Strategies and challenges for safe injection practice in developing countries.

Science.gov (United States)

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Predictors of safe delivery service utilization in arsi zone, South-East ethiopia.

Science.gov (United States)

Abera, Mulumebet; Gebremariam, Abebe; Belachew, Tefera

2011-08-01

Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilization in Arsi Zone, Southeast Ethiopia. A cross- sectional community based study using quantitative and qualitative methods was conducted from February 15(th) to March 15(th) 2006. A total of 1089 women who had at least one birth one year prior to the study were involved in the study from nine rural and four urban kebeles in three Woredas (Districts) selected using a systematic sampling method from all households in the study area. A pre-tested structured interviewer administered questionnaire was used to collect data. Information on the utilization of safe delivery service and socio-demographic, individual and institutional factors and past obstetric history were collected. Focus Group Discussion guide was used for qualitative data collection. The data were edited, cleaned, and entered into a computer and analyzed using SPSS for windows version 12.0. One thousand seventy four women who had at least one birth were interviewed making a response rate 98.6%. Two hundred seventy one (75.0%) of urban and 373(52.0%) rural women received antenatal care from skilled health professional at least once during their last pregnancy. Thirty-one (4.3%) of rural and 145 (40.4%) of urban women delivered in health institution. In multivariate analysis showed that residential area OR= 8.5, 95%CI; (5.1,13.9), parity OR=0.18, 95%CI; (0.08, 0.42), and ANC service use OR= 4.5, 95%CI; (2.2,8.9), and maternal education OR=4.6, 95%CI; (1.7,12.8), were most significant predictors of safe delivery service use by mothers

Socio Demographic Determinants of Delivery Practice in Rural Women of Bangladesh

Directory of Open Access Journals (Sweden)

Meherunnessa Begum

2013-07-01

Full Text Available Background: Every year, world wide, 200 million women become pregnant. The development of urban areas allowed women to receive more care and treatment. However, in rural areas such measures are not available to every woman. Data on delivery practice of rural woman may help the social and public health planners and decision makers to minimize and prevent maternal mortality and morbidity ensuring safe motherhood.Objective: The aim of the study was to observe the delivery practice of rural women of Bangladesh.Materials and method: A cross-sectional study was conducted and data were collected from Dhamrai upazila, Dhaka, Bangladesh in April 2008. Total 159 women of reproductive age group at least having one child were selected purposively to elicit information on various demographic, socioeconomic, cultural and selected programmatic variables including maternal health care and delivery practices.Results: Among the respondents about 55% were literate. Majority (80% of the respondents delivered at home and most of the them (71% felt that home delivery was comfortable where as about 29% of the respondents were compelled to deliver at home due to family decision and financial constraint. Among the deliveries about 82% occurred normally and 18.2% were by cesarean section. A considerable percentage of deliveries (49% were attended by traditional birth attendants. Blade was used for cutting umbilical cord in majority of the cases (74% who delivered at home. Most of the respondents (90% took ante natal check up and about 74% were vaccinated by tetanus toxoid.Conclusion: The results of the study suggest that a lot of work is still to do for the policy makers and health planners to target, plan, develop and deliver maternal health services to the rural women of Bangladesh.

Assessing delivery practices of mothers over time and over space in Uganda, 2003-2012.

Science.gov (United States)

Sprague, Daniel A; Jeffery, Caroline; Crossland, Nadine; House, Thomas; Roberts, Gareth O; Vargas, William; Ouma, Joseph; Lwanga, Stephen K; Valadez, Joseph J

2016-01-01

It is well known that safe delivery in a health facility reduces the risks of maternal and infant mortality resulting from perinatal complications. What is less understood are the factors associated with safe delivery practices. We investigate factors influencing health facility delivery practices while adjusting for multiple other factors simultaneously, spatial heterogeneity, and trends over time. We fitted a logistic regression model to Lot Quality Assurance Sampling (LQAS) data from Uganda in a framework that considered individual-level covariates, geographical features, and variations over five time points. We accounted for all two-covariate interactions and all three-covariate interactions for which two of the covariates already had a significant interaction, were able to quantify uncertainty in outputs using computationally intensive cluster bootstrap methods, and displayed outputs using a geographical information system. Finally, we investigated what information could be predicted about districts at future time-points, before the next LQAS survey is carried out. To do this, we applied the model to project a confidence interval for the district level coverage of health facility delivery at future time points, by using the lower and upper end values of known demographics to construct a confidence range for the prediction and define priority groups. We show that ease of access, maternal age and education are strongly associated with delivery in a health facility; after accounting for this, there remains a significant trend towards greater uptake over time. We use this model together with known demographics to formulate a nascent early warning system that identifies candidate districts expected to have low prevalence of facility-based delivery in the immediate future. Our results support the hypothesis that increased development, particularly related to education and access to health facilities, will act to increase facility-based deliveries, a factor

Safe Active Scanning for Energy Delivery Systems Final Report

Energy Technology Data Exchange (ETDEWEB)

Helms, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Salazar, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Scheibel, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Engels, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Reiger, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2017-09-30

The Department of Energy’s Cybersecurity for Energy Delivery Systems Program has funded Safe(r) Active Scanning for Energy Delivery Systems, led by Lawrence Livermore National Laboratory, to investigate and analyze the impacts of active scanning in the operational environment of energy delivery systems. In collaboration with Pacific Northwest National Laboratory and Idaho National Laboratory, active scans across three testbeds including 38 devices were performed. This report gives a summary of the initial literature survey performed on the SASEDS project as well as industry partner interview summaries and main findings from Phase 1 of the project. Additionally, the report goes into the details of scanning techniques, methodologies for testing, testbed descriptions, and scanning results, with appendices to elaborate on the specific scans that were performed. As a result of testing, a single device out of 38 exhibited problems when actively scanned, and a reboot was required to fix it. This single failure indicates that active scanning is not likely to have a detrimental effect on the safety and resilience of energy delivery systems. We provide a path forward for future research that could enable wide adoption of active scanning and lead utilities to incorporate active scanning as part of their default network security plans to discover and rectify rogue devices, adversaries, and services that may be on the network. This increased network visibility will allow operational technology cybersecurity practitioners to improve their situational awareness of networks and their vulnerabilities.

Safe meat-handling knowledge, attitudes and practices of private and government meat processing plants' workers: implications for future policy.

Science.gov (United States)

Adesokan, H K; Raji, A O Q

2014-03-01

Food-borne disease outbreaks remain a major global health challenge and cross-contamination from raw meat due to poor handling is a major cause in developing countries. Adequate knowledge of meat handlers is important in limiting these outbreaks. This study evaluated and compared the safe meat-handling knowledge, attitudes and practices (KAP) of private (PMPP) and government meat processing plants' (GMPP) workers in south-western Nigeria. This cross sectional study comprised 190 meat handlers (PMPP = 55; GMPP = 135). Data concerning their safe meat-handling knowledge, attitudes and practices as well as their socio-demographic characteristics, such as age, gender and work experience were collected. A significant association was observed between the type of meat processing plants and their knowledge (p = 0.000), attitudes (p = 0.000) and practices (p = 0.000) of safe meat-handling. Meat handlers in the GMPP were respectively, about 17 times (OR = 0.060, 95% CI: 0.018-0.203), 57 times (OR = 0.019, 95% CI: 0.007-0.054) and 111 times (OR = 0.009, 95% CI: 0.001- 0.067) less likely to obtain good knowledge, attitude and practice level of safe meat-handling than those from PMPP. Further, KAP levels were significantly associated with age group, education and work experience (p < 0.05). Study findings suggest the need for future policy in food industry in developing countries to accommodate increased involvement of private sector for improved food safety and quality delivery. Public health education on safe food handling and hygiene should be on the front burner among food handlers in general.

Safe waste management practices in beryllium facilities

International Nuclear Information System (INIS)

Bhat, P.N.; Soundararajan, S.; Sharma, D.N.

2012-01-01

Beryllium, an element with the atomic symbol Be, atomic number 4, has very high stiffness to weight ratio and low density. It has good electrical conductive properties with low coefficient of thermal expansion. These properties make the metal beryllium very useful in varied technological endeavours, However, beryllium is recognised as one of the most toxic metals. Revelation of toxic effects of beryllium resulted in institution of stringent health and safety practices in beryllium handling facilities. The waste generated in such facilities may contain traces of beryllium. Any such waste should be treated as toxic waste and suitable safe waste management practices should be adopted. By instituting appropriate waste management practice and through a meticulously incorporated safety measures and continuous surveillance exercised in such facilities, total safety can be ensured. This paper broadly discusses health hazards posed by beryllium and safe methods of management of beryllium bearing wastes. (author)

Strategies and challenges for safe injection practice in developing countries

OpenAIRE

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the earl...

The role of safe practices in hospitals’ total factor productivity

Directory of Open Access Journals (Sweden)

Timothy R Huerta

2011-01-01

Full Text Available Timothy R Huerta1, Mark A Thompson2, Eric W Ford31Center for Health Innovation, Education, and Research, 2Rawls College of Business, Texas Tech University, Lubbock, TX, USA; 3Forsyth Medical Center Distinguished Professor of Health Care, The University of North Carolina Greensboro, Greensboro, NC, USAAbstract: The dual aims of improving safety and productivity are a major part of the health care reform movement hospital leaders must manage. Studies exploring the two phenomena conjointly and over time are critical to understanding how change in one dimension influences the other over time. A Malmquist approach is used to assess hospitals’ relative productivity levels over time. Analysis of variance (ANOVA algorithms were executed to assess whether or not the Malmquist Indices (MIs correlate with the safe practices measure. The American Hospital Association’s annual survey and the Centers for Medicare and Medicaid Services’ Case Mix Index for fiscal years 2002–2006, along with Leapfrog Group’s annual survey for 2006 were used for this study. Leapfrog Group respondents have significantly higher technological change (TC and total factor productivity (TFP than nonrespondents without sacrificing technical efficiency changes. Of the three MIs, TC (P < 0.10 and TFP (P < 0.05 had significant relationships with the National Quality Forum’s Safe Practices score. The ANOVA also indicates that the mean differences of TFP measures progressed in a monotonic fashion up the Safe Practices scale. Adherence to the National Quality Forum’s Safe Practices recommendations had a major impact on hospitals’ operating processes and productivity. Specifically, there is evidence that hospitals reporting higher Safe Practices scores had above average levels of TC and TFP gains over the period assessed. Leaders should strive for increased transparency to promote both quality improvement and increased productivity.Keywords: safety, productivity, quality, safe

Iatrogenic Hepatitis C Virus Transmission and Safe Injection Practices.

Science.gov (United States)

Defendorf, Charles M; Paul, Sindy; Scott, George J

2018-05-01

Hepatitis C virus (HCV) infection poses significant adverse health effects. Improper use of vials, needles, syringes, intravenous bags, tubing, and connectors for injections and infusions is a current preventable cause of iatrogenic HCV transmission. Numerous cases have demonstrated the need for continued vigilance and the widespread nature of this iatrogenic infection risk across a variety of medical practice settings in the United States. Failure to implement the evidence-based Centers for Disease Control and Prevention (CDC) infection prevention guidelines exposes patients to preventable harm. The guidelines establish the requirement to notify patients in cases of suspected virus transmission, as well as to screen those patients who would not otherwise have been at risk for HCV seroconversion and other bloodborne pathogens. Legal and regulatory ramifications, including state, criminal, and tort laws, hold physicians and other health care professionals accountable to use safe injection practices. This article reviews the major health risks of HCV infection, significant effects of iatrogenic infection transmission, CDC guidelines for safe injection practices, and legal regulations and ramifications designed to promote safe injection practices.

Guidelines for safe practice of stereotactic body (ablative) radiation therapy

International Nuclear Information System (INIS)

Foote, Matthew; Barry, Tamara; Bailey, Michael; Smith, Leigh; Seeley, Anna; Siva, Shankar; Hegi-Johnson, Fiona; Booth, Jeremy; Ball, David; Thwaites, David

2015-01-01

The uptake of stereotactic ablative body radiation therapy (SABR) / stereotactic body radiation therapy (SBRT) worldwide has been rapid. The Australian and New Zealand Faculty of Radiation Oncology (FRO) assembled an expert panel of radiation oncologists, radiation oncology medical physicists and radiation therapists to establish guidelines for safe practice of SABR. Draft guidelines were reviewed by a number of international experts in the field and then distributed through the membership of the FRO. Members of the Australian Institute of Radiography and the Australasian College of Physical Scientists and Engineers in Medicine were also asked to comment on the draft. Evidence-based recommendations (where applicable) address aspects of departmental staffing, procedures and equipment, quality assurance measures, as well as organisational considerations for delivery of SABR treatments. Central to the guidelines is a set of key recommendations for departments undertaking SABR. These guidelines were developed collaboratively to provide an educational guide and reference for radiation therapy service providers to ensure appropriate care of patients receiving SABR.

Practical guide to content delivery networks

CERN Document Server

Held, Gilbert

2005-01-01

With a practical and organized approach to learning and implementation, A Practical Guide to Content Delivery Networks presents a step-by-step process for building a highly available and highly scalable content delivery network (CDN). CDN refers to the infrastructure behind any service that provides utility or access to data to an end user. This book offers terminology, tactics, potential problems to avoid, and individual layers of design, providing clear understanding of the framework for CDNs using a structural and visual approach. The text emphasizes a best-of-breed strategy, allowing a tec

Do Leadership Style, Unit Climate, and Safety Climate Contribute to Safe Medication Practices?

Science.gov (United States)

Farag, Amany; Tullai-McGuinness, Susan; Anthony, Mary K; Burant, Christopher

2017-01-01

This study aims at: examining if leadership style and unit climate predict safety climate; and testing the direct, indirect, and total effect of leadership style, unit climate, and safety climate on nurses' safe medication practices. The Institute of Medicine and nursing scholars propose that safety climate is a prerequisite to safety practices. However, there is limited empirical evidence about factors contributing to the development of safety climate and about the association with nurses' safe medication practices. This cross-sectional study used survey data from 246 RNs working in a Magnet® hospital. Leadership style and unit climate predicted 20% to 50% of variance on all safety climate dimensions. Model testing revealed the indirect impact of leadership style and unit climate on nurses' safe medication practices. Our hypothesized model explained small amount of the variance on nurses' safe medication practices. This finding suggests that nurses' safe medication practices are influenced by multiple contextual and personal factors that should be further examined.

How safe is GP obstetrics? An assessment of antenatal risk factors and perinatal outcomes in one rural practice.

Science.gov (United States)

Kirke, Andrew B

2010-01-01

Approximately one-fifth of Western Australian women deliver their babies in rural and remote regions of the state. The medical workforce caring for these women is predominantly non-specialist GP obstetricians. This article explores how safe is rural GP obstetrics. It reviews one rural obstetric practice in detail. In particular it asks these questions: What are the antenatal risk factors? What are the obstetric outcomes for the mother? What are the obstetric outcomes for the baby? This study is an audit of the author's obstetric practice over a two-year period from July 2007 to June 2009. The audit criteria included all obstetric patients managed by the author through to delivery and immediate post-partum care. Hospital and practice notes for 195 singleton pregnancies were reviewed. Antenatal risk factors, intrapartum events and immediate post-partum events for all patients cared for by the author through to delivery were recorded and compared with averages for Western Australia from published 2007 figures. The maternal population had mean age of 28.5 years, 2.1% were Aboriginal. Body mass index (BMI) at booking was a mean of 27.1 (range 18-40). Those with a BMI > 40 were referred elsewhere. Significant antenatal risks included smoking (14.9%), previous caesarean section (14.4%), hypertension (13.3%), pre-eclampsia (5.1%) and gestational diabetes (8.2%). Intrapartum there were high rates of induction (33.5%), epidural/spinal (34.7%) and shoulder dystocia (3.6%). Type of delivery was predominantly spontaneous vaginal (65.6%), vacuum (14.9%), forceps (2.6%), elective caesarean (9.7%) and non-elective caesarean (8.7%). Post-partum events included post-partum haemorrhage (10.3%), transfusion (1.5%), retained placenta (2.1%), neonatal jaundice (21.1%), neonatal seizures (1.5%) neonatal sepsis (1.5%) and neonatal special care or intensive care (SCU/NICU) admission (9.8%). The audit population was a group of relatively low risk pregnant women. Despite referral of more

Assessing delivery practices of mothers over time and over space in Uganda, 2003–2012

Directory of Open Access Journals (Sweden)

Daniel A. Sprague

2016-06-01

Full Text Available Abstract Background It is well known that safe delivery in a health facility reduces the risks of maternal and infant mortality resulting from perinatal complications. What is less understood are the factors associated with safe delivery practices. We investigate factors influencing health facility delivery practices while adjusting for multiple other factors simultaneously, spatial heterogeneity, and trends over time. Methods We fitted a logistic regression model to Lot Quality Assurance Sampling (LQAS data from Uganda in a framework that considered individual-level covariates, geographical features, and variations over five time points. We accounted for all two-covariate interactions and all three-covariate interactions for which two of the covariates already had a significant interaction, were able to quantify uncertainty in outputs using computationally intensive cluster bootstrap methods, and displayed outputs using a geographical information system. Finally, we investigated what information could be predicted about districts at future time-points, before the next LQAS survey is carried out. To do this, we applied the model to project a confidence interval for the district level coverage of health facility delivery at future time points, by using the lower and upper end values of known demographics to construct a confidence range for the prediction and define priority groups. Results We show that ease of access, maternal age and education are strongly associated with delivery in a health facility; after accounting for this, there remains a significant trend towards greater uptake over time. We use this model together with known demographics to formulate a nascent early warning system that identifies candidate districts expected to have low prevalence of facility-based delivery in the immediate future. Conclusions Our results support the hypothesis that increased development, particularly related to education and access to health facilities

International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-07-01

Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices.

International conference on safe decommissioning for nuclear activities: Assuring the safe termination of practices involving radioactive materials. Contributed papers

International Nuclear Information System (INIS)

2002-01-01

Thousands of operations involving the use of radioactive substances will end during the current century. While there is considerable regulatory experience in the 'front end' of the regulatory system for practices, the experience at the back end is more limited as fewer practices have actually been terminated. When a practice is terminated because the facility has reached the end of its useful life, action has to betaken to ensure the safe shutdown of the facility and allow the removal of regulatory controls. There are many issues involved in the safe termination of practices. These include setting criteria for the release of material and sites from regulatory control; determining the suitability of the various options for decommissioning nuclear facilities, managing the waste and material released from control (recycling, reuse or disposal), and the eventual remediation of the site. Some countries have put in place regulatory infrastructures and have developed programmes to manage the associated decommissioning and remediation activities. Other countries are at the stage of assessing what is involved in terminating such practices. The purpose of this Conference is to foster an information exchange on the safe an orderly termination of practices that involve the use of radioactive substances, including both decommissioning and environmental remediation, and to promote improved coherence internationally on strategies and criteria for the safe termination of practices

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Nermine Mohamed Tawfik Foda

2017-01-10

Jan 10, 2017 ... Background: Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms.

Harnessing hospital purchase power to design safe care delivery.

Science.gov (United States)

Ebben, Steven F; Gieras, Izabella A; Gosbee, Laura Lin

2008-01-01

Since the Institute of Medicine's well-publicized 1999 report To Err is Human, the healthcare patient safety movement has grown at an exponential pace. However, much more can be done to advance patient safety from a care process design vantage point-improving safety through effective care processes and technology integration. While progress is being made, the chasm between technology developers and caregivers remains a profound void. Why hasn't more been done to expand our view of patient safety to include technology design? Healthcare organizations have not consolidated their purchasing power to expect improved designs. This article will (1) provide an assessment of the present state of healthcare technology management and (2) provide recommendations for collaborative design of safe healthcare delivery systems.

Using mobile technology to promote safe sex and sexual health in adolescents: current practices and future recommendations

Directory of Open Access Journals (Sweden)

Cornelius JB

2016-04-01

Full Text Available Judith B Cornelius,1 Josephine A Appiah2 1School of Nursing, 2Health Services Research Doctoral Program, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA Abstract: Youth and young adults (19–24 years of age shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans. Keywords: mobile, safe sex, sexual health, practices, recommendations

Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

Directory of Open Access Journals (Sweden)

Wanjira Carol

2011-05-01

Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

A Safe Bacterial Microsyringe for In Vivo Antigen Delivery and Immunotherapy

Science.gov (United States)

Le Gouëllec, Audrey; Chauchet, Xavier; Laurin, David; Aspord, Caroline; Verove, Julien; Wang, Yan; Genestet, Charlotte; Trocme, Candice; Ahmadi, Mitra; Martin, Sandrine; Broisat, Alexis; Cretin, François; Ghezzi, Catherine; Polack, Benoit; Plumas, Joël; Toussaint, Bertrand

2013-01-01

The industrial development of active immunotherapy based on live-attenuated bacterial vectors has matured. We developed a microsyringe for antigen delivery based on the type III secretion system (T3SS) of P. aeruginosa. We applied the “killed but metabolically active” (KBMA) attenuation strategy to make this bacterial vector suitable for human use. We demonstrate that attenuated P. aeruginosa has the potential to deliver antigens to human antigen-presenting cells in vitro via T3SS with considerable attenuated cytotoxicity as compared with the wild-type vector. In a mouse model of cancer, we demonstrate that this KBMA strain, which cannot replicate in its host, efficiently disseminates into lymphoid organs and delivers its heterologous antigen. The attenuated strain effectively induces a cellular immune response to the cancerous cells while lowering the systemic inflammatory response. Hence, a KBMA P. aeruginosa microsyringe is an efficient and safe tool for in vivo antigen delivery. PMID:23531551

Safe Re-use Practices in Wastewater-Irrigated Urban Vegetable Farming in Ghana

DEFF Research Database (Denmark)

Keraita, Bernard; Abaidoo, R.C; Beernaerts, I.

2012-01-01

of stakeholders at different levels along the food chain. This paper presents an overview of safe re-use practices including farm-based water treatment methods, water application techniques, post-harvest handling practices, and washing methods. The overview is based on a comprehensive analysis of the literature......Irrigation using untreated wastewater poses health risks to farmers and consumers of crop products, especially vegetables. With hardly any wastewater treatment in Ghana, a multiple-barrier approach was adopted and safe re-use practices were developed through action research involving a number...... and our own specific studies, which used data from a broad range of research methods and approaches. Identifying, testing, and assessment of safe practices were done with the active participation of key actors using observations, extensive microbiological laboratory assessments, and field...

Assessment of the Electrical Power Requirements for Continued Safe Storage and Waste Feed Delivery Phase One

International Nuclear Information System (INIS)

MAY, T.H.

2000-01-01

This study evaluated the ability of the electrical distribution system to support safe storage as well as the first phase of the Waste Feed Delivery. Several recommendations are made to improve the electrical system. The ability to assure adequate Waste Feed Delivery (WFD) to the Privatization Contractor's vitrification facility is a key element in the overall Hanford cleanup schedule. An important aspect of this WFD is the availability of sufficient and appropriate electrical power in the single- and double-shell tank farms. The methodology for performing this review and the results are described

Sun safety knowledge and practice in UK postal delivery workers

OpenAIRE

Houdmont, J.; Davis, S.; Griffiths, A.

2015-01-01

Background: Postal delivery workers spend a large proportion of their work time outdoors, placing them at increased risk for skin cancer. To date, no studies have examined occupational sun safety knowledge and practice within this group in the UK.\\ud Aims: To describe the occupational sun safety knowledge and practice of UK postal delivery workers and to investigate the association of demographic, personal and occupational factors with knowledge and practice in order to identify potential str...

Association between clean delivery kit use, clean delivery practices, and neonatal survival: pooled analysis of data from three sites in South Asia.

Directory of Open Access Journals (Sweden)

Nadine Seward

2012-02-01

Full Text Available Sepsis accounts for up to 15% of an estimated 3.3 million annual neonatal deaths globally. We used data collected from the control arms of three previously conducted cluster-randomised controlled trials in rural Bangladesh, India, and Nepal to examine the association between clean delivery kit use or clean delivery practices and neonatal mortality among home births.Hierarchical, logistic regression models were used to explore the association between neonatal mortality and clean delivery kit use or clean delivery practices in 19,754 home births, controlling for confounders common to all study sites. We tested the association between kit use and neonatal mortality using a pooled dataset from all three sites and separately for each site. We then examined the association between individual clean delivery practices addressed in the contents of the kit (boiled blade and thread, plastic sheet, gloves, hand washing, and appropriate cord care and neonatal mortality. Finally, we examined the combined association between mortality and four specific clean delivery practices (boiled blade and thread, hand washing, and plastic sheet. Using the pooled dataset, we found that kit use was associated with a relative reduction in neonatal mortality (adjusted odds ratio 0.52, 95% CI 0.39-0.68. While use of a clean delivery kit was not always accompanied by clean delivery practices, using a plastic sheet during delivery, a boiled blade to cut the cord, a boiled thread to tie the cord, and antiseptic to clean the umbilicus were each significantly associated with relative reductions in mortality, independently of kit use. Each additional clean delivery practice used was associated with a 16% relative reduction in neonatal mortality (odds ratio 0.84, 95% CI 0.77-0.92.The appropriate use of a clean delivery kit or clean delivery practices is associated with relative reductions in neonatal mortality among home births in underserved, rural populations.

Safe practices and financial considerations in using oral chemotherapeutic agents.

Science.gov (United States)

Bartel, Sylvia B

2007-05-01

Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed. Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy. Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.

Interactive eLearning - a safe place to practice.

Science.gov (United States)

Einarson, Elisabeth; Moen, Anne; Kolberg, Ragnhild; Flingtorp, Gry; Linnerud, Eva

2009-01-01

Interactive web-based learning environment offers refreshing opportunities to create innovative solutions to explore and exploit informatics support on-the-job training. We report from a study where a hospital is created a interactive eLearning resource. The modules are creating a safe place to practice - to be used for introduction to the work and preparation for certification or re-certification of competencies.

Safe injection practice among health-care workers in Gharbiya Governorate, Egypt.

Science.gov (United States)

Ismail, N A; Aboul Ftouh, A M; El-Shoubary, W H; Mahaba, H

2007-01-01

We assessed safe injection practices among 1100 health-care workers in 25 health-care facilities in Gharbiya Governorate. Questionnaires were used to collect information and 278 injections were observed using a standardized checklist. There was a lack of infection control policies in all the facilities and a lack of many supplies needed for safe injection. Proper needle manipulation before disposal was observed in only 41% of injections, safe needle disposal in 47.5% and safe syringe disposal in 0%. Reuse of used syringes and needles was reported by 13.2% of the health-care workers and 66.2% had experienced a needle-stick injury. Only 11.3% had received a full course of hepatitis B vaccination.

Adoption of sun safe workplace practices by local governments.

Science.gov (United States)

Wallis, Allan; Andersen, Peter A; Buller, David B; Walkosz, Barbara; Lui, Lucia; Buller, Mary; Scott, Michael D; Jenkins, Rob

2014-01-01

Outdoor workers are especially susceptible to skin cancer--the most common, but also one of the most preventable, forms of cancer. Colorado, the location of the study, has the second highest rate of skin cancer deaths in the nation. Local government managers in Colorado-in municipalities, counties, and special districts-were surveyed to ascertain the extent to which they engage in formal (written) and informal practices to protect their outdoor workers against excessive exposure to sun. The survey consisted of 51 questions assessing awareness of formal or informal practices for sun protection of outdoor workers. An index of practices--the study's dependent variable--was created that was composed or practices such as providing employees free or reduced-cost sunscreen, wide-brimmed hats, sunglasses, long-sleeved work shirts, long work pants, and temporary or permanent outdoor shade shelters. Proscriptive policies, such as restricting the use of broad brimmed hats, were subtracted from the index. Surveys were completed by 825 administrators representing 98 jurisdictions. Responses from administrators in the same jurisdiction were averaged. More than 40% of responding jurisdictions indicated that they engaged in informal sun safety practices. Tests conducted to determine what variables might account for the adoption of these sun protection practices found that the degree to which a community could be regarded as cosmopolite and as having an individualistic political culture were significant predictors. Type of government was also significant. Although, higher community income was a significant predictor, neither local government budget nor size was significant. The adoption of sun safe practices bears low costs with potentially high returns. Findings from this study suggest that awareness campaigns might most effectively target cosmopolite communities, but that the greatest impact might be achieved by targeting localite communities. Government size and budget do not

Guidelines for Psychological Practice in Health Care Delivery Systems

Science.gov (United States)

American Psychologist, 2013

2013-01-01

Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

Sun safety knowledge and practice in UK postal delivery workers.

Science.gov (United States)

Houdmont, J; Davis, S; Griffiths, A

2016-06-01

Postal delivery workers spend a large proportion of their work time outdoors, placing them at increased risk of skin cancer. To date, no studies have examined occupational sun safety knowledge and practice within this group in the UK. To describe the occupational sun safety knowledge and practice of UK postal delivery workers and to investigate the association of demographic, personal and occupational factors with knowledge and practice in order to identify potential strategies for improving sun safety in this occupational group. Postal delivery workers completed a questionnaire that collected data on occupational sun safety knowledge and practice in addition to demographic, personal and workplace characteristics. One-way analysis of variances were applied to assess differences in knowledge and practice by these characteristics. A total of 1153 postal delivery workers completed the questionnaire, a 60% response rate. Thirty-three per cent reported receiving sun safety training within the previous 12 months. The majority of respondents reported correct knowledge on three of the six domains and good practice on four of the six behavioural domains. However, only one-fifth of respondents reported wearing sunglasses and ensuring a plentiful intake of water. Knowledge and practice differed significantly according to demographic, personal and workplace characteristics. There is a need to raise the profile of occupational skin cancer in this occupational group and to increase the priority given to occupational sun safety policies alongside targeted and tailored interventions, the effect of which can be evaluated. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

How to use current practice, risk analysis and standards to define hospital-wide policies on the safe use of infusion technology.

Science.gov (United States)

Timmerman, Annemoon M; Oliveira-Martens, Suzanne M; Snijder, Roland A; Nieman, Anders K; Egberts, Toine C

2015-08-01

Infusion therapy is widely used in hospitals. It is well known that medication errors constitute one of the highest risks to patient safety, leading to numerous adverse events concerning incorrect application of infusion technology. Both clinical practice and in vitro studies show that infusion of multiple medications via one access point induces unwanted phenomena such as backflow and an incorrect system response to interventions. Within the Metrology for Drug Delivery project, we addressed the role of infusion devices in drug delivery. We surveyed current practices for application in hospitals to provide input to standards and quality norms for the materials used in infusion technology. Furthermore, we organized meetings with clinicians and other relevant stakeholders to set up a risk analysis-based infusion policy, accompanied by easy to access operating procedures on infusion technology. It was found difficult to establish clear-cut infusion safety guidelines based on quantitative data because of the many different application areas and stakeholders. However, both the expert team and the survey indicated the value of multidisciplinary qualitative discussion for defining best practices. We advise to incorporate specific requirements on infusion devices in protocols and standards, adjusted to specific applications, to ensure safe use of infusion technology.

Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

Science.gov (United States)

Rohde, Emily; Domm, Elizabeth

2018-02-01

To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

Benchmarking Sustainability Practices Use throughout Industrial Construction Project Delivery

Directory of Open Access Journals (Sweden)

Sungmin Yun

2017-06-01

Full Text Available Despite the efforts for sustainability studies in building and infrastructure construction, the sustainability issues in industrial construction remain understudied. Further, few studies evaluate sustainability and benchmark sustainability issues in industrial construction from a management perspective. This study presents a phase-based benchmarking framework for evaluating sustainability practices use focusing on industrial facilities project. Based on the framework, this study quantifies and assesses sustainability practices use, and further sorts the results by project phase and major project characteristics, including project type, project nature, and project delivery method. The results show that sustainability practices were implemented higher in the construction and startup phases relative to other phases, with a very broad range. An assessment by project type and project nature showed significant differences in sustainability practices use, but no significant difference in practices use by project delivery method. This study contributes to providing a benchmarking method for sustainability practices in industrial facilities projects at the project phase level. This study also discusses and provides an application of phase-based benchmarking for sustainability in industrial construction.

Safe sleep practices and sudden infant death syndrome risk reduction: NICU and well-baby nursery graduates.

Science.gov (United States)

Fowler, Aja J; Evans, Patricia W; Etchegaray, Jason M; Ottenbacher, Allison; Arnold, Cody

2013-11-01

Our primary objective was to compare parents of infants cared for in newborn intensive care units (NICUs) and infants cared for in well-baby ("general") nurseries with regard to knowledge and practice of safe sleep practices/sudden infant death syndrome risk reduction measures and guidelines. Our secondary objective was to obtain qualitative data regarding reasons for noncompliance in both populations. Sixty participants (30 from each population) completed our survey measuring safe sleep knowledge and practice. Parents of NICU infants reported using 2 safe sleep practices-(a) always placing baby in crib to sleep and (b) always placing baby on back to sleep-significantly more frequently than parents of well infants. Additional findings and implications for future studies are discussed.

Practices in delivery and birth care from mothers’ perspective

Directory of Open Access Journals (Sweden)

Débora Apolinário

2016-01-01

Full Text Available Objective: to highlight the practices of delivery and birth care in a maternity ward from mothers’ perspective. Methods: descriptive cross-sectional study with a quantitative approach carried out in a maternity hospital of usual risk, with 100 regular postpartum mothers. It was used a semi-structured questionnaire as recommended by the World Health Organization. Results: among the practices that should be encouraged from birth care, stands out: women’s privacy; participation of the companion of their choice; the use of non-pharmacological methods for pain relief. Among the practices that should be eliminated: the transfer to the delivery room at the second stage and the lithotomy position. Conclusion: women are still passive in the birth process despite attempts to change the model of care during labor and birth.

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

Science.gov (United States)

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Beliefs And Practice Concerning Pregnancy Delivery And ...

African Journals Online (AJOL)

... taboos specific to pregnancy, but food restrictions were described. Antenatal and intrapartum care by spiritual and traditional midwives was considered superior to orthodox care. Practices by the midwives include turning a baby in an abnormal lie, massaging the vagina with oil in labour; conducting delivery without gloves ...

A Standardized Shift Handover Protocol: Improving Nurses’ Safe Practice in Intensive Care Units

Directory of Open Access Journals (Sweden)

Javad Malekzadeh

2013-08-01

Full Text Available Introduction: For maintaining the continuity of care and improving the quality of care, effective inter-shift information communication is necessary. Any handover error can endanger patient safety. Despite the importance of shift handover, there is no standard handover protocol in our healthcare settings. Methods In this one-group pretest-posttest quasi-experimental study conducted in spring and summer of 2011, we recruited a convenience sample of 56 ICU nurses. The Nurses’ Safe Practice Evaluation Checklist was used for data collection. The Content Validity Index and the inter-rater correlation coefficient of the checklist was 0.92 and 89, respectively. We employed the SPSS 11.5 software and the Mc Nemar and paired-samples t test for data analysis. Results: Study findings revealed that nurses’ mean score on the Safe Practice Evaluation Checklist increased significantly from 11.6 (2.7 to 17.0 (1.8 (P < 0.001. Conclusion: using a standard handover protocol for communicating patient’s needs and information improves nurses’ safe practice in the area of basic nursing care.

Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study.

Science.gov (United States)

Chen, Cheng; Yan, Yan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zeng, Guangyu; Liu, Shiping; Sha, Tingting; Li, Ling

2018-01-01

Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

Bioreducible Fluorinated Peptide Dendrimers Capable of Circumventing Various Physiological Barriers for Highly Efficient and Safe Gene Delivery.

Science.gov (United States)

Cai, Xiaojun; Jin, Rongrong; Wang, Jiali; Yue, Dong; Jiang, Qian; Wu, Yao; Gu, Zhongwei

2016-03-09

Polymeric vectors have shown great promise in the development of safe and efficient gene delivery systems; however, only a few have been developed in clinical settings due to poor transport across multiple physiological barriers. To address this issue and promote clinical translocation of polymeric vectors, a new type of polymeric vector, bioreducible fluorinated peptide dendrimers (BFPDs), was designed and synthesized by reversible cross-linking of fluorinated low generation peptide dendrimers. Through masterly integration all of the features of reversible cross-linking, fluorination, and polyhedral oligomeric silsesquioxane (POSS) core-based peptide dendrimers, this novel vector exhibited lots of unique features, including (i) inactive surface to resist protein interactions; (ii) virus-mimicking surface topography to augment cellular uptake; (iii) fluorination-mediated efficient cellular uptake, endosome escape, cytoplasm trafficking, and nuclear entry, and (iv) disulfide-cleavage-mediated polyplex disassembly and DNA release that allows efficient DNA transcription. Noteworthy, all of these features are functionally important and can synergistically facilitate DNA transport from solution to the nucleus. As a consequences, BFPDs showed excellent gene transfection efficiency in several cell lines (∼95% in HEK293 cells) and superior biocompatibility compared with polyethylenimine (PEI). Meanwhile BFPDs provided excellent serum resistance in gene delivery. More importantly, BFPDs offer considerable in vivo gene transfection efficiency (in muscular tissues and in HepG2 tumor xenografts), which was approximately 77-fold higher than that of PEI in luciferase activity. These results suggest bioreducible fluorinated peptide dendrimers are a new class of highly efficient and safe gene delivery vectors and should be used in clinical settings.

Continuous Delivery Practices in a Large Financial Organization

NARCIS (Netherlands)

Vassalo, Carmine; Zampetti, Fiorelli; Romano, D.; Beller, M.M.; Panichella, A.; Di Penta, M; Zaidman, A.E.

2016-01-01

Continuous Delivery is an agile software develop- ment practice in which developers frequently integrate changes into the main development line and produce releases of their software. An automated Continuous Integration infrastructure builds and tests these changes. Claimed advantages of CD include

Code of practice for the safe use of industrial radiography equipment (1989)

International Nuclear Information System (INIS)

1989-12-01

This code supersedes the Code of practice for the control and safe handling of sealed radioactive sources used in industrial radiography, published by the National Health and Medical Research Council (NHMRC) in 1968. It differs significantly from the former code because radiation protection practice and recommended standards have changed. The code covers the design, construction and requirements for the safe use of X-radiography equipment and gamma-radiography equipment. It provides illustrative working rules, detailed emergency procedures and comprehensive responsibilities and duties for all personnel involved in supplying and using industrial radiography equipment. The code details those equipment requirements, personnel requirements and work practices that the NHMRC considers necessary to keep exposures to ionizing radiation as low as reasonably achievable. Some equipment and facilities currently in use may not meet all of the mandatory requirements of this code. These requirements have been included in the code to encourage progress towards future compliance in the expectation that, in the interim, statutory authorities will apply them with discretion

Adoption of Sun Safe Work Place Practices by Local Governments

Science.gov (United States)

Wallis, Allan; Andersen, Peter A.; Buller, David B.; Walkosz, Barbara; Lui, Lucia; Buller, Mary; Scott, Michael D.; Jenkins, Rob

2014-01-01

Context Outdoor workers are especially susceptible to skin cancer, the most common, but also one of the most preventable, forms of cancer. Colorado, the location of the study, has the second highest rate of skin cancer deaths in the nation. Objective Local government managers in Colorado—in municipalities, counties and special districts—were surveyed in order to ascertain the extent to which they engage in formal (written) and informal practices to protect their outdoor workers against excessive exposure to sun. Design The survey consisted of 51 question assessing awareness of formal or informal practices for sun protection of outdoor workers. An index of practices--the study's dependent variable--was created that was comprised or practices such as providing employees free or reduced-cost sunscreen, wide-brimmed hats, sunglasses, long-sleeved work shirts, long work pants, and temporary or permanent outdoor shade shelters. Proscriptive policies, such as restricting the use of broad brimmed hats, were subtracted from the index. Surveys were completed by 825 administrators representing 98 jurisdictions. Responses from administrators in the same jurisdiction were averaged. Results Over 40 percent of responding jurisdictions indicated that they engaged in informal sun safety practices. Tests conducted to determine what variables might account for the adoption of these sun protection practices found that the degree to which a community could be regarded as cosmopolite and as having an individualistic political culture were significant predictors. Type of government was also significant. Although, higher community income was a significant predictor, neither local government budget nor size was significant. Conclusions The adoption of sun safe practices bears low costs with potentially high returns. Findings from this study suggest that awareness campaigns might most effectively target cosmopolite communities, but that the greatest impact might be achieved by targeting

Efficient and safe gene delivery to human corneal endothelium using magnetic nanoparticles.

Science.gov (United States)

Czugala, Marta; Mykhaylyk, Olga; Böhler, Philip; Onderka, Jasmine; Stork, Björn; Wesselborg, Sebastian; Kruse, Friedrich E; Plank, Christian; Singer, Bernhard B; Fuchsluger, Thomas A

2016-07-01

To develop a safe and efficient method for targeted, anti-apoptotic gene therapy of corneal endothelial cells (CECs). Magnetofection (MF), a combination of lipofection with magnetic nanoparticles (MNPs; PEI-Mag2, SO-Mag5, PalD1-Mag1), was tested in human CECs and in explanted human corneas. Effects on cell viability and function were investigated. Immunocompatibility was assessed in human peripheral blood mononuclear cells. Silica iron-oxide MNPs (SO-Mag5) combined with X-tremeGENE-HP achieved high transfection efficiency in human CECs and explanted human corneas, without altering cell viability or function. Magnetofection caused no immunomodulatory effects in human peripheral blood mononuclear cells. Magnetofection with anti-apoptotic P35 gene effectively blocked apoptosis in CECs. Magnetofection is a promising tool for gene therapy of corneal endothelial cells with potential for targeted on-site delivery.

Safe Operation of Nuclear Power Plants. Code of Practice and Technical Appendices

International Nuclear Information System (INIS)

1969-01-01

This book is in two parts. The first is a Code of Practice for the Safe Operation of Nuclear Power Plants and the second part is a compilation of technical appendices. Its object is to give information and illustrative examples that would be helpful in implementing the Code of Practice. This second part, although published under the same cover, is not part of the Code. Safe operation of a nuclear power plant postulates suitable siting and proper design, construction and management of the plant. Under the present Code of Practice for the Safe Operation of Nuclear Power Plants, those intending to operate the plant are recommended to prepare documentation which would deal with its operation and include safety analyses. The documentation in question would be reviewed by a regulatory body independent of the operating organization; operation would be authorized on the understanding that it would comply with limits and conditions designed to ensure safety. The Code may be subject to revision in the light of experience. The Appendices provide additional information together with some examples relating to certain topics dealt with in the Code; it must be emphasized that they are included as examples for information only and are not part of any recommendation. Purpose and scope: The recommendations in the Code are designed to protect the general public and the operating personnel from radiation hazards, and the Code forms part of the Agency's Safety Standards. The Code, which should be used in conjunction with the Agency's other Safety Standards, provides guidance and information to persons and authorities responsible for the operation of stationary nuclear power plants whose main function is the generation of thermal, mechanical or electrical power; it is not intended to apply to reactors used solely for experimental or research purposes. It sets forth minimum requirements which, it is believed, in the light of experience, must be met in order to achieve safe operation of a

Practical examples and discussion in junior high school biological delivery classes

OpenAIRE

石井, 照久; ISHII, Teruhisa

2013-01-01

Practical examples of the delivery class in junior high school biological education were reported. In 2006-2012, author did 13 times of delivery class in 5 junior high schools in Akita Prefecture. The contents of the delivery classes were‘‘Observation of animals in river’’, ‘‘Marine ecology’’, ‘‘Ecological problems’’ and ‘‘cells and DNA’’. In this report, these contents were discussed in regard to new course of education in Japan. Also, better delivery class in junior high school biological e...

Safe clinical practice for patients hospitalised in a suicidal crisis: a study protocol for a qualitative case study.

Science.gov (United States)

Berg, Siv Hilde; Rørtveit, Kristine; Walby, Fredrik A; Aase, Karina

2017-01-27

Suicide prevention in psychiatric care is arguably complex and incompletely understood as a patient safety issue. A resilient healthcare approach provides perspectives through which to understand this complexity by understanding everyday clinical practice. By including suicidal patients and healthcare professionals as sources of knowledge, a deeper understanding of what constitutes safe clinical practice can be achieved. This planned study aims to adopt the perspective of resilient healthcare to provide a deeper understanding of safe clinical practice for suicidal patients in psychiatric inpatient care. It will describe the experienced components and conditions of safe clinical practice and the experienced practice of patient safety. The study will apply a descriptive case study approach consisting of qualitative semistructured interviews and focus groups. The data sources are hospitalised patients in a suicidal crisis and healthcare professionals in clinical practice. This study was approved by the Regional Ethics Committee (2016/34). The results will be disseminated through scientific articles, a PhD dissertation, and national and international conferences. These findings can generate knowledge to be integrated into the practice of safety for suicidal inpatients in Norway and to improve the feasibility of patient safety measures. Theoretical generalisations can be drawn regarding safe clinical practice by taking into account the experiences of patients and healthcare professionals. Thus, this study can inform the conceptual development of safe clinical practice for suicidal patients. 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/.

