antibiotics used to treat resistant infections with a focus on implications for emergency medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

Emergence of Arthropod Transmitted infections in Kennel Dogs

Directory of Open Access Journals (Sweden)

Javed Jameel

Full Text Available Changing scenario of climate resulting from global warming and adversity of nature has also resulted in emergence and re-emergence of diseases transmitted by arthropods. Increasing trends of population growth of dogs has increased the chance of disease transmission due to readily available susceptible host. Babesiosis and Hepatozoonosis and Ehrlichiosis are the main arthropod borne diseases of dogs prevalent in India. The present article explains the importance of these arthropod transmitted infections in kennel dogs, research progress and reason for their emergence in the present scenario. [Vet. World 2011; 4(11.000: 522-528

Analysis of emergency response after the Chernobyl accident in Belarus: observed and prevented medical consequences, lessons learned

International Nuclear Information System (INIS)

Buglova, E.; Kenigsberg, J.

1997-01-01

Belarus is one of the most contaminated Republic due to the Chernobyl accident. 23% of the entire area of Belarus was contaminated with radionuclides. To protect the population after the accident different types of protective actions were performed during all phases, based on various temporary dose limits. An analysis of conducted protective actions and lessons obtained during the emergency response is briefly presented

Modelling the contact propagation of nosocomial infection in emergency departments

OpenAIRE

Jaramillo, Cecilia; Taboada, Manel; Epelde, Francisco; Rexachs, Dolores; Luque Amat, Emilio

2015-01-01

The nosocomial infection is a special kind of infection that is caused by microorganisms acquired inside a hospital. In the daily care process of an emergency department, the interactions between patients and sanitary staff create the environment for the transmission of such microorganisms. Rates of morbility and mortality due to nosocomial infections areimportant indicators of the quality of hospital work. In this research, we use Agent Based Modeling and Simulation tech...

Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era--a Conference at Harvard Medical School.

Science.gov (United States)

Knipe, David M; Whelan, Sean P

2015-08-01

Harvard Medical School convened a meeting of biomedical and clinical experts on 5 March 2015 on the topic of "Rethinking the Response to Emerging Microbes: Vaccines and Therapeutics in the Ebola Era," with the goals of discussing the lessons from the recent Ebola outbreak and using those lessons as a case study to aid preparations for future emerging infections. The speakers and audience discussed the special challenges in combatting an infectious agent that causes sporadic outbreaks in resource-poor countries. The meeting led to a call for improved basic medical care for all and continued support of basic discovery research to provide the foundation for preparedness for future outbreaks in addition to the targeted emergency response to outbreaks and targeted research programs against Ebola virus and other specific emerging pathogens. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Analysis of emergency response after the Chernobyl accident in Belarus: observed and prevented medical consequences, lessons learned

Energy Technology Data Exchange (ETDEWEB)

Buglova, E.; Kenigsberg, J. [Research Clinical Inst. of Radiation Medicine and Endocrinology, Minsk (Belarus)

1997-12-31

Belarus is one of the most contaminated Republic due to the Chernobyl accident. 23% of the entire area of Belarus was contaminated with radionuclides. To protect the population after the accident different types of protective actions were performed during all phases, based on various temporary dose limits. An analysis of conducted protective actions and lessons obtained during the emergency response is briefly presented 9 refs.

Acinetobacter infections as an emerging threat in intensive care units

International Nuclear Information System (INIS)

Tahseen, U.; Talib, M.T.

2015-01-01

Nosocomial infections caused by Acinetobacter species (Spp.) is an emerging threat in health care setups especially intensive care units (ICU). The objective of this observational study was to determine the pattern of Acinetobacter infections and its association with length of stay in patients admitted to our medical ICU from January to August 2011. Methods: All patients above 16 years of age with stay of more than 48 hours were checked for any development of new infections not present or incubating at the time of admission. Nosocomial infections were documented in the light of clinical findings and lab results. Data was analysed using statistical software SPSS 15.0. Results: A total of 146 patients had a stay of at least 48 hours; frequency of nosocomial infection was 30.8% out of which 57.8% were Acinetobacter infections. Respiratory system was most commonly involved. Acinetobacter Spp showed high resistance (96.2%) to penicillins, cephalosporins and even extended spectrum antibiotics including carbepenems, quinolones and piperacillin plus tazobactam. Extended drug resistance was seen in 92.3% isolates; while we found high susceptibility to tigecycline (88.5%) and polymyxins (100%). Acinetobacter Spp. infected patients had mean length of stay (LOS) of 12.92 days when compared to patients with other nosocomial infections and no infection with mean LOS of 7.05 days (p=0.05) and 4.86 days (p=0.00) respectively. Conclusions: Acinetobacter Spp infections increase with longer duration of stay in ICU. Emergence of multi-drug and extended-drug resistant Acinetobacter Spp is alarming and overwhelming at this rate for already stretched out health system with its economic and health implications. (author)

Emergency response of Fukushima Daini Nuclear Power Station during the Great East Japan Earthquake and its lessons

International Nuclear Information System (INIS)

Kawamura, Shinichi

2016-01-01

At the time of the occurrence of the Great East Japan Earthquake, Fukushima Daini Nuclear Power Station (hereinafter, Fukushima Daini) was operating four units of BWRS-5 type plants with an output of 1,100 MWe/unit. Among these plants, No. 1, 2, and 4 Units lost all the functions of heat removal equipment of reactors affected by tsunami. However, ad-hoc activities such as the exchange of submerged motors and temporary power installation allowed the recovery of residual heat removal (RHR) system, leading to a success in cold shutdown. This is a success story more than expectation in dealing with emergency situations, but not necessarily all of the correspondences were successfully carried out, leaving some problems. As lessons, the following are pointed out: (1) confirmation of the damage situation of the site and setting of priority rank of recovery, (2) securement of the means that do not depend on initial on-site activities, and (3) possession at the site of the skills of emergency restoration, equipment diagnostic technology, and repair technology. With reflecting lessons and challenges in these correspondences, Tokyo Electric Power Company is working to improve the accident response capability of the organization including Kashiwazaki-Kariwa Nuclear Power Station. As an example of effort of emergency response capability strengthening, there is an application of the US Incident Management System (IMS). The company is continuously making efforts for improving safety through training. (A.O.)

Thigh infection and subcutaneous emphysema: an emergency, review of literature and case discussion.

LENUS (Irish Health Repository)

Thakral, R

2011-06-01

Thigh infection associated with local emphysematous signs on presentation to the emergency room should alert the medical staff at once of potential complication associated with it. The infection may be associated with underlying bowel pathology and has a high mortality rate. Hence, emergency treatment should be instituted. We discuss a case with this uncommon presentation, treatment administered and relevant literature.

Emerging infectious diseases with cutaneous manifestations: Fungal, helminthic, protozoan and ectoparasitic infections.

Science.gov (United States)

Kollipara, Ramya; Peranteau, Andrew J; Nawas, Zeena Y; Tong, Yun; Woc-Colburn, Laila; Yan, Albert C; Lupi, Omar; Tyring, Stephen K

2016-07-01

Given increased international travel, immigration, changing climate conditions, and the increased incidence of iatrogenic immunosuppression, fungal, protozoan, helminthic, and ectoparasitic infections that were once uncommon are being seeing more frequently in the Western hemisphere. However, the diagnosis and management of these infections is fraught with a lack of consistency because there is a dearth of dermatology literature on the cutaneous manifestations of these infections. In addition, delays in the diagnosis and treatment of these diseases can lead to significant patient morbidity and mortality. We review the epidemiology, cutaneous manifestations, diagnostic modalities, and treatment options for emerging fungal, protozoan, helminthic, and ectoparasitic infections. It should be noted, however, that throughout this review we cite statistics documenting their increased incidence to back-up these infections as emerging, and although some of the diagnoses are clinical, others rely on newer laboratory tests, and the possibility exists that the increased incidence could be caused by better detection methods. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Improved nuclear emergency management system reflecting lessons learned from the emergency response at Fukushima Daini Nuclear Power Station after the Great East Japan Earthquake

International Nuclear Information System (INIS)

Kawamura, Shinichi; Narabayashi, Tadashi

2016-01-01

Three nuclear reactors at Fukushima Daini Nuclear Power Station lost all their ultimate heat sinks owing to damage from the tsunami caused by the Great East Japan Earthquake on March 11, 2011. Water was injected into the reactors by alternate measures, damaged cooling systems were restored with promptly supplied substitute materials, and all the reactors were brought to a cold shutdown state within four days. Lessons learned from this experience were identified to improve emergency management, especially in the areas of strategic response planning, logistics, and functions supporting response activities continuing over a long period. It was found that continuous planning activities reflecting information from plant parameters and response action results were important, and that relevant functions in emergency response organizations should be integrated. Logistics were handled successfully but many difficulties were experienced. Therefore, their functions should be clearly established and improved by emergency response organizations. Supporting emergency responders in the aspects of their physical and mental conditions was important for sustaining continuous response. As a platform for improvement, the concept of the Incident Command System was applied for the first time to a nuclear emergency management system, with specific improvement ideas such as a phased approach in response planning and common operation pictures. (author)

Emerging Acinetobacter schindleri in red eye infection of Pangasius ...

African Journals Online (AJOL)

This communication provides an insight into the emerging of new infection “red eye” in Pangasius sutchi and aimed to screen the prime pathogens involved in disease. The pathogen was isolated from diseased P. sutchi and characterized by morphological, biochemical and molecular approach, which includes 16s r RNA ...

Serum Lactate Predicts Adverse Outcomes in Emergency Department Patients With and Without Infection

Directory of Open Access Journals (Sweden)

Kimie Oedorf

2017-02-01

Full Text Available Introduction: Lactate levels are increasingly used to risk stratify emergency department (ED patients with and without infection. Whether a serum lactate provides similar prognostic value across diseases is not fully elucidated. This study assesses the prognostic value of serum lactate in ED patients with and without infection to both report and compare relative predictive value across etiologies. Methods: We conducted a prospective, observational study of ED patients displaying abnormal vital signs (AVS (heart rate ≥130 bpm, respiratory rate ≥24 bpm, shock index ≥1, and/or systolic blood pressure 4.0mmol/L. Trended stratified lactate levels were associated with deterioration for both infected (p 4mmol/L was an independent predictor of deterioration for patients with infection (OR 4.8, 95% CI: 1.7 – 14.1 and without infection (OR 4.4, 1.7 – 11.5. Conclusion: Lactate levels can risk stratify patients with AVS who have increased risk of adverse outcomes regardless of infection status. [West J Emerg Med. 2017;18(2258-266.

Are we prepared for emerging and re-emerging diseases? Experience and lessons from epidemics that occurred in Tanzania during the last five decades.

Science.gov (United States)

Karimuribo, Esron D; Mboera, Leonard E G; Mbugi, Erasto; Simba, Azma; Kivaria, Fredrick M; Mmbuji, Peter; Rweyemamu, Mark M

2011-12-01

This paper reviews preparedness for containing and controlling emerging and re-emerging diseases drawing lessons from disease events that occurred in animal and human populations in the last five decades (1961-2011). A comprehensive analysis based on retrieval and analysis of grey and published literature as well as reported cases was carried out to document type and trend of occurrence of emerging and re-emerging infectious diseases in different parts of Tanzania. Overall, the majority of diseases reported in the country were viral in nature followed by bacterial diseases. The trend for the occurrence shows a number of new emerging diseases as well as re-occurrence of old diseases in both animal (domestic and wild) and human populations. In humans, the major disease epidemics reported in the last five decades include cholera, influenza A H1N1, plague and rubella. In animals, the major epidemic diseases reported were Contagious Bovine Pleuropneumonia, Contagious Caprine Pleuropneumonia, Peste des petits ruminants and Giraffe Ear and Skin Diseases. Some epidemics have been reported in both human and animal populations including Rift Valley fever and anthrax. The emergence of the 'fit-for purpose' approaches and technologies such as the discipline of One Health, use of participatory epidemiology and disease surveillance and mobile technologies offers opportunity for optimal use of limited resources to improve early detection, diagnosis and response to disease events and consequently reduced impact of such diseases in animal and human populations.

Gross Domestic Pizza. Active Learning Lessons. Economics International.

Science.gov (United States)

Zaleskiene, Irena; Venger, Anatoly; MacDonald, Rich; Davis, Debbie

This lesson plan was developed through "Economics International," an international program to help build economic education infrastructures in the emerging market economies. It provides a lesson description; appropriate age level; economic concepts; content standards and benchmarks; related subject areas; instructional objectives; time…

Emerging infectious diseases with cutaneous manifestations: Viral and bacterial infections.

Science.gov (United States)

Nawas, Zeena Y; Tong, Yun; Kollipara, Ramya; Peranteau, Andrew J; Woc-Colburn, Laila; Yan, Albert C; Lupi, Omar; Tyring, Stephen K

2016-07-01

Given increased international travel, immigration, and climate change, bacterial and viral infections that were once unrecognized or uncommon are being seen more frequently in the Western Hemisphere. A delay in diagnosis and treatment of these diseases can lead to significant patient morbidity and mortality. However, the diagnosis and management of these infections is fraught with a lack of consistency because there is a dearth of dermatology literature on the cutaneous manifestations of these infections. We review the epidemiology, cutaneous manifestations, diagnosis, and management of these emerging bacterial and viral diseases. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Lessons learned from the post-emergency TABLETOP exercise in Baton Rouge, Louisiana, on August 28 and September 18, 1990

International Nuclear Information System (INIS)

1991-07-01

On August 28 and September 18, 1990, Gulf States Utilities, the States of Louisiana and Mississippi, five local parishes, six Federal agencies, and the American Nuclear Insurers participated in a post-emergency TABLETOP exercise in Baton Rouge, Louisiana. The purpose of the exercise was to examine the post-emergency roles, responsibilities, and resources of utility, State, local, Federal and insurance organizations in response to a hypothetical accident at the River Bend Station in Louisiana resulting in a significant release of radiation to the environment. In pursuit of this goal, five major focus areas were addressed: (1) ingestion pathway response; (2) reentry, relocation and return; (3) decontamination of recovery; (4) indemnification of financial losses; and (5) deactivation of the emergency response. This report documents the lessons learned from that exercise

Leishmaniasis, an emerging infection in travelers.

Science.gov (United States)

Pavli, Androula; Maltezou, Helena C

2010-12-01

Leishmaniasis is a vector-borne protozoan infection with a wide clinical spectrum, which ranges from asymptomatic infection to fatal visceral leishmaniasis. A review of the recent literature indicates a sharp increase in imported leishmaniasis cases in developed, non-endemic countries over the last decade, in association with increasing international tourism, military operations, and the influx of immigrants from endemic countries. South America is the main area for the acquisition of cutaneous leishmaniasis, and adventure travelers on long-term trips in highly-endemic forested areas are at particular risk. Popular Mediterranean destinations are emerging as the main areas of acquisition of visceral leishmaniasis for European travelers. Leishmaniasis should be considered in patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years ago. Appropriate counseling should be provided to adventure travelers, military personnel, researchers, and other groups of travelers likely to be exposed to sandflies in endemic areas. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Infection and natural history of emergency department-placed central venous catheters.

Science.gov (United States)

LeMaster, Christopher H; Schuur, Jeremiah D; Pandya, Darshan; Pallin, Daniel J; Silvia, Jennifer; Yokoe, Deborah; Agrawal, Ashish; Hou, Peter C

2010-11-01

Central line-associated bloodstream infection (CLABSI, hereafter referred to in this paper as "bloodstream infection") is a leading cause of hospital-acquired infection. To our knowledge, there are no previously published studies designed to determine the rate of bloodstream infection among central venous catheters placed in the emergency department (ED). We design a retrospective chart review methodology to determine bloodstream infection and duration of catheterization for central venous catheters placed in the ED. Using hospital infection control, administrative, and ED billing databases, we identified patients with central venous catheters placed in the ED between January 1, 2007, and December 31, 2008, at one academic, urban ED with an annual census of 57,000. We performed a structured, explicit chart review to determine duration of catheterization and confirm bloodstream infection. We screened 4,251 charts and identified 656 patients with central venous catheters inserted in the ED, 3,622 catheter-days, and 7 bloodstream infections. The rate of bloodstream infection associated with central venous catheters placed in the ED was 1.93 per 1,000 catheter-days (95% confidence interval 0.50 to 3.36). The mean duration of catheterization was 5.5 days (median 4; range 1 to 29 days). Among infected central venous catheters, the mean duration of catheterization was 8.6 days (median 7; range 2 to 19 days). A total of 667 central venous catheters were placed in the internal jugular (392; 59%), subclavian (145; 22%), and femoral (130; 19%) veins. The sensitivity of using ED procedural billing code for identifying ED-placed central venous catheters among patients subsequently admitted to any ICU was 74.9% (95% confidence interval 71.4% to 78.3%). The rate of ED bloodstream infection at our institution is similar to current rates in ICUs. Central venous catheters placed in the ED remain in admitted patients for a substantial period. Copyright © 2010 American College of

Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies.

Science.gov (United States)

Gillespie, Amaya M; Obregon, Rafael; El Asawi, Rania; Richey, Catherine; Manoncourt, Erma; Joshi, Kshiitij; Naqvi, Savita; Pouye, Ade; Safi, Naqibullah; Chitnis, Ketan; Quereshi, Sabeeha

2016-12-23

Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component-which UNICEF refers to as communication for development (C4D)-of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies continually as patterns

Zika virus infection: Past and present of another emerging vector-borne disease.

Science.gov (United States)

Sakkas, Hercules; Economou, Vangelis; Papadopoulou, Chrissanthy

2016-01-01

Zika virus infection is an emerging mosquito-borne disease, first identified in Uganda in 1947. It is caused by the Zika arbovirus, and transmitted by the bites of infected mosquitoes of the genus Aedes. For almost half a century, the Zika virus was reported as the causative agent of sporadic human infections. In 2007, the Zika virus emerged outside Asia and Africa causing an epidemic on the Island of Yap in Micronesia. The manifestation of the newly acquired human infection varies from asymptomatic to self-limiting acute febrile illness with symptoms and clinical features similar to those caused by the Dengue virus ('Dengue-like syndrome'). The real-time PCR and serological methods have been successfully applied for the diagnosis of the disease. The treatment is symptomatic, since there is no specific antiviral treatment or a vaccine. During the recent outbreaks in French Polynesia and Brazil, incidents of Guillain-Barrι syndrome and microcephaly were associated with Zika virus infection, giving rise to fears of further global spread of the virus. Prevention and vector control strategies have to be urgently implemented by national health authorities in order to contain future outbreaks in vulnerable populations. This review summarizes the existing information on Zika virus characteristics, pathogenesis and epidemiology, the available methods for the diagnosis of Zika virus infection and recent approaches for prevention and control.

Emergency thyroidectomy in infected thyroid cyst due to spontaneous gas forming organisms

International Nuclear Information System (INIS)

Masood, R.; Chudhary, I.A.; Shaumaila, T.

2008-01-01

We are reporting a case of a young female, who presented to emergency room with sudden increase in thyroid swelling, high fever and acute respiratory distress. Clinical diagnosis of spontaneous infection of thyroid cyst was made. Operative finding was infection of thyroid cyst with gas formation. Systemic antibiotics and operative intervention by subtotal thyroidectomy led to recovery of the patient. (author)

Zika virus infection and its emerging trends in Southeast Asia

Institute of Scientific and Technical Information of China (English)

Ahmad Ruzain Salehuddin; Haszianaliza Haslan; Norshalizah Mamikutty; Nurul Hannim Zaidun; Mohamad Fairuz Azmi; Mohamad Mu'izuddin Senin; Syed Baharom Syed Ahmad Fuad; Zar Chi Thent

2017-01-01

Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.

Putting Gino's lesson to work: Actor-network theory, enacted humanity, and rehabilitation.

Science.gov (United States)

Abrams, Thomas; Gibson, Barbara E

2016-02-01

This article argues that rehabilitation enacts a particular understanding of "the human" throughout therapeutic assessment and treatment. Following Michel Callon and Vololona Rabeharisoa's "Gino's Lesson on Humanity," we suggest that this is not simply a top-down process, but is cultivated in the application and response to biomedical frameworks of human ability, competence, and responsibility. The emergence of the human is at once a materially contingent, moral, and interpersonal process. We begin the article by outlining the basics of the actor-network theory that underpins "Gino's Lesson on Humanity." Next, we elucidate its central thesis regarding how disabled personhood emerges through actor-network interactions. Section "Learning Gino's lesson" draws on two autobiographical examples, examining the emergence of humanity through rehabilitation, particularly assessment measures and the responses to them. We conclude by thinking about how rehabilitation and actor-network theory might take this lesson on humanity seriously. © The Author(s) 2016.

Towards antiviral therapies for treating dengue virus infections.

Science.gov (United States)

Kaptein, Suzanne Jf; Neyts, Johan

2016-10-01

Dengue virus is an emerging human pathogen that poses a huge public health burden by infecting annually about 390 million individuals of which a quarter report with clinical manifestations. Although progress has been made in understanding dengue pathogenesis, a licensed vaccine or antiviral therapy against this virus is still lacking. Treatment of patients is confined to symptomatic alleviation and supportive care. The development of dengue therapeutics thus remains of utmost importance. This review focuses on the few molecules that were evaluated in dengue virus-infected patients: balapiravir, chloroquine, lovastatin, prednisolone and celgosivir. The lessons learned from these clinical trials can be very helpful for the design of future trials for the next generation of dengue virus inhibitors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Metropolises in emerging countries: actors in energy transitions? Lessons from Cape Town (South Africa)

International Nuclear Information System (INIS)

Jaglin, Sylvy

2017-01-01

The role of cities, as places and drivers of the energy transition is increasingly recognized. The research project Termos tested the robustness of this assumption in four cities of emerging countries by asking two questions: to what extent do urban local actors really drive an urban energy transition and of what kind? To what extent are their actions supporting an urban territorialisation of energy systems? The paper first presents the findings of this comparative research, which he then extends with the case study of Cape Town. It analyzes why, despite their energy and environmental voluntarism, the municipality have little room of manoeuvre, while the changes observed seem to strengthen the stranglehold of the 'central sphere' in the energy system. Analyzing this as the expression of a conflict between a strong national electricity sector and an alternative approach to energy issues carried by urban actors, it highlights the resulting tensions and their impact on the municipal actions, both limited by resistance but also 'swallowed up' by actors from the central sphere. The paper finally draws lessons from this example to enrich the general analysis of dynamics observed in other cities of emerging countries

Hospital design for better infection control

Directory of Open Access Journals (Sweden)

Lateef Fatimah

2009-01-01

Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges

Lessons learned from the special inspection program for emergency operating procedures: Conducted March--October 1988

International Nuclear Information System (INIS)

1989-04-01

The results of the team inspections conducted during 1988 for the Nuclear Regulatory Commission (NRC) Emergency Operating Procedures (EOPs) Inspection Program are summarized in this report. Inspection results are discussed in relation to past staff guidance provided to utilities for upgrade of EOPs. In this report the NRC presents information of particular interest to the nuclear power industry regarding concerns that were identified during the EOP team inspections and restates the staff's previous guidance in a format that more clearly illustrates the consequences of programmatic weaknesses. The information contained in this report is provided so that licensees may take advantage of the lessons learned from the EOP inspection effort. This report does not impose any new requirements related to the upgrading of EOPs. 7 refs

Addressing Ebola-related stigma: lessons learned from HIV/AIDS.

Science.gov (United States)

Davtyan, Mariam; Brown, Brandon; Folayan, Morenike Oluwatoyin

2014-01-01

HIV/AIDS and Ebola Virus Disease (EVD) are contemporary epidemics associated with significant social stigma in which communities affected suffer from social rejection, violence, and diminished quality of life. To compare and contrast stigma related to HIV/AIDS and EVD, and strategically think how lessons learned from HIV stigma can be applied to the current EVD epidemic. To identify relevant articles about HIV/AIDS and EVD-related stigma, we conducted an extensive literature review using multiple search engines. PubMed was used to search for relevant peer-reviewed journal articles and Google for online sources. We also consulted the websites of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health to retrieve up-to-date information about EVD and HIV/AIDS. Many stigmatizing attitudes and behaviors directed towards those with EVD are strikingly similar to those with HIV/AIDS but there are significant differences worthy of discussion. Both diseases are life-threatening and there is no medical cure. Additionally misinformation about affected groups and modes of transmission runs rampant. Unlike in persons with EVD, historically criminalized and marginalized populations carry a disproportionately higher risk for HIV infection. Moreover, mortality due to EVD occurs within a shorter time span as compared to HIV/AIDS. Stigma disrupts quality of life, whether it is associated with HIV infection or EVD. When addressing EVD, we must think beyond the immediate clinical therapeutic response, to possible HIV implications of serum treatment. There are emerging social concerns of stigma associated with EVD infection and double stigma associated with EVD and HIV infection. Drawing upon lessons learned from HIV, we must work to empower and mobilize prominent members of the community, those who recovered from the disease, and organizations working at the grassroots level to disseminate clear and accurate

Successful customer value management : Key lessons and emerging trends

NARCIS (Netherlands)

Verhoef, P.C.; Lemon, Katherine

In the past decade, firms have paid increasing attention to customer value management (CVM). Through customer-centric management systems, firms aim to maximize customer value. In this article, we put forth six important lessons that firms can employ for successful CVM, integrating available research

Mycoplasma genitalium: An Emerging Sexually Transmitted Infection

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Jessian L. Munoz

2016-01-01

Full Text Available Mycoplasma genitalium has been recognized as a cause of male urethritis, and there is now evidence suggesting that it causes cervicitis and pelvic inflammatory disease in women. M. genitalium is a slow growing organism, and, with the advent of nucleic acid amplification test (NAAT, more studies are being performed, and knowledge about the pathogenicity of this organism elucidated. With NAAT detection, treatment modalities have been studied, and the next challenge is to determine the most effective antimicrobial therapy. Doxycycline, the first-line antibiotic for urethritis, is largely ineffective in the treatment of M. genitalium and furthermore, resistance to macrolide has also emerged. The most effective drug is Moxifloxacin although there are emerging reports of resistance to it in various parts of the world. This paper not only highlights the current research and knowledge, but also reviews the diversity of health implications on the health of men and women infected with M. genitalium. Alternate antibiotics and the impact of M. genitalium on infertility are areas that require more studies as we continue to research into this microorganism.

H1N1 infection in emergency surgery: A cautionary tale.

LENUS (Irish Health Repository)

Galbraith, J G

2010-01-01

Pandemic 2009 influenza A H1N1 has spread rapidly since its first report in Mexico in March 2009. This is the first influenza pandemic in over 40 years and it atypically affects previously healthy young adults, with higher rates of morbidity and mortality. The medical literature has been inundated with reports of H1N1 infection, the majority found in critical care and internal medicine journals with a relative paucity in the surgical literature. Despite this, it remains an important entity that can impact greatly on acute surgical emergencies. We present a case of previously healthy 31-year-old male who underwent open appendectomy. His post-operative recovery was complicated by acute respiratory distress syndrome secondary to H1N1 infection. This case report highlights the impact that H1N1 virus can have on acute surgical emergencies and how it can complicate the post-operative course.

Dengue infection in the nervous system: lessons learned for Zika and Chikungunya

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Marzia Puccioni-Sohler

Full Text Available ABSTRACT Dengue, Zika and Chikungunya are emerging arboviruses and important causes of acute febrile disease in tropical areas. Although dengue does not represent a new condition, a geographic expansion over time has occurred with the appearance of severe neurological complications. Neglect has allowed the propagation of the vector (Aedes spp, which is also responsible for the transmission of other infections such as Zika and Chikungunya throughout the world. The increased number of infected individuals has contributed to the rise of neurological manifestations including encephalitis, myelitis, meningitis, Guillain-Barré syndrome and congenital malformations such as microcephaly. In this narrative review, we characterize the impact of the geographic expansion of the vector on the appearance of neurological complications, and highlight the lack of highly accurate laboratory tests for nervous system infections. This represents a challenge for public health in the world, considering the high number of travelers and people living in endemic areas.

Clostridium difficile Infection Among US Emergency Department Patients With Diarrhea and No Vomiting.

Science.gov (United States)

Abrahamian, Fredrick M; Talan, David A; Krishnadasan, Anusha; Citron, Diane M; Paulick, Ashley L; Anderson, Lydia J; Goldstein, Ellie J C; Moran, Gregory J

2017-07-01

The incidence of Clostridium difficile infection has increased and has been observed among persons from the community who have not been exposed to antibiotics or health care settings. Our aims are to determine prevalence of C difficile infection among emergency department (ED) patients with diarrhea and the prevalence among patients without traditional risk factors. We conducted a prospective observational study of patients aged 2 years or older with diarrhea (≥3 episodes/24 hours) and no vomiting in 10 US EDs (2010 to 2013). We confirmed C difficile infection by positive stool culture result and toxin assay. C difficile infection risk factors were antibiotic use or overnight health care stay in the previous 3 months or previous C difficile infection. We typed strains with pulsed-field gel electrophoresis. Of 422 participants, median age was 46 years (range 2 to 94 years), with median illness duration of 3.0 days and 43.4% having greater than or equal to 10 episodes of diarrhea during the previous 24 hours. At least one risk factor for C difficile infection was present in 40.8% of participants; 25.9% were receiving antibiotics, 26.9% had health care stay within the previous 3 months, and 3.3% had previous C difficile infection. Forty-three participants (10.2%) had C difficile infection; among these, 24 (55.8%) received antibiotics and 19 (44.2%) had health care exposure; 17 of 43 (39.5%) lacked any risk factor. Among participants without risk factors, C difficile infection prevalence was 6.9%. The most commonly identified North American pulsed-field gel electrophoresis (NAP) strains were NAP type 1 (23.3%) and NAP type 4 (16.3%). Among mostly adults presenting to US EDs with diarrhea and no vomiting, C difficile infection accounted for approximately 10%. More than one third of patients with C difficile infection lacked traditional risk factors for the disease. Among participants without traditional risk factors, prevalence of C difficile infection was

An update on emerging therapies for urinary tract infections.

Science.gov (United States)

Majeed, Aneela; Alarfaj, Sumaiah; Darouiche, Rabih; Mohajer, Mayar

2017-03-01

Urinary tract infections (UTIs) are the most common healthcare-acquired infections, and are associated with high morbidity and mortality. Worldwide use of antibiotics has led to a significant rise in resistant uropathogens emanating from both hospitals and communities. The huge concern of multidrug resistance (MDR) has led the Food and Drug Administration (FDA) to encourage drug companies to invest in the development of new antibiotics. Area covered: In this review we summarized data on already approved antibiotics, and selected emerging therapies that are currently in phase II and III trials with emphasis on complicated urinary tract infections (cUTIs). We performed our search using PubMed, ClinicalTrials.gov, Google Scholar and Pharmaprojects. Expert opinion: Efficacious antimicrobials are needed to overcome MDR organisms. There are several dugs in initial and later stages of development, but most of them lack full spectrum of activity against some Gram-negative organisms, particularly against MDR Pseudomonas aeruginosa. Better understanding of the pathogenesis of UTI and genetic engineering of pathogens can provide new drugs to combat resistance in the future.

Fascioliasis: can Cuba conquer this emerging parasitosis?

Science.gov (United States)

Rojas, Lázara; Vazquez, Antonio; Domenech, Ingrid; Robertson, Lucy J

2010-01-01

Fascioliasis, an emerging parasitic infection, impacts significantly on both veterinary and human health worldwide. Endemic foci are not limited only to areas of extensive livestock farming, but owing to the parasite's abilities to colonise new intermediate hosts and adapt to new environments, also occur in other places, including Cuba. In Cuba, despite a high prevalence of fascioliasis in livestock, and the widespread occurrence of two potential intermediate hosts, human infection has decreased steadily over the past 10 years. In other parts of the world, human fascioliasis is apparently becoming more frequent. Problems in counteracting the spread of fascioliasis, and approaches used in Cuba to limit zoonotic transmission are discussed, with emphasis on diagnostic and treatment problems, malacological initiatives, and the importance of an integrated control programme. Such programmes may be of benefit in other countries where the prevalence of human fascioliasis is increasing, and lessons may perhaps be learned from the Cuban approach. Copyright 2009 Elsevier Ltd. All rights reserved.

WNV infection - an emergent vector borne viral infection in Serbia: Current situation

Directory of Open Access Journals (Sweden)

Petrović Tamaš

2015-01-01

Full Text Available West Nile virus (WNV is a neurovirulent mosquito-borne Flavivirus with zoonotic potential. Virus is maintained in nature in an enzootic transmission cycle between avian hosts and mosquito vectors, but occasionally infects other vertebrates. The infection in horses and humans can be asymptomatic or it can have different clinical manifestations ranging from light febrile diseases to fatal meningoencephalitis. Recently, the number, frequency and severity of outbreaks with neurological consequences for birds, humans and horses have increased dramatically throughout central and south Europe, including Serbia, posing a serious veterinary and public health problem. The emergency of WNV infections in Serbia is described through the current epidemiology situation based on recent data on the incidence of WNV infection among virus natural hosts and vectors; sentinel (horses and other animal species, and in human population. The results of the WNV serology studies conducted on horse blood samples collected in different occasions during the last six years, and the results of the serology studies conducted among other animal species like pigs, wild boars, roe deer and dogs in Serbia are presented and discussed. Also, the results of the first studies on WNV presence in mosquito vectors and in wild birds as virus natural hosts in Serbia are presented and analyzed. In addition, the data on the WNV serology studies conducted in human population in Serbia in the last few years, and the existing data of WNV outbreaks in 2012 and 2013 are included. Regarding the existing knowledge on WNV epidemiology situation, the crucial role of veterinary service in early detection of WNV presence and ongoing national program of WNV surveillance in sentinel animals, mosquitoes and wild birds are discussed.

Venezuelan equine encephalitis emergence: Enhanced vector infection from a single amino acid substitution in the envelope glycoprotein

Science.gov (United States)

Brault, Aaron C.; Powers, Ann M.; Ortiz, Diana; Estrada-Franco, Jose G.; Navarro-Lopez, Roberto; Weaver, Scott C.

2004-01-01

In 1993 and 1996, subtype IE Venezuelan equine encephalitis (VEE) virus caused epizootics in the Mexican states of Chiapas and Oaxaca. Previously, only subtype IAB and IC VEE virus strains had been associated with major outbreaks of equine and human disease. The IAB and IC epizootics are believed to emerge via adaptation of enzootic (sylvatic, equine-avirulent) strains for high titer equine viremia that results in efficient infection of mosquito vectors. However, experimental equine infections with subtype IE equine isolates from the Mexican outbreaks demonstrated neuro-virulence but little viremia, inconsistent with typical VEE emergence mechanisms. Therefore, we hypothesized that changes in the mosquito vector host range might have contributed to the Mexican emergence. To test this hypothesis, we evaluated the susceptibility of the most abundant mosquito in the deforested Pacific coastal locations of the VEE outbreaks and a proven epizootic vector, Ochlerotatus taeniorhynchus. The Mexican epizootic equine isolates exhibited significantly greater infectivity compared with closely related enzootic strains, supporting the hypothesis that adaptation to an efficient epizootic vector contributed to disease emergence. Reverse genetic studies implicated a Ser → Asn substitution in the E2 envelope glycoprotein as the major determinant of the increased vector infectivity phenotype. Our findings underscore the capacity of RNA viruses to alter their vector host range through minor genetic changes, resulting in the potential for disease emergence. PMID:15277679

A Rooster and a Bean Seed. Active Learning Lessons. Economics International.

Science.gov (United States)

Lelyuk, Julia

This lesson plan was developed through "Economics International," an international program to help build economic education infrastructures in the emerging market economies. It provides a description of the lesson; appropriate age level; economic concepts; content standards and benchmarks; related subject areas; instructional objectives;…

The Vietnam Initiative on Zoonotic Infections (VIZIONS): A Strategic Approach to Studying Emerging Zoonotic Infectious Diseases.

Science.gov (United States)

Rabaa, Maia A; Tue, Ngo Tri; Phuc, Tran My; Carrique-Mas, Juan; Saylors, Karen; Cotten, Matthew; Bryant, Juliet E; Nghia, Ho Dang Trung; Cuong, Nguyen Van; Pham, Hong Anh; Berto, Alessandra; Phat, Voong Vinh; Dung, Tran Thi Ngoc; Bao, Long Hoang; Hoa, Ngo Thi; Wertheim, Heiman; Nadjm, Behzad; Monagin, Corina; van Doorn, H Rogier; Rahman, Motiur; Tra, My Phan Vu; Campbell, James I; Boni, Maciej F; Tam, Pham Thi Thanh; van der Hoek, Lia; Simmonds, Peter; Rambaut, Andrew; Toan, Tran Khanh; Van Vinh Chau, Nguyen; Hien, Tran Tinh; Wolfe, Nathan; Farrar, Jeremy J; Thwaites, Guy; Kellam, Paul; Woolhouse, Mark E J; Baker, Stephen

2015-12-01

The effect of newly emerging or re-emerging infectious diseases of zoonotic origin in human populations can be potentially catastrophic, and large-scale investigations of such diseases are highly challenging. The monitoring of emergence events is subject to ascertainment bias, whether at the level of species discovery, emerging disease events, or disease outbreaks in human populations. Disease surveillance is generally performed post hoc, driven by a response to recent events and by the availability of detection and identification technologies. Additionally, the inventory of pathogens that exist in mammalian and other reservoirs is incomplete, and identifying those with the potential to cause disease in humans is rarely possible in advance. A major step in understanding the burden and diversity of zoonotic infections, the local behavioral and demographic risks of infection, and the risk of emergence of these pathogens in human populations is to establish surveillance networks in populations that maintain regular contact with diverse animal populations, and to simultaneously characterize pathogen diversity in human and animal populations. Vietnam has been an epicenter of disease emergence over the last decade, and practices at the human/animal interface may facilitate the likelihood of spillover of zoonotic pathogens into humans. To tackle the scientific issues surrounding the origins and emergence of zoonotic infections in Vietnam, we have established The Vietnam Initiative on Zoonotic Infections (VIZIONS). This countrywide project, in which several international institutions collaborate with Vietnamese organizations, is combining clinical data, epidemiology, high-throughput sequencing, and social sciences to address relevant one-health questions. Here, we describe the primary aims of the project, the infrastructure established to address our scientific questions, and the current status of the project. Our principal objective is to develop an integrated approach to

Association between elevated pre-operative glycosylated hemoglobin and post-operative infections after non-emergent surgery

OpenAIRE

Blankush, Joseph M.; Leitman, I. Michael; Soleiman, Aron; Tran, Trung

2016-01-01

Background: A chronic state of impaired glucose metabolism affects multiple components of the immune system, possibly leading to an increased incidence of post-operative infections. Such infections increase morbidity, length of stay, and overall cost. This study evaluates the correlation between elevated pre-operative glycosylated hemoglobin (HbA1c) and post-operative infections. Study design: Adult patients undergoing non-emergent procedures across all surgical subspecialties from January...

Coinfection and Emergence of Rifamycin Resistance during a Recurrent Clostridium difficile Infection.

Science.gov (United States)

Stevenson, Emma C; Major, Giles A; Spiller, Robin C; Kuehne, Sarah A; Minton, Nigel P

2016-11-01

Clostridium difficile (Peptoclostridium difficile) is a common health care-associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhea to life-threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease, which often requires rehospitalization of patients. C. difficile was isolated from stool samples from a patient with two recurrent C. difficile infections. PCR ribotyping, whole-genome sequencing, and phenotypic assays were used to characterize these isolates. Genotypic and phenotypic screening of C. difficile isolates revealed multiple PCR ribotypes present and the emergence of rifamycin resistance during the infection cycle. Understanding both the clinical and bacterial factors that contribute to the course of recurrent infection could inform strategies to reduce recurrence. (This study has been registered at ClinicalTrials.gov under registration no. NCT01670149.). Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Henipavirus Infections: Lessons from Animal Models

Directory of Open Access Journals (Sweden)

Kévin P. Dhondt

2013-04-01

Full Text Available The Henipavirus genus contains two highly lethal viruses, the Hendra and Nipah viruses and one, recently discovered, apparently nonpathogenic member; Cedar virus. These three, negative-sense single-stranded RNA viruses, are hosted by fruit bats and use EphrinB2 receptors for entry into cells. The Hendra and Nipah viruses are zoonotic pathogens that emerged in the middle of 90s and have caused severe, and often fatal, neurologic and/or respiratory diseases in both humans and different animals; including spillover into equine and porcine species. Development of relevant models is critical for a better understanding of viral pathogenesis, generating new diagnostic tools, and assessing anti-viral therapeutics and vaccines. This review summarizes available data on several animal models where natural and/or experimental infection has been demonstrated; including pteroid bats, horses, pigs, cats, hamsters, guinea pigs, ferrets, and nonhuman primates. It recapitulates the principal features of viral pathogenesis in these animals and current knowledge on anti-viral immune responses. Lastly it describes the recently characterized murine animal model, which provides the possibility to use numerous and powerful tools available for mice to further decipher henipaviruses immunopathogenesis, prophylaxis, and treatment. The utility of different models to analyze important aspects of henipaviruses-induced disease in humans, potential routes of transmission, and therapeutic approaches are equally discussed.

THE MOLECULAR EVOLUTION OF THE MOST DANGEROUS EMERGING VIRUS INFECTIONS

Directory of Open Access Journals (Sweden)

Popov NN

2016-03-01

barriers and infect new hosts. Really, many recently emerged human diseases are caused by viruses that display active recombination or reassortment. The continual shuffling of genes of influenza A represents a example of the key role of reassortment for the new virus emergence. Available data demonstrate the possible origin of SARS-CoV from recombination of different bat SL-CoVs viruses strains. However in other cases the emergence of a specific virus cannot be directly attributed to its ability to recombine. For example, although SIV recombines at a high rate in natural reservoirs, there is no evidence that recombination assisted the cross-species transfer of the virus from the chimpanzee into humans. But mutagenesis and recombination actively shape the further molecular history of HIV in humans. Also it is not proved that recombination precede the cross-species jump of the Ebola virus. In summary, the available data suggest that although recombination, reassortment and mutagenesis is sometimes directly involved to the process of cross-species transmission, it is not a necessary precursor to successful viral emergence. Further investigations are required to reveal the role of genetic change in the history of virus emergence. We believe that comprehensive description of molecular evolution of new viruses has led to a better understanding of the causes and predictability of infection emergence.

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response.

Science.gov (United States)

Jacobsen, Kathryn H; Aguirre, A Alonso; Bailey, Charles L; Baranova, Ancha V; Crooks, Andrew T; Croitoru, Arie; Delamater, Paul L; Gupta, Jhumka; Kehn-Hall, Kylene; Narayanan, Aarthi; Pierobon, Mariaelena; Rowan, Katherine E; Schwebach, J Reid; Seshaiyer, Padmanabhan; Sklarew, Dann M; Stefanidis, Anthony; Agouris, Peggy

2016-03-01

As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.

Translational models of infection prevention and control: lessons from studying high risk aging populations.

Science.gov (United States)

Mody, Lona

2018-06-13

The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients. Using various methodologies including survey methods, observational epidemiology, randomized controlled studies, and collaboratives, we showed that indwelling device type is related to the site of multidrug-resistant organism (MDRO) colonization; multianatomic site colonization with MDROs is common; community-associated methicillin-resistant Staphylococcus aureus (MRSA) appeared in the nursing facility setting almost immediately following its emergence in acute care; (4) MDRO prevalence and catheter-associated infection rates can be reduced through a multimodal targeted infection prevention intervention; and (5) using a collaborative approach, such an intervention can be successfully scaled up. Our work advances the infection prevention field through translational research utilizing various methodologies, including quantitative and qualitative surveys, patient-oriented randomized controlled trials, and clinical microbiologic and molecular methods. The resulting interventions employ patient-oriented methods to reduce infections and antimicrobial resistance, and with partnerships from major national entities, can be implemented nationally.

Addressing Ebola-related Stigma: Lessons Learned from HIV/AIDS

Directory of Open Access Journals (Sweden)

Mariam Davtyan

2014-11-01

Full Text Available Background: HIV/AIDS and Ebola Virus Disease (EVD are contemporary epidemics associated with significant social stigma in which communities affected suffer from social rejection, violence, and diminished quality of life. Objective: To compare and contrast stigma related to HIV/AIDS and EVD, and strategically think how lessons learned from HIV stigma can be applied to the current EVD epidemic. Methods: To identify relevant articles about HIV/AIDS and EVD-related stigma, we conducted an extensive literature review using multiple search engines. PubMed was used to search for relevant peer-reviewed journal articles and Google for online sources. We also consulted the websites of the World Health Organization (WHO, Centers for Disease Control and Prevention (CDC, and the National Institutes of Health to retrieve up-to-date information about EVD and HIV/AIDS. Results: Many stigmatizing attitudes and behaviors directed towards those with EVD are strikingly similar to those with HIV/AIDS but there are significant differences worthy of discussion. Both diseases are life-threatening and there is no medical cure. Additionally misinformation about affected groups and modes of transmission runs rampant. Unlike in persons with EVD, historically criminalized and marginalized populations carry a disproportionately higher risk for HIV infection. Moreover, mortality due to EVD occurs within a shorter time span as compared to HIV/AIDS. Conclusions: Stigma disrupts quality of life, whether it is associated with HIV infection or EVD. When addressing EVD, we must think beyond the immediate clinical therapeutic response, to possible HIV implications of serum treatment. There are emerging social concerns of stigma associated with EVD infection and double stigma associated with EVD and HIV infection. Drawing upon lessons learned from HIV, we must work to empower and mobilize prominent members of the community, those who recovered from the disease, and organizations

Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

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K Asish

2016-01-01

Full Text Available Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs, presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected.The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI, separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

Hepatitis C virus infection may lead to slower emergence of P. falciparum in blood.

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Odile Ouwe-Missi-Oukem-Boyer

Full Text Available BACKGROUND: Areas endemic for Plasmodium falciparum, hepatitis B virus (HBV and hepatitis C virus (HCV overlap in many parts of sub-Saharan Africa. HBV and HCV infections develop in the liver, where takes place the first development stage of P. falciparum before its further spread in blood. The complex mechanisms involved in the development of hepatitis may potentially influence the development of the liver stage of malaria parasites. Understanding the molecular mechanisms of these interactions could provide new pathophysiological insights for treatment strategies in Malaria. METHODOLOGY: We studied a cohort of 319 individuals living in a village where the three infections are prevalent. The patients were initially given a curative antimalarial treatment and were then monitored for the emergence of asexual P. falciparum forms in blood, fortnightly for one year, by microscopy and polymerase chain reaction. PRINCIPAL FINDINGS: At inclusion, 65 (20.4% subjects had detectable malaria parasites in blood, 36 (11.3% were HBV chronic carriers, and 61 (18.9% were HCV chronic carriers. During follow-up, asexual P. falciparum forms were detected in the blood of 203 patients. The median time to P. falciparum emergence in blood was respectively 140 and 120 days in HBV- and HBV+ individuals, and 135 and 224 days in HCV- and HCV+ individuals. HCV carriage was associated with delayed emergence of asexual P. falciparum forms in blood relative to patients without HCV infection. CONCLUSIONS: This pilot study represents first tentative evidence of a potential epidemiological interaction between HBV, HCV and P. falciparum infections. Age is an important confounding factor in this setting however multivariate analysis points to an interaction between P. falciparum and HCV at the hepatic level with a slower emergence of P. falciparum in HCV chronic carriers. More in depth analysis are necessary to unravel the basis of hepatic interactions between these two pathogens

Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistant Staphylococcus aureus.