Clinical Practice Guideline: Safe Medication Use in the ICU.

Science.gov (United States)

Kane-Gill, Sandra L; Dasta, Joseph F; Buckley, Mitchell S; Devabhakthuni, Sandeep; Liu, Michael; Cohen, Henry; George, Elisabeth L; Pohlman, Anne S; Agarwal, Swati; Henneman, Elizabeth A; Bejian, Sharon M; Berenholtz, Sean M; Pepin, Jodie L; Scanlon, Mathew C; Smith, Brian S

2017-09-01

To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed. Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation. The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed

Code of practice for the safe use of industrial radiography equipment (1989)

International Nuclear Information System (INIS)

1989-12-01

This code supersedes the Code of Practice for the control and safe handling of sealed radioactive sources use din industrial radiography, published by the National Health and Medical Research Council (NHMRC) in 1968. It differs significantly from the former code because radiation protection practice and recommended standards have changed. The code covers the design, construction and requirements for the safe use of X-radiography equipment and gamma-radiography equipment. It provides illustrative working rules, detailed emergency procedures and comprehensive responsibilities and duties for all personnel involved in supplying and using industrial radiography equipment. The code details those equipment requirements, personnel requirements and work practices that the NHMRC considers necessary to keep exposures to ionizing radiation as low as reasonably achievable. Some equipment and facilities currently in use may not meet all of the mandatory requirements of this code. These requirements have been included in the code to encourage progress towards future compliance in the expectation that, in the interim, statutory authorities will apply them with discretion. 9 refs., tabs., ills

Current Practices in the Delivery of Undergraduate Exercise Physiology Content

Science.gov (United States)

Fisher, Michele M.

2013-01-01

The purpose of this study was to identify current practices for the delivery of exercise physiology content at the undergraduate level. An anonymous 22-item survey was sent to instructors of exercise physiology to collect information concerning the structure of course offerings and instructional practices. One hundred ten instructors responded to…

Setting priorities for safe motherhood interventions in resource-scarce settings.

Science.gov (United States)

Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

2010-01-01

Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

Astute and safe use of topical ocular corticosteroids in general practice

African Journals Online (AJOL)

Astute and safe use of topical ocular corticosteroids in general practice: ... is often contact-lens associated) and fungal keratitis. ... for 1 week in acute follicular conjunctivitis presumed to be ... Steroidal anti-inflammatory drugs. In: Rhee DJ. Ophthalmic Drug Guide. London: ... Cataract – by performing a red reflex test. • Herpes ...

Gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of malaysia.

Science.gov (United States)

Bin Nordin, R; Araki, S; Sato, H; Yokoyama, K; Bin Wan Muda, W A; Win Kyi, D

2001-01-01

To identify gender difference in safe and unsafe practice of pesticide handling in tobacco farmers of Malaysia, we conducted a 20-item questionnaire interview on storage of pesticide (4 questions), mixing of pesticide (3 questions), use of personal protective equipment and clothing while spraying pesticide (7 questions), activities during and after spraying of pesticide (5 questions), and maintenance of pesticide sprayer (1 question) in 496 tobacco farmers (395 males and 101 females) in Bachok District, Kelantan, Malaysia. Duration of employment was significantly longer in females than those in males (pwork habit, (3) reading and following instructions on pesticide label, (4) security, storage and disposal of pesticide container, (5) safe work habit, (6) proper handling of pesticide and maintenance of pesticide sprayer, (7) use of personal protective clothing, and (8) safe handling of pesticide. Results of analysis of covariance for the eight factor scores of all male and female farmers, controlling for educational level and duration of employment, showed that: (1) factor scores for use of personal protective equipment (pwork habit (p0.05). We therefore conclude that: (1) for female tobacco farmers, choice of personal attire tend to result in lower scores on use of personal protective equipment and personal protective clothing while personal hygiene practices result in lower score on safe work habit; and, (2) for male tobacco farmers, the lower scores on reading and following instruction on pesticide label and mixing pesticide and maintenance of pesticide sprayer in good condition suggests that they were not primarily involved in these activities. It is postulated that these differences in safe and unsafe practices of pesticide handling across gender is related to the choice of personal attire, personal hygiene practices and division of labour within farming households which in turn is influenced by prevailing sociocultural norms in the community.

Interaction between HIV awareness, knowledge, safe sex practice and HIV prevalence: evidence from Botswana.

Science.gov (United States)

Ray, Ranjan; Sinha, Kompal

2012-05-01

This paper makes methodological and empirical contributions to the study of HIV in the context of Botswana, a country with high HIV prevalence. Comparable evidence is presented from India to put the Botswana results in perspective. The results point to the strong role played by affluence and education in increasing HIV knowledge, promoting safe sex and reducing HIV prevalence. The study presents African evidence on the role played by the empowerment of women in promoting safe sex practices such as condom use. The lack of significant association between HIV prevalence and safe sex practice points to the danger of HIV-infected individuals spreading the disease through multiple sex partners and unprotected sex. This danger is underlined by the finding that females with multiple sex partners are at higher risk of being infected with HIV. These results take on special policy significance in the context of Botswana, where the issue of multiple sex partners has not been adequately addressed in the programme to contain the spread of HIV.

12 CFR 1.5 - Safe and sound banking practices; credit information required.

Science.gov (United States)

2010-01-01

... interest rate, credit, liquidity, price, foreign exchange, transaction, compliance, strategic, and... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Safe and sound banking practices; credit information required. 1.5 Section 1.5 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE...

Investing in nursing research in practice settings: a blueprint for building capacity.

Science.gov (United States)

Jeffs, Lianne; Smith, Orla; Beswick, Susan; Maoine, Maria; Ferris, Ella

2013-12-01

Engaging clinical nurses in practice-based research is a cornerstone of professional nursing practice and a critical element in the delivery of high-quality patient care. Practising staff nurses are well suited to identify the phenomena and issues that are clinically relevant and appropriate for research. In response to the need to invest in and build capacity in nursing research, hospitals have developed creative approaches to spark interest in nursing research and to equip clinical nurses with research competencies. This paper outlines a Canadian hospital's efforts to build research capacity as a key strategy to foster efficacious, safe and cost-effective patient care practices. Within a multi-pronged framework, several strategies are described that collectively resulted in enhanced research and knowledge translation productivity aimed at improving the delivery of safe and high-quality patient care.

National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

Science.gov (United States)

Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

2011-01-01

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the

Cell-penetrating DNA-binding protein as a safe and efficient naked DNA delivery carrier in vitro and in vivo

International Nuclear Information System (INIS)

Kim, Eun-Sung; Yang, Seung-Woo; Hong, Dong-Ki; Kim, Woo-Taek; Kim, Ho-Guen; Lee, Sang-Kyou

2010-01-01

Non-viral gene delivery is a safe and suitable alternative to viral vector-mediated delivery to overcome the immunogenicity and tumorigenesis associated with viral vectors. Using the novel, human-origin Hph-1 protein transduction domain that can facilitate the transduction of protein into cells, we developed a new strategy to deliver naked DNA in vitro and in vivo. The new DNA delivery system contains Hph-1-GAL4 DNA-binding domain (DBD) fusion protein and enhanced green fluorescent protein (EGFP) reporter plasmid that includes the five repeats of GAL4 upstream activating sequence (UAS). Hph-1-GAL4-DBD protein formed complex with plasmid DNA through the specific interaction between GAL4-DBD and UAS, and delivered into the cells via the Hph-1-PTD. The pEGFP DNA was successfully delivered by the Hph-1-GAL4 system, and the EGFP was effectively expressed in mammalian cells such as HeLa and Jurkat, as well as in Bright Yellow-2 (BY-2) plant cells. When 10 μg of pEGFP DNA was intranasally administered to mice using Hph-1-GAL4 protein, a high level of EGFP expression was detected throughout the lung tissue for 7 days. These results suggest that an Hph-1-PTD-mediated DNA delivery strategy may be an useful non-viral DNA delivery system for gene therapy and DNA vaccines.

Cell-penetrating DNA-binding protein as a safe and efficient naked DNA delivery carrier in vitro and in vivo

Energy Technology Data Exchange (ETDEWEB)

Kim, Eun-Sung; Yang, Seung-Woo [Department of Biotechnology, Yonsei University, Seoul 120-749 (Korea, Republic of); Hong, Dong-Ki; Kim, Woo-Taek [Department of Biology, Yonsei University, Seoul 120-749 (Korea, Republic of); Kim, Ho-Guen [Department of Pathology, Yonsei Medical School, Seoul 120-752 (Korea, Republic of); Lee, Sang-Kyou, E-mail: sjrlee@yonsei.ac.kr [Department of Biotechnology, Yonsei University, Seoul 120-749 (Korea, Republic of)

2010-01-29

Non-viral gene delivery is a safe and suitable alternative to viral vector-mediated delivery to overcome the immunogenicity and tumorigenesis associated with viral vectors. Using the novel, human-origin Hph-1 protein transduction domain that can facilitate the transduction of protein into cells, we developed a new strategy to deliver naked DNA in vitro and in vivo. The new DNA delivery system contains Hph-1-GAL4 DNA-binding domain (DBD) fusion protein and enhanced green fluorescent protein (EGFP) reporter plasmid that includes the five repeats of GAL4 upstream activating sequence (UAS). Hph-1-GAL4-DBD protein formed complex with plasmid DNA through the specific interaction between GAL4-DBD and UAS, and delivered into the cells via the Hph-1-PTD. The pEGFP DNA was successfully delivered by the Hph-1-GAL4 system, and the EGFP was effectively expressed in mammalian cells such as HeLa and Jurkat, as well as in Bright Yellow-2 (BY-2) plant cells. When 10 {mu}g of pEGFP DNA was intranasally administered to mice using Hph-1-GAL4 protein, a high level of EGFP expression was detected throughout the lung tissue for 7 days. These results suggest that an Hph-1-PTD-mediated DNA delivery strategy may be an useful non-viral DNA delivery system for gene therapy and DNA vaccines.

Guidance notes : safe practice for the use of nuclear density meters

International Nuclear Information System (INIS)

2000-06-01

These 'Guidance notes' have been written to provide information for owners and users on the safe care and use of instruments containing radioactive materials used for the measurement of moisture content and/or density of materials. They give practical guidance on compliance with the requirements of radiation protection legislation and the 'Code of safe practice for the use of nuclear density meters, NRL C15'. Some of these instruments have been known as 'soil moisture gauges' and others as 'nuclear density meters' or just 'NDMs'. For simplicity, these 'Guidance notes' will follow industry terminology and use the term 'nuclear density meter'. Some parts of these 'Guidance notes' and of the 'Code, NRL C15' are relevant for users of asphalt gauges containing radioactive sources. These are normally laboratory bench instruments, and are not portable field instruments. Nevertheless, the radioactive sources used are similar to those used for moisture measurement and the safety implications are similar. The units of measurement of radioactivity and radiation dose are discussed in Appendix 1. Appendix 2 contains consent application forms while sample transport forms can be found in Appendix 3. (author). 10 refs

Perspectives regarding antenatal care, delivery and breast feeding practices of women from Baluchistan, Pakistan

International Nuclear Information System (INIS)

Khoso, A.; Khan, A.Z.; Sayed, S.A.; Rafique, G.

2016-01-01

Background: Antenatal Care is one of the fundamental rights for women to safeguard their health. Neonatal mortality rates have remained relatively static, compared to the decline in infant and under 5 mortality rates, adverse practices regarding breast feeding and pre-lacteal feeds being the important factors responsible. This study aimed to explore the Antenatal Care, delivery and breast feeding practices in three districts of Blotchiness. Methods: It was a qualitative phenomenological design using Constrictive approach. The study was conducted in three districts of Baluchistan province, Gwadar, Quetta, Qila Saifullah. There were a total of 14 Focus Group Discussions with women regarding Antenatal Care, delivery and Breast feeding practices, followed by audio taping, transcription as verbatim and analysis through Nvivo version 2. A process was deployed for identification and reporting of the components in order to ensure quality and validity of the qualitative findings. Results: Across the sites, women attended ANC at least once. However, their descriptions of ANC often varied. The women preferred Dais instead of doctors, due to the affordability, customs and availability. A lack of trained doctors and long distances to get a check-up lead to home deliveries in the study setting. Colostrum was discarded by majority of the mothers, while prelacteal feed was a common practice. Conclusion: This paper has explored factors affecting ANC attendance, delivery and breast feeding practices across three settings. Both the demand and supply side factors have an important influence on practices. (author)

A Secular Trend in Birth Weight and Delivery Practices in Periurban Vietnam During 2005-2012.

Science.gov (United States)

Duong, Duc Minh; Nguyen, Anh Duy; Nguyen, Chuong Canh; Le, Vui Thi; Hoang, Son Ngoc; Bui, Ha Thi Thu

2017-07-01

The remarkable increase in Vietnamese economic conditions can increase the birth weight in neonates and better delivery practices among women. The Chi Linh Health and Demographic Surveillance System started in 2004. An open cohort of data consisting of about 57 561 people from 17 993 households has been followed primarily with respect to demography, economy, and education. The aim of this research is to study secular trends in delivery practice and birth weight in the past decade (2005-2012) in Chi Linh. We found a significant change in delivery rates at hospitals and cesarean section rates, but the birth weights over a decade of drastic economic development were stable. Furthermore, the findings show significant associations of birth weight and delivery practices with the child's sex, mother's age, and household income. Our results might be considered as representative for other similar periurban settings in Vietnam. We suggest that appropriate policies should be developed given the reduction in the use of delivery services in commune health centers in urban areas.

Safe biodegradable fluorescent particles

Science.gov (United States)

Martin, Sue I [Berkeley, CA; Fergenson, David P [Alamo, CA; Srivastava, Abneesh [Santa Clara, CA; Bogan, Michael J [Dublin, CA; Riot, Vincent J [Oakland, CA; Frank, Matthias [Oakland, CA

2010-08-24

A human-safe fluorescence particle that can be used for fluorescence detection instruments or act as a safe simulant for mimicking the fluorescence properties of microorganisms. The particle comprises a non-biological carrier and natural fluorophores encapsulated in the non-biological carrier. By doping biodegradable-polymer drug delivery microspheres with natural or synthetic fluorophores, the desired fluorescence can be attained or biological organisms can be simulated without the associated risks and logistical difficulties of live microorganisms.

Accessing Safe Deliveries in Tanzania (IMCHA) | IDRC ...

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

Few healthcare workers are trained to offer emergency obstetrical care, so timely ... With better access to skilled care and emergency services, the project aims to ... training program as it relates to health service delivery and health outcomes.

Effective Practices for Online Delivery of Quantitative Business Courses

Science.gov (United States)

Lam, Helen; Khare, Anshuman

2010-01-01

Online delivery of university-level courses has grown exponentially in the last decade and is increasingly being recognised as a viable and effective alternative to face-to-face classroom teaching. Many scholars have already written about the benefits and best practices of online teaching in general. However, not many studies have paid specific…

Interaction between HIV Awareness, Knowledge, Safe Sex Practice and HIV Incidence: Evidence from Botswana

OpenAIRE

Ranjan Ray; Kompal Sinha

2011-01-01

This paper makes methodological and empirical contributions to the study of HIV awareness, knowledge, incidence and safe sex practice in the context of Botswana, one of the most HIV prone countries in the world. While the focus is on Botswana, the paper presents comparable evidence from India to put the Botswana results in perspective. The results point to the strong role played by affluence and education in increasing HIV knowledge, promoting safe sex and reducing HIV incidence. The study pr...

APIC position paper: Safe injection, infusion, and medication vial practices in health care.

Science.gov (United States)

Dolan, Susan A; Arias, Kathleen Meehan; Felizardo, Gwen; Barnes, Sue; Kraska, Susan; Patrick, Marcia; Bumsted, Amelia

2016-07-01

The transmission of bloodborne viruses and other microbial pathogens to patients during routine health care procedures continues to occur because of the use of improper injection, infusion, medication vial, and point-of-care testing practices by health care personnel. These unsafe practices occur in various clinical settings and result in unacceptable and devastating events for patients. This document updates the Association for Professionals in Infection Control and Epidemiology 2010 position paper on safe injection, infusion, and medication vial practices in health care. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Collaborative Practice Model: Improving the Delivery of Bad News.

Science.gov (United States)

Bowman, Pamela N; Slusser, Kim; Allen, Deborah

2018-02-01

Ideal bad news delivery requires skilled communication and team support. The literature has primarily focused on patient preferences, impact on care decisions, healthcare roles, and communication styles, without addressing systematic implementation. This article describes how an interdisciplinary team, led by advanced practice nurses, developed and implemented a collaborative practice model to deliver bad news on a unit that had struggled with inconsistencies. Using evidence-based practices, the authors explored current processes, role perceptions and expectations, and perceived barriers to developing the model, which is now the standard of care and an example of interprofessional team collaboration across the healthcare system. This model for delivering bad news can be easily adapted to meet the needs of other clinical units.
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The use of collaboration to implement evidence-based safe practices

Directory of Open Access Journals (Sweden)

John R. Clarke

2013-12-01

Full Text Available The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year.

Access to Safe Water and Personal Hygiene Practices in the Kulandia Refugee Camp (Jerusalem).

Science.gov (United States)

Issa, Mohamad; McHenry, Michael; Issa, Abdul Aziz; Blackwood, R Alexander

2015-12-22

Diarrheal illness, frequently associated with fecal-oral transmission, is one of the leading causes of death worldwide. It is commonly preventable through the implementation of safe water practices. This experiment concerns how to best implement safe water practices in a quasi-permanent refugee camp setting with limited ability for structural changes. Specifically, we explore how health promotion activities that help identify target groups for hygiene interventions can play a role in disease prevention. An anonymous survey was conducted at the United Nations Relief and Works Agency Health Clinic in the Kulandia refugee camp to assess the safe water and personal hygiene practices. Demographic and social characteristics, accessible water and personal hygiene characteristics, and gastrointestinal (GI) burden for individuals and their households were assessed. A total of 96 individuals were enrolled; 62 females and 34 males. Approximately 58% of the sample had soap available and washed hands before and after eating and when preparing food. Piped water was the main source of drinking water (62%), while 31% of our sample utilized tanker-trucks. 93% of participants had access to toilet facilities, with 86% of these facilities being private households. 55% practice extra water hygiene measures on their household drinking water source. 51.3% considered vendor cleanliness when they were buying food. 51% had received formal health education. 68.8% had been taught by their parents, but only 55.2% were teaching their children and 15.6% had consistent access to a health professional for hygiene inquiries. Individual variables and hygiene practices associated with lower rates of diarrheal illnesses included having water piped into the home, proper hand washing, adequate soap availability, proper consideration of vendor cleanliness, higher income, levels of education, health hygiene education, and having access to healthcare professions to discuss hygiene related matters. This is

Code of safe practice for the use of x-rays in dentistry

International Nuclear Information System (INIS)

1991-06-01

The purpose of this Code of Safe Practice for the Use of X-rays in Dentistry is to provide criteria for working procedures, x-ray equipment and protective materials necessary for the use of x-rays in dental diagnosis according to currently accepted standards of safety. Conformity with this code may be taken as a primary indication of compliance with radiation protection legislation. 7 refs., 1 ill

Code of practice for the safe use of ionizing radiation in secondary schools (1986)

International Nuclear Information System (INIS)

1987-01-01

The code of practice is intended for schools and indicates the basic philosophy behind the current approach to the control of hazards associated with the use of ionizing radiation. The purpose of this code is to provide guidance on safe and proper practices in the use of radiation. It covers modes of radiation exposure, shielding, dose limits, responsibility, general rules, x-ray generators, general control of radioactive sources, sealed sources and unsealed sources

Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

Directory of Open Access Journals (Sweden)

Moyer Cheryl A

2012-06-01

Full Text Available Abstract Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1 Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2 Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3 Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of

Association between the safe delivery app and quality of care and perinatal survival in Ethiopia

DEFF Research Database (Denmark)

Lund, Stine; Boas, Ida Marie; Bedesa, Tariku

2016-01-01

the health care workers' knowledge and skills in neonatal resuscitation as long as 12 months after introduction. Perinatal mortality was nonsignificantly reduced after the intervention. The results are highly relevant in low-income countries, where quality of care is challenged by a lack of continuing......Importance: Health apps in low-income countries are emerging tools with the potential to improve quality of health care services, but few apps undergo rigorous scientific evaluation. Objective: To determine the effects of the safe delivery app (SDA) on perinatal survival and on health care workers......' knowledge and skills in neonatal resuscitation. Design, setting, and participants: In a cluster-randomized clinical trial in 5 rural districts of Ethiopia, 73 health care facilities were randomized to the mobile phone intervention or to standard care (control). From September 1, 2013, to February 1, 2015...

Implementation evaluation of steering teens safe: engaging parents to deliver a new parent-based teen driving intervention to their teens.

Science.gov (United States)

Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

2013-08-01

Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. Steering Teens Safe is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills with their teens. This implementation evaluation focuses on a sample of 83 parents who delivered Steering Teens Safe to their teens. One-, 2- and 3-month follow-up assessments were conducted with intervention parents to evaluate the self-reported quantity and quality of talking about, demonstrating, and practicing safe driving goals with teens; perceived success and benefit of the program; and barriers to implementation. Over 3 months of follow-up, parents discussed driving goals with their teens for a median of 101.5 minutes. The most frequently addressed topics were general safety principles, including distracted driving, driving in bad weather, wearing a seat belt, and being a safe passenger. Parents spent a median of 30 minutes practicing safe driving skills such as changing lanes. Sixty-seven percent of parents talked to their children about rural road safety, but just 36% demonstrated and half practiced these skills with their teens. Barriers to implementation include time and opportunity barriers and resistant attitudes of their teens. However, barriers neither affected frequency of engagement nor parents' perceived benefit and comfort in delivering the program. Parents with time/opportunity barriers also had higher practice and demonstration times than parents without these barriers. Findings indicate high acceptability among parent implementers and promise for real-world delivery. Future studies are needed to assess intervention impact.

Utilization of clean and safe delivery service package of health services extension program and associated factors in rural kebeles of Kafa Zone, Southwest Ethiopia.

Science.gov (United States)

Bayou, Negalign Berhanu; Gacho, Yohannes Haile Michael

2013-07-01

In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. Phistory of abortion, knowledge of danger signs and antenatal care attendance. Educating women and improving their knowledge about danger signs of pregnancy and labor is recommended. Health extension workers should consider antenatal care visits as opportunities for this purpose.

Implementing AORN recommended practices for a safe environment of care, part II.

Science.gov (United States)

Kennedy, Lynne

2014-09-01

Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Employment and contextual impact of safe and unsafe sexual practices for STI and HIV: the situation in China.

Science.gov (United States)

Wang, S M; Gao, M Y

2000-08-01

China's dual employment system plays a crucial role in sexually transmitted infections (STIs) and HIV-related safe and unsafe sexual practices among young Chinese people. Social and psychological determinants of safe and unsafe sexual practices for HIV infection among young people in Sichuan, China were examined. Our findings indicate that changes in China's social structure and employment system impact upon the social contextual involvement and socio-sexual practice of young Chinese people. The findings in the study suggest that the employment-related contextual involvement was a major predictor in the relationships between demography, information, and psychological risk-taking factors on one hand and the people's safe and unsafe sexual practices on the other. Self-employed people (officially called 'getihu') were more likely than the state-employed people to engage in unprotected sex with casual sexual partners. As China undergoes social restructuring and many state-employed people are laid off, the risk may also extend into the broader non-self-employed population as more state-employed people become involved not only in the self-employed getihu's socioeconomic activities but also in their unconventional socio-sexual practices. Collective vulnerability to STI and HIV, due to the current socio-sexual practices of the getihu young people, has created a new frontier for STI and HIV prevention in today's China, as well as demonstrating the importance of collective action with STI and AIDS prevention strategies within relevant social and sub-cultural contexts.

Jewish laws, customs, and practice in labor, delivery, and postpartum care.

Science.gov (United States)

Noble, Anita; Rom, Miriam; Newsome-Wicks, Mona; Engelhardt, Kay; Woloski-Wruble, Anna

2009-07-01

Many communities throughout the world, especially in the United States and Israel, contain large populations of religiously observant Jews. The purpose of this article is to provide a comprehensive, descriptive guide to specific laws, customs, and practices of traditionally, religious observant Jews for the culturally sensitive management of labor, delivery, and postpartum. Discussion includes intimacy issues between husband and wife, dietary laws, Sabbath observance, as well as practices concerning prayer, communication trends, modesty issues, and labor and birth customs. Health care professionals can tailor their practice by integrating their knowledge of specific cultures into their management plan.

Model Code of Safe Practice in the Petroleum Industry: Pt. 8

Energy Technology Data Exchange (ETDEWEB)

1991-01-01

This code has been prepared for use on a worldwide basis as a guide to safe practice for those concerned with drilling and production operations for oil and gas in offshore areas. It is intended to provide information and guidance on those offshore drilling, production and support activities which have an impact on safety and therefore require detailed care and attention. Each chapter of the Code covers an important drilling, production or support activity and has an introduction which describes the part each activity plays in the overall offshore operation. (author).

The effect of a structured neonatal resuscitation program on delivery room practices.

LENUS (Irish Health Repository)

Ryan, C A

2012-02-03

PURPOSE: This study evaluated the introduction of the Neonatal Resuscitation Program (NRP) of the American Academy of Pediatrics and the American Heart Association into the delivery room of an Irish maternity hospital. DESIGN: Prospective, controlled observational study of 51 deliveries before and 51 deliveries following the training of delivery room personnel in the NRP. SAMPLE: Participants were 33 nurse-midwives and 11 pediatric resident physicians. MAIN OUTCOME VARIABLE: Evaluation of postdelivery, newborn resuscitation practices. RESULTS: The introduction of the NRP was associated with significant improvements in delivery room preparation, in the evaluation and management of the newborn infant, and in thermal protection at birth. Although there was a trend to use more free-flow oxygen following the introduction of the NRP, this was not statistically significant. Bag and mask ventilation was also used more frequently following NRP training. However, there were no significant differences in the use of endotracheal intubation, chest compressions, and medications. Fifteen of the 51 infants became hypothermic prior to the introduction of the NRP; none of the infants developed hypothermia in the post-NRP part of the study.

Integration of the Opportunity-Ability-Motivation behavior change framework into a coaching-based WHO Safe Childbirth Checklist program in India.

Science.gov (United States)

Hirschhorn, Lisa R; Krasne, Margaret; Maisonneuve, Jenny; Kara, Nabihah; Kalita, Tapan; Henrich, Natalie; Rana, Darpan; Maji, Pinki; Delaney, Megan M; Firestone, Rebecca; Sharma, Narender; Kumar, Vishwajeet; Gawande, Atul A; Semrau, Katherine E A

2018-06-03

To evaluate whether integration of the Opportunity-Ability-Motivation plus Supplies (OAMS) framework into coaching improved the delivery of essential birth practices in a low-resource setting. This prospective mixed-methods study used routine coaching visit data obtained from the first eight intervention facilities of the BetterBirth trial in Uttar Pradesh, India, between December 19, 2014, and October 21, 2015. The 8-month intervention was peer coaching that integrated the OAMS framework to support uptake of the WHO Safe Childbirth Checklist. Descriptive statistics were used to measure nonadherence to essential birth practices. The frequency and accuracy of coaches' coding of barriers and the appropriateness of chosen resolution strategies to measure feasibility, acceptability, and fidelity of using OAMS, were assessed. Coaches observed 666 deliveries, including 12 602 practices. Overall, essential practice nonadherence decreased from 15.6% (262/1675 practices observed) to 4.5% (4/88 practices) (Pmotivation (287 [27.4%]) were the most frequently reported categories; the frequency of both decreased over time (P=0.003 and Prights reserved. This article is protected by copyright. All rights reserved.

Safe Injection Practices in Primary Health Care Settings of Naxalbari Block, Darjeeling District, West Bengal.

Science.gov (United States)

Chaudhuri, Sudip Banik; Ray, Kuntala

2016-01-01

Unsafe injection can transmit many diseases to patients, injection providers and healthy people of community. To find out critical steps whether executed according to recommended best practice methods, availability of equipments in health facilities for safe injection practices and some important steps of waste disposal methods. This facility-based cross-sectional observational study was conducted among 30 Auxiliary nurse midwives (ANM) & 27 nursing staffs (NS) to assess certain aspects of their practice while administrating injection and disposal of the disposables. Health facilities were also observed to asses necessary equipments of safe injection and waste disposal methods. Among the health workers 93.3% ANM and 100% NS took sterile syringe from sterile unopened packet, all of the study subjects washed hand before giving injection, 13.3% of ANMs and 8% of NS are fully vaccinated against Hep B, 53.3% of ANM and all NS are practices non recapping. Only 13.33% sub centres along with PHC & BPHC had at least one puncture resistant leak proof container, 86.7% sub centres, PHC are free from loose needles. Transport for off side treatment is the method of waste disposal in case of 73.3% cases sub centres, PHC & BPHC. There is need to educate, train and motivate service providers in proper methods of giving injection along with improve the adequacy of supply of required equipments.

Promoting Safe Motherhood in Jimma Zone, Ethiopia (IMCHA ...

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

Technology, communication, skills development. This project will ... -developing healthcare worker skills for safe deliveries. The project ... Canada launches new funding opportunity to support Canadian-African research teams studying Ebola.

Ante natal care services utilization, delivery practices and factors affecting them in tribal area of North Maharashtra

Directory of Open Access Journals (Sweden)

Sachin S Mumbare

2011-01-01

Full Text Available Background: Utilization of Ante natal care (ANC services is poor in the tribal areas, causing increased maternal morbidity and mortality. Objective: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. Design: Cross-sectional study. Materials and Methods: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. Results: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. Conclusion: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.

Pattern of Institutional delivery in Dadeldhura district of Nepal: A cross-sectional study

Directory of Open Access Journals (Sweden)

Damaru Prasad Paneru

2014-01-01

primary level health care facilities in terms of skilled attendants and materials to cater the growing acceptance of local level health facility is recommended to scale up safe delivery practices.

Varying influences of motivation factors on employees' likelihood to perform safe food handling practices because of demographic differences.

Science.gov (United States)

Ellis, Jason D; Arendt, Susan W; Strohbehn, Catherine H; Meyer, Janell; Paez, Paola

2010-11-01

Food safety training has been the primary avenue for ensuring food workers are performing proper food handling practices and thus, serving safe food. Yet, knowledge of safe food handling practices does not necessarily result in actual performance of these practices. This research identified participating food service employees' level of agreement with four factors of motivation (internal motivations, communication, reward-punishment, and resources) and determined if respondents with different demographic characteristics reported different motivating factors. Data were collected from 311 food service employees who did not have any supervisory responsibilities. Intrinsic motivation agreement scores were consistently the highest of all four motivational factors evaluated and did not differ across any of the demographic characteristics considered. In contrast, motivation agreement scores for communication, reward-punishment, and resources did differ based on respondents' gender, age, place of employment, job status, food service experience, completion of food handler course, or possession of a food safety certification. In general, respondents agreed that these motivation factors influenced their likelihood to perform various safe food handling procedures. This research begins to illustrate how employees' demographic characteristics influence their responses to various motivators, helping to clarify the complex situation of ensuring safe food in retail establishments. Future research into why employee willingness to perform varies more for extrinsic motivation than for intrinsic motivation could assist food service managers in structuring employee development programs and the work environment, in a manner that aids in improving external motivation (communication, reward-punishment, and resources) and capitalizing on internal motivation.

Development of Safe Food Handling Guidelines for Korean Consumers.

Science.gov (United States)

Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon

2015-08-01

The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers.

Tumor-activated prodrug (TAP)-conjugated nanoparticles with cleavable domains for safe doxorubicin delivery.

Science.gov (United States)

Guarnieri, Daniela; Biondi, Marco; Yu, Hui; Belli, Valentina; Falanga, Andrea P; Cantisani, Marco; Galdiero, Stefania; Netti, Paolo A

2015-03-01

A major issue in chemotherapy is the lack of specificity of many antitumor drugs, which cause severe side effects and an impaired therapeutic response. Here we report on the design and characterization of model tumor activated prodrug-conjugated polystyrene (PS) nanoparticles (TAP-NPs) for the release of doxorubicin (Dox) triggered by matrix metalloprotease-2 (MMP2) enzyme, which is overexpressed in the extracellular matrix of tumors. In particular, TAP-NPs were produced by attaching Dox to poly(ethylene glycol) (PEG) through two MMP2-cleavable enzymes. The resulting adduct was then tethered to PS NPs. Results showed that Dox release was actually triggered by MMP2 cleavage and was dependent on enzyme concentration, with a plateau around 20 nM. Furthermore, significant cell cytotoxicity was observed towards three cell lines only in the presence of MMP2, but not in cells without enzyme pre-treatment, even after NP internalization by cells. These findings indicate the potential of TAP-NPs as suitable nanocarriers for an on demand, tumor--specific delivery of antitumor drugs after the response to an endogenous stimulus. Further advancements will focus on the translation of this production technology to biodegradable systems for the safe transport of cytotoxic drug to tumor tissues. © 2014 Wiley Periodicals, Inc.

Safe use of ionizing radiations

Energy Technology Data Exchange (ETDEWEB)

1973-01-01

Based on the ''Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use'' (CIS 74-423), this handbook shows how hospital staff can avoid exposing themselves and others to these hazards. It is designed particularly for junior and student nurses. Contents: ionizing radiations, their types and characteristics; their uses and dangers; basic principles in their safe use; safe use in practice; explanation of terms.

Canadian East Coast offshore petroleum industry safe lifting practices respecting offshore pedestal cranes, offshore containers, loose gear, other lifting devices, and operational best practices : standard practices

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-11-15

This document was developed by a working group with representatives from the petroleum industry, the Offshore Petroleum Boards and Certifying Authorities. It outlines industry best practices for operators responsible for the management, planning and execution of offshore lifting operations. Its purpose is to assist in the interpretation of applicable legislation and standards. Considered within the practice are safe design requirements, manufacture, certification, testing, maintenance and inspection requirements for pedestal cranes, offshore containers, loose gear and lifting devices. Operational best practices for lifting operations are also included along with a section that identifies additional requirements for personnel lifting operations, including personnel transfers by crane and man-riding operations. 82 refs., 2 tabs., 4 figs., 3 appendices.

Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

Science.gov (United States)

Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

2016-10-06

Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

Chitosan/o-carboxymethyl chitosan nanoparticles for efficient and safe oral anticancer drug delivery: in vitro and in vivo evaluation.

Science.gov (United States)

Feng, Chao; Wang, Zhiguo; Jiang, Changqing; Kong, Ming; Zhou, Xuan; Li, Yang; Cheng, Xiaojie; Chen, Xiguang

2013-11-30

The present study investigated the ability of a polyelectrolyte complex (CS/CMCS-NPs), composed of chitosan (CS) and o-carboxymeymethy chitosan (CMCS) as a pH responsive carrier for oral delivery of doxorubicin hydrochloride (DOX). The obtained CS/CMCS-NPs were characterized for various parameters including morphology, particle size, zeta potential, entrapment efficiency and stability under the simulated GI tract conditions. The pH responsive stability of the DOX-loaded CS/CMCS nanoparticles (DOX:CS/CMCS-NPs) determined the drug release rate, which was lower in acidic pH than the neutral. Ex vivo intestinal adhesion and permeation indicated DOX:CS/CMCS-NGs were able to enhance absorption of DOX throughout the entire small intestine, especially in jejunum and ileum. Oral administration of DOX:CS/CMCS-NPs was effective to deliver DOX into blood, giving an absolute bioavailability of 42%. The tissue distribution and toxicity of DOX:CS/CMCS-NPs in rats showed low level of DOX in heart and kidney, and obviously decreased cardiac and renal toxicities. These results indicated CS/CMCS-NPs were highly efficient and safe as an oral delivery system for DOX. Copyright © 2013 Elsevier B.V. All rights reserved.

Infection control in delivery care units, Gujarat state, India: A needs assessment

Directory of Open Access Journals (Sweden)

Ramani KV

2011-05-01

Full Text Available Abstract Background Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%. Conclusions This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems

Academy of Nutrition and Dietetics: Scope of Practice for the Dietetic Technician, Registered.

Science.gov (United States)

2013-06-01

The Scope of Practice for the Dietetic Technician, Registered provides standards and tools to guide competence in performing nutrition and dietetics practice. Composed of statutory and individual components, the DTR's scope of practice is determined by state statute and the DTR's education, training, credentialing, and demonstrated and documented competence in practice. The Scope of Practice for the Dietetic Technician, Registered reflects the Academy's position on the DTR scope of practice and the essential technical assistance role of the DTR in providing safe timely person-centered care for the delivery of quality food and nutrition services.

Safe and stable noninvasive focal gene delivery to the mammalian brain following focused ultrasound.

Science.gov (United States)

Stavarache, Mihaela A; Petersen, Nicholas; Jurgens, Eric M; Milstein, Elizabeth R; Rosenfeld, Zachary B; Ballon, Douglas J; Kaplitt, Michael G

2018-04-27

with prior observations, no evidence of brain inflammation was observed from 2 weeks to 6 months following MRgFUS BBB opening, despite delivery of a virus and expression of a foreign protein in target neurons. CONCLUSIONS This study demonstrates that transitory BBB disruption using MRgFUS can be a safe and efficient method for site-specific delivery of viral vectors to the brain, raising the potential for noninvasive focal human gene therapy for neurological disorders.

Study protocol. IDUS - Instrumental delivery & ultrasound: a multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-01-01

Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 - 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.

Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations.

Science.gov (United States)

Assefa, Yibeltal; Van Damme, Wim; Hermann, Katharina

2010-01-01

PURPOSE OF VIEW: To illustrate and critically assess what is currently being published on the human resources for health dimension of antiretroviral therapy (ART) delivery models. The use of human resources for health can have an effect on two crucial aspects of successful ART programmes, namely the scale-up capacity and the long-term retention in care. Task shifting as the delegation of tasks from higher qualified to lower qualified cadres has become a widespread practice in ART delivery models in low-income countries in recent years. It is increasingly shown to effectively reduce the workload for scarce medical doctors without compromising the quality of care. At the same time, it becomes clear that task shifting can only be successful when accompanied by intensive training, supervision and support from existing health system structures. Although a number of recent publications have focussed on task shifting in ART delivery models, there is a lack of accessible information on the link between task shifting and patient outcomes. Current ART delivery models do not focus sufficiently on retention in care as arguably one of the most important issues for the long-term success of ART programmes. There is a need for context-specific re-designing of current ART delivery models in order to increase access to ART and improve long-term retention.

Level of awareness of cervical and breast cancer risk factors and safe practices among college teachers of different states in india: do awareness programmes have an impact on adoption of safe practices?

Science.gov (United States)

Shankar, Abhishek; Rath, Gk; Roy, Shubham; Malik, Abhidha; Bhandari, Ruchir; Kishor, Kunal; Barnwal, Keshav; Upadyaya, Sneha; Srivastava, Vivek; Singh, Rajan

2015-01-01

Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year

From Safe Systems to Patient Safety

DEFF Research Database (Denmark)

Aarts, J.; Nøhr, C.

2010-01-01

for the third conference with the theme: The ability to design, implement and evaluate safe, useable and effective systems within complex health care organizations. The theme for this conference was "Designing and Implementing Health IT: from safe systems to patient safety". The contributions have reflected...... and implementation of safe systems and thus contribute to the agenda of patient safety? The contributions demonstrate how the health informatics community has contributed to the performance of significant research and to translating research findings to develop health care delivery and improve patient safety......This volume presents the papers from the fourth International Conference on Information Technology in Health Care: Socio-technical Approaches held in Aalborg, Denmark in June 2010. In 2001 the first conference was held in Rotterdam, The Netherlands with the theme: Sociotechnical' approaches...

Practical considerations and patient selection for intrathecal drug delivery in the management of chronic pain

Directory of Open Access Journals (Sweden)

Saulino M

2014-11-01

Full Text Available Michael Saulino,1,2 Philip S Kim,3,4 Erik Shaw5 1MossRehab, Elkins Park, PA, USA; 2Department of Rehabilitation Medicine, Jefferson Medical College, Philadelphia, PA, USA; 3Helen F Graham Cancer Center, Christiana Care Health System, Newark, DE, USA; 4Center for Interventional Pain Spine, LLC., Bryn Mawr, PA, USA; 5Shepherd Pain Institute, Shepherd Center, Atlanta, GA, USA Abstract: Chronic pain continues to pose substantial and growing challenges for patients, caregivers, health care professionals, and health care systems. By the time a patient with severe refractory pain sees a pain specialist for evaluation and management, that patient has likely tried and failed several nonpharmacologic and pharmacologic approaches to pain treatment. Although relegated to one of the interventions of “last resort”, intrathecal drug delivery can be useful for improving pain control, optimizing patient functionality, and minimizing the use of systemic pain medications in appropriately selected patients. Due to its clinical and logistical requirements, however, intrathecal drug delivery may fit poorly into the classic pain clinic/interventional model and may be perceived as a "critical mass" intervention that is feasible only for large practices that have specialized staff and appropriate office resources. Potentially, intrathecal drug delivery may be more readily adopted into larger practices that can commit the necessary staff and resources to support patients' needs through the trialing, initiation, monitoring, maintenance, and troubleshooting phases of this therapy. Currently, two agents – morphine and ziconotide – are approved by the United States Food and Drug Administration for long-term intrathecal delivery. The efficacy and safety profiles of morphine have been assessed in long-term, open-label, and retrospective studies of >400 patients with chronic cancer and noncancer pain types. The efficacy and safety profiles of ziconotide have been

Poly-functional and long-lasting anticancer immune response elicited by a safe attenuated Pseudomonas aeruginosa vector for antigens delivery

Directory of Open Access Journals (Sweden)

Xavier Chauchet

2016-01-01

Full Text Available Live-attenuated bacterial vectors for antigens delivery have aroused growing interest in the field of cancer immunotherapy. Their potency to stimulate innate immunity and to promote intracellular antigen delivery into antigen-presenting cells could be exploited to elicit a strong and specific cellular immune response against tumor cells. We previously described genetically-modified and attenuated Pseudomonas aeruginosa vectors able to deliver in vivo protein antigens into antigen-presenting cells, through Type 3 secretion system of the bacteria. Using this approach, we managed to protect immunized mice against aggressive B16 melanoma development in both a prophylactic and therapeutic setting. In this study, we further investigated the antigen-specific CD8+ T cell response, in terms of phenotypic and functional aspects, obtained after immunizations with a killed but metabolically active P. aeruginosa attenuated vector. We demonstrated that P. aeruginosa vaccine induces a highly functional pool of antigen-specific CD8+ T cell able to infiltrate the tumor. Furthermore, multiple immunizations allowed the development of a long-lasting immune response, represented by a pool of predominantly effector memory cells which protected mice against late tumor challenge. Overall, killed but metabolically active P. aeruginosa vector is a safe and promising approach for active and specific antitumor immunotherapy.

Women's self-perception and self-care practice: implications for health care delivery.

Science.gov (United States)

Mendias, E P; Clark, M C; Guevara, E B

2001-01-01

Mexican American women experience unique health care needs related to integration of Mexican and American cultures. To learn how to better promote self-care practices and service utilization in women of Mexican origin living in Texas, researchers used a qualitative approach to interview a convenience sample of 11 low-income women attending a health clinic. Researchers collected narrative data about the women's perceptions of health, wellness, and self-care. Using the matrix approach described by Miles and Huberman, we organized findings around women's roles, including participants' descriptions of themselves, their health and wellness awareness, self-care practices for health/illness and wellness/nonwellness, barriers to self-care, origin of self-care practices, and perceptions of life control. Implications for health planning and service delivery are presented.

Investigating the Practical Impact of Agile Practices on the Quality of Software Projects in Continuous Delivery

OpenAIRE

Olumide Akerele; Muthu Ramachandran; Mark Dixon

2014-01-01

Various factors affect the impact of agile factors on the continuous delivery of software projects. This is a major reason why projects perform differently- some failing and some succeeding- when they implement some agile practices in various environments. This is not helped by the fact that many projects work within limited budget while project plans also change-- making them to fall into some sort of pressure to meet deadline when they fall behind in their planned work. This study investiga...

MicroRNA Delivery for Regenerative Medicine

OpenAIRE

Peng, Bo; Chen, Yongming; Leong, Kam W.

2015-01-01

MicroRNA (miRNA) directs post-transcriptional regulation of a network of genes by targeting mRNA. Although relatively recent in development, many miRNAs direct differentiation of various stem cells including induced pluripotent stem cells (iPSCs), a major player in regenerative medicine. An effective and safe delivery of miRNA holds the key to translating miRNA technologies. Both viral and nonviral delivery systems have seen success in miRNA delivery, and each approach possesses advantages an...

Understanding Effective Delivery of Patient and Family Education in Pediatric Oncology: A Systematic Review from the Children's Oncology Group

Science.gov (United States)

Rodgers, Cheryl C.; Laing, Catherine M.; Herring, Ruth Anne; Tena, Nancy; Leonardelli, Adrianne; Hockenberry, Marilyn; Hendricks-Ferguson, Verna

2016-01-01

A diagnosis of childhood cancer is a life-changing event for the entire family. Parents must not only deal with the cancer diagnosis but also acquire new knowledge and skills to safely care for their child at home. Best practices for delivery of patient/family education after a new diagnosis of childhood cancer are currently unknown. The purpose of this systematic review was to evaluate the existing body of evidence to determine the current state of knowledge regarding the delivery of education to newly diagnosed pediatric oncology patients and families. Eighty-three articles regarding educational methods, content, influencing factors, and interventions for newly diagnosed pediatric patients with cancer or other chronic illnesses were systematically identified, summarized, and appraised according to the GRADE criteria. Based on the evidence, ten recommendations for practice were identified. These recommendations address delivery methods, content, influencing factors, and educational interventions for parents and siblings. Transferring these recommendations into practice may enhance the quality of education delivered by healthcare providers, and received by patients and families following a new diagnosis of childhood cancer. PMID:27450361

Perception of pregnant women towards midwives: attitude and practice during child delivery in health institutions in Ogbomoso, South-West, Nigeria

Directory of Open Access Journals (Sweden)

Adeyemo F. Oluyemisi

2014-01-01

Full Text Available Background: This study aims to ascertain pregnant women’s perceptions of the attitudes and practice of midwives during labour in a mission teaching hospital and a state hospital in Ogbomoso, Southwest Nigeria, and to determine whether or not a relationship exists between patients’perceptions of midwives practice during delivery and the occurrence of neonatal deaths.Methods: The survey was conducted by administering the questionnaire adapted from Caring Behaviour Inventory (CBI to a random sample of five hundred and seventy nine respondent mothers who gave birth in either a Mission teaching hospital or a state hospital in Ogbomoso, Southwest Nigeria. This standardised questionnaire collects demographic data and patient perceptions of nursing attitudes and practice, ranking patients’ responses to a series of statements about the midwives on a four point Likert scale. Data was analysed using Pearson product moment correlation analyses and multiple regression analyses.Results: Our study revealed that there was a positive response on the attitude and practise of midwives during delivery by the respondents. Secondly, there was a positive impression on the influence of the attitude and practice of midwives during delivery by the respondents.Conclusions: There was no evidence of a relationship between patients’ perceptions of midwives practice during delivery and the occurrence of neonatal deaths.

Encapsulating the delivery of affordable housing: An overview of Malaysian practice

Directory of Open Access Journals (Sweden)

Jamaluddin Nor Baizura

2016-01-01

Full Text Available Urban population increases much faster than other geographical areas and this brings huge challenges to Malaysian government especially those responsible for the provision of housing. Moreover, the rise of living cost and pressure towards the current economic situation had inevitably led to huge demands for affordable housing. Thus, affordability and inaccessibility of people in owning a house has become one of the major issues in Malaysia. These issues are not only faced by the low-income group but mostly experienced by urban dwellers including the middle-income group whom are not eligible to apply for low-cost housing delivered by the government, yet cannot afford to buy a house. Hence, the Malaysian government had therefore established the Perumahan Rakyat 1 Malaysia (PR1MA as the catalyst in providing adequate, quality and affordable houses. Furthermore, the Syarikat Perumahan Negara Berhad (SPNB and the state governments also play their big role in providing affordable house at the state level. In trying to ensure smooth delivery of affordable housing, a systematic approach is required. This paper intends to examine the delivery of affordable housing in Malaysia. The objective was to assess the parties involved, and the various stages of the process. The methodology adopted for this study includes in-depth interviews with affordable housing agencies. Investigation showed that the major problem relates to a mismatch in the delivery of affordable housing. Moreover, the political and economic aspects, as well as the organization situation had also influenced the inefficiency of affordable housing delivery system. Additionally, the significant of this paper is expected to formulate an improved strategy and guidance in delivery system, thus ensuring that the method of practice is applicable throughout the country.

original article predictors of safe delivery service utilization in arsi

African Journals Online (AJOL)

Abrham

There is limited information on the mothers' use of skilled delivery services in the ... to conditions related to pregnancy and child birth. 99% of .... having favourable attitude towards utilization of ... two injections of Tetanus Toxoid vaccine during.

Physician practice management companies: implications for hospital-based integrated delivery systems.

Science.gov (United States)

Burns, L R; Robinson, J C

1997-01-01

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

Transdermal drug delivery

OpenAIRE

Prausnitz, Mark R.; Langer, Robert

2008-01-01

Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, non-cavitational ultrasound and iontophoresis have also resulted in clinical products; the ability ...

Noninvasive ocular drug delivery: potential transcorneal and other alternative delivery routes for therapeutic molecules in glaucoma.

Science.gov (United States)

Foldvari, Marianna

2014-01-01

Drug delivery to the eye is made difficult by multiple barriers (such as the tear film, cornea, and vitreous) between the surface of the eye and the treatment site. These barriers are difficult to surmount for the purposes of drug delivery without causing toxicity. Using nanotechnology tools to control, manipulate, and study delivery systems, new approaches to delivering drugs, genes, and antigens that are effective and safe can be developed. Topical administration to the ocular surface would be the safest method for delivery, as it is noninvasive and painless compared with other delivery methods. However, there is only limited success using topical delivery methods, especially for gene therapy. Current thinking on treatments of the future enabled by nanodelivery systems and the identification of target specificity parameters that require deeper understanding to develop successful topical delivery systems for glaucoma is highlighted.

MR pelvimetry - a practical alternative

International Nuclear Information System (INIS)

Wright, A.R.; English, P.T.; Cameron, H.M.; Wilsdon, J.B.

1992-01-01

Pelvimetry remains a useful technique as part of the assessment of the term breech pregnancy where vaginal delivery is planned. MR pelvimetry is accurate, well tolerated and shows soft-tissue structures as well as bone. It avoids the potentially carcinogenic effects of ionising radiation and is thought to be completely safe for mother and fetus. A technique of MR pelvimetry is described which uses gradient-echo sequences. This quick, practical method makes minimal in roads into valuable scanning time, and may therefore be considered a potentially cost-effective alternative to conventional pelvimetry. (orig.)

Carbon dioxide angiography: a simple and safe system of delivery

International Nuclear Information System (INIS)

Cronin, P.; Patel, J.V.; Kessel, D.O.; Robertson, I.; McPherson, S.J.

2005-01-01

Carbon dioxide (CO 2 ) is an established alternate angiographic contrast agent, which can be delivered by pump or hand injection. We describe a simple, safe and inexpensive hand injection system that delivers a known volume of CO 2 at atmospheric pressure and prevents contamination with room air

rAAV Vectors as Safe and Efficient Tools for the Stable Delivery of Genes to Primary Human Chondrosarcoma Cells In Vitro and In Situ

Directory of Open Access Journals (Sweden)

Henning Madry

2012-01-01

Full Text Available Treatment of chondrosarcoma remains a major challenge in orthopaedic oncology. Gene transfer strategies based on recombinant adenoassociated viral (rAAV vectors may provide powerful tools to develop new, efficient therapeutic options against these tumors. In the present study, we tested the hypothesis that rAAV is adapted for a stable and safe delivery of foreign sequences in human chondrosarcoma tissue by transducing primary human chondrosarcoma cells in vitro and in situ with different reporter genes (E. coli lacZ, firefly luc, Discosoma sp. RFP. The effects of rAAV administration upon cell survival and metabolic activities were also evaluated to monitor possibly detrimental effects of the gene transfer method. Remarkably, we provide evidence that efficient and prolonged expression of transgene sequences via rAAV can be safely achieved in all the systems investigated, demonstrating the potential of the approach of direct application of therapeutic gene vectors as a means to treat chondrosarcoma.

'Safe', yet violent? Women's experiences with obstetric violence during hospital births in rural Northeast India.

Science.gov (United States)

Chattopadhyay, Sreeparna; Mishra, Arima; Jacob, Suraj

2017-11-03

The majority of maternal health interventions in India focus on increasing institutional deliveries to reduce maternal mortality, typically by incentivising village health workers to register births and making conditional cash transfers to mothers for hospital births. Based on over 15 months of ethnographically informed fieldwork conducted between 2015 and 2017 in rural Assam, the Indian state with the highest recorded rate of maternal deaths, we find that while there has been an expansion in institutional deliveries, the experience of childbirth in government facilities is characterised by obstetric violence. Poor and indigenous women who disproportionately use state facilities report both tangible and symbolic violence including iatrogenic procedures such as episiotomies, in some instances done without anaesthesia, improper pelvic examinations, beating and verbal abuse during labour, with sometimes the shouting directed at accompanying relatives. While the expansion of institutional deliveries and access to emergency obstetric care is likely to reduce maternal mortality, in the absence of humane care during labour, institutional deliveries will continue to be characterised by the paradox of "safe" births (defined as simply reducing maternal deaths) and the deployment of violent practices during labour, underscoring the unequal and complex relationship between the bodies of the poor and reproductive governance.

Rural and Urban Differences in Vocational Rehabilitation Case Mix, Delivery Practices, and Employment Outcomes

Science.gov (United States)

Ipsen, Catherine; Swicegood, Grant

2015-01-01

Purpose: To examine rural and urban differences in Vocational Rehabilitation (VR) case mix, delivery practices, and employment outcomes. Methods: Rehabilitation Services Administration 911 (RSA-911) case data do not include location indicators that allow for rural analyses. We compiled RSA-911 data with county and ZIP code information from 47 VR…

Karate: Keep It Safe.

Science.gov (United States)

Jordan, David

1981-01-01

Safety guidelines for each phase of a karate practice session are presented to provide an accident-free and safe environment for teaching karate in a physical education or traditional karate training program. (JMF)

Stoppage - Vat Return and Accounting Practice in Re-Delivery of a Delivery Subject to Stoppage

Directory of Open Access Journals (Sweden)

Ahmet Yanık

2016-12-01

Full Text Available Value Added Tax (VAT is calculated based on the goods and service delivery costs realized by the corporations. Unless this VAT is subject to stoppage, seller takes the VAT from the purchaser in delivery of goods or services and then the corporate pays this amount to the tax office or sets off through the VAT he paid for his service or goods procurement. However, in some cases, Ministry of Finance holds not those providing the delivery or service but those purchasing or procuring the goods or services responsible partly or fully for the tax calculated based on the delivery or service fee. The purpose of this paper is to reveal VAT stoppage, accounting entries with regards to the corporation accepting the delivery and re-delivering it, VAT set off and VAT return in the re-delivery of a delivery subject to stoppage pursuant to General Communiqué of VAT Serial No 117

Creating Safe Spaces for Music Learning

Science.gov (United States)

Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

2014-01-01

This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

Ethical issues in cesarean delivery.

Science.gov (United States)

Chervenak, Frank A; McCullough, Laurence B

2017-08-01

Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.

Safe operation of critical assemblies and research reactors

Energy Technology Data Exchange (ETDEWEB)

NONE

1960-09-15

Some countries have accumulated considerable experience in the operation of these reactors and have in the process developed safe practices. On the other hand, other countries which have recently acquired, or will soon acquire, such reactors do not have sufficient background of experience with them to have developed full knowledge regarding their safe operation. In this situation, the International Atomic Energy Agency has considered that it would be useful to make available to all its Member States a set of recommendations on the safe operation of these reactors, based on the accumulated experience and best practices. The Director General accordingly nominated a Pane Ion Safe Operation of Critical Assemblies and Research Reactors to assist the Agency's Secretariat in drafting such recommendations

Turning theory into practice: the development of modern transdermal drug delivery systems and future trends.

Science.gov (United States)

Perumal, O; Murthy, S N; Kalia, Y N

2013-01-01

Despite its remarkable barrier function, the skin remains an attractive site for systemic drug delivery given its easy accessibility, large surface area and the possibility to bypass the gastrointestinal tract and the liver and so modify drug absorption kinetics. The pioneering work of Scheuplein, Higuchi and others in the 1960s helped to explain the processes involved in passive percutaneous absorption and led to the development of mathematical models to describe transdermal drug delivery. The intervening years have seen these theories turned to practice and a significant number of transdermal systems are now available including some that employ active drug delivery. This review briefly discusses the evolution of transdermal therapeutic systems over the years and the potential of newer transdermal technologies to deliver hydrophilic drugs and macromolecules through the skin. © 2013 S. Karger AG, Basel.

Reliability and Validity of a Questionnaire to Measure Consumer Knowledge regarding Safe Practices to Prevent Microbiological Contamination in Restaurants

Science.gov (United States)

Uggioni, Paula Lazzarin; Salay, Elisabette

2013-01-01

Objective: The objective of this study was to develop a validated and reliable questionnaire to measure consumer knowledge regarding safe practices to prevent microbiological contamination in restaurants and commercial kitchens. Methods: Non-probabilistic samples of individuals were interviewed in the city of Campinas, Brazil. Questionnaire items…

An Automated Safe-to-Mate (ASTM) Tester

Science.gov (United States)

Nguyen, Phuc; Scott, Michelle; Leung, Alan; Lin, Michael; Johnson, Thomas

2013-01-01

Safe-to-mate testing is a common hardware safety practice where impedance measurements are made on unpowered hardware to verify isolation, continuity, or impedance between pins of an interface connector. A computer-based instrumentation solution has been developed to resolve issues. The ASTM is connected to the circuit under test, and can then quickly, safely, and reliably safe-to-mate the entire connector, or even multiple connectors, at the same time.

Safe injections and waste management at a Sub-Saharan regional ...

African Journals Online (AJOL)

Objective: To assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in Northern Tanzania. Design: A cross sectional descriptive study with additional observations was conducted to assess the knowledge and practice of safe injections and ...

Operative vaginal deliveries in Zaria, Nigeria

African Journals Online (AJOL)

2009-10-05

Oct 5, 2009 ... were analyzed with respect to mode of delivery, indication for ... Making these procedures safer will improve safe motherhood in settings where there are performed. ..... training should not use vacuum extraction in real patients ...

siRNA delivery with lipid-based systems

DEFF Research Database (Denmark)

Foged, Camilla

2012-01-01

A key hurdle for the further development of RNA interference (RNAi) therapeutics like small interfering RNA (siRNA) is their safe and effective delivery. Lipids are promising and versatile carriers because they are based on Nature's own building blocks and can be provided with properties which......RNA into more hydrophobic lipoplexes, which promote passage of the siRNA across cellular membrane barriers, especially when lipids are added that facilitate membrane fusion. Despite these attractive features, siRNA delivery vehicles are facing a number of challenges such as the limited delivery efficiency...

Code of practice for the control and safe handling of radioactive sources used for therapeutic purposes (1988)

International Nuclear Information System (INIS)

1988-01-01

This Code is intended as a guide to safe practices in the use of sealed and unsealed radioactive sources and in the management of patients being treated with them. It covers the procedures for the handling, preparation and use of radioactive sources, precautions to be taken for patients undergoing treatment, storage and transport of radioactive sources within a hospital or clinic, and routine testing of sealed sources [fr

Feeling safe during an inpatient hospitalization: a concept analysis.

Science.gov (United States)

Mollon, Deene

2014-08-01

This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

The SafeBoosC Phase II Randomised Clinical Trial

DEFF Research Database (Denmark)

Pellicer, Adelina; Greisen, Gorm; Benders, Manon

2013-01-01

Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rStO2) reflects venous oxygen saturation. If cerebral metabolism is stable, rStO2 can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises that the bur...

Drug delivery and formulations.

Science.gov (United States)

Breitkreutz, Jörg; Boos, Joachim

2011-01-01

Paediatric drug delivery is a major challenge in drug development. Because of the heterogeneous nature of the patient group, ranging from newborns to adolescents, there is a need to use appropriate excipients, drug dosage forms and delivery devices for different age groups. So far, there is a lack of suitable and safe drug formulations for children, especially for the very young and seriously ill patients. The new EU legislation will enforce paediatric clinical trials and drug development. Current advances in paediatric drug delivery include interesting new concepts such as fast-dissolving drug formulations, including orodispersible tablets and oral thin strips (buccal wafers), and multiparticulate dosage forms based on mini-tabletting or pelletization technologies. Parenteral administration is likely to remain the first choice for children in the neonatal period and for emergency cases. Alternative routes of administration include transdermal, pulmonary and nasal drug delivery systems. A few products are already available on the market, but others still need further investigations and clinical proof of concept.

The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

Science.gov (United States)

Checkland, Kath; Harrison, Stephen

2010-01-01

In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

Amino acid-substituted gemini surfactant-based nanoparticles as safe and versatile gene delivery agents.

Science.gov (United States)

Singh, Jagbir; Yang, Peng; Michel, Deborah; Verrall, Ronald E; Foldvari, Marianna; Badea, Ildiko

2011-05-01

Gene based therapy represents an important advance in the treatment of diseases that heretofore have had either no treatment or cure. To capitalize on the true potential of gene therapy, there is a need to develop better delivery systems that can protect these therapeutic biomolecules and deliver them safely to the target sites. Recently, we have designed and developed a series of novel amino acid-substituted gemini surfactants with the general chemical formula C(12)H(25) (CH(3))(2)N(+)-(CH(2))(3)-N(AA)-(CH(2))(3)-N(+) (CH(3))(2)-C(12)H(25) (AA= glycine, lysine, glycyl-lysine and, lysyl-lysine). These compounds were synthesized and tested in rabbit epithelial cells using a model plasmid and a helper lipid. Plasmid/gemini/lipid (P/G/L) nanoparticles formulated using these novel compounds achieved higher gene expression than the nanoparticles containing the parent unsubstituted compound. In this study, we evaluated the cytotoxicity of P/G/L nanoparticles and explored the relationship between transfection efficiency/toxicity and their physicochemical characteristics (such as size, binding properties, etc.). An overall low toxicity is observed for all complexes with no significant difference among substituted and unsubstituted compounds. An interesting result revealed by the dye exclusion assay suggests a more balanced protection of the DNA by the glycine and glycyl-lysine substituted compounds. Thus, the higher transfection efficiency is attributed to the greater biocompatibility and flexibility of the amino acid/peptide-substituted gemini surfactants and demonstrates the feasibility of using amino acid-substituted gemini surfactants as gene carriers for the treatment of diseases affecting epithelial tissue.

Oral delivery of peptides and proteins using lipid-based drug delivery systems

DEFF Research Database (Denmark)

Li, Ping; Nielsen, Hanne Mørck; Müllertz, Anette

2012-01-01

INTRODUCTION: In order to successfully develop lipid-based drug delivery systems (DDS) for oral administration of peptides and proteins, it is important to gain an understanding of the colloid structures formed by these DDS, the mode of peptide and protein incorporation as well as the mechanism...... by which intestinal absorption of peptides and proteins is promoted. AREAS COVERED: The present paper reviews the literature on lipid-based DDS, employed for oral delivery of peptides and proteins and highlights the mechanisms by which the different lipid-based carriers are expected to overcome the two...... and proteins. EXPERT OPINION: Lipid-based DDS are safe and suitable for oral delivery of peptides and proteins. Significant progress has been made in this area with several technologies on clinical trials. However, a better understanding of the mechanism of action in vivo is needed in order to improve...

Transdermal drug delivery

Science.gov (United States)

Prausnitz, Mark R.; Langer, Robert

2009-01-01

Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, non-cavitational ultrasound and iontophoresis have also resulted in clinical products; the ability of iontophoresis to control delivery rates in real time provides added functionality. Third-generation delivery systems target their effects to skin’s barrier layer of stratum corneum using microneedles, thermal ablation, microdermabrasion, electroporation and cavitational ultrasound. Microneedles and thermal ablation are currently progressing through clinical trials for delivery of macromolecules and vaccines, such as insulin, parathyroid hormone and influenza vaccine. Using these novel second- and third-generation enhancement strategies, transdermal delivery is poised to significantly increase impact on medicine. PMID:18997767

Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

Directory of Open Access Journals (Sweden)

Jahn Albrecht

2010-04-01

Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

Novel electric power-driven hydrodynamic injection system for gene delivery: safety and efficacy of human factor IX delivery in rats.

Science.gov (United States)

Yokoo, T; Kamimura, K; Suda, T; Kanefuji, T; Oda, M; Zhang, G; Liu, D; Aoyagi, Y

2013-08-01

The development of a safe and reproducible gene delivery system is an essential step toward the clinical application of the hydrodynamic gene delivery (HGD) method. For this purpose, we have developed a novel electric power-driven injection system called the HydroJector-EM, which can replicate various time-pressure curves preloaded into the computer program before injection. The assessment of the reproducibility and safety of gene delivery system in vitro and in vivo demonstrated the precise replication of intravascular time-pressure curves and the reproducibility of gene delivery efficiency. The highest level of luciferase expression (272 pg luciferase per mg of proteins) was achieved safely using the time-pressure curve, which reaches 30 mm Hg in 10 s among various curves tested. Using this curve, the sustained expression of a therapeutic level of human factor IX protein (>500 ng ml(-1)) was maintained for 2 months after the HGD of the pBS-HCRHP-FIXIA plasmid. Other than a transient increase in liver enzymes that recovered in a few days, no adverse events were seen in rats. These results confirm the effectiveness of the HydroJector-EM for reproducible gene delivery and demonstrate that long-term therapeutic gene expression can be achieved by automatic computer-controlled hydrodynamic injection that can be performed by anyone.

Elaboration of Safe Community Assessment System

Directory of Open Access Journals (Sweden)

Birutė Mikulskienė

2013-08-01

Full Text Available The paper aims to design an assessment system to monitor and evaluate safety parameters and administrative efforts with the purpose to increase safety in municipalities. The safety monitoring system considered is to be the most important tool for creation and development of safe communities in Lithuania. Several methods were applied to achieve this purpose. In order to determine the role of local government in ensuring the safety of people, property and environment at the local level of a meta-analysis of research reports, the Lithuanian national legislation, strategic planning documents of the state and local government were carried out. Analysis of statistical data, structural analysis, comparative analysis and synthesis methods were used while investigating the areas of safety uncertainty, risk groups, identifying safety risk factors, determining their relationship, and creating a safe community assessment system. A safe community assessment system, which consists of two types of criteria, has been elaborated. The assessment system is based on the multi-level criteria for safety monitoring and the multi-level criteria for the evaluation of municipal activities in the field of building safety. Links between the criteria, peculiarities of their application and advantages in the process of safe community creation and development are analyzed. Design and implementation of the safe community assessment system is one of the most important stages to implement the idea of safe communities. The proposed system integrates a variety of risk areas, the safety achievement criteria are linked to the criteria used in the strategic planning. Periodic assessment of the safety situation using the proposed system ensures possibility to monitor current local safety conditions and assess the changes and the trends. A safe community assessment system is proposed to be used as a tool to unified municipalities safety comprehensiveness and compare safety level in

Elaboration of Safe Community Assessment System

Directory of Open Access Journals (Sweden)

Algirdas Astrauskas

2011-12-01

Full Text Available The paper aims to design an assessment system to monitor and evaluate safety parameters and administrative efforts with the purpose to increase safety in municipalities. The safety monitoring system considered is to be the most important tool for creation anddevelopment of safe communities in Lithuania. Several methods were applied to achieve this purpose. In order to determine the role of local government in ensuring the safety of people, property and environment at the local level of a meta-analysis of research reports,the Lithuanian national legislation, strategic planning documents of the state and local government were carried out. Analysis of statistical data, structural analysis, comparative analysis and synthesis methods were used while investigating the areas of safety uncertainty, risk groups, identifying safety risk factors, determining their relationship, and creating a safe community assessment system.A safe community assessment system, which consists of two types of criteria, has been elaborated. The assessment system is based on the multi-level criteria for safety monitoring and the multi-level criteria for the evaluation of municipal activities in the field of building safety. Links between the criteria, peculiarities of their application and advantages in the process of safe community creation and development are analyzed.Design and implementation of the safe community assessment system is one of the most important stages to implement the idea of safe communities. The proposed system integrates a variety of risk areas, the safety achievement criteria are linked to the criteria used in thestrategic planning. Periodic assessment of the safety situation using the proposed system ensures possibility to monitor current local safety conditions and assess the changes and the trends. A safe community assessment system is proposed to be used as a tool to unified municipalities safety comprehensiveness and compare safety level in

Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach.

Science.gov (United States)

Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

2018-04-14

Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market.

Liposomal drug delivery system from laboratory to clinic

Directory of Open Access Journals (Sweden)

Kshirsagar N

2005-01-01

Full Text Available The main objective of drug delivery systems is to deliver a drug effectively, specifically to the site of action and to achieve greater efficacy and minimise the toxic effects compared to conventional drugs. Amongst various carrier systems, liposomes have generated a great interest because of their versatility. Liposomes are vesicular concentric bilayered structures, which are biocompatible, biodegradable and nonimmumnogenic. They can control the delivery of drugs by targeting the drug to the site of action or by site avoidance drug delivery or by prolonged circulation of drugs. Amphotericin B (Amp B remains the drug of choice in most systemic mycoses and also as a second line treatment for Kala azar. However, its toxic effects often limit its use. Although the liposome delivery system has been tried for several drugs, only a few have been used in patients due to the slow development of necessary large-scale pharmaceutical procedures. This paper reviews the development of the technique for liposomal Amphotericin B (L-Amp-LRC-1, FungisomeTM drug delivery system in our laboratory in collaboration with the department of Biochemistry, Delhi University in India and proving the safety and efficacy of this preparation in clinical practice. It also attempts to compare the efficacy and benefits of our product for Indian patients with those of similar products and it includes facts from the publications that flowed from our work. As compared to conventional Amp B, Fungisome is infused over a much shorter period requiring a smaller volume and no premedication. It was found to be safe in patients who had developed serious unacceptable toxicity with conventional Amp B. In renal transplant patients, Fungisome did not produce any nephrotoxicity. Fungisome is effective in fungal infections resistant to fluconazole, conventional Amp B and in virgin and resistant cases of visceral leishmaniasis. The cost of any drug is of great significance, especially in India

Synthetic sustained gene delivery systems.

Science.gov (United States)

Agarwal, Ankit; Mallapragada, Surya K

2008-01-01

Gene therapy today is hampered by the need of a safe and efficient gene delivery system that can provide a sustained therapeutic effect without cytotoxicity or unwanted immune responses. Bolus gene delivery in solution results in the loss of delivered factors via lymphatic system and may cause undesired effects by the escape of bioactive molecules to distant sites. Controlled gene delivery systems, acting as localized depot of genes, provide an extended sustained release of genes, giving prolonged maintenance of the therapeutic level of encoded proteins. They also limit the DNA degradation in the nuclease rich extra-cellular environment. While attempts have been made to adapt existing controlled drug delivery technologies, more novel approaches are being investigated for controlled gene delivery. DNA encapsulated in nano/micro spheres of polymers have been administered systemically/orally to be taken up by the targeted tissues and provide sustained release once internalized. Alternatively, DNA entrapped in hydrogels or scaffolds have been injected/implanted in tissues/cavities as platforms for gene delivery. The present review examines these different modalities for sustained delivery of viral and non-viral gene-delivery vectors. Design parameters and release mechanisms of different systems made with synthetic or natural polymers are presented along with their prospective applications and opportunities for continuous development.

Nascer no Brasil: the presence of a companion favors the use of best practices in delivery care in the South region of Brazil.

Science.gov (United States)

Monguilhott, Juliana Jacques da Costa; Brüggemann, Odaléa Maria; Freitas, Paulo Fontoura; d'Orsi, Eleonora

2018-01-01

OBJECTIVE To analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil. METHODS This is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%. RESULTS Most women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49). CONCLUSIONS In the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted.

Effectiveness of community based Safe Motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania.

Science.gov (United States)

Mushi, Declare; Mpembeni, Rose; Jahn, Albrecht

2010-04-01

In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

Patients' evaluations of patient safety in English general practices: a cross-sectional study.

Science.gov (United States)

Ricci-Cabello, Ignacio; Marsden, Kate S; Avery, Anthony J; Bell, Brian G; Kadam, Umesh T; Reeves, David; Slight, Sarah P; Perryman, Katherine; Barnett, Jane; Litchfield, Ian; Thomas, Sally; Campbell, Stephen M; Doos, Lucy; Esmail, Aneez; Valderas, Jose M

2017-07-01

Description of safety problems and harm in general practices has previously relied on information from health professionals, with scarce attention paid to experiences of patients. To examine patient-reported experiences and outcomes of patient safety in primary care. Cross-sectional study in 45 general practices across five regions in the north, centre, and south of England. A version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire was sent to a random sample of 6736 patients. Main outcome measures included 'practice activation' (what a practice does to create a safe environment); 'patient activation' (how proactive are patients in ensuring safe healthcare delivery); 'experiences of safety events' (safety errors); 'outcomes of safety' (harm); and 'overall perception of safety' (how safe patients rate their practice). Questionnaires were returned by 1244 patients (18.4%). Scores were high for 'practice activation' (mean [standard error] = 80.4 out of 100 [2.0]) and low for 'patient activation' (26.3 out of 100 [2.6]). Of the patients, 45% reported experiencing at least one safety problem in the previous 12 months, mostly related to appointments (33%), diagnosis (17%), patient provider communication (15%), and coordination between providers (14%). Twenty-three per cent of the responders reported some degree of harm in the previous 12 months. The overall assessment of level of safety of practices was generally high (86.0 out of 100 [16.8]). Priority areas for patient safety improvement in general practices in England include appointments, diagnosis, communication, coordination, and patient activation. © British Journal of General Practice 2017.

The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

Science.gov (United States)

Vaida, Allen J

2015-06-01

This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

Future of human Chlamydia vaccine: potential of self-adjuvanting biodegradable nanoparticles as safe vaccine delivery vehicles.

Science.gov (United States)

Sahu, Rajnish; Verma, Richa; Dixit, Saurabh; Igietseme, Joseph U; Black, Carolyn M; Duncan, Skyla; Singh, Shree R; Dennis, Vida A

2018-03-01

There is a persisting global burden and considerable public health challenge by the plethora of ocular, genital and respiratory diseases caused by members of the Gram-negative bacteria of the genus Chlamydia. The major diseases are conjunctivitis and blinding trachoma, non-gonococcal urethritis, cervicitis, pelvic inflammatory disease, ectopic pregnancy, tubal factor infertility, and interstitial pneumonia. The failures in screening and other prevention programs led to the current medical opinion that an efficacious prophylactic vaccine is the best approach to protect humans from chlamydial infections. Unfortunately, there is no human Chlamydia vaccine despite successful veterinary vaccines. A major challenge has been the effective delivery of vaccine antigens to induce safe and effective immune effectors to confer long-term protective immunity. The dawn of the era of biodegradable polymeric nanoparticles and the adjuvanted derivatives may accelerate the realization of the dream of human vaccine in the foreseeable future. Areas covered: This review focuses on the current status of human chlamydial vaccine research, specifically the potential of biodegradable polymeric nanovaccines to provide efficacious Chlamydia vaccines in the near future. Expert commentary: The safety of biodegradable polymeric nanoparticles-based experimental vaccines with or without adjuvants and the array of available chlamydial vaccine candidates would suggest that clinical trials in humans may be imminent. Also, the promising results from vaccine testing in animal models could lead to human vaccines against trachoma and reproductive diseases simultaneously.

Be-safe travel, a web-based geographic application to explore safe-route in an area

Science.gov (United States)

Utamima, Amalia; Djunaidy, Arif

2017-08-01

In large cities in developing countries, the various forms of criminality are often found. For instance, the most prominent crimes in Surabaya, Indonesia is 3C, that is theft with violence (curas), theft by weighting (curat), and motor vehicle theft (curanmor). 3C case most often occurs on the highway and residential areas. Therefore, new entrants in an area should be aware of these kind of crimes. Route Planners System or route planning system such as Google Maps only consider the shortest distance in the calculation of the optimal route. The selection of the optimal path in this study not only consider the shortest distance, but also involves other factors, namely the security level. This research considers at the need for an application to recommend the safest road to be passed by the vehicle passengers while drive an area. This research propose Be-Safe Travel, a web-based application using Google API that can be accessed by people who like to drive in an area, but still lack of knowledge of the pathways which are safe from crime. Be-Safe Travel is not only useful for the new entrants, but also useful for delivery courier of valuables goods to go through the safest streets.

Bribes for Faster Delivery

OpenAIRE

Sanyal, Amal

2000-01-01

The paper models the practice of charging bribes for faster delivery of essential services in third world countries. It then examines the possibility of curbing corruption by supervision, and secondly, by introducing competition among delivery agents. It is argued that a supervisory solution eludes the problem because no hard evidence of the reduction of corruption can be established for this type of offenses. It is also shown that using more than one supplier cannot eliminate the practice, a...

Advanced practice nurses: starting an independent practice.

Science.gov (United States)

Lambert, V A; Lambert, C E

1996-01-01

Independent or private practice is the delivery of nursing services provided by nurses over which nurses have full control. With a changing healthcare system, nurses are in a prime position to negotiate the delivery of appropriate, acceptable, and cost-effective health care as independent practitioners. This article addresses the mission and goals of independent practice, community need, business structure of the practice, housing the practice, legal considerations, financing the practice, marketing issues, clientele, record keeping, and reimbursement.

MO-D-BRB-02: SBRT Treatment Planning and Delivery

International Nuclear Information System (INIS)

Yang, Y.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-02: SBRT Treatment Planning and Delivery

Energy Technology Data Exchange (ETDEWEB)

Yang, Y. [Stanford University Cancer Center (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

2017-09-01

To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary

Dendrimers as Carriers for siRNA Delivery and Gene Silencing: A Review

Directory of Open Access Journals (Sweden)

Jiangyu Wu

2013-01-01

Full Text Available RNA interference (RNAi was first literaturally reported in 1998 and has become rapidly a promising tool for therapeutic applications in gene therapy. In a typical RNAi process, small interfering RNAs (siRNA are used to specifically downregulate the expression of the targeted gene, known as the term “gene silencing.” One key point for successful gene silencing is to employ a safe and efficient siRNA delivery system. In this context, dendrimers are emerging as potential nonviral vectors to deliver siRNA for RNAi purpose. Dendrimers have attracted intense interest since their emanating research in the 1980s and are extensively studied as efficient DNA delivery vectors in gene transfer applications, due to their unique features based on the well-defined and multivalent structures. Knowing that DNA and RNA possess a similar structure in terms of nucleic acid framework and the electronegative nature, one can also use the excellent DNA delivery properties of dendrimers to develop effective siRNA delivery systems. In this review, the development of dendrimer-based siRNA delivery vectors is summarized, focusing on the vector features (siRNA delivery efficiency, cytotoxicity, etc. of different types of dendrimers and the related investigations on structure-activity relationship to promote safe and efficient siRNA delivery system.

Dendrimers as Carriers for siRNA Delivery and Gene Silencing: A Review

Science.gov (United States)

Huang, Weizhe; He, Ziying

2013-01-01

RNA interference (RNAi) was first literaturally reported in 1998 and has become rapidly a promising tool for therapeutic applications in gene therapy. In a typical RNAi process, small interfering RNAs (siRNA) are used to specifically downregulate the expression of the targeted gene, known as the term “gene silencing.” One key point for successful gene silencing is to employ a safe and efficient siRNA delivery system. In this context, dendrimers are emerging as potential nonviral vectors to deliver siRNA for RNAi purpose. Dendrimers have attracted intense interest since their emanating research in the 1980s and are extensively studied as efficient DNA delivery vectors in gene transfer applications, due to their unique features based on the well-defined and multivalent structures. Knowing that DNA and RNA possess a similar structure in terms of nucleic acid framework and the electronegative nature, one can also use the excellent DNA delivery properties of dendrimers to develop effective siRNA delivery systems. In this review, the development of dendrimer-based siRNA delivery vectors is summarized, focusing on the vector features (siRNA delivery efficiency, cytotoxicity, etc.) of different types of dendrimers and the related investigations on structure-activity relationship to promote safe and efficient siRNA delivery system. PMID:24288498

Project delivery system (PDS)

CERN Document Server

2001-01-01

As business environments become increasingly competitive, companies seek more comprehensive solutions to the delivery of their projects. "Project Delivery System: Fourth Edition" describes the process-driven project delivery systems which incorporates the best practices from Total Quality and is aligned with the Project Management Institute and ISO Quality Standards is the means by which projects are consistently and efficiently planned, executed and completed to the satisfaction of clients and customers.

Safe injection practices for administration of propofol.

Science.gov (United States)

King, Cecil A; Ogg, Mary

2012-03-01

Sepsis and postoperative infection can occur as a result of unsafe practices in the administration of propofol and other injectable medications. Investigations of infection outbreaks have revealed the causes to be related to bacterial growth in or contamination of propofol and unsafe medication practices, including reuse of syringes on multiple patients, use of single-use medication vials for multiple patients, and failure to practice aseptic technique and adhere to infection control practices. Surveys conducted by AORN and other researchers have provided additional information on perioperative practices related to injectable medications. In 2009, the US Food and Drug Administration and the Centers for Disease Control and Prevention convened a group of clinicians to gain a better understanding of the issues related to infection outbreaks and injectable medications. The meeting participants proposed collecting data to persuade clinicians to adopt new practices, developing guiding principles for propofol use, and describing propofol-specific, site-specific, and practitioner-specific injection techniques. AORN provides resources to help perioperative nurses reduce the incidence of postoperative infection related to medication administration. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Sustained subconjunctival protein delivery using a thermosetting gel delivery system.

Science.gov (United States)

Rieke, Erin R; Amaral, Juan; Becerra, S Patricia; Lutz, Robert J

2010-02-01

An effective treatment modality for posterior eye diseases would provide prolonged delivery of therapeutic agents, including macromolecules, to eye tissues using a safe and minimally invasive method. The goal of this study was to assess the ability of a thermosetting gel to deliver a fluorescently labeled protein, Alexa 647 ovalbumin, to the choroid and retina of rats following a single subconjunctival injection of the gel. Additional experiments were performed to compare in vitro to in vivo ovalbumin release rates from the gel. The ovalbumin content of the eye tissues was monitored by spectrophotometric assays of tissue extracts of Alexa 647 ovalbumin from dissected sclera, choroid, and retina at time points ranging from 2 h to 14 days. At the same time points, fluorescence microscopy images of tissue samples were also obtained. Measurement of intact ovalbumin was verified by LDS-PAGE analysis of the tissue extract solutions. In vitro release of Alexa 488 ovalbumin into 37 degrees C PBS solutions from ovalbumin-loaded gel pellets was also monitored over time by spectrophotometric assay. In vivo ovalbumin release rates were determined by measurement of residual ovalbumin extracted from gel pellets removed from rat eyes at various time intervals. Our results indicate that ovalbumin concentrations can be maintained at measurable levels in the sclera, choroid, and retina of rats for up to 14 days using the thermosetting gel delivery system. The concentration of ovalbumin exhibited a gradient that decreased from sclera to choroid and to retina. The in vitro release rate profiles were similar to the in vivo release profiles. Our findings suggest that the thermosetting gel system may be a feasible method for safe and convenient sustained delivery of proteins to choroidal and retinal tissue in the posterior segments of the eye.

Oral delivery of peptides and proteins using lipid-based drug delivery systems.

Science.gov (United States)

Li, Ping; Nielsen, Hanne Mørck; Müllertz, Anette

2012-10-01

In order to successfully develop lipid-based drug delivery systems (DDS) for oral administration of peptides and proteins, it is important to gain an understanding of the colloid structures formed by these DDS, the mode of peptide and protein incorporation as well as the mechanism by which intestinal absorption of peptides and proteins is promoted. The present paper reviews the literature on lipid-based DDS, employed for oral delivery of peptides and proteins and highlights the mechanisms by which the different lipid-based carriers are expected to overcome the two most important barriers (extensive enzymatic degradation and poor transmucosal permeability). This paper also gives a clear-cut idea about advantages and drawbacks of using different lipidic colloidal carriers ((micro)emulsions, solid lipid core particles and liposomes) for oral delivery of peptides and proteins. Lipid-based DDS are safe and suitable for oral delivery of peptides and proteins. Significant progress has been made in this area with several technologies on clinical trials. However, a better understanding of the mechanism of action in vivo is needed in order to improve the design and development of lipid-based DDS with the desired bioavailability and therapeutic profile.

Date fruit consumption at term: Effect on length of gestation, labour and delivery.

Science.gov (United States)

Razali, Nuguelis; Mohd Nahwari, Siti Hayati; Sulaiman, Sofiah; Hassan, Jamiyah

2017-07-01

Labour induction and augmentation with Prostaglandin and Oxytocin are well established as standard practice worldwide. They are safe when used judiciously, but may be associated with maternal and neonatal morbidities. Other safer alternatives have been studied including dates consumption during late pregnancy with various outcomes. The aim of this randomised controlled trial was to investigate the effect of date fruit consumption during late pregnancy on the onset of labour and need for induction or augmentation of labour. A total of 154 nulliparous women with an uncomplicated singleton pregnancy were randomly allocated to either dates-consumer (77) or control group (77). The women in the dates-consumer group had significantly less need for augmentation of labour and longer intervention to delivery interval. There was no significant difference in the onset of spontaneous labour. Dates consumption reduces the need for labour augmentation but does not expedite the onset of labour. Impact statement • Dates fruit consumption during late pregnancy has been shown to positively affect the outcome of labour and delivery. In this study, date consumption reduced the need for labour augmentation with oxytocin but did not expedite the onset of labour. Therefore, dates consumption in late pregnancy is a safe supplement to be considered as it reduced the need for labour intervention without any adverse effect on the mother and child. This further supports the finding of earlier studies.

Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.

Science.gov (United States)

Healey, Frances; Lowe, Derek; Darowski, Adam; Windsor, Julie; Treml, Jonathan; Byrne, Lisa; Husk, Janet; Phipps, Jill

2014-07-01

inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. : data on delivery of falls prevention processes were collected at baseline and for 18 months from nine FallSafe units and nine control units. Data on falls were collected from local risk management systems for 24 months, and data on under-reporting through staff surveys. : in FallSafe units, delivery of seven care bundle components significantly improved; most improvements were sustained after active project support was withdrawn. Twelve-month moving average of reported fall rates showed a consistent downward trend in FallSafe units but not controls. Significant reductions in reported fall rate were found in FallSafe units (adjusted rate ratio (ARR) 0.75, 95% confidence interval (CI) 0.68-0.84 P control units (ARR 0.91, 95% CI 0.81-1.03 P = 0.13). No significant changes in injurious fall rate were found in FallSafe units (ARR 0.86, 95% CI 0.71-1.03 P = 0.11), or controls (ARR 0.88, 95% CI 0.72-1.08 P = 0.13). In FallSafe units, staff certain falls had been reported increased from 60 to 77%. : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Making birthing safe for Pakistan women: a cluster randomized trial

Directory of Open Access Journals (Sweden)

Khan Muhammad

2012-07-01

Full Text Available Abstract Background Two out of three neonatal deaths occur in just 10 countries and Pakistan stands third among them. Maternal mortality is also high with most deaths occurring during labor, birth, and first few hours after birth. Enhanced access and utilization of skilled delivery and emergency obstetric care is the demonstrated strategy in reducing maternal and neonatal mortality. This trial aims to compare reduction in neonate mortality and utilization of available safe birthing and Emergency Obstetric and Neonatal Care services among pregnant mothers receiving ‘structured birth planning’, and/or ‘transport facilitation’ compared to routine care. Methods A pragmatic cluster randomized trial, with qualitative and economic studies, will be conducted in Jhang, Chiniot and Khanewal districts of Punjab, Pakistan, from February 2011 to May 2013. At least 29,295 pregnancies will be registered in the three arms, seven clusters per arm; 1 structured birth planning and travel facilitation, 2 structured birth planning, and 3 control arm. Trial will be conducted through the Lady Health Worker program. Main outcomes are difference in neonatal mortality and service utilization; maternal mortality being the secondary outcome. Cluster level analysis will be done according to intention-to-treat. Discussion A nationwide network of about 100,000 lady health workers is already involved in antenatal and postnatal care of pregnant women. They also act as “gatekeepers” for the child birthing services. This gate keeping role mainly includes counseling and referral for skill birth attendance and travel arrangements for emergency obstetric care (if required. The review of current arrangements and practices show that the care delivery process needs enhancement to include adequate information provision as well as informed “decision” making and planned “action” by the pregnant women. The proposed three-year research is to develop, through national

Theory and in vivo application of electroporative gene delivery.