Science.gov (United States)

Pallin, Daniel J; Egan, Daniel J; Pelletier, Andrea J; Espinola, Janice A; Hooper, David C; Camargo, Carlos A

2008-03-01

Test the hypotheses that emergency department (ED) visits for skin and soft tissue infections became more frequent during the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), and that antibiotics typically active against community-associated MRSA were chosen increasingly. From merged National Hospital Ambulatory Medical Care Survey data for 1993-2005, we identified ED visits with diagnosis of cellulitis, abscess, felon, impetigo, hidradenitis, folliculitis, infective mastitis, nonpurulent mastitis, breast abscess, or carbuncle and furuncle. Main outcomes were change over time in rate of ED visits with such a diagnosis and proportion of antibiotic regimens including an agent typically active against community-associated MRSA. We report national estimates derived from sample weights. We tested trends with least squares linear regression. In 1993, infections of interest were diagnosed at 1.2 million visits (95% confidence interval [CI] 0.96 to 1.5 million) versus 3.4 million in 2005 (95% CI 2.8 to 4.1 million; P for trend trend trend skin and soft tissue infections increased markedly from 1993 to 2005, contemporaneously with the emergence of community-associated MRSA. ED clinicians prescribed more antibiotics typically active against community-associated MRSA, especially trimethoprim-sulfamethoxazole. Possible confounders are discussed, such as increasing diabetes or shifts in locus of care.

The health of hospitals and lessons from history: public health and sanitary reform in the Dublin hospitals, 1858-1898.

Science.gov (United States)

Fealy, Gerard M; McNamara, Martin S; Geraghty, Ruth

2010-12-01

The aim was to examine, critically, 19th century hospital sanitary reform with reference to theories about infection and contagion. In the nineteenth century, measures to control epidemic diseases focused on providing clean water, removing waste and isolating infected cases. These measures were informed by the ideas of sanitary reformers like Chadwick and Nightingale, and hospitals were an important element of sanitary reform. Informed by the paradigmatic tradition of social history, the study design was a historical analysis of public health policy. Using the methods of historical research, documentary primary sources, including official reports and selected hospital archives and related secondary sources, were consulted. Emerging theories about infection were informing official bodies like the Board of Superintendence of Dublin Hospitals in their efforts to improve hospital sanitation. The Board secured important reforms in hospital sanitation, including the provision of technically efficient sanitary infrastructure. Public health measures to control epidemic infections are only as effective as the state of knowledge of infection and contagion and the infrastructure to support sanitary measures. Today, public mistrust about the safety of hospitals is reminiscent of that of 150 years ago, although the reasons are different and relate to a fear of contracting antimicrobial-resistant infections. A powerful historical lesson from this study is that resistance to new ideas can delay progress and improved sanitary standards can allay public mistrust. In reforming hospital sanitation, policies and regulations were established--including an inspection body to monitor and enforce standards--the benefits of which provide lessons that resonate today. Such practices, especially effective independent inspection, could be adapted for present-day contexts and re-instigated where they do not exist. History has much to offer contemporary policy development and practice reform and

Control of zoonoses in emergency situations: lessons learned during recent outbreaks (gaps and weaknesses of current zoonoses control programmes

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Darem Tabbaa

2008-12-01

Full Text Available In emergency situations, domestic animals and wildlife are, like people, exposed to infectious diseases and environmental contaminants in the air, soil, water and food. They can suffer from acute and/or chronic diseases from such exposure. Often animals serve as disease reservoirs or early warning systems for the community in regard to the spread of zoonotic diseases. Over 100 years of experience have shown that animal and human health are closely related. During the past few years, emergent disease episodes have increased; nearly all have involved zoonotic agents. As there is no way to predict when or where the next important new zoonotic pathogen will emerge or what its ultimate importance might be, investigation at the first sign of emergence of a new zoonotic disease is particularly important. Today, in many emerging situations, different activities involving zoonotic disease control are at risk because of failed investigative infrastructures or financial constraints. Considering that zoonotic diseases have their own characteristics, their prevention and control require unique strategies, based more on fundamental and applied research than on traditional approaches. Such strategies require cooperation and coordination between animal and public health sectors and the involvement of other disciplines and experts such as epidemiologists, entomologists, environmentalists and climatologists. Lessons learned from the avian influenza pandemic threat, the Crimean-Congo haemorrhagic fever and rabies outbreaks are presented and the gaps and weakness of current control programmes are discussed.

The first English (EFL) lesson : Initial settings or the emergence of a playful classroom culture

NARCIS (Netherlands)

van Dam, J.; Bannink, A.; Bell, N.

2017-01-01

This discourse-based micro-ethnographic study scrutinizes the various forms of play that are a recurrent and salient feature of a first English (EFL) lesson in a Dutch secondary school context. In the first part of the lesson collective speaking formats associated with cultural games and routines in

Sensitivity and Specificity of Empiric Treatment for Sexually Transmitted Infections in a Pediatric Emergency Department.

Science.gov (United States)

Breslin, Kristen; Tuchman, Lisa; Hayes, Katie L; Badolato, Gia; Goyal, Monika K

2017-10-01

To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment. We calculated test characteristics comparing clinician judgment for presumptive treatment for a sexually transmitted infection with the reference standard of the actual results of testing for a sexually transmitted infection. Of 1223 patient visits meeting inclusion criteria, 284 (23.2%) had a positive GC and/or CT test result. Empiric treatment was provided in 615 encounters (50.3%). Provider judgment for presumptive treatment had an overall sensitivity of 67.6% (95% CI, 61.8-73.0) and a specificity of 55% (95% CI, 51.7-58.2) for accurate GC and/or CT detection. Many adolescents tested for GC and CT receive empiric treatment at the initial emergency department visit. Provider judgment may lack sufficient sensitivity and specificity for identifying infected patients, resulting in the potential for undertreatment of true disease, overtreatment of uninfected patients, or both. Copyright © 2017 Elsevier Inc. All rights reserved.

Emergence of canine parvovirus subtype 2b (CPV-2b) infections in Australian dogs.

Science.gov (United States)

Clark, Nicholas J; Seddon, Jennifer M; Kyaw-Tanner, Myat; Al-Alawneh, John; Harper, Gavin; McDonagh, Phillip; Meers, Joanne

2018-03-01

Tracing the temporal dynamics of pathogens is crucial for developing strategies to detect and limit disease emergence. Canine parvovirus (CPV-2) is an enteric virus causing morbidity and mortality in dogs around the globe. Previous work in Australia reported that the majority of cases were associated with the CPV-2a subtype, an unexpected finding since CPV-2a was rapidly replaced by another subtype (CPV-2b) in many countries. Using a nine-year dataset of CPV-2 infections from 396 dogs sampled across Australia, we assessed the population dynamics and molecular epidemiology of circulating CPV-2 subtypes. Bayesian phylogenetic Skygrid models and logistic regressions were used to trace the temporal dynamics of CPV-2 infections in dogs sampled from 2007 to 2016. Phylogenetic models indicated that CPV-2a likely emerged in Australia between 1973 and 1988, while CPV-2b likely emerged between 1985 and 1998. Sequences from both subtypes were found in dogs across continental Australia and Tasmania, with no apparent effect of climate variability on subtype occurrence. Both variant subtypes exhibited a classical disease emergence pattern of relatively high rates of evolution during early emergence followed by subsequent decreases in evolutionary rates over time. However, the CPV-2b subtype maintained higher mutation rates than CPV-2a and continued to expand, resulting in an increase in the probability that dogs will carry this subtype over time. Ongoing monitoring programs that provide molecular epidemiology surveillance will be necessary to detect emergence of new variants and make informed recommendations to develop reliable detection and vaccine methods. Copyright © 2017 Elsevier B.V. All rights reserved.

Emergency planning and operating experience

International Nuclear Information System (INIS)

Halpern, O.; Breniere, J.

1984-01-01

The purpose of this paper is to derive lessons from operating experience for the planning of emergency measures. This operating experience has two facets: it is obtained not only from the various incidents and accidents which have occurred in countries with nuclear power programmes and from the resulting application of emergency plans but also from the different exercises and simulations carried out in France and in other countries. Experience generally confirms the main approaches selected for emergency plans. The lessons to be derived are of three types: first, it appears necessary to set forth precisely the responsibilities of each person involved in order to prevent a watering-down of decisions in the event of an accident; secondly, considerable improvements need to be made in the different communication networks to be used; and thirdly, small accidents with minor radiological consequences deserve as systematic and thorough an approach as large and more improbable accidents. (author)

Community Forest Management and the Emergence of Multi-Scale Governance Institutions: Lessons for REDD+ Development from Mexico, Brazil and Bolivia

Directory of Open Access Journals (Sweden)

Gabriel Medina

2011-03-01

Full Text Available At their most local, initiatives to reduce emissions from deforestation and degradation (REDD will depend on rural people to manage forest resources. Although the design of frameworks, mechanisms and arrangements, to implement REDD programs have received significant attention, it is not yet clear how REDD+ will function on the ground or how the participation of local populations will be assured. Community forest management (CFM could be an option under REDD+ depending on how it is negotiated, largely because of the expectation that CFM could reduce emissions from deforestation and degradation. Examining institutional factors in the emergence of successful CFM systems and local forest enterprises could provide valuable lessons for REDD planners. We examine cases of CFM development in Mexico, Brazil and Bolivia, to assess the role of multi-scaled governance institutions in their development. Comparing and contrasting advanced CFM systems to regions where it is still emerging, we will show how the establishment of a local organizational base for communal resource management is crucial.

Bird's Eye View of a Neonatologist: Clinical Approach to Emergency Neonatal Infection

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Fu-Kuei Huang

2016-06-01

Full Text Available Though the incidence of neonatal infection in term and near-term infants is relatively low, incidence of infection in preterm very low birth weight infants is as high as 20–30% and may result in neurodevelopmental impairment or mortality. Pediatricians should be familiar with recognition and emergency management of life-threatening neonatal infections, such as congenital pneumonia, early onset sepsis, late onset sepsis, bacterial and fungal meningitis, disseminated neonatal herpes simplex virus (HSV, and HSV meningoencephalitis. For the pediatrician, it is logical to approach the management of these infections by time of onset, i.e., early versus late onset of infection. Perinatal risk factors and simple laboratory tests, such as total white blood-cell count, immature/total ratio, and C-reactive protein are helpful in guiding the decision of antibiotics therapy. Successful management of these critical infections depends upon early diagnosis and timely administration of adequate antibiotics. Empiric antibiotic therapy must cover the most likely pathogens according to the risk factors of each individual neonate, and therapy duration is dependent upon culture results, clinical course, and the microorganism. Future research may focus on developing a practical neonatal sepsis score system based on risk factors and common biomarkers, which are readily available at bedside to make early accurate decisions and achieve better outcomes.

Dynasting Theory: Lessons in learning grounded theory

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Johnben Teik-Cheok Loy, MBA, MTS, Ph.D.

2011-06-01

Full Text Available This article captures the key learning lessons gleaned from the author’s experience learning and developing a grounded theory for his doctoral dissertation using the classic methodology as conceived by Barney Glaser. The theory was developed through data gathered on founders and successors of Malaysian Chinese family-own businesses. The main concern for Malaysian Chinese family businesses emerged as dynasting . the building, maintaining, and growing the power and resources of the business within the family lineage. The core category emerged as dynasting across cultures, where founders and successors struggle to transition from traditional Chinese to hybrid cultural and modernized forms of family business from one generation to the next. The key learning lessons were categorized under five headings: (a sorting through different versions of grounded theory, (b educating and managing research stakeholders, (c embracing experiential learning, (d discovering the core category: grounded intuition, and (e recognizing limitations and possibilities.Keywords: grounded theory, learning, dynasting, family business, Chinese

Enterococcus infection biology: lessons from invertebrate host models.

Science.gov (United States)

Yuen, Grace J; Ausubel, Frederick M

2014-03-01

The enterococci are commensals of the gastrointestinal tract of many metazoans, from insects to humans. While they normally do not cause disease in the intestine, they can become pathogenic when they infect sites outside of the gut. Recently, the enterococci have become important nosocomial pathogens, with the majority of human enterococcal infections caused by two species, Enterococcus faecalis and Enterococcus faecium. Studies using invertebrate infection models have revealed insights into the biology of enterococcal infections, as well as general principles underlying host innate immune defense. This review highlights recent findings on Enterococcus infection biology from two invertebrate infection models, the greater wax moth Galleria mellonella and the free-living bacteriovorous nematode Caenorhabditis elegans.

Emerging therapies for Clostridium difficile infection – focus on fidaxomicin

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Chaparro-Rojas F

2013-06-01

Full Text Available Fredy Chaparro-Rojas, Kathleen M MullaneDepartment of Medicine, Section of Infectious Diseases, University of Chicago, Chicago, IL, USAAbstract: The epidemiology of Clostridium difficile infections (CDI has evolved during the last decades, with an increase in the reported incidence, severity of cases, and rate of mortality and relapses. These increases have primarily affected some special populations including the elderly, patients requiring concomitant antibiotic therapy, patients with renal failure, and patients with cancer. Until recently, the treatment of CDI was limited to either metronidazole or vancomycin. New therapeutic options have emerged to address the shortcomings of current antibiotic therapy. Fidaxomicin stands out as the first-in-class oral macrocyclic antibiotic with targeted activity against C. difficile and minimal collateral damage on the normal colonic flora. Fidaxomicin has demonstrated performance not inferior to what is considered the “gold standard” available therapy for CDI, vancomycin, in two separate Phase III clinical trials, but with significant advantages, including fewer recurrences and higher rates of sustained clinical cures. Fidaxomicin constitutes an important development in targeted antibiotic therapy for CDI and must be considered as a first-line agent for patients with risk factors known to portend relapse and severe infection.Keywords: fidaxomicin, Clostridium difficile-associated diarrhea, CDAD, Clostridium difficile infection (CDI, vancomycin, metronidazole

Lessons Learned from the Response to Radiation Emergencies (1945-2010) (Spanish Edition); Enseñanzas extraídas de la respuesta a emergencias radiológicas

Energy Technology Data Exchange (ETDEWEB)

NONE

2014-07-15

occurred, most notably, the Windscale fire in 1957, the Three Mile Island accident in 1979, the Chernobyl accident in 1986, the Sarov accident in 1997 and the Tokaimura accident in 1999. Radiological emergencies have occurred throughout the world, and when invited by the country concerned, the IAEA has undertaken comprehensive reviews of the events, the purpose of which is to compile information about the causes of the accidents, the subsequent emergency response including medical management, dose reconstruction, public communication, etc., so that any lessons can be shared with national authorities and regulatory organizations, emergency planners and a broad range of specialists, including physicists, technicians and medical specialists, and persons responsible for radiation protection. It is appropriate to analyze the findings of these and other reports on the response to radiation emergencies in order to consolidate these lessons.

Cooperative Societies in Greenland and Nunavik: A Lesson on the Importance of Supporting Structures

DEFF Research Database (Denmark)

Winther, Gorm; Duhaime, Gerard

2002-01-01

Different co-operatives and constraints to the emergence of co-operatives are presented. Historical financial Data on Nunavik cooperatives suggest, that the co-operatives fared well and have accomplished growth. The lesson of the co-operative success in Nunavik and the failure of Co-operatives in......Different co-operatives and constraints to the emergence of co-operatives are presented. Historical financial Data on Nunavik cooperatives suggest, that the co-operatives fared well and have accomplished growth. The lesson of the co-operative success in Nunavik and the failure of Co...

Low level waste shipment accident lessons learned

International Nuclear Information System (INIS)

Rast, D.M.; Rowe, J.G.; Reichel, C.W.

1995-01-01

On October 1, 1994 a shipment of low-level waste from the Fernald Environmental Management Project, Fernald, Ohio, was involved in an accident near Rolla, Missouri. The accident did not result in the release of any radioactive material. The accident did generate important lessons learned primarily in the areas of driver and emergency response communications. The shipment was comprised of an International Standards Organization (ISO) container on a standard flatbed trailer. The accident caused the low-level waste package to separate from the trailer and come to rest on its top in the median. The impact of the container with the pavement and median inflicted relatively minor damage to the container. The damage was not substantial enough to cause failure of container integrity. The success of the package is attributable to the container design and the packaging procedures used at the Fernald Environmental Management Project for low-level waste shipments. Although the container survived the initial wreck, is was nearly breached when the first responders attempted to open the ISO container. Even though the container was clearly marked and the shipment documentation was technically correct, this information did not identify that the ISO container was the primary containment for the waste. The lessons learned from this accident have DOE complex wide applicability. This paper is intended to describe the accident, subsequent emergency response operations, and the lessons learned from this incident

Lessons from the History of Quarantine, from Plague to Influenza A

Centers for Disease Control (CDC) Podcasts

2013-05-08

Reginald Tucker reads an abridged version of the Emerging Infectious Diseases’ Historical Review, Lessons from the History of Quarantine, from Plague to Influenza A.  Created: 5/8/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/15/2013.

Summary of the Current Status of Lessons Learned From Fukushima Accident

International Nuclear Information System (INIS)

Pasamehmetoglu, Kemal

2013-01-01

This presentation introduced the current status of the lessons learned from the Fukushima accident, and in particular, the recommendations released by a NRC Near-term Task Force to enhance reactor safety in the 21. century. The near-term recommendations are focused on emergency power and emergency cooling availability during station blackout accidents

Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective

Science.gov (United States)

Vadlapudi, Aswani D.; Vadlapatla, Ramya K.; Mitra, Ashim K.

2015-01-01

Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly in immunocompromised patients. Moreover, some drugs are associated with dose-limiting toxicities which limit their further utility. Therefore, there is a need to develop new antiherpetic compounds with different mechanisms of action which will be safe and effective against emerging drug resistant viral isolates. Significant advances have been made towards the design and development of novel antiviral therapeutics during the last decade. As evident by their excellent antiviral activities, pharmaceutical companies are moving forward with several new compounds into various phases of clinical trials. This review provides an overview of structure and life cycle of HSV, progress in the development of new therapies, update on the advances in emerging therapeutics under clinical development and related recent patents for the treatment of Herpes simplex virus infections. PMID:23331181

Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus.

Science.gov (United States)

Das, Trina; Jaffar-Bandjee, Marie Christine; Hoarau, Jean Jacques; Krejbich Trotot, Pascale; Denizot, Melanie; Lee-Pat-Yuen, Ghislaine; Sahoo, Renubala; Guiraud, Pascale; Ramful, Duksha; Robin, Stephanie; Alessandri, Jean Luc; Gauzere, Bernard Alex; Gasque, Philippe

2010-06-01

Chikungunya virus (CHIKV) is transmitted by Aedes mosquitoes and causes an acute symptomatic illness with fever, skin rash, and incapacitating arthralgia, which can evolve into chronic rheumatoid arthritis in elderly patients. This is a tropical disease originally described in central/east Africa in the 1960s, but its 2004 re-emergence in Africa and rapid spread in lands in and around the Indian Ocean (Reunion island, India, Malaysia) as well as Europe (Italy) led to almost 6 million cases worldwide. The risk of importation and spreading diseases with long-term sequelae is even greater today given the global distribution of the vectors (including in the Americas), increased tourism and the apparent capacity of CHIKV to produce high levels of viremia (10(9)-10(12) virus/ml of blood) and new mutants. CHIKV-associated neuropathology was described early in the 1960s, but it is the unprecedented incidence rate in Indian Ocean areas with efficient clinical facilities that allowed a better description of cases with severe encephalitis, meningoencephalitis, peripheral neuropathies and deaths among newborns (mother-to-child infection), infants and elderly patients. Death rates following CHIKV infection were estimated at 1:1000 cases in la Reunion's outbreak. These clinical observations have been corroborated by experimental infection in several mouse models, leading to CNS pathologies. We further describe in this review the capacity of CHIKV to infect neurons and glial cells, delineate the fundamental innate (intrinsic) immune defence mechanisms to protect from infection and argue about the possible mechanisms involved in the encephalopathy. (c) 2010 Elsevier Ltd. All rights reserved.

Governance of tourism conservation partnerships: lessons from Kenya

NARCIS (Netherlands)

Nthiga, R.W.

2014-01-01

Governance of Tourism Conservation Partnerships: Lessons from Kenya

Rita Wairimu Nthiga

Since the 19th century nature conservation in Eastern Africa has evolved in different stages. Initial interventions emerged as a result of the decline and potential extinction of

"Give Me a Lesson and I'll Deliver It": Teaching Assistants' Experiences of Leading Primary Mathematics Lessons in England

Science.gov (United States)

Houssart, Jenny

2013-01-01

Teaching Assistants (TAs) in primary schools in England have a growing pedagogic role. For some, this sometimes includes responsibility for the whole class instead of the teacher. This article draws on 24 interview transcripts to examine the practice in the context of primary mathematics lessons and from TAs' viewpoints. Emergency cover is often…

Association between elevated pre-operative glycosylated hemoglobin and post-operative infections after non-emergent surgery.

Science.gov (United States)

Blankush, Joseph M; Leitman, I Michael; Soleiman, Aron; Tran, Trung

2016-09-01

A chronic state of impaired glucose metabolism affects multiple components of the immune system, possibly leading to an increased incidence of post-operative infections. Such infections increase morbidity, length of stay, and overall cost. This study evaluates the correlation between elevated pre-operative glycosylated hemoglobin (HbA1c) and post-operative infections. Adult patients undergoing non-emergent procedures across all surgical subspecialties from January 2010 to July 2014 had a preoperative HbA1c measured as part of their routine pre-surgical assessment. 2200 patient charts (1100 operative infection (superficial surgical site infection, deep wound/surgical space abscess, pneumonia, and/or urinary tract infection as defined by Centers for Disease Control criteria) within 30 days of surgery. Patients with HbA1c infection rate (3.8% in the HbA1c infection. Elevated HbA1c was, however, predictive of significantly increased risk of post-operative infection when associated with increased age (≥81 years of age) or dirty wounds. The risk factors of post-operative infection are multiple and likely synergistic. While pre-operative HbA1c level is not independently associated with risk of post-operative infection, there are scenarios and patient subgroups where pre-operative HbA1c is useful in predicting an increased risk of infectious complications in the post-operative period.

Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department.

Science.gov (United States)

de Guadiana Romualdo, Luis García; Torrella, Patricia Esteban; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Santos, Enrique Jiménez; Freire, Alejandro Ortín

2017-01-01

Presepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection. 223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy. Infection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance. Although presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified. Copyright © 2016 Elsevier B.V. All rights reserved.

Rural Entrepreneurship in Nigeria: Lessons From Scientific ...

African Journals Online (AJOL)

This article focussed on the lessons that can be garnered from the tenets of Scientific Management. We undertook an X-ray of the tenets of Scientific Management and how these tenets can be adopted to ensure the success of emerging entrepreneurs in the rural areas. Many rural entrepreneurs fail within a short period of ...

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases.

Science.gov (United States)

Meyer, Diane; Kirk Sell, Tara; Schoch-Spana, Monica; Shearer, Matthew P; Chandler, Hannah; Thomas, Erin; Rose, Dale A; Carbone, Eric G; Toner, Eric

2018-05-01

The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events. Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group. Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment. The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

241-SY-101 air lance removal lessons learned

International Nuclear Information System (INIS)

Moore, T.L.; Titzler, P.A.

1994-01-01

An emergency task was undertaken to remove four air lances and one thermocouple (TC) tree from tank 241-SY-101 (SY-101). This resulted from video observation that these pipes were being severely bent during periodic gas release events that regularly occurred every three to four months. At the time, the gas release events were considered to be the number one safety issue within the US Department of Energy (DOE) complex. This emergency removal task was undertaken on an extremely short schedule that required all activities possible to be completed in parallel. This approach and extremely short schedule, while successful, resulted in some undesirable consequences from less than desired time for design, reviews, equipment testing, operations training, and bad weather conditions. These consequences included leakage of liquid waste from the containers to the ground, higher than expected dose rates at the container surface, difficult field operations, and unexpected pipe configuration during removal. In addition, changes to environmental regulations and severe winter weather impacted the packaging and shipping activities required the prepare the removed pipes for storage at the Central Waste Complex (CWC). The purpose of this document is to identify lessons to be learned for future activities. In context of the emergency conditions that existed at the time and the urgency to remove these pipes, their removal was successfully completed under extremely difficult conditions and schedule. The success of the task should not be overshadowed by the desire to identify areas needing improvement and lessons to be learned. Many of the lessons identified in this document have already resulted in improved conduct of operations and engineering

Emergency Risk Communication: Lessons Learned from a Rapid Review of Recent Gray Literature on Ebola, Zika, and Yellow Fever.

Science.gov (United States)

Toppenberg-Pejcic, Deborah; Noyes, Jane; Allen, Tomas; Alexander, Nyka; Vanderford, Marsha; Gamhewage, Gaya

2018-03-20

A rapid review of gray literature from 2015 to 2016 was conducted to identify the lessons learned for emergency risk communication from recent outbreaks of Ebola, Zika, and yellow fever. Gray literature databases and key websites were searched and requests for documents were posted to expert networks. A total of 83 documents met inclusion criteria, 68 of which are cited in this report. This article focuses on the 3 questions, out of 12 posed by World Health Organization as part of a Guideline development process, dealing most directly with communicating risk during health emergencies: community engagement, trust building, and social media. Documents were evaluated for credibility using an Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist? and if the document contained a study, a method-specific tool was applied. A rapid content analysis of included sources was undertaken with relevant text either extracted verbatim or summarized and mapped against the questions. A database subset was created for each question and citations were assigned to the subset(s) for which they contained relevant information. Multiple designations per document were common. Database subsets were used to synthesize the results into a coherent narrative. The gray literature strongly underlines the central importance of local communities. A one-size-fits-all approach does not work. For maximum effectiveness, local communities need to be involved with and own emergency risk communication processes, preferably well before an emergency occurs. Social media can open new avenues for communication, but is not a general panacea and should not be viewed as a replacement for traditional modes of communication. In general, the gray literature indicates movement toward greater recognition of emergency risk communication as a vitally important element of public health.

Testing for Zika virus infection in pregnancy: key concepts to deal with an emerging epidemic.

Science.gov (United States)

Eppes, Catherine; Rac, Martha; Dunn, James; Versalovic, James; Murray, Kristy O; Suter, Melissa A; Sanz Cortes, Magda; Espinoza, Jimmy; Seferovic, Maxim D; Lee, Wesley; Hotez, Peter; Mastrobattista, Joan; Clark, Steven L; Belfort, Michael A; Aagaard, Kjersti M

2017-03-01

Zika virus is an emerging mosquito-borne (Aedes genus) arbovirus of the Flaviviridae family. Following epidemics in Micronesia and French Polynesia during the past decade, more recent Zika virus infection outbreaks were first reported in South America as early as May 2013 and spread to now 50 countries throughout the Americas. Although no other flavivirus has previously been known to cause major fetal malformations following perinatal infection, reports of a causal link between Zika virus and microcephaly, brain and ocular malformations, and fetal loss emerged from hard-hit regions of Brazil by October 2015. Among the minority of infected women with symptoms, clinical manifestations of Zika virus infection may include fever, headache, arthralgia, myalgia, and maculopapular rash; however, only 1 of every 4-5 people who are infected have any symptoms. Thus, clinical symptom reporting is an ineffective screening tool for the relative risk assessment of Zika virus infection in the majority of patients. As previously occurred with other largely asymptomatic viral infections posing perinatal transmission risk (such as HIV or cytomegalovirus), we must develop and implement rapid, sensitive, and specific screening and diagnostic testing for both viral detection and estimation of timing of exposure. Unfortunately, despite an unprecedented surge in attempts to rapidly advance perinatal clinical testing for a previously obscure arbovirus, there are several ongoing hindrances to molecular- and sonographic-based screening and diagnosis of congenital Zika virus infection. These include the following: (1) difficulty in estimating the timing of exposure for women living in endemic areas and thus limited interpretability of immunoglobulin M serologies; (2) cross-reaction of immunoglobulin serologies with other endemic flaviruses, such as dengue; (3) persistent viremia and viruria in pregnancy weeks to months after primary exposure; and (4) fetal brain malformations and anomalies

Knowledge into action: Some lessons from the histories of hazards

DEFF Research Database (Denmark)

Hansen, Steffen Foss; Gee, D.

fuels and nuclear power provide lessons for prudent actions on the potential hazards of emerging technologies such as from nanotechnology, GMO food, radio-frequency from mobile phones, and the new generation of nuclear plants (See “Late Lessons from Early Warnings” volume I and II from the European...... and engagement of the public. In this paper, we analyse these latter barriers to getting knowledge into action and illustrate some ways and means by which science and precautionary measures, including regulations, market based instruments, and increased awareness and engagement of the public, could be designed...

Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

Science.gov (United States)

Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

2013-04-01

Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

Ecohealth Emerging Infectious Diseases Research Initiative (EcoEID)

International Development Research Centre (IDRC) Digital Library (Canada)

The emphasis will be on capacity building, networking and policy impact at the regional level. Lessons learned from .... Articles de revue. Disability weight of Clonorchis sinensis infection : captured from community study and model simulation.

Pearl Harbor: lessons for the dam safety community

Energy Technology Data Exchange (ETDEWEB)

Martin, T.E. [AMEC Earth and Environmental Ltd., Burnaby, BC (Canada)

2001-10-01

Every good dam safety program must be based on surveillance and emergency response planning. The same principles apply to the gathering of information for military intelligence and the planning of defence tactics. Lessons learned from failure have spurred the advancement of dam engineering. Dam safety experts can benefit from the inadequacies encountered by the military community, with the most famous occurring on December 7, 1941 in Pearl Harbor. Both intelligence gathering and contingency response planning failed miserably. The data was not properly disseminated, interpreted, analysed. The proper response to the situation was not initiated. Human error and failure to communicate are the two main reasons that explain the debacle. The inquiries into the tragedy at Pearl Harbor provided valuable lessons, related to individual and organizational failures, which the authors shared in this presentation. The relevance to dam safety was made. All Federal Bureau of Investigation (FBI) agents must read the lessons drawn from Pearl Harbor, as they have responsibility for dam safety. 4 refs.

Emerging Viral Infections in Sub-Saharan Africa and the Developing Nervous System: A Mini Review.

Science.gov (United States)

Kakooza-Mwesige, Angelina; Mohammed, Abdul H; Kristensson, Krister; Juliano, Sharon L; Lutwama, Julius J

2018-01-01

The global public health concern is heightened over the increasing number of emerging viruses, i.e., newly discovered or previously known that have expanded into new geographical zones. These viruses challenge the health-care systems in sub-Saharan Africa (SSA) countries from which several of them have originated and been transmitted by insects worldwide. Some of these viruses are neuroinvasive, but have been relatively neglected by neuroscientists. They may provide experiments by nature to give a time window for exposure to a new virus within sizeable, previously non-infected human populations, which, for instance, enables studies on potential long-term or late-onset effects on the developing nervous system. Here, we briefly summarize studies on the developing brain by West Nile, Zika, and Chikungunya viruses, which are mosquito-borne and have spread worldwide out of SSA. They can all be neuroinvasive, but their effects vary from malformations caused by prenatal infections to cognitive disturbances following perinatal or later infections. We also highlight Ebola virus, which can leave surviving children with psychiatric disturbances and cause persistent infections in the non-human primate brain. Greater awareness within the neuroscience community is needed to emphasize the menace evoked by these emerging viruses to the developing brain. In particular, frontline neuroscience research should include neuropediatric follow-up studies in the field on long-term or late-onset cognitive and behavior disturbances or neuropsychiatric disorders. Studies on pathogenetic mechanisms for viral-induced perturbations of brain maturation should be extended to the vulnerable periods when neurocircuit formations are at peaks during infancy and early childhood.

Lessons from the Electricity Auctions in Brazil

International Nuclear Information System (INIS)

Dutra, Joisa; Menezes, Flavio

2005-01-01

The first lesson to emerge from the recent auctions falls within a category that might be described as 'higher costs of reforms in developing economies.' These range from bidders' fears of future government-imposed price caps to technical issues, such as the potential loss of efficiency resulting from bidders' lack of knowledge about ceiling prices, reference supply, and the demand reduction mechanism

Emergence of new Salmonella Enteritidis phage types in Europe? Surveillance of infections in returning travellers

Directory of Open Access Journals (Sweden)

Andersson Yvonne

2004-09-01

Full Text Available Abstract Background Among human Salmonella Enteritidis infections, phage type 4 has been the dominant phage type in most countries in Western Europe during the last years. This is reflected in Salmonella infections among Swedish travellers returning from abroad. However, there are differences in phage type distribution between the countries, and this has also changed over time. Methods We used data from the Swedish infectious disease register and the national reference laboratory to describe phage type distribution of Salmonella Enteritidis infections in Swedish travellers from 1997 to 2002, and have compared this with national studies conducted in the countries visited. Results Infections among Swedish travellers correlate well with national studies conducted in the countries visited. In 2001 a change in phage type distribution in S. Enteritidis infections among Swedish travellers returning from some countries in southern Europe was observed, and a previously rare phage type (PT 14b became one of the most commonly diagnosed that year, continuing into 2002 and 2003. Conclusions Surveillance of infections among returning travellers can be helpful in detecting emerging infections and outbreaks in tourist destinations. The information needs to be communicated rapidly to all affected countries in order to expedite the implementation of appropriate investigations and preventive measures.

FDG PET/CT in infection and inflammation—current and emerging clinical applications

International Nuclear Information System (INIS)

Vaidyanathan, S.; Patel, C.N.; Scarsbrook, A.F.; Chowdhury, F.U.

2015-01-01

Integrated positron emission tomography/computed tomography (PET/CT) with the glucose analogue, 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG), is an evolving hybrid imaging technique in the evaluation of an important and diverse group of pathological conditions, which are characterised by infection and aseptic inflammation. With a rapidly expanding body of evidence, it is being increasingly recognised that, in addition to its established role in oncological imaging, FDG PET/CT also has clinical utility in suspected infection and inflammation. The technique can identify the source of infection or inflammation in a timely fashion ahead of morphological changes on conventional anatomical imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), map the extent and severity of disease, identify sites for tissue sampling, and assess therapy response. FDG PET/CT exhibits distinct advantages over traditional radionuclide imaging techniques in terms of shorter duration of examination, higher spatial resolution, non-invasive nature of acquisition, ability to perform quantitative analyses, and the provision of a synergistic combination of functional and anatomical imaging. With the use of illustrative clinico-radiological cases, this article discusses the current and emerging evidence for the use of FDG PET/CT in a broad spectrum of disorders, such as fever of unknown origin, sarcoidosis, large vessel vasculitis, musculoskeletal infections, joint prosthesis or implant-related complications, human immunodeficiency virus (HIV)-related infections, and miscellaneous indications, such as IgG4-related systemic disease. It will also briefly summarise the role of more novel tracers such as FDG-labelled leukocytes and gallium-68 PET tracers in this arena

Immune response to mycobacterial infection: lessons from flow cytometry.

Science.gov (United States)

Rovina, Nikoletta; Panagiotou, Marios; Pontikis, Konstantinos; Kyriakopoulou, Magdalini; Koulouris, Nikolaos G; Koutsoukou, Antonia

2013-01-01

Detecting and treating active and latent tuberculosis are pivotal elements for effective infection control; yet, due to their significant inherent limitations, the diagnostic means for these two stages of tuberculosis (TB) to date remain suboptimal. This paper reviews the current diagnostic tools for mycobacterial infection and focuses on the application of flow cytometry as a promising method for rapid and reliable diagnosis of mycobacterial infection as well as discrimination between active and latent TB: it summarizes diagnostic biomarkers distinguishing the two states of infection and also features of the distinct immune response against Mycobacterium tuberculosis (Mtb) at certain stages of infection as revealed by flow cytometry to date.

Immune Response to Mycobacterial Infection: Lessons from Flow Cytometry

Directory of Open Access Journals (Sweden)

Nikoletta Rovina

2013-01-01

Full Text Available Detecting and treating active and latent tuberculosis are pivotal elements for effective infection control; yet, due to their significant inherent limitations, the diagnostic means for these two stages of tuberculosis (TB to date remain suboptimal. This paper reviews the current diagnostic tools for mycobacterial infection and focuses on the application of flow cytometry as a promising method for rapid and reliable diagnosis of mycobacterial infection as well as discrimination between active and latent TB: it summarizes diagnostic biomarkers distinguishing the two states of infection and also features of the distinct immune response against Mycobacterium tuberculosis (Mtb at certain stages of infection as revealed by flow cytometry to date.

Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study

Science.gov (United States)

Nijman, Ruud G; Vergouwe, Yvonne; Thompson, Matthew; van Veen, Mirjam; van Meurs, Alfred H J; van der Lei, Johan; Steyerberg, Ewout W; Moll, Henriette A

2013-01-01

Objective To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Design Prospective observational diagnostic study. Setting Three paediatric emergency care units: two in the Netherlands and one in the United Kingdom. Participants Children with fever, aged 1 month to 15 years, at three paediatric emergency care units: Rotterdam (n=1750) and the Hague (n=967), the Netherlands, and Coventry (n=487), United Kingdom. A prediction model was constructed using multivariable polytomous logistic regression analysis and included the predefined predictor variables age, duration of fever, tachycardia, temperature, tachypnoea, ill appearance, chest wall retractions, prolonged capillary refill time (>3 seconds), oxygen saturation rule out the presence of other SBIs. Discriminative ability (C statistic) to predict pneumonia was 0.81 (95% confidence interval 0.73 to 0.88); for other SBIs this was even better: 0.86 (0.79 to 0.92). Risk thresholds of 10% or more were useful to identify children with serious bacterial infections; risk thresholds less than 2.5% were useful to rule out the presence of serious bacterial infections. External validation showed good discrimination for the prediction of pneumonia (0.81, 0.69 to 0.93); discriminative ability for the prediction of other SBIs was lower (0.69, 0.53 to 0.86). Conclusion A validated prediction model, including clinical signs, symptoms, and C reactive protein level, was useful for estimating the likelihood of pneumonia and other SBIs in children with fever, such as septicaemia/meningitis and urinary tract infections. PMID:23550046

Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care

NARCIS (Netherlands)

M. Thompson (M.); A. van den Bruel (Ann); J. Verbakel (Johannes); M. Lakhanpaul (Monica); T. Haj-Hassan (Tanya); R. Stevens (Richard); H.A. Moll (Henriëtte); F. Buntinx (Frank); M.Y. Berger (Marjolein); B. Aertgeerts (Bert); R. Oostenbrink (Rianne); D. Mant (David)

2012-01-01

textabstractBackground: Although the vast majority of children with acute infections are managed at home, this is one of the most common problems encountered in children attending emergency departments (EDs) and primary care. Distinguishing children with serious infection from those with minor or

Visual business ecosystem intelligence: lessons from the field.

Science.gov (United States)

Basole, Rahul C

2014-01-01

Macroscopic insight into business ecosystems is becoming increasingly important. With the emergence of new digital business data, opportunities exist to develop rich, interactive visual-analytics tools. Georgia Institute of Technology researchers have been developing and implementing visual business ecosystem intelligence tools in corporate settings. This article discusses the challenges they faced, the lessons learned, and opportunities for future research.

Emergence of unusual species of enterococci causing infections, South India

Directory of Open Access Journals (Sweden)

Rao Sambasiva R

2005-03-01

emergence of high-level aminoglycoside and beta-lactam resistance among different species apart from intrinsic vancomycin resistance by some species, while all the species tested were susceptible for linezolid and teicoplanin. Conclusion Our study reveals the emergence of multi-drug resistance among unusual species of enterococci posing a serious therapeutic challenge. Precise identification of enterococci to species level enables us to access the species-specific antimicrobial resistance characteristics, apart from knowing the epidemiological pattern and their clinical significance in human infections.

Brucellosis as an emerging threat in developing economies: lessons from Nigeria.

Science.gov (United States)

Ducrotoy, Marie J; Bertu, Wilson J; Ocholi, Reuben A; Gusi, Amahyel M; Bryssinckx, Ward; Welburn, Sue; Moriyón, Ignacio

2014-07-01

Nigeria is the most populous country in Africa, has a large proportion of the world's poor livestock keepers, and is a hotspot for neglected zoonoses. A review of the 127 accessible publications on brucellosis in Nigeria reveals only scant and fragmented evidence on its spatial and temporal distribution in different epidemiological contexts. The few bacteriological studies conducted demonstrate the existence of Brucella abortus in cattle and sheep, but evidence for B. melitensis in small ruminants is dated and unclear. The bulk of the evidence consists of seroprevalence studies, but test standardization and validation are not always adequately described, and misinterpretations exist with regard to sensitivity and/or specificity and ability to identify the infecting Brucella species. Despite this, early studies suggest that although brucellosis was endemic in extensive nomadic systems, seroprevalence was low, and brucellosis was not perceived as a real burden; recent studies, however, may reflect a changing trend. Concerning human brucellosis, no studies have identified the Brucella species and most reports provide only serological evidence of contact with Brucella in the classical risk groups; some suggest brucellosis misdiagnoses as malaria or other febrile conditions. The investigation of a severe outbreak that occurred in the late 1970s describes the emergence of animal and human disease caused by the settling of previously nomadic populations during the Sahelian drought. There appears to be an increasing risk of re-emergence of brucellosis in sub-Saharan Africa, as a result of the co-existence of pastoralist movements and the increase of intensive management resulting from growing urbanization and food demand. Highly contagious zoonoses like brucellosis pose a threat with far-reaching social and political consequences.

Brucellosis as an Emerging Threat in Developing Economies: Lessons from Nigeria

Science.gov (United States)

Ducrotoy, Marie J.; Bertu, Wilson J.; Ocholi, Reuben A.; Gusi, Amahyel M.; Bryssinckx, Ward; Welburn, Sue; Moriyón, Ignacio

2014-01-01

Nigeria is the most populous country in Africa, has a large proportion of the world's poor livestock keepers, and is a hotspot for neglected zoonoses. A review of the 127 accessible publications on brucellosis in Nigeria reveals only scant and fragmented evidence on its spatial and temporal distribution in different epidemiological contexts. The few bacteriological studies conducted demonstrate the existence of Brucella abortus in cattle and sheep, but evidence for B. melitensis in small ruminants is dated and unclear. The bulk of the evidence consists of seroprevalence studies, but test standardization and validation are not always adequately described, and misinterpretations exist with regard to sensitivity and/or specificity and ability to identify the infecting Brucella species. Despite this, early studies suggest that although brucellosis was endemic in extensive nomadic systems, seroprevalence was low, and brucellosis was not perceived as a real burden; recent studies, however, may reflect a changing trend. Concerning human brucellosis, no studies have identified the Brucella species and most reports provide only serological evidence of contact with Brucella in the classical risk groups; some suggest brucellosis misdiagnoses as malaria or other febrile conditions. The investigation of a severe outbreak that occurred in the late 1970s describes the emergence of animal and human disease caused by the settling of previously nomadic populations during the Sahelian drought. There appears to be an increasing risk of re-emergence of brucellosis in sub-Saharan Africa, as a result of the co-existence of pastoralist movements and the increase of intensive management resulting from growing urbanization and food demand. Highly contagious zoonoses like brucellosis pose a threat with far-reaching social and political consequences. PMID:25058178

Systematic review and validation of prediction rules for identifying children with serious infections in emergency departments and urgent-access primary care

NARCIS (Netherlands)

Thompson, M.; Van den Bruel, A.; Verbakel, J.; Lakhanpaul, M.; Haj-Hassan, T.; Stevens, R.; Moll, HA; Buntinx, F.; Berger, M.; Aertgeerts, B.; Oostenbrink, R.; Mant, D.

Background: Although the vast majority of children with acute infections are managed at home, this is one of the most common problems encountered in children attending emergency departments (EDs) and primary care. Distinguishing children with serious infection from those with minor or self-limiting

Blood stream infection by an emerging pathogen Oligella ureolytica in a cancer patient: Case report and review of literature

Directory of Open Access Journals (Sweden)

Frincy K Baruah

2014-01-01

Full Text Available Oligella ureolytica is an emerging bacteria rarely implicated as a human pathogen. It is infrequently recovered from clinical specimens probably because of inadequate processing of non-fermenting oxidase positive Gram negative bacilli. We present here a case of a 30 year old male suffering from right lung adenocarcinoma (moderately differentiated with multiple abdominal lymph node metastasis with Syringohydromyelia whose blood culture yielded Oligella ureolytica in pure culture. Oligella ureolytica isolation in pure culture and the patient′s response to targeted treatment supported that Oligella ureolytica was the true causative agent of the blood stream infection. Early suspicion, diagnosis and treatment with potent antibiotics are needed to prevent further complications resulting from infection with this emerging pathogen.

Development of an extended framework for emergency response criteria. Interim report for comments

International Nuclear Information System (INIS)

2005-01-01

Experience from response to recent nuclear and radiological emergencies has clearly demonstrated the importance of an efficient response system that includes, among other components, emergency plans, procedures, and internally consistent operational criteria. An analysis of lessons identified from recent responses has shown that a lack of crucial components in the emergency response system could result in major radiological and nonradiological consequences at the national level. One of the reasons for the overwhelming psychological consequences of the Chernobyl and Goiania emergencies was public mistrust of decision-makers, who lost their credibility by frequently changing the criteria for taking action. Moreover, national response arrangements that are incompatible among countries can result in major mistrust by the public. It is considered important to have internationally agreed criteria and guidance for emergency response established in advance of an emergency. Currently there are several IAEA safety standards that contain recommendations for response to radiation emergencies, addressing principles and response criteria. Mindful of the lessons identified from recent emergencies, the IAEA convened in November 2001 a technical committee meeting (TCM) to develop aspects of the technical basis for emergency response to radiation emergencies. At this meeting, the lessons from response to the Chernobyl, Goiania and other emergencies over the past years were examined to identify where revisions were needed to the existing international guidance for response. In particular, the existing international criteria and guidance for taking protective and other actions were examined in the light of these lessons. The objectives of this document are: (1) to propose an extension of existing criteria for undertaking protective and other actions during or following a nuclear or radiological emergency that: addresses the lessons from past emergencies, addresses the recently

Key regulatory and safety issues emerging NEA activities. Lessons Learned from Fukushima Dai-ichi NPS Accident - Key Regulatory and Safety Issues

International Nuclear Information System (INIS)

Nakoski, John

2013-01-01

intervention and performance under extreme conditions; evaluations of metallic components and structures under high-seismic loads; risks assessments for natural external initiating events; and defence-in-depth, including the robustness of electrical systems. A recent joint research project has also been started that will include a benchmarking study of accident codes and the collection of data from the damaged reactors at the Fukushima Daiichi NPS. CRPPH activities in response to the Fukushima Daiichi NPS accident include an update of report on Short-term Countermeasures in Case of a Nuclear or Radiological Emergency that was last updated in 2003; the performance of a survey on emergency management lessons learned; developing lesson learned in the management of occupational exposure in high-radiation areas; and providing support to the Japanese Government by co-ordination and participation in workshops on decontamination and recovery and other technical topics

Emergency preparedness

CERN Document Server

Cennini, E; Oortman Gerlings, P

2009-01-01

On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

Lessons learnt from the introduction of the contraceptive implant in ...

African Journals Online (AJOL)

This article explores the complexities of introducing new contra ... framework[1,2] and other emerging literature, lessons are identified and key .... events and negative user experiences related to inadequate quality of care, which even if ..... completion; CM, JS, NLD: reviewed and assisted with the development of the initial ...

Building Innovation Subsidiaries in Emerging Markets

DEFF Research Database (Denmark)

Pogrebnyakov, Nicolai; Kristensen, Jonas D.

2011-01-01

Innovation subsidiaries increasingly follow manufacturing subsidiaries into emerging markets. Compared to well-established Western economies, emerging markets present unique challenges for the development of innovation management capabilities at subsidiaries. This paper distinguishes between...... multinational pharmaceutical company, Novo Nordisk. Lessons learned include assigning the subsidiary responsibility for a self-contained piece of work while maintaining a central R&D function, balancing local and in-company management, using local innovation talent, and educating new hires into the company...

Emergency planning for industrial hazards

International Nuclear Information System (INIS)

Gow, H.B.F.; Kay, R.W.

1988-01-01

The European Communities have produced a Directive on the Major Accident Hazards of Certain Industrial Activities which sets out standards for the control and mitigation of the hazards presented by sites and storages which contain significant quantities of dangerous substances. An essential element of these controls is the provision of effective on-and off-site emergency plans. This conference explores the considerable research effort which is going on throughout the world in the improvement of systems for emergency planning. Attention was also drawn to areas where difficulties still exist, for example in predicting the consequences of an accident, the complexities of communication problems and the difficulties arising from involvement of the public. The proceedings are in six parts which deal with organizations implementing emergency planning: on- and off-site emergency planning and design; techniques for emergency plans; expenses and auditing of emergency plans; lessons learnt from the emergency management of major accidents; information to the public to and during emergencies. (author)

A Harvest of Practical Insights : Lessons Learned in Agriculture, Agribusiness, Sustainable Rural Development, and Climate Change

OpenAIRE

International Finance Corporation

2012-01-01

This IFC SmartBook is a compilation of sixteen IFC SmartLessons that presents practical lessons learned by staff from across the IFC and the World Bank on approaches for engaging in agriculture that have led to success. Agribusiness is a crucial economic sector, for food security of course, for managing water stress and ecosystem services, but also as a source of employment in emerging mar...

Immune Response to Mycobacterial Infection: Lessons from Flow Cytometry

OpenAIRE

Rovina, Nikoletta; Panagiotou, Marios; Pontikis, Konstantinos; Kyriakopoulou, Magdalini; Koulouris, Nikolaos G.; Koutsoukou, Antonia

2013-01-01

Detecting and treating active and latent tuberculosis are pivotal elements for effective infection control; yet, due to their significant inherent limitations, the diagnostic means for these two stages of tuberculosis (TB) to date remain suboptimal. This paper reviews the current diagnostic tools for mycobacterial infection and focuses on the application of flow cytometry as a promising method for rapid and reliable diagnosis of mycobacterial infection as well as discrimination between active...

The role of infections and coinfections with newly identified and emerging respiratory viruses in children

Directory of Open Access Journals (Sweden)

Debiaggi Maurizia

2012-10-01

Full Text Available Abstract Acute respiratory infections are a major cause of morbidity in children both in developed and developing countries. A wide range of respiratory viruses, including respiratory syncytial virus (RSV, influenza A and B viruses, parainfluenza viruses (PIVs, adenovirus, rhinovirus (HRV, have repeatedly been detected in acute lower respiratory tract infections (LRTI in children in the past decades. However, in the last ten years thanks to progress in molecular technologies, newly discovered viruses have been identified including human Metapneumovirus (hMPV, coronaviruses NL63 (HcoV-NL63 and HKU1 (HcoV-HKU1, human Bocavirus (HBoV, new enterovirus (HEV, parechovirus (HpeV and rhinovirus (HRV strains, polyomaviruses WU (WUPyV and KI (KIPyV and the pandemic H1N1v influenza A virus. These discoveries have heavily modified previous knowledge on respiratory infections mainly highlighting that pediatric population is exposed to a variety of viruses with similar seasonal patterns. In this context establishing a causal link between a newly identified virus and the disease as well as an association between mixed infections and an increase in disease severity can be challenging. This review will present an overview of newly recognized as well as the main emerging respiratory viruses and seek to focus on the their contribution to infection and co-infection in LRTIs in childhood.

Competition Policies in Emerging Economies: Lessons and ...

International Development Research Centre (IDRC) Digital Library (Canada)

30 juil. 2008 ... Do small developing economies, or SDEs, need a specific competition policy to ... to promote competition and business creation, yet the economic and ... in Emerging Economies features in-depth analysis of two strategic ...

Perspectives on Adult Education, Human Resource Development, and the Emergence of Workforce Development

Science.gov (United States)

Jacobs, Ronald L.

2014-01-01

This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…

There is no Theory of Everything a physics perspective on emergence

CERN Document Server

English, Lars Q

2017-01-01

The main purpose of this book is to introduce a broader audience to emergence by illustrating how discoveries in the physical sciences have informed the ways we think about it.  In a nutshell, emergence asserts that non-reductive behavior arises at higher levels of organization and complexity. As physicist Philip Anderson put it, “more is different.”  Along the text's conversational tour through the terrain of quantum physics, phase transitions, nonlinear and statistical physics, networks and complexity, the author highlights the various philosophical nuances that arise in encounters with emergence. The final part of the book zooms out to reflect on some larger lessons that emergence affords us. One of those larger lessons is the realization that the great diversity of theories and models, and the great variety of independent explanatory frameworks, will always be with us in the sciences and beyond. There is no “Theory of Everything” just around the corner waiting to be discovered. One of the main b...

Applying business intelligence innovations to emergency management.

Science.gov (United States)

Schlegelmilch, Jeffrey; Albanese, Joseph

2014-01-01

The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation.

Lessons learned bulletin

International Nuclear Information System (INIS)

1994-05-01

During the past four years, the Department of Energy -- Savannah River Operations Office and the Westinghouse Savannah River Company (WSRC) Environmental Restoration (ER) Program completed various activities ranging from waste site investigations to closure and post closure projects. Critiques for lessons learned regarding project activities are performed at the completion of each project milestone, and this critique interval allows for frequent recognition of lessons learned. In addition to project related lessons learned, ER also performs lessons learned critiques. T'he Savannah River Site (SRS) also obtains lessons learned information from general industry, commercial nuclear industry, naval nuclear programs, and other DOE sites within the complex. Procedures are approved to administer the lessons learned program, and a database is available to catalog applicable lessons learned regarding environmental remediation, restoration, and administrative activities. ER will continue to use this database as a source of information available to SRS personnel

Emerging sexually transmitted viral infections: 1. Review of Ebola virus disease.

Science.gov (United States)

Caswell, Rachel J; Manavi, Kaveh

2017-11-01

This is the first in a series of articles reviewing four viral infections, Ebola virus, Zika virus, human T-cell lymphotropic virus, type 1 and hepatitis C virus, with an emphasis on recent advances in our understanding of their sexual transmission. With current day speed and ease of travel it is important for staff in sexual healthcare services to know and understand these infections when patients present to them and also to be able to advise those travelling to endemic regions. Following the recent resurgence in West Africa, this first article looks at Ebola virus disease (EVD). EVD has a high mortality rate and, of note, has been detected in the semen of those who have cleared the virus from their blood and have clinically recovered from the disease. As the result of emerging data, the WHO now recommends safe sex practices for all male survivors of EVD for 12 months after the onset of the disease or after having had two consecutive negative tests of semen specimens for the virus. This review provides an up-to-date summary of what is currently known about EVD and its implications for sexual health practice.

[Consensus statement of the National AIDS Plan Secretariat, Spanish Society of Emergency Medicine and AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology on Emergency and Human Immunodeficiency Virus Infection].

Science.gov (United States)

2013-01-01

Supporting non-HIV specialist professionals in the treatment of patients with urgent diseases resulting from HIV infection. These recommendations have been agreed by an expert panel from the National AIDS Plan Secretariat, the Spanish Society of Emergency Medicine, and the AIDS Study Group. A review has been made of the safety and efficacy results of clinical trials and cohort studies published in biomedical journals (PubMed and Embase) or presented at conferences. The strength of each recommendation (A, B, C) and the level of supporting evidence (I, II, III) are based on a modification of the criteria of the Infectious Diseases Society of America. The data to be collected from the emergency medical history in order to recognize the patient at risk of HIV infection were specified. It stressed the basic knowledge of ART principles and its importance in terms of decline in morbidity and mortality of HIV+ patients and referring to the HIV specialist for follow-up, where appropriate, including drug interactions. Management of different emergency situations that may occur in patients with HIV infection is also mentioned. The non-HIV specialist professional, will find the necessary tools to approach HIV patients with an emergency disease. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Main lessons based on the Chernobyl nuclear power plant accident liquidation experience

International Nuclear Information System (INIS)

Vasil'chenko, V.N.; Nosovskij, A.V.

2006-01-01

The authors review the main lessons of the Chernobyl nuclear power plant accident and the liquidation of its consequences in the area of the nuclear reactors safety operation, any major accident management, liquidation accident consequences criteria, emergency procedures, preventative measures and treatment irradiated victims, the monitoring methods etc. The special emphasis is put on the questions of the emergency response and the antiaccidental measures planning in frame of international cooperation program

A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi.

Science.gov (United States)

Burdon Bailey, Jordana L; Gamble, Luke; Gibson, Andrew D; Bronsvoort, Barend M deC; Handel, Ian G; Mellanby, Richard J; Mazeri, Stella

2018-03-01

Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children's knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both prabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both prabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren.

A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi

Science.gov (United States)

Burdon Bailey, Jordana L.; Gamble, Luke; Gibson, Andrew D.; Bronsvoort, Barend M. deC.; Handel, Ian G.; Mellanby, Richard J.; Mazeri, Stella

2018-01-01

Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children’s knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both prabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both prabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren. PMID:29522517

Lessons learned from the Fukushima accident to improve the performance of the national nuclear preparedness system

International Nuclear Information System (INIS)

Dewi Apriliani

2013-01-01

A study of emergency response failure in the early phase of a nuclear accident in Fukushima, Japan has conducted. This study aimed to obtain lesson learned from the problems and constraints that exist at the time of the Fukushima emergency response. This lesson learned will be adjusted to the situation, conditions and problems in nuclear preparedness systems in Indonesia, so that it can obtain the necessary recommendations to improve the performance of SKNN (National Nuclear Emergency Preparedness System). Recommendations include: improvements in coordination and information systems, including early warning systems and dissemination of information; improvements in the preparation of emergency plans/contingency plan, which includes an integrated disaster management; improvement in the development of disaster management practice/field exercise, by extending the scenario and integrate it with nuclear disaster, chemical, biological, and acts of terrorism; and improvement in public education of nuclear emergency preparedness and also improvement in management for dissemination of information to the public and the mass media. These improvements need to be done as part of efforts in preparing a reliable nuclear emergency preparedness in order to support nuclear power plant development plan. (author)

Intergenerational Lessons and 'Fabulous Stories'.

Science.gov (United States)

Lewenson, Sandra B; Welch, Cathryne A; Hassmiller, Susan B

2015-10-01

While directing the Future of Nursing: Campaign for Action, Susan B. Hassmiller, the Robert Wood Johnson Foundation's senior adviser for nursing, realized the value that nursing history could bring to the campaign. She decided to interview her mother, Jacqueline J. Wouwenberg, a 1947 graduate of the Bellevue Hospital School of Nursing, in order to better understand and contextualize changes that had occurred in the nursing profession during the 20th century. In collaboration with nurse historians Cathryne A. Welch and Sandra B. Lewenson, Hassmiller participated in interviewing her mother and was also interviewed herself. The stories that emerged revealed a great deal: each woman had found that nursing had given them countless opportunities that reflected the time periods in which they lived. Wouwenberg's experiences, transmitted to Hassmiller through words and actions, also served as important lessons for her daughter. This article shares five lessons: be independent and courageous, know that nursing has no bounds, follow your passion, honor diversity, and give back. It also asks readers to reflect on the relevance of nurses' work from one generation to the next..

Lesson learned from two radiological incidents in industrial radiography in Iran

International Nuclear Information System (INIS)

Samimi, Bijan; Deevband Mohammad, Reza; Kardan Mohammad, Reza; Eshraghi, Ahmad

2006-01-01

This paper discussed two incidents occurred in Iran, follow-up investigations as well as lessons learned. Two Industrial Gamma Radiography Projectors (I.G.R.P.) included Ir-192 source with activities 24 and 30 Curies respectively were stolen. One of them was stolen in an industrial area with high security provision and the other one has been stolen at the home town without any security provision. The lessons learned from these incidents are discussed and the results are proposed as recommendations. Investigations show that the reasons for these incidents are as follows: 1. Insufficient training programs for radiographers. 2. Lack of specific emergency procedure for this type of incident in the company. 3. Not efficient National Emergency Plan for this type of threat. 4. Lack of technical and administrative measures to separate radioactive sources from unauthorized persons. 5. Lack of security plan in the company. 6. Insufficient supervision of Radiation Protection Officer (R.P.O.) or responsible person at the site. (authors)

Lesson learned from two radiological incidents in industrial radiography in Iran

Energy Technology Data Exchange (ETDEWEB)

Samimi, Bijan; Deevband Mohammad, Reza; Kardan Mohammad, Reza; Eshraghi, Ahmad [National Radiation Protection Department (NRPD) Atomic Energy Organization of Iran (AEOI) (Iran, Islamic Republic of)

2006-07-01

This paper discussed two incidents occurred in Iran, follow-up investigations as well as lessons learned. Two Industrial Gamma Radiography Projectors (I.G.R.P.) included Ir-192 source with activities 24 and 30 Curies respectively were stolen. One of them was stolen in an industrial area with high security provision and the other one has been stolen at the home town without any security provision. The lessons learned from these incidents are discussed and the results are proposed as recommendations. Investigations show that the reasons for these incidents are as follows: 1. Insufficient training programs for radiographers. 2. Lack of specific emergency procedure for this type of incident in the company. 3. Not efficient National Emergency Plan for this type of threat. 4. Lack of technical and administrative measures to separate radioactive sources from unauthorized persons. 5. Lack of security plan in the company. 6. Insufficient supervision of Radiation Protection Officer (R.P.O.) or responsible person at the site. (authors)

Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations

Directory of Open Access Journals (Sweden)

Sukhen Samanta

2014-01-01

Full Text Available Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block, intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa and the role of plasmapheresis in leptospira related jaundice with renal failure.

Bats and Emerging Infections: An Ecological and Virological Puzzle.

Science.gov (United States)

Serra-Cobo, Jordi; López-Roig, Marc

2017-01-01

More than 200 viruses have been detected in bats. Some unique bat characteristics can explain the roles played in the maintenance and transmission of viruses: long phylogenetic history can have originated coevolution processes, great number of species are adapted to live in different environments, big mobility, long lifespan and gregarious behaviour of many species.To analyse zoonoses long longitudinal studies are needed with a multidisciplinary approximation to obtain the following eco-epidemiological data: colony size, number of bats per species, population structure, behaviour of each species, degree of contact between bats, social structure, remaining time of bats in the colony, colony type, foraging area, turnover rate of individuals, shelter temperature, relationship with other colonies and co-infection processes. These data allows assessing the epidemiological risk and which preventive measures are necessary to take.The structure and functionality of ecosystems are changing worldwide at an unprecedented rate and can modify the interactions between humans and infected bats. There are more or less local factors that can affect the emergence and spread of diseases (environmental alterations, changes in land use, human population growth, changes in human socioeconomic behavior or social structure, people mobility increase, trade increase, forest fires, extreme weather events, wars, breakdown in public health infrastructure, etc.).Twenty-three percent of all bat species in the world are decreasing. How does the regression of bat species affect the dynamic of viruses? The dichotomy between health risk and bat preservation is compatible with a preventive task based on more information and training.

Risk communication in the case of the Fukushima accident: Impact of communication and lessons to be learned.

Science.gov (United States)

Perko, Tanja

2016-10-01

Risk communication about the Fukushima Daiichi nuclear power plant accident in 2011 was often not transparent, timely, clear, nor factually correct. However, lessons related to risk communication have been identified and some of them are already addressed in national and international communication programmes and strategies. The Fukushima accident may be seen as a practice scenario for risk communication with important lessons to be learned. As a result of risk communication failures during the accident, the world is now better prepared for communication related to nuclear emergencies than it was 5 years ago The present study discusses the impact of communication, as applied during the Fukushima accident, and the main lessons learned. It then identifies pathways for transparent, timely, clear and factually correct communication to be developed, practiced and applied in nuclear emergency communication before, during, and after nuclear accidents. Integr Environ Assess Manag 2016;12:683-686. © 2016 SETAC. © 2016 SETAC.

The stethoscope in the Emergency Department: a vector of infection?

Science.gov (United States)

Núñez, S.; Moreno, A.; Green, K.; Villar, J.

2000-01-01

The purposes of this study were to determine whether microorganisms can be isolated from the membranes of stethoscopes used by clinicians and nurses, and to analyse whether or not the degree of bacterial colonization could be reduced with different cleaning methods. We designed a transversal before-after study in which 122 stethoscopes were examined. Coagulase negative staphylococci (which are also potentially pathogenic microorganisms) were isolated together with 13 other potentially pathogenic microorganisms, including S. aureus, Acinetobacter sp. and Enterobacter agglomerans. The most effective antiseptic was propyl alcohol. Analysis of the cleaning habits of the Emergency Department (ED) staff, showed that 45% cleaned the stethoscope annually or never. The isolation of potentially pathogenic microorganisms suggests that the stethoscope must be considered as a potential vector of infection not only in the ED but also in other hospital wards and out-patient clinics. PMID:10813148

The "Emerging" and "Emergent" Present: A View on the Indeterminate Nature of Mathematics Lessons

Science.gov (United States)

Roth, Wolff-Michael; Maheux, Jean-François

2014-01-01

The notion of emergence has considerable currency in mathematics education. However, the notion tends to be used in a descriptive way rather than being theorized and developed as a phenomenon sui generis. The purpose of this article is to contribute to building a theory of "emergence." After providing an exemplifying description and…

Lessons learned in terms of crisis management

International Nuclear Information System (INIS)

2006-01-01

This document outlines that nobody was prepared to the crisis which occurred after the Chernobyl accident, whether in Russia, Europe or France. In order to illustrate the fact that crisis management has been different from one country to another, the report describes how the crisis has been managed in Norway (which has been quickly reached by fallouts and with a rather high level) and in Switzerland. It comments radioactivity measurements performed in France during spring 1986 by the SCPRI, the CEA and the ISPN. It discusses the lessons drawn in France in terms of emergency situation management regarding the protection of the population, crisis management, and the French post-accidental doctrine. It comments the lessons drawn in eastern European countries, with the cooperative implication of the IRSN. International projects are evoked: the Chernobyl Centre, the French-German Initiative, the European projects (EURANOS, NERIS, FARMING, STRATEGY, MOSES and SAMEN)

Breathing Life into Engineering: A Lesson Study Life Science Lesson

Science.gov (United States)

Lawrence, Maria; Yang, Li-Ling; Briggs, May; Hession, Alicia; Koussa, Anita; Wagoner, Lisa

2016-01-01

A fifth grade life science lesson was implemented through a lesson study approach in two fifth grade classrooms. The research lesson was designed by a team of four elementary school teachers with the goal of emphasizing engineering practices consistent with the "Next Generation Science Standards" (NGSS) (Achieve Inc. 2013). The fifth…

Worldwide market developments : lessons for Alberta

International Nuclear Information System (INIS)

Percival, J.F.

1998-01-01

A review of competitive retail electricity markets in Argentina, New Zealand, Australia and California were discussed, highlighting lessons for Alberta policy makers, market designers and electricity retailers. Some of the emerging strategies in the retail electricity marketplace such as horizontal integration, generation retailing, defensive retailing and virtual vertical integration were explored. Emphasis was on showing that electricity retailing is not an easy business. It is a business for large and existing players, and although horizontal and vertical integration have growth and profit potential, there are also risks

HCI Lessons From PlayStation VR

OpenAIRE

Habgood, Jacob; Wilson, David; Moore, David; Alapont, Sergio

2017-01-01

PlayStation VR has quickly built up a significant user-base of over a million headsets and its own ecosystem of games across a variety of genres. These games form part of a rapidly evolving testing ground for design solutions which can usefully inform HCI design for virtual reality. This paper reviews every PlayStation VR title released in the first three months of its lifecycle in order to identify emerging themes for locomotion. These themes are discussed with respect to the lessons learned...

The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health.

Science.gov (United States)

Pillai, Satish K; Beekmann, Susan E; Santibanez, Scott; Polgreen, Philip M

2014-04-01

In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN.

Drug resistance in community-acquired respiratory tract infections: role for an emerging antibacterial

Directory of Open Access Journals (Sweden)

Lorenzo Aguilar

2010-06-01

Full Text Available Lorenzo Aguilar1, María-José Giménez1, José Barberán21Microbiology Department, School of Medicine, University Complutense, Madrid; 2Infectious Diseases Department, Hospital Central de la Defensa Gomez Ulla, Madrid, SpainAbstract: The nasopharynx is the ecological niche where evolution towards resistance occurs in respiratory tract isolates. Dynamics of different bacterial populations in antibiotic-free multibacterial niches are the baseline that antibiotic treatments can alter by shifting the competitive balance in favor of resistant populations. For this reason, antibiotic resistance is increasingly being considered to be an ecological problem. Traditionally, resistance has implied the need for development of new antibiotics for which basic efficacy and safety data are required prior to licensing. Antibiotic development is mainly focused on demonstrating clinical efficacy and setting susceptibility breakpoints for efficacy prediction. However, additional information on pharmacodynamic data predicting absence of selection of resistance and of resistant subpopulations, and specific surveillance on resistance to core antibiotics (to detect emerging resistances and its link with antibiotic consumption in the community are valuable data in defining the role of a new antibiotic, not only from the perspective of its therapeutic potential but also from the ecologic perspective (countering resistances to core antibiotics in the community. The documented information on cefditoren gleaned from published studies in recent years is an example of the role for an emerging oral antibacterial facing current antibiotic resistance in community-acquired respiratory tract infections.Keywords: respiratory tract infection, antibiotic resistance, cefditoren, community

The Knitting Lesson.

Science.gov (United States)

Smith, Pamela

1987-01-01

Based on Jean-Francois Millet's 1869 painting, "The Knitting Lesson," this lesson's goal is to introduce students in grades seven through nine to genre (everyday life) painting the nineteenth century. The lesson is also designed to show that some aspects of genre may be timeless. (BSR)

Skin Infections and Antibiotic Stewardship: Analysis of Emergency Department Prescribing Practices, 2007-2010

Directory of Open Access Journals (Sweden)

Daniel J. Pallin

2014-05-01

Full Text Available Introduction: National guidelines suggest that most skin abscesses do not require antibiotics, and that cellulitis antibiotics should target streptococci, not community-associated MRSA (CA-MRSA. The objective of this study is to describe antimicrobial treatment of skin infections in U.S. emergency departments (EDs and analyze potential quality measures. Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS is a 4-stage probability sample of all non-federal U.S. ED visits. In 2007 NHAMCS started recording whether incision and drainage was performed at ED visits. We conducted a retrospective analysis, pooling 2007-2010 data, identified skin infections using diagnostic codes, and identified abscesses by performance of incision and drainage. We generated national estimates and 95% confidence intervals using weighted analyses; quantified frequencies and proportions; and evaluated antibiotic prescribing practices. We evaluated 4 parameters that might serve as quality measures of antibiotic stewardship, and present 2 of them as potentially robust enough for implementation. Results: Of all ED visits, 3.2% (95% confidence interval 3.1-3.4% were for skin infection, and 2.7% (2.6-2.9% were first visits for skin infection, with no increase over time (p=0.80. However, anti-CA-MRSA antibiotic use increased, from 61% (56-66% to 74% (71-78% of antibiotic regimens (p<0.001. Twenty-two percent of visits were for abscess, with a non-significant increase (p=0.06. Potential quality measures: Among discharged abscess patients, 87% were prescribed antibiotics (84-90%, overuse. Among antibiotic regimens for abscess patients, 84% included anti-CA-MRSA agents (81-89%, underuse. Conclusion: From 2007-2010, use of anti-CA-MRSA agents for skin infections increased significantly, despite stable visit frequencies. Antibiotics were over-used for discharged abscess cases, and CA-MRSA-active antibiotics were underused among regimens when antibiotics were used for

Head and neck trauma in Iraq and Afghanistan: different war, different surgery, lessons learned.

Science.gov (United States)

Brennan, Joseph

2013-10-01

The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice. A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records. The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care. The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned. The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

The history of a lesson

DEFF Research Database (Denmark)

Rasmussen, Mikkel Vedby

2003-01-01

and emphasises the need to study the history of lessons rather than the lessons of history. This approach shows that Munich is the end point of a constitutive history that begins in the failure of the Versailles treaty to create a durable European order following the First World War. The Munich lesson is thus......The article investigates the concept of lessons in IR. By means of a constructivist critique of the 'lessons literature', the article analyses one of the most important of IR lessons: that of Munich. Examining how the Munich lesson came about, the article shows the praxeological nature of lessons...... one element of the lesson of Versailles, which is a praxeology that defines how the West is to make peace, and against whom peace must be defended. The lesson of Versailles has been, at least in part, constitutive of the outbreak of the Cold War, and it continues to define the Western conception...

International conference on non-military radiation emergencies: [Final technical report

International Nuclear Information System (INIS)

1986-01-01

The subject of this report was limited to non-military radiation emergencies because such events needed to be addressed and the topic was considered to be manageable. The Conference theme developed around the lessons learned from the radiation emergencies at Chernobyl, Three Mile Island, and Windscale. Specific topics to be considered included acute and long-term effects of radiation exposure; frequency and nature of radiation emergencies; national standards for exposures to ionizing radiation; plans and procedures for responding to emergencies at the hospital, community, and national levels; and responsibilities of physicians and other health professionals regarding radiation exposures and emergencies

Rapid response to an emerging infectious disease - Lessons learned from development of a synthetic DNA vaccine targeting Zika virus.

Science.gov (United States)

Kudchodkar, Sagar B; Choi, Hyeree; Reuschel, Emma L; Esquivel, Rianne; Jin-Ah Kwon, Jackie; Jeong, Moonsup; Maslow, Joel N; Reed, Charles C; White, Scott; Kim, J Joseph; Kobinger, Gary P; Tebas, Pablo; Weiner, David B; Muthumani, Kar

2018-03-17

Vaccines are considered one of the greatest advances in modern medicine. The global burden of numerous infectious diseases has been significantly reduced, and in some cases, effectively eradicated through the deployment of specific vaccines. However, efforts to develop effective new vaccines against infectious pathogens such as influenza, Human immunodeficiency virus (HIV), dengue virus (DENV), chikungunya virus (CHIKV), Ebola virus, and Zika virus (ZIKV) have proven challenging. Zika virus is a mosquito-vectored flavivirus responsible for periodic outbreaks of disease in Africa, Southeast Asia, and the Pacific Islands dating back over 50 years. Over this period, ZIKV infections were subclinical in most infected individuals and resulted in mild cases of fever, arthralgia, and rash in others. Concerns about ZIKV changed over the past two years, however, as outbreaks in Brazil, Central American countries, and Caribbean islands revealed novel aspects of infection including vertical and sexual transmission modes. Cases have been reported showing dramatic neurological pathologies including microcephaly and other neurodevelopmental problems in babies born to ZIKV infected mothers, as well as an increased risk of Guillain-Barre syndrome in adults. These findings prompted the World Health Organization to declare ZIKV a public health emergency in 2016, which resulted in expanded efforts to develop ZIKV vaccines and immunotherapeutics. Several ZIKV vaccine candidates that are immunogenic and effective at blocking ZIKV infection in animal models have since been developed, with some of these now being evaluated in the clinic. Additional therapeutics under investigation include anti-ZIKV monoclonal antibodies (mAbs) that have been shown to neutralize infection in vitro as well as protect against morbidity in mouse models of ZIKV infection. In this review, we summarize the current understanding of ZIKV biology and describe our efforts to rapidly develop a vaccine against ZIKV

Lesson Learning at JPL

Science.gov (United States)

Oberhettinger, David

2011-01-01

A lessons learned system is a hallmark of a mature engineering organization A formal lessons learned process can help assure that valuable lessons get written and published, that they are well-written, and that the essential information is "infused" into institutional practice. Requires high-level institutional commitment, and everyone's participation in gathering, disseminating, and using the lessons

Infection as a Background to Safety: Source Material for Teaching.

Science.gov (United States)

Wyatt, H. V.

1986-01-01

Offers selections from papers which illustrate accidents, epidemics, and bad practices which could be used as background material for lessons on laboratory safety. Advocates the need for instruction on pathogenicity and infectivity. (ML)

Hymenolepis nana Impact Among Children in the Highlands of Cusco, Peru: An Emerging Neglected Parasite Infection.

Science.gov (United States)

Cabada, Miguel M; Morales, Maria Luisa; Lopez, Martha; Reynolds, Spencer T; Vilchez, Elizabeth C; Lescano, Andres G; Gotuzzo, Eduardo; Garcia, Hector Hugo; White, Clinton A

2016-11-02

Hymenolepis nana is the most common cestode infection in the world. However, limited information is available regarding its impact on affected populations. We studied the epidemiology and symptoms associated with hymenolepiasis among children 3-16 years old in 16 rural communities of the highlands of the Cusco region in Peru. Information on demographics, socioeconomic status, symptoms as reported by parents, and parasitological testing was obtained from the database of an ongoing Fasciola hepatica epidemiologic study. A total of 1,230 children were included in the study. Forty-five percent were infected with at least one pathogenic intestinal parasite. Giardia spp. (22.9%) was the most common, followed by Hymenolepis (17.4%), Fasciola (14.1%), Ascaris lumbricoides (6.1%), and Strongyloides stercoralis (2%). The prevalence of Hymenolepis infection varied by community, by other parasitic infections, and by socioeconomic status. However, only years of education of the mother, use of well water, and age less than 10 years were associated with Hymenolepis infection in the multivariate analysis. Hymenolepis nana infection was associated with diarrhea, jaundice, headaches, fever, and fatigue. Children with > 500 eggs/g of stool were more likely to have symptoms of weight loss, jaundice, diarrhea, and fever. Hymenolepis nana infection and age were the only factors retained in the multivariate analysis modeling diarrhea. Hymenolepiasis is a common gastrointestinal helminth in the Cusco region and is associated with significant morbidity in children in rural communities. The impact caused by the emergence of Hymenolepis as a prevalent intestinal parasite deserves closer scrutiny. © The American Society of Tropical Medicine and Hygiene.

Safety Requirements / Design Criteria for SFR. Lessons Learned from the Fukushima Dai-ichi Accident

International Nuclear Information System (INIS)

Yllera, Javier

2013-01-01

After the Fukushima event (March 2011) the IAEA has started an action to review and revise, if necessary, all Safety Standards to take into consideration the lessons learned from the accident. The Safety Standards that need to be revised have been identified. A Prioritization Approach has been established: The first priority is to review safety guides applicable for NPPs and spent fuel storage with focus on the measures for the prevention and mitigation of severe accident due to external hazards - ● Regulatory framework, Safety assessment, Management system, Radiation protection and Emergency Preparedness and response; ● Sitting, Design, Operation of NPPs ● Decommissioning and Waste Management. Original sources for lessons learned: IAE fact Finding Mission, Japan´s report to the Ministerial Conference, INSAG Report, etc. Later, other lesson sources considered

Burden of emerging/re emerging diseases in India

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Burden of emerging/re emerging diseases in India. 1-2 million deaths for 1994 epidemic of plague. 20,565 deaths in 2004 due to rabies. 400 million chronic carriers of hepatitis B virus. More than 18 million carriers of hepatitis C virus. 'Mutant' measles virus infection in ...

The potential for emerging therapeutic options for Clostridium difficile infection

Science.gov (United States)

Mathur, Harsh; Rea, Mary C; Cotter, Paul D; Ross, R Paul; Hill, Colin

2014-01-01

Clostridium difficile is mainly a nosocomial pathogen and is a significant cause of antibiotic-associated diarrhea. It is also implicated in the majority of cases of pseudomembranous colitis. Recently, advancements in next generation sequencing technology (NGS) have highlighted the extent of damage to the gut microbiota caused by broad-spectrum antibiotics, often resulting in C. difficile infection (CDI). Currently the treatment of choice for CDI involves the use of metronidazole and vancomycin. However, recurrence and relapse of CDI, even after rounds of metronidazole/vancomycin administration is a problem that must be addressed. The efficacy of alternative antibiotics such as fidaxomicin, rifaximin, nitazoxanide, ramoplanin and tigecycline, as well as faecal microbiota transplantation has been assessed and some have yielded positive outcomes against C. difficile. Some bacteriocins have also shown promising effects against C. difficile in recent years. In light of this, the potential for emerging treatment options and efficacy of anti-C. difficile vaccines are discussed in this review. PMID:25564777

Community-Based Disaster Management: A Lesson Learned From Community Emergency Response Management in Banyumas, Indonesia

Science.gov (United States)

Pratama, A. Y.; Sariffuddin, S.

2018-02-01

This article aimed to review community-based disaster management in terms of its independent coordination and disaster management. Community resilience was tested during disaster emergency. While panic, the community is required to be viable and able to evacuate, manage logistic, collect data on damage and the victim, and coordinate with outsiders independently. The community in Gununglurah Village, Banyumas Regency which was hit by a landslide in 2015 provides a lesson learned about community based disaster management. This research used qualitative descriptive methodology with in-depth interview with 23 informants from the community, donor institution, village officers, and government officers. Through traditional and informal methods, the community implemented disaster management that was categorized into 3 mechanisms that were social, functional, and sequential mechanism. These mechanisms controlled different portion in which social mechanism holds the most important role in disaster management, then functional mechanism and sequential mechanism. Various community activities in the village equipped the community with organizational experience to manage logistic, human resource and other coordination. In 2007, in fact, there was vulnerability risk assessment done by the local government, which recommended efforts to be done by the community to reduce the disaster risk, yet it was not implemented. It was interesting to note that in spite of the independent disaster management there was a scientific assessment neglected. Based on this research, a new discussion on how to synchronize the endogenous knowledge with scientific modern knowledge was opened.

The development of nuclear power and emergency response

International Nuclear Information System (INIS)

Pan Ziqiang

2007-01-01

Nuclear power is a safe, clean energy, which has been evidenced by the history of nuclear power development. Nuclear power is associated with very low risk but not equal to zero. Accident emergency response and preparedness is a final barrier necessary to reduce potential risks that may arise from nuclear power plants, which must be enhanced. In the course of accident emergency response and preparedness, it is highly necessary to draw domestic and foreign experiences and lessons. Lastly, the paper presents the discussions of some issues which merit attention with respect to emergency response and preparedness in China. (authors)

Building Accessible Educational Web Sites: The Law, Standards, Guidelines, Tools, and Lessons Learned

Science.gov (United States)

Liu, Ye; Palmer, Bart; Recker, Mimi

2004-01-01

Professional education is increasingly facing accessibility challenges with the emergence of webbased learning. This paper summarizes related U.S. legislation, standards, guidelines, and validation tools to make web-based learning accessible for all potential learners. We also present lessons learned during the implementation of web accessibility…

Lessons for South Africa from global trends in environmental labelling of buildings and construction products

CSIR Research Space (South Africa)

Ampofo-Anti, NL

2012-02-01

Full Text Available This chapter examines the international state-of-the-art of environmental labelling of buildings and construction products; and discusses ways in which the emerging South African framework for environmental labelling could benefit from the lessons...

Emerging and Re-Emerging Zoonoses of Dogs and Cats

Directory of Open Access Journals (Sweden)

Bruno B. Chomel

2014-07-01

Full Text Available Since the middle of the 20th century, pets are more frequently considered as “family members” within households. However, cats and dogs still can be a source of human infection by various zoonotic pathogens. Among emerging or re-emerging zoonoses, viral diseases, such as rabies (mainly from dog pet trade or travel abroad, but also feline cowpox and newly recognized noroviruses or rotaviruses or influenza viruses can sicken our pets and be transmitted to humans. Bacterial zoonoses include bacteria transmitted by bites or scratches, such as pasteurellosis or cat scratch disease, leading to severe clinical manifestations in people because of their age or immune status and also because of our closeness, not to say intimacy, with our pets. Cutaneous contamination with methicillin-resistant Staphylococcus aureus, Leptospira spp., and/or aerosolization of bacteria causing tuberculosis or kennel cough are also emerging/re-emerging pathogens that can be transmitted by our pets, as well as gastro-intestinal pathogens such as Salmonella or Campylobacter. Parasitic and fungal pathogens, such as echinococcosis, leishmaniasis, onchocercosis, or sporotrichosis, are also re-emerging or emerging pet related zoonoses. Common sense and good personal and pet hygiene are the key elements to prevent such a risk of zoonotic infection.

Degree of agreement among sepsis diagnosis criteria in adult emergency room patients with infection

Science.gov (United States)

Sinto, R.; Chandra, A. T.; Lie, K. C.; Suwarto, S.

2018-03-01

The study on the degree of agreement among three established sepsis diagnosis criteria become the necessity to investigate the best sepsis diagnosis criteria in Indonesia further. A cross-sectional study of adult Emergency Room patients hospitalized with a diagnosis of infection in CiptoMangunkusumo Hospital, Indonesia was conducted during March and April 2017. We recorded diagnosis, gender, age, comorbidities, infection source, and origin. Every subject was classified into sepsis and non-sepsis based on 1991, 2001 and sepsis-3 criteria. Raw % and Kappa agreement coefficients (κ) were calculated according to previously established formula to measure the degree of agreement among three diagnostic criteria. As many as 278 subjects were included in this study. The raw % agreement and κ between 1991 and 2001 criteria is 69.07% and 0.34 respectively. The raw % agreement and κ between 2001 and sepsis-3 criteria is 56.12% and 0.15 respectively. The raw % agreement and κ between 1991 and sepsis-3 criteria is 48.19% and -0.02. In conclusions, there is afair agreement between 1991 and 2001 criteria, poor agreement between 2001 and sepsis-3 criteria, and poor disagreement between 1991 and sepsis-3 criteria. This necessitates further Indonesian study of the best diagnosis criteria to diagnose an infected patient with sepsis.

An overview of mosquitoes and emerging arboviral infections in the Zagreb area, Croatia.

Science.gov (United States)

Klobucar, Ana; Benic, Nikola; Krajcar, Darko; Kosanovic-Licina, Mirjana Lana; Tesic, Vanja; Merdic, Enrih; Vrucina, Ivana; Savic, Vladimir; Barbic, Ljubo; Stevanovic, Vladimir; Pem-Novosel, Iva; Vilibic-Cavlek, Tatjana

2016-12-30

Mosquito control in the Zagreb area has been conducted for many years, whereas the fauna has only been investigated in the last 20 years. So far 30 mosquito species have been detected in the city area. Culex pipiens form molestus is the dominant mosquito species in indoor breeding sites. In forested areas and areas exposed to flooding, the active period is early spring and the dominant species are Ochlerotatus sticticus, Ochlerotatus cantans, Ochlerotatus geniculatus and Aedes vexans. The eudominant mosquito species found in the artificial breeding sites are Culex pipiens and the Asian tiger mosquito, Aedes albopictus. Invasive Ae. albopictus, present in the Zagreb area since 2004, has expanded to a larger area of the city during the last three years. The recent emergence of the human West Nile virus and Usutu virus neuroinvasive disease in Zagreb and its surroundings highlighted the role of mosquitoes as vectors of emerging arboviruses. The paper focuses on mosquito species and arboviral infections detected in humans and animals in the Zagreb area, Croatia.

Emerging and potentially emerging viruses in water environments

Directory of Open Access Journals (Sweden)

Giuseppina La Rosa

2012-12-01

Full Text Available Among microorganisms, viruses are best fit to become emerging pathogens since they are able to adapt not only by mutation but also through recombination and reassortment and can thus become able to infect new hosts and to adjust to new environments. Enteric viruses are among the commonest and most hazardous waterborne pathogens, causing both sporadic and outbreak-related illness. The main health effect associated with enteric viruses is gastrointestinal illness, but they can also cause respiratory symptoms, conjunctivitis, hepatitis, central nervous system infections, and chronic diseases. Non-enteric viruses, such as respiratory and epitheliotrophic viruses are not considered waterborne, as they are not readily transmitted to water sources from infected individuals. The present review will focus on viral pathogens shown to be transmitted through water. It will also provide an overview of viruses that had not been a concern for waterborne transmission in the past, but that may represent potentially emerging waterborne pathogens due to their occurrence and persistence in water environments.

Evolutionary ecology of virus emergence.

Science.gov (United States)

Dennehy, John J

2017-02-01

The cross-species transmission of viruses into new host populations, termed virus emergence, is a significant issue in public health, agriculture, wildlife management, and related fields. Virus emergence requires overlap between host populations, alterations in virus genetics to permit infection of new hosts, and adaptation to novel hosts such that between-host transmission is sustainable, all of which are the purview of the fields of ecology and evolution. A firm understanding of the ecology of viruses and how they evolve is required for understanding how and why viruses emerge. In this paper, I address the evolutionary mechanisms of virus emergence and how they relate to virus ecology. I argue that, while virus acquisition of the ability to infect new hosts is not difficult, limited evolutionary trajectories to sustained virus between-host transmission and the combined effects of mutational meltdown, bottlenecking, demographic stochasticity, density dependence, and genetic erosion in ecological sinks limit most emergence events to dead-end spillover infections. Despite the relative rarity of pandemic emerging viruses, the potential of viruses to search evolutionary space and find means to spread epidemically and the consequences of pandemic viruses that do emerge necessitate sustained attention to virus research, surveillance, prophylaxis, and treatment. © 2016 New York Academy of Sciences.

Use of human immunoglobulins as an anti-infective treatment: the experience so far and their possible re-emerging role.

Science.gov (United States)

Bozzo, Jordi; Jorquera, Juan I

2017-06-01

Pooled human immunoglobulins (IGs) are prepared from plasma obtained from healthy donors as a concentrated antibody-containing solution. In addition, high-titer IGs (hyperimmune) against a specific pathogen can be obtained from vaccinated or convalescing donors. Currently, IGs can be used for the treatment of a variety of infections for which no specific therapy exists or that remain difficult to treat. Moreover, the recent pathogen outbreaks for which there is no approved treatment have renewed attention to the role of convalescent plasma and IGs. Areas covered: In this review, a historical perspective of the use of sera and IGs in humans as anti-infective agents (any viral, bacterial, parasitic infection), excluding immunodeficient patients, is presented from early development to the latest clinical studies. A Medline search was conducted to examine the peer-reviewed literature, with no date limits. Expert commentary: Human pooled plasma-derived IG products benefit from the polyclonal response of every individual donor and from the interindividual variability in such response. The trend to increased availability of vaccines for infectious diseases also opens new potential applications of hyperimmune IGs for emerging or re-emerging infectious diseases (e.g.: Ebola, Zika, Dengue), for the prevention and treatment in the general population, healthcare personnel and caregivers.

Clinical Management of Skin and Soft Tissue Infections in the U.S. Emergency Departments

Directory of Open Access Journals (Sweden)

Rakesh D. Mistry

2014-07-01

Full Text Available Introduction: Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA has emerged as the most common cause of skin and soft-tissue infections (SSTI in the United States. A nearly three-fold increase in SSTI visit rates had been documented in the nation’s emergency departments (ED. The objective of this study was to determine characteristics associated with ED performance of incision and drainage (I+D and use of adjuvant antibiotics in the management of skin and soft tissue infections (SSTI. Methods: Cross-sectional study of the National Hospital Ambulatory Medical Care Survey, a nationally representative database of ED visits from 2007-09. Demographics, rates of I+D, and adjuvant antibiotic therapy were described. We used multivariable regression to identify factors independently associated with use of I+D and adjuvant antibiotics. Results: An estimated 6.8 million (95% CI: 5.9-7.8 ED visits for SSTI were derived from 1,806 sampled visits; 17% were for children <18 years of age and most visits were in the South (49%. I+D was performed in 27% (95% CI 24-31 of visits, and was less common in subjects <18 years compared to adults 19-49 years (p<0.001, and more common in the South. Antibiotics were prescribed for 85% of SSTI; there was no relationship to performance of I+D (p=0.72. MRSA-active agents were more frequently prescribed after I+D compared to non-drained lesions (70% versus 56%, p<0.001. After multivariable adjustment, I+D was associated with presentation in the South (OR 2.36; 95% CI 1.52-3.65 compared with Northeast, followed by West (OR 2.13; 1.31-3.45, and Midwest (OR 1.96; 1.96-3.22. Conclusion:Clinical management of most SSTIs in the U.S. involves adjuvant antibiotics, regardless of I+D. Although not necessarily indicated, CA-MRSA effective therapy is being used for drained SSTI. [West J Emerg Med. 2014;15(4:491–498.

Infections and Coinfections of Questing Ixodes ricinus Ticks by Emerging Zoonotic Pathogens in Western Switzerland

Science.gov (United States)

Lommano, Elena; Bertaiola, Luce; Dupasquier, Christèle

2012-01-01

In Europe, Ixodes ricinus is the vector of many pathogens of medical and veterinary relevance, among them Borrelia burgdorferi sensu lato and tick-borne encephalitis virus, which have been the subject of numerous investigations. Less is known about the occurrence of emerging tick-borne pathogens like Rickettsia spp., Babesia spp., “Candidatus Neoehrlichia mikurensis,” and Anaplasma phagocytophilum in questing ticks. In this study, questing nymph and adult I. ricinus ticks were collected at 11 sites located in Western Switzerland. A total of 1,476 ticks were analyzed individually for the simultaneous presence of B. burgdorferi sensu lato, Rickettsia spp., Babesia spp., “Candidatus Neoehrlichia mikurensis,” and A. phagocytophilum. B. burgdorferi sensu lato, Rickettsia spp., and “Candidatus Neoehrlichia mikurensis” were detected in ticks at all sites with global prevalences of 22.5%, 10.2%, and 6.4%, respectively. Babesia- and A. phagocytophilum-infected ticks showed a more restricted geographic distribution, and their prevalences were lower (1.9% and 1.5%, respectively). Species rarely reported in Switzerland, like Borrelia spielmanii, Borrelia lusitaniae, and Rickettsia monacensis, were identified. Infections with more than one pathogenic species, involving mostly Borrelia spp. and Rickettsia helvetica, were detected in 19.6% of infected ticks. Globally, 34.2% of ticks were infected with at least one pathogen. The diversity of tick-borne pathogens detected in I. ricinus in this study and the frequency of coinfections underline the need to take them seriously into consideration when evaluating the risks of infection following a tick bite. PMID:22522688

Lessons learned with molecular methods targeting the BCSP-31 membrane protein for diagnosis of human brucellosis.