Science.gov (United States)

Somiari, S; Glasspool-Malone, J; Drabick, J J; Gilbert, R A; Heller, R; Jaroszeski, M J; Malone, R W

2000-09-01

Efficient and safe methods for delivering exogenous genetic material into tissues must be developed before the clinical potential of gene therapy will be realized. Recently, in vivo electroporation has emerged as a leading technology for developing nonviral gene therapies and nucleic acid vaccines (NAV). Electroporation (EP) involves the application of pulsed electric fields to cells to enhance cell permeability, resulting in exogenous polynucleotide transit across the cytoplasmic membrane. Similar pulsed electrical field treatments are employed in a wide range of biotechnological processes including in vitro EP, hybridoma production, development of transgenic animals, and clinical electrochemotherapy. Electroporative gene delivery studies benefit from well-developed literature that may be used to guide experimental design and interpretation. Both theory and experimental analysis predict that the critical parameters governing EP efficacy include cell size and field strength, duration, frequency, and total number of applied pulses. These parameters must be optimized for each tissue in order to maximize gene delivery while minimizing irreversible cell damage. By providing an overview of the theory and practice of electroporative gene transfer, this review intends to aid researchers that wish to employ the method for preclinical and translational gene therapy, NAV, and functional genomic research.

Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study

Directory of Open Access Journals (Sweden)

Georgiou Andrew

2009-11-01

Full Text Available Abstract Background Widespread adoption of information and communication technologies (ICT is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. Design A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. Discussion A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care

Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

Science.gov (United States)

Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

2009-11-08

Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider

European Model Code of safe practice in the storage and handling of petroleum products. Part I. Operations

Energy Technology Data Exchange (ETDEWEB)

1973-01-01

This safe practice code was prepared by a working group consisting of experts from 10 Western European countries. It consists of short guidelines and technical advice on general precautions, injuries and medical services, permits to work, fire prevention and fighting, jetties, pipework, storage tanks, static electricity, electrical equipment, road vehicles, tank cars, handling of bitumen products, liquefied petroleum gases, packed products and training of personnel. The code is supplemented by 10 appendices, including a suggested syllabus for a 2-day course on fire prevention and emergency action for managers of oil installations.

Current and emerging lipid-based systems for transdermal drug delivery.

Science.gov (United States)

Singla, Sumeet K; Sachdeva, Vishal

2015-01-01

Developing a transdermal drug delivery system is a challenging task considering the selective permeability of the skin and the physicochemical properties the drug must possess to permeate through the skin. Lipid-based drug delivery systems have contributed a great deal in this direction in the last few decades, and thereby have helped to expand the range of therapeutic molecules that can be delivered through the skin in a safe and effective manner. Additionally, vesicular delivery systems such as nanoparticles and emulsions have also played important roles in providing alternative novel approaches for drug delivery. In this article, we will discuss some of the current and future lipid-based systems for transdermal drug delivery along with the associated challenges.

Radiotherapy practice in an unregulated environment: Call for joint action

International Nuclear Information System (INIS)

Elegba, Sh.

2001-01-01

There are five radiotherapy centres and thousands of diagnostic x-ray units in Nigeria. There is a five-year old radiation protection decree, which is yet to be implemented. Consequently, radiotherapy and radio-diagnosis are practiced in the country without any form of regulatory guidelines backed by law. This paper is a call for the concerted effort of the WHO and the IAEA to persuade the Nigerian Government to establish the Nigerian Nuclear Regulatory Authority. This will ensure safe applications of atomic energy in the national heath delivery system. (author)

MicroRNA delivery for regenerative medicine.

Science.gov (United States)

Peng, Bo; Chen, Yongming; Leong, Kam W

2015-07-01

MicroRNA (miRNA) directs post-transcriptional regulation of a network of genes by targeting mRNA. Although relatively recent in development, many miRNAs direct differentiation of various stem cells including induced pluripotent stem cells (iPSCs), a major player in regenerative medicine. An effective and safe delivery of miRNA holds the key to translating miRNA technologies. Both viral and nonviral delivery systems have seen success in miRNA delivery, and each approach possesses advantages and disadvantages. A number of studies have demonstrated success in augmenting osteogenesis, improving cardiogenesis, and reducing fibrosis among many other tissue engineering applications. A scaffold-based approach with the possibility of local and sustained delivery of miRNA is particularly attractive since the physical cues provided by the scaffold may synergize with the biochemical cues induced by miRNA therapy. Herein, we first briefly cover the application of miRNA to direct stem cell fate via replacement and inhibition therapies, followed by the discussion of the promising viral and nonviral delivery systems. Next we present the unique advantages of a scaffold-based delivery in achieving lineage-specific differentiation and tissue development. Copyright © 2015 Elsevier B.V. All rights reserved.

Providing safe drinking water to 1.2 billion unserved people

Energy Technology Data Exchange (ETDEWEB)

Gadgil, Ashok J.; Derby, Elisabeth A.

2003-06-01

Despite substantial advances in the past 100 years in public health, technology and medicine, 20% of the world population, mostly comprised of the poor population segments in developing countries (DCs), still does not have access to safe drinking water. To reach the United Nations (UN) Millennium Goal of halving the number of people without access to safe water by 2015, the global community will need to provide an additional one billion urban residents and 600 million rural residents with safe water within the next twelve years. This paper examines current water treatment measures and implementation methods for delivery of safe drinking water, and offers suggestions for making progress towards the goal of providing a timely and equitable solution for safe water provision. For water treatment, based on the serious limitations of boiling water and chlorination, we suggest an approach based on filtration coupled with ultraviolet (UV) disinfection, combined with public education. Additionally, owing to the capacity limitations for non-governmental organizations (NGOs) to take on this task primarily on their own, we suggest a strategy based on financially sustainable models that include the private sector as well as NGOs.

Application of microencapsulation for the safe delivery of green tea polyphenols in food systems: Review and recent advances.

Science.gov (United States)

Massounga Bora, Awa Fanny; Ma, Shaojie; Li, Xiaodong; Liu, Lu

2018-03-01

Green tea has been associated with the prevention and reduction of a wide range of severe health conditions such as cancer, immune, and cardiovascular diseases. The health benefits associated with green tea consumption have been predominantly attributed to green tea polyphenols. The functional properties of green tea polyphenols are mainly anti-oxidative, antimutagenic, anticarcinogenic, anti-microbial, etc. These excellent properties have recently gained considerable attention in the food industry. However, their application is limited by their sensitivity to factors like temperature, light, pH, oxygen, etc. More, studies have reported the occurrence of unpleasant taste and color transfer during food processing. Lastly, the production of functional food requires to maintain the stability, bioactivity, and bioavailability of the active compounds. To tackle these obstacles, technological approaches like microencapsulation have been developed and applied for the formulation of green tea-enriched food products. The present review discusses the novelty in microencapsulation techniques for the safe delivery of green tea polyphenols in food matrices. After a literature on the green tea polyphenols composition, and their health attributes, the encapsulation methods and the coating materials are presented. The application of green tea encapsulates in food matrices as well as their effect on food functional and sensory properties are also discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Poly(3-hydroxybutyrate-co-R-3-hydroxyhexanoate) nanoparticles with polyethylenimine coat as simple, safe, and versatile vehicles for cell targeting

DEFF Research Database (Denmark)

Wu, Linping; Wang, Danyang; Parhamifar, Ladan

2014-01-01

A simple and highly safe poly(3-hydroxybutyrate-co-R-3-hydroxyhexanoate) nanoparticulate delivery system that targets different cell types is developed. A sub-cytotoxic level of polyethylenimine coat mediates universal cell targeting. Internalized nanoparticles traffic along endolysosomal compart...... compartments, endoplasmic reticulum and the Golgi complex. Nanoparticles have no detrimental effects on cell morphology and respiration.......A simple and highly safe poly(3-hydroxybutyrate-co-R-3-hydroxyhexanoate) nanoparticulate delivery system that targets different cell types is developed. A sub-cytotoxic level of polyethylenimine coat mediates universal cell targeting. Internalized nanoparticles traffic along endolysosomal...

Selecting a Dynamic Simulation Modeling Method for Health Care Delivery Research—Part 2: Report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force

NARCIS (Netherlands)

Marshall, Deborah A.; Burgos-Liz, Lina; IJzerman, Maarten Joost; Crown, William; Padula, William V.; Wong, Peter K.; Pasupathy, Kalyan S.; Higashi, Mitchell K.; Osgood, Nathaniel D.

2015-01-01

In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling

Implicit attitudes towards risky and safe driving

DEFF Research Database (Denmark)

Martinussen, Laila Marianne; Sømhovd, Mikael Julius; Møller, Mette

; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

Future of Automated Insulin Delivery Systems.

Science.gov (United States)

Castle, Jessica R; DeVries, J Hans; Kovatchev, Boris

2017-06-01

Advances in continuous glucose monitoring (CGM) have brought on a paradigm shift in the management of type 1 diabetes. These advances have enabled the automation of insulin delivery, where an algorithm determines the insulin delivery rate in response to the CGM values. There are multiple automated insulin delivery (AID) systems in development. A system that automates basal insulin delivery has already received Food and Drug Administration approval, and more systems are likely to follow. As the field of AID matures, future systems may incorporate additional hormones and/or multiple inputs, such as activity level. All AID systems are impacted by CGM accuracy and future CGM devices must be shown to be sufficiently accurate to be safely incorporated into AID. In this article, we summarize recent achievements in AID development, with a special emphasis on CGM sensor performance, and discuss the future of AID systems from the point of view of their input-output characteristics, form factor, and adaptability.

Ergonomics: safe patient handling and mobility.

Science.gov (United States)

Hallmark, Beth; Mechan, Patricia; Shores, Lynne

2015-03-01

This article reviews and investigates the issues surrounding ergonomics, with a specific focus on safe patient handling and mobility. The health care worker of today faces many challenges, one of which is related to the safety of patients. Safe patient handling and mobility is on the forefront of the movement to improve patient safety. This article reviews the risks associated with patient handling and mobility, and informs the reader of current evidence-based practice relevant to this area of care. Copyright © 2015 Elsevier Inc. All rights reserved.

A review of drug delivery systems based on nanotechnology and green chemistry: green nanomedicine.

Science.gov (United States)

Jahangirian, Hossein; Lemraski, Ensieh Ghasemian; Webster, Thomas J; Rafiee-Moghaddam, Roshanak; Abdollahi, Yadollah

2017-01-01

This review discusses the impact of green and environmentally safe chemistry on the field of nanotechnology-driven drug delivery in a new field termed "green nanomedicine". Studies have shown that among many examples of green nanotechnology-driven drug delivery systems, those receiving the greatest amount of attention include nanometal particles, polymers, and biological materials. Furthermore, green nanodrug delivery systems based on environmentally safe chemical reactions or using natural biomaterials (such as plant extracts and microorganisms) are now producing innovative materials revolutionizing the field. In this review, the use of green chemistry design, synthesis, and application principles and eco-friendly synthesis techniques with low side effects are discussed. The review ends with a description of key future efforts that must ensue for this field to continue to grow.

Safe handling of tritium

International Nuclear Information System (INIS)

1991-01-01

The main objective of this publication is to provide practical guidance and recommendations on operational radiation protection aspects related to the safe handling of tritium in laboratories, industrial-scale nuclear facilities such as heavy-water reactors, tritium removal plants and fission fuel reprocessing plants, and facilities for manufacturing commercial tritium-containing devices and radiochemicals. The requirements of nuclear fusion reactors are not addressed specifically, since there is as yet no tritium handling experience with them. However, much of the material covered is expected to be relevant to them as well. Annex III briefly addresses problems in the comparatively small-scale use of tritium at universities, medical research centres and similar establishments. However, the main subject of this publication is the handling of larger quantities of tritium. Operational aspects include designing for tritium safety, safe handling practice, the selection of tritium-compatible materials and equipment, exposure assessment, monitoring, contamination control and the design and use of personal protective equipment. This publication does not address the technologies involved in tritium control and cleanup of effluents, tritium removal, or immobilization and disposal of tritium wastes, nor does it address the environmental behaviour of tritium. Refs, figs and tabs

Self-Management to Increase Safe Driving Among Short-Haul Truck Drivers

Science.gov (United States)

Hickman, Jeffrey S.; Geller, E. Scott

2005-01-01

The relative impact of a self-management for safety (SMS) process was evaluated at two short-haul trucking terminals. Participants in the Pre-Behavior group (n = 21) recorded their intentions to engage in specific safe versus at-risk driving behaviors before leaving the terminal (i.e., before making any of their deliveries for the day), whereas…

Postoperative Stereotactic Body Radiation Therapy (SBRT) for Spine Metastases: A Critical Review to Guide Practice

Energy Technology Data Exchange (ETDEWEB)

Redmond, Kristin J., E-mail: kjanson3@jhmi.edu [Department of Radiation Oncology, Johns Hopkins University, Baltimore, Maryland (United States); Lo, Simon S. [Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, Ohio (United States); Fisher, Charles [Department of Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia (Canada); Sahgal, Arjun [Department of Radiation Oncology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario (Canada)

2016-08-01

Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beam radiation therapy and postoperative spine SBRT. Lastly, an in-depth practical discussion with respect to treatment planning and delivery considerations is provided to help guide optimal practice.

TU-A-304-02: Treatment Simulation, Planning and Delivery for SBRT

Energy Technology Data Exchange (ETDEWEB)

Yang, Y.

2015-06-15

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

An efficient parallel stochastic simulation method for analysis of nonviral gene delivery systems

KAUST Repository

Kuwahara, Hiroyuki

2011-01-01

Gene therapy has a great potential to become an effective treatment for a wide variety of diseases. One of the main challenges to make gene therapy practical in clinical settings is the development of efficient and safe mechanisms to deliver foreign DNA molecules into the nucleus of target cells. Several computational and experimental studies have shown that the design process of synthetic gene transfer vectors can be greatly enhanced by computational modeling and simulation. This paper proposes a novel, effective parallelization of the stochastic simulation algorithm (SSA) for pharmacokinetic models that characterize the rate-limiting, multi-step processes of intracellular gene delivery. While efficient parallelizations of the SSA are still an open problem in a general setting, the proposed parallel simulation method is able to substantially accelerate the next reaction selection scheme and the reaction update scheme in the SSA by exploiting and decomposing the structures of stochastic gene delivery models. This, thus, makes computationally intensive analysis such as parameter optimizations and gene dosage control for specific cell types, gene vectors, and transgene expression stability substantially more practical than that could otherwise be with the standard SSA. Here, we translated the nonviral gene delivery model based on mass-action kinetics by Varga et al. [Molecular Therapy, 4(5), 2001] into a more realistic model that captures intracellular fluctuations based on stochastic chemical kinetics, and as a case study we applied our parallel simulation to this stochastic model. Our results show that our simulation method is able to increase the efficiency of statistical analysis by at least 50% in various settings. © 2011 ACM.

Evaluation of the CDC safe water-storage intervention to improve ...

African Journals Online (AJOL)

Evaluation of the CDC safe water-storage intervention to improve the microbiological quality of point-of-use drinking water in rural communities in South Africa. ... use of safe household water-storage devices and water treatment processes and improvement of hygiene and sanitation practices in these rural households.

Study Protocol. IDUS -- Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-09-13

AbstractBackgroundInstrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.Methods\\/DesignA multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha.DiscussionIt is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries.Trial registrationCurrent Controlled Trials ISRCTN72230496

Think Before You Ink: Are Tattoos Safe?

Science.gov (United States)

... Consumers Consumer Updates Think Before You Ink: Are Tattoos Safe? Share Tweet Linkedin Pin it More sharing ... I be concerned about unsafe practices, or the tattoo ink itself? Both. While you can get serious ...

Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

Science.gov (United States)

Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

2012-12-01

A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.

The safe home project.

Science.gov (United States)

Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

2011-12-01

The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe

Practice development using video-reflexive ethnography: promoting safe space(s towards the end of life in hospital

Directory of Open Access Journals (Sweden)

Aileen Collier

2016-05-01

Full Text Available Background: There is international consensus of the need for improved palliative and end-of-life care in hospital settings. What is less clear is how such improvements might be realised in practice. Research and practice improvement methodologies need to acknowledge the relational, spiritual, moral and ethical as well as physical dimensions of death and dying if improvements in care are to be achieved. Aims and objectives: The aim of this article is to explore the potential of video-reflexive ethnography as a practice development methodology to improve care of people with a life-limiting illness in the hospital setting. Methods: The study used video-reflexive ethnography and was underpinned by an indigenous research ethical framework. Findings: Study findings highlight the potential of video-reflexive ethnography as a practice development methodology. The reach of video extended internally and externally beyond immediate practice research sites to make hospital dying tangible. The research acted as a disruptive innovation, foregrounding peoples’ (patients and families expertise as well as that of healthcare workers. For some patient and family participants, the research offered a visual legacy. Conclusions: The theories underpinning video-reflexive ethnography and practice development are closely aligned; the former has potential as a practice development methodology to promote person-centred palliative and end-of-life care. The underpinning philosophical, ethical and values framework through which it is applied, along with the skills and aptitude of facilitation, are critical if its potential is to be realised. Implications for practice development: The delivery of person-centred end-of-life care may be facilitated by: Healthcare workers seeing themselves and those they care for differently Healthcare organisations seeing their employees as well as patients and families differently Researchers also being prepared to see themselves differently

Brownfields and Urban Agriculture: Interim Guidelines for Safe Gardening Practices

Science.gov (United States)

This document is a condensation of the input of experts from the government, the nonprofit sector, and academia who gathered to outline the range of issues which need to be addressed in order to safely grow food on former brownfield sites.

C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

Science.gov (United States)

Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

2017-07-01

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

Pengaruh Fundamental Safe Work Practice Terhadap Pencegahan Kecelakaan Kerja Bagian Workover di PT. ACS Duri

Directory of Open Access Journals (Sweden)

M. Saifullah

2012-05-01

Full Text Available PT. Asrindo Citraseni Satria (ACS is a company engaged in oil and gas and is a sub contractor PT.CPI. PT. ACS has implemented FSWP whose objective which is to identify, assess, reduce, control or eliminate the risks associated with the work, but until now there is still a work accident that occurred even in small quantities. The author would like to know about the effect of application of the section Fundamental Safe Work Practice (FSWP can prevent the accident in workover PT. ACS Duri. This research uses quantitative analytical survey, with the design of Cross Sectional conducted from May to June 2012 with a large sample of 122 of the 360 people who work in the workover. Samples were taken by using a system Accidental Sampling, and the data processed using a computer program to analyze the independent variables in the form of application as well as the dependent variable is FSWP occupational accidents and tested using Chi-square. The results showed that, the application of FSWP can prevent accidents which includes Standard Operating Procedure (SOP with the value of P = 0.01 is smaller than the value of α = 0.05 that means there are a significant correlation between the application of SOP with workplace accidents, PTW with a value of P = 0.02 is more smaller than the value of α = 0.05 means that there are significant correlation between the application of Permit To Work (PTW accidents, and tagged with a value of P = 0.01 is smaller than the value of α= 0.05 means there is a significant correlation between the application of Log Out/Tag Out (LOTO by accident. It was concluded that, the application of FSWP can reduce / reduce the number of occupational accidents in the workover, and is expected for the management of HES to improving the knowledge for employee about the aspects of FSWP (SWA, Hazard Analysis, SOP, Access Control, PPE, MSDS, Housekeeping, PTW & Other Safe Work Practices.

Staying Safe While Doing Science in Public: Emerging Best Practices for Social Media

Science.gov (United States)

Jefferson, A.; McKinnon, M.

2016-12-01

Doing science in public has incalculable benefits for professional networking, science advocacy, and public outreach, but it also carries significant risks. Online harassment related to social media use can pose significant emotional hardship, negatively impact professional standing, and even threaten physical welfare. Women, people of color, and other underrepresented people in science are disproportionately targeted for anonymous online harassment. We analyzed our experiences with online harassment, and tactics for managing this harassment. While anecdotal, our experiences cover scientists with differing identities and fields, demonstrating that while the details change the overarching patterns remain the same. Fear of becoming a target poses a significant barrier to engaging in public discourse about science. But it is possible to mitigate this risk. Successful strategies for social media to promote science while staying safe are slowly creating a body of emerging best practices. These tactics include proactively restricting access to personal information, developing strategies for identifying and responding to deliberate antagonists (trolls), and choosing when and how to participate in volatile topics. They also require full-community engagement from creating support networks, partnering with allies to manage sudden floods of hostility, and educating on security practices for protecting colleagues' potentially sensitive personal information. It is our hope that frank and open discussion of the realistic threat passed by harassment and strategies for mitigating that threat will jump start a culture of online safety amongst geoscientists, and encourage our most vulnerable and underrepresented scientists to participate in the public sphere.

Safe China final report. Promoting the EU and German standards and practices of environmental protection and industrial safety in China

Energy Technology Data Exchange (ETDEWEB)

Jovanovic, A.; Guntrum, R.; Liu, Y. (eds.)

2013-07-01

This document presents the results of the international technology transfer and cooperation project SafeChina (''Promoting the EU and German standards and practices of Environmental Protection and Industrial Safety in China'', www.safechina.risk-technologies.com). The purpose of the project was to build an education, training and certification infrastructure and to offer to Chinese engineers and other professionals the possibility to learn about the EU HSE practices and regulation and qualify as Environmental- and Safety engineers according to the EU criteria, guidelines and practice. The main partners in the project have been Steinbeis University Berlin/Steinbeis Transfer Institute Advanced Risk Technologies, and the OEG mbH (Deutsche lnvestitions- und Entwicklungsgesellschaft mbH), subsidiary of KfW Banking Group, Germany. Main Chinese partners were Beijing Municipal Institute of Labour Protection and Capital University of Economics and Business, Beijing.

Safe China final report. Promoting the EU and German standards and practices of environmental protection and industrial safety in China

International Nuclear Information System (INIS)

Jovanovic, A.; Guntrum, R.; Liu, Y.

2013-01-01

This document presents the results of the international technology transfer and cooperation project SafeChina (''Promoting the EU and German standards and practices of Environmental Protection and Industrial Safety in China'', www.safechina.risk-technologies.com). The purpose of the project was to build an education, training and certification infrastructure and to offer to Chinese engineers and other professionals the possibility to learn about the EU HSE practices and regulation and qualify as Environmental- and Safety engineers according to the EU criteria, guidelines and practice. The main partners in the project have been Steinbeis University Berlin/Steinbeis Transfer Institute Advanced Risk Technologies, and the OEG mbH (Deutsche lnvestitions- und Entwicklungsgesellschaft mbH), subsidiary of KfW Banking Group, Germany. Main Chinese partners were Beijing Municipal Institute of Labour Protection and Capital University of Economics and Business, Beijing.

Delivery of modulated electron beams with conventional photon multi-leaf collimators

International Nuclear Information System (INIS)

Klein, Eric E; Mamalui-Hunter, Maria; Low, Daniel A

2009-01-01

Electron beam radiotherapy is an accepted method to treat shallow tumors. However, modulation of electrons to customize dose distributions has not readily been achieved. Studies of bolus and tertiary collimation systems have been met with limitations. We pursue the use of photon multi-leaf collimators (MLC) for modulated electron radiotherapy (MERT) to achieve customized distributions for potential clinical use. As commercial planning systems do not support the use of MLC with electrons, planning was conducted using Monte Carlo calculations. Segmented and dynamic modulated delivery of multiple electron segments was configured, calculated and delivered for validation. Delivery of electrons with segmented or dynamic leaf motion was conducted. A phantom possessing an idealized stepped target was planned and optimized with subsequent validation by measurements. Finally, clinical treatment plans were conducted for post-mastectomy and cutaneous lymphoma of the scalp using forward optimization techniques. Comparison of calculations and measurements was successful with agreement of ±2%/2 mm for the energies, segment sizes, depths tested for delivered segments for the dynamic and segmented delivery. Clinical treatment plans performed provided optimal dose coverage of the target while sparing distal organs at risk. Execution of plans using an anthropomorphic phantom to ensure safe and efficient delivery was conducted. Our study validates that MERT is not only possible using the photon MLC, but the efficient and safe delivery inherent with the dynamic delivery provides an ideal technique for shallow tumor treatment.

Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Directory of Open Access Journals (Sweden)

Murphy Deirdre J

2012-09-01

Full Text Available Abstract Background Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. Methods/Design A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. Discussion It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Trial registration Current Controlled Trials ISRCTN72230496

Liver cell-targeted delivery of therapeutic molecules.

Science.gov (United States)

Kang, Jeong-Hun; Toita, Riki; Murata, Masaharu

2016-01-01

The liver is the largest internal organ in mammals and is involved in metabolism, detoxification, synthesis of proteins and lipids, secretion of cytokines and growth factors and immune/inflammatory responses. Hepatitis, alcoholic or non-alcoholic liver disease, hepatocellular carcinoma, hepatic veno-occlusive disease, and liver fibrosis and cirrhosis are the most common liver diseases. Safe and efficient delivery of therapeutic molecules (drugs, genes or proteins) into the liver is very important to increase the clinical efficacy of these molecules and to reduce their side effects in other organs. Several liver cell-targeted delivery systems have been developed and tested in vivo or ex vivo/in vitro. In this review, we discuss the literature concerning liver cell-targeted delivery systems, with a particular emphasis on the results of in vivo studies.

A community of practice approach to bioanalysis delivery: the role of the Preclinical Bioanalysis and Toxicokinetics department at AstraZeneca.

Science.gov (United States)

Wilson, Amanda; Silvester, Stephen; Woods, Karen

2014-05-01

Retaining regulated bioanalysis within AstraZeneca (AZ) is important for the effective delivery of nonclinical and clinical bioanalysis. The focus for the in-house team is the delivery of high-throughput bioanalysis and toxicokinetics support for investigational toxicology; however, by retaining GLP compliance, AZ will have an in-house understanding of every candidate drug that is progressed into development by supporting the first rodent GLP study for each project. The majority of nonclinical bioanalysis and all of the clinical bioanalysis are delivered by two external partnership models. This article describes the key benefits of retaining GLP compliance, the partnership interactions, discusses the management of non-GLP support in a GLP environment and how, having practical experience of regulatory facing method development, validation and study execution adds value to the AZ portfolio delivery.

Determinants of knowledge of critical danger signs, safe childbirth and immediate newborn care practices among auxiliary midwives: a cross sectional survey in Myanmar.

Science.gov (United States)

Than, Kyu Kyu; Morgan, Alison; Pham, Minh Duc; Beeson, James G; Luchters, Stanley

2017-07-05

The re-emergence of community-based health workers such as the auxiliary midwives (AMWs) in Myanmar, who are local female volunteers, has been an important strategy to address global health workforce shortages. The Myanmar government recommends one AMW for every village. The aim of this study is to investigate the current knowledge of critical danger signs and practices for safe childbirth and immediate newborn care of AMWs to inform potential task shifting of additional healthcare responsibilities. A cross-sectional survey was conducted from July 2015 to June 2016 in three hard-to-reach areas in Myanmar. Face-to-face interviews were conducted using a pretested questionnaire. Among 262 AMWs participating in the study, only 8% of AMWs were able to identify at least 80% of 20 critical danger signs. Factors associated with greater knowledge of critical danger signs included older age over 35 years (adjusted OR (AOR) 2.19, 95% CI 0.99 to 4.83), having received refresher training within the last year (AOR 2.20, 95% CI 1.21 to 4.01) and receiving adequate supervision (AOR 5.04, 95% CI 2.74 to 9.29). Those who employed all six safe childbirth and immediate newborn care practices were more likely to report greater knowledge of danger signs (AOR 2.81, 95% CI 1.50 to 5.26), adequate work supervision (AOR 3.18 95% CI 1.62 to 6.24) and less education (AOR 0.44, 95% CI 0.23 to 0.88). The low level of knowledge of critical danger signs and reported practices for safe childbirth identified suggest that an evaluation of the current AMW training and supervision programme needs to be revisited to ensure that existing practices, including recognition of danger signs, meet quality care standards before new interventions are introduced or new responsibilities given to AMWs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Experiences of practice facilitators working on the Improved Delivery of Cardiovascular Care project: Retrospective case study.

Science.gov (United States)

Liddy, Clare; Rowan, Margo; Valiquette-Tessier, Sophie-Claire; Drosinis, Paul; Crowe, Lois; Hogg, William

2018-01-01

To examine the barriers to and facilitators of practice facilitation experienced by participants in the Improving Delivery of Cardiovascular Care (IDOCC) project. Case studies of practice facilitators' narrative reports. Eastern Ontario. Primary care practices that participated in the IDOCC project. Cases were identified by calculating sum scores in order to determine practices' performance relative to their peers. Two case exemplars were selected that scored within ± 1 SD of the total mean score, and a qualitative analysis of practice facilitators' narrative reports was conducted using a 5-factor implementation framework to identify barriers and facilitators. Narratives were divided into 3 phases: planning, implementation, and sustainability. Barriers and facilitators fluctuated over the intervention's 3 phases. Site A reported more barriers (n = 47) than facilitators (n = 38), while site B reported a roughly equal number of barriers (n = 144) and facilitators (n = 136). In both sites, the most common barriers involved organizational and provider factors and the most common facilitators were associated with innovation and structural factors. Both practices encountered various barriers and facilitators throughout the IDOCC's 3 phases. The case studies reveal the complex interactions of these factors over time, and provide insight into the implementation of practice facilitation programs. Copyright© the College of Family Physicians of Canada.

Challenges to Safe Injection Practices in Ambulatory Care.

Science.gov (United States)

Anderson, Laura; Weissburg, Benjamin; Rogers, Kelli; Musuuza, Jackson; Safdar, Nasia; Shirley, Daniel

2017-05-01

Most recent infection outbreaks caused by unsafe injection practices in the United States have occurred in ambulatory settings. We utilized direct observation and a survey to assess injection practices at 31 clinics. Improper vial use was observed at 13 clinics (41.9%). Pharmacy support and healthcare worker education may improve injection practices. Infect Control Hosp Epidemiol 2017;38:614-616.

Surgical education and adult learning: Integrating theory into practice [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Prem Rashid

2017-02-01

Full Text Available Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: ‘surgical education theory’ and ‘adult learning theory medical’. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable.

Safe sex

Science.gov (United States)

... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

Safe operation of research reactors and critical assemblies. Code of practice and annexes. 1984 ed

International Nuclear Information System (INIS)

1984-01-01

The safe operation of research reactors and critical assemblies (hereafter termed 'reactors') requires proper design, construction, management and supervision. This Code of Practice deals mainly with management and supervision. The provisions of the Code apply to the whole life of the reactor, including modification, updating and upgrading. The Code may be subject to revision in the light of experience and the state of technology. The Code is aimed at defining minimum requirements for the safe operation of reactors. Emphasis is placed on which safety requirements should be met rather than on specifying how these requirements may be met. The Code also provides guidance and information to persons and authorities responsible for the operation of reactors. The Code recommends that documents dealing with the operation of reactors and including safety analyses be prepared and submitted for review and approval to a regulatory body. Operation would be authorized on the understanding that it would comply with limits and conditions designed to ensure safety. The Code covers a wide range of reactor types, which gives rise to a variety of safety issues. Safety issues applicable to specific reactor types only (e.g. fast reactors) are not necessarily covered in this Code. Some of the recommendations in the Code are not directly applicable to critical assemblies. A recommendation may therefore be interpreted according to the type of reactor concerned. In such cases the words 'adequate' and 'appropriate' are used to mean 'adequate' or 'appropriate' for the type of reactor under consideration.

PLGA-Based Nanoparticles: a Safe and Suitable Delivery Platform for Osteoarticular Pathologies.

Science.gov (United States)

Riffault, Mathieu; Six, Jean-Luc; Netter, Patrick; Gillet, Pierre; Grossin, Laurent

2015-12-01

Despite the promising applications of PLGA based particles, studies examining the fate and consequences of these particles after intra-articular administration in the joint are scanty. This study was carried out to evaluate the neutrality of the unloaded delivery system on different articular cell types. To facilitate tracking, we have thus developed a fluorescent core of particles, combined to a hyaluronate shell for cell recognition. Fluorescence pictures were taken at time intervals to assess the internalization and the corresponding inflammatory response was monitored by RT-qPCR and biochemical measurements. After NPs pre-treatment, mesenchymal stem cells (MSCs) were cultured into chondrogenic, adipogenic or osteogenic differentiation media, to investigate if NPs exposure interferes with differentiation ability. Finally, intra-articular injections were performed in healthy rat knees and joint's structure analysed by histological studies. Particles were detected in cytoplasm 8 h after exposure. Internalization led to a slight and reversible increase of inflammatory markers, but lower than in inflammatory conditions. We have confirmed particles exposure minimal neutrality on MSCs pluripotency. Histological exams of joint after intra-articular injections do not demonstrate any side effects of NPs. Our findings suggest that such a delivery platform is well tolerated locally and could be used to deliver active molecules to the joint.

Mucosal vaccines: a paradigm shift in the development of mucosal adjuvants and delivery vehicles.

Science.gov (United States)

Srivastava, Atul; Gowda, Devegowda Vishakante; Madhunapantula, SubbaRao V; Shinde, Chetan G; Iyer, Meenakshi

2015-04-01

Mucosal immune responses are the first-line defensive mechanisms against a variety of infections. Therefore, immunizations of mucosal surfaces from which majority of infectious agents make their entry, helps to protect the body against infections. Hence, vaccinization of mucosal surfaces by using mucosal vaccines provides the basis for generating protective immunity both in the mucosal and systemic immune compartments. Mucosal vaccines offer several advantages over parenteral immunization. For example, (i) ease of administration; (ii) non-invasiveness; (iii) high-patient compliance; and (iv) suitability for mass vaccination. Despite these benefits, to date, only very few mucosal vaccines have been developed using whole microorganisms and approved for use in humans. This is due to various challenges associated with the development of an effective mucosal vaccine that can work against a variety of infections, and various problems concerned with the safe delivery of developed vaccine. For instance, protein antigen alone is not just sufficient enough for the optimal delivery of antigen(s) mucosally. Hence, efforts have been made to develop better prophylactic and therapeutic vaccines for improved mucosal Th1 and Th2 immune responses using an efficient and safe immunostimulatory molecule and novel delivery carriers. Therefore, in this review, we have made an attempt to cover the recent advancements in the development of adjuvants and delivery carriers for safe and effective mucosal vaccine production. © 2015 APMIS. Published by John Wiley & Sons Ltd.

What's Wrong with Bribery? An Example Utilizing Access to Safe Drinking Water

Science.gov (United States)

Dhooge, Lucien J.

2013-01-01

This case study examines the role of bribery in the global marketplace through an example involving access to safe drinking water in the developing world. Parts II and III set out the objectives and methods of classroom delivery for the case study. Part IV is the background reading relating to bribery with particular emphasis on the Foreign…

Poor perinatal care practices in urban slums: Possible role of social mobilization networks

Directory of Open Access Journals (Sweden)

Khan Zulfia

2009-01-01

Full Text Available Background: Making perinatal care accessible to women in marginalized periurban areas poses a public health problem. Many women do not utilize institutional care in spite of physical accessibility. Home-based care by traditional birth attendants (TBA is hazardous. Inappropriate early neonatal feeding practices are common. Many barriers to perinatal care can be overcome by social mobilization and capacity building at the community level. Objectives: To determine the existing perinatal practices in an urban slum and to identify barriers to utilization of health services by mothers. Study Design: This is a cross-sectional descriptive study. Setting and Participants: The high-risk periurban areas of Nabi Nagar, Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers (Community Mobilization Coordinators or CMCs already working in an NGO in the area. A total of 92 mothers were interviewed at home. Current perinatal practices and reasons for utilizing or not utilizing health services were the topics of inquiry. Statistical Analysis: Data was tabulated and analyzed using SPSS 12. Results: Analyses revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices as more than 60% of the women had home deliveries conducted by traditional untrained or trained birth attendants. Reasons for preferring home deliveries were mostly tradition (41.9% or related to economics (30.7%. A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, the umbilical cord was cut using the edge of a broken cup. Although breast-feeding was universal, inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 hours in 8% of the cases. Several mothers had breastfeeding problems

Safe motherhood at risk?

Science.gov (United States)

Thompson, A

1996-12-01

Health professionals' negative attitudes toward clients often exacerbate the problems women face in terms of health status and access to health care. Thus, the health professionals can themselves be obstacles to women seeking the health care they need. A key challenge to midwives, in addition to providing technically competent services, is gaining insight into the people for whom they are responsible so that childbirth traditions are treated with respect and women are offered dignity. Safe motherhood requires intersectoral collaboration. Many innovative approaches to safe motherhood are based on the community's participation in planning services that meet the needs of women. Other approaches are based on decentralization of services. For example, a large university teaching hospital in Lusaka, Zambia, set up birthing centers around the city to take the pressure off the hospital. Midwives head up these centers, which are close to the women's homes. Decentralization of delivery services has improved the physical and emotional outcomes for mothers and newborns. Midwives must be prepared to articulate concerns about inequalities and deficiencies in the health care system in order to persuade the government to change. Women, including midwives, need to form multidisciplinary alliances to work together to effect change. The front-line workers in maternity care are midwives. They should adopt the following strategies to become even more effective in their efforts to make motherhood safer. They should listen to what women say about their needs. They should scale services to a manageable, human scale. They should learn the skills to become politically active advocates. They should work with other midwives, women, leaders, and other professional groups. Motherhood can be safe when women have more control over their own decision making, the education to liberate themselves to make their own decisions, and access to skilled care.

Do management practices support or constrain safe driving behaviour? A multi-level investigation in a sample of occupational drivers.

Science.gov (United States)

Newnam, Sharon; Warmerdam, Amanda; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

2017-05-01

It has been estimated that one-third of all work-related deaths occur while driving for work-related purposes. Despite this, many organisations are unaware of the practices, beyond those that identify and control the impact of unforeseen events (i.e., risk management), that predispose drivers to risk. This study addresses the issue by identifying the management practices operationalised as, High Performance Workplace Systems (HPWS) that influence safe driver behaviour. The study also explores the value given to safety by senior level management as a moderator of the relationship between HPWS practices and driver behaviour. Each factor was tested within a two level hierarchical model consisting of 911 drivers, nested within 161 supervisors and 83 organisations. The findings highight that under conditions of high investment in job and work design, communication and selection practices, drivers reported poorer driving behaviour. An interaction effect also demonstrated that under conditions of high investment in remuneration, drivers reported safer behaviour, but only when they perceived that managers valued and prioritised safety. The findings challenge current thinking in the management of workplace road safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Topical and transdermal drug delivery: principles and practice

National Research Council Canada - National Science Library

Benson, Heather A. E; Watkinson, Adam C

2012-01-01

.... Providing an overview of the current science in drug and cosmetic application to and through the skin, Topical and Transdermal Drug Delivery includes treatment of skin conditions, skin permeation...

Nanomaterials for delivery of nucleic acid to the central nervous system (CNS)

DEFF Research Database (Denmark)

Wang, Danyang; Wu, Lin-Ping

2017-01-01

-related disease, such as neurodegeneration and disorders, suitable, safe and effective drug delivery nanocarriers have to been developed to overcome the blood brain barrier (BBB), which is the most inflexible barrier in human body. Here, we highlight the structure and function of barriers in the central nervous...... system (CNS) and summary several types of nanomaterials which can be potentially used in the brain delivery nucleic acid....

Recommended Practices for the Safe Design and Operation of Flywheels

Energy Technology Data Exchange (ETDEWEB)

Bender, Donald Arthur [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-12-01

Flywheel energy storage systems are in use globally in increasing numbers . No codes pertaining specifically to flywheel energy storage exist. A number of industrial incidents have occurred. This protocol recommends a technical basis for safe flywheel de sign and operation for consideration by flywheel developers, users of flywheel systems and standards setting organizations.

Synthetic torpor: A method for safely and practically transporting experimental animals aboard spaceflight missions to deep space

Science.gov (United States)

Griko, Yuri; Regan, Matthew D.

2018-02-01

Animal research aboard the Space Shuttle and International Space Station has provided vital information on the physiological, cellular, and molecular effects of spaceflight. The relevance of this information to human spaceflight is enhanced when it is coupled with information gleaned from human-based research. As NASA and other space agencies initiate plans for human exploration missions beyond low Earth orbit (LEO), incorporating animal research into these missions is vitally important to understanding the biological impacts of deep space. However, new technologies will be required to integrate experimental animals into spacecraft design and transport them beyond LEO in a safe and practical way. In this communication, we propose the use of metabolic control technologies to reversibly depress the metabolic rates of experimental animals while in transit aboard the spacecraft. Compared to holding experimental animals in active metabolic states, the advantages of artificially inducing regulated, depressed metabolic states (called synthetic torpor) include significantly reduced mass, volume, and power requirements within the spacecraft owing to reduced life support requirements, and mitigated radiation- and microgravity-induced negative health effects on the animals owing to intrinsic physiological properties of torpor. In addition to directly benefitting animal research, synthetic torpor-inducing systems will also serve as test beds for systems that may eventually hold human crewmembers in similar metabolic states on long-duration missions. The technologies for inducing synthetic torpor, which we discuss, are at relatively early stages of development, but there is ample evidence to show that this is a viable idea and one with very real benefits to spaceflight programs. The increasingly ambitious goals of world's many spaceflight programs will be most quickly and safely achieved with the help of animal research systems transported beyond LEO; synthetic torpor may

Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

African Journals Online (AJOL)

Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

Safe sleep practices in a New Zealand community and development of a Sudden Unexpected Death in Infancy (SUDI) risk assessment instrument.

Science.gov (United States)

Galland, Barbara C; Gray, Andrew; Sayers, Rachel M; Heath, Anne-Louise M; Lawrence, Julie; Taylor, Rachael; Taylor, Barry J

2014-10-13

Interventions to prevent sudden unexpected death in infancy (SUDI) have generally been population wide interventions instituted after case-control studies identified specific childcare practices associated with sudden death. While successful overall, in New Zealand (NZ), the rates are still relatively high by international comparison. This study aims to describe childcare practices related to SUDI prevention messages in a New Zealand community, and to develop and explore the utility of a risk assessment instrument based on international guidelines and evidence. Prospective longitudinal study of 209 infants recruited antenatally. Participant characteristics and infant care data were collected by questionnaire at: baseline (third trimester), and monthly from infant age 3 weeks through 23 weeks. Published meta-analyses data were used to estimate individual risk ratios for 6 important SUDI risk factors which, when combined, yielded a "SUDI risk score". Most infants were at low risk for SUDI with 72% at the lowest or slightly elevated risk (combined risk ratio ≤1.5). There was a high prevalence of the safe practices: supine sleeping (86-89% over 3-19 weeks), mother not smoking (90-92% over 3-19 weeks), and not bed sharing at a young age (87% at 3 weeks). Five independent predictors of a high SUDI risk score were: higher parity (P =0.028), younger age (P =0.030), not working or caring for other children antenatally (P =0.031), higher depression scores antenatally (P =0.036), and lower education (P =0.042). Groups within the community identified as priorities for education about safe sleep practices beyond standard care are mothers who are young, have high parity, low educational levels, and have symptoms of depression antenatally. These findings emphasize the importance of addressing maternal depression as a modifiable risk factor in pregnancy.

Delivery systems for antimicrobial peptides

DEFF Research Database (Denmark)

Nordström, Randi; Malmsten, Martin

2017-01-01

Due to rapidly increasing resistance development against conventional antibiotics, finding novel approaches for the treatment of infections has emerged as a key health issue. Antimicrobial peptides (AMPs) have attracted interest in this context, and there is by now a considerable literature...... on the identification such peptides, as well as on their optimization to reach potent antimicrobial and anti-inflammatory effects at simultaneously low toxicity against human cells. In comparison, delivery systems for antimicrobial peptides have attracted considerably less interest. However, such delivery systems...... are likely to play a key role in the development of potent and safe AMP-based therapeutics, e.g., through reducing chemical or biological degradation of AMPs either in the formulation or after administration, by reducing adverse side-effects, by controlling AMP release rate, by promoting biofilm penetration...

Otic drug delivery systems: formulation principles and recent developments.

Science.gov (United States)

Liu, Xu; Li, Mingshuang; Smyth, Hugh; Zhang, Feng

2018-04-25

Disorders of the ear severely impact the quality of life of millions of people, but the treatment of these disorders is an ongoing, but often overlooked challenge particularly in terms of formulation design and product development. The prevalence of ear disorders has spurred significant efforts to develop new therapeutic agents, but perhaps less innovation has been applied to new drug delivery systems to improve the efficacy of ear disease treatments. This review provides a brief overview of physiology, major diseases, and current therapies used via the otic route of administration. The primary focuses are on the various administration routes and their formulation principles. The article also presents recent advances in otic drug deliveries as well as potential limitations. Otic drug delivery technology will likely evolve in the next decade and more efficient or specific treatments for ear disease will arise from the development of less invasive drug delivery methods, safe and highly controlled drug delivery systems, and biotechnology targeting therapies.