Science.gov (United States)

Sanjuan-Jimenez, Rocio; Colmenero, Juan D; Morata, Pilar

2017-06-01

Brucellosis remains an emerging and re-emerging zoonosis worldwide causing high human morbidity. It usually affects persons who are permanently exposed to fastidious microorganisms of the Brucella genus and has a nonspecific clinical picture. Thus, diagnosis of brucellosis can sometimes be difficult. Molecular techniques have recently been found very useful in the diagnosis of brucellosis together with its common and very diverse focal complications. We herein review all the lessons learned by our group concerning the molecular diagnosis of human brucellosis over the last twenty years. The results, initially using one-step conventional PCR, later PCR-ELISA and more recently real-time PCR, using both fluorescent intercalating reagents (SYBR-Green I) and specific probes (Taqman), have shown that these techniques are all much more sensitive than bacteriological methods and more specific than the usual serological techniques for the diagnosis of primary infection, the post-treatment control of the disease, early detection of relapse and the diagnosis of focal complications. Optimization of the technique and improvements introduced over the years show that molecular methods, currently accessible for most clinical laboratories, enable easy rapid diagnosis of brucellosis at the same time as they avoid any risk to laboratory personnel while handling live Brucella spp. Copyright © 2017 Elsevier B.V. All rights reserved.

Emerging souvenirs-clinical presentation of the returning traveller with imported arbovirus infections in Europe.

Science.gov (United States)

Eckerle, I; Briciu, V T; Ergönül, Ö; Lupşe, M; Papa, A; Radulescu, A; Tsiodras, S; Tsitou, C; Drosten, C; Nussenblatt, V R; Reusken, C B; Sigfrid, L A; Beeching, N J

2018-03-01

Arboviruses are an emerging group of viruses that are causing increasing health concerns globally, including in Europe. Clinical presentation usually consists of a nonspecific febrile illness that may be accompanied by rash, arthralgia and arthritis, with or without neurological or haemorrhagic syndromes. The range of differential diagnoses of other infectious and noninfectious aetiologies is broad, presenting a challenge for physicians. While knowledge of the geographical distribution of pathogens and the current epidemiological situation, incubation periods, exposure risk factors and vaccination history can help guide the diagnostic approach, the nonspecific and variable clinical presentation can delay final diagnosis. This narrative review aims to summarize the main clinical and laboratory-based findings of the three most common imported arboviruses in Europe. Evidence is extracted from published literature and clinical expertise of European arbovirus experts. We present three cases that highlight similarities and differences between some of the most common travel-related arboviruses imported to Europe. These include a patient with chikungunya virus infection presenting in Greece, a case of dengue fever in Turkey and a travel-related case of Zika virus infection in Romania. Early diagnosis of travel-imported cases is important to reduce the risk of localized outbreaks of tropical arboviruses such as dengue and chikungunya and the risk of local transmission from body fluids or vertical transmission. Given the global relevance of arboviruses and the continuous risk of (re)emerging arbovirus events, clinicians should be aware of the clinical syndromes of arbovirus fevers and the potential pitfalls in diagnosis. Copyright © 2018. Published by Elsevier Ltd.

Nuclear emergency management: what is new?

International Nuclear Information System (INIS)

Lazo, T.; Mundigl, S.

2003-01-01

Through the use of internationally organised, multinational drills, a wealth of experience and knowledge have been gained at both the national and international levels. The lessons learnt primarily concerned the early, urgent-communication phases of nuclear emergencies, and are currently in the process of being consolidated and incorporated into national structures and approaches. The focus of current works is shifting towards later accident phases, particularly to the mid-term phase, when control has been regained of the emergency situation but the accident consequences have yet to be addressed. In addition to these ''classic'' nuclear emergency response interests, since the 11 september 2001 national authorities have been concerned with accident response capabilities in case of terrorist acts that might involve radiation. (A.L.B.)

The financial turmoil and the lessons from the emerging world ...

International Development Research Centre (IDRC) Digital Library (Canada)

Further, he argues that maintaining growth in emerging economies may be decisive to avoiding the risk of a global ... the same level of hedging against global risks while keeping lower reserves. ... Vietnam seeks optimal size for emerging businesses ... A new report launched by the Global Entrepreneurship Monitor (GEM) ...

Taenia solium Cysticercosis--The lessons of history.

Science.gov (United States)

Del Brutto, Oscar H; García, Héctor H

2015-12-15

Human taeniasis as well as porcine and human cysticercosis--caused by the pork tapeworm Taenia solium--are ancient diseases. The fact that pigs were considered impure in the ancient Greece and that the Koran prohibited the consumption of pork, were likely related to the knowledge that cysticercosis may affect swine. Evidence suggests that human cysticercosis was also present in the ancient Egypt and Rome. During the Renaissance, the causative agent was properly identified and human cases were recognized. Confirmation that both taeniasis and cysticercosis were caused by the same parasite was provided during the 19th Century by German pathologists. During the 20th Century, bouts of human cysticercosis in non-endemic regions left us valuable lessons on the mechanisms of disease acquisition and spread. These included a large series of neurocysticercosis cases in the United Kingdom that occurred after the return of troops stationed in India (which demonstrated that symptoms may occur years after infection), the epidemic of cysticercosis-related epilepsy in the Ekari people of Papua New Guinea occurring after the gift of pigs with cysticercosis received from Indonesia (demonstrating the fast establishment of endemic transmission and the impact of cysticercosis in epilepsy frequency), and the occurrence of neurocysticercosis among members of an Orthodox Jewish community of New York City, related to Latin American Taenia carriers working in their houses (highlighting the fact that cysticercosis transmission do not require the presence of infected pigs). These lessons of history have significantly contributed to our current knowledge on this disease. Copyright © 2015 Elsevier B.V. All rights reserved.

Dermatologic challenges of health care for displaced people. lessons from a German emergency refugee camp

Directory of Open Access Journals (Sweden)

Uwe Wollina

2016-04-01

Full Text Available Background: The World faces the highest waves of displaced people since World War II. There is limited knowledge about need of dermatological care for refugees and asylum seekers. Methods: We report the experience with a temporary emergency refugee camp in Dresden form the viewpoint of a hospital department. This is a descriptive report covering the period of 10 weeks. Results: In this refugee camp up to 1 100 people were hosted. The male to female ratio was 5.3. The majority of inhabitants were young males (60%, 20% were children. While 40% of refuges came from Syria, Afghanistan, Iraq and Pakistan were also important countries of origin. Communication war a crucial issue while providing health care. Dermatologic service was granted as consultation, outpatient and inpatient clinic. Most contacts were noted in the outpatient clinic. The majority of patient attended the clinic with communicable diseases such as bacterial or viral infections and infestations. Wounds and chronic inflammatory diseases were rather uncommon. Only 4 patients had to be treated in the hospital (inpatient clinic. Conclusions: Displaced people (refugees, asylum seekers come in big waves to Europe. Dermatologic service is an important part of first aid health care in an emergency camp. Language barriers and cultural barriers have to overcome for optimal service. This is the first report from Germany.

Feline Immunodeficiency Virus Cross-Species Transmission: Implications for Emergence of New Lentiviral Infections.

Science.gov (United States)

Lee, Justin; Malmberg, Jennifer L; Wood, Britta A; Hladky, Sahaja; Troyer, Ryan; Roelke, Melody; Cunningham, Mark; McBride, Roy; Vickers, Winston; Boyce, Walter; Boydston, Erin; Serieys, Laurel; Riley, Seth; Crooks, Kevin; VandeWoude, Sue

2017-03-01

Owing to a complex history of host-parasite coevolution, lentiviruses exhibit a high degree of species specificity. Given the well-documented viral archeology of human immunodeficiency virus (HIV) emergence following human exposures to simian immunodeficiency virus (SIV), an understanding of processes that promote successful cross-species lentiviral transmissions is highly relevant. We previously reported natural cross-species transmission of a subtype of feline immunodeficiency virus, puma lentivirus A (PLVA), between bobcats ( Lynx rufus ) and mountain lions ( Puma concolor ) for a small number of animals in California and Florida. In this study, we investigate host-specific selection pressures, within-host viral fitness, and inter- versus intraspecies transmission patterns among a larger collection of PLV isolates from free-ranging bobcats and mountain lions. Analyses of proviral and viral RNA levels demonstrate that PLVA fitness is severely restricted in mountain lions compared to that in bobcats. We document evidence of diversifying selection in three of six PLVA genomes from mountain lions, but we did not detect selection among 20 PLVA isolates from bobcats. These findings support the hypothesis that PLVA is a bobcat-adapted virus which is less fit in mountain lions and under intense selection pressure in the novel host. Ancestral reconstruction of transmission events reveals that intraspecific PLVA transmission has occurred among panthers ( Puma concolor coryi ) in Florida following the initial cross-species infection from bobcats. In contrast, interspecific transmission from bobcats to mountain lions predominates in California. These findings document outcomes of cross-species lentiviral transmission events among felids that compare to the emergence of HIV from nonhuman primates. IMPORTANCE Cross-species transmission episodes can be singular, dead-end events or can result in viral replication and spread in the new species. The factors that determine which

Lessons from emergency laparotomy for abdominal tuberculosis in ...

African Journals Online (AJOL)

Committee and the Biomedical Research Ethics Committee of the. University of ... A prospective audit of all patients with abdominal TB undergoing emergency laparotomy was conducted. .... support or proceed to a laparotomy with its attendant risks. ... surgical management of intestinal tuberculosis at tertiary care hospital.

Laboratory biosafety for handling emerging viruses

Directory of Open Access Journals (Sweden)

I. Made Artika

2017-05-01

Full Text Available Emerging viruses are viruses whose occurrence has risen within the past twenty years, or whose presence is likely to increase in the near future. Diseases caused by emerging viruses are a major threat to global public health. In spite of greater awareness of safety and containment procedures, the handling of pathogenic viruses remains a likely source of infection, and mortality, among laboratory workers. There is a steady increase in both the number of laboratories and scientist handling emerging viruses for diagnostics and research. The potential for harm associated to work with these infectious agents can be minimized through the application of sound biosafety concepts and practices. The main factors to the prevention of laboratory-acquired infection are well-trained personnel who are knowledgable and biohazard aware, who are perceptive of the various ways of transmission, and who are professional in safe laboratory practice management. In addition, we should emphasize that appropriate facilities, practices and procedures are to be used by the laboratory workers for the handling of emerging viruses in a safe and secure manner. This review is aimed at providing researchers and laboratory personnel with basic biosafety principles to protect themselves from exposure to emerging viruses while working in the laboratory. This paper focuses on what emerging viruses are, why emerging viruses can cause laboratory-acquired infection, how to assess the risk of working with emerging viruses, and how laboratory-acquired infection can be prevented. Control measures used in the laboratory designed as such that they protect workers from emerging viruses and safeguard the public through the safe disposal of infectious wastes are also addressed.

Selected emerging infectious diseases of squamata.

Science.gov (United States)

Latney, La'toya V; Wellehan, James

2013-05-01

It is important that reptile clinicians have an appreciation for the epidemiology, clinical signs, pathology, diagnostic options, and prognostic parameters for novel and emerging infectious diseases in squamates. This article provides an update on emerging squamate diseases reported in the primary literature within the past decade. Updates on adenovirus, iridovirus, rhabdovirus, arenavirus, and paramyxovirus epidemiology, divergence, and host fidelity are presented. A new emerging bacterial disease of Uromastyx species, Devriesea agamarum, is reviewed. Chrysosporium ophiodiicola-associated mortality in North American snakes is discussed. Cryptosporidium and pentastomid infections in squamates are highlighted among emerging parasitic infections. Copyright © 2013 Elsevier Inc. All rights reserved.

Use of Pneumococcal Disease Epidemiology to Set Policy and Prevent Disease during 20 Years of the Emerging Infections Program.

Science.gov (United States)

Moore, Matthew R; Whitney, Cynthia G

2015-09-01

Two decades ago, the Emerging Infections Program of the US Centers for Disease Control and Prevention implemented what seemed like a simple yet novel idea: a population- and laboratory-based surveillance system designed to identify and characterize invasive bacterial infections, including those caused by Streptococcus pneumoniae. This system, known as Active Bacterial Core surveillance, has since served as a flexible platform for following trends in invasive pneumococcal disease and studying vaccination as the most effective method for prevention. We report the contributions of Active Bacterial Core surveillance to every pneumococcal vaccine policy decision in the United States during the past 20 years.

Hantaviruses as emergent zoonoses

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LS Ullmann

2008-01-01

Full Text Available Hantaviruses belong to the Bunyaviridae family, which consists of vector-borne viruses. These viruses can provoke two infection types: hemorrhagic fever with renal syndrome (HFRS - which occurs in the Old World - and hantavirus cardiopulmonary syndrome (HCPS - an emergent zoonosis that can be found in many countries of the western hemisphere. Rodents are hantavirus reservoirs and each species seems to host a different virus type. Humans acquire the infection by inhaling contaminated aerosol particles eliminated by infected animals. The factors involved in the emergence of hantavirus infections in the human population include ecological modifications and changes in human activities. The most important risk factor is contact between man and rodents, as a result of agricultural, forestry or military activities. Rodent control remains the primary strategy for preventing hantavirus diseases, including via health education and hygienic habits.

Consequence Management and International Nuclear Emergency Exercises: Lessons from INEX 3

International Nuclear Information System (INIS)

Wim Molhoek; Vince McClelland; Amanda Stegen; Brian Ahier; Ted Lazo

2006-01-01

The OECD Nuclear Energy Agency (Nea) has a long tradition of expertise in the area of nuclear emergency policy, preparedness, and management. The 1986 Chernobyl accident demonstrated that nuclear accidents may have consequences over wide areas, highlighting the need for international cooperation, coordination and communication. From the beginning, the Nea focus of work, as carried out by the Working Party on Nuclear Emergency Matters, has been on improving the effectiveness of international nuclear emergency preparedness and management. A major pillar of this work has been the preparation and organisation of the International Nuclear Emergency Exercise (I.N.E.X.) series. Beginning in 1993, the Nea I.N.E.X. series has proved successful in testing and developing arrangements for nuclear emergency response. The I.N.E.X.-1,-2 and -2000 series, which focussed on the early-phase of an emergency, provided a unique forum for testing existing as well as new arrangements and concepts for international nuclear emergency management, and succeeded in establishing a recognised international nuclear emergency exercise culture. In response to international interest in the longer term consequence management issues that will arise after an emergency, the Nea developed a third generation of exercises, I.N.E.X. 3. The I.N.E.X. 3 series of national level table-top exercises focused on the response to widespread radiological contamination of the environment and the issues likely to be raised in the medium to longer term period after such an event. Exercise objectives included an investigation of decisions on agricultural countermeasures and food restrictions, countermeasures such as travel and trade, recovery management and public information. The evaluation aimed to identify aspects of national decision-making which would benefit from international co-ordination, compare national approaches and identify 'best' practices in these circumstances. An International Evaluation Workshop will

Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature

Directory of Open Access Journals (Sweden)

Piseth Seng

2016-04-01

Conclusions: R. ornithinolytica is an underreported, emerging hospital-acquired infection and is particularly associated with invasive procedures. R. ornithinolytica should never be considered simply a saprophytic bacterium that occasionally contaminates bronchial lavage or other deep respiratory samples or surgical sites. Physicians should be aware of the high rates of antimicrobial resistance of R. ornithinolytica isolates so that immediate broad-spectrum antibiotic treatment can be established before accurate microbiological results are obtained.

Defining a risk-informed framework for whole-of-government lessons learned: A Canadian perspective.

Science.gov (United States)

Friesen, Shaye K; Kelsey, Shelley; Legere, J A Jim

Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations. The Canadian Safety and Security Program recently supported a project to define a comprehensive framework that would allow public safety and security partners to regularly share event response best practices, and prioritize recommendations originating from after action reviews. This framework consists of several inter-locking elements: a comprehensive literature review/environmental scan of international programs; a survey to collect data from end users and management; the development of a taxonomy for organizing and structuring information; a risk-informed methodology for selecting, prioritizing, and following through on recommendations; and standardized templates and tools for tracking recommendations and ensuring implementation. This article discusses the efforts of the project team, which provided "best practice" advice and analytical support to ensure that a systematic approach to lessons learned was taken by the federal community to improve prevention, preparedness, and response activities. It posits an approach by which one might design a systematic process for information sharing and event response coordination-an approach that will assist federal departments to institutionalize a cross-government lessons learned program.

Learning Lessons from TMI to Fukushima and Other Industrial Accidents: Keys for Assessing Safety Management Practices

International Nuclear Information System (INIS)

Dechy, N.; Rousseau, J.-M.; Dien, Y.; Montmayeul, R.; Llory, M.

2016-01-01

The main objective of the paper is to discuss and to argue about transfer, from an industrial sector to another industrial sector, of lessons learnt from accidents. It will be achieved through the discussion of some theoretical foundations and through the illustration of examples of application cases in assessment of safety management practices in Nuclear Power Plant (NPP). The nuclear energy production industry has faced three big ones in 30 years (TMI, Chernobyl, Fukushima) involving three different reactor technologies operated in three quite different cultural, organizational and regulatory contexts. Each of those accident has been the origin of questions, but also generator of lessons, some changing the worldview (see Wilpert and Fahlbruch, 1998) of what does cause an accident in addition to the engineering view about the importance of technical failures (human error, safety culture, sociotechnical interactions). Some of their main lessons were implemented such as improvements of human-machine interfaces ergonomics, recast of some emergency operating procedures, severe accident mitigation strategies and crisis management. Some lessons did not really provide deep changes. It is the case for organizational lessons such as, organizational complexity, management of production pressures, regulatory capture, and failure to learn, etc.

Lessons learned from community-based approaches to sodium reduction.

Science.gov (United States)

Kane, Heather; Strazza, Karen; Losby, Jan L; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S; Frost, Corey; Margolis, Marjorie; Hersey, James

2015-01-01

This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. A multiple case study design was used. This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. The project team conducted a document review of program materials and semistructured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption.

Lessons learned during the successful eradication of bovine tuberculosis from Australia

Science.gov (United States)

More, S. J.; Radunz, B.; Glanville, R. J.

2015-01-01

There are very few international examples of the successful eradication of bovine tuberculosis (TB, caused by infection with Mycobacterium bovis) from a national cattle population. This paper presents a brief overview of the successful TB eradication programme in Australia from 1970, with primary emphasis on lessons of international relevance that were learned from the Australian experience. The national brucellosis and tuberculosis eradication campaign ran for 27 years from 1970 to 1997 and has been followed by ongoing abattoir surveillance. Rapid progress towards eradication was made in southern Australia, but proved much more challenging in extensive pastoral areas of northern Australia. Declaration of TB freedom was made on December 31, 1997. A range of factors were critical to this success, including a compelling rationale for eradication, an agreed final outcome, industry commitment and financial support, a business model for programme planning, implementation and review, consistent and transparent technical standards underpinned by a strict regulatory regime and applied research, the critical role of abattoir surveillance, effective elimination of residual infection and objective measures of programme progress. Although direct translation of some of these experiences may not be possible, many of the lessons learned from the Australian experience may be relevant to other countries. PMID:26338937

Best Practices in Wireless Emergency Alerts

Science.gov (United States)

2014-02-01

S. & Sorenson, John H. Communication of Emergency Public Warnings: A Social Science Perspective and State-of-the Art Assessment. Oak Ridge National...that reduces the likelihood of loss of life can be valued through actuarial processes but also has value for which there is no accounting. While...in its use and adoption. A computer science professor at the University of California–Berkeley describes one of the lessons learned from this

Infection control during filoviral hemorrhagic fever outbreaks

Directory of Open Access Journals (Sweden)

N Raabe Vanessa

2012-01-01

Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

When ageing and disasters collide: Lessons from 16 international case studies

International Nuclear Information System (INIS)

Powell, S.; Plouffe, L.; Gorr, P.

2009-01-01

Sixteen case studies examined the impact of various natural disasters and conflict-related emergencies on older people, the strengths and gaps in emergency planning, response and recovery, and the contributions older people made to their families and communities. Case examples were chosen from both developed and developing countries. Older persons suffered disproportionate impacts in several cases. Regardless of the country's level of prosperity, those most affected tended to be economically disadvantaged, disabled or frail, women, socially isolated, or caregivers of family members. Emergency responders were often not aware of distinct needs or abilities of older persons and not equipped to respond appropriately. The best emergency practices recognised and included specific needs within mainstream efforts and integrated older persons in community planning, response and recovery activities. This paper presents the 'lessons learned' from these case studies and makes the case for greater attention to this segment of the population in emergency management. (authors)

Emergence of a novel subpopulation of CC398 Staphylococcus aureus infecting animals is a serious hazard for humans

Directory of Open Access Journals (Sweden)

Nathalie Laure Van Der Mee-Marquet

2014-12-01

Full Text Available Until recently, Staphylococcus aureus from clonal complex (CC398 were mostly described as colonizing asymptomatic raised pigs and pig-farmers. Currently, the epidemiology of the CC398 lineage is becoming more complex. CC398 human-adapted isolates are increasingly being identified in bloodstream infections in humans living in animal-free environments. In addition, CC398 isolates are increasingly responsible for invasive infections in various animals. CC398 isolates that colonize asymptomatic pigs and the isolates that infect humans living in animal-free environments (human-adapted isolates both lack several clinically important S. aureus–associated virulence factors but differ on the basis of their prophage content. Recent findings have provided insight into the influence of a φMR11-like helper prophage on the ability of CC398 isolates to infect humans. To assess the recent spread of the CC398 lineage to various animal species and to investigate the links between the φMR11-like prophage and the emergence of CC398 isolates infecting animals, we studied 277 isolates causing infections in unrelated animals. The prevalence of CC398 isolates increased significantly between 2007 and 2013 (p<0.001; 31.8 % of the animal isolates harbored the φMR11-like prophage. High-density DNA microarray experiments with 37 representative infected-animal isolates positive for φMR11-like DNA established that most infected-animal isolates carried many genetic elements related to antimicrobial resistance and virulence genes, and a φ3 prophage encoding immune-modulating proteins and associated with animal-to-human jumps. Our findings suggest recent clonal expansion and dissemination of a new subpopulation of CC398 isolates, responsible for invasive infections in various animals, with a considerable potential to colonize and infect humans, probably greater than that of human-adapted CC398 isolates, justifying active surveillance.

Emergency Physicians at War.

Science.gov (United States)

Muck, Andrew E; Givens, Melissa; Bebarta, Vikhyat S; Mason, Phillip E; Goolsby, Craig

2018-05-01

Operation Enduring Freedom (OEF-A) in Afghanistan and Operation Iraqi Freedom (OIF) represent the first major, sustained wars in which emergency physicians (EPs) fully participated as an integrated part of the military's health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM) training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units. EPs have brought their combat experience home to civilian practice. This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

An Analysis of Emergency Healthcare Delivery in Ghana: Lessons ...

African Journals Online (AJOL)

Ghana medical emergencies usually result from road traffic accidents, during which ..... electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices and trauma care.

Strategy for developing and conducting nuclear emergency exercises

International Nuclear Information System (INIS)

2007-01-01

Emergency situations demand that actions be taken by responsible organisations and individuals at the site of the emergency and at the local, national and international levels to mitigate the impact on people and the environment. Effective emergency response requires development and implementation of emergency plans and procedures; established arrangements at the local, national and international levels; acquisition and maintenance of resources (funding, equipment and personnel); training of personnel; conduct of exercises; and a 'feedback programme' whereby improvements to the emergency management system are made based on lessons identified from exercises and actual events. A means for demonstrating the effectiveness of an emergency programme is through the conduct of exercises. Exercises demonstrate the effectiveness of plans, procedures, training and equipment; adequacy of response arrangements and resources; capabilities of response personnel in performing their assigned tasks; ability of individuals and organisations to work together; and provide a forum for exploring and testing revisions, modifications, and new and/or proposed changes to any emergency programme element in near realistic situations. Exercises may range in scope from small-scale drills to large-scale national or international exercises. There is clear benefit to organisations in supporting, developing and conducting well-managed exercises. Exercising is a resource-intensive tool; however, it is a critical tool for enhancing performance, testing arrangements and identifying areas for improvement. A thoroughly developed strategy should therefore be in place to ensure maximum value from an exercise programme. This report contributes to the good practice and management of exercise programmes by providing a strategy for improving the value of planning, conducting, participating in and/or supporting exercises. The OECD/NEA International Nuclear Emergency Exercise (INEX) series undertaken over the

The Emergence of Hospital Accreditation Programs in East Africa: Lessons from Uganda, Kenya, and Tanzania

Directory of Open Access Journals (Sweden)

Jeffrey Lane

2014-01-01

Full Text Available The objective of this manuscript was to examine existing hospital accreditation systems in three East African countries (Uganda, Kenya and Tanzania, assess attitudes and opinions of key stakeholders regarding hospital accreditation systems in the region, and identify lessons regarding sustainable and effective implementation of hospital accreditation systems in resource-limited countries. National hospital accreditation systems were found in Kenya and Tanzania. Uganda’s accreditation system, known as Yellow Star, had been suspended. Attitudes and opinions of key stakeholders almost unanimously supported the idea of establishing new national hospital accreditation programs, but opinions differed regarding whether that system should be operated by the government or a private independent organization. Our analysis supports the following lessons regarding accreditation systems in the region: (1 self-funding mechanisms are critical to long-term success; (2 external assessments occurred more frequently in our focus countries than accreditation systems in developed countries; (3 Kenya has established framework for providing financial incentives to highly performing hospitals, but these links need to be strengthened; and (4 automatic accreditation of governmental health facilities in Kenya and Tanzania illustrate the potential hazard of public authorities overseeing accreditation programs.

The Emergence of Hospital Accreditation Programs in East Africa: Lessons from Uganda, Kenya, and Tanzania

Directory of Open Access Journals (Sweden)

Jeffrey Lane

2014-03-01

Full Text Available The objective of this manuscript was to examine existing hospital accreditation systems in three East African countries (Uganda, Kenya and Tanzania, assess attitudes and opinions of key stakeholders regarding hospital accreditation systems in the region, and identify lessons regarding sustainable and effective implementation of hospital accreditation systems in resource-limited countries. National hospital accreditation systems were found in Kenya and Tanzania. Uganda’s accreditation system, known as Yellow Star, had been suspended. Attitudes and opinions of key stakeholders almost unanimously supported the idea of establishing new national hospital accreditation programs, but opinions differed regarding whether that system should be operated by the government or a private independent organization. Our analysis supports the following lessons regarding accreditation systems in the region: (1 self--‐funding mechanisms are critical to long-term success; (2 external assessments occurred more frequently in our focus countries than accreditation systems in developed countries; (3 Kenya has established framework for providing financial incentives to highly performing hospitals, but these links need to be strengthened; and (4 automatic accreditation of governmental health facilities in Kenya and Tanzania illustrate the potential hazard of public authorities overseeing accreditation programs.

Deep organ space infection after emergency bowel resection and anastomosis: The anatomic site does not matter.

Science.gov (United States)

Benjamin, Elizabeth; Siboni, Stefano; Haltmeier, Tobias; Inaba, Kenji; Lam, Lydia; Demetriades, Demetrios

2015-11-01

Deep organ space infection (DOSI) is a serious complication after emergency bowel resection and anastomosis. The aim of this study was to identify the incidence and risk factors for the development of DOSI. National Surgical Quality Improvement Program database study including patients who underwent large bowel or small bowel resection and primary anastomosis. The incidence, outcomes, and risk factors for DOSI were evaluated using univariate and multivariate analyses. A total of 87,562 patients underwent small bowel, large bowel, or rectal resection and anastomosis. Of these, 14,942 (17.1%) underwent emergency operations and formed the study population. The overall mortality rate in emergency operations was 12.5%, and the rate of DOSI was 5.6%. A total of 18.0% required ventilatory support in more than 48 hours, and 16.0% required reoperation. Predictors of DOSI included age, steroid use, sepsis or septic shock on admission, severe wound contamination, and advanced American Society of Anesthesiologists classification. The anatomic location of resection and anastomosis was not significantly associated with DOSI. Patients undergoing emergency bowel resection and anastomosis have a high mortality, risk of DOSI, and systemic complications. Independent predictors of DOSI include wound and American Society of Anesthesiologists classification, sepsis or septic shock on admission, and steroid use. The anatomic location of resection and anastomosis was not significantly associated with DOSI. Epidemiologic/prognostic study, level III.

Emergency preparedness in obstetrics.

Science.gov (United States)

Haeri, Sina; Marcozzi, David

2015-04-01

During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future.

Classroom Management and Lesson Planning(4)

Institute of Scientific and Technical Information of China (English)

2006-01-01

Lesson PlanningTask 1As teachers,we all need to plan our lessons before we teach.Make a list of things that you think need tobe included in a lesson plan.Then compare and discuss your list with another teacher.Also think about reasonswhy we need to plan our lessons.

Lesson study: Professional development and its impact on science teacher self-efficacy

Science.gov (United States)

Roberts, Megan Rae

This study focuses on an analysis of a professional development program known as lesson study via data obtained during an in-service professional development program for secondary school science teachers. The purpose of this study was to examine the self-efficacy beliefs of one group of science teachers related to their experiences in a lesson study. Another purpose for this research, aligned with the first, included a theoretical analysis of the lesson study construct to see if its design promoted positive self-efficacy beliefs of its participants. The research is framed within the context of social constructivism and self-efficacy and is qualitative in nature and utilized descriptive analysis as a means of research. Case studies were conducted detailing two of the six participants. Data sources included researcher field notes and transcriptions of all planning and debriefing sessions; individual interviews with each participant and the schools' principal; a participant questionnaire, and the Science Teaching Efficacy Belief Instrument. Themes that emerged included the positive perceptions of lesson study as a collaborative and teacher-centered experience; the understanding that lesson study can instill a sense of professionalism to those who participate in the process; the sense that discussing student learning using objective observations from classroom is a powerful way to assess learning and uncover personal teacher beliefs; and the insight that the time commitment that lesson study requires can inhibit teachers and schools from sustaining it as a form of on-going professional development. Although these themes are consistent with the research on lesson study in Japan and elsewhere in the United States, they also extend the research on self-efficacy and science teacher professional development. In the end, this study supported some of the conclusions of the self-efficacy research as it relates to professional development while also adding that interpersonal

Constellation Program Lessons Learned. Volume 2; Detailed Lessons Learned

Science.gov (United States)

Rhatigan, Jennifer; Neubek, Deborah J.; Thomas, L. Dale

2011-01-01

These lessons learned are part of a suite of hardware, software, test results, designs, knowledge base, and documentation that comprises the legacy of the Constellation Program. The context, summary information, and lessons learned are presented in a factual format, as known and described at the time. While our opinions might be discernable in the context, we have avoided all but factually sustainable statements. Statements should not be viewed as being either positive or negative; their value lies in what we did and what we learned that is worthy of passing on. The lessons include both "dos" and "don ts." In many cases, one person s "do" can be viewed as another person s "don t"; therefore, we have attempted to capture both perspectives when applicable and useful. While Volume I summarizes the views of those who managed the program, this Volume II encompasses the views at the working level, describing how the program challenges manifested in day-to-day activities. Here we see themes that were perhaps hinted at, but not completely addressed, in Volume I: unintended consequences of policies that worked well at higher levels but lacked proper implementation at the working level; long-term effects of the "generation gap" in human space flight development, the need to demonstrate early successes at the expense of thorough planning, and the consequences of problems and challenges not yet addressed because other problems and challenges were more immediate or manifest. Not all lessons learned have the benefit of being operationally vetted, since the program was cancelled shortly after Preliminary Design Review. We avoid making statements about operational consequences (with the exception of testing and test flights that did occur), but we do attempt to provide insight into how operational thinking influenced design and testing. The lessons have been formatted with a description, along with supporting information, a succinct statement of the lesson learned, and

Classroom Management and Lesson Planning(4)

Institute of Scientific and Technical Information of China (English)

2006-01-01

@@ Lesson Planning Task 1 As teachers,we all need to plan our lessons before we teach.Make a list of things that you think need to be included in a lesson plan.Then compare and discuss your list with another teacher.Also think about reasons why we need to plan our lessons.

Cyprinid herpesvirus 2 infection emerged in cultured gibel carp, Carassius auratus gibelio in China.

Science.gov (United States)

Xu, Jin; Zeng, Lingbing; Zhang, Hui; Zhou, Yong; Ma, Jie; Fan, Yuding

2013-09-27

An epizootic with severe mortality has emerged in cultured gibel carp, Carassius auratus gibelio, in China since 2009, and caused huge economic loss. The signs and epidemiology background of the disease were investigated. Parasite examination, bacteria and virus isolation were carried out for pathogen isolation. The causative pathogen was obtained and identified as Cyprinid herpesvirus 2 (CyHV-2) by experimental infection, electron microscopy, cell culture, PCR assay and sequence alignment, designated as CyHV-2-JSSY. Experimental infection proved the high virulence of CyHV-2-JSSY to healthy gibel carp. Electron microscopy revealed that the viral nucleocapsid was hexagonal in shape measuring 110-120 nm in diameter with a 170-200 nm envelope. The virus caused significant CPE in Koi-Fin cells at the early passages, but not beyond the fifth passages. Sequence alignment of the partial viral helicase gene (JX566884) showed that it shared 99-100% identity to the published sequences of other CyHV-2 isolates. This study represented the first isolation and identification of CyHV-2 in cultured gibel carp in China and laid a foundation for the further studies of the disease. Copyright © 2013 Elsevier B.V. All rights reserved.

Lesson Planning the Kodaly Way.

Science.gov (United States)

Boshkoff, Ruth

1991-01-01

Discusses the contribution of Zoltan Kodaly to music lesson planning. Emphasizes preparation, presentation, and practice as the three important strategies in teaching concepts and skills to be included in a lesson plan. Includes a sample lesson plan covering a semester and advice on choosing song material. (DK)

Lessons Learned From Community-Based Approaches to Sodium Reduction

Science.gov (United States)

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

Enhancing private sector engagement: Louisiana's business emergency operations centre.

Science.gov (United States)

Day, Jamison M; Strother, Shannon; Kolluru, Ramesh; Booth, Joseph; Rawls, Jason; Calderon, Andres

2010-07-01

Public sector emergency management is more effective when it coordinates its efforts with private sector companies that can provide useful capabilities faster, cheaper and better than government agencies. A business emergency operations centre (EOC) provides a space for private sector and non-governmental organisations to gather together in support of government efforts. This paper reviews business-related EOC practices in multiple US states and details the development of a new business EOC by the State of Louisiana, including lessons learned in response to the May 2010 oil spill.

Lesson Learned from the Recent Operating Experience of Domestic Nuclear Power Plants

International Nuclear Information System (INIS)

Lee, Chang-Ju; Kim, Min-Chull; Koo, Bon-Hyun; Kim, Sang-Jae; Lee, Kyung-Won; Kim, Ji-Tae; Lee, Durk-Hun

2007-01-01

According to the public concerns, it seems that one of the main missions of a nuclear regulatory body is to collect operational experiences from various nuclear facilities, and to analyze their follow-up information. The extensive use of lessons learned from operating experiences to back fit safety systems, improve operator training and emergency procedures, and to focus more attention on human factors, safety culture and quality management systems are also desired. Collecting operational experiences has been mainly done regarding the incidents and major failures of components (so called 'event'), which usually demands lots of regulatory resources. This paper concentrates on new information, i.e. lesson learned from recent investigation results of domestic events which contain 5 years' experience. This information can induce many insights for improving operational safety of nuclear power plants (NPPs)

Emergency Physicians at War

Directory of Open Access Journals (Sweden)

Melissa Givens

2018-03-01

Full Text Available Operation Enduring Freedom (OEF-A in Afghanistan and Operation Iraqi Freedom (OIF represent the first major, sustained wars in which emergency physicians (EPs fully participated as an integrated part of the military’s health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units. EPs have brought their combat experience home to civilian practice. This narrative review summarizes the history, contributions, and lessons learned by EPs during OEF-A/OIF and describes changes to daily clinical practice of EM derived from the combat environment.

Emerging monoclonal antibodies against Clostridium difficile infection.

Science.gov (United States)

Péchiné, Séverine; Janoir, Claire; Collignon, Anne

2017-04-01

Clostridium difficile infections are characterized by a high recurrence rate despite antibiotic treatments and there is an urgent need to develop new treatments such as fecal transplantation and immonotherapy. Besides active immunotherapy with vaccines, passive immunotherapy has shown promise, especially with monoclonal antibodies. Areas covered: Herein, the authors review the different assays performed with monoclonal antibodies against C. difficile toxins and surface proteins to treat or prevent primary or recurrent episodes of C. difficile infection in animal models and in clinical trials as well. Notably, the authors lay emphasis on the phase III clinical trial (MODIFY II), which allowed bezlotoxumab to be approved by the Food and Drug Administration and the European Medicines Agency. They also review new strategies for producing single domain antibodies and nanobodies against C. difficile and new approaches to deliver them in the digestive tract. Expert opinion: Only two human Mabs against TcdA and TcdB have been tested alone or in combination in clinical trials. However, many animal model studies have provided rationale for the use of Mabs and nanobodies in C. difficile infection and pave the way for further clinical investigation.

Analysing the integration of engineering in science lessons with the Engineering-Infused Lesson Rubric

Science.gov (United States)

Peterman, Karen; Daugherty, Jenny L.; Custer, Rodney L.; Ross, Julia M.

2017-09-01

Science teachers are being called on to incorporate engineering practices into their classrooms. This study explores whether the Engineering-Infused Lesson Rubric, a new rubric designed to target best practices in engineering education, could be used to evaluate the extent to which engineering is infused into online science lessons. Eighty lessons were selected at random from three online repositories, and coded with the rubric. Overall results documented the strengths of existing lessons, as well as many components that teachers might strengthen. In addition, a subset of characteristics was found to distinguish lessons with the highest level of engineering infusion. Findings are discussed in relation to the potential of the rubric to help teachers use research evidence-informed practice generally, and in relation to the new content demands of the U.S. Next Generation Science Standards, in particular.

With Interest It Comes To...Unconscionable Clauses in Sales Contracts. A Student's Lesson Plan [and] A Teacher's Lesson Plan [and] A Lawyer's Lesson Plan.

Science.gov (United States)

Howard, Estelle; And Others

One of a series of secondary level teaching units presenting case studies with pro and con analysis of particular legal problems, the document presents a student's lesson plan, a teacher's lesson plan, and a lawyer's lesson plan on unconscionable clauses in sales contracts. The unit acquaints students with the operation of sales contracts and…

C-reactive protein velocity to distinguish febrile bacterial infections from non-bacterial febrile illnesses in the emergency department

OpenAIRE

Paran, Yael; Yablecovitch, Doron; Choshen, Guy; Zeitlin, Ina; Rogowski, Ori; Ben-Ami, Ronen; Katzir, Michal; Saranga, Hila; Rosenzweig, Tovit; Justo, Dan; Orbach, Yaffa; Halpern, Pinhas; Berliner, Shlomo

2009-01-01

Introduction C-reactive protein (CRP) is a real-time and low-cost biomarker to distinguish febrile bacterial infections from non-bacterial febrile illnesses. We hypothesised that measuring the velocity of the biomarker instead of its absolute serum concentration could enhance its ability to differentiate between these two conditions. Methods We prospectively recruited adult patients (age ? 18 years) who presented to the emergency department with fever. We recorded their data regarding the ons...

Linking Effectively: Learning Lessons from Successful Collaboration in Science and Technology

National Research Council Canada - National Science Library

Wagner, Caroline S

2002-01-01

.... It is presented in a format that draws lessons from the case studies and then presents key questions that emerged from the cases that can serve as a guide to others seeking to formulate similar collaborative programs. The first section discusses the growing role that international collaboration is playing in science and technology (S&T). Here we also discuss the case study methodology used for this study. The second section presents a framework of.

Lessons learned related to packaging and transportation

International Nuclear Information System (INIS)

Wallen, C.

1995-01-01

The use of lessons learned as a tool for learning from past experiences is well established, especially by many organizations within the nuclear industry. Every person has, at some time, used the principles of lessons learned to adopt good work practices based on their own experiences or the experiences of others. Lessons learned can also help to avoid the recurrence of adverse practices, which is often an area that most lessons-learned programs tend to focus on. This paper will discuss how lessons learned relate to packaging and transportation issues and events experienced at Department of Energy (DOE) facilities. It will also discuss the role performed by the Office of Nuclear and Facility Safety's Office of Operating Experience Analysis and Feedback in disseminating lessons learned and operating experience feedback to the DOE complex. The central concept of lessons learned is that any organization should be able to learn from its own experiences and events. In addition, organizations should implement methodologies to scan external environments for lessons learned, to analyze and determine the relevance of lessons learned, and to bring about the necessary changes learned from these experiences. With increased concerns toward facility safety, the importance of utilizing the lessons-learned principles and the establishment of lessons-learned programs can not be overstated

EXPLORING HEALTHCARE-ASSOCIATED INFECTIONS: KNOWLEDGE, ATTITUDE, AND BEHAVIOR OF EMERGENCY NURSES WORKING IN BANDUNG, INDONESIA

Directory of Open Access Journals (Sweden)

Hudzaifah Al Fatih

2016-10-01

Full Text Available Background: Healthcare associated Infections (HAIs is considered being the most serious patient safety issue in health care settings and nurses in Emergency Department (ED face greater risk of exposure to infectious pathogens. Objective: The objectives of this study were to examine knowledge, attitude and behavior towards HAIs of Indonesian nurses working in ED and to examine the relationship among the above three variables. Method: A cross-sectional study with self-reported survey was conducted at four hospitals in Bandung, Indonesia. The Healthcare Associated Infections Survey consisting of four domains: demographic characteristics, knowledge, attitude and behavior related to HAIs was used. The participants of this study covered 115 nurses. Results: The mean of overall performance on the knowledge was good 21.23 ±5.173 (range 9-30 and 92.2% of them believed that guideline for HAIs control practice can reduced the risk of infections. The mean score for behavior when practicing infection control was 37.7±5.570 (26-50. Marital status and working hours per week, influenced nurses’ knowledge of HAIs (rs = 0.185, p = 0.048. Work experienced have negative correlation with attitude towards HAIs (rs = -0.196, p = 0.035. Furthermore, type of hospital and working hours per week have been associated with nurses’ behavior towards HAIs (r = 0.191, p = 0.04. There were no significant relationship between knowledge, attitude and behavior towards HAIs. Conclusion: Even though the majority of ED nurses in Indonesia believe that precautionary guidelines can reduce the risk of HAIs, this study has indicated that nurses’ behavior toward HAIs still insufficient.

Vaccination of Non-Domestic Animals against Emerging Virus Infections

NARCIS (Netherlands)

J.D.W. Philippa (Joost)

2007-01-01

markdownabstract__Abstract__ Since the 1980's, emerging and re-emerging infectious diseases have made an enormous impact on public and animal health, food supply, economies, and the environment. An estimated 75% of emerging infectious diseases in humans are zoonotic (pathogens of non-human

Cellular uptake: lessons from supramolecular organic chemistry.

Science.gov (United States)

Gasparini, Giulio; Bang, Eun-Kyoung; Montenegro, Javier; Matile, Stefan

2015-07-04

The objective of this Feature Article is to reflect on the importance of established and emerging principles of supramolecular organic chemistry to address one of the most persistent problems in life sciences. The main topic is dynamic covalent chemistry on cell surfaces, particularly disulfide exchange for thiol-mediated uptake. Examples of boronate and hydrazone exchange are added for contrast, comparison and completion. Of equal importance are the discussions of proximity effects in polyions and counterion hopping, and more recent highlights on ring tension and ion pair-π interactions. These lessons from supramolecular organic chemistry apply to cell-penetrating peptides, particularly the origin of "arginine magic" and the "pyrenebutyrate trick," and the currently emerging complementary "disulfide magic" with cell-penetrating poly(disulfide)s. They further extend to the voltage gating of neuronal potassium channels, gene transfection, and the delivery of siRNA. The collected examples illustrate that the input from conceptually innovative chemistry is essential to address the true challenges in biology beyond incremental progress and random screening.

Invasive Fungal Infections in Patients with Hematological Malignancies: Emergence of Resistant Pathogens and New Antifungal Therapies

Directory of Open Access Journals (Sweden)

Maria N. Gamaletsou

2018-02-01

Full Text Available Invasive fungal infections caused by drug-resistant organisms are an emerging threat to heavily immunosuppressed patients with hematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis and empirical and preemptive therapy, result in long-term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the nonlinear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors. The widespread use of agricultural and industrial fungicides with similar chemical structures and mechanisms of action has resulted in the development of environmental reservoirs for some drug-resistant fungi, especially azole-resistant Aspergillus species, which have been reported from four continents. The majority of resistant strains have the mutation TR34/L98H, a finding suggesting that the source of resistance is the environment. The global emergence of new fungal pathogens with inherent resistance, such as Candida auris, is a new public health threat. The most common mechanism of antifungal drug resistance is the induction of efflux pumps, which decrease intracellular drug concentrations. Overexpression, depletion, and alteration of the drug target are other mechanisms of resistance. Mutations in the ERG11 gene alter the protein structure of C-demethylase, reducing the efficacy of antifungal triazoles. Candida species become echinocandin-resistant by mutations in FKS genes. A shift in the epidemiology of Candida towards resistant non-albicans Candida spp. has emerged among patients with hematological malignancies. There is no definite association between antifungal resistance, as defined by elevated minimum inhibitory concentrations, and clinical outcomes in this population. Detection of genes or mutations conferring resistance with the use of molecular methods

Lessons for Teaching Art Criticism.

Science.gov (United States)

Barrett, Terry, Ed.; Clark, Gilbert, Ed.

This collection of lessons is meant to be a practical guide to help teachers engage children in art criticism. The lessons generally follow a similar format. Most suggest an age group but may be modified for use with younger or older students. Several authors suggest variations and extensions for lessons that include studio activities. A broad…

"Frankenstein." [Lesson Plan].

Science.gov (United States)

Simon, Melanie

Based on Mary Shelley's novel "Frankenstein," this lesson plan presents activities designed to help students understand that active readers interpret a novel (its characters, plot, setting, and theme) in different ways; and the great literature can be and has been adapted in many ways over time. The main activity of the lesson involves students…

Adenovirus infection in children with acute lower respiratory tract infections in Beijing, China, 2007 to 2012.

Science.gov (United States)

Liu, Chunyan; Xiao, Yan; Zhang, Jing; Ren, Lili; Li, Jianguo; Xie, Zhengde; Xu, Baoping; Yang, Yan; Qian, Suyun; Wang, Jianwei; Shen, Kunling

2015-10-01

Human adenoviruses (HAdV) play a significant role in pediatric respiratory tract infections. To date, over 60 types of HAdV have been identified. Here, HAdV types are characterized in children in the Beijing area with acute lower respiratory tract infections (ALRTIs) and the clinical features and laboratory findings of hospitalized HAdV-infected cases are described. Respiratory specimens were collected from pediatric patients with ALRTIs in the emergency department or from those admitted to Beijing Children's Hospital between March 2007 and December 2012. Infections with common respiratory viruses were determined by PCR or RT-PCR. HAdV positive samples were further typed by PCR and sequencing. Among 3356 patients with ALRTIs, 194 (5.8 %) were found to have HAdV infection. HAdV infection was primarily confined to children (88.35 %) less than 5 years of age. A total of 11 different types of HAdV were detected throughout the study period, with HAdV-B7 (49.0 %) and HAdV-B3 (26.3 %) as the most prevalent types, followed by HAdV-C2 (7.7 %) and HAdVC1 (4.6 %). Newly emerging and re-emergent types or variants, HAdV-B55 (n = 5), HAdV-C57 (n = 3), and HAdV-B14p1 (n = 1), were identified. Results also included the reported first case of co-infection with HAdV-C2 and HAdV-C57. Clinical entities of patients with single HAdV infection (n = 49) were similar to those with mixed HAdV/respiratory syncytial virus (RSV) infections (n = 41). Patients with HAdV-B7 infection had longer duration of fever and higher serum levels of muscle enzymes than HAdV-B3-infected patients. During the study period, HAdV-B7 and HAdV-B3 were the predominant types identified in pediatric ALRTIs. HAdV-B7 infection tends to have more severe clinical consequences. The presence of newly emerging types or variants and co-infection with different types of HAdV highlights the need for constant and close surveillance of HAdV infection.

Phagocytosis: history's lessons.

Science.gov (United States)

Garg, Manish; Chandawarkar, Rajiv Y

2013-01-01

The assimilation of lessons from the past is an essential component of education for scientists of tomorrow. These lessons are not easy to find. History books on science are few and usually highly dramatized and biographies of scientists tend to exaggerate the pomp of scientific discovery. Both underplay the hard and laborious work that is integral to any scientific pursuit. Here we illustrate one such example. A century ago, the Nobel Prize in Medicine was awarded to two scientists: Ilya Metchnikoff, a Russian zoologist, for the discovery ofphagocytosis-a cell-mediated ingestion ofmicrobes; and Paul Ehrlich, a distinguished physician-scientist, for discovering a highly antigen-specific serum-derived antibody-based immune defense. These two diametrically opposing views of the host-pathogen interaction set the stage for a strife that led to seminal advancements in immunology. Mirrored in this journey are important lessons for scientists today--ubiquitously as applicable to modern scientific life as they were a century ago. This commentaryhighlights these lessons--a fitting centenary to a well-deserved recognition.

Human Infection in Wild Mountain Gorillas

Centers for Disease Control (CDC) Podcasts

2011-04-25

This podcast discusses a study about the transmission of Human Metapneumovirus Infection to wild mountain gorillas in Rwanda in 2009, published in the April 2011 issue of Emerging Infectious Diseases. Dr. Ian Lipkin, Director of the Center for Infection and Immunity and Dr. Gustavo Palacios, investigator in the Center of Infection & Immunity share details of this study.  Created: 4/25/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 5/2/2011.

Community Resilience Education: Lessons Learned from an Emerging Community of Practice - NOAA's Environmental Literacy Grantees

Science.gov (United States)

Schoedinger, S. E.; McDougall, C.

2017-12-01

NOAA supports community resilience to extreme weather events, climate change and other environmental hazards by preparing communities through Weather Ready Nation and through programs addressing coastal community needs. These programs primarily target adult decisions makers in a professional capacity (emergency managers, city planners, et al.), leaving non-professional audiences without opportunities to understand and develop the skills to prepare for the threats and vulnerabilities that their communities face. As a result, resilience became the focus of NOAA's Environmental Literacy Grants in 2015. The goal of these investments is to strengthen the public's and/or K-12 students' environmental literacy to enable informed decision-making necessary for community resilience to extreme weather events and other environmental hazards. Funded projects build an understanding of Earth systems and the threats and vulnerabilities that are associated with a community's location, are aligned with existing adaptation/resilience plans, and connect audiences to relevant tools and resources to prepare for and respond to these hazards. These first few years of investment will create new models for how education can improve community resilience. Although these projects incorporate a variety of approaches, a few common themes stand out: empowering youth and adults to increase their understanding of locally relevant natural hazards and stresses; giving youth a voice in resilience planning; and student-led vulnerability assessments of their schools and communities. In this session we will report on the first convening of the principal investigators of our 13 funded projects, which represents the beginning of a new community of practice focused on resilience education. We will specifically share lessons learned about: engaging youth and adults about climate change and resiliency; working with local resilience/adaptation planners; and case studies on the use of NOAA's Digital Coast and

Lessons learned from unintended consequences about erasing the stigma of mental illness.

Science.gov (United States)

Corrigan, Patrick W

2016-02-01

Advocates and scientists have partnered to develop and evaluate programs meant to erase the egregious effects of the different forms of stigma. Enough evidence has been collected to yield lessons about approaches to stigma change. Some of the most insightful of these lessons emerge from unintended consequences of good intentioned approaches, and are the focus of this paper. They include the limited benefits of education especially when compared to contact, beating stigma is more than changing words, beware pity as a message, understand the competing agendas of stigma change, replace ideas of normalcy with solidarity, and avoid framing self-stigma as the problem of people with mental illness and not of society. The paper ends with consideration of the back seat role that psychiatrists and other mental health providers should have in stigma change. © 2015 World Psychiatric Association.

Bactericidal assessment of nano-silver on emerging and re-emerging human pathogens.

Science.gov (United States)

Anuj, Samir A; Gajera, Harsukh P; Hirpara, Darshna G; Golakiya, Baljibhai A

2018-04-24

With the threat of the growing number of bacteria resistant to antibiotics, the re-emergence of previously deadly infections and the emergence of new infections, there is an urgent need for novel therapeutic agent. Silver in the nano form, which is being used increasingly as antibacterial agents, may extend its antibacterial application to emerging and re-emerging multidrug-resistant pathogens, the main cause of nosocomial diseases worldwide. In the present study, a completely bottom up method to prepare green nano-silver was used. To explore the action of nano-silver on emerging Bacillus megaterium MTCC 7192 and re-emerging Pseudomonas aeruginosa MTCC 741 pathogenic bacteria, the study includes an analysis of the bacterial membrane damage through Scanning Electron Microscope (SEM) as well as alternation of zeta potential and intracellular leakages. In this work, we observed genuine bactericidal property of nano-silver as compare to broad spectrum antibiotics against emerging and re-emerging mode. After being exposed to nano-silver, the membrane becomes scattered from their original ordered arrangement based on SEM observation. Moreover, our results also suggested that alternation of zeta potential enhanced membrane permeability, and beyond a critical point, it leads to cell death. The leakages of intracellular constituents were confirmed by Gas Chromatography-Mass Spectrometry (GC-MS). In conclusion, the combine results suggested that at a specific dose, nano-silver may destroy the structure of bacterial membrane and depress its activity, which causes bacteria to die eventually. Copyright © 2018 Elsevier GmbH. All rights reserved.

Ontario Power Generation Fukushima emergency response drill strengthens and lessons learned - Ontario Power Generation Fukushima Emergency Response Drill Highlights

International Nuclear Information System (INIS)

Miller, David W.

2014-01-01

Japan's Fukushima Daiichi severe nuclear accident in March 2011 has resulted in a reassessment of nuclear emergency response and preparedness in Canada. On May 26, 27 and 28, 2014 Ontario Power Generation (OPG) conducted the first North American full scale nuclear emergency response exercise designed to include regional, provincial and federal bodies as well as the utility. This paper describes the radiological aspects of the OPG Exercise Unified Response (ExUR) with emphasis on deployment of new Fukushima equipment on the Darlington site, management of emergency workers deplored in the vicinity of Darlington to collect environmental samples and radiation measurements, performance of dose calculations, communication of dose projections and protective actions to local, provincial and federal agencies and conduct of vehicle, truck and personnel monitoring and decontamination facilities. The ExUR involved more than 1000 personnel from local, provincial and federal bodies. Also, 200 OPG employees participated in the off-site emergency response duties. The objective of the ExUR was to test and enhance the preparedness of the utility (OPG), government and non-government agencies and communities to respond to a nuclear emergency. The types of radiological instrumentation and mobile facilities employed are highlighted in the presentation. The establishment of temporary emergency rooms with 8 beds and treatment facilities to manage potentially contaminated injuries from the nuclear emergency is also described. (author)

[Zika virus infection: a new public health emergency with great media impact].

Science.gov (United States)

Caylà, Joan A; Domínguez, Ángela; Rodríguez Valín, Elena; de Ory, Fernando; Vázquez, Ana; Fortuny, Claudia

Infection with Zika virus (ZV) has become a new epidemic, with great impact on the media, and is having a strong effect in Latin American countries. Its possible association with microcephaly and Guillain-Barré syndrome prompted the World Health Organization (WHO) to declare on 1 February 2016 that this epidemic is a public health emergency of international concern. Epidemiological data show an increasing incidence in countries like Brazil and Colombia, and that the epidemic is still expanding in many other countries. Between January 2007 and 27 April 2016, the WHO detected transmission in 55 countries (in 42 of these, this was the first outbreak of Zika) and 1,198 microcephalies and other neurological disorders in Brazil. Also, during 2015-2016, 13 countries detected an increase in Guillain-Barré syndrome and/or confirmation of ZV associated with Guillain-Barré syndrome. Research has already demonstrated a causal relationship between microcephaly and other serious brain disorders in newborns and ZV infection in the mother. Clinically, many cases are asymptomatic and it can be difficult to distinguish this diagnosis from that of other arboviruses. Vector control in Spain is a priority because of the presence of the Aedes albopictus (tiger mosquito). Early diagnosis is recommended, as is avoiding travel to endemic areas and unprotected sex, and ensuring that the high political profile, which can prevent this epidemic from becoming a high prevalence endemic disease, does not cause us to forget about other health problems. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Emergency preparedness and response in the Commonwealth of Pennsylvania - the Three Mile Island incident

International Nuclear Information System (INIS)

Henderson, O.K.

1981-01-01

This paper addresses the emergency response mechanism and legal basis in effect in the Commonwealth of Pennsylvania at the time of the Three Mile Island incident. It reviews the sequence of events as they directly affected the Pennsylvania Emergency Management Agency and examines the method used by the Agency to discharge its responsibilities. Finally, the paper lists some of the lessons learned from the Three Mile Island experience. (author)

Plasmodium knowlesi from archival blood films: Further evidence that human infections are widely distributed and not newly emergent in Malaysian Borneo

Science.gov (United States)

Lee, Kim-Sung; Cox-Singh, Janet; Brooke, George; Matusop, Asmad; Singh, Balbir

2009-01-01

Human infections with Plasmodium knowlesi have been misdiagnosed by microscopy as Plasmodium malariae due to their morphological similarities. Although microscopy-identified P. malariae cases have been reported in the state of Sarawak (Malaysian Borno) as early as 1952, recent epidemiological studies suggest the absence of indigenous P. malariae infections. The present study aimed to determine the past incidence and distribution of P. knowlesi infections in the state of Sarawak based on archival blood films from patients diagnosed by microscopy as having P. malariae infections. Nested PCR assays were used to identify Plasmodium species in DNA extracted from 47 thick blood films collected in 1996 from patients in seven different divisions throughout the state of Sarawak. Plasmodium knowlesi DNA was detected in 35 (97.2%) of 36 blood films that were positive for Plasmodium DNA, with patients originating from all seven divisions. Only one sample was positive for P. malariae DNA. This study provides further evidence of the widespread distribution of human infections with P. knowlesi in Sarawak and its past occurrence. Taken together with data from previous studies, our findings suggest that P. knowlesi malaria is not a newly emergent disease in humans. PMID:19358848

Urinary tract infections in women

African Journals Online (AJOL)

Urinary tract infections (UTIs) are common bacterial infections in women, with ... Acute cystitis refers to symptomatic infection of the bladder in the lower ... lungs in a patient with pneumonia.4. Risk factors ... use of antimicrobial agents for community-acquired UTIs has resulted in the emergence of antimicrobial resistance.

Assessment and Prognosis for Nuclear Emergency Management in Korea

Energy Technology Data Exchange (ETDEWEB)

Jeong, Seung-Young; Lee, Hyun-Ha; Lee, Young-Min; Park, Sang-Hyun; Nam, Kwang-Woo; Jeong, Sang-Houn; Jin, Sobeom; Kim, Dong-Il; Kim, Wan-Joo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2015-05-15

The nuclear accident of Fukushima, March 2011, raised public concerns over the safety of nuclear facilities and emergency preparedness in Korea. Therefore, KINS has enhanced the AtomCARE for assessment and prognosis and environmental monitoring system. The KINS has reinforced the radiological/radioactive environment monitoring system across the country to ensure prompt and effective protective measures for the public. Also, the act of radiological emergency management revised to adopt (PAZ) and the (UPZ) at 2014. All in all, Korea will give comprehensive effort to reflect the lessons learned from Fukushima accident for improvement of the assessment and prognosis system. This paper reviews the status of assessment and prognosis system for nuclear emergency response in Korea. The Korea Institute of Nuclear Safety (KINS) performs the regulation and radiological emergency preparedness of the nuclear facilities and radiation utilizations.

Nutritional Status Driving Infection by Trypanosoma cruzi: Lessons from Experimental Animals

Directory of Open Access Journals (Sweden)

Guilherme Malafaia

2011-01-01

Full Text Available This paper reviews the scientific knowledge about protein-energy and micronutrient malnutrition in the context of Chagas disease, especially in experimental models. The search of articles was conducted using the electronic databases of SciELO (Scientific Electronic Library Online, PubMed and MEDLINE published between 1960 and March 2010. It was possible to verify that nutritional deficiencies (protein-energy malnutrition and micronutrient malnutrition exert a direct effect on the infection by T. cruzi. However, little is known about the immunological mechanisms involved in the relationship “nutritional deficiencies and infection by T. cruzi”. A hundred years after the discovery of Chagas disease many aspects of this illness still require clarification, including the effects of nutritional deficiencies on immune and pathological mechanisms of T. cruzi infection.

Development of procedure for emergency response in the combined disaster

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

Lessons learned from operating experience at the emergency after a East Japan Great Earthquake, have shown that development of decision making procedure and criteria for protective action implementation would be important at the emergency in the combined disaster such as nuclear accidents caused by natural disasters (including tsunami, flood, heavy snow, fire, etc.). In this study, the problemdefinition, the concept of operation and the data development were planned for three years since fiscal year 2011. In tins year, trial calculation of evacuation time estimate (ETE) for the wide area was performed. Moreover, the basic concept and procedure for carrying out ETE condidering the combined emergency were developed based on the last year results. (author)

Development of procedure for emergency response in the combined disaster

International Nuclear Information System (INIS)

2013-01-01

Lessons learned from operating experience at the emergency after a East Japan Great Earthquake, have shown that development of decision making procedure and criteria for protective action implementation would be important at the emergency in the combined disaster such as nuclear accidents caused by natural disasters (including tsunami, flood, heavy snow, fire, etc.). In this study, the problemdefinition, the concept of operation and the data development were planned for three years since fiscal year 2011. In tins year, trial calculation of evacuation time estimate (ETE) for the wide area was performed. Moreover, the basic concept and procedure for carrying out ETE condidering the combined emergency were developed based on the last year results. (author)

Lesson study in prospective mathematics teacher education: didactic and paradidactic technology in the post-lesson reflection

DEFF Research Database (Denmark)

Rasmussen, Klaus

2016-01-01

This paper presents a detailed analysis of the post-lesson reflection, carried out in the context of eight cases of lesson study conducted by teams of Danish, lower secondaryprospective teachers and their supervisors. The participants, representing different institutions, were all new to the less...... and concern to the whole profession of mathematics teachers and the analysis adds to our insight into the potential of lesson study in prospective education as a meeting place where pertinent actors contribute to the expansion and dissemination of shared professional knowledge......This paper presents a detailed analysis of the post-lesson reflection, carried out in the context of eight cases of lesson study conducted by teams of Danish, lower secondaryprospective teachers and their supervisors. The participants, representing different institutions, were all new to the lesson...... study format. Nevertheless, it is demonstrated how their interaction shape the development of discourse about mathematical learning. The anthropological theory of the didactic is employed as the theoretical approach to analyse the mathematical and primarily didactical praxeologies developed...

Implementation of Technology in an Elementary Mathematics Lesson: The Experiences of Pre-Service Teachers at One University

Science.gov (United States)

Herron, Julie

2010-01-01

This study examined pre-service teachers' responses to implementing technology into elementary mathematics lessons. Instructional Architect (IA) was the web-base technology used by the pre-service teachers. Four themes emerged from the data: (a) insights into technology, (b) struggles with technology, (c) access to the mathematics and (d) learning…

Challenges in the management of cardiovascular emergencies in Sub-Saharan Africa: a case report of acute heart failure complicating infective endocarditis in a semi-urban setting in Cameroon.

Science.gov (United States)

Nkoke, Clovis; Teuwafeu, Denis; Nkouonlack, Cyrille; Abanda, Martin; Kouam, Wilfried; Mapina, Alice; Makoge, Christelle; Hamadou, Ba

2018-04-25

Infective endocarditis is a deadly disease if not promptly treated with antibiotics either in association with cardiac surgery or not. Cardiac complications are the most common complications seen in infective endocarditis. Heart failure remains the most common cause of mortality and the most common indication for cardiac surgery in patients with infective endocarditis which is increasingly available in resource limited settings. We report a case of native valve infective endocarditis of the aortic valve in a 27-year old female in a semi-urban setting in Cameroon complicated by severe aortic valve regurgitation and heart failure. She presented with a 2 month history of fever and a 2 weeks history of rapidly worsening shortness of breath. Emergency cardiac surgery was indicated which unfortunately could not be performed leading to the death of the patient. In spite of improvement in availability of diagnostic and therapeutic modalities for cardiovascular emergencies, affordability is still a challenge. Universal health coverage is advocated else the ravages of premature mortality from cardiovascular diseases may continue to remain unchecked in Sub-Saharan Africa.

Analysis of emergency response to fukushima nuclear accident in Japan and suggestions for China's nuclear emergency management

International Nuclear Information System (INIS)

Li Wei; Ding Qihua; Wu Haosong

2014-01-01

On March 11, 2011, the Fukushima Dai-ichi Nuclear Power Station of the Tokyo Electric Power Company ('TEPCO') was hit and damaged by a magnitude 9 earthquake and accompanying tsunami. The accident is determined to be of the highest rating on the International Nuclear Event Scale. The Government of Japan and TEPCO have taken emergency response actions on-site and off-site at the accident. It became clear through the investigation that the accident had been initiated on the occasion of a natural disaster of an earthquake and tsunami, but there have been various complex problems behind this very serious and large scale accident. For an example, the then-available accident preventive measures and disaster preparedness of TEPCO were insufficient against tsunami and severe accidents; inadequate TEPCO emergency responses to the accident at the site were also identified. The accident rang the alarm for the nuclear safety of nuclear power plants. It also taught us a great of lessons in nuclear emergency management. (authors)

Geographic Information System (GIS) Emergency Support for the May 2000 Cerro Grande Wildfire, Los Alamos, New Mexico, USA

Energy Technology Data Exchange (ETDEWEB)

C.R.Mynard; G.N.Keating; P.M.Rich; D.R. Bleakly

2003-05-01

In May 2000 the Cerro Grande wildfire swept through Los Alamos, New Mexico, burning approximately 17,400 ha (43,000 acres) and causing evacuation of Los Alamos National Laboratory (LANL) and the communities of Los Alamos and White Rock. An integral part of emergency response during the fire was the use of geographic information system (GIS) technology, which continues to be used in support of post-fire restoration and environmental monitoring. During the fire Laboratory GIS staff and volunteers from other organizations worked to produce maps and provide support for emergency managers, including at an emergency GIS facility in Santa Fe. Subsequent to the fire, Laboratory GIS teams supported the multiagency Burned Area Emergency Rehabilitation (BAER) team to provide GIS data and maps for planning mitigation efforts. The GIS teams continue to help researchers, operations personnel, and managers deal with the tremendous changes caused by the fire. Much of the work is under the auspices of the Cerro Grande Rehabilitation Project (CGRP) to promote recovery from fire damage, improve information exchange, enhance emergency management, and conduct mitigation activities. GIS efforts during the fire provided important lessons about institutional matters, working relationships, and emergency preparedness. These lessons include the importance of (1) an integrated framework for assessing natural and human hazards in a landscape context; (2) a strong GIS capability for emergency response; (3) coordinated emergency plans for GIS operations; (4) a method for employees to report their whereabouts and receive authoritative information during an evacuation; (5) GIS data that are complete, backed-up, and available during an emergency; (6) adaptation of GIS to the circumstances of the emergency; (7) better coordination in the GIS community; (8) better integration of GIS into LANL operations; and (9) a central data warehouse for data and metadata. These lessons are important for planning

Threats and Re-emergence of Chickungunya Fever in Indian Sub-continent

Directory of Open Access Journals (Sweden)

Mahajan S

2009-02-01

Full Text Available Zoonoses are among the most frequent and dreaded risk to which mankind is exposed today, human health is inextricably linked to animal health and production. Over the past 6 years, a number of zoonotic and vector borne viral diseases were recorded in South-east Asia and the Western Pacific and there was sudden upsurge in the number of emerging and re-emerging zoonotic diseases in Indian Sub-continent and Chikungunya fever is one of them. The precise reasons for the re-emergence of Chikungunya in the Indian subcontinent as well as the other small countries in the southern Indian Ocean are an enigma. Although, it is well recognized that re-emergence of viral infections are due to a variety of social, environmental, behavioural and biological changes, which of these contributed to the re-emergence of Chikungunya virus would be interesting to unravel. Chikungunya is generally spread through bites of infected mosquitoes; mosquitoes become infected when they feed on a animal infected with CHIK virus. Monkey and possibly other wild animals may serve as reservoirs of infection. [Vet. World 2009; 2(1.000: 40-42

Zika Virus: Critical Information for Emergency Providers.

Science.gov (United States)

Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark

2016-08-01

Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers. Copyright © 2016 Elsevier Inc. All rights reserved.

International nuclear emergency exercises: lessons learned from the I.N.E.X. series

International Nuclear Information System (INIS)

Ahier, B.

2008-01-01

Since the early 1990's, the OECD Nuclear Energy Agency (NEA) has offered its member countries a forum for improving efficiency and effectiveness in nuclear emergency management, with a particular focus on international aspects. A central approach to this has been the International Nuclear Emergency Exercise (INEXI series. Since 1993, the INEX series has proved successful in testing and advancing arrangements for nuclear emergency response. INEX 1, 2 and 2000, which focused on early-phase issues, provided a unique forum to test arrangements and concepts for international nuclear emergency management, particularly international communications, coordination and decision-making. Importantly, these exercises established a recognised international nuclear emergency exercise culture. The most recent exercise, INEX 3, was developed in response to international interest in longer term post-emergency issues. Conducted in 2005-2006, INEX 3 focused on later-phase consequence management issues following discovery of serious radio-logical contamination in the environment. The post-exercise evaluation identified several aspects of national consequence management which would benefit from international cooperation, and to which the international community could usefully contribute as part of planning and preparedness. (author)

Mycobacterial infections: Still a millennium bug - the imaging features of mycobacterial infections

International Nuclear Information System (INIS)

Koh, D.M.; Bell, J.R.G.; Burkill, G.J.C.; Padley, S.P.G.; Healy, J.C.

2001-01-01

Mycobacterial infection is re-emerging as a major health care concern. Although Mycobacterium tuberculosis (MTB) is still the most important pathogen, atypical mycobacterium (AMB) infections are becoming increasingly common. We present a pictorial review of the imaging features of these infections in the chest, abdomen, brain and musculoskeletal system. Imaging similarities and differences between the normal and the immunocompromised host will be highlighted. Koh, D. M. et al. Clinical Radiology (2001)

The future of emerging disease

International Nuclear Information System (INIS)

Debell, R. M.

2009-01-01

A recent study has demonstrated that the numbers of emerging infectious diseases has risen dramatically since 1940. Two processes are responsible: microbial adaptation that results in human infection and human exposure to newly adapted microbes that occurs for several reasons including increased human intrusion into tropical forests, lack of access to health care, population growth and changes in demographics, inadequate and deteriorating public health infrastructure, misuse of antimicrobial drugs, urbanization and crowding, modern travel, and increased trade and expanded markets for imported foods. For more than 40 years, methicillin-resistant Staphylococcus aureus (MRSA) has been almost impossible to treat. In a recent worldwide study, 54.3 percent of emerging bacterial infections resulted from drug adaptation resistance. Serious diarrheal infections caused by Escherichia coli O157:H7 have become frequent in the U.S. From May 27th to July 1st, 2008, 49 infections occurred in the U.S., and 27 were hospitalized. From its inception in 2003, SARS has resulted in more than 8000 cases and 774 deaths. In 1999, West Nile virus appeared initially in New York City. By 2004 this virus was found in birds and mosquitoes in 48 states and by 2007 in the U.S., there were 3,630 cases including 124 deaths. Before December 1st, 1981, no one ever heard of HIV. It is estimated that 25 million people have died of AIDS. Each emergent disease has its own history of recognition, spread, and severity. Through this review, the future of emergent disease is characterized as highly dependent upon the convergence of human exposures in a modern world and microbial adaptation.(author)

The 2015 Nepal earthquake disaster: lessons learned one year on.

Science.gov (United States)

Hall, M L; Lee, A C K; Cartwright, C; Marahatta, S; Karki, J; Simkhada, P

2017-04-01

The 2015 earthquake in Nepal killed over 8000 people, injured more than 21,000 and displaced a further 2 million. One year later, a national workshop was organized with various Nepali stakeholders involved in the response to the earthquake. The workshop provided participants an opportunity to reflect on their experiences and sought to learn lessons from the disaster. One hundred and thirty-five participants took part and most had been directly involved in the earthquake response. They included representatives from the Ministry of Health, local and national government, the armed forces, non-governmental organizations, health practitioners, academics, and community representatives. Participants were divided into seven focus groups based around the following topics: water, sanitation and hygiene, hospital services, health and nutrition, education, shelter, policy and community. Facilitated group discussions were conducted in Nepalese and the key emerging themes are presented. Participants described a range of issues encountered, some specific to their area of expertize but also more general issues. These included logistics and supply chain challenges, leadership and coordination difficulties, impacts of the media as well as cultural beliefs on population behaviour post-disaster. Lessons identified included the need for community involvement at all stages of disaster response and preparedness, as well as the development of local leadership capabilities and community resilience. A 'disconnect' between disaster management policy and responses was observed, which may result in ineffective, poorly planned disaster response. Finding time and opportunity to reflect on and identify lessons from disaster response can be difficult but are fundamental to improving future disaster preparedness. The Nepal Earthquake National Workshop offered participants the space to do this. It garnered an overwhelming sense of wanting to do things better, of the need for a Nepal-centric approach

Opt-out screening strategy for HIV infection among patients attending emergency departments: systematic review and meta-analysis.

Science.gov (United States)

Henriquez-Camacho, C; Villafuerte-Gutierrez, P; Pérez-Molina, J A; Losa, J; Gotuzzo, E; Cheyne, N

2017-07-01

International health agencies have promoted nontargeted universal (opt-out) HIV screening tests in different settings, including emergency departments (EDs). We performed a systematic review and meta-analysis to assess the testing uptake of strategies (opt-in targeted, opt-in nontargeted and opt-out) to detect new cases of HIV infection in EDs. We searched the Pubmed and Embase databases, from 1984 to April 2015, for opt-in and opt-out HIV diagnostic strategies used in EDs. Randomized controlled or quasi experimental studies were included. We assessed the percentage of positive individuals tested for HIV infection in each programme (opt-in and opt-out strategies). The mean percentage was estimated by combining studies in a random-effect meta-analysis. The percentages of individuals tested in the programmes were compared in a random-effect meta-regression model. Data were analysed using stata version 12. Quality assessments were performed using the Newcastle-Ottawa Scale. Of the 90 papers identified, 28 were eligible for inclusion. Eight trials used opt-out, 18 trials used opt-in, and two trials used both to detect new cases of HIV infection. The test was accepted and taken by 75 155 of 172 237 patients (44%) in the opt-out strategy, and 73 581 of 382 992 patients (19%) in the opt-in strategy. The prevalence of HIV infection detected by the opt-out strategy was 0.40% (373 cases), that detected by the opt-in nontargeted strategy was 0.52% (419 cases), and that detected by the opt-in targeted strategy was 1.06% (52 cases). In this meta-analysis, the testing uptake of the opt-out strategy was not different from that of the opt-in strategy to detect new cases of HIV infection in EDs. © 2016 British HIV Association.

Study on the action guidelines for medical support team for nuclear and radiological emergency

International Nuclear Information System (INIS)

Liu Chang'an; Liu Ying; Geng Xiusheng

2006-01-01

Objective: To study the action guidelines for medical support team for nuclear and radiological emergency. Methods: It is based on the experience and lessons learned in the course of meeting the emergencies preparedness and response of nuclear and radiological emergencies in China and abroad with the reference of the relevant reports of International Atomic Energy Agency. Results: Essential requirements and practical recommendations for the roles, responsibilities, emergency preparedness, principles and procedures of medical assistance at the scene, as well as the radiological protection of medical support team were provided. Conclusion: The document mentioned above can be applied to direct the establishment, effective medical preparedness and response of the medical support team for nuclear and radiological emergency. (authors)

Lessons from first generation biofuels and implications for the sustainability appraisal of second generation biofuels

International Nuclear Information System (INIS)

Mohr, Alison; Raman, Sujatha

2013-01-01

Aims: The emergence of second generation (2G) biofuels is widely seen as a sustainable response to the increasing controversy surrounding the first generation (1G). Yet, sustainability credentials of 2G biofuels are also being questioned. Drawing on work in Science and Technology Studies, we argue that controversies help focus attention on key, often value-related questions that need to be posed to address broader societal concerns. This paper examines lessons drawn from the 1G controversy to assess implications for the sustainability appraisal of 2G biofuels. Scope: We present an overview of key 1G sustainability challenges, assess their relevance for 2G, and highlight the challenges for policy in managing the transition. We address limitations of existing sustainability assessments by exploring where challenges might emerge across the whole system of bioenergy and the wider context of the social system in which bioenergy research and policy are done. Conclusions: Key lessons arising from 1G are potentially relevant to the sustainability appraisal of 2G biofuels depending on the particular circumstances or conditions under which 2G is introduced. We conclude that sustainability challenges commonly categorised as either economic, environmental or social are, in reality, more complexly interconnected (so that an artificial separation of these categories is problematic). - Highlights: • Controversy surrounding 1G biofuels is relevant to sustainability appraisal of 2G. • Challenges for policy in managing the transition to 2G biofuels are highlighted. • A key lesson is that sustainability challenges are complexly interconnected

The individual teacher in lesson study collaboration

DEFF Research Database (Denmark)

Skott, Charlotte Krog; Møller, Hanne

2017-01-01

used in lesson study research. Design/methodology/approach The authors use collective case studies. By being participant observers the authors provide detailed descriptions of two selected teachers’ lived experiences of lesson study collaboration. In addition to gain first-hand insights, the authors...... in the participation of each of the two teachers during a two-year lesson study project. By comparing these shifts the authors identify significant conditions for their individual learning. Research limitations/implications Although the study is small scale, both the insights into the different ways in which teachers...... participated and the theoretical insights might be valuable for other lesson study research approaches. Practical implications This paper provides valuable insights into conditions that might influence teachers’ participation in lesson study activities, especially in cultures with little experience of lesson...

Weaving Together Science and English: An Interconnected Model of Language Development for Emergent Bilinguals

Science.gov (United States)

Ciechanowski, Kathryn M.

2014-01-01

This research explores third-grade science and language instruction for emergent bilinguals designed through a framework of planning, lessons, and assessment in an interconnected model including content, linguistic features, and functions. Participants were a team of language specialist, classroom teacher, and researcher who designed…

GYM score: 30-day mortality predictive model in elderly patients attended in the emergency department with infection.

Science.gov (United States)

González Del Castillo, Juan; Escobar-Curbelo, Luis; Martínez-Ortíz de Zárate, Mikel; Llopis-Roca, Ferrán; García-Lamberechts, Jorge; Moreno-Cuervo, Álvaro; Fernández, Cristina; Martín-Sánchez, Francisco Javier

2017-06-01

To determine the validity of the classic sepsis criteria or systemic inflammatory response syndrome (heart rate, respiratory rate, temperature, and leukocyte count) and the modified sepsis criteria (systemic inflammatory response syndrome criteria plus glycemia and altered mental status), and the validity of each of these variables individually to predict 30-day mortality, as well as develop a predictive model of 30-day mortality in elderly patients attended for infection in emergency departments (ED). A prospective cohort study including patients at least 75 years old attended in three Spanish university ED for infection during 2013 was carried out. Demographic variables and data on comorbidities, functional status, hemodynamic sepsis diagnosis variables, site of infection, and 30-day mortality were collected. A total of 293 patients were finally included, mean age 84.0 (SD 5.5) years, and 158 (53.9%) were men. Overall, 185 patients (64%) fulfilled the classic sepsis criteria and 224 patients (76.5%) fulfilled the modified sepsis criteria. The all-cause 30-day mortality was 13.0%. The area under the curve of the classic sepsis criteria was 0.585 [95% confidence interval (CI) 0.488-0.681; P=0.106], 0.594 for modified sepsis criteria (95% CI: 0.502-0.685; P=0.075), and 0.751 (95% CI: 0.660-0.841; P20 bpm; Morbidity-Charlson index ≥3) to predict 30-day mortality, with statistically significant differences (P=0.004 and Pcapacity than the classic and the modified sepsis criteria to predict 30-day mortality in elderly patients attended for infection in the ED.

Emerging (val)ganciclovir resistance during treatment of congenital CMV infection: a case report and review of the literature.

Science.gov (United States)

Morillo-Gutierrez, Beatriz; Waugh, Sheila; Pickering, Ailsa; Flood, Terence; Emonts, Marieke

2017-08-22

Congenital cytomegalovirus (cCMV) infection is an important illness that is a common cause of hearing loss in newborn infants and a major cause of disability in children. For that reason, treatment of symptomatic patients with either ganciclovir or its pro-drug valganciclovir is recommended. Treatment duration of 6 months has been shown to be more beneficial than shorter courses; however, there is uncertainty regarding emergence of resistance strains, secondary effects and long term sequelae. Here we present a female infant with symptomatic cCMV who was treated from day 5 of life with oral valganciclovir. In spite of close monitoring of her drug levels and increments of her treatment dose according to weight gain, she developed ganciclovir resistance after 4 months of treatment, with increasing viraemia and petechiae. Adherence to treatment was assessed and felt to be good. Clinically, although she had marked developmental delay, she was making steady progress. In view of the development of resistance treatment was stopped at 5 months of age. No secondary effects of ganciclovir were noted during the whole course. There were few cases in the literature reporting resistance to ganciclovir for cCMV before the new recommendations for a 6 months treatment course for this infection were published. As demonstrated in our patient, surveillance with periodic viral loads and drug monitoring are vital to identify emerging resistance and optimise antiviral dosing according to weight gain.

What Happens at the Lesson Start?

Science.gov (United States)

Saloviita, Timo

2016-01-01

Transitional periods, such as lesson starts, are necessary steps from one activity to another, but they also compete with time for actual learning. The aim of the present study was to replicate a previous pilot study on lesson starts and explore possible disturbances. In total, 130 lesson starts in Finnish basic education in grades 1-9 were…

Democratization in the Arab World: A Summary of Lessons from Around the Globe

Science.gov (United States)

2013-01-01

along with a worldwide decline in commodity prices , eroded already limited revenues. A third factor was the emergence of private actors who pressed for...opposition who proved no less prone to authoritar- ian tendencies than their predecessors, as in Zambia . Unlike some of the more successful cases, in...exercised by the military officer who led a coup and then Democratization in the Arab World: A Summary of Lessons 21 promptly transferred power to a

Lesson study i Danmark?

DEFF Research Database (Denmark)

Mogensen, Arne

2009-01-01

Der beskrives et japansk lesson study forløb, og det diskuteres i hvilket omfang, de gode japanske erfaringer kan overføres til dansk matematikundervisning.......Der beskrives et japansk lesson study forløb, og det diskuteres i hvilket omfang, de gode japanske erfaringer kan overføres til dansk matematikundervisning....

Prevalence Of Syphilis ( Treponema pallidum ) – An Emerging ...

African Journals Online (AJOL)

Abstract. Background: In general,the risk of transfusion transmitted infections has been greatly reduced today. However, blood borne bacterial, viral as well as parasitic infections and emerging infections transmitted through transfusion are an area of increasing concern. More recently, there has been a resurgence of syphilis ...

Severe accident management at nuclear power plants - emergency preparedness and response actions

International Nuclear Information System (INIS)

Pawar, S.K.; Krishnamurthy, P.R.

2015-01-01

This paper describes the current level of emergency planning and preparedness and also improvement in the emergency management programme over the years including lessons learned from Fukushima accident, hazard analysis and categorization of nuclear facilities into hazard category for establishing the emergency preparedness class, classification of emergencies based on the Emergency Action Levels (EAL), development of EAL’s for PHWR, Generic Criteria in terms of projected dose for initiating protective actions (precautionary urgent protective actions, urgent protective actions, early protective actions), operational intervention levels (OIL), Emergency planning zones and distances, protection strategy and reference levels, use of residual dose for establishing reference levels for optimization of protection strategy, criteria for termination of emergency, transition of emergency exposure situation to existing exposure situation or planned exposure situation, criteria for medical managements of exposed persons and guidance for controlling the dose of emergency workers. This paper also highlights the EALs for typical PHWR type reactors for all types of emergencies (plant, site and offsite), transition from emergency operating procedures (EOP) to accident management guidelines (AMG) to emergency response actions and proposed implementation of guidelines

Nuclear emergency preparedness and management the international nuclear emergency exercise Inex 2000

International Nuclear Information System (INIS)

Mundigl, St.

2003-01-01

With the initiation of the first international nuclear emergency exercise INEX 1, performed as a table-top exercise in 1993, the international community tested, for the first time, approaches and policies in place to manage a nuclear or radiological emergency. INEX 1 with its related workshops led to a wealth of lessons learned and to an improvement in nuclear emergency management. The INEX 2 exercise series, initiated by the NEA and performed between 1996 and 1999, established an international nuclear emergency 'exercise culture' leading to a clear improvement of the international aspects of nuclear emergency preparedness and management. INEX 2 was a series of four command post exercises based on national nuclear emergency exercises in Switzerland, Finland, Hungary and Canada. Simulated accidents at nuclear power plants were used to test existing procedures in emergency response and management, and to analyse local, regional, national and international emergency plans under realistic conditions. In addition, the exercises allowed the participating countries to gain experience using new concepts and tools. The most significant result of INEX 2 and a major step forward in nuclear emergency management was the development of a new communication and information exchange strategy, which is currently implemented by various NEA member countries as well as by the international community in general. The objective of this new strategy is to assist the decision-maker by improving the selection of the data transmitted, by encouraging the transmission and reception of such data and information using modern communication methods, e.g. secure world wide web technologies, and by defining emergency monitoring and modelling needs. To test the validity and usefulness of the newly-developed strategy, the NEA proposed to organize an international nuclear emergency exercise, INEX 2000, similar in scope to the INEX 2 exercises. In addition, the NEA suggested to include, for the first

St. Louis FUSRAP Lessons Learned

International Nuclear Information System (INIS)

Eberlin, J.; Williams, D.; Mueller, D.

2003-01-01

The purpose of this paper is to present lessons learned from fours years' experience conducting Remedial Investigation and Remedial Action activities at the St. Louis Downtown Site (SLDS) under the Formerly Utilized Sites Remedial Action Program (FUSRAP). Many FUSRAP sites are experiencing challenges conducting Remedial Actions within forecasted volume and budget estimates. The St. Louis FUSRAP lessons learned provide insight to options for cost effective remediation at FUSRAP sites. The lessons learned are focused on project planning (budget and schedule), investigation, design, and construction

Biomarkers and Molecular Analysis to Improve Bloodstream Infection Diagnostics in an Emergency Care Unit

Science.gov (United States)

Loonen, Anne J. M.; de Jager, Cornelis P. C.; Tosserams, Janna; Kusters, Ron; Hilbink, Mirrian; Wever, Peter C.; van den Brule, Adriaan J. C.

2014-01-01

Molecular pathogen detection from blood is still expensive and the exact clinical value remains to be determined. The use of biomarkers may assist in preselecting patients for immediate molecular testing besides blood culture. In this study, 140 patients with ≥ 2 SIRS criteria and clinical signs of infection presenting at the emergency department of our hospital were included. C-reactive protein (CRP), neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) levels were determined. One ml EDTA blood was obtained and selective pathogen DNA isolation was performed with MolYsis (Molzym). DNA samples were analysed for the presence of pathogens, using both the MagicPlex Sepsis Test (Seegene) and SepsiTest (Molzym), and results were compared to blood cultures. Fifteen patients had to be excluded from the study, leaving 125 patients for further analysis. Of the 125 patient samples analysed, 27 presented with positive blood cultures of which 7 were considered to be contaminants. suPAR, PCT, and NLCR values were significantly higher in patients with positive blood cultures compared to patients without (p molecular assays perform poorly when one ml whole blood is used from emergency care unit patients. NLCR is a cheap, fast, easy to determine, and rapidly available biomarker, and therefore seems most promising in differentiating BSI from non-BSI patients for subsequent pathogen identification using molecular diagnostics. PMID:24475269

A Relevant Lesson: Hitler Goes to the Mall

Science.gov (United States)

Gerwin, David

2003-01-01

A "Motivation" eliciting the "Aim" of each lesson initiates each lesson in the orthodox "developmental lesson-plan" that has dominated classroom instruction in NYC public schools for at least the past half-century. An action-research study of 38 lesson-plans (over 5 each from 5 teachers) drawn from student-teaching…

Engendering Responses to Complex Emergencies: Lessons from South Sudan

Science.gov (United States)

2016-03-01

bolster the effectiveness of their response—for both women and men—in the affected communities. But what do the gender dimensions of a complex emergency... gender justice in South Sudan,” Oxfam (March 2013). 2 Thomas Pluemper and Eric Neumeyer, “The Unequal Burden of War: The Effect of Armed Conflict...single natural disaster, but by a combination of political and ethnic conflict, social inequality , poverty, and many other interrelated factors. As

Cryptosporidium Infections Among Children in Peru

Centers for Disease Control (CDC) Podcasts

2008-09-25

Cryptosporidium is a waterborne bacteria that can cause severe diarrhea and vomiting. In this podcast, Dr. Vita Cama, CDC microbiologist, discusses an article in the October 2008 issue of Emerging Infectious Diseases. The paper examines Cryptosporidium infections among children in Peru, including the number of infections, symptoms experienced, and what species of Crypto were responsible.  Created: 9/25/2008 by Emerging Infectious Diseases.   Date Released: 9/25/2008.

Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.

Science.gov (United States)

Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth

2014-09-01

There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.

Creating a meaningful infection control program: one home healthcare agency's lessons.

Science.gov (United States)

Poff, Renee McCoy; Browning, Sarah Via

2014-03-01

Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

Ethical aspects of the effects of the Chernobyl accident: lessons and problems

International Nuclear Information System (INIS)

Mishatkina, T.V.; Mel'nov, S.B.; Sarana, Yu.V.

2011-01-01

The different aspects of observing of eco- and bioethics principles and requirements upon the attitude to human in the situations of emergency are discussed basing on the tragic lessons of the Chernobyl catastrophe. They are attitude to population located in the region influenced by the catastrophe, attitude to the liquidators, and attitude to the subjects of biomedical researches. The characteristics of the moral and psychological factors of radioecological stress are given. Ethical issues of estimation of low dose radiation effects are analyzed

Beautiful Beads: A Lesson in Making Beads with Friendly Clay. AMACO[R] Lesson.

Science.gov (United States)

Gamble, Harriet; Gamble, David

This lesson resource includes a brief summary of the history of bead making and historic fascination with beads as adornment. A focus on design elements, color theory, craftsmanship, and technical skill in bead making is encouraged. The plan includes lesson goals and objectives; background preparation; a glossary of terms; a list of supplies; and…

Cerebral scedosporiosis: an emerging fungal infection in severe neutropenic patients. CT features and CT pathologic correlation

Energy Technology Data Exchange (ETDEWEB)

Marco de Lucas, Enrique; Sadaba, Pablo; Lastra Garcia-Baron, Pedro; Ruiz Delgado, Maria Luisa; Gonzalez Mandly, Andres; Gutierrez, Agustin; Diez, Consuelo [Hospital Universitario Marques de Valdecilla, Department of Radiology, Santander, Cantabria (Spain); Cuevas, Jorge; Fernandez, Fidel [Hospital Universitario Marques de Valdecilla, Department of Pathology, Santander, Cantabria (Spain); Salesa, Ricardo [Hospital Universitario Marques de Valdecilla, Department of Microbiology, Santander, Cantabria (Spain); Bermudez, Arancha [Hospital Universitario Marques de Valdecilla, Department of Hematology, Santander, Cantabria (Spain); Marco de Lucas, Fernando [Hospital de Basurto, Department of Hematology, Bilbao, Vizcaya (Spain)

2006-02-01

Scedosporium prolificans is an emerging opportunistic fungal agent encountered in severely neutropenic patients. The purpose of this paper is to describe the main cranial CT findings from a retrospective review of six patients (four men and two women, 18-66 years old) afflicted with disseminated infection by S. prolificans with neurological symptoms. They were severely neutropenic and presented with severe respiratory failure and conscience deterioration, with a subsequent 100% mortality. The final diagnosis was established by autopsy (performed in five patients) and blood culture findings. Cranial CT showed multiple low-density lesions in four patients without contrast enhancement located in the basal ganglia and corticomedullary junction. Autopsy findings of these lesions demonstrated necrosis and hyphae proliferation inside brain infarcts. Also, two of the patients had a subarachnoid hemorrhage, but angiography could not be performed. CT and autopsy findings were fairly similar to those encountered in cerebral aspergillosis; however, possibly because of its rapid and fatal evolution, no edema or ring enhancing lesions were encountered. Thus, Scedosporium can be included as a rare but possible cause of invasive fungal disseminated central nervous system infections in severely neutropenic patients. (orig.)

Cerebral scedosporiosis: an emerging fungal infection in severe neutropenic patients. CT features and CT pathologic correlation

International Nuclear Information System (INIS)

Marco de Lucas, Enrique; Sadaba, Pablo; Lastra Garcia-Baron, Pedro; Ruiz Delgado, Maria Luisa; Gonzalez Mandly, Andres; Gutierrez, Agustin; Diez, Consuelo; Cuevas, Jorge; Fernandez, Fidel; Salesa, Ricardo; Bermudez, Arancha; Marco de Lucas, Fernando

2006-01-01

Scedosporium prolificans is an emerging opportunistic fungal agent encountered in severely neutropenic patients. The purpose of this paper is to describe the main cranial CT findings from a retrospective review of six patients (four men and two women, 18-66 years old) afflicted with disseminated infection by S. prolificans with neurological symptoms. They were severely neutropenic and presented with severe respiratory failure and conscience deterioration, with a subsequent 100% mortality. The final diagnosis was established by autopsy (performed in five patients) and blood culture findings. Cranial CT showed multiple low-density lesions in four patients without contrast enhancement located in the basal ganglia and corticomedullary junction. Autopsy findings of these lesions demonstrated necrosis and hyphae proliferation inside brain infarcts. Also, two of the patients had a subarachnoid hemorrhage, but angiography could not be performed. CT and autopsy findings were fairly similar to those encountered in cerebral aspergillosis; however, possibly because of its rapid and fatal evolution, no edema or ring enhancing lesions were encountered. Thus, Scedosporium can be included as a rare but possible cause of invasive fungal disseminated central nervous system infections in severely neutropenic patients. (orig.)