Virosome, a hybrid vehicle for efficient and safe drug delivery and its emerging application in cancer treatment.

Science.gov (United States)

Liu, Hanqing; Tu, Zhigang; Feng, Fan; Shi, Haifeng; Chen, Keping; Xu, Ximing

2015-06-01

A virosome is an innovative hybrid drug delivery system with advantages of both viral and non-viral vectors. Studies have shown that a virosome can carry various biologically active molecules, such as nucleic acids, peptides, proteins and small organic molecules. Targeted drug delivery using virosome-based systems can be achieved through surface modifications of virosomes. A number of virosome-based prophylactic and therapeutic products with high safety profiles are currently available in the market. Cancer treatment is a big battlefield for virosome-based drug delivery systems. This review provides an overview of the general concept, preparation procedures, working mechanisms, preclinical studies and clinical applications of virosomes in cancer treatment.

Enhanced delivery of biodegradable mPEG-PLGA-PLL ...

Indian Academy of Sciences (India)

... effectively down-regulate the mRNA and protein expression of PDGF‐BB thanNPs plus US (P=0.014 and P=0.007, respectively). Histology showed no evident tissue damage after UTMDmediatedNPs loading siRNA transfection. UTMD could be used safely to enhance the delivery of mPEG-PLGAPLLNPs loading siRNA ...

Safe male circumcision in Botswana: tension between traditional practices and biomedical marketing.

Science.gov (United States)

Katisi, Masego; Daniel, Marguerite

2015-01-01

Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance.

[Stimulation of labour with oxytocin and ventouse deliveries are inadequately documented].

Science.gov (United States)

Lindved, Birgitte Freilev; Kierkegaard, Ole; Anhøj, Jacob

2014-09-15

A retrospective sample of 180 records from four regional hospitals and five university hospitals in Denmark was collected and the documentation for use of oxytocin in augmentation of labour and ventouse deliveries according to the national guidelines was registered. Only approximately half of the elements in the national guidelines were documented. This shows that there is a potential for improvement in the ongoing Danish national quality improvement project Safe Deliveries (Sikre Fødsler).

Safe operation of critical assemblies and research reactors. Code of practice and Technical appendix. 1971 ed

International Nuclear Information System (INIS)

Cox, J.

1971-01-01

This book is in two parts. The first is a Code of Practice for the Safe Operation of Critical Assemblies and Research Reactors, prepared as a result of a meeting of experts which took place in Vienna on 20-24 May 1968. The Code has been prepared by the International Atomic Energy Agency in co-operation with the World Health Organization, and its publication is sponsored by both organizations. In addition, the Code was approved by the Board of Governors of the International Atomic Energy Agency on 16 December 1968 as part of the Agency's safety standards, which are applied to operations undertaken by Member States with the assistance of the Agency. The Board, in approving the publication of the present book, also recommended Member States to take the Code into account in the formulation of national regulations and recommendations. The second part of the book is a Technical Appendix to give information and illustrative samples that would be helpful in implementing the Code of Practice. This second part, although published under the same cover, is not part of the Code. An extensive Bibliography, amplifying the Technical Appendix, is included at the end.

Instrumental delivery: clinical practice guidelines from the French College of Gynaecologists and Obstetricians.

Science.gov (United States)

Vayssière, Christophe; Beucher, Gael; Dupuis, Olivier; Feraud, Olivia; Simon-Toulza, Caroline; Sentilhes, Loïc; Meunier, Emmanuelle; Parant, Olivier; Schmitz, Thomas; Riethmuller, Didier; Baud, Olivier; Galley-Raulin, Fabienne; Diemunsch, Pierre; Pierre, Fabrice; Schaal, Jean-Patrick; Fournié, Alain; Oury, Jean François

2011-11-01

Routine use of a partograph is associated with a reduction in the use of forceps, but is not associated with a reduction in the use of vacuum extraction (Level A). Early artificial rupture of the membranes, associated with oxytocin perfusion, does not reduce the number of operative vaginal deliveries (Level A), but does increase the rate of fetal heart rate abnormalities (Level B). Early correction of lack of progress in dilatation by oxytocin perfusion can reduce the number of operative vaginal deliveries (Level B). The use of low-concentration epidural infusions of bupivacaine potentiated by morphinomimetics reduces the number of operative interventions compared with larger doses (Level A). Placement of an epidural before 3-cm dilatation does not increase the number of operative vaginal deliveries (Level A). Posterior positions of the fetus result in more operative vaginal deliveries (Level B). Manual rotation of the fetus from a posterior position to an anterior position may reduce the number of operative deliveries (Level C). Walking during labour is not associated with a reduction in the number of operative vaginal deliveries (Level A). Continuous support of the parturient by a midwife or partner/family member during labour reduces the number of operative vaginal deliveries (Level A). Under epidural analgesia, delayed pushing (2h after full dilatation) reduces the number of difficult operative vaginal deliveries (Level A). Ultrasound is recommended if there is any clinical doubt about the presentation of the fetus (Level B). The available scientific data are insufficient to contra-indicate attempted midoperative delivery (professional consensus). The duration of the operative intervention is slightly shorter with forceps than with a vacuum extractor (Level C). Nonetheless, the urgency of operative delivery is not a reason to choose one instrument over another (professional consensus). The cup-shaped vacuum extractor seems to be the instrument of choice for

Operationalizing the Reciprocal Engagement Model of Genetic Counseling Practice: a Framework for the Scalable Delivery of Genomic Counseling and Testing.

Science.gov (United States)

Schmidlen, Tara; Sturm, Amy C; Hovick, Shelly; Scheinfeldt, Laura; Scott Roberts, J; Morr, Lindsey; McElroy, Joseph; Toland, Amanda E; Christman, Michael; O'Daniel, Julianne M; Gordon, Erynn S; Bernhardt, Barbara A; Ormond, Kelly E; Sweet, Kevin

2018-02-19

With the advent of widespread genomic testing for diagnostic indications and disease risk assessment, there is increased need to optimize genetic counseling services to support the scalable delivery of precision medicine. Here, we describe how we operationalized the reciprocal engagement model of genetic counseling practice to develop a framework of counseling components and strategies for the delivery of genomic results. This framework was constructed based upon qualitative research with patients receiving genomic counseling following online receipt of potentially actionable complex disease and pharmacogenomics reports. Consultation with a transdisciplinary group of investigators, including practicing genetic counselors, was sought to ensure broad scope and applicability of these strategies for use with any large-scale genomic testing effort. We preserve the provision of pre-test education and informed consent as established in Mendelian/single-gene disease genetic counseling practice. Following receipt of genomic results, patients are afforded the opportunity to tailor the counseling agenda by selecting the specific test results they wish to discuss, specifying questions for discussion, and indicating their preference for counseling modality. The genetic counselor uses these patient preferences to set the genomic counseling session and to personalize result communication and risk reduction recommendations. Tailored visual aids and result summary reports divide areas of risk (genetic variant, family history, lifestyle) for each disease to facilitate discussion of multiple disease risks. Post-counseling, session summary reports are actively routed to both the patient and their physician team to encourage review and follow-up. Given the breadth of genomic information potentially resulting from genomic testing, this framework is put forth as a starting point to meet the need for scalable genetic counseling services in the delivery of precision medicine.

Drug delivery via porous silicon: a focused patent review.

Science.gov (United States)

Kulyavtsev, Paulina A; Spencer, Roxanne P

2017-03-01

Although silicon is more commonly associated with computer chips than with drug delivery, with the discovery that porous silicon is a viable biocompatible material, mesoporous silicon with pores between 2 and 50 nm has been loaded with small molecule and biomolecule therapeutics and safely implanted for controlled release. As porous silicon is readily oxidized, porous silica must also be considered for drug delivery applications. Since 2010, only a limited number of US patents have been granted, primarily for ophthalmologic and immunotherapy applications, in contrast to the growing body of technical literature in this area.

Family-centred care delivery

Science.gov (United States)

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-01-01

Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

Insulin-loaded poly(epsilon-caprolactone) nanoparticles: efficient, sustained and safe insulin delivery system.

Science.gov (United States)

de Araújo, Thiago M; Teixeira, Zaine; Barbosa-Sampaio, Helena C; Rezende, Luiz F; Boschero, Antonio C; Durán, Nelson; Höehr, Nelci F

2013-06-01

The aim of this work was to develop an efficient, biodegradable, biocompatible and safe controlled release system using insulin-loaded poly(epsilon-caprolactone) (PCL) nanoparticles. The insulin-loaded PCL nanoparticles were prepared by double emulsion method (water-in-oil-in-water) using Pluronic F68 as emulsifier. Using the double emulsion method a high insulin encapsulation efficiency (90.6 +/-1.6%) with a zeta potential of -29 +/-2.7 mV and average particle size of 796 +/-10.5 nm was obtained. Insulin-loaded PCL nanoparticles showed no toxicity to MIN6 cells. Insulin nanoparticles administered subcutaneously and intraperitoneally in rats reduced glycaemia of basal levels after 15 minutes, and presented a sustainable hypoglycemic effect on insulin-dependent type 1 diabetic rats, showing to be more efficient than unencapsulated insulin. Furthermore, these nanoparticles were not hepatotoxic, as evaluated by the effect over liver cell-death and oxidative stress scavenger system in rats. These results suggest that insulin-loaded PCL nanoparticles prepared by water-in-oil-in-water emulsion method are biocompatible, efficient and safe insulin-delivering system with controlled insulin release, which indicates that it may be a powerful tool for insulin-dependent patients care.

A conceptual model of physician work intensity: guidance for evaluating policies and practices to improve health care delivery.

Science.gov (United States)

Horner, Ronnie D; Matthews, Gerald; Yi, Michael S

2012-08-01

Physician work intensity, although a major factor in determining the payment for medical services, may potentially affect patient health outcomes including quality of care and patient safety, and has implications for the redesign of medical practice to improve health care delivery. However, to date, there has been minimal research regarding the relationship between physician work intensity and either patient outcomes or the organization and management of medical practices. A theoretical model on physician work intensity will provide useful guidance to such inquiries. To describe an initial conceptual model to facilitate further investigations of physician work intensity. A conceptual model of physician work intensity is described using as its theoretical base human performance science relating to work intensity. For each of the theoretical components, we present relevant empirical evidence derived from a review of the current literature. The proposed model specifies that the level of work intensity experienced by a physician is a consequence of the physician performing the set of tasks (ie, demands) relating to a medical service. It is conceptualized that each medical service has an inherent level of intensity that is experienced by a physician as a function of factors relating to the physician, patient, and medical practice environment. The proposed conceptual model provides guidance to researchers as to the factors to consider in studies of how physician work intensity impacts patient health outcomes and how work intensity may be affected by proposed policies and approaches to health care delivery.

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

Science.gov (United States)

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

Magnetotactic Bacterial Cages as Safe and Smart Gene Delivery Vehicles

KAUST Repository

Alsaiari, Shahad K.; Ezzedine, Alaa H.; Abdallah, Abdallah; Sougrat, Rachid; Khashab, Niveen M.

2016-01-01

In spite of the huge advances in the area of synthetic carriers, their efficiency still poorly compares to natural vectors. Herein, we report the use of unmodified magnetotactic bacteria as a guidable delivery vehicle for DNA functionalized gold nanoparticles (AuNPs). High cargo loading is established under anaerobic conditions (bacteria is alive) through endocytosis where AuNPs are employed as transmembrane proteins mimics (facilitate endocytosis) as well as imaging agents to verify and quantify loading and release. The naturally bio-mineralized magnetosomes, within the bacteria, induce heat generation inside bacteria through magnetic hyperthermia. Most importantly after exposing the system to air (bacteria is dead) the cell wall stays intact providing an efficient bacterial vessel. Upon incubation with THP-1 cells, the magnetotactic bacterial cages (MBCs) adhere to the cell wall and are directly engulfed through the phagocytic activity of these cells. Applying magnetic hyperthermia leads to the dissociation of the bacterial microcarrier and eventual release of cargo.

Magnetotactic Bacterial Cages as Safe and Smart Gene Delivery Vehicles

KAUST Repository

Alsaiari, Shahad K.

2016-07-27

In spite of the huge advances in the area of synthetic carriers, their efficiency still poorly compares to natural vectors. Herein, we report the use of unmodified magnetotactic bacteria as a guidable delivery vehicle for DNA functionalized gold nanoparticles (AuNPs). High cargo loading is established under anaerobic conditions (bacteria is alive) through endocytosis where AuNPs are employed as transmembrane proteins mimics (facilitate endocytosis) as well as imaging agents to verify and quantify loading and release. The naturally bio-mineralized magnetosomes, within the bacteria, induce heat generation inside bacteria through magnetic hyperthermia. Most importantly after exposing the system to air (bacteria is dead) the cell wall stays intact providing an efficient bacterial vessel. Upon incubation with THP-1 cells, the magnetotactic bacterial cages (MBCs) adhere to the cell wall and are directly engulfed through the phagocytic activity of these cells. Applying magnetic hyperthermia leads to the dissociation of the bacterial microcarrier and eventual release of cargo.

Online Learning of Safe Patient Transfers in Occupational Therapy Education

Directory of Open Access Journals (Sweden)

Cynthia L. Hayden D. H. Ed., OTR/L, CHT

2013-02-01

Full Text Available Online higher education is steadily increasing. For programs in allied health to be offered effectively in an elearning format, clinical psychomotor skills need to be addressed. The aim of this research was to design, implement, and evaluate an online safe patient transfers module for occupational therapy assistant (OTAstudents. The efficacy of teaching safe patient transfers in an e-learning environment was appraised using both quantitative and qualitative analysis. The applied research project was completed at a Tennessee community college. A convenience sample of eighteen students participated in the pilot study. Twenty-five studentsparticipated in the subsequent study. The instructional design of the course was based on Mager’s CriterionReferenced Instruction model. Streaming video was used as the delivery method for course material. A pretest/posttest evaluated the students’ cognitive knowledge of safe patient transfers. A behavioral transferscompetency checklist was used to rate videotapes of students’ performance of assisted stand pivot and dependent sliding board transfers. Research findings indicated students were able to learn this psychomotor clinical skill online with beginning proficiency. A paired t-test showed marked improvement of cognitive knowledge. A student learning survey revealed the majority of students preferred at least one hands-on classroom session where instructor feedback and interaction with classmates confirmed safe and effectiveclinical technique.

Impact of managed care on healthcare delivery practices: the perception of healthcare administrators and clinical practitioners.

Science.gov (United States)

Tietze, Mari F

2003-01-01

Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.

Impact of a low-technology simulation-based obstetric and newborn care training scheme on non-emergency delivery practices in Guatemala.

Science.gov (United States)

Walton, Anna; Kestler, Edgar; Dettinger, Julia C; Zelek, Sarah; Holme, Francesca; Walker, Dilys

2016-03-01

To assess the effect of a low-technology simulation-based training scheme for obstetric and perinatal emergency management (PRONTO; Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) on non-emergency delivery practices at primary level clinics in Guatemala. A paired cross-sectional birth observation study was conducted with a convenience sample of 18 clinics (nine pairs of intervention and control clinics) from June 28 to August 7, 2013. Outcomes included implementation of practices known to decrease maternal and/or neonatal mortality and improve patient care. Overall, 25 and 17 births occurred in intervention and control clinics, respectively. Active management of the third stage of labor was appropriately performed by 20 (83%) of 24 intervention teams versus 7 (50%) of 14 control teams (P=0.015). Intervention teams implemented more practices to decrease neonatal mortality than did control teams (P<0.001). Intervention teams ensured patient privacy in 23 (92%) of 25 births versus 11 (65%) of 17 births for control teams (P=0.014). All 15 applicable intervention teams kept patients informed versus 6 (55%) of 11 control teams (P=0.001). Differences were also noted in teamwork; in particular, skill-based tools were used more often at intervention sites than control sites (P=0.012). Use of PRONTO enhanced non-emergency delivery care by increasing evidence-based practice, patient-centered care, and teamwork. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Diatomite silica nanoparticles for drug delivery

OpenAIRE

Ruggiero, Immacolata; Terracciano, Monica; Martucci, Nicola M; De Stefano, Luca; Migliaccio, Nunzia; Tatè, Rosarita; Rendina, Ivo; Arcari, Paolo; Lamberti, Annalisa; Rea, Ilaria

2014-01-01

Diatomite is a natural fossil material of sedimentary origin, constituted by fragments of diatom siliceous skeletons. In this preliminary work, the properties of diatomite nanoparticles as potential system for the delivery of drugs in cancer cells were exploited. A purification procedure, based on thermal treatments in strong acid solutions, was used to remove inorganic and organic impurities from diatomite and to make them a safe material for medical applications. The micrometric diatomite p...

Transfer pricing and safe harbours

Directory of Open Access Journals (Sweden)

Veronika Solilová

2013-01-01

Full Text Available Transfer prices are significant for both taxpayers and tax administrations because they determine in large part taxable profits of associated enterprises in different tax jurisdictions. Moreover, in the context of taxation, transfer prices must be complied with the arm’s length principle. However, Multinational Enterprises have been faced daily by conflicting rules and approaches to applying the arm’s length principle, burdensome documentation requirements, inconsistent audit standards and unpredictable competent authority outcomes. Therefore, the Committee on Fiscal Affairs launched another project on the administrative aspects of transfer pricing in 2010. On 16 May 2013 as a partial solution of this project was approved by the OECD Council the Revised Section E on Safe Harbours in Chapter IV of the Transfer Pricing Guidelines for Multinational Enterprises and Tax Authorities. The paper is focused on significant changes of newly approved chapter IV of the Transfer Pricing Guidelines for Multinational Enterprises and Tax Authorities, further on analysis of practice in this area, on advantages and disadvantages of safe harbours for taxpayers and competent authorities with aim to suggest recommendations on use of safe harbours in the Czech Republic.

Supporting transvisibility and gender diversity in nursing practice and education: embracing cultural safety.

Science.gov (United States)

Kellett, Peter; Fitton, Chantelle

2017-01-01

Many nursing education programs deserve a failing grade with respect to supporting gender diversity in their interactions with their students and in terms of the curricular content directed toward engaging in the safe and supportive nursing care of transgender clients. This situation contributes to transinvisibility in the nursing profession and lays a foundation for nursing practice that does not recognize the role that gender identity plays in the health and well-being of trans-clients and trans-nurses. This article seeks to raise readers' awareness about the problems inherent to transinvisibility and to propose several curricular and structural-level interventions that may serve to gradually increase the recognition of gender diversity in the planning and delivery of nursing education and practice. Contextualized in gender and intersectionality theory, cultural safety is presented as a viable and appropriate framework for engaging in these upstream approaches to addressing gender diversity in nursing education and practice. Among the structural interventions proposed are as follows: inclusive information systems, creation of gender neutral and safe spaces, lobbying for inclusion of competencies that address care of trans-persons in accreditation standards and licensure examinations and engaging in nursing research in this area. © 2016 John Wiley & Sons Ltd.

76 FR 81904 - Solicitation of New Safe Harbors and Special Fraud Alerts

Science.gov (United States)

2011-12-29

... Medicaid Patient and Program Protection Act of 1987, Public Law 100-93 Sec. 14, the Act, Sec. 1128B(b), 42...-called ``safe harbor'' provisions, specifying various payment and business practices that, although... basis for administrative sanctions. OIG safe harbor provisions have been developed ``to limit the reach...

Optimizing Cancer Care Delivery through Implementation Science

Directory of Open Access Journals (Sweden)

Heather B Neuman

2016-01-01

Full Text Available The 2013 Institute of Medicine report investigating cancer care concluded that the cancer care delivery system is in crisis due to an increased demand for care, increasing complexity of treatment, decreasing work force and rising costs. Engaging patients and incorporating evidence-based care into routine clinical practice are essential components of a high quality cancer delivery system. However, a gap currently exists between the identification of beneficial research findings and application in clinical practice. Implementation research strives to address this gap. In this review, we discuss key components of high quality implementation research. We then apply these concepts to a current cancer care delivery challenge in women’s health, specifically the implementation of a surgery decision aid for women newly diagnosed with breast cancer.

A new electrospray method for targeted gene delivery.

Science.gov (United States)

Boehringer, Stephan; Ruzgys, Paulius; Tamò, Luca; Šatkauskas, Saulius; Geiser, Thomas; Gazdhar, Amiq; Hradetzky, David

2018-03-05

A challenge for gene therapy is absence of safe and efficient local delivery of therapeutic genetic material. An efficient and reproducible physical method of electrospray for localized and targeted gene delivery is presented. Electrospray works on the principle of coulombs repulsion, under influence of electric field the liquid carrying genetic material is dispersed into micro droplets and is accelerated towards the targeted tissue, acting as a counter electrode. The accelerated droplets penetrate the targeted cells thus facilitating the transfer of genetic material into the cell. The work described here presents the principle of electrospray for gene delivery, the basic instrument design, and the various optimized parameters to enhance gene transfer in vitro. We estimate a transfection efficiency of up to 60% was achieved. We describe an efficient gene transfer method and a potential electrospray-mediated gene transfer mechanism.

Ligand-Modified Human Serum Albumin Nanoparticles for Enhanced Gene Delivery.

Science.gov (United States)

Look, Jennifer; Wilhelm, Nadine; von Briesen, Hagen; Noske, Nadja; Günther, Christine; Langer, Klaus; Gorjup, Erwin

2015-09-08

The development of nonviral gene delivery systems is a great challenge to enable safe gene therapy. In this study, ligand-modified nanoparticles based on human serum albumin (HSA) were developed and optimized for an efficient gene therapy. Different glutaraldehyde cross-linking degrees were investigated to optimize the HSA nanoparticles for gene delivery. The peptide sequence arginine-glycine-aspartate (RGD) and the HIV-1 transactivator of transduction sequence (Tat) are well-known as promising targeting ligands. Plasmid DNA loaded HSA nanoparticles were covalently modified on their surface with these different ligands. The transfection potential of the obtained plasmid DNA loaded RGD- and Tat-modified nanoparticles was investigated in vitro, and optimal incubation conditions for these preparations were studied. It turned out that Tat-modified HSA nanoparticles with the lowest cross-linking degree of 20% showed the highest transfection potential. Taken together, ligand-functionalized HSA nanoparticles represent promising tools for efficient and safe gene therapy.

Naturapolyceutics: The Science of Utilizing Natural Polymers for Drug Delivery

Directory of Open Access Journals (Sweden)

Ndidi C. Ngwuluka

2014-05-01

Full Text Available Naturapolyceutics defines the emerging science and technology platform that blends natural polymers and pharmaceutics for the design and development of drug delivery systems. Natural polymers due to their biological properties, sustainability, chemical flexibility, human and eco-friendliness are promising in this field. As drug delivery advances, there will be need for more polymers. Given that polymers utilized in pharmaceuticals require regulatory approval, robust processes are undertaken to facilitate the production of pharmaceutical grade natural polymers. This review provides insight into the processes—extraction, purification, modifications and characterizations—involved in the eventual utilization of natural polymers for drug delivery. The versatility of natural polymers and particularly modified natural polymers in targeted drug delivery, micro-/nano-drug delivery, theranostics, BioMEMs and generally in research and development of highly efficient, safe and quality products is demonstrated. Natural polymers are polymers of today and tomorrow. Therefore, the shift to undertake training, extensive research and subsequent commercialization of more natural polymers—novel and underutilized—for drug delivery is now!

A Clinical Nurse Leader (CNL) practice development model to support integration of the CNL role into microsystem care delivery.

Science.gov (United States)

Kaack, Lorraine; Bender, Miriam; Finch, Michael; Borns, Linda; Grasham, Katherine; Avolio, Alice; Clausen, Shawna; Terese, Nadine A; Johnstone, Diane; Williams, Marjory

The Veterans Health Administration (VHA) Office of Nursing Services (ONS) was an early adopter of Clinical Nurse Leader (CNL) practice, generating some of the earliest pilot data of CNL practice effectiveness. In 2011 the VHA ONS CNL Implementation & Evaluation Service (CNL I&E) piloted a curriculum to facilitate CNL transition to effective practice at local VHA settings. In 2015, the CNL I&E and local VHA setting stakeholders collaborated to refine the program, based on lessons learned at the national and local level. The workgroup reviewed the literature to identify theoretical frameworks for CNL practice and practice development. The workgroup selected Benner et al.'s Novice-to-Expert model as the defining framework for CNL practice development, and Bender et al.'s CNL Practice Model as the defining framework for CNL practice integration. The selected frameworks were cross-walked against existing curriculum elements to identify and clarify additional practice development needs. The work generated key insights into: core stages of transition to effective practice; CNL progress and expectations for each stage; and organizational support structures necessary for CNL success at each stage. The refined CNL development model is a robust tool that can be applied to support consistent and effective integration of CNL practice into care delivery. Published by Elsevier Inc.

Process development work plan for waste feed delivery system

International Nuclear Information System (INIS)

Papp, I.G.

1998-01-01

This work plan defines the process used to develop project definition for Waste Feed Delivery (WFD). Project definition provides the direction for development of definitive design media required for the ultimate implementation of operational processing hardware and software. Outlines for the major deliverables are attached as appendices. The implementation of hardware and software will accommodate requirements for safe retrieval and delivery of waste currently stored in Hanford's underground storage tanks. Operations and maintenance ensure the availability of systems, structures, and components for current and future planned operations within the boundary of the Tank Waste Remediation System (TWRS) authorization basis

The U.S. Twin Delivery Volume and Association with Cesarean Delivery Rates: A Hospital-Level Analysis.

Science.gov (United States)

Easter, Sarah Rae; Robinson, Julian N; Carusi, Daniela; Little, Sarah E

2018-03-01

 The objective of this study was to test whether hospitals experienced in twin delivery have lower rates of cesarean delivery for twins.  We divided obstetric hospitals in the 2011 National Inpatient Sample by quartile of annual twin deliveries and compared twin cesarean delivery rates between hospitals with weighted linear regression. We used Pearson's coefficients to correlate a hospital's twin cesarean delivery rate to its overall cesarean delivery and vaginal birth after cesarean (VBAC) rates.  Annual twin delivery volume ranged from 1 to 506 across the 547 analyzed hospitals with a median of 10 and mode of 3. Adjusted rates of cesarean delivery were independent of delivery volume with a rate of 75.5 versus 74.8% in the lowest and highest volume hospitals ( p  = 0.09 across quartiles). A hospital's cesarean delivery rate for twins moderately correlated with the overall cesarean rate ( r  = 0.52, p  < 0.01) and inversely correlated with VBAC rate ( r  =  - 0.42, p  < 0.01).  Most U.S. obstetrical units perform a low volume of twin deliveries with no decrease in cesarean delivery rates at higher volume hospitals. Twin cesarean delivery rates correlate with other obstetric parameters such as singleton cesarean delivery and VBAC rates suggesting twin cesarean delivery rate is more closely related to a hospital's general obstetric practice than its twin delivery volume. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Safe injection procedures, injection practices, and needlestick ...

African Journals Online (AJOL)

Nermine Mohamed Tawfik Foda

2017-01-10

Jan 10, 2017 ... sures regarding disposable injection equipment, waste containers, hand hygiene ... injection practices lead to high prevalence of NSSIs in operating rooms. .... guidelines, the availability of training courses to HCWs, and provi-.

Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices

Directory of Open Access Journals (Sweden)

Pierre Ernst

1998-01-01

Full Text Available Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI; its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.

Human Factors on the Flight Deck Safe Piloting Behaviour in Practice

CERN Document Server

Scheiderer, Joachim

2013-01-01

What is for a professional pilot required to fly as safe as possible? Written by pilots the book gives a detailed introduction into the basics of accident prevention in air traffic. Explicit background knowledge as well as detailed listings of safety relevant features in human behaviour are included.

Waste Feed Delivery Planning at Hanford - 13232

International Nuclear Information System (INIS)

Certa, Paul J.; Hohl, Ted M.; Kelly, James W.; Larsen, Douglas C.; West, Elizha B.; Ritari, Jaakob S.; Rodriguez, Juissepp S.

2013-01-01

The Integrated Waste Feed Delivery Plan (IWFDP) describes how waste feed will be delivered to the Waste Treatment and Immobilization Plant (WTP) to safely and efficiently accomplish the River Protection Project (RPP) mission. The IWFDP, which is integrated with the Baseline Case operating scenario, is comprised of three volumes. Volume 1 - Process Strategy provides an overview of waste feed delivery (WFD) and describes how the WFD system will be used to prepare and deliver feed to the WTP based on the equipment configuration and functional capabilities of the WFD system. Volume 2 - Campaign Plan describes the plans for the first eight campaigns for delivery to the WTP, evaluates projected feed for systematic issues, projects 242-A Evaporator campaigns, and evaluates double-shell tank (DST) space and availability of contingency feed. Volume 3 - Project Plan identifies the scope and timing of the DST and infrastructure upgrade projects necessary to feed the WTP, and coordinates over 30 projectized projects and operational activities that comprise the needed WFD upgrades. (authors)

Waste Feed Delivery Planning at Hanford - 13232

Energy Technology Data Exchange (ETDEWEB)

Certa, Paul J.; Hohl, Ted M.; Kelly, James W.; Larsen, Douglas C.; West, Elizha B.; Ritari, Jaakob S.; Rodriguez, Juissepp S. [Washington River Protection Solutions, LLC, P.O. 850, Richland, WA 99352 (United States)

2013-07-01

The Integrated Waste Feed Delivery Plan (IWFDP) describes how waste feed will be delivered to the Waste Treatment and Immobilization Plant (WTP) to safely and efficiently accomplish the River Protection Project (RPP) mission. The IWFDP, which is integrated with the Baseline Case operating scenario, is comprised of three volumes. Volume 1 - Process Strategy provides an overview of waste feed delivery (WFD) and describes how the WFD system will be used to prepare and deliver feed to the WTP based on the equipment configuration and functional capabilities of the WFD system. Volume 2 - Campaign Plan describes the plans for the first eight campaigns for delivery to the WTP, evaluates projected feed for systematic issues, projects 242-A Evaporator campaigns, and evaluates double-shell tank (DST) space and availability of contingency feed. Volume 3 - Project Plan identifies the scope and timing of the DST and infrastructure upgrade projects necessary to feed the WTP, and coordinates over 30 projectized projects and operational activities that comprise the needed WFD upgrades. (authors)

Waste feed delivery planning at Hanford-13232

International Nuclear Information System (INIS)

Certa, Paul J.; West, Elizha B.; Rodriguez, Juissepp S.; Hohl, Ted M.; Larsen, Douglas C.; Ritari, Jaakob S.; Kelly, James W.

2013-01-01

The Integrated Waste Feed Delivery Plan (IWFDP) describes how waste feed will be delivered to the Waste Treatment and Immobilization Plant (WTP) to safely and efficiently accomplish the River Protection Project (RPP) mission. The IWFDP, which is integrated with the Baseline Case operating scenario, is comprised of three volumes. Volume 1 - Process Strategy provides an overview of waste feed delivery (WFD) and describes how the WFD system will be used to prepare and deliver feed to the WTP based on the equipment configuration and functional capabilities of the WFD system. Volume 2 - Campaign Plan describes the plans for the first eight campaigns for delivery to the WTP, evaluates projected feed for systematic issues, projects 242-A Evaporator campaigns, and evaluates double-shell tank (DST) space and availability of contingency feed. Volume 3 - Project Plan identifies the scope and timing of the DST and infrastructure upgrade projects necessary to feed the WTP, and coordinates over 30 projectized projects and operational activities that comprise the needed WFD upgrades

Ion-Responsive Drug Delivery Systems.

Science.gov (United States)

Yoshida, Takayuki; Shakushiro, Kohsuke; Sako, Kazuhiro

2018-02-08

Some kinds of cations and anions are contained in body fluids such as blood, interstitial fluid, gastrointestinal juice, and tears at relatively high concentration. Ionresponsive drug delivery is available to design the unique dosage formulations which provide optimized drug therapy with effective, safe and convenient dosing of drugs. The objective of the present review was to collect, summarize, and categorize recent research findings on ion-responsive drug delivery systems. Ions in body fluid/formulations caused structural changes of polymers/molecules contained in the formulations, allow formulations exhibit functions. The polymers/molecules responding to ions were ion-exchange resins/fibers, anionic or cationic polymers, polymers exhibiting transition at lower critical solution temperature, self-assemble supramolecular systems, peptides, and metalorganic frameworks. The functions of ion-responsive drug delivery systems were categorized to controlled drug release, site-specific drug release, in situ gelation, prolonged retention at the target sites, and enhancement of drug permeation. Administration of the formulations via oral, ophthalmic, transdermal, and nasal routes has showed significant advantages in the recent literatures. Many kinds of drug delivery systems responding to ions have been reported recently for several administration routes. Improvement and advancement of these systems can maximize drugs potential and contribute to patients in the world. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

Instructional maps of safe working methods and practices for separate types of opera-tions conducted in the oil mine

Directory of Open Access Journals (Sweden)

И. В. Климова

2017-06-01

Full Text Available Instructing personnel in the issues of labor protection and industrial safety at hazardous facilities is one of the main tasks that face the employer; the quality with which this procedure is organized and carried out defines not only company’s indicators, but the mere possibility of its normal functioning. The paper contains a detailed overview of the typical content of standard documentation, which is currently used when conducting operations in the oil mines of Yarega high-viscosity oil deposit. Distinct features and unique nature of this oil field require special measures to guarantee safety of personnel and all facilities in general.The author proposes and reviews an additional type of operating guidelines – instructional map of safe working methods and practices. It is more illustrative than existing documentation (charts of inclined shaft development, labor protection regulations, which allows to upgrade the process of instructing personnel in the oil mines, to improve the quality of instructions and to reduce the risk of emergencies, accidents, industrial injuries.The author reviews the structure of suggested instructional map, offers a detailed arrangement diagram for the main thematic sections of the map, as well as their content. Instructional maps are regarded as a type of operating guidelines that include: description and characteristics of equipment, instruments and appliances; general safety requirements; content and execution sequence of operational elements with their graphical images; distribution of responsibilities with an indication of their priority in case the operations are conducted by several workers; specific safety requirements for equipment, materials, instruments, safety clothes and footwear, personal protective gear etc. (prohibitions, warnings.Advantages and disadvantages of proposed instructional maps of safe working methods and practices are highlighted.

A BIM-Info delivery protocol

Directory of Open Access Journals (Sweden)

Martin Hooper

2015-10-01

Full Text Available Today, with many of the technological issues of integrated information management resolved (perhaps excluding the matter of interoperability, defining the content and status of BIM information deliveries remains both a practical and a theoretical problem. New BIM tools and new design processes and procedures have led to a certain confusion of what information is needed for particular BIM uses. This paper seeks to explore and enable a method of defining the content of model information deliverables through a review of 2 key primary specific BIM uses: 3d Design Coordination and Early Energy Appraisal through an analysis of practical application. The scope of this study is limited to a review of information flow within residential projects in a Swedish context and looks at two projects with a view to identify and establish a common definition of the key BIM objects and properties necessary for particular tasks. The key deliverable from this study is the BIM-Info Delivery Protocol (IDP which attempts to align consultant BIM-information delivery expectations and represents a tangible solution to assist consultants to manage BIM information. Concluding reflections consider the positioning of the IDP relative to the on-going development of IDMs / MVDs and highlight the key constituent parameters of an Information Delivery Specification (IDS.

Clinical Decision Support and Optional Point of Care Testing of Renal Function for Safe Use of Antibiotics in Elderly Patients : A Retrospective Study in Community Pharmacy Practice

NARCIS (Netherlands)

Heringa, Mette; Floor-Schreudering, Annemieke; De Smet, Peter A G M; Bouvy, Marcel L

2017-01-01

OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a

Cesarean delivery rates and obstetric culture - an Italian register-based study.

Science.gov (United States)

Plevani, Cristina; Incerti, Maddalena; Del Sorbo, Davide; Pintucci, Armando; Vergani, Patrizia; Merlino, Luca; Locatelli, Anna

2017-03-01

Cesarean delivery rates are rising due to multiple factors, including less use of operative vaginal delivery and vaginal birth after cesarean delivery, which often reflect local obstetric practices. Objectives of the study were to analyze the relations between cesarean delivery, these practices, and perinatal outcomes. We included all deliveries in the 72 hospitals of Lombardia, a region in northern Italy, during the year 2013. The delivery certificate was used as data source. Pearson's correlation coefficient and logistic regression were used for statistical analysis. We included 87 896 deliveries. The number of deliveries per hospital ranged from 140 to 6123. The rate of cesarean delivery was 28.3% (range 9.9-86.4%), operative vaginal delivery 4.7% (range 0.2-10.0%), and vaginal birth after cesarean 17.3% (range 0-79.2%). We found a significant inverse correlation between rates of overall cesarean delivery and operative vaginal delivery (r = -0.25, p = 0.04). The correlation between rate of overall cesarean delivery and vaginal birth after cesarean was also inverse and significant (r = -0.57, p cesarean delivery rate and the rates of Apgar score at 5 min cesarean delivery, could reduce the rising cesarean delivery rate. This will require a change in obstetric culture, continuing education of healthcare providers, and leadership. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Evaluation of Urban Freight Deliveries using Microsimulation and Surrogate Safety Measures

Science.gov (United States)

2018-02-01

Freight deliveries on signalized urban streets are known to cause lane blockages during deliveries. When delivery vehicles block lanes of traffic near signalized intersections, the capacity of the intersection is affected. Current practice is for tra...

Acute oxygen therapy: a review of prescribing and delivery practices

Directory of Open Access Journals (Sweden)

Cousins JL

2016-05-01

Full Text Available Joyce L Cousins,1–3 Peter AB Wark,3–5 Vanessa M McDonald2–5 1Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Sydney, 2School of Nursing and Midwifery, 3Priority Research Centre for Healthy Lungs, 4School of Medicine and Public Health, The University of Newcastle, 5Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, NSW, Australia Abstract: Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patients who are at risk of type II respiratory failure in whom the risk of hypercapnia is well established. In recent times, several international bodies have advocated for the prescription of oxygen therapy in an attempt to reduce this risk in vulnerable patient groups. Despite this guidance, published data have demonstrated that there has been poor uptake of these recommendations. Multiple interventions have been tested to improve concordance, and while some of these interventions show promise, the sustainability of these interventions are less convincing. In this review, we summarize data that have been published on the prevalence of oxygen prescription and the accurate and appropriate administration of this drug therapy. We also identify strategies that have shown promise in facilitating changes to oxygen prescription and delivery practice. There is a clear need to investigate the barriers, facilitators, and attitudes of clinicians in relation to the prescription of oxygen therapy in acute care. Interventions based on these findings then need to be designed and tested to facilitate the application of evidence-based guidelines to support sustained changes in practice, and ultimately improve patient care. Keywords: chronic obstructive pulmonary disease, COPD, type II respiratory failure, oxygen therapy, prescribing, hypoxia, hypercapnia

A safe workplace

International Nuclear Information System (INIS)

Rittsel, Hans; Andersson, Bengt A.

1993-01-01

Full text: The video 'A safe workplace' has been produced by ABB Atom in order to create a tool for showing different target audiences that ABB Atom Nuclear Fuel Production Plant is a safe workplace and to 'de-mystify' nuclear fuel production. The main target audiences are visitor groups and employees of the company, but the video also qualifies for use as an information tool for other target groups who ask for a proper explanation of the way nuclear fuel is produced. The summarized content of the video is as follows: All individual steps of the production process are described with focus on the safety, quality and environmental requirements. The first part shows the delivery of UF 6 (uranium hexafluoride) to the plant and the following process for the conversion to UO 2 (uranium dioxide). The conversion method used is wet conversion that includes evaporation, precipitation, filtration, washing, reduction and stabilization. The next part is a description of the fuel pellet manufacture including uranium oxide blending, pellet pressing, sintering, grinding and a final visual inspection. A separate part, describing the manufacture of fuel pellets with a burnable neutron absorber, is included. The third part shows how to produce fuel rods and complete assemblies. Some of the moments of quality supervision that support the entire manufacturing process are also shown. The last part of the video comprises a brief description of the manufacture of fuel channels and other reactor core components like control rods. The video is produced with a Swedish spoken narrative. The playing time is 15 minutes. The video will be delivered with a text printed in English and copies reproduced in the PAL/VHS system may be ordered from ABB Atom Communication Dept. telefax no +4621-11 41 90, at the price of USD 100.- or SEK 750.- each. (author)

Dendrimers: a class of polymers in the nanotechnology for the delivery of active pharmaceuticals.

Science.gov (United States)

Samad, Abdus; Alam, Md Intakhab; Saxena, Kinshuk

2009-01-01

Dendrimers represent a class of novel polymers having unique molecular architectures characterized by their well-defined structure, with a high degree of molecular uniformity, low polydispersity and properties that make them attractive materials for the development of nanomedicines. The dendrimer drug delivery can be achieved by coupling a drug through one of two approaches. Hydrophobic drugs can be complexed within the hydrophobic dendrimer interior to make them water-soluble or drugs can be covalently coupled onto the surface of the dendrimer. In addition, dendrimers have been shown to be capable of bypassing efflux transporters. A new generation of dendrimer-based delivery systems will enable the efficient transport of drugs across cellular barriers. This review deals principally with the synthesis, characterization and recent applications of dendrimers. In future it will only ever be possible to designate a dendrimer as safe means of drug delivery related to a specific application. However, so far limited clinical experience using dendrimers makes it impossible to designate any particular system which is safe and non toxic. Although there is widespread concern as to the safety of nanosized particles, preclinical and clinical experience gained during the development of polymeric excipients, biomedical polymers and polymer therapeutics showed that judicious development of dendrimer chemistry for each specific application will ensure development of safe and important materials for biomedical and pharmaceutical use.

On-site management of investigational products and drug delivery systems in conformity with Good Clinical Practices (GCPs).

Science.gov (United States)

Méthot, Julie; Brisson, Diane; Gaudet, Daniel

2012-04-01

Investigators and research teams participating in clinical trials have to deal with complex investigational products, study designs, and research environments. The emergence of new drug delivery systems and investigational products combining more than one drug and the development of biodrugs such as monoclonal antibodies, peptides, siRNA, and gene therapy to treat orphan or common diseases constitute a new challenge for investigators and clinical sites. We describe the requirements and challenges of drug management in conformity with Good Clinical Practices (GCPs) for investigators and sites participating in clinical trials. Review At all sites participating in clinical trials, standard operating procedures (SOPs) covering the critical path of drug and drug delivery systems management are required. All steps should be auditable, including reception, validation, storage, access, preparation, distribution, techniques of administration, use, return, and destruction of research products. Biodrugs require traceability and specific SOPs on the management of potential immune reactions. Investigational products must be stored under standard auditable conditions. The traceability of storage conditions (including temperature) requires these conditions to be monitored on a continuous basis. A dedicated space with restricted access limited to authorized qualified personnel facilitates the monitoring. The development of standardized, auditable settings and the application of dedicated, site-specific SOPs for the management of investigational products and drug delivery systems contribute to guarantee the compliance to GCP requirements.

Arkansas People Participating in Lead Education (APPLE): results of a lead-safe training program.

Science.gov (United States)

Ferguson, Alesia; Bursac, Zoran; Kern, David F

2011-06-01

Lead is still seen as one of the most harmful environmental toxins for young children, with the predominant source being deteriorating lead-based paint. Those at continued risk include those living in homes built before 1978, renovators and remodelers, and especially those with limited access to proper healthcare and diets. Proper training on lead-safe work practices focused on preventing and reducing the spread of lead dust can help reduce lead exposure. Presented in this paper are experiences in delivering lead-safe work practices training in six Arkansas cities, and results from pre- and post- surveys delivered before and immediately after the training. Pre- and post-surveys assess strong and weak areas of training. Participants demonstrated positive shifts in attitude and behavior towards lead-safe work practices following training. However, our research found that more emphasis should be focused on clarifying current lead exposure sources and routes for children.

Nanostructures for delivery of natural antimicrobials in food.

Science.gov (United States)

Lopes, Nathalie Almeida; Brandelli, Adriano

2017-04-10

Natural antimicrobial compounds are a topic of utmost interest in food science due to the increased demand for safe and high-quality foods with minimal processing. The use of nanostructures is an interesting alternative to protect and delivery antimicrobials in food, also providing controlled release of natural compounds such as bacteriocins and antimicrobial proteins, and also for delivery of plant derived antimicrobials. A diversity of nanostructures are capable of trapping natural antimicrobials maintaining the stability of substances that are frequently sensitive to food processing and storage conditions. This article provides an overview on natural antimicrobials incorporated in nanostructures, showing an effective antimicrobial activity on a diversity of food spoilage and pathogenic microorganisms.

Genetic engineering of a temperate phage-based delivery system for CRISPR/Cas9 antimicrobials against Staphylococcus aureus.