Sporotrichosis: an emerging neglected opportunistic infection in HIV-infected patients in Rio de Janeiro, Brazil.

Science.gov (United States)

Freitas, Dayvison Francis Saraiva; Valle, Antonio Carlos Francesconi do; da Silva, Margarete Bernardo Tavares; Campos, Dayse Pereira; Lyra, Marcelo Rosandiski; de Souza, Rogerio Valls; Veloso, Valdiléa Gonçalves; Zancopé-Oliveira, Rosely Maria; Bastos, Francisco Inácio; Galhardo, Maria Clara Gutierrez

2014-08-01

Sporotrichosis associated with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil, affecting a large at-risk population, which includes HIV-infected individuals. We assessed patients co-infected by Sporothrix spp. and HIV over time in the context of an unabated sporotrichosis epidemic. A retrospective cohort retrieved information from a National reference institute for infectious diseases regarding 48 patients with sporotrichosis-HIV co-infection (group 1) as well as 3,570 patients with sporotrichosis (group 2), from 1987 through March 2013. Most patients from group 1 were male (68.8%), whereas women were predominant in group 2 (69.1%; psporotrichosis over time, whereas hospitalization was very unlikely in group 2, among whom approximately 1% were hospitalized over time. Dissemination of sporotrichosis was the main cause of hospitalization in both groups, although it was more common among hospitalized patients from group 1 (19/21 [90.5%] vs. 16/37 [43.2%]; psporotrichosis (3/48 vs. 5/3,570). The diagnosis of sporotrichosis elicited HIV testing and subsequent diagnosis in 19/48 patients, whereas 23/48 patients were simultaneously diagnosed with the two infections. HIV infection aggravates sporotrichosis, with a higher incidence of severe disseminated cases and a higher number of hospitalizations and deaths. Underserved populations, among whom sporotrichosis has been propagated, have been affected by different transmissible (e.g., HIV) and non-transmissible diseases. These populations should be targeted by community development programs and entitled to integrated management and care of their superimposed burdens.

Emerging infections: Shewanella - A series of five cases

Directory of Open Access Journals (Sweden)

Krishna Kanchan Sharma

2010-01-01

Full Text Available Background : Shewanella spp. are unusual cause of disease in humans; however, reports of Shewanella infections have been increasing. Shewanella is a ubiquitous organism that has been isolated from many foods, sewage, and both from fresh and salt water. Earlier it was named as Pseudomonas putrefaciens or Shewanella putrefaciens. There are several reports describing this organism causing human infections such as cellulitis, abscesses, bacteremia, wound infection, etc. It is oxidase and catalase-positive non-fermenter gram-negative rod that produces hydrogen sulfide. Aims : The study was conducted to identify Shewanella spp., which was wrongly reported as Pseudomonas spp. Materials and Methods : Clinical samples were cultured as per standard clinical laboratory procedure. We tested the non-lactose-fermenting colonies for oxidase positivity. Oxidase-positive colony was inoculated in triple sugar iron slant (TSI to know the hydrogen sulfide production. Hydrogen sulfide positive colonies were further tested for citrate, urease, indole, and amino acid decarboxylation and acid and gas production from sugars. Results : Five isolates identified as Pseudomonas spp. during preliminary testing were proved to be Shewanella spp. on further testing. Conclusions : It will help in better understanding the epidemiology, pathogenesis and risk factors associated with these and prevention of the rare pathogenic organisms.

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

Science.gov (United States)

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Bats, emerging infectious diseases, and the rabies paradigm revisited

Science.gov (United States)

Kuzmin, Ivan V.; Bozick, Brooke; Guagliardo, Sarah A.; Kunkel, Rebekah; Shak, Joshua R.; Tong, Suxiang; Rupprecht, Charles E

2011-01-01

The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be ‘orphan’ but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels. PMID:24149032

Bats, emerging infectious diseases, and the rabies paradigm revisited.

Science.gov (United States)

Kuzmin, Ivan V; Bozick, Brooke; Guagliardo, Sarah A; Kunkel, Rebekah; Shak, Joshua R; Tong, Suxiang; Rupprecht, Charles E

2011-06-20

The significance of bats as sources of emerging infectious diseases has been increasingly appreciated, and new data have been accumulated rapidly during recent years. For some emerging pathogens the bat origin has been confirmed (such as lyssaviruses, henipaviruses, coronaviruses), for other it has been suggested (filoviruses). Several recently identified viruses remain to be 'orphan' but have a potential for further emergence (such as Tioman, Menangle, and Pulau viruses). In the present review we summarize information on major bat-associated emerging infections and discuss specific characteristics of bats as carriers of pathogens (from evolutionary, ecological, and immunological positions). We also discuss drivers and forces of an infectious disease emergence and describe various existing and potential approaches for control and prevention of such infections at individual, populational, and societal levels.

Analysing the Integration of Engineering in Science Lessons with the Engineering-Infused Lesson Rubric

Science.gov (United States)

Peterman, Karen; Daugherty, Jenny L.; Custer, Rodney L.; Ross, Julia M.

2017-01-01

Science teachers are being called on to incorporate engineering practices into their classrooms. This study explores whether the Engineering-Infused Lesson Rubric, a new rubric designed to target best practices in engineering education, could be used to evaluate the extent to which engineering is infused into online science lessons. Eighty lessons…

Lessons from the organisation of the UK medical services deployed in support of Operation TELIC (Iraq) and Operation HERRICK (Afghanistan).

Science.gov (United States)

Bricknell, Martin C M; Nadin, M

2017-08-01

This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis ' the golden thread ' and eight ' silver bullets ' as themes to institutionalise the learning to deliver the golden thread. One additional theme, mentoring indigenous healthcare systems and providers, emerged as a completely new capability requirement. The DMS has established a programme of work to implement these lessons. 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/.

Reporting Helicopter Emergency Medical Services in Major Incidents

DEFF Research Database (Denmark)

Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

2016-01-01

OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

Snake fungal disease: an emerging threat to wild snakes.

Science.gov (United States)

Lorch, Jeffrey M; Knowles, Susan; Lankton, Julia S; Michell, Kathy; Edwards, Jaime L; Kapfer, Joshua M; Staffen, Richard A; Wild, Erik R; Schmidt, Katie Z; Ballmann, Anne E; Blodgett, Doug; Farrell, Terence M; Glorioso, Brad M; Last, Lisa A; Price, Steven J; Schuler, Krysten L; Smith, Christopher E; Wellehan, James F X; Blehert, David S

2016-12-05

Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused by Ophidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Prevention of Recurrent Staphylococcal Skin Infections

OpenAIRE

Creech, C. Buddy; Al-Zubeidi, Duha N.; Fritz, Stephanie A.

2015-01-01

Staphylococcus aureus infections pose a significant health burden. The emergence of community-associated methicillin-resistant S. aureus has resulted in an epidemic of skin and soft tissue infections (SSTI), and many patients experience recurrent SSTI. As S. aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent SSTI or in settings of ongoing transmission. S. aureus infections often cluster within households and asymptomatic carr...

After Virginia Tech: an analysis of Internet and social media use in campus emergency preparedness.

Science.gov (United States)

Guth, David W

2013-01-01

This study gauges the degree to which the nation's colleges and universities learned a key lesson of the 2007 Virginia Tech tragedy: the need to rapidly disseminate emergency information to the campus community. A content analysis of 162 school Web sites found that three of four contained emergency preparedness information. It appears that most are now prepared to use the Internet and social media to alert stakeholders in the event of campus crises. However, less than half had links to emergency/safety information on their home pages. School size and governance appeared to factor in its placement on each Web site.

Human Infection in Wild Mountain Gorillas

Centers for Disease Control (CDC) Podcasts

This podcast discusses a study about the transmission of Human Metapneumovirus Infection to wild mountain gorillas in Rwanda in 2009, published in the April 2011 issue of Emerging Infectious Diseases. Dr. Ian Lipkin, Director of the Center for Infection and Immunity and Dr. Gustavo Palacios, investigator in the Center of Infection & Immunity share details of this study.

Meningitis secondary to Cryptococcus gattii,an emerging pathogen affecting immunocompetent hosts

Institute of Scientific and Technical Information of China (English)

Laura Cookman; Maria Hugi

2013-01-01

BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In this study,we describe the first reported emergency medicine case of meningitis associated with Cryptococcus gattii to alert providers of this insidious,emerging global pathogen infecting immunocompetent individuals.METHODS:We provided a case report and accompanying review of the literature.A MEDLINE search for the term Cryptoccocus gattii was performed to obtain background information on Cryptococcus gattii.RESULTS:After two months of hospitalization,the patient was eventually discharged neurologically intact except for a continued mild bilateral hearing deficit.CONCLUSION:Cryptococcus gattii is an emerging world pathogen,which affects otherwise healthy,immunocompetent patients and requires timely identification and treatment in order to prevent severe neurological sequelae.

The nature of immune responses to urinary tract infections

Science.gov (United States)

Abraham, Soman N.; Miao, Yuxuan

2016-01-01

The urinary tract is constantly exposed to microorganisms that inhabit the gastrointestinal tract, but generally the urinary tract resists infection by gut microorganisms. This resistance to infection is mainly ascribed to the versatility of the innate immune defences in the urinary tract as the adaptive immune responses are limited, particularly when only the lower urinary tract is infected. In recent years, as the strengths and weaknesses of the immune system of the urinary tract have emerged and as the virulence attributes of uropathogens are recognized, several potentially effective and unconventional strategies to contain or prevent urinary tract infections have emerged. PMID:26388331

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response

International Nuclear Information System (INIS)

2012-05-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2.

Clostridium difficile Infection in Outpatients

Centers for Disease Control (CDC) Podcasts

2011-11-07

Dr. Jon Mark Hirshon, Associate Professor of Emergency Medicine at the University of Maryland School of Medicine, discusses Clostridium difficile infection in outpatients.  Created: 11/7/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/21/2011.

Emerging Zika Virus Infection: A Rapidly Evolving Situation.

Science.gov (United States)

Bordi, Licia; Avsic-Zupanc, Tatjana; Lalle, Eleonora; Vairo, Francesco; Capobianchi, Maria Rosaria; da Costa Vasconcelos, Pedro Fernando

2017-01-01

Zika virus is a mosquito-borne flavivirus, firstly identified in Uganda and responsible for sporadic human cases in Africa and Asia until recently, when large outbreak occurred in Pacific Ocean and the Americas. Since the main vectors during its spread outside of Africa have been Ae. albopictus and Ae. aegypti mosquitoes, which are widely distributed all over the world, there is urgent need for a coordinated response for prevention and spread of ZIKV epidemics.Despite clinical manifestation of Zika virus infection are usually mild and self limiting, there are reports suggesting, during the recent epidemic, an association of ZIKV infection with severe consequences, including fetal/newborn microcephaly, due to vertical in utero transmission, autoimmune-neurological presentations including cranial nerve dysfunction, and Guillain-Barré Syndrome in adults. The primary mode of transmission of Zika virus between humans is through the bite of an infected female mosquito of the Aedes genus, but also sexual and blood transfusion transmission may occur. Moreover, a case of non-sexual spread from one person to another has been described, indicating that we still have more to learn about Zika transmission.Biological basis for pathogenetic effects are under investigation. Laboratory diagnosis is challenging since, so far, there are no "gold standard" diagnostic tools, and the low and short viremia in the acute phase, and together with the high cross-reactivity among the members of flavivirus genus are the most challenging aspects to be overcome.

Manual for first responders to a radiological emergency. Emergency preparedness and response

International Nuclear Information System (INIS)

2008-01-01

lessons learned from using IAEA-TECDOC-1162, previous emergencies and research, while ensuring consistency with the IAEA Safety Standards Series No. GS-R-2. The publication is cosponsored by the Comite technique international de prevention et d'extinction du feu (CTIF), the Pan American Health Organization (PAHO) and the World Health Organization (WHO)

Emergency response to a highway accident in Springfield, Massachusetts, on December 16, 1991

International Nuclear Information System (INIS)

1992-06-01

On December 16, 1991, a truck carrying unirradiated (fresh) nuclear fuel was involved in an accident on US Interstate 91, in Springfield, Massachusetts. This report describes the emergency response measures undertaken by local, State, Federal, and private parties. The report also discusses ''lessons learned'' from the response to the accident and suggests areas where improvements might be made

Experience and lessons learned from emergency disposal of Fukushima nuclear power station accident

International Nuclear Information System (INIS)

Xu Xiegu; Zhen Bei; Yang Xiaoming; Chen Xiaohua

2012-01-01

After Fukushima nuclear accident, we visited the related medical aid agencies for nuclear accidents and conducted investigations in disaster-affected areas in Japan. This article summarizes the problems with emergency disposal of Fukushima nuclear accident while disclosing problems should be solved during the emergency force construction for nuclear accidents. (authors)

Simple and Practical Efficiency Lessons

Science.gov (United States)

Kolpin, Van

2018-01-01

The derivation of conditions necessary for Pareto efficient production and exchange is a lesson frequently showcased in microeconomic theory textbooks. Traditional delivery of this lesson is, however, limited in its scope of application and can be unnecessarily convoluted. The author shows that the universe of application is greatly expanded and a…

Lessons Learned from Protective Immune Responses to Optimize Vaccines against Cryptosporidiosis.

Science.gov (United States)

Lemieux, Maxime W; Sonzogni-Desautels, Karine; Ndao, Momar

2017-12-24

In developing countries, cryptosporidiosis causes moderate-to-severe diarrhea and kills thousands of infants and toddlers annually. Drinking and recreational water contaminated with Cryptosporidium spp. oocysts has led to waterborne outbreaks in developed countries. A competent immune system is necessary to clear this parasitic infection. A better understanding of the immune responses required to prevent or limit infection by this protozoan parasite is the cornerstone of development of an effective vaccine. In this light, lessons learned from previously developed vaccines against Cryptosporidium spp. are at the foundation for development of better next-generation vaccines. In this review, we summarize the immune responses elicited by naturally and experimentally-induced Cryptosporidium spp. infection and by several experimental vaccines in various animal models. Our aim is to increase awareness about the immune responses that underlie protection against cryptosporidiosis and to encourage promotion of these immune responses as a key strategy for vaccine development. Innate and mucosal immunity will be addressed as well as adaptive immunity, with an emphasis on the balance between T H 1/T H 2 immune responses. Development of more effective vaccines against cryptosporidiosis is needed to prevent Cryptosporidium spp.-related deaths in infants and toddlers in developing countries.

Discrepant coagulation profile in HIV infection

DEFF Research Database (Denmark)

Haugaard, Anna Karen; Lund, Tamara T.; Birch, Carsten

2013-01-01

In HIV infection, cardiovascular disease (CVD) has emerged as a clinical problem, and elevated D-dimer has been reported. The pathophysiologic mechanisms underlying this remain unclear. We aimed to investigate whether untreated HIV-infected individuals display evidence of functional coagulopathy...

Sepsis patients in the emergency department : stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score?

NARCIS (Netherlands)

Quinten, Vincent M.; van Meurs, Matijs; Wolffensperger, Anna E.; ter Maaten, Jan C.; Ligtenberg, Jack J M

2017-01-01

OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical

Planning geometry lessons with learning platforms

DEFF Research Database (Denmark)

Tamborg, Andreas Lindenskov

mathematics teachers’ joint planning of a lesson in geometry with a learning platform called Meebook is analyzed using the instrumental approach. It is concluded that the interface in Meebook orients the teachers work toward what the students should do rather than what they should learn, although the latter......This paper investigates how mathematics teachers plan lessons with a recently implemented Danish learning platform designed to support teachers in planning lessons in line with a recent objective-oriented curriculum. Drawing on data from observations of and interviews with teachers, three...... is a key intention behind the implementation of the platform. It is also concluded that when the teachers succeed in using learning objectives actively in their planning, the objectives support the teachers in designing lessons that correspond with their intentions. The paper concludes with a discussion...

Odontogenic Infections: A 1-year Retrospective Study.

Science.gov (United States)

Mahmoodi, Benjamin; Weusmann, Jens; Azaripour, Adriano; Braun, Benedikt; Walter, Christian; Willershausen, Brita

2015-04-01

The purpose of this study was to analyze the prevalence, demographic patterns and management of odontogenic infections in patients undergoing treatment in an outpatient dental emergency service of a university hospital. In a retrospective study of the year 2012, all patients suffering from odontogenic infections were included. Demographic data, diagnosis and the conducted treatment were analyzed. Odontogenic infections were defined as pulpitis, apical and marginal periodontitis, abscesses and pericoronitis. A total of 2,058 out of 4,209 emergency patients suffered from odontogenic infections. The majority (45.0%) had an apical periodontitis, 20.8% abscesses, 17.3% a marginal periodontitis, 16.3% a pulpitis and 5.8% a pericoronitis. Mean age was 37.5 ± 17.0 years standard deviation (SD) (1.2-96.4). Most patients were 20 to 29 years (24.6%), followed by the age group of 30 to 39 year old patients (21.0%). Males were affected more frequently (55.5%) than females (45.5%). Most of the patients (64.5%) of the patients received a dental or surgical treatment. Antibiotics were prescribed in 31.7% of cases. Amoxicillin was the most common prescribed antibiotic (54.5%). Odontogenic infections represent one of the main reasons for consulting the emergency service. Due to the high number of cases and the severe complications, dentists have to be familiar with the surgical management of odontogenic infections as well as the appropriate use of antibiotics. Nearly half of all patients who sought, treatment in the emergency service had an odontogenic infectious disease. This should be considered for the organization and planning of the service.

Endodontic treatment completion following emergency pulpectomy.

LENUS (Irish Health Repository)

Lynch, C D

2010-06-01

Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit.

Masterwork Art Lesson: Kandinsky Watercolors.

Science.gov (United States)

LiPira, Michael

2003-01-01

Presents an art lesson used with sixth-grade students which also can be used with other grade levels. Explains that the artwork of Wassily Kandinsky served as inspiration for this lesson. Explains that the students learned about abstract art and used watercolors to create their own paintings in the style of Kandinsky. (CMK)

Bead Game Simulation. Lesson Plan.

Science.gov (United States)

Ripp, Ken

This lesson plan offers students the opportunity to participate in the three basic economic systems (market, command, and tradition). By working in each of the systems, students will internalize the fundamental values present in each system and will gain insights into the basic advantages and disadvantages of each system. The lesson plan provides…

Implementing US Department of Energy lessons learned programs. Volume 2

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-01

The DOE Lessons Learned Handbook is a two-volume publication developed to supplement the DOE Lessons Learned Standard (DOE-STD-7501-95) with information that will organizations in developing or improving their lessons learned programs. Volume 1 includes greater detail than the Standard in areas such as identification and documentation of lessons learned; it also contains sections on specific processes such as training and performance measurement. Volume 2 (this document) contains examples of program documents developed by existing lessons learned programs as well as communications material, functional categories, transmittal documents, sources of professional and industry lessons learned, and frequently asked questions about the Lessons Learned List Service.

Physically active academic lessons in elementary children.

Science.gov (United States)

Bartholomew, John B; Jowers, Esbelle M

2011-06-01

Although schools are an ideal location to conduct interventions that target children, the emphasis on standardized testing makes it difficult to implement interventions that do not directly support academic instruction. In response, physically active academic lessons have been developed as a strategy to increase physical activity while also addressing core educational goals. Texas I-CAN! is one incarnation of this approach. We will review the on-going research on the impact of these active lessons on: teacher implementation, child step count, child attention control, and academic performance. The collected studies support the impact of physically active academic lessons on each area of interest. If these data can be replicated, it suggests that teachers might find these lessons of benefit to their primary role as educators, which should ease dissemination of these and other physically active lessons in elementary schools. Copyright © 2011 Elsevier Inc. All rights reserved.

Chikungunya fever: A re-emerging viral infection

Directory of Open Access Journals (Sweden)

Chhabra M

2008-01-01

Full Text Available Chikungunya (CHIK fever is a re-emerging viral disease characterized by abrupt onset of fever with severe arthralgia followed by constitutional symptoms and rash lasting for 1-7 days. The disease is almost self-limiting and rarely fatal. Chikungunya virus (CHIKV is a RNA virus belonging to family Togaviridae, genus Alphavirus. Molecular characterization has demonstrated two distinct lineages of strains which cause epidemics in Africa and Asia. These geographical genotypes exhibit differences in the transmission cycles. In contrast to Africa where sylvatic cycle is maintained between monkeys and wild mosquitoes, in Asia the cycle continues between humans and the Aedes aegypti mosquito. CHIKV is known to cause epidemics after a period of quiescence. The first recorded epidemic occurred in Tanzania in 1952-1953. In Asia, CHIK activity was documented since its isolation in Bangkok, Thailand in 1958. Virus transmission continued till 1964. After hiatus, the virus activity re-appeared in the mid-1970s and declined by 1976. In India, well-documented outbreaks occurred in 1963 and 1964 in Kolkata and southern India, respectively. Thereafter, a small outbreak of CHIK was reported from Sholapur district, Maharashtra in 1973. CHIKV emerged in the islands of South West Indian Ocean viz. French island of La Reunion, Mayotee, Mauritius and Seychelles which are reporting the outbreak since February, 2005. After quiescence of about three decades, CHIKV re-emerged in India in the states of Andhra Pradesh, Karnataka, Maharashtra, Madhya Pradesh and Tamil Nadu since December, 2005. Cases have also been reported from Rajasthan, Gujarat and Kerala. The outbreak is still continuing. National Institute of Communicable Diseases has conducted epidemiological, entomological and laboratory investigations for confirmation of the outbreak. These have been discussed in detail along with the major challenges that the country faced during the current outbreak.

Lesson Study and History Education

Science.gov (United States)

Halvorsen, Anne-Lise; Kesler Lund, Alisa

2013-01-01

This article examines the experiences of a group of fifth-grade teachers who used lesson study, a teacher-driven form of professional development, to teach history in a project supported by a Teaching American History Grant. The project addressed the following questions: What does a lesson study cycle for history education look like? What…

Five-year forward view: lessons from emergency care at the extremes of age.

Science.gov (United States)

Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

2018-03-01

Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

Value pricing pilot program : lessons learned

Science.gov (United States)

2008-08-01

This "Lessons Learned Report" provides a summary of projects sponsored by the Federal Highway Administration's (FHWA's) Congestion and Value Pricing Pilot Programs from 1991 through 2006 and draws lessons from a sample of projects with the richest an...

Students’ motivation in a disc golf-lesson and a soccer-lesson: An experimental study in the Physical Education setting

Directory of Open Access Journals (Sweden)

Kristian Vernegaard

2017-09-01

Full Text Available One of the purposes of physical education (PE in both Norway and Denmark is that PE should inspire to a lifelong active lifestyle. Based on the self-determination theory, the aim of the present study was to compare students’ intrinsic motivation, extrinsic motivation, and perceived competence in a lifestyle sport inspired PE-lesson (disc golf to a traditional PE-lesson (soccer and general PE. In addition, we aimed to investigate whether differences in motivation and perceived competence were conditional of the students’ relative attitude toward PE. The result of the study revealed that perceived competence was higher in the disc golf-lesson compared to the soccer-lesson and general PE. No overall differences in intrinsic motivation were found. However, when investigating differences in intrinsic motivation according to the students’ relative attitude toward PE, the results indicated that the students with a negative attitude toward PE was significantly more intrinsically motivated in disc golf-lesson compared to soccer-lesson and general PE. The findings may be seen as further recommendations to physical educators to vary the activity choices in physical education classes.

Goiania radiation accident: activities carried out and lessons learned based on personal experience

International Nuclear Information System (INIS)

Silva, F.C.A. da

2017-01-01

Goiânia Radiological Accident, on September 13, 1987, with a radioactive source of cesium-137 with 50.9 TBq, used in radiotherapy, is one of the most important accidents in the scientific area, representing a milestone for all workers in the areas of radiation protection and radiological emergency that worked during the event. A personal view of the Goiânia Radiological Accident is presented, showing some activities carried out in contaminated areas and lessons learned based on own experience during the event

Immunity to intestinal pathogens: lessons learned from Salmonella

Science.gov (United States)

McSorley, Stephen J.

2014-01-01

Summary Salmonella are a common source of food or water-borne infection and cause a wide range of clinical disease in human and animal hosts. Salmonella are relatively easy to culture and manipulate in a laboratory setting, and the infection of laboratory animals induces robust innate and adaptive immune responses. Thus, immunologists have frequently turned to Salmonella infection models to expand understanding of immunity to intestinal pathogens. In this review, I summarize current knowledge of innate and adaptive immunity to Salmonella and highlight features of this response that have emerged from recent studies. These include the heterogeneity of the antigen-specific T-cell response to intestinal infection, the prominence of microbial mechanisms to impede T and B-cell responses, and the contribution of non-cognate pathways for elicitation of T-cell effector functions. Together, these different issues challenge an overly simplistic view of host-pathogen interaction during mucosal infection but also allow deeper insight into the real-world dynamic of protective immunity to intestinal pathogens. PMID:24942689

Learning to observe mathematical learning in lesson studies

DEFF Research Database (Denmark)

Rasmussen, Klaus; Østergaard, Camilla Hellsten; Foss, Kristian Kildemoes

2016-01-01

This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which ena...... enable or hinder fruitful lesson study. While substantial research has been carried out in the general field of bserving pupils’ learning processes and teachers’ pedagogical practice, little is known about this in the particular setting of lesson study....

New developments in the German emergency planning as a consequence of Fukushima; Neue Entwicklungen im deutschen Notfallschutz nach Fukushima

Energy Technology Data Exchange (ETDEWEB)

Welte, Ulrike

2015-06-01

The analysis of the reactor accident in Fukushima Daiichi in March 2011 (lessons learned) in Germany and other countries has consequences for the national emergency planning in the respective governmental authorities. The contribution summarizes the most important aspects of the extended emergency plan concepts elaborated by the German SSK (Strahlenschutzkommission) and the RSK (Reaktorschutzkommission). The radiological principles were revised, recommendations concerning the monitoring and measuring equipment, accident scenarios for the emergency planning and measures for the post-accident phases are included in the concept.

Lessons learned in terms of crisis management; Les enseignements en matiere de gestion de crise

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

This document outlines that nobody was prepared to the crisis which occurred after the Chernobyl accident, whether in Russia, Europe or France. In order to illustrate the fact that crisis management has been different from one country to another, the report describes how the crisis has been managed in Norway (which has been quickly reached by fallouts and with a rather high level) and in Switzerland. It comments radioactivity measurements performed in France during spring 1986 by the SCPRI, the CEA and the ISPN. It discusses the lessons drawn in France in terms of emergency situation management regarding the protection of the population, crisis management, and the French post-accidental doctrine. It comments the lessons drawn in eastern European countries, with the cooperative implication of the IRSN. International projects are evoked: the Chernobyl Centre, the French-German Initiative, the European projects (EURANOS, NERIS, FARMING, STRATEGY, MOSES and SAMEN)

Lessons learned from the Fukushima Dai-ichi accident and responses in NRA regulatory requirements

International Nuclear Information System (INIS)

Fuketa, Toyoshi

2014-01-01

The author would like to present significant lessons learned from the TEPCO’s Fukushima Dai-ichi accident and responses in regulatory requirements developed by the Nuclear Regulation Authority for power-producing light water reactors. The presentation will cover prevention of structures, systems and components failures, measures to prevent common cause failures, prevention of core damage, mitigation of severe accidents, emergency preparedness, continuous improvement of safety, use of probabilistic risk assessment, and post-accident regulation on the Fukushima Dai-ichi. (author)

Quality assurance and assessment of preparedness at DAE-ERCs for handling radiological emergencies in public domain

International Nuclear Information System (INIS)

Sharma, R.; Murali, S.; Singh, Rajvir; Pradeepkumar, K.S.

2014-01-01

The radiological emergencies are very rare in occurrence the mechanism to improve the preparedness can be ensured through conducting mock exercises/drills. Emergency kit comprises of adequate number of radiation monitoring equipments and PPEs required for response is kept in readiness at ERC. There is a need of training modules on radiological emergencies for all stake holders e.g. district officials, Local Police, Medical professionals and National Disaster Response Force (NDRF) to improve the knowledge and response capability. The adaptability to situations is important for ERTs based on the lessons learned from emergency at Mayapuri, Delhi. The role and responsibility of different agencies have been identified and drafted in the preparedness plan to meet the challenges during response

Snake fungal disease: An emerging threat to wild snakes

Science.gov (United States)

Lorch, Jeffrey M.; Knowles, Susan N.; Lankton, Julia S.; Michell, Kathy; Edwards, Jaime L.; Kapfer, Joshua M.; Staffen, Richard A.; Wild, Erik R.; Schmidt, Katie Z.; Ballmann, Anne; Blodgett, Doug; Farrell, Terence M.; Glorioso, Brad M.; Last, Lisa A.; Price, Steven J.; Schuler, Krysten L.; Smith, Christopher; Wellehan, James F. X.; Blehert, David S.

2016-01-01

Since 2006, there has been a marked increase in the number of reports of severe and often fatal fungal skin infections in wild snakes in the eastern USA. The emerging condition, referred to as snake fungal disease (SFD), was initially documented in rattlesnakes, where the infections were believed to pose a risk to the viability of affected populations. The disease is caused byOphidiomyces ophiodiicola, a fungus recently split from a complex of fungi long referred to as the Chrysosporium anamorph of Nannizziopsis vriesii (CANV). Here we review the current state of knowledge about O. ophiodiicola and SFD. In addition, we provide original findings which demonstrate that O. ophiodiicola is widely distributed in eastern North America, has a broad host range, is the predominant cause of fungal skin infections in wild snakes and often causes mild infections in snakes emerging from hibernation. This new information, together with what is already available in the scientific literature, advances our knowledge of the cause, pathogenesis and ecology of SFD. However, additional research is necessary to elucidate the factors driving the emergence of this disease and develop strategies to mitigate its impacts.

[Cryptosporidiosis: an emerging zoonosis].

Science.gov (United States)

Del Coco, V F; Córdoba, M A; Basualdo, J A

2009-01-01

The genus Cryptosporidium, responsible for producing cryptosporidiosis, includes several species. Humans and livestock are the main sources of infection. Waterborne cryptosporidiosis outbreaks are associated with drinking water. The infective parasite stage is the oocyst, which is resistant to conventional potabilization treatments. In immunocompetent hosts it produces acute, self-limiting diarrhoea. In immunocompromised people, it could develop severe, life-threatening pattern forms of the infection. People with AIDS are especially susceptible to these clinical forms. Cryptosporidium infections are also considered a major cause of morbimortality in calves, which leads to important economic losses. In the last years, there has been an increase of patients suffering from different causes of immunosuppression, and the need to find an effective therapy against Cryptosporidium has become greater. In spite of the many attempts of the pharmaceutical industry to develop an effective antiparasitic agent to treat cryptosporidiosis, this infection and its clinical consequences still constitute a major public health problem. This article analizes the taxonomy, morphology, biology and life cycle of Cryptosporidium. Clinical, immunological, epidemiological features and diagnosis of cryptosporidiosis are also included. Treatment and prevention of the infection are discussed, and future tendencies are suggested for this emerging parasitic infection.

Keiko, Killer Whale. [Lesson Plan].

Science.gov (United States)

Discovery Communications, Inc., Bethesda, MD.

This lesson plan presents activities designed to help students understand that Keiko, the killer whale, lived for a long time in an aquarium and had to be taught to live independently; and that computer users can get updates on how Keiko is doing. The main activity of the lesson involves middle school students working in small groups to produce a…

Exercising the federal radiological emergency response plan

International Nuclear Information System (INIS)

Gant, K.S.; Adler, M.V.; Wolff, W.F.

1986-01-01

Multiagency exercises were an important part of the development of the Federal Radiological Emergency Response Plan. This paper concentrates on two of these exercises, the Federal Field Exercise in March 1984 and the Relocation Tabletop Exercise in December 1985. The Federal Field Exercise demonstrated the viability and usefulness of the draft plan; lessons learned from the exercise were incorporated into the published plan. The Relocation Tabletop Exercise examined the federal response in the postemergency phase. This exercise highlighted the change over time in the roles of some agencies and suggested response procedures that should be developed or revised. 8 refs

Mini-Lessons on Language (The Round Table).

Science.gov (United States)

English Journal, 1993

1993-01-01

Describes several successful lessons that provide students with new awareness of the English language. Includes lessons focusing on language change, onomatopoeia, slang, word origin, dialect, and language functions. (MM)

1986 viewpoint of emergency preparedness in the upper midwest

International Nuclear Information System (INIS)

Parkyn, J.D.

1986-01-01

The recent Soviet emergency preparedness disaster has started a new round of interactions between utilities and civil governments regarding the adequacy of emergency preparedness around nuclear plants. The 1986 annual meeting of the cooperative produced several questions regarding the potentials of the plant and its impact on the public and the cooperative in the event of an off-normal situation. Emergency preparedness requires a real partnership between local civil authorities and the utility in a close spirit of cooperation with local law enforcement, which is frequently charged with the strongest burdens of emergency planning. It is more evident that the virtual veto power of local branches of government over emergency preparedness needs to be more fully recognized by utilities. Early notification and warning systems are coming under a tighter scrutiny as public perception of their fallibility increases. Another continuing problem with emergency preparedness has been the recognition that guarantees of reaching every individual, particularly in more hostile environments, can not be easily made. The lessons learned in nuclear planning indicate that this is an area too often not given a high enough threshold in the total spectrum of nuclear safety and which, from the utility standpoint, needs to be elevated to a higher threshold of importance

The Secret Life of RNA: Lessons from Emerging Methodologies.

Science.gov (United States)

Medioni, Caroline; Besse, Florence

2018-01-01

The last past decade has witnessed a revolution in our appreciation of transcriptome complexity and regulation. This remarkable expansion in our knowledge largely originates from the advent of high-throughput methodologies, and the consecutive discovery that up to 90% of eukaryotic genomes are transcribed, thus generating an unanticipated large range of noncoding RNAs (Hangauer et al., 15(4):112, 2014). Besides leading to the identification of new noncoding RNA species, transcriptome-wide studies have uncovered novel layers of posttranscriptional regulatory mechanisms controlling RNA processing, maturation or translation, and each contributing to the precise and dynamic regulation of gene expression. Remarkably, the development of systems-level studies has been accompanied by tremendous progress in the visualization of individual RNA molecules in single cells, such that it is now possible to image RNA species with a single-molecule resolution from birth to translation or decay. Monitoring quantitatively, with unprecedented spatiotemporal resolution, the fate of individual molecules has been key to understanding the molecular mechanisms underlying the different steps of RNA regulation. This has also revealed biologically relevant, intracellular and intercellular heterogeneities in RNA distribution or regulation. More recently, the convergence of imaging and high-throughput technologies has led to the emergence of spatially resolved transcriptomic techniques that provide a means to perform large-scale analyses while preserving spatial information. By generating transcriptome-wide data on single-cell RNA content, or even subcellular RNA distribution, these methodologies are opening avenues to a wide range of network-level studies at the cell and organ-level, and promise to strongly improve disease diagnostic and treatment.In this introductory chapter, we highlight how recently developed technologies aiming at detecting and visualizing RNA molecules have contributed to

Bloodstream Infections with Mycobacterium tuberculosis among HIV patients

Centers for Disease Control (CDC) Podcasts

2010-09-23

This podcast looks at bloodstream infections with Mycobacterium tuberculosis and other pathogens among outpatients infected with HIV in Southeast Asia. CDC health scientist Kimberly McCarthy discusses the study and why bloodstream infections occur in HIV-infected populations.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/23/2010.

Building clinicians-researchers partnerships: lessons from diverse natural settings and practice-oriented initiatives.

Science.gov (United States)

Castonguay, Louis G; Youn, Soo Jeong; Xiao, Henry; Muran, J Christopher; Barber, Jacques P

2015-01-01

In this concluding paper, we identify the type of studies conducted by 11 teams of contributors to a special issue on building clinicians-researchers partnerships. Those studies were conducted across a variety of clinical settings. We also integrate the lessons that have emerged from their collaborative initiatives in terms of obstacles faced, strategies adopted to address these challenges, benefits gained, and general recommendations offered to facilitate studies conducted with or by clinicians. The paper ends with the authors' thoughts about the future success of practice-oriented research in general.

Improving Mathematics Teaching as Deliberate Practice through Chinese Lesson Study

Science.gov (United States)

Huang, Rongjin; Prince, Kyle M.; Barlow, Angela T.

2017-01-01

This study examined how a ninth grade teacher improved an Algebra I lesson through a lesson study approach. We used multiple data sources to investigate the improvement of the lesson towards student-centered mathematics instruction, perceived benefits of the teacher, and factors associated with the improvement of teaching. The lesson group…

Adult Catheter Care and Infection Prevention Guide

Science.gov (United States)

... and go to an emergency room or clinic. Bring your repair kit because, unfortunately, many emergency rooms do not have them. • Ask your clinician about a sutureless securement device to reduce the risk of infection and accidental ...

Craft Lessons: Teaching Writing K-8. Second Edition

Science.gov (United States)

Fletcher, Ralph; Portalupi, JoAnn

2007-01-01

Since its publication in 1998 Craft Lessons has become a mainstay of writing teachers, both new and experienced. Practical lessons--each printed on one page--and the instructional language geared to three grade-level groupings: K-2, 3-4, and 5-8 are contained in this book. In the decade since Craft Lessons' publication the world has changed in…

Babesia microti infection, eastern Pennsylvania, USA.

Science.gov (United States)

Acosta, Marcela E Perez; Ender, Peter T; Smith, Erin M; Jahre, Jeffrey A

2013-07-01

Infection with Babesia microti has not been well-described in eastern Pennsylvania, USA, despite the vector of this organism being prevalent. We report 3 cases of babesiosis in eastern Pennsylvania in persons without recent travel outside the region or history of blood transfusions, suggesting emergence of this infection.

Anticipating students' reasoning and planning prompts in structured problem-solving lessons

Science.gov (United States)

Vale, Colleen; Widjaja, Wanty; Doig, Brian; Groves, Susie

2018-02-01

Structured problem-solving lessons are used to explore mathematical concepts such as pattern and relationships in early algebra, and regularly used in Japanese Lesson Study research lessons. However, enactment of structured problem-solving lessons which involves detailed planning, anticipation of student solutions and orchestration of whole-class discussion of solutions is an ongoing challenge for many teachers. Moreover, primary teachers have limited experience in teaching early algebra or mathematical reasoning actions such as generalising. In this study, the critical factors of enacting the structured problem-solving lessons used in Japanese Lesson Study to elicit and develop primary students' capacity to generalise are explored. Teachers from three primary schools participated in two Japanese Lesson Study teams for this study. The lesson plans and video recordings of teaching and post-lesson discussion of the two research lessons along with students' responses and learning are compared to identify critical factors. The anticipation of students' reasoning together with preparation of supporting and challenging prompts was critical for scaffolding students' capacity to grasp and communicate generality.

Implementation of pre-exposure prophylaxis for human immunodeficiency virus infection: progress and emerging issues in research and policy.

Science.gov (United States)

Cáceres, Carlos F; Borquez, Annick; Klausner, Jeffrey D; Baggaley, Rachel; Beyrer, Chris

2016-01-01

In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives. Those guidelines present a timely challenge to health systems for the scaling up of not only treatment for every person living with HIV infection but also the offer of PrEP to those at substantial risk. Delivery and uptake of both universal antiretroviral therapy (ART) and PrEP will require nation-wide commitment and could reinvigorate health systems to develop more comprehensive "combination prevention" programmes and support wider testing linked to both treatments and other prevention options for populations at highest risk who are currently not accessing services. Various gaps in current health systems will need to be addressed to achieve strategic scale-up of PrEP, including developing prioritization strategies, strengthening drug regulations, determining cost and funding sources, training health providers, supporting user adherence and creating demand. The initial steps in the scale-up of PrEP globally suggest feasibility, acceptability and likely impact. However, to prevent setbacks in less well-resourced settings, countries will need to anticipate and address challenges such as operational and health systems barriers, drug cost and regulatory policies, health providers' openness to prescribing PrEP to populations at substantial risk, demand and legal and human rights issues. Emerging problems will require creative solutions and will continue to illustrate the complexity of PrEP implementation.

Clinical characteristics of dental emergencies and prevalence of dental trauma at a university hospital emergency center in Korea.

Science.gov (United States)

Bae, Ji-Hyun; Kim, Young-Kyun; Choi, Yong-Hoon

2011-10-01

The aim of this study was to examine the clinical characteristics of dental emergency patients who visited a university hospital emergency center and to evaluate the incidence of dental trauma. A retrospective chart review of patients with dental complaints and who visited the Seoul National University Bundang Hospital (SNUBH) emergency center in Gyeonggi-do, Korea, from January 2009 to December 2009 was conducted. Information regarding age, gender, the time, day, and month of presentation, diagnosis, treatment, and follow up was collected and analyzed. One thousand four hundred twenty-five patients with dental problems visited the SNUBH emergency center. Dental patients accounted for 1.47% of the total 96,708 patients at the emergency center. The male-to-female ratio was 1.68:1, with a considerably larger number of male patients (62.7%). The age distribution peak was at 0-9 years (27.5%), followed by patients in their forties (14.1%). The number of patients visiting the dental emergency center peaked in May (14.2%), on Sundays (22.4%), and between 2100 and 2400 h (20.8%). The patients' chief complaints were as follows: dental trauma, dental infection, oral bleeding, and temporomandibular joint disorder (TMD). The prevalence of dental trauma was 66%. The reasons for dental emergency visits included the following: dental trauma, dental infection, oral bleeding, and TMD, with 66% of the patients requiring management of dental trauma. It is important that dentists make a prompt, accurate diagnosis and initiate effective treatment in case of dental emergencies, especially dental trauma. © 2011 John Wiley & Sons A/S.

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (Chinese Edition)

International Nuclear Information System (INIS)

2013-01-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (French Edition)

International Nuclear Information System (INIS)

2013-01-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (Chinese Edition)

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-09-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2.

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (Arabic Edition)

International Nuclear Information System (INIS)

2014-01-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (Russian Edition)

International Nuclear Information System (INIS)

2014-01-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2

Communication with the Public in a Nuclear or Radiological Emergency. Emergency Preparedness and Response (Spanish Edition)

International Nuclear Information System (INIS)

2013-01-01

account of the lessons learned from past emergencies, including the accident at TEPCO's Fukushima Daiichi Nuclear Power Station in 2011, and from research, while ensuring consistency with IAEA Safety Standards Series No. GS-R-2

Emergency exercise ''Mosel 90''

International Nuclear Information System (INIS)

Miska, H.H.

1993-01-01

An emergency exercise for the environs of the nuclear power plant CPN de Cattenom was performed from April, 5th to 7th, 1990. Administration and operational personnel from Luxembourg, Saarland, and Rhineland-Palatinate (RP) participated in the combined staff and field exercise; the competent French authority, la Prefecture de Metz, played the role of the licencee. While each responsible authority tested its alarm -and response plan and trained its personnel, a major aim of the off-site exercise was to investigate and improve the methods of communication in this border region location; the outer planning zone (radius 25 km) of the French reactors encompasses parts of Luxembourg and of the two German states mentioned above. Preparation and scenario of the exercise will be explained and lessons learned will be discussed

Urinary Tract Infections due to Multidrug-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Chicago Emergency Department

Directory of Open Access Journals (Sweden)

Thana Khawcharoenporn

2013-01-01

Full Text Available Background. Selection of empiric antibiotics for urinary tract infections (UTIs has become more challenging because of the increasing rates of multidrug-resistant Enterobacteriaceae (MDRE infections. Methods. This retrospective study was conducted to determine antibiotic resistance patterns, risk factors, and appropriate empiric antibiotic selection for MDRE UTIs. Adult patients seen in the Emergency Department (ED with Enterobacteriaceae UTIs during 2008-2009 were identified from review of microbiology records. MDRE were defined as organisms resistant to at least 3 categories of antibiotics. Results. There were 431 eligible patients; 83 (19% had MDRE UTIs. Resistance rates for individual antibiotics among MDRE UTIs were significantly greater than non-MDRE UTIs: levofloxacin, 72% versus 14%; TMP-SMX, 77% versus 12%; amoxicillin-clavulanate, 35% versus 4%; nitrofurantoin, 21% versus 12%, and ceftriaxone, 20% versus 0%. All Enterobacteriaceae isolates were susceptible to ertapenem (MIC ≤ 2 mg/L. Independent risk factors for MDRE UTI were prior fluoroquinolone use within 3 months (adjusted odds ratio (aOR 3.64; , healthcare-associated risks (aOR 2.32; , and obstructive uropathy (aOR 2.22; . Conclusion. Our study suggests that once-daily intravenous or intramuscular ertapenem may be appropriate for outpatient treatment of ED patients with MDRE UTI.

Vaccines for emerging infectious diseases: Lessons from MERS coronavirus and Zika virus.

Science.gov (United States)

Maslow, Joel N

2017-12-02

The past decade and a half has been characterized by numerous emerging infectious diseases. With each new threat, there has been a call for rapid vaccine development. Pathogens such as the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the Zika virus represent either new viral entities or viruses emergent in new geographic locales and characterized by novel complications. Both serve as paradigms for the global spread that can accompany new pathogens. In this paper, we review the epidemiology and pathogenesis of MERS-CoV and Zika virus with respect to vaccine development. The challenges in vaccine development and the approach to clinical trial design to test vaccine candidates for disease entities with a changing epidemiology are discussed.

Hepatitis E virus genotype three infection of human liver chimeric mice as a model for chronic HEV infection

NARCIS (Netherlands)

M.D.B. van de Garde (Martijn D.B.); S.D. Pas (Suzan); G. van der Net (Guido); R.A. de Man (Robert); A.D.M.E. Osterhaus (Albert); B.L. Haagmans (Bart); A. Boonstra (Andre); T. Vanwolleghem (Thomas)

2016-01-01

textabstractGenotype (gt) 3 hepatitis E virus (HEV) infections are emerging in Western countries. Immunosuppressed patients are at risk of chronic HEV infection and progressive liver damage, but no adequate model system currently mimics this disease course. Here we explore the possibilities of in

Emergency preparedness and response to 'Not-in-a-Facility' radiological accidents

International Nuclear Information System (INIS)

Grlicarev, Igor

2008-01-01

The paper provides an overview of lessons learned from the past radiological accidents, which have not occurred in an operating facility, i.e. 'not-in-a-facility' radiological emergencies. A method to analyze status of prevention of accidents is proposed taking into account the experiences and findings from the past events. The main emergency planning items are discussed, which would render effective response in case of such emergencies. Although the IAEA has published many documents about establishing an adequate emergency response capability, it is not an easy task to bring these recommendations into life. This paper gives some hints how to overcome the most obvious difficulties while users of these documents trying to adapt the guidance to their own needs. The special cases of alpha emitters and radiological dispersal devices were considered separately. The balanced approach to emergency response is promoted throughout the text, which means that a level of preparedness should be commensurate to the threat and the existing resources should be used to the extent possible. (author)

Professor's Page: Do Demonstration Lessons Work?

Science.gov (United States)

Clarke, Doug

2011-01-01

As part of a large research and professional development project funded by the Catholic Education Office Melbourne (CEOM), called "Contemporary Teaching and Learning of Mathematics," the ACU team has been leading demonstration lessons. There is certainly not universal agreement on the worth of demonstration lessons in the mathematics…

Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

Science.gov (United States)

Pedigo, Ryan Anthony; Zaurova, Milana

2017-06-22

Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

HIV-infected men who have sex with men who identify themselves as belonging to subcultures are at increased risk for hepatitis C infection

NARCIS (Netherlands)

Matser, Amy; Vanhommerig, Joost; Schim van der Loeff, Maarten F.; Geskus, Ronald B.; de Vries, Henry J. C.; Prins, Jan M.; Prins, Maria; Bruisten, Sylvia M.

2013-01-01

Hepatitis C virus (HCV) emerged as sexually transmitted infection among HIV-infected men who have sex with men (MSM). We studied whether HCV circulated in identifiable high-risk MSM subcultures and performed phylogenetic analysis. HIV-infected MSM were recruited at the sexually transmitted

Strategic Planning for Emergencies: Lessons Learned from Katrina

International Nuclear Information System (INIS)

Hamilton, M. G.; Mashhadi, H.; Habeck, D.

2007-01-01

The tragedy that was unleashed when hurricane Katrina hit the United States southern coast and most particularly New Orleans is still being examined. Regardless of the allocation of blame for the response, or lack thereof, several very important components of what needs to be included in effective strategic, management, and response plans were revealed in the aftermath. The first tenet is to be sure not to make the problem worse. In other words, the goal is to prevent emergencies from becoming a disaster that subsequently grows to a catastrophe. Essential components that need to be addressed start with protection and rescue of affected people. Several characteristics of an effective strategic plan that will address saving lives include leadership, continuity of government and business, effective communications, adequate evacuation plans and security of electronic infrastructure. Katrina analysis confirms that the process to integrate all the components is too complex to be accomplished ad hoc. This presentation will outline objective methodology to successfully integrate the various facets that comprise an effective strategic plan, management plan, and tactical plans.(author)

Actinobaculum schaalii, a new cause of knee prosthetic joint infection in elderly.

Science.gov (United States)

Jacquier, H; Benmansour, H; Zadegan, F; Hannouche, D; Micaelo, M; Mongiat-Artus, P; Salomon, E; Cambau, E; Berçot, B

2016-08-01

Actinobaculum schaalii is an emerging pathogen particularly involved in urinary tract infection of elderly people and/or patient with urological risk factors of urinary tract infection. This microorganism is a difficult-to-diagnose pathogen and is rarely involved in systemic or deep infections. Here, we report the first case of prosthetic joint infection due to A. schaalii in an 84-year-old man with a benign prostatic hyperplasia associated with chronic retention of urine. This case underlines the importance to optimize the diagnosis of emerging uropathogens as A. schaalii, to prevent systemic infections, particularly in patients with orthopaedic implants.

The emerging ST8 methicillin-resistant Staphylococcus aureus clone in the community in Japan: associated infections, genetic diversity, and comparative genomics.

Science.gov (United States)

Iwao, Yasuhisa; Ishii, Rumiko; Tomita, Yusuke; Shibuya, Yasuhiro; Takano, Tomomi; Hung, Wei-Chun; Higuchi, Wataru; Isobe, Hirokazu; Nishiyama, Akihito; Yano, Mio; Matsumoto, Tetsuya; Ogata, Kikuyo; Okubo, Takeshi; Khokhlova, Olga; Ho, Pak-Leung; Yamamoto, Tatsuo

2012-04-01

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a major concern worldwide. In the United States, ST8 CA-MRSA with SCCmecIVa (USA300) has been predominant, affecting the entire United States. In this study, we investigated Japanese ST8 CA-MRSA with new SCCmecIVl (designated ST8 CA-MRSA/J), which has emerged in Japan since 2003. Regarding community spread and infections, ST8 CA-MRSA/J spread in 16.2-34.4% as a major genotype in the community in Japan, and was associated with skin and soft tissue infections (SSTIs), colitis, and invasive infections (sepsis, epidural abscesses, and necrotizing pneumonia), including influenza prodrome cases and athlete infections, similar to USA300. It spread to even public transport and Hong Kong through a Japanese family. Regarding genetic diversity, ST8 CA-MRSA/J included ST and spa variants and was classified into at least three pulsed-field gel electrophoresis types, ST8 Jα to γ. Of those, ST8 Jβ was associated with severe invasive infections. As for genomics, ST8 CA-MRSA/J showed high similarities to USA300, but with marked diversity in accessory genes; e.g., ST8 CA-MRSA/J possessed enhanced cytolytic peptide genes of CA-MRSA, but lacked the Panton-Valentine leukocidin phage and arginine catabolic mobile element, unlike USA300. The unique features of ST8 CA-MRSA/J included a novel mosaic SaPI (designated SaPIj50) carrying the toxic shock syndrome toxin-1 gene with high expression; the evolution included salvage (through recombination) of hospital-acquired MRSA virulence. The data suggest that ST8 CA-MRSA/J has become a successful native clone in Japan, in association with not only SSTIs but also severe invasive infections (posing a threat), requiring attention.

Lessons Learned from Protective Immune Responses to Optimize Vaccines against Cryptosporidiosis

Directory of Open Access Journals (Sweden)

Maxime W. Lemieux

2017-12-01

Full Text Available In developing countries, cryptosporidiosis causes moderate-to-severe diarrhea and kills thousands of infants and toddlers annually. Drinking and recreational water contaminated with Cryptosporidium spp. oocysts has led to waterborne outbreaks in developed countries. A competent immune system is necessary to clear this parasitic infection. A better understanding of the immune responses required to prevent or limit infection by this protozoan parasite is the cornerstone of development of an effective vaccine. In this light, lessons learned from previously developed vaccines against Cryptosporidium spp. are at the foundation for development of better next-generation vaccines. In this review, we summarize the immune responses elicited by naturally and experimentally-induced Cryptosporidium spp. infection and by several experimental vaccines in various animal models. Our aim is to increase awareness about the immune responses that underlie protection against cryptosporidiosis and to encourage promotion of these immune responses as a key strategy for vaccine development. Innate and mucosal immunity will be addressed as well as adaptive immunity, with an emphasis on the balance between TH1/TH2 immune responses. Development of more effective vaccines against cryptosporidiosis is needed to prevent Cryptosporidium spp.-related deaths in infants and toddlers in developing countries.

Finding a new drug and vaccine for emerging swine flu: What is the concept?

Directory of Open Access Journals (Sweden)

Viroj Wiwanitkit

2009-08-01

Full Text Available Viroj WiwanitkitWiwanitkit House, Bangkhae, Bangkok 10160Abstract: Influenza is a well known infection of the respiratory system. The main clinical manifestations of influenza include fever, sore throat, headache, cough, coryza, and malaise. Apart from the well known classical influenza, there are also groups of influenza virus infections that are called “atypical infection”. These infections are usually due to a novel influenza virus infection. In early 2009, an emerging novel influenza originating from Mexico called swine flu was reported. The World Health Organization noted a level VI precaution, the highest level precaution possible, for this newest influenza virus infection. As of June 2009, it is not known if this disease will be successfully controlled. Finding new drugs and vaccine for the emerging swine flu is still required to cope with this emerging worldwide problem.Keywords: swine flu, drug, vaccine, concept

Introduction of new terms and lessons for radiological protection after Fukushima Dai-Ichi accident

International Nuclear Information System (INIS)

Singh, Vishwanath P.; Managanvi, S.S.; Bhat, H.R.

2012-01-01

The nuclear accidents in the world are very few among various types of operating facilities. However when an accident happened, we have learnt a lot to improve the philosophy, term, definitions, document preparation, equipment's requirement, supporting systems, awareness program and restriction etc. After Fukushima Dai-ichi we have learnt a lot, in this view this paper has been prepared to discuss for radiological protection aspects. Discussion: The probability of nuclear accidents is negligible but when happens, it opens new doors of lessons for radiological protection practices for occupational workers, emergency workers for damage control to prevent catastrophic situation/rescue to life saving actions and the member of the public. The Chernobyl and Three Mile Island accidents have provided a lot experiences for management of emergency situations, documentation, radiation emergency preparedness, emergency equipment's, concept of defense-in-depth, emergency planning zone (EPZ), accidental dose limits, estimation of source term and public dose, intervention levels, decision supporting system, remedial actions in public domain; decontamination of person, houses/building and land and etc. Recent Fukushima Dai-ichi accident in Japan was managed in appreciable manner but still new definitions and lessons for radiological protection have been emerged out. The present paper discusses difficulties w. r. t. the radiological aspects observed/faced by Japanese during nuclear crises. The accident introduced new terms as Natural Dose Rate Unit (NDRU), voluntary evacuation, deliberate evacuation area, restricted area and difference between evacuation zone and EPZ. The Fukushima accident has enforced worldwide regulators and operators to review the individual dose limit and amendment for raise in the dose limit during accident, availability of efficient/adequate quantities of personal dosimeter in public domain, collection arrangement of bulk amount of radioactive wastes

Etiology and clinical characterization of respiratory virus infections in adult patients attending an emergency department in Beijing.

Directory of Open Access Journals (Sweden)

Xiaoyan Yu

Full Text Available BACKGROUND: Acute respiratory tract infections (ARTIs represent a serious global health burden. To date, few reports have addressed the prevalence of respiratory viruses (RVs in adults with ARTIs attending an emergency department (ED. Therefore, the potential impact of respiratory virus infections on such patients remains unknown. METHODOLOGY/PRINCIPAL FINDINGS: To determine the epidemiological and clinical profiles of common and recently discovered respiratory viruses in adults with ARTIs attending an ED in Beijing, a 1-year consecutive study was conducted from May, 2010, to April, 2011. Nose and throat swab samples from 416 ARTI patients were checked for 13 respiratory viruses using multiple reverse transcription polymerase chain reaction(RT-PCR assays for common respiratory viruses, including influenza viruses (Flu A, B, and adenoviruses (ADVs, picornaviruses (PICs, respiratory syncytial virus (RSV, parainfluenza viruses (PIVs 1-3, combined with real-time RT-PCR for human metapneumovirus (HMPV and human coronaviruses (HCoVs, -OC43, -229E, -NL63, and -HKU1. Viral pathogens were detected in 52.88% (220/416 of patient samples, and 7.21% (30/416 of patients tested positive for more than one virus. PICs (17.79% were the dominant agents detected, followed by FluA (16.11%, HCoVs (11.78%, and ADV (11.30%. HMPV, PIVs, and FluB were also detected (<3%, but not RSV. The total prevalence and the dominant virus infections detected differed significantly between ours and a previous report. Co-infection rates were high for HCoV-229E (12/39, 30.76%, PIC (22/74, 29.73%, ADV (12/47, 25.53% and FluA (15/67, 22.39%. Different patterns of clinical symptoms were associated with different respiratory viruses. CONCLUSIONS: The pattern of RV involvement in adults with ARTIs attending an ED in China differs from that previously reported. The high prevalence of viruses (PIC, FluA, HCoVs and ADV reported here strongly highlight the need for the development of safe and

Defense Language Institute Russian Basic Course. Volumes XXVIII, Lessons 131-140. Volume XXX, Lessons 151-159.

Science.gov (United States)

Defense Language Inst., Washington, DC.

The 19 lessons in these two volumes are intended for the advanced phase of a 159-lesson intensive audiolingual basic Russian course developed recently by the Defense Language Institute to train native speakers of English to a Level 3 second language proficiency. These third and fifth volumes contain such features as (1) texts on the Russian Civil…

Emerging Animal Parasitic Diseases: A Global Overview and Appropriate Strategies for their Monitoring and Surveillance in Nigeria.

Science.gov (United States)

Atehmengo, Ngongeh L; Nnagbo, Chiejina S

2014-01-01

Emerging animal parasitic diseases are reviewed and appropriate strategies for efficient monitoring and surveillance in Nigeria are outlined. Animal and human parasitic infections are distinguished. Emerging diseases have been described as those diseases that are being recognised for the first time or diseases that are already recorded but their frequency and/or geographic range is being increased tremendously. Emergence of new diseases may be due to a number of factors such as the spread of a new infectious agent, recognition of an infection that has been in existence but undiagnosed, or when it is realised that an established disease has an infectious origin. The terms could also be used to describe the resurgence of a known infection after its incidence had been known to have declined. Emerging infections are compounding the control of infectious diseases and huge resources are being channeled to alleviate the rising challenge. The diseases are numerous and include helminth, protozoal / rickettsial and entomological. A list of parasitic emerging diseases in Nigeria is included. Globally occurring emerging parasitic diseases are also outlined. Emerging and re-emerging infections can be brought about by many factors including climate change and global warming, changes in biodiversity, population mobility, movement of animals, globalisation of commerce/trade and food supply, social and cultural factors such as food eating habits, religious beliefs, farming practices, trade of infected healthy animals, reduction in the available land for animals, immune-suppressed host and host density and misuse or over use of some drugs leading to drug resistance.

Emerging Animal Parasitic Diseases: A Global Overview and Appropriate Strategies for their Monitoring and Surveillance in Nigeria

Science.gov (United States)

Atehmengo, Ngongeh L; Nnagbo, Chiejina S

2014-01-01

Emerging animal parasitic diseases are reviewed and appropriate strategies for efficient monitoring and surveillance in Nigeria are outlined. Animal and human parasitic infections are distinguished. Emerging diseases have been described as those diseases that are being recognised for the first time or diseases that are already recorded but their frequency and/or geographic range is being increased tremendously. Emergence of new diseases may be due to a number of factors such as the spread of a new infectious agent, recognition of an infection that has been in existence but undiagnosed, or when it is realised that an established disease has an infectious origin. The terms could also be used to describe the resurgence of a known infection after its incidence had been known to have declined. Emerging infections are compounding the control of infectious diseases and huge resources are being channeled to alleviate the rising challenge. The diseases are numerous and include helminth, protozoal / rickettsial and entomological. A list of parasitic emerging diseases in Nigeria is included. Globally occurring emerging parasitic diseases are also outlined. Emerging and re-emerging infections can be brought about by many factors including climate change and global warming, changes in biodiversity, population mobility, movement of animals, globalisation of commerce/trade and food supply, social and cultural factors such as food eating habits, religious beliefs, farming practices, trade of infected healthy animals, reduction in the available land for animals, immune-suppressed host and host density and misuse or over use of some drugs leading to drug resistance. PMID:25328553

Children's Satisfaction with Private Music Lessons.

Science.gov (United States)

Rife, Nora A.; Shnek, Zachary M.; Lauby, Jennifer L.; Lapidus, Leah Blumberg

2001-01-01

Determines the language children use to express their feelings of satisfaction with private music lessons. Offers a list of statements from children about private music lessons to be used to assess those feelings. Discusses the effects of age, gender, and musical instruments on satisfaction for music educators. Includes references. (DAJ)

Human Spaceflight Conjunction Assessment: Lessons Learned

Science.gov (United States)

Smith, Jason T.

2011-01-01

This viewgraph presentation reviews the process of a human space flight conjunction assessment and lessons learned from the more than twelve years of International Space Station (ISS) operations. Also, the application of these lessons learned to a recent ISS conjunction assessment with object 84180 on July 16, 2009 is also presented.

Integrating UNESCO ICT-Based Instructional Materials in Chemistry Lessons

Directory of Open Access Journals (Sweden)

CHARLIE P. NACARIO

2014-08-01

Full Text Available This study determined the effectiveness of the lessons in Chemistry integrating UNESCO ICT-based instructional material on the achievement of Chemistry students at Central Bicol State University of Agriculture. It aimed to identify lessons that may be developed integrating UNESCO ICT-based instructional materials, determine the effect of the developed lessons using the material on: conceptual understanding; science process skills; and attitude towards chemistry and gather insights from the experiences of the students and teacher. The study used the single group pretest and posttest experimental design. Descriptive, quantitative and qualitative techniques were also utilized. Quantitative data were taken from the pretest-posttest results on the Test on Conceptual Understanding, Science Process Skills and Chemistry Attitudinaire. Qualitative data were drawn from the experts’ assessment of the developed lessons and research instruments, and the insights of students and teacher. The developed lessons integrating UNESCO ICT-based instructional materials were Atomic Model and Structure, Periodic Table of Elements, Chemical Bonding, and Balancing Chemical Equation. These lessons increased the conceptual understanding of the students by topic and skill from very low mastery to average mastery level. The students have slightly improved along the different science process skills. After teaching the lessons, the students’ attitude also improved. The students became more motivated and interested in Chemistry and the lessons were student centered and entailed teacher’s competence and flexibility in computer use.

Field building: lessons from the Robert Wood Johnson Foundation's anthology series.

Science.gov (United States)

Isaacs, Stephen L; Knickman, James R

2005-01-01

As editors of the Robert Wood Johnson Foundation's (RWJF's) anthology series, we have examined the entire range of the foundation's grant making since 1972. We found that the RWJF has enjoyed considerable success in building fields--from nurse practitioners to tobacco control to end-of-life care. The RWJF has done this by shaping fields as they were emerging, by adopting a wide-ranging "bear hug" approach, and by staying the course. The lessons from the RWJF's field-building efforts are relevant for both large and small foundations: Small funders can develop strategic plans aimed at building fields in their home state or locality.

FRMAC-93 lessons learned report

International Nuclear Information System (INIS)

Kerns, K.C.

1994-03-01

FRMAC-93 simulated a radiological accident at the Fort Calhoun nuclear power plant, 25 miles north of Omaha, Nebraska. The exercise involved the state Iowa and Nebraska, NRC as the lead Federal agency, FRMAC (Federal Radiological Monitoring and Assessment Center), and several federal agencies with statutory emergency responsibility. FRMAC-93 was a major 2-day field exercise designed to determine the effectiveness, coordination, and operations of a DOE-managed FRMAC. Other objectives were to ensure that appropriate priorities were established and assistance was provided to the states and the lead Federal agency by FRMAC. Day 1 involved the Fort Calhoun evaluated plume phase exercise. On Day 2, the flow of data, which was slow initially, improved so that confidence of states and other federal responders in FRMAC support capabilities was high. The impact and lessons learned from FRMAC-93 provided the necessary impetus to make organizational and operational changes to the FRMAC program, which were put into effect in the DOE exercise FREMONT at Hanford 3 months later

Analyzing R&D Activities of Foreign Enterprises in Emerging Economies. Lessons from Turkey

OpenAIRE

M. Teoman Pamukçu; Erkan Erdil

2011-01-01

Emerging economies have played an important role in the internationalization of R&D activities at least since the 1990s. Turkey, an emerging economy and at same time an accession country to the European Union which signed a Customs Union Agreement with the EU already in 1995, is no exception. In-depth face-to-face semi-structured interviews were conducted with R&D directors of 26 multinational companies operating in Turkey –with headquarters located in France, Germany, Italy, Japan, Switzerla...

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

NARCIS (Netherlands)

Sartelli, M.; Chichom-Mefire, A.; Labricciosa, F.M.; Hardcastle, T.; Abu-Zidan, F.M.; Adesunkanmi, A.K.; Ansaloni, L.; Bala, M.; Balogh, Z.J.; Beltran, M.A.; Ben-Ishay, O.; Biffl, W.L.; Birindelli, A.; Cainzos, M.A.; Catalini, G.; Ceresoli, M.; Che Jusoh, A.; Chiara, O.; Coccolini, F.; Coimbra, R.; Cortese, F.; Demetrashvili, Z.; Saverio, S. Di; Diaz, J.J.; Egiev, V.N.; Ferrada, P.; Fraga, G.P.; Ghnnam, W.M.; Lee, J.G.; Gomes, C.A.; Hecker, A.; Herzog, T.; Kim, J.I.; Inaba, K.; Isik, A.; Karamarkovic, A.; Kashuk, J.; Khokha, V.; Kirkpatrick, A.W.; Kluger, Y.; Koike, K.; Kong, V.Y.; Leppaniemi, A.; Machain, G.M.; Maier, R.V.; Marwah, S.; McFarlane, M.E.; Montori, G.; Moore, E.E.; Negoi, I.; Olaoye, I.; Omari, A.H.; Ordonez, C.A.; Pereira, B.M.; Junior, G.A.; Pupelis, G.; Reis, T.; Sakakhushev, B.; Sato, N.; Segovia Lohse, H.A.; Shelat, V.G.; Soreide, K.; Uhl, W.; Ulrych, J.; Goor, H. van; Velmahos, G.C.; Yuan, K.C.; Wani, I.; Weber, D.G.; Zachariah, S.K.; Catena, F.

2017-01-01

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial

Free Trade and Tariffs: Level III, Unit 2, Lesson 1; Capitalism, Communism, Socialism: Lesson 2; Nationalism vs. Internationalism: Lesson 3. Advanced General Education Program. A High School Self-Study Program.

Science.gov (United States)

Manpower Administration (DOL), Washington, DC. Job Corps.

This self-study program for high-school level contains lessons on: Free Trade and Tariffs; Capitalism, Communism, Socialism; and Nationalism vs. Internationalism. Each of the lessons concludes with a Mastery Test to be completed by the student. (DB)

The Role of a Commander in Military Lessons Learned Systems

Directory of Open Access Journals (Sweden)

Zenon Waliński

2015-06-01

Full Text Available The aim of the paper is to investigate the role of a commander in military Lessons Learned systems. In order to achieve the aim, the paper presents (1 the architecture of the Lessons Learned capabilities in the U.S. Army, NATO and the Polish Armed Forces, (2 the commander’s role in the Lessons Learned process (3 the commander’s role in fostering Lessons Learned organisation culture. The paper is based on multiple case study analysis including Lessons Learned systems in NATO, the U.S. Army and the Polish Armed Forces.

Vaccines for emerging infectious diseases: Lessons from MERS coronavirus and Zika virus

Science.gov (United States)

Maslow, Joel N.

2017-01-01

ABSTRACT The past decade and a half has been characterized by numerous emerging infectious diseases. With each new threat, there has been a call for rapid vaccine development. Pathogens such as the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the Zika virus represent either new viral entities or viruses emergent in new geographic locales and characterized by novel complications. Both serve as paradigms for the global spread that can accompany new pathogens. In this paper, we review the epidemiology and pathogenesis of MERS-CoV and Zika virus with respect to vaccine development. The challenges in vaccine development and the approach to clinical trial design to test vaccine candidates for disease entities with a changing epidemiology are discussed. PMID:28846484

Bruce A restart (execution and lessons-learned)

International Nuclear Information System (INIS)

Soini, J.

2011-01-01

Lessons learned with the Bruce Units 3 and 4 restart have been incorporated into the current refurbishment of Units 1 and 2. In addition, lessons learned on the lead unit (U2) are aggressively applied on the lagging unit (U1) to maximize efficiency and productivity. There will be a discussion on how this internal OPEX, along with external lessons learned, are used to continuously improve all aspects of the Bruce A Restart project management cycle, from scope selection, through planning and scheduling, to execution.

Educating Next Generation Leaders: Lessons for Emerging Economies from John Dewey

Science.gov (United States)

Hartman, Laura Pincus; Neame, Alexandra; Gedro, Julie

2014-01-01

The purpose of this discussion is to explore how the educational and social philosophy of John Dewey offers insight for those involved in education evolution in emerging economies, with a particular emphasis on nurturing leaders who are capable of recognizing and responding effectively to the challenges of a globalized economy now and for the next…

The physical education lesson in Turkish primary schools: Affective ...

African Journals Online (AJOL)

In the study students' affective entry characteristics related to Physical Education lessons were examined based on three dimensions: interest towards the lesson, level of motivation in the lesson and educational gains. The study further aimed to investigate how these three dimensions were affected by the gender factor.

Inductive & Deductive Science Thinking: A Model for Lesson Development

Science.gov (United States)

Bilica, Kim; Flores, Margaret

2009-01-01

Middle school students make great learning gains when they participate in lessons that invite them to practice their developing scientific reasoning skills; however, designing developmentally appropriate, clear, and structured lessons about scientific thinking and reasoning can be difficult. This challenge can be met through lessons that teach…

Study on IAEA international emergency response exercise convEx-3

International Nuclear Information System (INIS)

Yamamoto, Kazuya

2007-05-01

The International Atomic Energy Agency (IAEA) carried out a large-scale international emergency response exercise in 2005 under the designated name of ConvEx-3(2005), at Romania. This review report summarizes a study about ConvEx-3(2005) based on several related open literature. The ConvEx-3 was conducted in accordance with Agency's safety standard series and requirements in the field of Emergency Preparedness and Response. The study on the preparation, conduct and evaluation of ConvEx-3(2005) exercise is expected to provide very useful knowledge for development of drills and educational programs conducted by Nuclear Emergency Assistance and Training Center (NEAT). Especially, study on the exercise evaluations is instrumental in improving evaluations of drills planned by the national government and local governments. As international cooperation among Asian countries in the field of nuclear emergency preparedness and response is going to realize, it is very useful to survey and consider scheme and methodology about international emergency preparedness, response and exercise referring the knowledge of this ConvEx-3 study. The lessons learned from this study of ConvEx-3(2005) are summarized in four chapters; methodology of exercises and educational programs, exercise evaluation process, amendments/verification of the emergency response plan of NEAT, and technical issues of systems for emergency response and assistance of NEAT relevant to interface for international emergency communication. (author)

CANDIDURIA AMONG HIV- INFECTED PATIENTS ATTENDING A ...

African Journals Online (AJOL)

colonization and infection or between upper or lower urinary tract infections. Objective: This ... important public health problem of modern times (1). HIV/AIDS ... contamination of urine specimen, colonization of bladder due ... patients and do not require antifungal medication. (24). ... Emergent yeast colonies were stored for.

The Problem about Technology in STEM Education: Some Findings from Action Research on the Professional Development & Integrated STEM Lessons in Informal Fields

Directory of Open Access Journals (Sweden)

Tomoki Saito

2015-04-01

Full Text Available Since 2013, the authors’ Japanese team in the Department of Science Education at Shizuoka University has held trials of STEM Education in informal fields as participatory action research (e.g., Science museum in Shizuoka, Lifelong Learning Center in Fujieda City, and STEM Summer camp for the preparation for implementing STEM education in public schools and for proposing science education reform in a Japanese context. Problems in preparing STEM lessons include numerous new instructional materials and programs and emerging specialized schools. In addition, while most of these initiatives address one or more of the STEM subjects separately, there are increasing calls for emphasizing connections between and among the subjects (Honey, Pearson and Schweingruber, 2014. Unfamiliar problems for Japanese teachers are, What is Engineering? What is Design? and How can they be implemented in lessons? While gathering STEM learning materials to implement in their STEM Summer Camp, the authors noticed a pattern with which to develop a STEM lesson and developed a template “T-SM-E” in reference to prior STEM studies. After the STEM Summer Camp, the authors introduced the model in the pre-service teacher preparation program. As a result, the authors received suggestions about how teachers can develop integrated STEM lessons, how undergraduate (UG teachers can implement it in their lessons, and how teachers can assess student learning in their STEM lessons. From standard based student assessments and reflections written by the UG teachers, the authors found that it was difficult for the UG teachers to include technology in their lessons, and their assessment also indicated that the students did not show performance proficiency in technology. The authors discuss this existing problem in the Japanese education system.

A Qualitative Study on Primary School Mathematics Lesson Evaluation

Science.gov (United States)

Zhao, Dongchen; Ma, Yunpeng

2009-01-01

Through the qualitative interviews of five implementers of primary school mathematics curriculum, this study addresses the ways in which mathematics lessons are evaluated. Results show that each evaluator recognizes different aspects of a "good lesson," however, among all criteria, the design of the lesson plan, realization of the lesson…

Lessons from Fukushima for Improving the Safety of Nuclear Reactors

Science.gov (United States)

Lyman, Edwin

2012-02-01

The March 2011 accident at the Fukushima Daiichi nuclear power plant has revealed serious vulnerabilities in the design, operation and regulation of nuclear power plants. While some aspects of the accident were plant- and site-specific, others have implications that are broadly applicable to the current generation of nuclear plants in operation around the world. Although many of the details of the accident progression and public health consequences are still unclear, there are a number of lessons that can already be drawn. The accident demonstrated the need at nuclear plants for robust, highly reliable backup power sources capable of functioning for many days in the event of a complete loss of primary off-site and on-site electrical power. It highlighted the importance of detailed planning for severe accident management that realistically evaluates the capabilities of personnel to carry out mitigation operations under extremely hazardous conditions. It showed how emergency plans rooted in the assumption that only one reactor at a multi-unit site would be likely to experience a crisis fail miserably in the event of an accident affecting multiple reactor units simultaneously. It revealed that alternate water injection following a severe accident could be needed for weeks or months, generating large volumes of contaminated water that must be contained. And it reinforced the grim lesson of Chernobyl: that a nuclear reactor accident could lead to widespread radioactive contamination with profound implications for public health, the economy and the environment. While many nations have re-examined their policies regarding nuclear power safety in the months following the accident, it remains to be seen to what extent the world will take the lessons of Fukushima seriously and make meaningful changes in time to avert another, and potentially even worse, nuclear catastrophe.

"Elements of Astronomy": A Television Course of 30 Lessons

Science.gov (United States)

Perez, J. P. D.; Del Pozo, E. P. G.; Rodriguez, R. R. T.; Mendez, A. M. B.; Rodriguez, E. R. F.; Gamez, R. G. D.

2006-08-01

It was broadcasted to all Cuba from March to December 2005, one lesson per week, transmitting three times each lesson, this means 90 hours of broadcasting. It was one of the courses of the Program "University for All", that Educative Channel produced. The Thematic: Sky Coordinates and Constellations; Astronomical Instruments; Solar System; Planets and their Moons; Comets, Asteroids and Meteoroids; Sun; Cosmic Environment and Space Weather; Stars; Galaxy and Quasars; Observable Universe; Life, Intelligent Life and Civilizations in the Universe; and History of Astronomy in Cuba. The professor staff was a group of 5 researchers of the Astronomy Department. They did an effort that each lesson had the best information level with a minimum of mathematical expressions. And were used more than 60 slides and various astronomical films fragments per lesson. To make one lesson was analyzed several astronomical films, selected a group of fragments and pre-edited into various blocks with the TV specialists, later a power point presentation was conformed using all available information on-line and bibliography. Then the lesson was recorded by the TV specialist at the Educative Channel and latter reviewed and improved by one AVID edition. The Course groundwork began in April 2003, with the first list of 12 lessons, later in June was increased to18 lessons, and started the work of "Tabloide" making; it is a journal-type book of 32 pages, equivalent to about 120 normal pages including 64 illustrations. At December 2004 the Course was increased to 30 lessons and the "Tabloide" was send to editor, later 200,000 exemplars was published. Many people followed Course and "Tabloide" was shopped in some months.

Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Instructor's Lesson Plans.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this instructor's guide provides a standardized approach for providing training in emergency medical care for first responders to traffic accidents. The objective of the course is to provide training in all aspects of emergency medical…

Hepatitis E virus (HEV) genotype 3 infection of human liver chimeric mice as a model for chronic HEV infection

NARCIS (Netherlands)

M.D.B. van de Garde (Martijn D.B.); S.D. Pas (Suzan); Van Der Net, G. (Guido); R.A. de Man (Robert); A.D.M.E. Osterhaus (Albert); B.L. Haagmans (Bart); P.A. Boonstra (André); T. Vanwolleghem (Thomas)

2016-01-01

textabstractGenotype 3 (gt3) hepatitis E virus (HEV) infections are emerging in Western countries. Immunosuppressed patients are at risk of chronic HEV infection and progressive liver damage, but no adequate model system currently mimics this disease course. Here we explore the possibilities of in

Lessons learned from accidents investigations

Energy Technology Data Exchange (ETDEWEB)

Zuniga-Bello, P. [Consejo Nacional de Ciencia y Tecnologia (CONACYT), Mexico City (Mexico); Croft, J. [National Radiological Protection Board (United Kingdom); Glenn, J

1997-12-31

Accidents from three main practices: medical applications, industrial radiography and industrial irradiators are used to illustrate some common causes of accidents and the main lessons to be learned. A brief description of some of these accidents is given. Lessons learned from the described accidents are approached by subjects covering: safety culture, quality assurance, human factors, good engineering practice, defence in depth, security of sources, safety assessment and monitoring and verification compliance. (author)

Lessons learned from accident investigations

International Nuclear Information System (INIS)

Zuniga-Bello, P.; Croft, J.R.; Glenn, J.

1998-01-01

Accidents in three main practices - medical applications, industrial radiography and industrial irradiators - are used to illustrate some common causes of accidents and the main lessons to be learned from them. A brief description of some of these accidents is given. Lessons learned from the accidents described are approached bearing in mind: safety culture, quality assurance, human factors, good engineering practice, defence in depth, security of sources, safety assessment and monitoring and verification compliance. (author)

Challenges Presented by Re-Emerging Sexually Transmitted Infections in HIV Positive Men who have Sex with Men: An Observational Study of Lymphogranuloma Venereum in the UK.

Science.gov (United States)

Rönn, Minttu; Hughes, Gwenda; Simms, Ian; Ison, Cathy; Alexander, Sarah; White, Peter J; Ward, Helen

2014-08-01

United Kingdom has reported the largest documented outbreak of lymphogranuloma venereum (LGV), a re-emerging sexually transmitted infection (STI) which is primarily seen in HIV-positive men who have sex with men (MSM). A diagnostic service was established in response to the outbreak linked to a voluntary LGV Enhanced Surveillance system. We examined the performance of this novel surveillance system to identify utility in tracking a re-emerging infection. We described laboratory data on samples and surveillance data from case reports for LGV from 2004-2010. We performed a cross-sectional analysis comparing clinical and behavioural characteristics of HIV-positive and HIV-negative/unknown LGV cases diagnosed in MSM using multivariable logistic regression models with generalised estimating equations to control for repeat infections. LGV Surveillance data were available for 87% (1,370/1,581) of LGV cases (after de-duplication). There were 1,342 episodes in 1,281 MSM, most of whom were known to be HIV-positive (1,028/1,281, 80.2%,). HIV-positive men reported a shorter duration of symptoms (aOR 0.5; 95%CI 0.3, 0.8 for reporting more than a week compared to a week or less) in comparison to HIV-negative/unknown MSM, and were more likely to report unprotected receptive anal intercourse (aOR 2.7; 95% CI 1.3, 5.8). The surveillance identified the population at greater risk of infection based on higher levels of risk behaviour in HIV-positive LGV cases. However, there was diagnostic bias towards HIV-positive LGV cases who presented with a shorter duration of symptoms when compared to HIV-negative/unknown LGV cases.

Visitor restriction policies and practices in children's hospitals in North America: results of an Emerging Infections Network Survey.

Science.gov (United States)

Pong, Alice L; Beekmann, Susan E; Faltamo, Mekleet M; Polgreen, Philip M; Shane, Andi L

2018-06-21

To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. An electronic survey to characterize VRPP in pediatric healthcare facilities. The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%). Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.

Emerging Chlamydia psittaci infections in the chicken industry and pathology of Chlamydia psittaci genotype B and D strains in specific pathogen free chickens.

Science.gov (United States)

Yin, Lizi; Kalmar, Isabelle D; Lagae, Stefanie; Vandendriessche, Stien; Vanderhaeghen, Wannes; Butaye, Patrick; Cox, Eric; Vanrompay, Daisy

2013-03-23

Sera of 30 Belgian and 10 Northern French chicken farms were tested by a Chlamydia (C.) psittaci major outer membrane protein (MOMP) based ELISA. Ninety-six percent, 93% and 90% of the Belgian broilers, broiler breeders and layers were seropositive. Ninety-one percent of the French broilers were seropositive. In addition, tissues of 5 Belgian and 5 French broiler farms were examined at slaughter. All French farms were culture positive while C. psittaci was cultured from the lungs of 80% of examined Belgian farms. C. psittaci infections are apparently emerging in chickens raised in Belgium and Northern France. We could proof Hill-Evans postulates for chicken-derived C. psittaci genotype B and D strains. Chicken-processing plant employees should be considered a risk group for human psittacosis. There is a need for higher awareness and for efficient risk assessment and management of C. psittaci infections in chickens as chlamydiosis in broilers seems to be underdiagnosed and infections with highly virulent strains do occur. Copyright © 2012 Elsevier B.V. All rights reserved.

Supporting teachers' technology integration in lesson plans

NARCIS (Netherlands)

Janssen, Noortje

2017-01-01

Lesson planning offers rich opportunities for teachers to consider and implement technology in the classroom. This dissertation investigated the design and effectiveness of supplementary information to assist pre-service teachers during the lesson planning process. Based on the Technological,

Cryptosporidium Infections Among Children in Peru

Centers for Disease Control (CDC) Podcasts

Cryptosporidium is a waterborne bacteria that can cause severe diarrhea and vomiting. In this podcast, Dr. Vita Cama, CDC microbiologist, discusses an article in the October 2008 issue of Emerging Infectious Diseases. The paper examines Cryptosporidium infections among children in Peru, including the number of infections, symptoms experienced, and what species of Crypto were responsible.

Landscape of emerging and re-emerging infectious diseases in China: impact of ecology, climate, and behavior.

Science.gov (United States)

Liu, Qiyong; Xu, Wenbo; Lu, Shan; Jiang, Jiafu; Zhou, Jieping; Shao, Zhujun; Liu, Xiaobo; Xu, Lei; Xiong, Yanwen; Zheng, Han; Jin, Sun; Jiang, Hai; Cao, Wuchun; Xu, Jianguo

2018-02-01

For the past several decades, the infectious disease profile in China has been shifting with rapid developments in social and economic aspects, environment, quality of food, water, housing, and public health infrastructure. Notably, 5 notifiable infectious diseases have been almost eradicated, and the incidence of 18 additional notifiable infectious diseases has been significantly reduced. Unexpectedly, the incidence of over 10 notifiable infectious diseases, including HIV, brucellosis, syphilis, and dengue fever, has been increasing. Nevertheless, frequent infectious disease outbreaks/events have been reported almost every year, and imported infectious diseases have increased since 2015. New pathogens and over 100 new genotypes or serotypes of known pathogens have been identified. Some infectious diseases seem to be exacerbated by various factors, including rapid urbanization, large numbers of migrant workers, changes in climate, ecology, and policies, such as returning farmland to forests. This review summarizes the current experiences and lessons from China in managing emerging and re-emerging infectious diseases, especially the effects of ecology, climate, and behavior, which should have merits in helping other countries to control and prevent infectious diseases.

Emergency presurgical visit

Directory of Open Access Journals (Sweden)

Alfredo Castro Díaz

2009-07-01

Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

Lessons Learned for Space Safety from the Fukushima Nuclear Power Plant Accident

Science.gov (United States)

Nogami, Manami; Miki, Masami; Mitsui, Masami; Kawada, Ysuhiro; Takeuchi, Nobuo

2013-09-01

On March 11 2011, Tohoku Region Pacific Coast Earthquake hit Japan and caused the devastating damage. The Fukushima Nuclear Power Station (NPS) was also severely damaged.The Japanese NPSs are designed based on the detailed safety requirements and have multiple-folds of hazard controls to the catastrophic hazards as in space system. However, according to the initial information from the Tokyo Electric Power Company (TEPCO) and the Japanese government, the larger-than-expected tsunami and subsequent events lost the all hazard controls to the release of radioactive materials.At the 5th IAASS, Lessons Learned from this disaster was reported [1] mainly based on the "Report of the Japanese Government to the IAEA Ministerial Conference on Nuclear Safety" [2] published by Nuclear Emergency Response Headquarters in June 2011, three months after the earthquake.Up to 2012 summer, the major investigation boards, including the Japanese Diet, the Japanese Cabinet and TEPCO, published their final reports, in which detailed causes of this accident and several recommendations are assessed from each perspective.In this paper, the authors examine to introduce the lessons learned to be applied to the space safety as findings from these reports.

Lessons Learned in Software Testing A Context-Driven Approach

CERN Document Server

Kaner, Cem; Pettichord, Bret

2008-01-01

Decades of software testing experience condensed into the most important lessons learned.The world's leading software testing experts lend you their wisdom and years of experience to help you avoid the most common mistakes in testing software. Each lesson is an assertion related to software testing, followed by an explanation or example that shows you the how, when, and why of the testing lesson. More than just tips, tricks, and pitfalls to avoid, Lessons Learned in Software Testing speeds you through the critical testing phase of the software development project without the extensive trial an

Lesson Planning with the Common Core

Science.gov (United States)

Estes, Linda A.; McDuffie, Amy Roth; Tate, Cathie

2014-01-01

Planning a lesson can be similar to planning a road trip--a metaphor the authors use to describe how they applied research and theory to their lesson planning process. A map and mode of transportation, the Common Core State Standards for Mathematics (CCSSM) and textbooks as resources, can lead to desired destinations, such as students engaging in…

The emergence of scientific management in America

Directory of Open Access Journals (Sweden)

Sorin-George Toma

2014-05-01

Full Text Available A scientific approach to management was initiated for the first time in America in the late 19th century. Scientific management arose mainly from the need to increase efficiency in America, but other key factors were the spread of big businesses and the expanding application of science in industry. The aims of our paper are to present the emergence of scientific management in America and to emphasize the contribution of some of the most representatives American authors to its development. The methodological approach is literature review. Our paper shows that scientific management was essentially an American achievement that provided useful lessons for the whole human society.

Host Factors in Ebola Infection.

Science.gov (United States)

Rasmussen, Angela L

2016-08-31

Ebola virus (EBOV) emerged in West Africa in 2014 to devastating effect, and demonstrated that infection can cause a broad range of severe disease manifestations. As the virus itself was genetically similar to other Zaire ebolaviruses, the spectrum of pathology likely resulted from variable responses to infection in a large and genetically diverse population. This review comprehensively summarizes current knowledge of the host response to EBOV infection, including pathways hijacked by the virus to facilitate replication, host processes that contribute directly to pathogenesis, and host-pathogen interactions involved in subverting or antagonizing host antiviral immunity.

[Economics] Introductory Lesson (Begin Day One). Lesson Plan.

Science.gov (United States)

Lewin, Roland

This introductory lesson on teaching economics concepts contains sections on the following: purpose; objectives; time; materials needed; and step-by-step classroom procedures. The focus is on the economic problem of scarcity and opportunity costs. Attached is an original skit, "There's no such thing as a free lunch," and a chart that…

Outline of Fukushima nuclear accident and future action. Lessons learned from accident and countermeasure plan

International Nuclear Information System (INIS)

Fukuda, Toshihiko

2012-01-01

Fukushima nuclear accident was caused by loss of all AC power sources (SBO) and loss of ultimate heat sink (LUHS) at Fukushima Daiichi Nuclear Power Plants (NPPs) hit by the Great East Japan Earthquake. This article reviewed outline of Fukushima nuclear accident progression when on year had passed since and referred to lessons learned from accident and countermeasure plan to prevent severe accident in SBO and LUHS events by earthquake and tsunami as future action. This countermeasure would be taken to (1) prevent serious flooding in case a tsunami overwhelms the breakwater, with improving water tightness of rooms for emergency diesel generator, batteries and power centers, (2) enhance emergency power supply and cooling function with mobile electricity generator, high pressure fire pump car and alternate water supply source, (3) mitigate environmental effects caused by core damage with installing containment filtered venting, and (4) enforce emergency preparedness in case of severe accident. Definite countermeasure plan for Kashiwazaki-Kariwa NPPs was enumerated. (T. Tanaka)

English language-in-education: A lesson planning model for subject ...

African Journals Online (AJOL)

English language-in-education: A lesson planning model for subject teachers. ... lack of critical academic language skills in English as the Language of Learning and ... process of lesson design and the 'forward' process of lesson presentation.

Stakeholder involvement in development and design of appropriate emergency preparedness routines in Slovakia

International Nuclear Information System (INIS)

Duranova, T.; Kusovska, Z.; Metke, E.; Sladek, V.; Sokolikova, A.

2009-01-01

The paper presents the process of stakeholder involvement in development and implementation of appropriate emergency preparedness routines in Slovakia in last five years. The paper presents the discussion of good practices, which made the work undertaken valuable and effective. The paper reflects the lessons learned during the course representing five years of stakeholder involvement effort. The paper gives detailed information on used practices and real process taken place in Slovakia. (authors)

Feedback of safety - related operational experience: Lessons learned

Energy Technology Data Exchange (ETDEWEB)

Elias, D [Commonwealth Edison Co. (United States)

1997-09-01

The presentation considers the following aspects of feedback of safety-related operational experience: lessons learned program, objectives, personnel characteristics; three types of documents for transmitting lessons learned issues.

Feedback of safety - related operational experience: Lessons learned

International Nuclear Information System (INIS)

Elias, D.

1997-01-01

The presentation considers the following aspects of feedback of safety-related operational experience: lessons learned program, objectives, personnel characteristics; three types of documents for transmitting lessons learned issues

Driver. D530.2 – Tools for the Lessons Learned Framework

NARCIS (Netherlands)

Schaik, M.G. van; et al

2016-01-01

In this deliverable D530.2 “Tools for the Lessons Learned Framework” the overall lessons learned framework will be clarified based on the delivery D53.1 “Lessons Learned Framework Concept” and aligned with the deliverable D52.1 “Harmonized competence framework”. The Tools for the Lessons Learned

Dialysis: Reducing Infections and Changing Culture

Centers for Disease Control (CDC) Podcasts

2018-03-19

This podcast is an account from an infection preventionist about the challenges and successes with engaging dialysis care teams to focus on “Zero Preventable Infections” in outpatient dialysis facilities.  Created: 3/19/2018 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/19/2018.

Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?

Science.gov (United States)

Costa-Farré, Cristina; Prades, Marta; Ribera, Thaïs; Valero, Oliver; Taurà, Pilar

2014-04-01

Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia were recorded. Surgical wounds were assessed daily for infection during hospitalisation and follow up information was obtained after discharge. A total of 84 adult horses were included. SSI developed in 34 (40.4%) horses. Multivariate logistic regression showed that PaO2, anaesthetic time and subcutaneous suture material were predictors of SSI (AUC=0.76, sensitivity=71%, specificity=65%). The use of polyglycolic acid sutures increased the risk and horses with a PaO2 value 2h had the highest risk of developing SSI (OR=9.01; 95% CI 2.28-35.64). The results of this study confirm the hypothesis that low intraoperative PaO2 contributes to the development of SSI following colic surgery. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ecopathology of Ranaviruses Infecting Amphibians

Directory of Open Access Journals (Sweden)

Andrew Storfer

2011-11-01

Full Text Available Ranaviruses are capable of infecting amphibians from at least 14 families and over 70 individual species. Ranaviruses infect multiple cell types, often culminating in organ necrosis and massive hemorrhaging. Subclinical infections have been documented, although their role in ranavirus persistence and emergence remains unclear. Water is an effective transmission medium for ranaviruses, and survival outside the host may be for significant duration. In aquatic communities, amphibians, reptiles and fish may serve as reservoirs. Controlled studies have shown that susceptibility to ranavirus infection and disease varies among amphibian species and developmental stages, and likely is impacted by host-pathogen coevolution, as well as, exogenous environmental factors. Field studies have demonstrated that the likelihood of epizootics is increased in areas of cattle grazing, where aquatic vegetation is sparse and water quality is poor. Translocation of infected amphibians through commercial trade (e.g., food, fish bait, pet industry contributes to the spread of ranaviruses. Such introductions may be of particular concern, as several studies report that ranaviruses isolated from ranaculture, aquaculture, and bait facilities have greater virulence (i.e., ability to cause disease than wild-type isolates. Future investigations should focus on the genetic basis for pathogen virulence and host susceptibility, ecological and anthropogenic mechanisms contributing to emergence, and vaccine development for use in captive populations and species reintroduction programs.