Science.gov (United States)

Park, Joo Youn; Moon, Bo Youn; Park, Juw Won; Thornton, Justin A; Park, Yong Ho; Seo, Keun Seok

2017-03-21

Discovery of clustered, regularly interspaced, short palindromic repeats and the Cas9 RNA-guided nuclease (CRISPR/Cas9) system provides a new opportunity to create programmable gene-specific antimicrobials that are far less likely to drive resistance than conventional antibiotics. However, the practical therapeutic use of CRISPR/Cas9 is still questionable due to current shortcomings in phage-based delivery systems such as inefficient delivery, narrow host range, and potential transfer of virulence genes by generalized transduction. In this study, we demonstrate genetic engineering strategies to overcome these shortcomings by integrating CRISPR/Cas9 system into a temperate phage genome, removing major virulence genes from the host chromosome, and expanding host specificity of the phage by complementing tail fiber protein. This significantly improved the efficacy and safety of CRISPR/Cas9 antimicrobials to therapeutic levels in both in vitro and in vivo assays. The genetic engineering tools and resources established in this study are expected to provide an efficacious and safe CRISPR/Cas9 antimicrobial, broadly applicable to Staphylococcus aureus.

76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

Science.gov (United States)

2011-03-08

... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

Waste Feed Delivery Raw Water and Potable Water and Compressed Air Capacity Evaluation

International Nuclear Information System (INIS)

MAY, T.H.

2000-01-01

This study evaluated the ability of the Raw Water, Potable Water, and Compressed Air systems to support safe storage as well as the first phase of the Waste Feed Delivery. Several recommendations are made to improve the system

Discovery of Cationic Polymers for Non-viral Gene Delivery using Combinatorial Approaches

Science.gov (United States)

Barua, Sutapa; Ramos, James; Potta, Thrimoorthy; Taylor, David; Huang, Huang-Chiao; Montanez, Gabriela; Rege, Kaushal

2015-01-01

Gene therapy is an attractive treatment option for diseases of genetic origin, including several cancers and cardiovascular diseases. While viruses are effective vectors for delivering exogenous genes to cells, concerns related to insertional mutagenesis, immunogenicity, lack of tropism, decay and high production costs necessitate the discovery of non-viral methods. Significant efforts have been focused on cationic polymers as non-viral alternatives for gene delivery. Recent studies have employed combinatorial syntheses and parallel screening methods for enhancing the efficacy of gene delivery, biocompatibility of the delivery vehicle, and overcoming cellular level barriers as they relate to polymer-mediated transgene uptake, transport, transcription, and expression. This review summarizes and discusses recent advances in combinatorial syntheses and parallel screening of cationic polymer libraries for the discovery of efficient and safe gene delivery systems. PMID:21843141

Laser assisted drug delivery: a review of an evolving technology.

Science.gov (United States)

Sklar, Lindsay R; Burnett, Christopher T; Waibel, Jill S; Moy, Ronald L; Ozog, David M

2014-04-01

Topically applied drugs have a relatively low cutaneous bioavailability. This article reviews the existing applications of laser assisted drug delivery, a means by which the permeation of topically applied agents can be enhanced into the skin. The existing literature suggests that lasers are a safe and effective means of enhancing the delivery of topically applied agents through the skin. The types of lasers most commonly studied in regards to drug delivery are the carbon dioxide (CO2 ) and erbium:yttrium-aluminum-garnet (Er:YAG) lasers. Both conventional ablative and fractional ablative modalities have been utilized and are summarized herein. The majority of the existing studies on laser assisted drug delivery have been performed on animal models and additional human studies are needed. Laser assisted drug delivery is an evolving technology with potentially broad clinical applications. Multiple studies demonstrate that laser pretreatment of the skin can increase the permeability and depth of penetration of topically applied drug molecules for both local cutaneous and systemic applications. © 2014 Wiley Periodicals, Inc.

A review of drug delivery systems based on nanotechnology and green chemistry: green nanomedicine

Directory of Open Access Journals (Sweden)

Jahangirian H

2017-04-01

Full Text Available Hossein Jahangirian,1 Ensieh Ghasemian Lemraski,2 Thomas J Webster,1 Roshanak Rafiee-Moghaddam,3 Yadollah Abdollahi4 1Department of Chemical Engineering, Northeastern University, Boston, MA, USA; 2Department of Chemistry, Faculty of Science, Ilam University, Ilam, Iran; 3School of Chemical Sciences and Food Technology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, 4Department of Electrical Engineering, Faculty of Engineering, University of Malaysia, Kuala Lumpur, Malaysia Abstract: This review discusses the impact of green and environmentally safe chemistry on the field of nanotechnology-driven drug delivery in a new field termed “green nanomedicine”. Studies have shown that among many examples of green nanotechnology-driven drug delivery systems, those receiving the greatest amount of attention include nanometal particles, polymers, and biological materials. Furthermore, green nanodrug delivery systems based on environmentally safe chemical reactions or using natural biomaterials (such as plant extracts and microorganisms are now producing innovative materials revolutionizing the field. In this review, the use of green chemistry design, synthesis, and application principles and eco-friendly synthesis techniques with low side effects are discussed. The review ends with a description of key future efforts that must ensue for this field to continue to grow. Keywords: green chemistry, cancer, drug delivery, nanoparticle

Efficacious and safe tissue-selective controlled gene therapy approaches for the cornea.

Directory of Open Access Journals (Sweden)

Rajiv R Mohan

2011-04-01

Full Text Available Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5, and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.5×10(12 vg/ml expressing green fluorescent protein gene (GFP was topically applied onto normal or diseased (fibrotic or neovascularized rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit eyes were induced with photorefractive keratectomy using excimer laser and VEGF (630 ng using micropocket assay, respectively. Slit-lamp biomicroscopy and immunocytochemistry were used to confirm fibrosis and neovascularization in rabbit corneas. The levels, location and duration of delivered-GFP gene expression in the rabbit stroma were measured with immunocytochemistry and/or western blotting. Slot-blot measured delivered-GFP gene copy number. Confocal microscopy performed in whole-mounts of cornea and thick corneal sections determined geometric and spatial localization of delivered-GFP in three-dimensional arrangement. AAV5 toxicity and safety were evaluated with clinical eye exam, stereomicroscopy, slit-lamp biomicroscopy, and H&E staining. A single 2-minute AAV5 topical application via custom delivery-technique efficiently and selectively transduced keratocytes in the anterior stroma of normal and diseased rabbit corneas as evident from immunocytochemistry and confocal microscopy. Transgene expression was first detected at day 3, peaked at day 7, and was maintained up to 16 weeks (longest tested time point. Clinical and slit-lamp eye examination in live rabbits and H&E staining did not reveal any significant changes between AAV5

Cesarean delivery practices in teaching public and non- government ...

African Journals Online (AJOL)

admin

previous cesarean section scar and other non medical indications like .... from the delivery record of the year 2011 (from January ... Confidentiality and privacy of all data were highly ..... monitoring, and lack of facility for electronic fetal heart.

Application of polymeric nanoparticles and micelles in insulin oral delivery

Directory of Open Access Journals (Sweden)

Milind Sadashiv Alai

2015-09-01

Full Text Available Diabetes mellitus is an endocrine disease in which the pancreas does not produce sufficient insulin or the body cannot effectively use the insulin it produces. Insulin therapy has been the best choice for the clinical management of diabetes mellitus. The current insulin therapy is via subcutaneous injection, which often fails to mimic the glucose homeostasis that occurs in normal individuals. This provokes numerous attempts to develop a safe and effective noninvasive route for insulin delivery. Oral delivery is the most convenient administration route. However, insulin cannot be well absorbed orally because of its rapid enzymatic degradation in the gastrointestinal tract. Therefore, nanoparticulate carriers such as polymeric nanoparticles and micelles are employed for the oral delivery of insulin. These nanocarriers protect insulin from degradation and facilitate insulin uptake via a transcellular and/or paracellular pathway. This review article focuses on the application of nanoparticles and micelles in insulin oral delivery. The recent advances in this topic are also reviewed.

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal.

Science.gov (United States)

Gyawali, Sudesh; Rathore, Devendra S; Kc, Bhuvan; Shankar, P Ravi

2013-01-03

Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a) to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b) to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. A descriptive cross-sectional mixed type (qualitative and quantitative) survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. The in-charges (eight males, two females) who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable) injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal training in waste management. Certain safe injection

Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal

Directory of Open Access Journals (Sweden)

Gyawali Sudesh

2013-01-01

Full Text Available Abstract Background Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. Methodology A descriptive cross-sectional mixed type (qualitative and quantitative survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. Results The in-charges (eight males, two females who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal

Innovative vaccine delivery strategies in response to a cholera outbreak in the challenging context of Lake Chilwa. A rapid qualitative assessment.

Science.gov (United States)

Heyerdahl, Leonard W; Ngwira, Bagrey; Demolis, Rachel; Nyirenda, Gabriel; Mwesawina, Maurice; Rafael, Florentina; Cavailler, Philippe; Bernard Le Gargasson, Jean; Mengel, Martin A; Gessner, Bradford D; Guillermet, Elise

2017-11-07

A reactive campaign using two doses of Shanchol Oral Cholera Vaccine (OCV) was implemented in 2016 in the Lake Chilwa Region (Malawi) targeting fish dependent communities. Three strategies for the second vaccine dose delivery (including delivery by a community leader and self-administration) were used to facilitate vaccine access. This assessment collected vaccine perceptions and opinions about the OCV campaign of 313 study participants, including: fishermen, fish traders, farmers, community leaders, and one health and one NGO officer. Socio-demographic surveys were conducted, In Depth Interviews and Focus Group Discussions were conducted before and during the campaign. Some fishermen perceived the traditional delivery strategy as reliable but less practical. Delivery by traditional leaders was acceptable for some participants while others worried about traditional leaders not being trained to deliver vaccines or beneficiaries taking doses on their own. A slight majority of beneficiaries considered the self-administration strategy practical while some beneficiaries worried about storing vials outside of the cold chain or losing vials. During the campaign, a majority of participants preferred receiving oral vaccines instead of injections given ease of intake and lack of pain. OCV was perceived as efficacious and safe. However, a lack of information on how sero-protection may be delayed and the degree of sero-protection led to loss of trust in vaccine potency among some participants who witnessed cholera cases among vaccinated individuals. OCV campaign implementation requires accompanying communication on protective levels, less than 100% vaccine efficacy, delays in onset of sero-protection, and out of cold chain storage. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cool and Safe: Multiplicity in Safe Innovation at Unilever

Science.gov (United States)

Penders, Bart

2011-01-01

This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

Relationships between Safe Pesticide Practice and Perceived Benefits and Subjective Norm, and the Moderation Role of Information Acquisition: Evidence from 971 Farmers in China.

Science.gov (United States)

Wang, Jianhua; Deng, Yuanyuan; Ma, Yuting

2017-08-25

Improper use of pesticides among farmers has caused food safety issues which are serious threats to public health in China. A central question concerns how to motivate farmers to self-regulate their pesticide usage. The paper aims to identify the influence of an internal driving factor, i.e., perceived benefits, and an external driving factor, i.e., subjective norm, on farmers' safe pesticide behaviors, and whether the two factors are moderated by the exposure to information on government policies and the market, based on a sample of 971 farmers selected from 5 Chinese provinces. The results revealed that farmers' safe pesticide usage was predominately driven by perceived benefits whereas external pressure or subjective norm did not play much of a role. Interaction effects were found between the exposure to market information and perceived benefits, and also between subjective norm and exposure to government policy. Extensions agencies are recommended to effectively convey to farmers the benefits to follow safe pesticide practices. Meanwhile, surveillance and monitoring systems should be established so that the prices of their agricultural products are reflected by the quality of the products.

Improving the delivery of preventive care services.

Science.gov (United States)

Hung, Dorothy Y

2007-05-01

Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.

Firewood processing and delivery logistics; Polttopuun kaesittely- ja jakelulogistiikka

Energy Technology Data Exchange (ETDEWEB)

Nevalainen, A [Tulipuu Oy, Juuka (Finland)

1997-12-31

The aim of this research is to develop the processing and the delivery of firewood in order to improve the obtainability of firewood in the urban areas, to increase the user friendliness of the firewood, and to reduce the delivery costs of it. The project consists of development of recycled firewood processing and transportation units, organisation of the delivery and the testing of these in practice

Firewood processing and delivery logistics; Polttopuun kaesittely- ja jakelulogistiikka

Energy Technology Data Exchange (ETDEWEB)

Nevalainen, A. [Tulipuu Oy, Juuka (Finland)

1996-12-31

The aim of this research is to develop the processing and the delivery of firewood in order to improve the obtainability of firewood in the urban areas, to increase the user friendliness of the firewood, and to reduce the delivery costs of it. The project consists of development of recycled firewood processing and transportation units, organisation of the delivery and the testing of these in practice

Implicit attitudes towards risky and safe driving in a Danish sample

DEFF Research Database (Denmark)

Martinussen, Laila Marianne

; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States.

Science.gov (United States)

Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E

2018-03-01

With published evidence-based Standards for Psychosocial Care for Children with Cancer and their Families, it is important to know the current status of their implementation. This paper presents data on delivery of psychosocial care related to the Standards in the United States. Pediatric oncologists, psychosocial leaders, and administrators in pediatric oncology from 144 programs completed an online survey. Participants reported on the extent to which psychosocial care consistent with the Standards was implemented and was comprehensive and state of the art. They also reported on specific practices and services for each Standard and the extent to which psychosocial care was integrated into broader medical care. Participants indicated that psychosocial care consistent with the Standards was usually or always provided at their center for most of the Standards. However, only half of the oncologists (55.6%) and psychosocial leaders (45.6%) agreed or strongly agreed that their psychosocial care was comprehensive and state of the art. Types of psychosocial care provided included evidence-based and less established approaches but were most often provided when problems were identified, rather than proactively. The perception of state of the art care was associated with practices indicative of integrated psychosocial care and the extent to which the Standards are currently implemented. Many oncologists and psychosocial leaders perceive that the delivery of psychosocial care at their center is consistent with the Standards. However, care is quite variable, with evidence for the value of more integrated models of psychosocial services. © 2017 Wiley Periodicals, Inc.

Nanoparticulate delivery systems for antiviral drugs.

Science.gov (United States)

Lembo, David; Cavalli, Roberta

2010-01-01

Nanomedicine opens new therapeutic avenues for attacking viral diseases and for improving treatment success rates. Nanoparticulate-based systems might change the release kinetics of antivirals, increase their bioavailability, improve their efficacy, restrict adverse drug side effects and reduce treatment costs. Moreover, they could permit the delivery of antiviral drugs to specific target sites and viral reservoirs in the body. These features are particularly relevant in viral diseases where high drug doses are needed, drugs are expensive and the success of a therapy is associated with a patient's adherence to the administration protocol. This review presents the current status in the emerging area of nanoparticulate delivery systems in antiviral therapy, providing their definition and description, and highlighting some peculiar features. The paper closes with a discussion on the future challenges that must be addressed before the potential of nanotechnology can be translated into safe and effective antiviral formulations for clinical use.

Lessons from Semmelweis:A Social Epidemiologic Update On Safe Motherhood

Directory of Open Access Journals (Sweden)

Julie Cwikel

2008-01-01

Full Text Available In this historical review, Ignaz Semmelweis's study of handwashing to prevent puerperal fever is described and used as a benchmark from which to identify salient issues that are informative to today's women’s health activists working for Safe Motherhood. The epidemiology of contemporary excess maternal mortality is reviewed. Using the conceptual framework of social epidemiology, the paper addresses four issues that were problematic in Semmelweis’ era. New tools in public health are presented that can help to solve critical, still challenging problems to reduce excess maternal mortality, nosocomial infections, and puerperal fever at childbirth: 1 progress in behavioral methods to promote health behavior change, 2 the introduction of participatory action research, 3 the diffusion of evidence-based public health practice and 4 understanding how politics and health interact and present challenges when trying to meet public health goals. Social exclusion and marginality are still key issues in determining who has access to safe motherhood and who risks her life in maternity. Applied social epidemiology allows practitioners to make effective use of the already accumulated evidence and translate it into effective public health practice to promote safe motherhood around the world.

Personalizing knowledge delivery services: a conceptual framework

Science.gov (United States)

Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

2003-01-01

Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

Comparison of Fetomaternal Outcome between 47 Deliveries Following Successful External Cephalic Version for Breech Presentation and 7456 Deliveries Following Spontaneous Cephalic Presentation.

Science.gov (United States)

de Gregorio, Nikolaus; Friedl, Thomas; Schramm, Amelie; Reister, Frank; Janni, Wolfgang; Ebner, Florian

2017-08-25

Achieving a cephalic position after a successful external cephalic version (ECV) is desired to result in delivery and fetal outcomes that are similar to those of deliveries following spontaneous cephalic presentation. We performed a retrospective cohort study including patients with successful ECV following fetal breech position (ECV cohort, n = 47) or with a singleton spontaneous cephalic pregnancy at ≥37 weeks of gestational age (control group, n = 7,456) attempting a vaginal delivery between 2010 and 2013 at the University Hospital Ulm. The mode of delivery and fetal outcome parameters were compared between these 2 groups using nonparametric statistics. ECV cohort and control group did not differ with respect to maternal age, parity, gestational age at birth, and fetal gender. There were no significant differences between the 2 groups with regard to all parameters indicating fetal outcome. However, the rate of cesarean sections was higher after successful ECV compared to spontaneous cephalic presentation (27.7 vs. 12.8%, OR 2.615). While vaginal delivery is less likely to happen after a successful ECV compared to spontaneous cephalic singleton pregnancies, fetal outcome parameters showed no difference between the 2 groups. Physicians should be counseling and encouraging women to attempt ECV, as it is a safe and effective procedure. © 2017 S. Karger AG, Basel.

Safe management of cesarean section in a patient of Eisenmenger syndrome

Directory of Open Access Journals (Sweden)

Silvia Minicucci

2012-01-01

Full Text Available We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO (as a bridge to recovery or bridge to salvage was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.

Albumin-mediated delivery of siRNA

DEFF Research Database (Denmark)

Bienk, Konrad

2015-01-01

. The human body, however, possesses several natural transport mechanisms for active transport of molecules. Amongst these is albumin, which is the most abundant plasma protein and has a circulatory half-life of ~21 days, partially due to engagement and recycling by the neonatal Fc receptor (FcRn). Albumin...... vehicle. This proof of concept silencing showed that siRNA can be used for therapeutic purposes without the use of non-biocompatible polymer or lipid materials. This work, therefore, provides a novel technology platform for the safe delivery of siRNA therapeutics....

Instrumental vaginal delivery - an assessment of use in a tertiary ...

African Journals Online (AJOL)

O'SHEHU

Results: The incidence of instrumental vaginal delivery was 1.06% of all deliveries ... and the most common maternal complication was post-partum ... that in modern obstetric practice, the goal is ... expulsive efforts due to fatigue or exhaustion.

Procedure of safe handling with cytostatic drugs

Directory of Open Access Journals (Sweden)

Kodžo Dragan

2003-01-01

Full Text Available Working group for safe handling with cytostatic drugs has been formed by the Ministry of Health, and it consists of professionals from IORS, Federal Bureau of Weights and Measures, Industrial Medicine, Institute of Hematology, Military Medical Academy, and Crown Agents. The aim of this working group is to prepare procedures for safe handling with cytostatic drugs, as well as program for educational seminar for nurses, medical technicians, and pharmaceutical technicians. The procedures will serve as a guide of good practice of oncology health care, and will refer to all actions that health care professionals carry out from the moment of drugs arrival to the pharmacy to the moment of their application. In the first segment of this procedure, general rules are given for working with cytotoxic agents, control for risky exposures, safe system of work, control of working environment, monitoring of the employees' health condition adequate protection in the working environment, protective equipment of the employees (gloves, mask, cap, eyeglasses, shoe covers, coats and chambers for vertical laminary air stream. Storing of cytostatics, procedure in case of accident, and waste handling and removal are also described in this segment. Fifty-three standard operational procedures are described in detail in the second segment. Training scheme for preparation of chemotherapy is given in the third segment - education related to various fields and practical part, which would be carried out through workshops, and at the end of the course participants would pass a test and obtain certificate. After the procedures for safe handling with cytostatics are legally regulated employer will have to provide minimum of protective equipment, special rooms for the drugs dissolving, chambers with laminar airflow, 6 hours working time, rotation of the staff working with drugs dissolving in intervals of every five years, higher efficiency, better health control. In conclusion

Improving Safe Sleep Modeling in the Hospital through Policy Implementation.

Science.gov (United States)

Heitmann, Rachel; Nilles, Ester K; Jeans, Ashley; Moreland, Jackie; Clarke, Chris; McDonald, Morgan F; Warren, Michael D

2017-11-01

Introduction Sleep-related infant deaths are major contributors to Tennessee's high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics' safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality.

Zeolites: promising candidates for drug delivery systems (DDSs)

OpenAIRE

Vilaça, Natália; Amorim, Ricardo; Baltazar, Fátima; Fonseca, António Manuel; Neves, Isabel C.

2012-01-01

[Excerpt] The aim of controlled drug delivery systems (DDSs) is to administer the necessary amount of drug safely and effectively to specific sites in the human body and to regulate the temporal drug profile for maximum therapeutic benefits.[1] Zeolites are crystalline aluminosilicates solids with very regular microporous structures and they have been recently considered for medical use due to their biological properties and stability in biological environments.[1,2] The large variety in ...

A framework for the organization and delivery of systemic treatment.

Science.gov (United States)

Vandenberg, T; Coakley, N; Nayler, J; Degrasse, C; Green, E; Mackay, J A; McLennan, C; Smith, A; Wilcock, L; Trudeau, M E

2009-01-01

Increasing systemic treatment and shortages of oncology professionals in Canada require innovative approaches to the safe and effective delivery of intravenous (IV) cancer treatment. We conducted a systematic review of the clinical and scientific literature, and an environmental scan of models in Canada, the United Kingdom, Australia, and New Zealand. We then developed a framework for the organization and delivery of IV systemic treatment. The systematic review covered the medline, embase, cinahl, and HealthStar databases. The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine. The Systemic Treatment Working Group reviewed the evidence and developed a draft framework using evidence-based analysis, existing recommendations from various jurisdictions, and expert opinion based on experience and consensus. The draft was assessed by Ontario stakeholders and reviewed and approved by Cancer Care Ontario. The poor quantity and quality of the evidence necessitated a consensus-derived model. That model comprises four levels of care determined by a regional systemic treatment program and three integrated structures (integrated cancer programs, affiliate institutions, and satellite institutions), each with a defined scope of practice and a specific organizational framework. New models of care are urgently required beyond large centres, particularly in geographically remote or rural areas. Despite limited applicable evidence, the development and successful implementation of this framework is intended to create sustainable, accessible, quality care and to measurably improve patient outcomes.

Polyplex micelle installing intracellular self-processing functionalities without free catiomers for safe and efficient systemic gene therapy through tumor vasculature targeting.

Science.gov (United States)

Chen, Qixian; Osada, Kensuke; Ge, Zhishen; Uchida, Satoshi; Tockary, Theofilus A; Dirisala, Anjaneyulu; Matsui, Akitsugu; Toh, Kazuko; Takeda, Kaori M; Liu, Xueying; Nomoto, Takahiro; Ishii, Tekihiko; Oba, Makoto; Matsumoto, Yu; Kataoka, Kazunori

2017-01-01

Both efficiency and safety profiles are crucial for promotion of gene delivery systems towards practical applications. A promising template system was previously developed based on block catiomer of poly(ethylene glycol) (PEG)-b-poly{N'-[N-(2-aminoethyl)-2-aminoehtyl]aspartamide}-cholesteryl [PEG-PAsp(DET)-cholesteryl] with strategies of ligand conjugation at the α-terminus for specific affinity to the targeted cells and cholesteryl conjugation at the ω-terminus for structural stabilization to obtain systemic retention. Aiming for advocating this formulation towards practical applications, in the current study, the binding profile of this polymer to plasmid DNA (pDNA) was carefully studied to address an issue of toxicity origin. Quantification of free polymer composition confirmed that the toxicity mainly results from unbound polymer and polyplex micelle itself has negligible toxicity. This evaluation allowed for identifying an optimal condition to prepare safe polyplex micelles for systemic application that possess maximal polymer-binding but exclude free polymers. The identified polyplex micelles then faced a drawback of limited transfection efficiency due to the absence of free polymer, which is an acknowledged tendency found in various synthetic gene carriers. Thus, series of functional components was strategically compiled to improve the transfection efficiency such as attachment of cyclic (Arg-Gly-Asp) (cRGD) peptide as a ligand onto the polyplex micelles to facilitate cellular uptake, use of endosome membrane disruptive catiomer of PAsp(DET) for facilitating endosome escape along with use of the conjugated cholesteryl group to amplify the effect of PAsp(DET) on membrane disruption, so as to obtain efficient transfection. The mechanistic investigation respecting the appreciated pH dependent protonation behavior of PAsp(DET) permitted to depict an intriguing scenario how the block catiomers manage to escape from the endosome entrapment in response to the p

Cheques and challenges: business performance in New Zealand general practice.

Science.gov (United States)

Greatbanks, Richard; Doolan-Noble, Fiona; McKenna, Alex

2017-09-01

INTRODUCTION New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors. AIM To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice. METHODS For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data. RESULTS All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand. DISCUSSION As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of 'super practices' based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya.

Science.gov (United States)

Kimani-Murage, Elizabeth W; Madise, Nyovani J; Fotso, Jean-Christophe; Kyobutungi, Catherine; Mutua, Martin K; Gitau, Tabither M; Yatich, Nelly

2011-05-26

The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). The study indicates poor

GN and C Subsystem Concept for Safe Precision Landing of the Proposed Lunar MARE Robotic Science Mission

Science.gov (United States)

Carson, John M., III; Johnson, Andrew E.; Anderson, F. Scott; Condon, Gerald L.; Nguyen, Louis H.; Olansen, Jon B.; Devolites, Jennifer L.; Harris, William J.; Hines, Glenn D.; Lee, David E.;

Safe Is Not Enough: Better Schools for LGBTQ Students

Science.gov (United States)

Sadowski, Michael

2016-01-01

"Safe Is Not Enough" illustrates how educators can support the positive development of LGBTQ students in a comprehensive way so as to create truly inclusive school communities. Using examples from classrooms, schools, and districts across the country, Michael Sadowski identifies emerging practices such as creating an LGBTQ-inclusive…

Importance of safety review to the safe operation of a nuclear plant

International Nuclear Information System (INIS)

Brinkerhoff, L.C.

1978-01-01

Widely differing standards of construction of nuclear reactors are employed in different countries. Although the reactor vendors, including designers and construction contractors, have a vested interest in safety, the ultimate responsibility for safety rests with the reactor facility operator. Even though governmental agencies, either directly or indirectly, must take a strong lead in developing policies and practices of safe operation, the reactor facility operator must recognize and accept the full responsibility for safe operation of the facility. The policies and practices of safe operation imposed by governmental agencies must help assure the prudent operation and the adequate maintenance of those structures, systems, and components of importance to safety. Since each country has a slightly different philosophy for achieving safety and each vendor utilizes different structures, systems, and components to fulfil this philosophy, it is imperative that the facility operator adequately maintain those engineered safety features and those plant protective systems which have been engineered into achieving the desired levels of safety. An additional method of helping to assure that those structures, systems, and components of importance to safety are prudently operated and adequately maintained is to assign the full safety responsibility for the overall operations of the reactor facility to the operating organization, i.e. assigning a 'line of responsibility' within the reactor facility operator. This assurance can be further strengthened by requiring that the facility operator establish a safety review body that overviews the operation and assures that the operating organization complies with those policies and practices of safe operation which have been imposed on the reactor facility. (author)

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

Science.gov (United States)

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Level of awareness of lung cancer risk factors, signs, symptoms and safe practices among college teachers of different states in India: Do awareness programmes have an impact on adoption of safe practices?

Science.gov (United States)

Shankar, A; Roy, S; Bhandari, R; Malik, A; Rath, G K; Julka, P K; Barnwal, K; Upadhyaya, S; Singh, R; Srivastava, V

2015-09-01

information and effective warnings about cigarette smoking are necessary to increase public awareness. To ensure the adoption of safe practices in the lifestyle of people who smoke and consume alcohol, awareness programmes such as the pink chain campaign should be conducted regularly, frequently and more widely in various areas of India.

Learning From Critical Collective Spaces: Reflections on the Community-Diversity Dialectic in Safe Spaces

OpenAIRE

Wallin-Ruschman, Jennifer; Patka, Mazna

2016-01-01

Safe spaces have the potential to become prefigurative groups that aim to create social change. The idea of a safe space as a place separate and sheltered from dominant culture to mobilize for social change has gained traction in a number of academic and practical areas. However, safe spaces have the ability to be both progressive and regressive. To guide our discussion we utilize the concept of community-diversity dialectic to address the tension between these forces within two settings. Fir...

Culturally Safe Health Initiatives for Indigenous Peoples in Canada: A Scoping Review.

Science.gov (United States)

Brooks-Cleator, Lauren; Phillipps, Breanna; Giles, Audrey

2018-01-01

Background Cultural safety has the potential to improve the health disparities between Indigenous and non-Indigenous Canadians, yet practical applications of the concept are lacking in the literature. Purpose This study aims to identify the key components of culturally safe health initiatives for the Indigenous population of Canada to refine its application in health-care settings. Methods We conducted a scoping review of the literature pertaining to culturally safe health promotion programs, initiatives, services, or care for the Indigenous population in Canada. Our initial search yielded 501 publications, but after full review of 44 publications, 30 were included in the review. After charting the data, we used thematic analysis to identify themes in the data. Results We identified six themes: collaboration/partnerships, power sharing, address the broader context of the patient's life, safe environment, organizational and individual level self-reflection, and training for health-care providers. Conclusion While it is important to recognize that the provision of culturally safe initiatives depend on the specific interaction between the health-care provider and the patient, having a common understanding of the components of cultural safety, such as those that we identified through this research, will help in the transition of cultural safety from theory into practice.

Diatomite silica nanoparticles for drug delivery

Science.gov (United States)

Ruggiero, Immacolata; Terracciano, Monica; Martucci, Nicola M.; De Stefano, Luca; Migliaccio, Nunzia; Tatè, Rosarita; Rendina, Ivo; Arcari, Paolo; Lamberti, Annalisa; Rea, Ilaria

2014-07-01

Diatomite is a natural fossil material of sedimentary origin, constituted by fragments of diatom siliceous skeletons. In this preliminary work, the properties of diatomite nanoparticles as potential system for the delivery of drugs in cancer cells were exploited. A purification procedure, based on thermal treatments in strong acid solutions, was used to remove inorganic and organic impurities from diatomite and to make them a safe material for medical applications. The micrometric diatomite powder was reduced in nanoparticles by mechanical crushing, sonication, and filtering. Morphological analysis performed by dynamic light scattering and transmission electron microscopy reveals a particles size included between 100 and 300 nm. Diatomite nanoparticles were functionalized by 3-aminopropyltriethoxysilane and labeled by tetramethylrhodamine isothiocyanate. Different concentrations of chemically modified nanoparticles were incubated with cancer cells and confocal microscopy was performed. Imaging analysis showed an efficient cellular uptake and homogeneous distribution of nanoparticles in cytoplasm and nucleus, thus suggesting their potentiality as nanocarriers for drug delivery.

Diatomite silica nanoparticles for drug delivery.

Science.gov (United States)

Ruggiero, Immacolata; Terracciano, Monica; Martucci, Nicola M; De Stefano, Luca; Migliaccio, Nunzia; Tatè, Rosarita; Rendina, Ivo; Arcari, Paolo; Lamberti, Annalisa; Rea, Ilaria

2014-01-01

Diatomite is a natural fossil material of sedimentary origin, constituted by fragments of diatom siliceous skeletons. In this preliminary work, the properties of diatomite nanoparticles as potential system for the delivery of drugs in cancer cells were exploited. A purification procedure, based on thermal treatments in strong acid solutions, was used to remove inorganic and organic impurities from diatomite and to make them a safe material for medical applications. The micrometric diatomite powder was reduced in nanoparticles by mechanical crushing, sonication, and filtering. Morphological analysis performed by dynamic light scattering and transmission electron microscopy reveals a particles size included between 100 and 300 nm. Diatomite nanoparticles were functionalized by 3-aminopropyltriethoxysilane and labeled by tetramethylrhodamine isothiocyanate. Different concentrations of chemically modified nanoparticles were incubated with cancer cells and confocal microscopy was performed. Imaging analysis showed an efficient cellular uptake and homogeneous distribution of nanoparticles in cytoplasm and nucleus, thus suggesting their potentiality as nanocarriers for drug delivery. 87.85.J81.05.Rm; 61.46. + w.

Solid lipid nanoparticles mediate non-viral delivery of plasmid DNA to dendritic cells

Science.gov (United States)

Penumarthi, Alekhya; Parashar, Deepti; Abraham, Amanda N.; Dekiwadia, Chaitali; Macreadie, Ian; Shukla, Ravi; Smooker, Peter M.

2017-06-01

There is an increasing demand for novel DNA vaccine delivery systems, mainly for the non-viral type as they are considered relatively safe. Therefore, solid lipid nanoparticles (SLNs) were investigated for their suitability as a non-viral DNA vaccine delivery system. SLNs were synthesised by a modified solvent-emulsification method in order to study their potential to conjugate with plasmid DNA and deliver them in vitro to dendritic cells using eGFP as the reporter plasmid. The DNA-SLN complexes were characterised by electron microscopy, gel retardation assays and dynamic light scattering. The cytotoxicity assay data supported their biocompatibility and was used to estimate safe threshold concentration resulting in high transfection rate. The transfection efficiency of these complexes in a dendritic cell line was shown to increase significantly compared to plasmid alone, and was comparable to that mediated by lipofectamine. Transmission electron microscopy studies delineated the pathway of cellular uptake. Endosomal escape was observed supporting the mechanism of transfection.

The Use of Collaboration to Implement Evidence-Based Safe Practices

OpenAIRE

Clarke, John R.

2013-01-01

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with instituti...

METHODOLOGICAL APPROACHES TO ORGANIZATION OF SAFE INFORMATION AND EDUCATIONAL ENVIRONMENT OF THE UNIVERSITY

Directory of Open Access Journals (Sweden)

A. N. Privalov

2017-01-01

Full Text Available Introduction. One of the tendencies of modern higher education is the ubiquitous use of information and communication technologies. At the same time, the functioning of the electronic information and educational environment (IEE of the university should be based on the means of IEE and the condition of its information security.The aim of the research is conceptualization of a problem of the rational organization of the safe information and education environment of higher education institution wherein reliable protection of its infrastructure, the personal and unique information of a pupil and teacher and virtual space of their educational interaction is provided.Methodology and research methods. System-based approach is a key approach to organization of safe educational environment of the university. From the point of view of authors, personal-activity and functional approaches are expedient while designing and development of a safe IEE. Socio-historical and theoretical-methodological analysis, modeling, research and synthesis of experience of effective application of the systems approach in educational professional organizations are used.Results and scientific novelty. The concept «safe information educational environment of the university» is specified wherein the first word has to express a predominant quality of the system. Creating a safe information environment in educational professional organizations provides a convenient and safe educational environment in the process of professional training of university students. The components and directions for the organization of the safe IEE are highlighted. Practical recommendations for its design and successful functioning are given.Practical significance. The materials of the present research can be demanded by managers and administrative employees of educational organizations. 

Advanced drug delivery approaches against periodontitis.

Science.gov (United States)

Joshi, Deeksha; Garg, Tarun; Goyal, Amit K; Rath, Goutam

2016-01-01

Periodontitis is an inflammatory disease of gums involving the degeneration of periodontal ligaments, creation of periodontal pocket and resorption of alveolar bone, resulting in the disruption of the support structure of teeth. According to WHO, 10-15% of the global population suffers from severe periodontitis. The disease results from the growth of a diverse microflora (especially anaerobes) in the pockets and release of toxins, enzymes and stimulation of body's immune response. Various local or systemic approaches were used for an effective treatment of periodontitis. Currently, controlled local drug delivery approach is more favorable as compared to systemic approach because it mainly focuses on improving the therapeutic outcomes by achieving factors like site-specific delivery, low dose requirement, bypass of first-pass metabolism, reduction in gastrointestinal side effects and decrease in dosing frequency. Overall it provides a safe and effective mode of treatment, which enhances patient compliance. Complete eradication of the organisms from the sites was not achieved by using various surgical and mechanical treatments. So a number of polymer-based delivery systems like fibers, films, chips, strips, microparticles, nanoparticles and nanofibers made from a variety of natural and synthetic materials have been successfully tested to deliver a variety of drugs. These systems are biocompatible and biodegradable, completely fill the pockets, and have strong retention on the target site due to excellent mucoadhesion properties. The review summarizes various available and recently developing targeted delivery devices for the treatment of periodontitis.

Gene delivery to skeletal muscle results in sustained expression and systemic delivery of a therapeutic protein.

Science.gov (United States)

Kessler, P D; Podsakoff, G M; Chen, X; McQuiston, S A; Colosi, P C; Matelis, L A; Kurtzman, G J; Byrne, B J

1996-11-26

Somatic gene therapy has been proposed as a means to achieve systemic delivery of therapeutic proteins. However, there is limited evidence that current methods of gene delivery can practically achieve this goal. In this study, we demonstrate that, following a single intramuscular administration of a recombinant adeno-associated virus (rAAV) vector containing the beta-galactosidase (AAV-lacZ) gene into adult BALB/c mice, protein expression was detected in myofibers for at least 32 weeks. A single intramuscular administration of an AAV vector containing a gene for human erythropoietin (AAV-Epo) into mice resulted in dose-dependent secretion of erythropoietin and corresponding increases in red blood cell production that persisted for up to 40 weeks. Primary human myotubes transduced in vitro with the AAV-Epo vector also showed dose-dependent production of Epo. These results demonstrate that rAAV vectors are able to transduce skeletal muscle and are capable of achieving sustained expression and systemic delivery of a therapeutic protein following a single intramuscular administration. Gene therapy using AAV vectors may provide a practical strategy for the treatment of inherited and acquired protein deficiencies.

Gene delivery to skeletal muscle results in sustained expression and systemic delivery of a therapeutic protein

Science.gov (United States)

Kessler, Paul D.; Podsakoff, Gregory M.; Chen, Xiaojuan; McQuiston, Susan A.; Colosi, Peter C.; Matelis, Laura A.; Kurtzman, Gary J.; Byrne, Barry J.

1996-01-01

Somatic gene therapy has been proposed as a means to achieve systemic delivery of therapeutic proteins. However, there is limited evidence that current methods of gene delivery can practically achieve this goal. In this study, we demonstrate that, following a single intramuscular administration of a recombinant adeno-associated virus (rAAV) vector containing the β-galactosidase (AAV-lacZ) gene into adult BALB/c mice, protein expression was detected in myofibers for at least 32 weeks. A single intramuscular administration of an AAV vector containing a gene for human erythropoietin (AAV-Epo) into mice resulted in dose-dependent secretion of erythropoietin and corresponding increases in red blood cell production that persisted for up to 40 weeks. Primary human myotubes transduced in vitro with the AAV-Epo vector also showed dose-dependent production of Epo. These results demonstrate that rAAV vectors are able to transduce skeletal muscle and are capable of achieving sustained expression and systemic delivery of a therapeutic protein following a single intramuscular administration. Gene therapy using AAV vectors may provide a practical strategy for the treatment of inherited and acquired protein deficiencies. PMID:8943064

Nanoscale Nutrient Delivery Systems for Food Applications: Improving Bioactive Dispersibility, Stability, and Bioavailability.

Science.gov (United States)

McClements, David Julian

2015-07-01

There has been a surge of interest in the development of nanoscale systems for the encapsulation, protection, and delivery of lipophilic nutrients, vitamins, and nutraceuticals. This review article highlights the challenges associated with incorporating these lipophilic bioactive components into foods, and then discusses potential nanoscale delivery systems that can be used to overcome these challenges. In particular, the desirable characteristics required for any nanoscale delivery system are presented, as well as methods of fabricating them and of characterizing them. An overview of different delivery systems is given, such as microemulsions, nanoemulsions, emulsions, microgels, and biopolymer nanoparticles, and their potential applications are discussed. Nanoscale delivery systems have considerable potential within the food industry, but they must be carefully formulated to ensure that they are safe, economically viable, and effective. Nanoscale delivery systems have numerous potential applications in the food industry for encapsulating, protecting, and releasing bioactive agents, such as nutraceuticals and vitamins. This review article highlights methods for designing, fabricating, characterizing, and utilizing edible nanoparticles from a variety of different food-grade ingredients. © 2015 Institute of Food Technologists®

Gelatin nanoparticles enhance delivery of hepatitis C virus recombinant NS2 gene.

Science.gov (United States)

Sabet, Salwa; George, Marina A; El-Shorbagy, Haidan M; Bassiony, Heba; Farroh, Khaled Y; Youssef, Tareq; Salaheldin, Taher A

2017-01-01

Development of an effective non-viral vaccine against hepatitis C virus infection is of a great importance. Gelatin nanoparticles (Gel.NPs) have an attention and promising approach as a viable carrier for delivery of vaccine, gene, drug and other biomolecules in the body. The present study aimed to develop stable Gel.NPs conjugated with nonstructural protein 2 (NS2) gene of Hepatitis C Virus genotype 4a (HCV4a) as a safe and an efficient vaccine delivery system. Gel.NPs were synthesized and characterized (size: 150±2 nm and zeta potential +17.6 mv). NS2 gene was successfully cloned and expressed into E. coli M15 using pQE-30 vector. Antigenicity of the recombinant NS2 protein was confirmed by Western blotting to verify the efficiency of NS2 as a possible vaccine. Then NS2 gene was conjugated to gelatin nanoparticles and a successful conjugation was confirmed by labeling and imaging using Confocal Laser Scanning Microscope (CLSM). Interestingly, the transformation of the conjugated NS2/Gel.NPs complex into E. coli DH5-α was 50% more efficient than transformation with the gene alone. In addition, conjugated NS2/Gel.NPs with ratio 1:100 (w/w) showed higher transformation efficiency into E. coli DH5-α than the other ratios (1:50 and 2:50). Gel.NPs effectively enhanced the gene delivery in bacterial cells without affecting the structure of NS2 gene and could be used as a safe, easy, rapid, cost-effective and non-viral vaccine delivery system for HCV.

The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

DEFF Research Database (Denmark)

Pop, Paul; Scholle, Detlef; Hansson, Hans

2016-01-01

This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

Advances in research of targeting delivery and controlled release of drug-loaded nanoparticles

International Nuclear Information System (INIS)

Tan Zhonghua

2003-01-01

Biochemistry drug, at present, is still the main tool that human struggle to defeat the diseases. So, developing safe and efficacious technique of drug targeting delivery and controlled release is key to enhance curative effect, decrease drug dosage, and lessen its side effect. Drug-loaded nanoparticles, which is formed by conjugate between nanotechnology and modern pharmaceutics, is a new fashioned pharmic delivery carrier. Because of advantages in pharmic targeting transport and controlled or slow release and improving bioavailability, it has been one of developing trend of modern pharmaceutical dosage forms

High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

NARCIS (Netherlands)

Morsing, IE; Tinnevelt, Marcel; Jansen, Nicolaas J.G.; Koomen, E

2015-01-01

High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation

Newborn care practices in rural Bangladesh

Directory of Open Access Journals (Sweden)

Islam MT

2015-07-01

Full Text Available Mohammad Tajul Islam,1 Nazrul Islam,2 Yukie Yoshimura,1 Monjura Khatun Nisha,3 Nawzia Yasmin4 1Safe Motherhood Promotion Project, Japan International Cooperation Agency (JICA, Dhaka, Bangladesh; 2School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 3International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b; 4Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh Background: Neonatal mortality is high in Bangladesh. Most of the neonatal deaths are preventable through simple and cost-effective essential newborn care interventions. Studies to document the determinants of unhealthy newborn care practices are scarce. Objective: The objective of this study is to describe the pattern of neonatal care practices and their determinants in rural Bangladesh. Methodology: This study is based on baseline data of a community-based intervention to assess impact of limited postnatal care services on maternal and neonatal health-seeking behavior. Data from 510 women, who had a live birth at home 1 year prior to survey, of six randomly selected unions of an Upazila (subdistrict were analyzed. Results: Majority of the respondents were at an age group of 20–34 years. Only 6% had delivery by skilled providers. Immediate drying and wrapping, and giving colostrums to newborns were almost universal. Unhealthy practices, like unclean cord care (42%, delayed initiation of breastfeeding (60%, use of prelacteals (36%, and early bathing (71% were very common. Muslims were more likely to give early bath (adjusted odds ratio [OR]: 2.01; 95% confidence interval [CI]: 1.13–3.59; P=0.018 and delay in initiating breastfeeding (adjusted OR: 1.45; 95% CI: 1.18–1.78; P<0.001 to newborns. Practice of giving prelacteals was associated with teenage mothers (adjusted OR: 2.26; 95% CI: 1.19–4.28; P=0.013 and women’s lack of education (adjusted OR: 2.64; 95% CI: 1.46–4.77; P=0

Varying gestational age patterns in cesarean delivery: An international comparison

NARCIS (Netherlands)

Delnord, M.; Blondel, B.; Drewniak, N.; Klungsøyr, K.; Bolumar, F.; Mohangoo, A.; Gissler, M.; Szamotulska, K.; Lack, N.; Nijhuis, J.; Velebil, P.; Sakkeus, L.; Chalmers, J.; Zeitlin, J.; Haidinger, G.; XMartens, G.; Misselwitz, B.; Wenzlaff, P.; Bonham, S.; Jaselioniene, J.; Gatt, M.; Klungsøyr, K.; Barros, H.; Novak, Z.; Gottvall, K.