UNLEARNED LESSONS OF CONTEMPORARY HISTORY

Directory of Open Access Journals (Sweden)

А Н Данилов

2017-12-01

Full Text Available The article considers the complex geopolitical situation in the global world at the end of the second decade of the 21st century as determined by the consequences of the collapse of the Soviet Union and by the new world order. The author seeks to answer the questions who will define the current geopolitical situation, whose aims it will reflect, what will become the basis of new geopolitical realities, the basis of moral solidarity of humankind, and the spiritual basis of future civilizations. The new challenges give rise to a desperate struggle for different scenarios for building a happy life. Moreover, it is not clear which ideal of the future world will be widely supported as a development guideline. The recognition as such of the standard of living and development of the strongest ones becomes a real threat to the new civilization for it leads to the loss of national interests of sovereign states, and to the loss of an independent future. Today, there is an active search for new theories and concepts that will adequately explain con-temporary global processes. In this thematic context, the author identifies main lessons not learned by the world political elites. The first lesson: new states are not born in an empty place, their common history is a great advantage ensuring prospects for the further development of interstate cooperation. The second lesson: the widespread falsification of history has a negative impact on national, cultural and social-group identity in transforming societies. The third lesson: after the collapse of the Soviet Union, the post-war balance of power was destroyed together with the system of checks and balances in world politics (a bipolar model of the world. The fourth lesson: under radical social transformations, the moral system of the population devaluates with numerous crisis consequences.

New and emerging chlamydial infections of creatures great and small

Directory of Open Access Journals (Sweden)

A. Taylor-Brown

2017-07-01

Full Text Available Until recently, our knowledge of the host range and diversity of members of the Chlamydiaceae, obligate intracellular bacterial pathogens of humans and animals, was thought to be nearly complete. Aided by advances in molecular diagnostics, a new picture is emerging, however, that the host barriers may be looser than previously thought for many chlamydial species. While cross-host transmission of chlamydial species is a concern for animal health, new reports highlight an emerging zoonotic risk for several species associated with intensification of farming and the widespread popularity of companion animals. The description of an expanded cohort of new species within this family from avian and reptilian hosts has also highlighted how much we still have to learn about the biology and pathogenicity of the Chlamydiaceae as a whole. Reports emerging about these relatives of the traditional chlamydial pathogens are matched by the continued identification of novel Chlamydia-related bacteria in the phylum Chlamydiae, providing evidence that many may be pathogenic to humans or animals and pose a zoonotic or vector-borne risk. The review examines the new hosts described for well-characterized chlamydial veterinary pathogens, emerging novel chlamydial species and the potential for these to cause disease in their respective hosts.

RNA Transcriptional Biosignature Analysis for Identifying Febrile Infants With Serious Bacterial Infections in the Emergency Department

Science.gov (United States)

Mahajan, Prashant; Kuppermann, Nathan; Suarez, Nicolas; Mejias, Asuncion; Casper, Charlie; Dean, J. Michael; Ramilo, Octavio

2015-01-01

Objectives To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. Methods We designed a prospective multicenter cohort study with the aim of enrolling more than 4000 febrile infants 60 days and younger. To ensure success of conducting complex genomic studies in emergency department (ED) settings, we established an infrastructure within the Pediatric Emergency Care Applied Research Network, including 21 sites, to evaluate RNA transcriptional profiles in young febrile infants. We developed a comprehensive manual of operations and trained site investigators to obtain and process blood samples for RNA extraction and genomic analyses. We created standard operating procedures for blood sample collection, processing, storage, shipping, and analyses. We planned to prospectively identify, enroll, and collect 1 mL blood samples for genomic analyses from eligible patients to identify logistical issues with study procedures. Finally, we planned to batch blood samples and determined RNA quantity and quality at the central microarray laboratory and organized data analysis with the Pediatric Emergency Care Applied Research Network data coordinating center. Below we report on establishment of the infrastructure and the feasibility success in the first year based on the enrollment of a limited number of patients. Results We successfully established the infrastructure at 21 EDs. Over the first 5 months we enrolled 79% (74 of 94) of eligible febrile infants. We were able to obtain and ship 1 mL of blood from 74% (55 of 74) of enrolled participants, with at least 1 sample per participating ED. The 55 samples were shipped and evaluated at the microarray laboratory, and 95% (52 of 55) of blood samples were of adequate quality and contained sufficient RNA for expression

Emergence of Trichosporon mycotoxinivorans (Apiotrichum mycotoxinivorans) invasive infections in Latin America.

Science.gov (United States)

Almeida, João Nobrega de; Francisco, Elaine Cristina; Barberino, Maria Goreth M de Andrade; Silva, Luiz Vicente Ribeiro F da; Brandão, Oriana M; Colombo, Arnaldo Lopes; Padovan, Ana Carolina Barbosa

2017-10-01

We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF) had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.

The implementation of school-based lesson study at elementary school

Directory of Open Access Journals (Sweden)

Purnomo Purnomo

2017-07-01

Full Text Available This study aims to describe and interpret the implementation of school-based lesson study in SDN I Kretek. This study uses the qualitative research. The data were collected through in-depth interviews, participant observation, field notes, and documentation. The data validity was determined through sources and techniques triangulation. The data were analyzed using the Interactive Analysis Model from Miles and Huberman. The results show: (1 the planning of school-based lesson study program at SDN 1 Kretek has been implemented from the beginning of the school year 2014/2015 by establishing school-based lesson study team. This team is responsible for planning, managing, and evaluating school-based lesson study program at SDN 1 Kretek, (2 school-based lesson study at SDN 1 Kretek is implemented in three phases, namely planning, implementation, and reflection, and (3 The evaluation of lesson study is conducted by each teacher who has conducted the open class and conducted thoroughly with a meeting by a team of school-based lesson study SDN 1 Kretek at the end of the school year.

The natech events during the 17 August 1999 Kocaeli earthquake: aftermath and lessons learned

Directory of Open Access Journals (Sweden)

S. Girgin

2011-04-01

Full Text Available Natural-hazard triggered technological accidents (natechs at industrial facilities have been recognized as an emerging risk. Adequate preparedness, proper emergency planning, and effective response are crucial for the prevention of natechs and mitigation of the consequences. Under the conditions of a natural disaster, the limited resources, the possible unavailability of mitigation measures, and the lack of adequate communication complicate the management of natechs. The analysis of past natechs is crucial for learning lessons and for preventing or preparing for future natechs. The 17 August 1999, Kocaeli earthquake, which was a devastating disaster hitting one of the most industrialized regions of Turkey, offers opportunities in this respect. Among many natechs that occurred due to the earthquake, the massive fire at the TUPRAS Izmit refinery and the acrylonitrile spill at the AKSA acrylic fiber production plant were especially important and highlight problems in the consideration of natechs in emergency planning, response to industrial emergencies during natural hazards, and information to the public during and following the incidents. The analysis of these events shows that even the largest and seemingly well-prepared facilities can be vulnerable to natechs if risks are not considered adequately.

Childhood urinary tract infection in Benin City: pathogens and ...

African Journals Online (AJOL)

Childhood urinary tract infection in Benin City: pathogens and antimicrobial ... of bacterial isolates implicated in urinary tract infection (UTI) amongst children was ... There is also an emerging resistance of common pathogens to azithromycin ...

Lessons from the other side: what can we learn from the private sector?

Science.gov (United States)

Clarke, D

1999-01-01

Business has reacted in an impressive manner to increasing globalisation, short-term stock market pressure for performance, emerging industries and new technologies. While the private sector has become increasingly competitive, the public sector has not adopted this commercial rigour. Funding pressures on health services will continue, as will increasing consumer and staff demands and the blurring of public and private health care provision. As a result, there are lessons and techniques the public and private health sectors should learn from each other. I have drawn the issues that follow from my experience in the steel and food industries.

Lessons from obesity prevention for the prevention of mental disorders: the primordial prevention approach.

Science.gov (United States)

Hayward, Joshua; Jacka, Felice N; Waters, Elizabeth; Allender, Steven

2014-09-10

Emerging evidence supports a relationship between risk factors for obesity and the genesis of the common mental disorders, depression and anxiety. This suggests common mental disorders should be considered as a form of non-communicable disease, preventable through the modification of lifestyle behaviours, particularly diet and physical activity. Obesity prevention research since the 1970's represents a considerable body of knowledge regarding strategies to modify diet and physical activity and so there may be clear lessons from obesity prevention that apply to the prevention of mental disorders. For obesity, as for common mental disorders, adolescence represents a key period of vulnerability. In this paper we briefly discuss relationships between modifiable lifestyle risk factors and mental health, lifestyle risk factor interventions in obesity prevention research, the current state of mental health prevention, and the implications of current applications of systems thinking in obesity prevention research for lifestyle interventions. We propose a potential focus for future mental health promotion interventions and emphasise the importance of lessons available from other lifestyle modification intervention programmes.

Application of non-structural protein antibody tests in substantiating freedom from foot-and-mouth disease virus infection after emergency vaccination of cattle

DEFF Research Database (Denmark)

Paton, D.J.; de Clercq, K.; Greiner, Matthias

2006-01-01

There has been much debate about the use of the so-called "vaccinate-to-live" policy for the control of foot-and-mouth disease (FMD) in Europe, according to which, spread of the FMD virus (FMDV) from future outbreaks could be controlled by a short period of "emergency" vaccination of surrounding...... herds, reducing the need for large-scale pre-emptive culling of at-risk animals. Since vaccinated animals may become subclinically infected with FMDV following challenge exposure, it is necessary to either remove all vaccinates (vaccinate-to-kill) or to detect and remove vaccinates in which virus......) of FMDV, which are induced by infection with the virus, but not by vaccination with purified FMD vaccines. Using test sensitivity and specificity data established at a recent workshop on NSP assays [Brocchi E, Bergmann I, Dekker A, Paton DJ, Sammin DJ, Greiner M, et al. Comparative performance of six...

Plant Identification Characteristics for Deciduous Trees & Shrubs. Lesson Plans.

Science.gov (United States)

Burkholder, Kathy

This manual contains a group of lesson plans designed for use with a slide series (not included here). Its purpose is to introduce students to the basic concepts and terminology used in the identification of deciduous trees and shrubs. The manual is composed of 12 lesson plans. The first lesson is an introduction to plant identification. The…

NAPAP: A lesson in science, policy

International Nuclear Information System (INIS)

Russell, M.

1993-01-01

Perplexing environmental questions, such as acid rain and global warming, cry out for policy solutions based upon solid scientific evidence. Scientists and politicians agree on this but have trouble finding an effective way to do it. Milton Russell of the University of Tennessee and Oak Ridge National Laboratory describes a major, but only partially successful, effort that he believes contains valuable lessons for scientists and policy makers in the future. It is the National Acid Precipitation Assessment Program (NAPAP), launched in 1980 to generate the latest scientific evidence to guide national debate on clean-air legislation. The program open-quotes created an unprecedented body of scientific research on an environmental issue of the first order,close quotes Russell says. Yet, he admits, its influence was virtually nil on the legislation that ultimately emerged on the subject. Russell blames this lack of influence on NAPAP's failure to provide adequate assessment of its research findings, its failure to communicate the results on a timely and effective basis, and on open-quotes political forces that sought legislation rather than a full explication of issues.close quotes Out of the experience, Russell finds lessons for the future: open-quotes First, if the scientific finding are to have an impact on policy, assessment must become a priority as important as scientific research. Second, for projects designed to help decision makers, scientific research must be considered a resource, not an end product. Third, timely, lucid communication must be an essential element of the project, not a marginal activity.close quotes NAPAP, Russell concludes, open-quotes proved a long-term scientific success and a short-term policy disappointment.close quotes Then he warns, open-quotes Future science programs ignore the NAPAP experience at their own risk.close quotes

Considerations for implementing an organizational lessons learned process.

Energy Technology Data Exchange (ETDEWEB)

Fosshage, Erik D

2013-05-01

This report examines the lessons learned process by a review of the literature in a variety of disciplines, and is intended as a guidepost for organizations that are considering the implementation of their own closed-loop learning process. Lessons learned definitions are provided within the broader context of knowledge management and the framework of a learning organization. Shortcomings of existing practices are summarized in an attempt to identify common pitfalls that can be avoided by organizations with fledgling experiences of their own. Lessons learned are then examined through a dual construct of both process and mechanism, with emphasis on integrating into organizational processes and promoting lesson reuse through data attributes that contribute toward changed behaviors. The report concludes with recommended steps for follow-on efforts.

Towards a lessons learned system for critical software

International Nuclear Information System (INIS)

Andrade, J.; Ares, J.; Garcia, R.; Pazos, J.; Rodriguez, S.; Rodriguez-Paton, A.; Silva, A.

2007-01-01

Failure can be a major driver for the advance of any engineering discipline and Software Engineering is no exception. But failures are useful only if lessons are learned from them. In this article we aim to make a strong defence of, and set the requirements for, lessons learned systems for safety-critical software. We also present a prototype lessons learned system that includes many of the features discussed here. We emphasize that, apart from individual organizations, lessons learned systems should target industrial sectors and even the Software Engineering community. We would like to encourage the Software Engineering community to use this kind of systems as another tool in the toolbox, which complements or enhances other approaches like, for example, standards and checklists

Towards a lessons learned system for critical software

Energy Technology Data Exchange (ETDEWEB)

Andrade, J. [University of A Coruna. Campus de Elvina, s/n. 15071, A Coruna (Spain)]. E-mail: jag@udc.es; Ares, J. [University of A Coruna. Campus de Elvina, s/n. 15071, A Coruna (Spain)]. E-mail: juanar@udc.es; Garcia, R. [University of A Coruna. Campus de Elvina, s/n. 15071, A Coruna (Spain)]. E-mail: rafael@udc.es; Pazos, J. [Technical University of Madrid. Campus de Montegancedo, s/n. 28660, Boadilla del Monte, Madrid (Spain)]. E-mail: jpazos@fi.upm.es; Rodriguez, S. [University of A Coruna. Campus de Elvina, s/n. 15071, A Coruna (Spain)]. E-mail: santi@udc.es; Rodriguez-Paton, A. [Technical University of Madrid. Campus de Montegancedo, s/n. 28660, Boadilla del Monte, Madrid (Spain)]. E-mail: arpaton@fi.upm.es; Silva, A. [Technical University of Madrid. Campus de Montegancedo, s/n. 28660, Boadilla del Monte, Madrid (Spain)]. E-mail: asilva@fi.upm.es

2007-07-15

Failure can be a major driver for the advance of any engineering discipline and Software Engineering is no exception. But failures are useful only if lessons are learned from them. In this article we aim to make a strong defence of, and set the requirements for, lessons learned systems for safety-critical software. We also present a prototype lessons learned system that includes many of the features discussed here. We emphasize that, apart from individual organizations, lessons learned systems should target industrial sectors and even the Software Engineering community. We would like to encourage the Software Engineering community to use this kind of systems as another tool in the toolbox, which complements or enhances other approaches like, for example, standards and checklists.

Refining MARGINS Mini-Lessons Using Classroom Observations

Science.gov (United States)

Iverson, E. A.; Manduca, C. A.; McDaris, J. R.; Lee, S.

2009-12-01

One of the challenges that we face in developing teaching materials or activities from research findings is testing the materials to determine that they work as intended. Traditionally faculty develop material for their own class, notice what worked and didn’t, and improve them the next year. However, as we move to a community process of creating and sharing teaching materials, a community-based process for testing materials is appropriate. The MARGINS project has piloted such a process for testing teaching materials and activities developed as part of its mini-lesson project (http://serc.carleton.edu/margins/index.html). Building on prior work developing mechanisms for community review of teaching resources (e.g. Kastens, 2002; Hancock and Manduca, 2005; Mayhew and Hall, 2007), the MARGINS evaluation team developed a structured classroom observation protocol. The goals of field testing are to a) gather structured, consistent feedback for the lesson authors based on classroom use; b) guide reviewers of these lessons to reflect on research-based educational practice as a framework for their comments; c) collect information on the data and observations that the reviewer used to underpin their review; d) determine which mini-lessons are ready to be made widely available on the website. The protocol guides faculty observations on why they used the activity, the effectiveness of the activity in their classroom, the success of the activity in leading to the desired learning, and what other faculty need to successfully use the activity. Available online (http://serc.carleton.edu/margins/protocol.html), the protocol can be downloaded and completed during instruction with the activity. In order to encourage review of mini-lessons using the protocol, a workshop focused on review and revision of activities was held in May 2009. In preparation for the workshop, 13 of the 28 participants chose to field test a mini-lesson prior to the workshop and reported that they found this

Mycoplasma genitalium Infections

Centers for Disease Control (CDC) Podcasts

2018-02-08

Dr. Lisa Manhart, a professor of Epidemiology and Global Health with the Center for AIDS and STD at the University of Washington, discusses Mycoplasma genitalium Infections.  Created: 2/8/2018 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/8/2018.

Lessons from Early Medicaid Expansions Under Health Reform..

Data.gov (United States)

U.S. Department of Health & Human Services — Lessons from Early Medicaid Expansions Under Health Reform, Interviews with Medicaid Officials In a new study entitled Lessons from Early Medicaid Expansions Under...

How to Manage and Control Healthcare Associated Infections

Science.gov (United States)

Wijaya, L.

2018-03-01

Healthcare associated infections (HAI) are the major complications of modern medical therapy. The most important HAIs are related to invasive devices including central line- associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and surgical-site infections (SSI). Excessive use of antibiotics has also led to the emergence and the global dissemination of antibiotic resistant bacteria over the last few decades. Reducing HAIs will involve a multi-modal approach to infection control practices as well as antibiotic stewardship program.

Emergence of Trichosporon mycotoxinivorans (Apiotrichum mycotoxinivorans invasive infections in Latin America

Directory of Open Access Journals (Sweden)

João Nobrega de Almeida Jr

Full Text Available We report the first two cases of Trichosporon mycotoxinivorans infections in Latin America. We also conducted a literature review and a microbiological investigation, including that of clinical and environmental isolates. A 30-year-old man with chronic renal failure had disseminated infection after dialysis and a 15-year-old boy with cystic fibrosis (CF had pulmonary exacerbations with positive respiratory samples. A review of the relevant literature revealed that deep-seated infections were related to immunosuppression or invasive devices, while most of the CF patients showed a decline in lung function after positive cultures. Phylogenetic analyses revealed three distinct circulating genotypes. MALDI-TOF mass spectrometry analysis showed similar spectral profiles and correctly identified all strains/isolates. Biofilm production was documented in a bloodstream isolate and biofilm-producing cells showed high minimum inhibitory concentrations against antifungals.

Prevalence of Trichomonas vaginalis Infection among Pregnant ...

African Journals Online (AJOL)

Trichomoniasis caused by Trichomonas vaginalis has emerged as one of the most common sexually transmitted infections. The infection may lead to an important complication in pregnancy, as it has been related with prematurity and low birth weight. The aim of this study was to determine the prevalence of T. vaginalis ...

Persistent infection caused by Hobi-like pestivirus.

Science.gov (United States)

Decaro, Nicola; Losurdo, Michele; Lucente, Maria Stella; Sciarretta, Rossana; Mari, Viviana; Larocca, Vittorio; Elia, Gabriella; Cavaliere, Nicola; Martella, Vito; Fasanella, Antonio; Buonavoglia, Canio

2013-04-01

A calf persistently infected by Hobi-like pestivirus was monitored for about 6 months, displaying clinical signs typical of bovine viral diarrhea virus persistent infection and shedding the virus through all body secretions, with maximal titers detected in urine. This report provides new insights into the pathogenesis of the emerging pestivirus.

Compact Fluorescent Lighting in America: Lessons Learned on the Way to Market

Energy Technology Data Exchange (ETDEWEB)

Sandahl, Linda J.; Gilbride, Theresa L.; Ledbetter, Marc R.; Steward, Heidi E.; Calwell, Chris

2006-05-22

This report describes the history of compact fluorescent lamps (CFLs) in America. CFLs were introduced in the 1970s; however, it has taken more than 20 years for them to gain widespread recognition in the U.S. residential lighting market. This report reviews the development of CFLs, efforts to increase market acceptance of them, and barriers to that acceptance. Lessons to be learned from this study of CFLs are identified in hopes of assisting future market introduction efforts for other promising energy-efficient technologies. This report was prepared by the Pacific Northwest National Laboratory for the U.S. Department of Energy’s Office of Building Technologies, Emerging Technologies Program.

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

Science.gov (United States)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Investigating Shigella sonnei Infections

Centers for Disease Control (CDC) Podcasts

2011-11-17

Dr. Nancy Strockbine, Chief of the Escherichia and Shigella Reference Unit at CDC, discusses Shigella sonnei infections.  Created: 11/17/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/21/2011.

Lessons from Goiania

International Nuclear Information System (INIS)

Nazari Alves, R.

2000-01-01

The lessons learned from the radiological accident of Goiania in 1987 derived from the observations from the Regulatory Agency which was in charge of the decontamination tasks may be consolidated into four classes: Preventive Actions, characterised as those that aim to minimise the probability of occurrence of a radiological accident; Minimisation of time between the moment of the accident occurrence and the beginning of intervention, in case a radiological accident does occur, despite all preventive measures; Intervention, which is correlated to the type of installation, its geographical location, the social classes involved and their contamination vectors; and Follow up, for which well established rules to allow continuing monitoring of the victims and rebuilding of homes are necessary. The greatest lesson of all was the need for integration of the professionals involved, from all organizations. (author)

Lessons learned on digital systems safety

International Nuclear Information System (INIS)

Sivertsen, Terje

2005-06-01

A decade ago, in 1994, lessons learned from Halden research activities on digital systems safety were summarized in the reports HWR-374 and HWR-375, under the title 'A Lessons Learned Report on Software Dependability'. The reports reviewed all activities made at the Halden Project in this field since 1977. As such, the reports provide a wealth of information on Halden research. At the same time, the lessons learned from the different activities are made more accessible to the reader by being summarized in terms of results, conclusions and recommendations. The present report provides a new lessons learned report, covering the Halden Project research activities in this area from 1994 to medio 2005. As before, the emphasis is on the results, conclusions and recommendations made from these activities, in particular how they can be utilized by different types of organisations, such as licensing authorities, safety assessors, power companies, and software developers. The contents of the report have been edited on the basis of input from a large number of Halden work reports, involving many different authors. Brief summaries of these reports are included in the last part of the report. (Author)

Finnish Students’ Engagement in Science Lessons

Directory of Open Access Journals (Sweden)

Janna Linnansaari

2015-05-01

Full Text Available The decreasing number of students who are engaged in science learning has been recognised as a problem. The pre-conditions of engagement and actual engagement were examined using a novel research method to obtain detailed information on Finnish students’ engagement in different situations and to gain a better understanding of this phenomenon. The study’s participants consisted of 68 students (31 girls, 37 boys from 9th grade and 67 students (46 girls, 21 boys from 1st grade in upper secondary school. The research aimed to answer the following question: How does Finnish students’ engagement occur in exact and life science lessons? Participants received smartphones equipped with a smartphone application that included an experience sampling method questionnaire. The smartphones were programmed to emit a signal during every science lesson and otherwise randomly during the day (from 8 am to 8 pm. The results reveal that situation and grade had significant effects on students’ pre-conditions of engagement and actual engagement. Our results also show that girls had the highest interest in life science lessons and boys in exact science lessons.

Lesson Study-Building Communities of Learning Among Pre-Service Science Teachers

Science.gov (United States)

Hamzeh, Fouada

Lesson Study is a widely used pedagogical approach that has been used for decades in its country of origin, Japan. It is a teacher-led form of professional development that involves the collaborative efforts of teachers in co-planning and observing the teaching of a lesson within a unit for evidence that the teaching practices used help the learning process (Lewis, 2002a). The purpose of this research was to investigate if Lesson Study enables pre-service teachers to improve their own teaching in the area of science inquiry-based approaches. Also explored are the self-efficacy beliefs of one group of science pre-service teachers related to their experiences in Lesson Study. The research investigated four questions: 1) Does Lesson Study influence teacher preparation for inquiry-based instruction? 2) Does Lesson Study improve teacher efficacy? 3) Does Lesson Study impact teachers' aspiration to collaborate with colleagues? 4) What are the attitudes and perceptions of pre-service teachers to the Lesson Study idea in Science? The 12 participants completed two pre- and post-study surveys: STEBI- B, Science Teaching Efficacy Belief Instrument (Enochs & Riggs, 1990) and ASTQ, Attitude towards Science Teaching. Data sources included student teaching lesson observations, lesson debriefing notes and focus group interviews. Results from the STEBI-B show that all participants measured an increase in efficacy throughout the study. This study added to the body of research on teaching learning communities, professional development programs and teacher empowerment.

Lessons of nuclear robot history

International Nuclear Information System (INIS)

Oomichi, Takeo

2014-01-01

Severe accidents occurred at Fukushima Daiichi Nuclear Power Station stirred up people's great expectation of nuclear robot's deployment. However unexpected nuclear disaster, especially rupture of reactor building caused by core meltdown and hydrogen explosion, made it quite difficult to introduce nuclear robot under high radiation environment to cease accidents and dispose damaged reactor. Robotics Society of Japan (RSJ) set up committee to look back upon lessons learned from 50 year's past experience of nuclear robot development and summarized 'Lessons of nuclear robot history', which was shown on the home page website of RSJ. This article outlined it with personal comment. History of nuclear robot developed for inspection and maintenance at normal operation and for specific required response at nuclear accidents was reviewed with many examples at home and abroad for TMI, Chernobyl and JCO accidents. Present state of Fukushima accident response robot's introduction and development was also described with some comments on nuclear robot development from academia based on lessons. (T. Tanaka)

Clostridium difficile infection: current, forgotten and emerging treatment options.

Science.gov (United States)

Drekonja, Dimitri M

2014-09-01

Clostridium difficile infection (CDI) has increased in incidence and severity, and is now among the most common nosocomial infections. Several agents are available for the initial treatment of CDI, some of which are rarely used, and none of which is clearly superior for initial clinical cure. Fidaxomicin appears to offer a benefit in terms of preventing recurrent disease, although the cost-benefit ratio is debated. Recurrent CDI is a major challenge, occurring after 15-30% of initial episodes. The treatment of recurrent CDI is difficult, with sparse evidence available to support any particular agent. Fecal microbiota therapy, also known as 'stool transplantation', appears to be highly effective, although availability is currently limited, and the regulatory environment is in flux. Synthetic stool products and an orally available fecal microbiota therapy product are both under investigation, which may address the problem of availability. As with most infectious diseases, an effective vaccine would be a welcome addition to our armamentarium, but none is currently available.

PENERAPAN LESSON STUDY UNTUK MENINGKATAN KEMAMPUAN MENGAJAR MAHASISWA CALON GURU FISIKA

Directory of Open Access Journals (Sweden)

Rif’ati Dina Handayani

2015-02-01

ABSTRAK Lesson study merupakan suatu model pengembangan kemampuan mengajar melalui pengkajian pembelajaran secara kolaboratif dan berkelanjutan. Lesson study dilaksanakan dalam tiga tahapan, yaitu plan, do, see yang dilaksanakan secara terstruktur, bersiklus dan berkelanjutan. Dalam penelitian ini subjek dari pelaksanaan lesson study adalah empat orang  mahasiswa calon guru fisika yang sedang melaksanakan PPL di salah satu SMP Negeri di Bondowoso. Hasil penelitian menunjukkan bahwa penerapan lesson study dapat meningkatkan kemampuan mengajar mahasiswa calon guru fisika dari kriteria kurang baik menjadi kriteria sangat baik. Kata kunci: Calon guru fisika, Lesson Study, Kemampuan Mengajar

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract.

Science.gov (United States)

Kline, Kimberly A; Lewis, Amanda L

2016-04-01

Gram-positive bacteria are a common cause of urinary-tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.

Constellation Program: Lessons Learned. Volume 1; Executive Summary

Science.gov (United States)

Rhatigan, Jennifer L. (Editor)

2011-01-01

This document (Volume I) provides an executive summary of the lessons learned from the Constellation Program. A companion Volume II provides more detailed analyses for those seeking further insight and information. In this volume, Section 1.0 introduces the approach in preparing and organizing the content to enable rapid assimilation of the lessons. Section 2.0 describes the contextual framework in which the Constellation Program was formulated and functioned that is necessary to understand most of the lessons. Context of a former program may seem irrelevant in the heady days of new program formulation. However, readers should take some time to understand the context. Many of the lessons would be different in a different context, so the reader should reflect on the similarities and differences in his or her current circumstances. Section 3.0 summarizes key findings developed from the significant lessons learned at the program level that appear in Section 4.0. Readers can use the key findings in Section 3.0 to peruse for particular topics, and will find more supporting detail and analyses in Section 4.0 in a topical format. Appendix A contains a white paper describing the Constellation Program formulation that may be of use to readers wanting more context or background information. The reader will no doubt recognize some very similar themes from previous lessons learned, blue-ribbon committee reviews, National Academy reviews, and advisory panel reviews for this and other large-scale human spaceflight programs; including Apollo, Space Shuttle, Shuttle/Mir, and the ISS. This could represent an inability to learn lessons from previous generations; however, it is more likely that similar challenges persist in the Agency structure and approach to program formulation, budget advocacy, and management. Perhaps the greatest value of these Constellation lessons learned can be found in viewing them in context with these previous efforts to guide and advise the Agency and its

Do Lessons in Nature Boost Subsequent Classroom Engagement? Refueling Students in Flight

Directory of Open Access Journals (Sweden)

Ming Kuo

2018-01-01

Full Text Available Teachers wishing to offer lessons in nature may hold back for fear of leaving students keyed up and unable to concentrate in subsequent, indoor lessons. This study tested the hypothesis that lessons in nature have positive—not negative—aftereffects on subsequent classroom engagement. Using carefully matched pairs of lessons (one in a relatively natural outdoor setting and one indoors, we observed subsequent classroom engagement during an indoor instructional period, replicating these comparisons over 10 different topics and weeks in the school year, in each of two third grade classrooms. Pairs were roughly balanced in how often the outdoor lesson preceded or followed the classroom lesson. Classroom engagement was significantly better after lessons in nature than after their matched counterparts for four of the five measures developed for this study: teacher ratings; third-party tallies of “redirects” (the number of times the teacher stopped instruction to direct student attention back onto the task at hand; independent, photo-based ratings made blind to condition; and a composite index each showed a nature advantage; student ratings did not. This nature advantage held across different teachers and held equally over the initial and final 5 weeks of lessons. And the magnitude of the advantage was large. In 48 out of 100 paired comparisons, the nature lesson was a full standard deviation better than its classroom counterpart; in 20 of the 48, the nature lesson was over two standard deviations better. The rate of “redirects” was cut almost in half after a lesson in nature, allowing teachers to teach for longer periods uninterrupted. Because the pairs of lessons were matched on teacher, class (students and classroom, topic, teaching style, week of the semester, and time of day, the advantage of the nature-based lessons could not be attributed to any of these factors. It appears that, far from leaving students too keyed up to concentrate

Manual for first responders to a radiological emergency. Emergency preparedness and response. Publication date: June 2007

International Nuclear Information System (INIS)

2007-08-01

lessons learned from using IAEA-TECDOC-1162, previous emergencies and research, while ensuring consistency with the IAEA Safety Standards Series No. GS-R-2. The publication is cosponsored by the Comite technique international de prevention et d'extinction du feu (CTIF), the Pan American Health Organization (PAHO) and the World Health Organization (WHO)

Manual for first responders to a radiological emergency. Emergency preparedness and response. Publication date: October 2006

International Nuclear Information System (INIS)

2006-10-01

lessons learned from using IAEA-TECDOC-1162, previous emergencies and research, while ensuring consistency with the IAEA Safety Standards Series No. GS-R-2. The publication is cosponsored by the Comite technique international de prevention et d'extinction du feu (CTIF), the Pan American Health Organization (PAHO) and the World Health Organization (WHO)

Fungal Wound Infection

Centers for Disease Control (CDC) Podcasts

2016-01-28

Dr. David Tribble, acting director of the infectious disease clinical research program at Uniformed Services University of the Health Sciences, discusses fungal wound infections after combat trauma.  Created: 1/28/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/28/2016.

Development of short Indonesian lesson plan to improve teacher performance

Science.gov (United States)

Yulianto, B.; Kamidjan; Ahmadi, A.; Asteria, P. V.

2018-01-01

The developmental research was motivated by the results of preliminary study through interviews, which revealed almost all of the teachers did not create lesson plan themselves. As a result of this load, the performance of the real learning in the classroom becomes inadequate. Moreover, when lesson plan was not made by teachers themselves, the learning process becomes ineffective. Therefore, this study designed to develop a prototype of the short lesson plan, in particular, Indonesian language teaching, and to investigate its effectiveness. The participants in the study were teachers who were trained through lesson study group to design short model’s lesson plan. Questionnaires and open-ended questions were used, and the quantitative and qualitative data obtained were analyzed accordingly. The analysis of the quantitative data, aided with SPSS, were frequency, percentage, and means, whereas the qualitative data were analyzed descriptively. The results showed that the teachers liked the model, and they were willing to design their own lesson plan. The observation data revealed that the classroom learning process became more interactive, and classroom atmosphere was more engaging and natural because the teachers did not stick to the lesson plan made by other teachers.

[Emerging viral infections and hepatotropic virus].

Science.gov (United States)

Arsuaga, Marta; de la Calle-Prieto, Fernando; Negredo Antón, Ana; Vázquez González, Ana

2016-10-01

Environmental degradation, population movements and urban agglomerations have broken down the borders for infectious diseases. The expansion of microorganisms has entered an increasing area of transmission vectors. The lack of immunity of the population leads to an increased risk of spreading infectious diseases. Furthermore, the decline in vaccination rates in developed countries and socio-economic difficulties in large regions has meant that diseases in the process of eradication have re-emerged. That is why health care workers must be trained to avoid delaying in diagnosis and to accelerate the implementation of public health measures. A great deal of education and health prevention should fall under the responsibilities of travellers who move around different regions. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections

NARCIS (Netherlands)

Schuetz, Philipp; Wirz, Yannick; Sager, Ramon; Christ-Crain, Mirjam; Stolz, Daiana; Tamm, Michael; Bouadma, Lila; Luyt, Charles E; Wolff, Michel; Chastre, Jean; Tubach, Florence; Kristoffersen, Kristina B; Burkhardt, Olaf; Welte, Tobias; Schroeder, Stefan; Nobre, Vandack; Wei, Long; Bucher, Heiner C; Bhatnagar, Neera; Annane, Djillali; Reinhart, Konrad; Branche, Angela; Damas, Pierre; Nijsten, Maarten W N; de Lange, Dylan W; Deliberato, Rodrigo O; Lima, Stella Ss; Maravić-Stojković, Vera; Verduri, Alessia; Cao, Bin; Shehabi, Yahya; Beishuizen, Albertus; Jensen, Jens-Ulrik S; Corti, Caspar; van Oers, Jos A; Falsey, Ann R; de Jong, Evelien; Oliveira, Carolina F; Beghe, Bianca; Briel, Matthias; Mueller, Beat

2017-01-01

BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about

Early effect of American Academy of Pediatrics Urinary Tract Infection Guidelines on radiographic imaging and diagnosis of vesicoureteral reflux in the emergency room setting.

Science.gov (United States)

Arlen, Angela M; Merriman, Laura S; Kirsch, Jared M; Leong, Traci; Scherz, Hal C; Smith, Edwin A; Broecker, Bruce H; Kirsch, Andrew J

2015-05-01

In 2011 the AAP revised practice parameters on febrile urinary tract infection in infants and children 2 to 24 months old. New imaging recommendations invigorated the ongoing debate regarding the diagnosis and management of vesicoureteral reflux. We compared evaluations in these patients with febrile urinary tract infection before and after guideline publication. During 2 separate 6-month periods 350 patients 2 to 24 months old were evaluated in the emergency room setting. Demographics, urine culture, renal-bladder ultrasound, voiding cystourethrogram and admission status were assessed. A total of 172 patients presented with initial febrile urinary tract infection in 2011, of whom 47 (27.3%) required hospitalization, while 42 of 178 (23.6%) were admitted in 2012. Admission by year did not significantly differ (p = 0.423). After guideline revision 41.2% fewer voiding cystourethrograms were done (72.1% of cases in 2011 vs 30.9% in 2012, p urinary tract infection. We found no relationship between renal-bladder ultrasound and abnormal voiding cystourethrogram, consistent with previous findings that call ultrasound into question as the determinant for additional imaging. Whether forgoing routine voiding cystourethrogram results in increased morbidity is the subject of ongoing study. Copyright © 2015. Published by Elsevier Inc.

Chikungunya: an emerging viral infection with varied clinical presentations in Bangladesh: Reports of seven cases.

Science.gov (United States)

Rahim, Muhammad Abdur; Uddin, Khwaja Nazim

2017-08-15

Chikungunya is an emerging and rapidly spreading viral infection in many parts of the world including Bangladesh. It shares many epidemiological and clinical characteristics with dengue. So, a sound knowledge is required for its detection and differentiation from dengue, specially in endemic regions. We present seven confirmed cases of chikungunya having different clinical presentations occurring among middle aged males and females from different socio-economic background in Dhaka city, the capital of Bangladesh. All patients had fever and aches and pains. Less common features were rash, diarrhea, vomiting and altered liver biochemistry. Dengue was excluded in six patients. Paracetamol remained the mainstay of treatment during febrile periods, but over 50% of the patients had prolonged joint symptoms requiring non-steroidal anti-inflammatory drugs. In spite of being a self-limiting disease, chikungunya may have different presentations and a protracted clinical course. During the febrile episode, exclusion of dengue is equally important. Physicians should be aware of the condition and public health initiatives are necessary to break the disease transmission.

Pacemaker Primary Curriculum; Lesson Book Level B.

Science.gov (United States)

Ross, Dorothea M.; Ross, Sheila A.

This lesson book, which is the second in a four-level program for young children with learning difficulties, describes the purpose of and equipment and procedures for teaching lessons in the following subjects areas on the primary grade level: arithmetic, reading, vocabulary, listening, planning, problem solving, social behavior, art, music, and…

Pacemaker Primary Curriculum; Lesson Book Level A.

Science.gov (United States)

Ross, Dorothea M.; Ross, Sheila A.

This lesson book, which is the first in a four-level program for young children with learning difficulties, describes the purpose of and equipment and procedures for teaching lessons in the following subject areas on the kindergarten level: arithmetic concepts, number concepts, reading readiness, vocabulary, language, listening, social behavior,…

Pacemaker Primary Curriculum; Lesson Book Level C.

Science.gov (United States)

Ross, Dorothea M.; Ross, Sheila A.

This lesson book, which is the third in a four-level program for young children with learning difficulties, describes the purpose of and equipment and procedures for teaching lessons in the following subject areas on the primary grade level: arithmetic, reading, vocabulary, spelling, printing, listening, planning, problem solving, social behavior,…

Pacemaker Primary Curriculum; Lesson Book Level D.

Science.gov (United States)

Ross, Dorothea M.; Ross, Sheila A.

This lesson book, which is the last in a four-level program for young children with learning difficulties, describes the purpose of and equipment and procedures for teaching lessons in the following subject areas on the primary level: arithmetic, reading, vocabulary, spelling, printing, listening, planning and problem solving, social behavior,…

Emergence of CD4+ and CD8+ Polyfunctional T Cell Responses Against Immunodominant Lytic and Latent EBV Antigens in Children With Primary EBV Infection

Directory of Open Access Journals (Sweden)

Janice K. P. Lam

2018-03-01

Full Text Available Long term carriers were shown to generate robust polyfunctional T cell (PFC responses against lytic and latent antigens of Epstein-Barr virus (EBV. However, the time of emergence of PFC responses against EBV antigens, pattern of immunodominance and difference between CD4+ and CD8+ T cell responses during various stages of EBV infection are not clearly understood. A longitudinal study was performed to assess the development of antigen-specific PFC responses in children diagnosed to have primary symptomatic (infectious mononucleosis [IM] and asymptomatic (AS EBV infection. Evaluation of IFN-γ secreting CD8+ T cell responses upon stimulation by HLA class I-specific peptides of EBV lytic and latent proteins by ELISPOT assay followed by assessment of CD4+ and CD8+ PFC responses upon stimulation by a panel of overlapping EBV peptides for co-expression of IFN-γ, TNF-α, IL-2, perforin and CD107a by flow cytometry were performed. Cytotoxicity of T cells against autologous lymphoblastoid cell lines (LCLs as well as EBV loads in PBMC and plasma were also determined. Both IM and AS patients had elevated PBMC and plasma viral loads which declined steadily during a 12-month period from the time of diagnosis whilst decrease in the magnitude of CD8+ T cell responses toward EBV lytic peptides in contrast to increase toward latent peptides was shown with no significant difference between those of IM and AS patients. Both lytic and latent antigen-specific CD4+ and CD8+ T cells demonstrated polyfunctionality (defined as greater or equal to three functions concurrent with enhanced cytotoxicity against autologous LCLs and steady decrease in plasma and PBMC viral loads over time. Immunodominant peptides derived from BZLF1, BRLF1, BMLF1 and EBNA3A-C proteins induced the highest proportion of CD8+ as well as CD4+ PFC responses. Diverse functional subtypes of both CD4+ and CD8+ PFCs were shown to emerge at 6–12 months. In conclusion, EBV antigen-specific CD4+ and CD

Neighborhood Disadvantage, Residential Segregation, and Beyond-Lessons for Studying Structural Racism and Health.

Science.gov (United States)

Riley, Alicia R

2018-04-01

A recent surge of interest in identifying the health effects of structural racism has coincided with the ongoing attention to neighborhood effects in both epidemiology and sociology. Mindful of these currents in the literature, it makes sense that we are seeing an emergent tendency in health disparities research to operationalize structural racism as either neighborhood disadvantage or racial residential segregation. This review essay synthesizes findings on the relevance of neighborhood disadvantage and residential segregation to the study of structural racism and health. It then draws on recent literature to propose four lessons for moving beyond traditional neighborhood effects approaches in the study of structural racism and health. These lessons are (1) to shift the focus of research from census tracts to theoretically meaningful units of analysis, (2) to leverage historic and geographic variation in race relations, (3) to combine data from multiple sources, and (4) to challenge normative framing that aims to explain away racial health disparities without discussing racism or racial hierarchy. The author concludes that research on the health effects of structural racism should go beyond traditional neighborhood effects approaches if it is to guide intervention to reduce racial and ethnic health disparities.

Severe deterministic effects of external exposure and intake of radioactive material: basis for emergency response criteria

International Nuclear Information System (INIS)

Kutkov, V; Buglova, E; McKenna, T

2011-01-01

Lessons learned from responses to past events have shown that more guidance is needed for the response to radiation emergencies (in this context, a 'radiation emergency' means the same as a 'nuclear or radiological emergency') which could lead to severe deterministic effects. The International Atomic Energy Agency (IAEA) requirements for preparedness and response for a radiation emergency, inter alia, require that arrangements shall be made to prevent, to a practicable extent, severe deterministic effects and to provide the appropriate specialised treatment for these effects. These requirements apply to all exposure pathways, both internal and external, and all reasonable scenarios, to include those resulting from malicious acts (e.g. dirty bombs). This paper briefly describes the approach used to develop the basis for emergency response criteria for protective actions to prevent severe deterministic effects in the case of external exposure and intake of radioactive material.

Pylephlebitis: An Uncommon Complication of Intra-Abdominal Infection

Directory of Open Access Journals (Sweden)

Salim R Surani

2011-05-01

Full Text Available We herein present a case of pylephlebitis, which is an infective suppurative thrombosis of the portal vein. Pylephlebitis is an uncommon complication of intra-abdominal infections and carries with it significant morbidity and mortality. [West J Emerg Med. 2011;12(4:575–576.

Lessons from tele-emergency: improving care quality and health outcomes by expanding support for rural care systems.

Science.gov (United States)

Mueller, Keith J; Potter, Andrew J; MacKinney, A Clinton; Ward, Marcia M

2014-02-01

Tele-emergency services provide immediate and synchronous audio/video connections, most commonly between rural low-volume hospitals and an urban "hub" emergency department. We performed a systematic literature review to identify tele-emergency models and outcomes. We then studied a large tele-emergency service in the upper Midwest. We sent a user survey to all seventy-one hospitals that used the service and received 292 replies. We also conducted telephone interviews and site visits with ninety clinicians and administrators at twenty-nine of these hospitals. Participants reported that tele-emergency improves clinical quality, expands the care team, increases resources during critical events, shortens time to care, improves care coordination, promotes patient-centered care, improves the recruitment of family physicians, and stabilizes the rural hospital patient base. However, inconsistent reimbursement policy, cross-state licensing barriers, and other regulations hinder tele-emergency implementation. New value-based payment systems have the potential to reduce these barriers and accelerate tele-emergency expansion.

Emergency Wound Care After a Disaster

Centers for Disease Control (CDC) Podcasts

2006-08-10

Apply first aid to treat cuts and scrapes and prevent infection. To care for a bleeding cut, put pressure on it until the bleeding has stopped.  Created: 8/10/2006 by Emergency Communications System.   Date Released: 11/16/2007.

Knowledge and Cognitive Process Dimensions of Technology Teachers' Lesson Objectives

Science.gov (United States)

Mathumbu, David; Rauscher, Willem; Braun, Max

2014-01-01

A clearly stated lesson objective is considered an essential component of a well-planned lesson. Many teachers of Technology, a relatively new subject in South African schools, teach Technology with rather limited training both in content and methodological approaches. This study sought to investigate and classify lesson objectives framed or…

Connecting polar research to NGSS STEM classroom lessons

Science.gov (United States)

Brinker, R.; Kast, D.

2016-12-01

Next Generation Science Standards (NGSS) are designed to bring consistent, rigorous science teaching across the United States. Topics are categorized as Performance Expectations (PE), Disciplinary Core Ideas (DCI), Cross-Cutting Concepts (CCC), and Science and Engineering Practices (SEP). NGSS includes a focus on environmental science and climate change across grade levels. Earth and planetary sciences are required at the high school level. Integrating polar science lessons into NGSS classrooms brings relevant, rigorous climate change curriculum across grade levels. Polar science provides opportunities for students to use current data during lessons, conduct their own field work, and collaborate with scientists. Polar science provides a framework of learning that is novel to most students. Inquiry and engagement are high with polar science lessons. Phenomenon related to polar science provide an excellent tool for science teachers to use to engage students in a lesson, stimulate inquiry, and promote critical thinking. When taught effectively, students see the connections between their community, polar regions and climate change, regardless of where on the planet students live. This presentation describes examples of how to effectively implement NGSS lessons by incorporating polar science lessons and field research. Examples of introductory phenomenon and aligned PEs, CCCs, DCIs, and SEPs are given. Suggested student activities, assessments, examples of student work, student research, labs, and PolarTREC fieldwork, use of current science data, and connections to scientists in the field are provided. The goals of the presentation are to give teachers a blueprint to follow when implementing NGSS lessons, and give scientists an understanding of the basics of NGSS so they may be better able to relate their work to U.S. science education and be more effective communicators of their science findings.