2014-01-01

Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and

Refining and validating a conceptual model of Clinical Nurse Leader integrated care delivery.

Science.gov (United States)

Bender, Miriam; Williams, Marjory; Su, Wei; Hites, Lisle

2017-02-01

To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Sequential mixed methods. A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. © 2016 John Wiley & Sons Ltd.

Management for nuclear power plants for safe operation

International Nuclear Information System (INIS)

Kueffer, K.

1981-01-01

This lecture covers management aspects which have an immediate bearing on safety and identifies the objectives and tasks of management which are required for safe operation of a nuclear power plant and is based on the Codes of Practice and Safety Guides of the IAEA as well as arrangements in use at the Swiss Nuclear Power Station Beznau. (orig./RW)

Recent Advances in the Application of Vitamin E TPGS for Drug Delivery

Science.gov (United States)

Yang, Conglian; Wu, Tingting; Qi, Yan; Zhang, Zhiping

2018-01-01

D-ɑ-tocopheryl polyethylene glycol succinate (Vitamin E TPGS or TPGS) has been approved by FDA as a safe adjuvant and widely used in drug delivery systems. The biological and physicochemical properties of TPGS provide multiple advantages for its applications in drug delivery like high biocompatibility, enhancement of drug solubility, improvement of drug permeation and selective antitumor activity. Notably, TPGS can inhibit the activity of ATP dependent P-glycoprotein and act as a potent excipient for overcoming multi-drug resistance (MDR) in tumor. In this review, we aim to discuss the recent advances of TPGS in drug delivery including TPGS based prodrugs, nitric oxide donor and polymers, and unmodified TPGS based formulations. These potential applications are focused on enhancing delivery efficiency as well as the therapeutic effect of agents, especially on overcoming MDR of tumors. It also demonstrates that the clinical translation of TPGS based nanomedicines is still faced with many challenges, which requires more detailed study on TPGS properties and based delivery system in the future. PMID:29290821

Bioreducible Lipid-like Nanoparticles for Intracellular Protein Delivery

Science.gov (United States)

Arellano, Carlos Luis

Protein-based therapy is one of the most direct ways to manipulate cell function and treat human disease. Although protein therapeutics has made its way to clinical practice, with five of the top fifteen global pharmaceuticals being peptide or protein-based drugs, one common limitation is that the effects of protein therapy are only achieved through the targeting of cell surface receptors and intracellular domains. Due to the impermeability of the cell membrane to most foreign materials, entire classes of potentially therapeutic proteins cannot thoroughly be studied without a safe and efficient method of transporting proteins into the cytosol. We report the use of a combinatorially-designed bioreducible lipid-like material (termed "lipidoid") - based protein delivery platform for the transfection of human cancer cell lines. Lipidoid nanoparticles are synthesized through a thin film dispersion method. The degradation of the bioreducible nanoparticles was observed when exposed to glutathione, a highly reductive compound present in the cytosol. We demonstrate that the nanoparticles are capable of transfecting a dose-dependent concentration of our model protein, beta-galactosidase into HeLa cells. Furthermore, formulations of the lipidoid containing the cytotoxic proteins saporin and RNase-A are both capable of inhibiting tumor cell proliferation as observed in in vitro treatment of different human cancer cell lines. There was no observed loss in protein activity after lyophilization and long--term storage, indicating the potential of pre-clinical applications. Overall, we demonstrate an effective approach to protein formulation and intracellular delivery. We believe that our formulations will lead to the study of a whole class of previously untapped therapeutics that may generate new solutions for previously untreatable diseases.

Safe Kids Worldwide

Science.gov (United States)

... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

Large arteriolar component of oxygen delivery implies a safe margin of oxygen supply to cerebral tissue.

Science.gov (United States)

Sakadžić, Sava; Mandeville, Emiri T; Gagnon, Louis; Musacchia, Joseph J; Yaseen, Mohammad A; Yucel, Meryem A; Lefebvre, Joel; Lesage, Frédéric; Dale, Anders M; Eikermann-Haerter, Katharina; Ayata, Cenk; Srinivasan, Vivek J; Lo, Eng H; Devor, Anna; Boas, David A

2014-12-08

What is the organization of cerebral microvascular oxygenation and morphology that allows adequate tissue oxygenation at different activity levels? We address this question in the mouse cerebral cortex using microscopic imaging of intravascular O2 partial pressure and blood flow combined with numerical modelling. Here we show that parenchymal arterioles are responsible for 50% of the extracted O2 at baseline activity, and the majority of the remaining O2 exchange takes place within the first few capillary branches. Most capillaries release little O2 at baseline acting as an O2 reserve that is recruited during increased neuronal activity or decreased blood flow. Our results challenge the common perception that capillaries are the major site of O2 delivery to cerebral tissue. The understanding of oxygenation distribution along arterio-capillary paths may have profound implications for the interpretation of blood-oxygen-level dependent (BOLD) contrast in functional magnetic resonance imaging and for evaluating microvascular O2 delivery capacity to support cerebral tissue in disease.

Temperature-sensitive microemulsion gel: an effective topical delivery system for simultaneous delivery of vitamins C and E.

Science.gov (United States)

Rozman, Branka; Zvonar, Alenka; Falson, Francoise; Gasperlin, Mirjana

2009-01-01

Microemulsions (ME)--nanostructured systems composed of water, oil, and surfactants--have frequently been used in attempts to increase cutaneous drug delivery. The primary objective addressed in this work has been the development of temperature-sensitive microemulsion gel (called gel-like ME), as an effective and safe delivery system suitable for simultaneous topical application of a hydrophilic vitamin C and a lipophilic vitamin E. By changing water content of liquid o/w ME (o/w ME), a gel-like ME with temperature-sensitive rheological properties was formed. The temperature-driven changes in its microstructure were confirmed by rotational rheometry, viscosity measurements, and droplet size determination. The release studies have shown that the vitamins' release at skin temperature from gel-like ME were comparable to those from o/w ME and were much faster and more complete than from o/w ME conventionally thickened with polymer (o/w ME carbomer). According to effectiveness in skin delivery of both vitamins, o/w ME was found the most appropriate, followed by gel-like ME and by o/w ME carbomer, indicating that no simple correlation between vitamins release and skin absorption could be found. The cytotoxicity studies revealed good cell viability after exposure to ME and confirmed all tested microemulsions as nonirritant.

Are nursing students safe when choosing gluteal intramuscular injection locations?

Science.gov (United States)

Cornwall, J

2011-01-01

Nurses are required to perform gluteal intramuscular (IM) injections in practice. There are dangers associated with erroneous performance of this task, particularly with dorsogluteal injections. Knowledge regarding safe injection practice is therefore vital for nursing students. Fifty-eight second year students at a New Zealand Nursing School were given schematic drawings of the posterior and lateral aspects of the gluteal region. They were asked to mark and justify the safest location for gluteal IM injections. Fifty-seven students marked the dorsal schematic and one the lateral, with 38 (66.7%) marking in the upper outer quadrant (UOQ). Twenty indicating the UOQ (52.6%) wrote 'sciatic' or 'nerve' in justifying their location. Nineteen (33.3%) marked a location outside the UOQ; nine (47.4%) of these mentioned 'sciatic' or 'nerve' as reasons for injection safety. Overall, 50% of students mentioned 'sciatic' or 'nerve' in justifying the safety of their chosen injection location. Results suggest some second year nursing students do not understand safe gluteal IM injection locations and rationale. Current teaching practices and IM injection techniques could be revisited to prepare students more effectively; this may help prevent pathologies arising from this procedure.

The human factor: the critical importance of effective teamwork and communication in providing safe care

OpenAIRE

Leonard, M; Graham, S; Bonacum, D

2004-01-01

Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

Infant Safe Sleep Interventions, 1990-2015: A Review.

Science.gov (United States)

Salm Ward, Trina C; Balfour, Giselle M

2016-02-01

Sleep-related infant deaths remain a major public health issue. Multiple interventions have been implemented in efforts to increase adherence to safe sleep recommendations. We conducted a systematic review of the international research literature to synthesize research on interventions to reduce the risk of sleep-related deaths and their effectiveness in changing infant sleep practices. We searched PubMed, CINAHL, PsycINFO, and Google Scholar for peer-reviewed articles published between 1990 and 2015 which described an intervention and reported results. Twenty-nine articles were included for review. Studies focused on infant caregivers, health care professionals, peers, and child care professionals. Targeted behaviors included sleep position, location, removing items from the crib, breastfeeding, smoke exposure, clothing, pacifier use, and knowledge of Sudden Infant Death Syndrome. Most articles described multi-faceted interventions, including: one-on-one or group education, printed materials, visual displays, videos, and providing resources such as cribs, pacifiers, wearable blankets, and infant t-shirts. Two described public education campaigns, one used an educative questionnaire, and one encouraged maternal note taking. Health professional interventions included implementing safe sleep policies, in-service training, printed provider materials, eliciting agreement on a Declaration of Safe Sleep Practice, and sharing adherence data. Data collection methods included self-report via surveys and observational crib audits. Over half of the studies utilized comparison groups which helped determine effectiveness. Most articles reported some degree of success in changing some of the targeted behaviors; no studies reported complete adherence to recommendations. Future studies should incorporate rigorous evaluation plans, utilize comparison groups, and collect demographic and collect follow-up data.

PEGylated composite nanoparticles of PLGA and polyethylenimine for safe and efficient delivery of pDNA to lungs.

Science.gov (United States)

Kolte, Atul; Patil, Sushilkumar; Lesimple, Pierre; Hanrahan, John W; Misra, Ambikanandan

2017-05-30

Achieving stable, efficient and non-toxic pulmonary gene delivery is most challenging requirement for successful gene therapy to lung. Composite nanoparticles (NPs) of the poly(lactic-co-glycolic acid) (PLGA) and cationic polymer polyethyleneimine (PEI) is an efficient alternative to viral and liposomal vectors for the pulmonary delivery of pDNA. NPs with different weight ratios (0-12.5%w/w) of PLGA/PEI were prepared and characterized for size, morphology, surface charge, pDNA loading and in vitro release. The in vitro cell uptake and transfection studies in the CFBE41o-cell line revealed that NPs with 10% w/w PEI were more efficient but they exhibited significant cytotoxicity in MTT assays, challenging the safety of this formulation. Surface modifications of these composite NPs through PEGylation reduced toxicity and enhanced cellular uptake and pDNA expression. PEGylation improved diffusion of NPs through the mucus barrier and prevented uptake by pulmonary macrophages. Finally, PEGylated composite NPs were converted to DPI by lyophilization and combined with lactose carrier particles, which resulted in improved aerosolization properties and lung deposition, without affecting pDNA bioactivity. This study demonstrates that a multidisciplinary approach may enable the local delivery of pDNA to lung tissue for effective treatment of deadly lung diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

Diamond encapsulated photovoltaics for transdermal power delivery.

Science.gov (United States)

Ahnood, A; Fox, K E; Apollo, N V; Lohrmann, A; Garrett, D J; Nayagam, D A X; Karle, T; Stacey, A; Abberton, K M; Morrison, W A; Blakers, A; Prawer, S

2016-03-15

A safe, compact and robust means of wireless energy transfer across the skin barrier is a key requirement for implantable electronic devices. One possible approach is photovoltaic (PV) energy delivery using optical illumination at near infrared (NIR) wavelengths, to which the skin is highly transparent. In the work presented here, a subcutaneously implantable silicon PV cell, operated in conjunction with an external NIR laser diode, is developed as a power delivery system. The biocompatibility and long-term biostability of the implantable PV is ensured through the use of an hermetic container, comprising a transparent diamond capsule and platinum wire feedthroughs. A wavelength of 980 nm is identified as the optimum operating point based on the PV cell's external quantum efficiency, the skin's transmission spectrum, and the wavelength dependent safe exposure limit of the skin. In bench-top experiments using an external illumination intensity of 0.7 W/cm(2), a peak output power of 2.7 mW is delivered to the implant with an active PV cell dimension of 1.5 × 1.5 × 0.06 mm(3). This corresponds to a volumetric power output density of ~20 mW/mm(3), significantly higher than power densities achievable using inductively coupled coil-based approaches used in other medical implant systems. This approach paves the way for further ministration of bionic implants. Copyright © 2015 Elsevier B.V. All rights reserved.

Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

Science.gov (United States)

Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

2018-01-03

In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and

7 CFR 46.44 - Good delivery.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE MARKETING OF PERISHABLE AGRICULTURAL COMMODITIES REGULATIONS (OTHER... conditions, will meet the following additional requirements on delivery at the contract destination: (a...

Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India.

Science.gov (United States)

Bruce, Sharon G; Blanchard, Andrea K; Gurav, Kaveri; Roy, Anuradha; Jayanna, Krishnamurthy; Mohan, Haranahalli L; Ramesh, Banadakoppa M; Blanchard, James F; Moses, Stephen; Avery, Lisa

2015-02-27

The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional deliveries there are still considerable barriers to utilization and quality of services, particularly in rural areas, that may mitigate improvements achieved by MNCH interventions. This paper aims to explore the factors influencing preference for home, public or private hospital delivery among rural pregnant and new mothers in three northern districts of Karnataka state, South India. In-depth qualitative interviews were conducted in 2010 among 110 pregnant women, new mothers (infants born within past 3 months), their husbands and mothers-in-law. Interviews were conducted in the local language (Kannada) and then translated to English for analysis. The interviews of pregnant women and new mothers were used for analysis to ultimately develop broader themes around definitions of quality care from the perspective of service users, and the influence this had on their delivery site preferences. Geographical and financial access were important barriers to accessing institutional delivery services in all districts, and among those both above and below the poverty line. Access issues of greatest concern were high costs at private institutions, continuing fees at public hospitals and the inconsistent receipt of government incentives. However, views on quality of care that shaped delivery site preferences were deeply rooted in socio-cultural expectations for comfortable, respectful and safe care that must ultimately be addressed to change negative perceptions about institutional, and particularly public hospital, care at delivery. In the literature, quality of care beyond access has largely been overlooked in favour of support for incentives on the demand side, and more trained

MODELING OF TARGETED DRUG DELIVERY PART II. MULTIPLE DRUG ADMINISTRATION

Directory of Open Access Journals (Sweden)

A. V. Zaborovskiy

2017-01-01

Full Text Available In oncology practice, despite significant advances in early cancer detection, surgery, radiotherapy, laser therapy, targeted therapy, etc., chemotherapy is unlikely to lose its relevance in the near future. In this context, the development of new antitumor agents is one of the most important problems of cancer research. In spite of the importance of searching for new compounds with antitumor activity, the possibilities of the “old” agents have not been fully exhausted. Targeted delivery of antitumor agents can give them a “second life”. When developing new targeted drugs and their further introduction into clinical practice, the change in their pharmacodynamics and pharmacokinetics plays a special role. The paper describes a pharmacokinetic model of the targeted drug delivery. The conditions under which it is meaningful to search for a delivery vehicle for the active substance were described. Primary screening of antitumor agents was undertaken to modify them for the targeted delivery based on underlying assumptions of the model.

Stock Photographs Do Not Comply With Infant Safe Sleep Guidelines.

Science.gov (United States)

Goodstein, Michael H; Lagon, Elena; Bell, Theodore; Joyner, Brandi L; Moon, Rachel Y

2018-04-01

We evaluated images in popular stock photography websites for adherence with American Academy of Pediatrics (AAP) guidelines for safe infant sleep practices. Three top stock photo websites were used to collect photographs generated from key phrases. All images depicting an infant sleep environment were analyzed for consistency with AAP guidelines. Descriptive statistics, chi-square and z test of proportions, were conducted. A total of 1233 of 1947 stock photographs showed sleeping infants on a flat surface. In all, 627 (50.8%) photographs showed the infant in the supine position and 79 (5%) of all infant sleep environments were adherent with AAP recommendations. Bedding inconsistent with safe sleep recommendations was identified in 1133 images (71.3%), with blankets noted in 49.5%. Images depicting sleeping infants on stock photography sites do not routinely adhere to AAP recommendations. Media messages inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices.

"Same Room, Safe Place".

Science.gov (United States)

Keene Woods, Nikki

2017-04-01

There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

Science.gov (United States)

2012-01-01

Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR) is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD) as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1) Distance to the health facilities and difficulties and costs of getting there; (2) Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3) The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4) The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and their families could be

Engineering Microneedle Patches for Vaccination and Drug Delivery to Skin.

Science.gov (United States)

Prausnitz, Mark R

2017-06-07

Microneedle patches (MNPs) contain arrays of solid needles measuring hundreds of microns in length that deliver drugs and vaccines into skin in a painless, easy-to-use manner. Optimal MNP design balances multiple interdependent parameters that determine mechanical strength, skin-insertion reliability, drug delivery efficiency, painlessness, manufacturability, and other features of MNPs that affect their performance. MNPs can be made by adapting various microfabrication technologies for delivery of small-molecule drugs, biologics, and vaccines targeted to the skin, which can have pharmacokinetic and immunologic advantages. A small number of human clinical trials, as well as a large and growing market for MNP products for cosmetics, indicate that MNPs can be used safely, efficaciously, and with strong patient acceptance. More advanced clinical trials and commercial-scale manufacturing will facilitate development of MNPs to realize their potential to dramatically increase patient access to otherwise-injectable drugs and to improve drug performance via skin delivery.

Job satisfaction of practice assistants in general practice in Germany: an observational study

NARCIS (Netherlands)

Goetz, K.; Campbell, S.; Broge, B.; Brodowski, M.; Steinhaeuser, J.; Wensing, M.; Szecsenyi, J.

2013-01-01

BACKGROUND: Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. OBJECTIVE: To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction,

Highly Efficient Intracellular Protein Delivery by Cationic Polyethyleneimine-Modified Gelatin Nanoparticles

Directory of Open Access Journals (Sweden)

Ming-Ju Chou

2018-02-01

Full Text Available Intracellular protein delivery may provide a safe and non-genome integrated strategy for targeting abnormal or specific cells for applications in cell reprogramming therapy. Thus, highly efficient intracellular functional protein delivery would be beneficial for protein drug discovery. In this study, we generated a cationic polyethyleneimine (PEI-modified gelatin nanoparticle and evaluated its intracellular protein delivery ability in vitro and in vivo. The experimental results showed that the PEI-modified gelatin nanoparticle had a zeta potential of approximately +60 mV and the particle size was approximately 135 nm. The particle was stable at different biological pH values and temperatures and high protein loading efficiency was observed. The fluorescent image results revealed that large numbers of particles were taken up into the mammalian cells and escaped from the endosomes into the cytoplasm. In a mouse C26 cell-xenograft cancer model, particles accumulated in cancer cells. In conclusion, the PEI-modified gelatin particle may provide a biodegradable and highly efficient protein delivery system for use in regenerative medicine and cancer therapy.

Esomeprazole: a safe alternative to lansoprazole allergy?

Science.gov (United States)

Kara, Muammer; Tanoglu, Alpaslan; Kutlu, Ali; Sirkeci, Ozgur; Kekilli, Murat

2014-08-01

Proton pump inhibitors (PPIs) are widely prescribed drugs in daily practice. Allergic reactions, even small number of anaphylactic reactions to PPIs have been reported. Omeprazole, lansoprazole, pantoprazole, rapeprazol and esomeprazole are classified in the same group. Despite the similarity of biochemical structures among these drugs, presence of cross-reactivity between PPIs is controversial.1,2 In this letter, we present 3 lansoprazole allergy cases, who were prescribed and took esomeprazole safely after allergic reactions to lansoprazole.

Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery.

Science.gov (United States)

Reinhard, Joscha; Sänger, Nicole; Hanker, Lars; Reichenbach, Lena; Yuan, Juping; Herrmann, Eva; Louwen, Frank

2013-04-01

To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures. This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 37(0/7) (259 days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome. On the same day after the ECV procedure two patients (2 %), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4 % of women had cephalic presentation (n = 38) and 58.5 % (n = 55) remained breech presentation. One patient remained transverse presentation (n = 1; 1.1 %). Vaginal delivery was observed by 73.7 % of cephalic presentation (n = 28), whereas 26.3 % (n = 10) had in-labour Caesarean sections. Of those, who selected a trial of vaginal breech delivery, 42.4 % (n = 14) delivered vaginally and 57.6 % (n = 19) delivered via Caesarean section. There is a statistically significant difference between the rate of vaginal birth between cephalic presentation and trial of vaginal breech delivery (p = 0.009), however, no difference in neonatal outcome was observed. ECV is a safe procedure and can reduce not only the rate of elective Caesarean sections due to breech presentation but also the rate of in-labour Caesarean sections even if a trial of vaginal breech delivery is attempted.

Decationized polyplexes for targeted delivery of nucleic acids : from carrier design to in vivo evaluation

NARCIS (Netherlands)

Novo, Luís

2014-01-01

Gene therapy is considered a promising treatment for current intractable diseases. However, the clinical applicability of gene therapy is highly dependent on the development of safe and efficient gene delivery vectors. So far, viral vectors have been used for clinical applications, but due to severe

Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals.

Science.gov (United States)

Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Lukasiewicz, Gloria; Truong, Therese Macasiray

2016-02-01

Within hospital pediatric units, there is a lack of consistent application or modeling of the American Academy of Pediatrics recommendations for safe infant sleep. The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions. This multi-institutional study was conducted by using baseline observations collected for sleep location, position, and environment (collectively, "safe sleep") of infants admitted to pediatric units. Interventions consisted of: (1) staff education, including a commitment to promote safe sleep; (2) implementing site-generated safe sleep policies; (3) designating supply storage in patient rooms; and/or (4) caregiver education. Postintervention observations of safe sleep were collected. Eight hospitals participated from the Inpatient FOCUS Group of the Children's Hospital Association. Each site received institutional review board approval/exemption. Safe sleep was observed for 4.9% of 264 infants at baseline and 31.2% of 234 infants postintervention (Ppresent in 77% of cribs at baseline and 44% postintervention. However, the mean number of unsafe items observed in each sleeping environment was reduced by >50% (P=.001). Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment. Moving forward, hospitals should evaluate their compliance with American Academy of Pediatrics recommendations and embrace initiatives to improve modeling of safe sleep. Copyright © 2016 by the American Academy of Pediatrics.

Caesarean delivery: An experience from a tertiary institution in North ...

African Journals Online (AJOL)

increasing use of CS as a mode of delivery in Europe and the. USA is because of fear of malpractice litigation, increased ... Daniel and Singh: Caesarean delivery, Nigeria. 19. Nigerian Journal of Clinical Practice • Jan-Feb ..... Efetie RE, Umezulike AC, Agboghoroma CO. Caesarean section at the. National Hospital, Abuja ...

Seaweed Polysaccharide-Based Nanoparticles: Preparation and Applications for Drug Delivery

Directory of Open Access Journals (Sweden)

Jayachandran Venkatesan

2016-01-01

Full Text Available In recent years, there have been major advances and increasing amounts of research on the utilization of natural polymeric materials as drug delivery vehicles due to their biocompatibility and biodegradability. Seaweed polysaccharides are abundant resources and have been extensively studied for several biological, biomedical, and functional food applications. The exploration of seaweed polysaccharides for drug delivery applications is still in its infancy. Alginate, carrageenan, fucoidan, ulvan, and laminarin are polysaccharides commonly isolated from seaweed. These natural polymers can be converted into nanoparticles (NPs by different types of methods, such as ionic gelation, emulsion, and polyelectrolyte complexing. Ionic gelation and polyelectrolyte complexing are commonly employed by adding cationic molecules to these anionic polymers to produce NPs of a desired shape, size, and charge. In the present review, we have discussed the preparation of seaweed polysaccharide-based NPs using different types of methods as well as their usage as carriers for the delivery of various therapeutic molecules (e.g., proteins, peptides, anti-cancer drugs, and antibiotics. Seaweed polysaccharide-based NPs exhibit suitable particle size, high drug encapsulation, and sustained drug release with high biocompatibility, thereby demonstrating their high potential for safe and efficient drug delivery.

Systemic gene delivery to the central nervous system using Adeno-associated virus

Directory of Open Access Journals (Sweden)

Mathieu eBOURDENX

2014-06-01

Full Text Available Adeno-associated virus (AAV-mediated gene delivery has emerged as an effective and safe tool for both preclinical and clinical studies of neurological disorders. The recent discovery that several serotypes are able to cross the blood-brain-barrier when administered systemically has been a real breakthrough in the field of neurodegenerative diseases. Widespread transgene expression after systemic injection could spark interest as a therapeutic approach. Such strategy will avoid invasive brain surgery and allow non-focal gene therapy promising for CNS diseases affecting large portion of the brain. Here, we will review the recent results achieved through different systemic routes of injection generated in the last decade using systemic AAV-mediated delivery and propose a brief assessment of their values. In particular, we emphasize how the methods used for virus engineering could improve brain transduction after peripheral delivery.

When do we think it is Safe to Drive after Hand Surgery? – Current Practice and Legal Perspective

LENUS (Irish Health Repository)

Murphy, SF

2016-11-01

Patients recovering from hand surgery frequently ask when it is safe to drive and it is unclear where the responsibility lies; the surgeon, the patient or the insurance company. An eight-question survey looking at various aspects of clinical practice was circulated to consultant and trainee plastic and orthopaedic surgeons in Ireland and the UK. Of the 89 surgeons who replied, (53%) felt the decision when to drive was the patient’s compared with the insurance company (40%) and the surgeon (7%). 80% advised patients to contact their insurance company. 87% were unaware of current regulations or guidelines. National guidelines were vague and left the decision with the treating doctor. Similarly, major insurers advise patients to contact their doctor for advice. From a legal standpoint, the patient has a duty of care to other road users to be in full control of his vehicle prior to driving, regardless of any advice received.

Hydrocolloid-based nutraceutical delivery systems

Energy Technology Data Exchange (ETDEWEB)

Janaswamy, Srinivas; Youngren, Susanne R. (Purdue)

2012-07-11

Nutraceuticals are important due to their inherent health benefits. However, utilization and consumption are limited by their poor water solubility and instability at normal processing and storage conditions. Herein, we propose an elegant and novel approach for the delivery of nutraceuticals in their active form using hydrocolloid matrices that are inexpensive and non-toxic with generally recognized as safe (GRAS) status. Iota-carrageenan and curcumin have been chosen as models of hydrocolloid and nutraceutical compounds, respectively. The iota-carrageenan network maintains a stable organization after encapsulating curcumin molecules, protects them from melting and then releases them in a sustained manner. These findings lay a strong foundation for developing value-added functional and medicinal foods.

Transportation risk management : international practices for program development and project delivery.

Science.gov (United States)

2012-08-01

Managing transportation networks, including agency : management, program development, and project : delivery, is extremely complex and fraught with : uncertainty. Administrators, planners, and engineers : coordinate a multitude of organizational and ...

Recent advances in dendrimer-based nanovectors for tumor-targeted drug and gene delivery

Science.gov (United States)

Kesharwani, Prashant; Iyer, Arun K.

2015-01-01

Advances in the application of nanotechnology in medicine have given rise to multifunctional smart nanocarriers that can be engineered with tunable physicochemical characteristics to deliver one or more therapeutic agent(s) safely and selectively to cancer cells, including intracellular organelle-specific targeting. Dendrimers having properties resembling biomolecules, with well-defined 3D nanopolymeric architectures, are emerging as a highly attractive class of drug and gene delivery vector. The presence of numerous peripheral functional groups on hyperbranched dendrimers affords efficient conjugation of targeting ligands and biomarkers that can recognize and bind to receptors overexpressed on cancer cells for tumor-cell-specific delivery. The present review compiles the recent advances in dendrimer-mediated drug and gene delivery to tumors by passive and active targeting principles with illustrative examples. PMID:25555748

An impact evaluation of the safe motherhood promotion project in Bangladesh: evidence from Japanese aid-funded technical cooperation.

Science.gov (United States)

Kamiya, Yusuke; Yoshimura, Yukie; Islam, Mohammad Tajul

2013-04-01

This paper reports the findings from a quasi-experimental impact evaluation of the Safe Motherhood Promotion Project (SMPP) conducted in the Narsingdi district of Bangladesh. SMPP is a Japanese aid-funded technical cooperation project aimed at developing local capacities to tackle maternal and newborn health problems in rural areas. We assessed whether the project interventions, in particular, community-based activities under the Model Union approach, had a favorable impact on women's access to and knowledge of maternal health care during pregnancy and childbirth. The project comprises a package of interlinked interventions to facilitate safe motherhood practices at primary and secondary care levels. The primary-level activities focused on community mobilization through participatory approaches. The secondary-level activities aimed at strengthening organizational and personnel capacities for delivering emergency obstetric care (EmOC) at district and sub-district level hospitals. The project impact was estimated by difference-in-differences logistic regressions using two rounds of cross-sectional household survey data. The results showed that the project successfully increased the utilization of antenatal visits and postpartum EmOC services and also enhanced women's knowledge of danger signs during pregnancy and delivery. The project also reduced income inequalities in access to antenatal care. In contrast, we found no significant increase in the use of skilled birth attendants (SBA) in the project site. Nonetheless, community mobilization activities and the government's voucher scheme played a complementary role in promoting the use of SBA. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bespoke program design for school-aged therapy disability service delivery.

Science.gov (United States)

Weatherill, Pamela; Bahn, Susanne; Cooper, Trudi

2012-01-01

This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

Regulatory Framework and Current Practices of the Radioactive Material Safe and Secure Transport in Albania

International Nuclear Information System (INIS)

Dollani, K.; Grillo, B.; Telhaj, E.

2016-01-01

Attempts for the establishing of a safe and secure radioactive material transport in Albania began a decade ago with formulation of the different regulation in the field of safe and secure handling of the radioactive materials. In 2004 a special regulation for the safe transport of radioactive material was prepared and approved by the National Radiation Protection Commission). This regulation has been based in the IAEA standards for the radioactive material transport and was reviewed periodically. The last regulation of the radioactive material transport was approved by Albanian government through a governmental ordinance. The transport of the radioactive material in Albania is performed by licensed subjects, which fulfill all requirements of the mentioned governmental ordinance. Based in the existing regulation, for each transport of radioactive material, a special permission is issued by NRPC. The issuing of permission allows competent authority to provide necessary information on transport regularity and to have under survey all transports of the radioactive material carried out inside the country. Last year were issued more than 80 permissions for the transport of the different types and categories of the radioactive sources. (author)

DroidSafe

Science.gov (United States)

2016-12-01

Massachusetts Avenue, Build E19-750 Cambridge , MA 02139-4307 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS...Activity objects illustrating the challenges of points-to and information flow analysis...measure how many malicious flows Droid- Safe was able to detect). As these results illustrate , DroidSafe implements an analysis of unprece- dented

From concept to application: the impact of a community-wide intervention to improve the delivery of preventive services to children.

Science.gov (United States)

Margolis, P A; Stevens, R; Bordley, W C; Stuart, J; Harlan, C; Keyes-Elstein, L; Wisseh, S

2001-09-01

of life to provide parental education on fetal and infant health and development, enhance parents' informal support systems, and link parents with needed health and human services. We included training in injury prevention and discipline, and home visitors assisted mothers in obtaining care from one of the primary care offices. There were high levels of participation, changes in the organization of the delivery system, and improvements in preventive health outcomes. Agencies cooperated in joint contracting, staff training, and defining program eligibility. All 8 eligible practices agreed to participate and 7/8 implemented at least 1 new office system element. Of eligible women, 89% agreed to participate, and outcome data were available on 80% (180/225). After adjusting for differences in baseline characteristics, intervention group women were significantly more likely than comparison group women to use contraceptives (69% vs 47%), not smoke tobacco (27% vs 54%) and have a safe and stimulating home environment for their children. Intervention group children were more likely to have had an appropriate number of well-child care visits (57% vs 37%) and less likely to be injured (2% vs 7%). Intervention mothers also received Aid to Families with Dependent Children for fewer months after the birth of their child (7.7 months vs 11.3 months). We observed a number of positive effects at all 3 levels of intervention. Policy-level changes at the state and community led to lasting changes in the organization and financing of care, which enabled changes in clinical services to take place. These changes have now been expanded beyond this community to other communities in the state. We were also able to engage multiple practice organizations, reduce duplication, and improve the coordination of care. Changes in the process of preventive services delivery were noted in participating practices. Finally, the outcomes of the family-level intervention were comparable in direction and

Safe havens in Europe

DEFF Research Database (Denmark)

Paldam, Martin

2013-01-01

Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11 countries are richer than their large neighbors. It is shown that causality is from small to safe haven to wealth, and that theoretically...... equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity...... of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds....

Traveling Safely with Medicines

Science.gov (United States)

... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

Planning, delivery, and quality assurance of treatment with dynamic multileaf collimator for prostate: a strategy for large scale implementation

International Nuclear Information System (INIS)

Burman, Chandra; Chen, Chui; Kutcher, Gerald; Leibel, Steven; Zelefsky, Michael; LoSasso, Thomas; Spirou, Spiridon; Wu Qiuwen; Stein, Jorge; Mohan, Radhe; Ling, C. Clifton; Fuks, Zvi

1996-01-01

Purpose: In an attempt to improve tumor control of patients treated for the adenocarcinoma of the prostate, we have implemented a technique to deliver a prescribed dose of 81 Gy. At such high doses, the surrounding normal organs such as the rectum, bladder, and femur impose challenging constraints. We present a method to plan and deliver intensity modulated fields with dynamic multileaf collimators (DMLCs) in an effort to meet the difficult constraints. While the planning technique which uses inverse planning has been described in the literature, safe delivery with DMLC is a new and challenging problem. We will describe in detail our procedures with the emphasis on the delivery problems and chosen solutions. Procedures for the quality assurance of DMLC will be described. Methods and Materials: Using a recently developed and modified inverse planning algorithm, we have developed a 5-field intensity modulated plan that is delivered using DMLC. The planner specifies the target, normal organs, and the desired doses for these tissues and for the overlap regions. The planning system designs the desired intensity profiles to meet the specified criteria. To deliver the dose DMLCs provide a practical and convenient method. A procedure has been developed for the dose delivery. A scheme has been designed to determine the leaf motion to produce the required intensity pattern based on the prescribed dose and the dose rate. In order to ensure that the dose is delivered as planned, we have instituted the following procedures: (1) verification of the aperture shape on a localization port film, (2) an additional dose calculation, which uses the delivered leaf motion, and compares the difference between the planned and delivered doses, (3) comparison of the machine log files, generated during the actual dose delivery, with the planned leaf motions, (4) comparison of the measured dose profile in a flat phantom with the calculated dose distribution using the prescribed treatment

Obstetrician perceptions of the causes of high cesarean delivery rates in Turkey.

Science.gov (United States)

Küçük, Mert

2017-07-01

To assess obstetricians' perceptions surrounding cesarean delivery rates in Turkey. The present cross-sectional descriptive study was performed between May 1 and June 30, 2016. Practicing obstetricians with contact details known by the researchers and those attending a conference in Turkey were asked to complete a self-administered questionnaire that collected demographic data and information on participants' opinions, beliefs, knowledge, attitudes, and practices related to cesarean delivery. There were 100 obstetricians who responded to the survey. Awareness of high cesarean delivery rates was reported by 96 (96%) participants and 95 (95%) respondents said they were supportive of efforts to reduce it. There were 60 (60%), 83 (83%), and 100 (100%) participants aware of associations between high cesarean delivery rates and increased maternal and infant mortality; increased risk of uterine rupture; and increased risk of placenta previa, placenta accreta, and emergency cesarean hysterectomy, respectively. The most commonly reported reason for high cesarean delivery rates was high compensation costs during medical litigation legal proceedings, reported by all 100 (100%) participants. Participants were generally aware of the risks associated with high cesarean delivery rates. The results suggest that the greatest concern among obstetricians who perform cesarean deliveries was malpractice litigation. © 2017 International Federation of Gynecology and Obstetrics.

Implementation Evaluation of "Steering Teens Safe": Engaging Parents to Deliver a New Parent-Based Teen Driving Intervention to Their Teens

Science.gov (United States)

Ramirez, Marizen; Yang, Jingzhen; Young, Tracy; Roth, Lisa; Garinger, Anne; Snetselaar, Linda; Peek-Asa, Corinne

2013-01-01

Parents play a fundamental role in teaching their children safe driving skills to reduce risk of motor vehicle crashes, the leading cause of death for teens. "Steering Teens Safe" is a new parent-based intervention that equips parents with communication skills to talk about, demonstrate, and practice safe driving behaviors and skills…

Is Communication Improved With the Implementation of an Obstetrical Version of the World Health Organization Safe Surgery Checklist?

Science.gov (United States)

Govindappagari, Shravya; Guardado, Amanda; Goffman, Dena; Bernstein, Jeffrey; Lee, Colleen; Schonfeld, Sara; Angert, Robert; McGowan, Andrea; Bernstein, Peter S

2016-09-08

Communication failures are consistently seen as a root cause of preventable adverse outcomes in obstetrics. We assessed whether use of an Obstetric Safe Surgery Checklist for cesarean deliveries (CDs), based on the WHO Safe Surgery Checklist, can improve communication; reduce team member confusion about urgency of the case; and decrease documentation discrepancies among nursing, obstetric, anesthesia, and pediatric staff. Retrospective review of 600 CDs on our 2 labor and delivery suites before and after the introduction of 2 consecutive versions of our obstetric safe surgery checklist (100 cases in each cohort) was undertaken. The first version was released in 2010, and after modifications based on initial findings, our current version was released in 2014. One hundred consecutive CDs were identified from each of the 3 periods at each hospital, and charts for those patients and newborns were abstracted. Notes by obstetricians, nurses, anesthesiologists, and pediatricians were reviewed. We compared the rates of agreement in the documentation of the indication for the CD between the different members of the team. Chi-square analyses were performed. Complete agreement among the 4 specialties in the documented indication for CD before introduction of our initial safe surgery checklist was noted in 59% (n = 118) of cases. After initial checklist introduction, agreement decreased to 43% (n = 86; P = 0.002). We then modified our checklist to include indication for CD and level of urgency and changed our policy to include pediatric staff participation in the timeout. Agreement in a subsequent chart review increased to 80% (n = 160), significantly better than in our initial analysis (P < 0.001) and our interim review (P < 0.001). The greatest improvement in agreement was observed between obstetricians and pediatricians. Implementation of a safe surgery checklist can improve communication at CDs, but care should be taken when implementing checklists because they can have

Stereotactic body radiotherapy for liver tumors. Principles and practical guidelines of the DEGRO Working Group on Stereotactic Radiotherapy

International Nuclear Information System (INIS)

Sterzing, Florian; Brunner, Thomas B.; Ernst, Iris; Greve, Burkhard; Baus, Wolfgang W.; Herfarth, Klaus; Guckenberger, Matthias

2014-01-01

This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors. The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics. Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided. SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity. (orig.) [de

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

Directory of Open Access Journals (Sweden)

Mutua Martin K

2011-05-01

Full Text Available Abstract Background The World Health Organisation (WHO recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. Results There was universal breastfeeding with almost all children (99% having ever been breastfed. However, more than a third (37% were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability; health seeking behaviour (place of delivery and; neighbourhood

Safe Operation of Critical Assemblies and Research Reactors

Energy Technology Data Exchange (ETDEWEB)

NONE

1961-05-15

This Manual is provided as a guide to the safe operation of critical assemblies and small research reactors. It is intended that it should be used by all authorities and persons concerned with, or responsible for, the use of such equipment, in addition to the scientists and technologists who are actually working with, or operating it. It is suggested that it will be of use to those wishing to design and manufacture, or purchase, critical assemblies or research reactors, as well as those already in possession of them, and that it will prove particularly helpful to those users who have no direct access to other collected sources of information. This Manual is not a set of rules or a code of practice, but a series of recommendations which must be interpreted with scientific judgement in their application to any particular problem. The guiding principles are given from which good operational procedures may be established and improved. The promulgation of rigid standards is both impossible and undesirable at the present time, since the topics discussed form part of a rapidly growing science and technology. Therefore, any recommendations made should not be used to restrict or inhibit future developments. The Manual is intended mainly for use in those Member States where there has been little experience in the operation of critical assemblies and research reactors. It has been compounded from the best practices which exist in Member States having a large amount of such experience, so that nothing in it should conflict with the best practices to be encountered in the field of safe operation.

Safe Operation of Critical Assemblies and Research Reactors

International Nuclear Information System (INIS)

1961-01-01

This Manual is provided as a guide to the safe operation of critical assemblies and small research reactors. It is intended that it should be used by all authorities and persons concerned with, or responsible for, the use of such equipment, in addition to the scientists and technologists who are actually working with, or operating it. It is suggested that it will be of use to those wishing to design and manufacture, or purchase, critical assemblies or research reactors, as well as those already in possession of them, and that it will prove particularly helpful to those users who have no direct access to other collected sources of information. This Manual is not a set of rules or a code of practice, but a series of recommendations which must be interpreted with scientific judgement in their application to any particular problem. The guiding principles are given from which good operational procedures may be established and improved. The promulgation of rigid standards is both impossible and undesirable at the present time, since the topics discussed form part of a rapidly growing science and technology. Therefore, any recommendations made should not be used to restrict or inhibit future developments. The Manual is intended mainly for use in those Member States where there has been little experience in the operation of critical assemblies and research reactors. It has been compounded from the best practices which exist in Member States having a large amount of such experience, so that nothing in it should conflict with the best practices to be encountered in the field of safe operation.

Music Therapy Clinical Practice in Hospice: Differences Between Home and Nursing Home Delivery.

Science.gov (United States)

Liu, Xiaodi; Burns, Debra S; Hilliard, Russell E; Stump, Timothy E; Unroe, Kathleen T

2015-01-01

Hospice music therapy is delivered in both homes and nursing homes (NH). No studies to date have explored differences in music therapy delivery between home and NH hospice patients. To compare music therapy referral reasons and delivery for hospice patients living in NH versus home. A retrospective, electronic medical record review was conducted from a large U.S. hospice of patients receiving music therapy between January 1, 2006, and December 31, 2010. Among the 4,804 patients, 2,930 lived in an NH and 1,847 patients lived at home. Compared to home, NH hospice patients were more likely to be female, older, unmarried, and Caucasian. For home hospice patients, the top referral reasons were patient/family emotional and spiritual support, quality of life, and isolation. The most frequent referral reasons for NH hospice patients were isolation, quality of life, and patient/family emotional and spiritual support. Differences in music therapy delivery depended mainly on patients' primary diagnosis and location of care. Results suggest differences in referral reasons and delivery based on an interaction between location of care and patient characteristics. Delivery differences are likely a result of individualized assessment and care plans developed by the music therapist and other interdisciplinary team members to address the unique needs of the patient. Thus, it is important to have professionally trained music therapists assess and provide tailored music-based interventions for patients with different referral reasons and personal characteristics. This study also supports staffing decisions based on patient need rather than average daily census. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recent progress on fabrication and drug delivery applications of nanostructured hydroxyapatite.

Science.gov (United States)

Mondal, Sudip; Dorozhkin, Sergy V; Pal, Umapada

2018-07-01

Through this brief review, we provide a comprehensive historical background of the development of nanostructured hydroxyapatite (nHAp), and its application potentials for controlled drug delivery, drug conjugation, and other biomedical treatments. Aspects associated with efficient utilization of hydroxyapatite (HAp) nanostructures such as their synthesis, interaction with drug molecules, and other concerns, which need to be resolved before they could be used as a potential drug carrier in body system, are discussed. This review focuses on the evolution of perceptions, practices, and accomplishments in providing improved delivery systems for drugs until date. The pioneering developments that have presaged today's fascinating state of the art drug delivery systems based on HAp and HAp-based composite nanostructures are also discussed. Special emphasis has been given to describe the application and effectiveness of modified HAp as drug carrier agent for different diseases such as bone-related disorders, carriers for antibiotics, anti-inflammatory, carcinogenic drugs, medical imaging, and protein delivery agents. As only a very few published works made comprehensive evaluation of HAp nanostructures for drug delivery applications, we try to cover the three major areas: concepts, practices and achievements, and applications, which have been consolidated and patented for their practical usage. The review covers a broad spectrum of nHAp and HAp modified inorganic drug carriers, emphasizing some of their specific aspects those needed to be considered for future drug delivery applications. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Therapeutic Approaches and Drug Discovery > Nanomedicine for Respiratory Disease Nanotechnology Approaches to Biology > Cells at the Nanoscale. © 2017 Wiley Periodicals, Inc.

Field distribution and DNA transport in solid tumors during electric field-mediated gene delivery.

Science.gov (United States)

Henshaw, Joshua W; Yuan, Fan

2008-02-01

Gene therapy has a great potential in cancer treatment. However, the efficacy of cancer gene therapy is currently limited by the lack of a safe and efficient means to deliver therapeutic genes into the nucleus of tumor cells. One method under investigation for improving local gene delivery is based on the use of pulsed electric field. Despite repeated demonstration of its effectiveness in vivo, the underlying mechanisms behind electric field-mediated gene delivery remain largely unknown. Without a thorough understanding of these mechanisms, it will be difficult to further advance the gene delivery. In this review, the electric field-mediated gene delivery in solid tumors will be examined by following individual transport processes that must occur in vivo for a successful gene transfer. The topics of examination include: (i) major barriers for gene delivery in the body, (ii) distribution of electric fields at both cell and tissue levels during the application of external fields, and (iii) electric field-induced transport of genes across each of the barriers. Through this approach, the review summarizes what is known about the mechanisms behind electric field-mediated gene delivery and what require further investigations in future studies.

Towards effective extension delivery approach and strategies for ...

African Journals Online (AJOL)

Towards effective extension delivery approach and strategies for food security poverty ... Journal Home > Vol 6, No 1 (2010) > ... groups, promotion of best practices and environment friendly initiatives among others were recommended.

Consensus shaping and safe space public participation processes

Energy Technology Data Exchange (ETDEWEB)

Andersson, Kjell [Karita Research AB, Taeaby (Sweden)

2015-07-01

Stakeholder involvement and public participation is recognized as a necessary part of nuclear waste management. It is possible to see three driving forces behind this development: (1) a deliberative movement with its roots in the 1960s leftish movement (a philosophical argument), (2) the need for public acceptance of proposed solutions (a practical argument), and (3) the need for awareness and clarity before crucial decisions are made (a practical and democratic argument). Depending on which driving force dominates an initiative for public participation, the initiator is likely to prefer certain public participation processes before others. The initiator has to select among a large number of processes already having been implemented or design a new one tailored for the specific situation. The process choice is crucial for which stakeholders are able to join and which goals can be reached. Much of the debate about public participation has referred to the ''Arnstein ladder'' (Arnstein, 1969) or its modernized versions, such as the participation ladder used in the IPPA Project (Richardson et.al. 2011) building on work by the Netherlands Environmental Assessment Agency (MNP, 2008). The various forms of ladders have in common an increasing level of ambition for participation from low to high. The higher up on the ladder, the better it is often anticipated. However, with this should follow more responsibility and accountability of all participants, which in practice is often lacking. There are also practical problems in using the ladder to map public participation processes. For example the step 'collaboration' is ambiguous as it can mean different things. In the RISCOM Process, participants collaborate to improve clarity and awareness but not for finding common solutions. Therefore, the RISCOM Process (Vojtechova, 2009) does not fit into the ladder structure. To avoid these and other problems it is suggested to use three basic approaches to

Consensus shaping and safe space public participation processes

International Nuclear Information System (INIS)

Andersson, Kjell

2015-01-01

Stakeholder involvement and public participation is recognized as a necessary part of nuclear waste management. It is possible to see three driving forces behind this development: (1) a deliberative movement with its roots in the 1960s leftish movement (a philosophical argument), (2) the need for public acceptance of proposed solutions (a practical argument), and (3) the need for awareness and clarity before crucial decisions are made (a practical and democratic argument). Depending on which driving force dominates an initiative for public participation, the initiator is likely to prefer certain public participation processes before others. The initiator has to select among a large number of processes already having been implemented or design a new one tailored for the specific situation. The process choice is crucial for which stakeholders are able to join and which goals can be reached. Much of the debate about public participation has referred to the ''Arnstein ladder'' (Arnstein, 1969) or its modernized versions, such as the participation ladder used in the IPPA Project (Richardson et.al. 2011) building on work by the Netherlands Environmental Assessment Agency (MNP, 2008). The various forms of ladders have in common an increasing level of ambition for participation from low to high. The higher up on the ladder, the better it is often anticipated. However, with this should follow more responsibility and accountability of all participants, which in practice is often lacking. There are also practical problems in using the ladder to map public participation processes. For example the step 'collaboration' is ambiguous as it can mean different things. In the RISCOM Process, participants collaborate to improve clarity and awareness but not for finding common solutions. Therefore, the RISCOM Process (Vojtechova, 2009) does not fit into the ladder structure. To avoid these and other problems it is suggested to use three basic approaches to

Using Observational Data to Estimate the Effect of Hand Washing and Clean Delivery Kit Use by Birth Attendants on Maternal Deaths after Home Deliveries in Rural Bangladesh, India and Nepal.

Directory of Open Access Journals (Sweden)

Nadine Seward

Full Text Available Globally, puerperal sepsis accounts for an estimated 8-12% of maternal deaths, but evidence is lacking on the extent to which clean delivery practices could improve maternal survival. We used data from the control arms of four cluster-randomised controlled trials conducted in rural India, Bangladesh and Nepal, to examine associations between clean delivery kit use and hand washing by the birth attendant with maternal mortality among home deliveries.We tested associations between clean delivery practices and maternal deaths, using a pooled dataset for 40,602 home births across sites in the three countries. Cross-sectional data were analysed by fitting logistic regression models with and without multiple imputation, and confounders were selected a priori using causal directed acyclic graphs. The robustness of estimates was investigated through sensitivity analyses.Hand washing was associated with a 49% reduction in the odds of maternal mortality after adjusting for confounding factors (adjusted odds ratio (AOR 0.51, 95% CI 0.28-0.93. The sensitivity analysis testing the missing at random assumption for the multiple imputation, as well as the sensitivity analysis accounting for possible misclassification bias in the use of clean delivery practices, indicated that the association between hand washing and maternal death had been over estimated. Clean delivery kit use was not associated with a maternal death (AOR 1.26, 95% CI 0.62-2.56.Our evidence suggests that hand washing in delivery is critical for maternal survival among home deliveries in rural South Asia, although the exact magnitude of this effect is uncertain due to inherent biases associated with observational data from low resource settings. Our findings indicating kit use does not improve maternal survival, suggests that the soap is not being used in all instances that kit use is being reported.

TU-A-304-03: Quality Assurance, Safety, and Other Practical Aspects of SBRT

International Nuclear Information System (INIS)

Benedict, S.

2015-01-01

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems

TU-A-304-03: Quality Assurance, Safety, and Other Practical Aspects of SBRT

Energy Technology Data Exchange (ETDEWEB)

Benedict, S. [UC Davis Cancer Center (United States)

2015-06-15

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

Escola segura Safe school

Directory of Open Access Journals (Sweden)

Edson Ferreira Liberal

2005-11-01

growing evidence that intervention has multiple components, focusing on health education practices, with the participation of the whole community. The aim of those interventions is to help students and community members to adopt healthy and safe behaviors. Schools are taking on an increasing role in health promotion, disease prevention, and injury prevention. In the context of prevention of external causes of morbidity and mortality, it is important to recognize a risky environment, places, and risk behaviors as favorable to injury and violence, as well as the concept of accident as something one can avoid. CONCLUSION: Implementation of safe schools represents a promising new direction for school-based preventive work. It is important to note that a safe school should intervene not only in its physical structure, but it should also make it as safe as possible by gathering the school community through health education, and mainly encouraging healthy behavior.

Non-invasive Oil-Based Method to Increase Topical Delivery of Nucleic Acids to Skin.

Science.gov (United States)

Vij, Manika; Alam, Shamshad; Gupta, Nidhi; Gotherwal, Vishvabandhu; Gautam, Hemlata; Ansari, Kausar M; Santhiya, Deenan; Natarajan, Vivek T; Ganguli, Munia

2017-06-07

Topical delivery of nucleic acids to skin has huge prospects in developing therapeutic interventions for cutaneous disorders. In spite of initial success, clinical translation is vastly impeded by the constraints of bioavailability as well as stability in metabolically active environment of skin. Various physical and chemical methods used to overcome these limitations involve invasive procedures or compounds that compromise skin integrity. Hence, there is an increasing demand for developing safe skin penetration enhancers for efficient nucleic acid delivery to skin. Here, we demonstrate that pretreatment of skin with silicone oil can increase the transfection efficiency of non-covalently associated peptide-plasmid DNA nanocomplexes in skin ex vivo and in vivo. The method does not compromise skin integrity, as indicated by microscopic evaluation of cellular differentiation, tissue architecture, enzyme activity assessment, dye penetration tests using Franz assay, and cytotoxicity and immunogenicity analyses. Stability of nanocomplexes is not hampered on pretreatment, thereby avoiding nuclease-mediated degradation. The mechanistic insights through Fourier transform infrared (FTIR) spectroscopy reveal some alterations in the skin hydration status owing to possible occlusion effects of the enhancer. Overall, we describe a topical, non-invasive, efficient, and safe method that can be used to increase the penetration and delivery of plasmid DNA to skin for possible therapeutic applications. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

High output stomas: ensuring safe discharge from hospital to home.

Science.gov (United States)

Smith, Lisa

High-output stomas are a challenge for the patient and all health professionals involved. This article discusses safe discharge home for this patient group, encouraging collaborative working practices between acute care trust and the community services. The authors also discuss the management of a high-output stoma and preparation and education of the patient before discharge home.

Knowledge, Attitudes, and Practice of Medical Students Regarding ...

African Journals Online (AJOL)

knowledge and attitudes among male student regarding occupational risks of HBV ... Most of the students surveyed 63.0% (58/92) considered vaccine is safe and .... blood, 70.7% (65/92) during delivery from the infected mothers .... The complete vaccine series induces protective antibody levels in >95% of infants, children.

Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

Directory of Open Access Journals (Sweden)

Sychareun Vanphanom

2012-08-01

Full Text Available Abstract Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1 Distance to the health facilities and difficulties and costs of getting there; (2 Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3 The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4 The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and

Practice Bulletin No. 161: External Cephalic Version.

Science.gov (United States)

2016-02-01

In the United States, there is a widespread belief that the overall cesarean delivery rate is higher than necessary. Efforts are being directed toward decreasing the number of these procedures, in part by encouraging physicians to make changes in their management practices. Because breech presentations are associated with a high rate of cesarean delivery, there is renewed interest in techniques such as external cephalic version (ECV) and vaginal breech delivery. The purpose of this document is to provide information about ECV by summarizing the relevant evidence presented in published studies and to make recommendations regarding its use in obstetric practice.

Radiological protection in dental practice

Energy Technology Data Exchange (ETDEWEB)

1975-01-01

Intended to be complementary to the more comprehensive document, ''Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use'' (CIS 74-423), the purpose of this booklet is to give dentists some basic information on the safe use of X-rays. Contents: why protection from X-rays; responsibility for radiation protection; protection during a dental examination; ensuring a safe installation; sources of further information. Appendices: maximum permissible doses; useful addresses; summary of relevant recommendations from the Code of Practice; notes on film processing.

Development of Safe and Effective Botanical Dietary Supplements.

Science.gov (United States)

van Breemen, Richard B

2015-11-12

Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug-botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements.

Development of Safe and Effective Botanical Dietary Supplements

Science.gov (United States)

2015-01-01

Regulated differently than drugs or foods, the market for botanical dietary supplements continues to grow worldwide. The recently implemented U.S. FDA regulation that all botanical dietary supplements must be produced using good manufacturing practice is an important step toward enhancing the safety of these products, but additional safeguards could be implemented, and unlike drugs, there are currently no efficacy requirements. To ensure a safe and effective product, botanical dietary supplements should be developed in a manner analogous to pharmaceuticals that involves identification of mechanisms of action and active constituents, chemical standardization based on the active compounds, biological standardization based on pharmacological activity, preclinical evaluation of toxicity and potential for drug–botanical interactions, metabolism of active compounds, and finally, clinical studies of safety and efficacy. Completing these steps will enable the translation of botanicals from the field to safe human use as dietary supplements. PMID:26125082

Green related practices for construction procurement

Science.gov (United States)

Bidin, Z. A.; Bohari, A. A. M.; Rais, S. L. A.; Saferi, M. M.

2018-04-01

Environment degradation issue has been a worldwide problem and various efforts have been done to minimise the problem. Construction sectors are pointed as one of the major contributors to its construction activities. Green-oriented procurement [GP] is considered as an environmental strategy to integrate the environmental practices into the construction delivery. Thus, this paper reviews the concept of GP and the practices related to it. The outcome of this research findings provides a basis for understanding the concept of GP and the further development of GP. The listed GP practices identified from this paper can serve as guidelines for industry practitioners to design, implement, and benchmarking the green practices in their procurement delivery.

Instrumental vaginal delivery: a dying saving art; an experience at ...

African Journals Online (AJOL)

Of the 12 interviewed doctors only 4 (28.6%) had ever used vacuum for deliveries where out of 24 interviewed midwives, only 8 (33.3%) had ever used vacuum for delivery. All of them self reported to have a theoretical knowledge on the use of vacuum but only 5 (35.7%) of the interviewed doctors said they had a practical ...

Code of Practice for the safe transport of radioactive substances 1990

International Nuclear Information System (INIS)

1990-01-01

This Federal Code revises an earlier Code on the same subject issued in 1982 and was formulated under the Environment Protection (Nuclear Codes) Act 1978. The purpose of the Code is to establish uniform safety standards, applicable throughout the Commonwealth of Australia, to provide for the protection of persons and the environment, against any dangers associated with the transport of radioactive substances. The Code uses as a basis the IAEA Regulations for the Safe Transport of Radioactive Materials. This new edition takes into account the 1985 Edition of the Regulations incorporating the 1988 Supplement and provides, furthermore, that radiation protection standards will also be subject to recommendations of the Australian National Health and Medical Research Council [fr

Risk assessments and safe machinery ensuring compliance with the EU directives

CERN Document Server

Jespen, Torben

2016-01-01

This book describes the prerequisites for the placing on the market and the safe use of machinery in compliance with the relevant EU Directives, especially the Machinery Directive 2006/42. It provides readers with high-level knowledge concerning the Essential Health and Safety Requirements (EHSR) that machinery must fulfill. The approach and principles of the Machinery Directive were most recently made worldwide acknowledged in the ILO code of practice on safe machinery, released in 2013. The book addresses that code, as well as providing valuable insight into other EU Product and Workplace legislation. Focusing on the key aspect of safe machinery, the “machinery safety risk assessment”, which allows readers to better understand the more difficult aspects of risk assessments, the book equips readers to tackle problems at the manufacturing stage and in different use scenarios, introducing them to risk reduction techniques and functional safety aspects.

Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).

Science.gov (United States)

Patel, Puja; Hemmeger, Heather; Kozak, Mary Ann; Gernant, Stephanie A; Snyder, Margie E

2015-01-01

To describe the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). Retail chain, independent, and hospital/health system outpatient community pharmacies throughout Indiana, with a total of 127 pharmacy members represented by 26 site coordinators. Rx-SafeNet, a statewide practice-based research network (PBRN) formed in 2010 and administered by the Purdue University College of Pharmacy. Barriers and facilitators to participation in available research studies, confidence participating in research, and satisfaction with overall network communication. 22 of 26 site coordinators participated, resulting in an 85% response rate. Most (72.2%) of the respondents had received a doctor of pharmacy degree, and 13.6% had postgraduate year (PGY)1 residency training. The highest reported benefits of PBRN membership were an enhanced relationship with the Purdue University College of Pharmacy (81% agreed or strongly agreed) and enhanced professional development (80% agreed or strongly agreed). Time constraints were identified as the greatest potential barrier to network participation, reported by 62% of respondents. In addition, the majority (59%) of survey respondents identified no prior research experience. Last, respondents' confidence in performing research appeared to increase substantially after becoming network members, with 43% reporting a lack of confidence in engaging in research before joining the network compared with 90% reporting confidence after joining the network. In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation. These findings will assist network leadership in identifying opportunities to positively increase member participation

[Safe and family-centered maternity hospitals: organizational culture of maternity hospitals in the province of Buenos Aires].

Science.gov (United States)

Ramos, Silvina; Romero, Mariana; Ortiz, Zulma; Brizuela, Vanessa

2015-12-01

In 2010, the Safe and Family-Centered Maternity Hospitals initiative was launched in order to transform large public maternity centers into settings where safe practices are implemented and the rights of women, newborn infants and families are warranted. As a result, the paradigm of perinatal care was modified. This article reports on the findings of organizational culture as a component for the implementation of the initiative. The sample was selected in a non-probabilistic way and was made up of 29 public hospitals located in the province of Buenos Aires that participated in the initiative. During 2011 and 2012, an anonymous, self-administered survey was completed by members of the Department of Neonatology and the Department of Obstetrics. The survey collected information on three dimensions of the organizational culture: organizational environment, safe practices, and facilitation of change. A total of 1828 surveys were collected; 51% of survey respondents stated that there is a need to improve communication by having more meetings, while 60% made a positive assessment of various aspects of leadership. Work overload was described as the main cause of conflicts by 60%. Approximately 25% agreed and showed commitment with the initiative of transforming maternity centers. Adherence to practices was dissimilar depending on the practice, but half of survey respondents reported that there were genuine reasons for change. The assessment of the organizational culture showed that commitment to the Safe and Family-Centered Maternity Hospitals initiative is yet to be consolidated, and the evaluation of leadership is not comprehensive. Work overload and communication failures are the main reasons for conflict.

Successful delivery of adjuvant external beam radiotherapy for ependymoma in a patient with Ondine's curse

International Nuclear Information System (INIS)

Choi, Mehee; Thoma, Miranda; Tolekidis, George; Byrne, Richard W.; Diaz, Aidnag Z.

2015-01-01

Ondine's curse is a rare, potentially life-threatening disorder characterized by loss of automatic breathing during sleep and preserved voluntary breathing. It is seldom encountered in the radiotherapy clinic but can pose significant technical challenges and safety concerns in the delivery of a prescribed radiation course. We report a unique case of successful delivery of radiotherapy for ependymoma in a patient with Ondine's curse. A 53-year-old gentleman presented with vertigo when lying down. Brain magnetic resonance imaging revealed an enhancing mass in the floor of the fourth ventricle. He underwent maximal safe resection. Pathology revealed ependymoma. The patient was referred for radiotherapy. Computed tomography simulation was performed in supine position with 3-point thermoplastic mask immobilization. Sequential TomoTherapy plans were developed. At first scheduled treatment, shortly after mask placement, his arms went limp and he was unresponsive. Vitals showed oxygen saturation 83%, pulse 127, and blood pressure 172/97 mm Hg. He was diagnosed with Ondine's curse thought secondary to previous brainstem damage; the combination of lying flat and pressure from the mask was causing him to go into respiratory arrest. As supine positioning did not seem clinically advisable, he was simulated in prone position. A RapidArc plan and a back-up conformal plan were developed. Prescriptions were modified to meet conservative organs-at-risk constraints. Several strategies were used to minimize uncertainties in set-up reproducibility associated with prone positioning. He tolerated prone RapidArc treatments well. The report highlights the importance of applying practical patient safety and treatment planning/delivery strategies in the management of this challenging case.

How Do Obstetric and Neonatology Teams Communicate Prior to High-Risk Deliveries?

Science.gov (United States)

Sundgren, Nathan C; Suresh, Gautham K

2018-01-01

 Improving communication in healthcare improves the quality of care and patient outcomes, but communication between obstetric and neonatal teams before and during a high-risk delivery is poorly studied.  We developed a survey to study communication between obstetric and neonatal teams around the time of a high-risk delivery. We surveyed neonatologists from North America and asked them to answer questions about their institutions' communication practices.  The survey answers revealed variations in communication practices between responders. Most institutions relied on nursing to communicate obstetric information to the neonatal team. Although a minority of institutions used a standardized communication process to summon neonatology team or to communicate in the delivery room, these reported higher rates of information sharing and greater satisfaction with communication between services.  Standardized communication procedures are an underutilized method of communication and have the potential to improve communication around high-risk deliveries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Delivery room triage of large for gestational age infants of diabetic mothers.

Science.gov (United States)

Cordero, Leandro; Rath, Krista; Zheng, Katherine; Landon, Mark B; Nankervis, Craig A

2014-01-01

To review our 4-year experience (2008-2011) with delivery room triage of large for gestational age infants of diabetic mothers. Retrospective cohort investigation of 311 large for gestational age infants of diabetic mothers (White's Class A1 (77), A2 (87), B (77), and C-R (70)). Of 311 women, 31% delivered at 34-36 weeks gestational age and 69% at term. While 70% were delivered by cesarean, 30% were vaginal deliveries. A total of 160 asymptomatic infants were triaged from the delivery room to the well baby nursery. Of these, 55 (34%) developed hypoglycemia. In 43 cases, the hypoglycemia was corrected by early feedings; in the remaining 12, intravenous dextrose treatment was required. A total of 151 infants were triaged from the delivery room to the neonatal intensive care unit. Admission diagnoses included respiratory distress (51%), prevention of hypoglycemia (27%), prematurity (21%), and asphyxia (1%). Hypoglycemia affected 66 (44%) of all neonatal intensive care unit infants. Safe triage of asymptomatic large for gestational age infants of diabetic mothers from the delivery room to well baby nursery can be accomplished in the majority of cases. Those infants in need of specialized care can be accurately identified and effectively treated in the neonatal intensive care unit setting.

Assessing fidelity of delivery of smoking cessation behavioural support in practice.

Science.gov (United States)

Lorencatto, Fabiana; West, Robert; Christopherson, Charlotte; Michie, Susan

2013-04-04

Effectiveness of evidence-based behaviour change interventions is likely to be undermined by failure to deliver interventions as planned. Behavioural support for smoking cessation can be a highly cost-effective, life-saving intervention. However, in practice, outcomes are highly variable. Part of this may be due to variability in fidelity of intervention implementation. To date, there have been no published studies on this. The present study aimed to: evaluate a method for assessing fidelity of behavioural support; assess fidelity of delivery in two English Stop-Smoking Services; and compare the extent of fidelity according to session types, duration, individual practitioners, and component behaviour change techniques (BCTs). Treatment manuals and transcripts of 34 audio-recorded behavioural support sessions were obtained from two Stop-Smoking Services and coded into component BCTs using a taxonomy of 43 BCTs. Inter-rater reliability was assessed using percentage agreement. Fidelity was assessed by examining the proportion of BCTs specified in the manuals that were delivered in individual sessions. This was assessed by session type (i.e., pre-quit, quit, post-quit), duration, individual practitioner, and BCT. Inter-coder reliability was high (87.1%). On average, 66% of manual-specified BCTs were delivered per session (SD 15.3, range: 35% to 90%). In Service 1, average fidelity was highest for post-quit sessions (69%) and lowest for pre-quit (58%). In Service 2, fidelity was highest for quit-day (81%) and lowest for post-quit sessions (56%). Session duration was not significantly correlated with fidelity. Individual practitioner fidelity ranged from 55% to 78%. Individual manual-specified BCTs were delivered on average 63% of the time (SD 28.5, range: 0 to 100%). The extent to which smoking cessation behavioural support is delivered as specified in treatment manuals can be reliably assessed using transcripts of audiotaped sessions. This allows the investigation of

Accident history, risk perception and traffic safe behaviour.

Science.gov (United States)

Ngueutsa, Robert; Kouabenan, Dongo Rémi

2017-09-01

This study clarifies the associations between accident history, perception of the riskiness of road travel and traffic safety behaviours by taking into account the number and severity of accidents experienced. A sample of 525 road users in Cameroon answered a questionnaire comprising items on perception of risk, safe behaviour and personal accident history. Participants who reported involvement in more than three accidents or involvement in a severe accident perceived road travel as less risky and also reported behaving less safely compared with those involved in fewer, or less severe accidents. The results have practical implications for the prevention of traffic accidents. Practitioner Summary: The associations between accident history, perceived risk of road travel and safe behaviour were investigated using self-report questionnaire data. Participants involved in more than three accidents, or in severe accidents, perceived road travel as less risky and also reported more unsafe behaviour compared with those involved in fewer, or less severe accidents. Campaigns targeting people with a less serious, less extensive accident history should aim to increase awareness of hazards and the potential severity of their consequences, as well as emphasising how easy it is to take the recommended preventive actions. Campaigns targeting those involved in more frequent accidents, and survivors of serious accidents, should address feelings of invulnerability and helplessness.

Transdermal Drug Delivery: Innovative Pharmaceutical Developments Based on Disruption of the Barrier Properties of the Stratum Corneum

Directory of Open Access Journals (Sweden)

Ahlam Zaid Alkilani

2015-10-01

Full Text Available The skin offers an accessible and convenient site for the administration of medications. To this end, the field of transdermal drug delivery, aimed at developing safe and efficacious means of delivering medications across the skin, has in the past and continues to garner much time and investment with the continuous advancement of new and innovative approaches. This review details the progress and current status of the transdermal drug delivery field and describes numerous pharmaceutical developments which have been employed to overcome limitations associated with skin delivery systems. Advantages and disadvantages of the various approaches are detailed, commercially marketed products are highlighted and particular attention is paid to the emerging field of microneedle technologies.

Transdermal Drug Delivery: Innovative Pharmaceutical Developments Based on Disruption of the Barrier Properties of the stratum corneum

Science.gov (United States)

Zaid Alkilani, Ahlam; McCrudden, Maelíosa T.C.; Donnelly, Ryan F.

2015-01-01

The skin offers an accessible and convenient site for the administration of medications. To this end, the field of transdermal drug delivery, aimed at developing safe and efficacious means of delivering medications across the skin, has in the past and continues to garner much time and investment with the continuous advancement of new and innovative approaches. This review details the progress and current status of the transdermal drug delivery field and describes numerous pharmaceutical developments which have been employed to overcome limitations associated with skin delivery systems. Advantages and disadvantages of the various approaches are detailed, commercially marketed products are highlighted and particular attention is paid to the emerging field of microneedle technologies. PMID:26506371

[Delivery of the IUGR fetus].

Science.gov (United States)

Perrotin, F; Simon, E G; Potin, J; Laffon, M

2013-12-01

The purpose of this paper is to review available data regarding the management of delivery in intra uterine growth retarded fetuses and try to get recommendations for clinical obstetrical practice. Bibliographic research performed by consulting PubMed database and recommendations from scientific societies with the following words: small for gestational age, intra-uterine growth restriction, fetal growth restriction, very low birth weight infants, as well as mode of delivery, induction of labor, cesarean section and operative delivery. The diagnosis of severe IUGR justifies the orientation of the patient to a referral centre with all necessary resources for very low birth weight or premature infants Administration of corticosteroids for fetal maturation (before 34 WG) and a possible neuroprotective treatment by with magnesium sulphate (before 32-33 WG) should be discussed. Although elective caesarean section is common, there is no current evidence supporting the use of systematic cesarean section, especially when the woman is in labor. Induction of labor, even with unfavorable cervix is possible under continuous FHR monitoring, in favorable obstetric situations and in the absence of severe fetal hemodynamic disturbances. Instrumental delivery and routine episiotomy are not recommended. For caesarean section under spinal anesthesia, an adequate anesthetic management must ensure the maintenance of basal blood pressure. Compared with appropriate for gestational age fetus, IUGR fetus is at increased risk of metabolic acidosis or perinatal asphyxia during delivery. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Code of practice : safe use of ionizing radiation

International Nuclear Information System (INIS)

1988-07-01

Ionizing radiation is used extensively in the field of scientific research. The risk of uncontrolled exposure to both the worker and the environment is ever present. The purpose of this Code is to set out practices considered by the CSIRO Health and Safety Committee to be appropriate for CSIRO staff and, if followed, they will result in appropriate protection for research staff and the environment. The Code does not cover sources of non-ionizing radiation such as microwave ovens, RF generators and laser sources

Microneedle-mediated transdermal delivery of nanostructured lipid carriers for alkaloids from Aconitum sinomontanum.

Science.gov (United States)

Guo, Teng; Zhang, Yongtai; Li, Zhe; Zhao, Jihui; Feng, Nianping

2017-09-12

A combination method using microneedle (MN) pretreatment and nanostructured lipid carriers (NLCs) was developed to improve the transdermal delivery of therapeutics. The MN treatment of the skin and co-administration of NLCs loaded with total alkaloids isolated from Aconitum sinomontanum (AAS-NLCs) significantly increased the skin permeation of the drugs. Fluorescence imaging confirmed that MNs could provide microchannels penetrating the stratum corneum, and delivery of NLCs through the channels led to their deeper permeation. In vivo studies showed that combination of AAS-NLCs with MNs (AAS-NLCs-MN) in transdermal delivery could improve the bioavailability and maintain stable drug concentrations in the blood. Moreover, AAS-NLCs-MN showed benefits in eliminating paw swelling, decreasing inflammation and pain, and regulating immune function in adjuvant arthritis rats. After administration of AAS-NLCs-MN, no skin irritation was observed in rabbits, and electrocardiograms of rats showed improved arrhythmia. These results indicated that the dual approach combining MN insertion and NLCs has the potential to provide safe transdermal delivery and to improve the therapeutic efficacy through sustained release of AAS.

Multilayered pyramidal dissolving microneedle patches with flexible pedestals for improving effective drug delivery.

Science.gov (United States)

Lau, Shinying; Fei, Jie; Liu, Haoran; Chen, Weixing; Liu, Ran

2017-11-10

Dissolving microneedles have been employed as a safe and convenient transdermal delivery system for drugs and vaccines. To improve effective drug delivery, a multilayered pyramidal dissolving microneedle patch, composed of silk fibroin tips with the ability of robust mechanical strength, rapid dissolution and drug release supported on a flexible polyvinyl alcohol (PVA) pedestal is reported. To show the utility of this approach the ability of the fabricated microneedles to deliver insulin is demonstrated. The dissolving microneedles have sufficient mechanical strength to be inserted into abdomen skin of mice to a depth of approximately 150μm, and release their encapsulated insulin into the skin to cause a hypoglycemic effect. The fabrication of microneedles avoids high temperature which benefits storage stability at room temperature for 20d. This result indicates >99.4% of insulin remained in the microneedles. In comparison to traditional needle-based administration, the proposed multilayered pyramidal dissolving microneedle patches enable self-administration, miniaturization, pain-free administration, drug delivery and drug stability, all being important features in needle free drug delivery. Copyright © 2016 Elsevier B.V. All rights reserved.

Synthesis of the project leadership staffing needs for successful development of alternative delivery programs.

Science.gov (United States)

2017-08-01

This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...

Working Safely with Robot Workers: Recommendations for the New Workplace

Science.gov (United States)

Murashov, Vladimir; Hearl, Frank; Howard, John

2016-01-01

The increasing use of robots in performing tasks alongside or together with human coworkers raises novel occupational safety and health issues. The new 21st century workplace will be one in which occupational robotics plays an increasing role. This paper describes the increasing complexity of robots and proposes a number of recommendations for the practice of safe occupational robotics. PMID:26554511

Working safely with robot workers: Recommendations for the new workplace.

Science.gov (United States)

Murashov, Vladimir; Hearl, Frank; Howard, John

2016-01-01

The increasing use of robots in performing tasks alongside or together with human co-workers raises novel occupational safety and health issues. The new 21st century workplace will be one in which occupational robotics plays an increasing role. This article describes the increasing complexity of robots and proposes a number of recommendations for the practice of safe occupational robotics.

SAFE Newsletter

OpenAIRE

2013-01-01

The Center of Excellence SAFE – “Sustainable Architecture for Finance in Europe” – is a cooperation of the Center for Financial Studies and Goethe University Frankfurt. It is funded by the LOEWE initiative of the State of Hessen (Landes-Offensive zur Entwicklung wissenschaftlich-ökonomischer Exzellenz). SAFE brings together more than 40 professors and just as many junior researchers who are all dedicated to conducting research in support of a sustainable financial architecture. The Center has...

Long-term delivery of nerve growth factor by encapsulated cell biodelivery in the Göttingen minipig basal forebrain

DEFF Research Database (Denmark)

Fjord-Larsen, L; Kusk, P; Tornøe, Jens

2010-01-01

Nerve growth factor (NGF) prevents cholinergic degeneration in Alzheimer's disease (AD) and improves memory in AD animal models. In humans, the safe delivery of therapeutic doses of NGF is challenging. For clinical use, we have therefore developed an encapsulated cell (EC) biodelivery device...

Investigation of enzyme-sensitive lipid nanoparticles for delivery of siRNA to blood–brain barrier and glioma cells

DEFF Research Database (Denmark)

Bruun, Jonas; Larsen, Trine Bjørnbo; Jølck, Rasmus Irming

2015-01-01

Clinical applications of siRNA for treating disorders in the central nervous system require development of systemic stable, safe, and effective delivery vehicles that are able to cross the impermeable blood–brain barrier (BBB). Engineering nanocarriers with low cellular interaction during systemi...

Safe working hours--doctors in training a best practice issue.

Science.gov (United States)

Lewis, Andrew

2002-01-01

In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.

Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

Science.gov (United States)

Vrkljan, Brenda H; Cranney, Ann; Worswick, Julia; O'Donnell, Siobhan; Li, Linda C; Gélinas, Isabelle; Byszewski, Anna; Man-Son-Hing, Malcolm; Marshall, Shawn

2010-01-01

We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

Enhanced antitumor effects of novel intracellular delivery of an active form of menaquinone-4, menahydroquinone-4, into hepatocellular carcinoma.

Science.gov (United States)

Setoguchi, Shuichi; Watase, Daisuke; Matsunaga, Kazuhisa; Matsubara, Misa; Kubo, Yohei; Kusuda, Mariko; Nagata-Akaho, Nami; Enjoji, Munechika; Nakashima, Manabu; Takeshita, Morishige; Karube, Yoshiharu; Takata, Jiro

2015-02-01

Reduced cellular uptake of menaquinone-4 (MK-4), a vitamin K2 homolog, in human hepatocellular carcinoma (HCC) limits its usefulness as a safe long-term antitumor agent for recurrent HCC and produces des-γ-carboxy prothrombin (DCP). We hypothesized that effective delivery of menahydroquinone-4 (MKH), the active form of MK-4 for γ-glutamyl carboxylation, into HCC cells is critical for regulating HCC growth, and may enable it to be applied as a safe antitumor agent. In this study, we verified this hypothesis using menahydroquinone-4 1,4-bis-N,N-dimethylglycinate hydrochloride (MKH-DMG), a prodrug of MKH, and demonstrated its effectiveness. Intracellular delivery of MKH and subsequent growth inhibition of PLC/PRF/5 and Hep3B (DCP-positive) and SK-Hep-1 (DCP-negative) cells after MKH-DMG administration were determined and compared with MK-4. The activity of MKH-DMG against tumor progression in the liver alongside DCP formation was determined in a spleen-liver metastasis mouse model. MKH-DMG exhibited greater intracellular delivery of MKH in vitro (AUC0-72 hour of MKH) and increased growth-inhibitory activity against both DCP-positive and DCP-negative HCC cell lines. The phenomena of MKH delivery into cells in parallel with simultaneous growth inhibition suggested that MKH is the active form for growth inhibition of HCC cells. Cell-cycle arrest was determined to be involved in the growth inhibition mechanisms of MKH-DMG. Furthermore, MKH-DMG showed significant inhibition of tumor progression in the liver, and a substantial decrease in plasma DCP levels in the spleen-liver metastasis mouse model. Our results suggest that MKH-DMG is a promising new candidate antitumor agent for safe long-term treatment of HCC. ©2014 American Association for Cancer Research.

Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies.

Directory of Open Access Journals (Sweden)

Ian Young

Full Text Available Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers' perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11, moderate (11, and low (9. Overarching analytical themes included: 1 safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2 most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3 consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed.

Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies

Science.gov (United States)

Young, Ian; Waddell, Lisa

2016-01-01

Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11), moderate (11), and low (9). Overarching analytical themes included: 1) safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2) most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3) consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed. PMID:27907161

Care delivery and compensation system changes: a case study of organizational readiness within a large dental care practice organization in the United States.

Science.gov (United States)

Cunha-Cruz, Joana; Milgrom, Peter; Huebner, Colleen E; Scott, JoAnna; Ludwig, Sharity; Dysert, Jeanne; Mitchell, Melissa; Allen, Gary; Shirtcliff, R Mike

2017-12-20

Dental care delivery systems in the United States are consolidating and large practice organizations are becoming more common. At the same time, greater accountability for addressing disparities in access to care is being demanded when public funds are used to pay for care. As change occurs within these new practice structures, attempts to implement change in the delivery system may be hampered by failure to understand the organizational climate or fail to prepare employees to accommodate new goals or processes. Studies of organizational behavior within oral health care are sparse and have not addressed consolidation of current delivery systems. The objective of this case study was to assess organizational readiness for implementing change in a large dental care organization consisting of staff model clinics and affiliated dental practices and test associations of readiness with workforce characteristics and work environment. A dental care organization implemented a multifaceted quality improvement program, called PREDICT, in which community-based mobile and clinic-based dental services were integrated and the team compensated based in part on meeting performance targets. Dental care providers and supporting staff members (N = 181) were surveyed before program implementation and organizational readiness for implementing change (ORIC) was assessed by two 5-point scales: change commitment and efficacy. Providers and staff demonstrated high organizational readiness for change. Median change commitment was 3.8 (Interquartile range [IQR]: 3.3-4.3) and change efficacy was 3.8 (IQR: 3.0-4.2). In the adjusted regression model, change commitment was associated with organizational climate, support for methods to arrest tooth decay and was inversely related to office chaos. Change efficacy was associated with organizational climate, support for the company's mission and was inversely related to burnout. Each unit increase in the organizational climate scale predicted 0

Managing the safe mobility of older road users: How to cope with their diversity?

DEFF Research Database (Denmark)

Haustein, Sonja; Marin-Lamellet, Claude

2014-01-01

Against the background of an ageing population, the management of older people's safe mobility is becoming an increasingly important issue. Mobility is vital for older people's quality of life and several examples of good practice that support older people's safe mobility already exist. However...... groups who are already users and improve their (safe) use of the preferred transport mode. However, they do not seem to succeed in increasing mobility options, e.g. by encouraging car-reliant users to cycle or use public transport or by helping older women to continue to drive. We advise that existing...... systems, a lack of programmes to increase perceived security, as well as a comprehensive scheme for older drivers who have to stop driving....

Social Influence and Safe Behavior in Manufacturing

DEFF Research Database (Denmark)

Hald, Kim Sundtoft

2018-01-01

This research presents a model designed to explore the cognitive and social mechanisms that mediate the relationship between organizational safety climate and safety behaviors. Specifically the presented research demonstrates the usefulness of Sussmann and Vecchio (1982) social influence interpre......This research presents a model designed to explore the cognitive and social mechanisms that mediate the relationship between organizational safety climate and safety behaviors. Specifically the presented research demonstrates the usefulness of Sussmann and Vecchio (1982) social influence...... interpretation of worker motivation to understand safety motivation. Survey data was collected from 428 employees in seven factories within the electronics industry in China. The data were analyzed using structural modelling. The results suggest that factory workers with more knowledge about the products...... that the total effects of a factory workers experience with safety and health problems seems to affect safe work behavior negatively, and that this is caused by a decrease in confidence and abilities to work safely. In relation to practical implications the present study demonstrate how manufacturing managers...

Safe Harbor Legislation for Juvenile Victims of Sex Trafficking: A Myopic View of Improvements in Practice

Directory of Open Access Journals (Sweden)

Kimberly Mehlman-Orozco

2015-02-01

Full Text Available Current social and political realties have focused attention on human trafficking in the United States. Although new mechanisms for criminalizing offenders and protecting victims are increasingly funded and implemented across the country, empirical exploration into the efficacy of these interventions is lacking. This article uses yearly count data on juvenile prostitution arrests aggregated at the state level to explore the criminalization of commercial sexually exploited children post safe harbor policy implementation. Preliminary data from four states suggests that the passage of safe harbor laws may not reduce the number of juveniles arrested for prostitution crimes. Implications for future research are discussed.

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System

Science.gov (United States)

Durant, Anne Foss; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California’s Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes. PMID:26828076

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

Science.gov (United States)

Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

Inhibition of Xenograft tumor growth by gold nanoparticle-DNA oligonucleotide conjugates-assisted delivery of BAX mRNA.

Directory of Open Access Journals (Sweden)

Ji-Hyun Yeom

Full Text Available Use of non-biological agents for mRNA delivery into living systems in order to induce heterologous expression of functional proteins may provide more advantages than the use of DNA and/or biological vectors for delivery. However, the low efficiency of mRNA delivery into live animals, using non-biological systems, has hampered the use of mRNA as a therapeutic molecule. Here, we show that gold nanoparticle-DNA oligonucleotide (AuNP-DNA conjugates can serve as universal vehicles for more efficient delivery of mRNA into human cells, as well as into xenograft tumors generated in mice. Injections of BAX mRNA loaded on AuNP-DNA conjugates into xenograft tumors resulted in highly efficient mRNA delivery. The delivered mRNA directed the efficient production of biologically functional BAX protein, a pro-apoptotic factor, consequently inhibiting tumor growth. These results demonstrate that mRNA delivery by AuNP-DNA conjugates can serve as a new platform for the development of safe and efficient gene therapy.

Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery.

Science.gov (United States)

Seligman, K; Ramachandran, B; Hegde, P; Riley, E T; El-Sayed, Y Y; Nelson, L M; Butwick, A J

2017-05-01

Compared to vaginal delivery, women undergoing cesarean delivery are at increased risk of postpartum hemorrhage. Management approaches may differ between those undergoing prelabor cesarean delivery compared to intrapartum cesarean delivery. We examined surgical interventions, blood component use, and maternal outcomes among those experiencing severe postpartum hemorrhage within the two distinct cesarean delivery cohorts. We performed secondary analyses of data from two cohorts who underwent prelabor cesarean delivery or intrapartum cesarean delivery at a tertiary obstetric center in the United States between 2002 and 2012. Severe postpartum hemorrhage was classified as an estimated blood loss ≥1500mL or receipt of a red blood cell transfusion up to 48h post-cesarean delivery. We examined blood component use, medical and surgical interventions and maternal outcomes. The prelabor cohort comprised 269 women and the intrapartum cohort comprised 278 women. In the prelabor cohort, one third of women received red blood cells intraoperatively or postoperatively, respectively. In the intrapartum cohort, 18% women received red blood cells intraoperatively vs. 44% postoperatively (Pcesarean delivery had the highest rates of morbidity, with 18% requiring hysterectomy and 16% requiring intensive care admission. Our findings provide a snapshot of contemporary transfusion and surgical practices for severe postpartum hemorrhage management during cesarean delivery. To determine optimal transfusion and management practices in this setting, large pragmatic studies are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Safety on the Job. Some Guidelines for Working Safely. Instructor's Edition.

Science.gov (United States)

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This teacher's guide was developed to help teachers (especially in Oklahoma) promote safe practices on the job. As a supplement to existing programs in the requirements for job safety, this book can also promote same basic safety attitudes and help support basic safety concepts, with an emphasis on accident prevention. The guide contains eight…

Cytotoxicity and Acute Gastrointestinal Toxicity of Bacterial Cellulose-Poly (acrylamide-sodium acrylate Hydrogel: A Carrier for Oral Drug Delivery

Directory of Open Access Journals (Sweden)

Manisha Pandey 1,2 * , Hira Choudhury 1, Mohd Cairul Iqbal Mohd Amin 2

2016-12-01

Full Text Available Background: Preliminary safety evaluation of polymer intended to use as drug delivery carrier is essential. Methods: In this study polyacrylamide grafted bacterial cellulose (BC/AM hydrogel was prepared by microwave irradiation initiated free radical polymerization. The synthesized hydrogel was subjected to in vitro cytotoxicity and acute gastrointestinal toxicity studies to evaluate its biological safety as potential oral drug delivery carrier. Results: The results indicate that hydrogel was non cytotoxic and did not show any histopathological changes in GI tract after a high dose of oral administration. Conclusion: The results revealed that hydrogel composed of bacterial cellulose and polyacrylamide is safe as oral drug delivery carrier.

Better safe than sorry: Understanding the toxicological properties of inorganic nanoparticles manufactured for biomedical applications.