Suchergebnisse

The COST action "Standardising output-based surveillance to control non-regulated diseases of cattle in the European Union (SOUND control), " aims to harmonise the results of surveillance and control programmes (CPs) for non-EU regulated cattle diseases to facilitate safe trade and improve overall control of cattle infectious diseases. In this paper we aimed to provide an overview on the diversity of control for these diseases in Europe. A non-EU regulated cattle disease was defined as an infectious disease of cattle with no or limited control at EU level, which is not included in the European Union Animal health law Categories A or B under Commission Implementing Regulation (EU) 2020/2002. A CP was defined as surveillance and/or intervention strategies designed to lower the incidence, prevalence, mortality or prove freedom from a specific disease in a region or country. Passive surveillance, and active surveillance of breeding bulls under Council Directive 88/407/EEC were not considered as CPs. A questionnaire was designed to obtain country-specific information about CPs for each disease. Animal health experts from 33 European countries completed the questionnaire. Overall, there are 23 diseases for which a CP exists in one or more of the countries studied. The diseases for which CPs exist in the highest number of countries are enzootic bovine leukosis, bluetongue, infectious bovine rhinotracheitis, bovine viral diarrhoea and anthrax (CPs reported by between 16 and 31 countries). Every participating country has on average, 6 CPs (min-max: 1-13) in place. Most programmes are implemented at a national level (86%) and are applied to both dairy and non-dairy cattle (75%). Approximately one-third of the CPs are voluntary, and the funding structure is divided between government and private resources. Countries that have eradicated diseases like enzootic bovine leukosis, bluetongue, infectious bovine rhinotracheitis and bovine viral diarrhoea have implemented CPs for other diseases to further improve the health status ...

Background: Reducing the number of tobacco outlets may help reduce smoking uptake and use; public support for such action is essential. We explored how Twitter users responded to the announcement by US pharmacy chain CVS that it was voluntarily ending tobacco sales. Methods: We used Twitter's application programming interface to retrieve tweets and retweets posted over an 8-day period in February 2014 that contained two trending CVS-related hashtags (#cvs and #cvsquits). We manually coded 6,257 tweets as positive, negative, or neutral. Results: The majority of tweets were positive (56.0 %) or neutral (39.4 %). Conclusions: There was little disapproval of CVS's decision to end tobacco sales among Twitter users, possibly due to the voluntary nature of the decision. The level of support suggests that CVS's image and bottom line will not suffer as a result. Further voluntary actions to end tobacco sales - which may lay the groundwork for legislation - should be incentivized and supported.

Complex early and late neuropathies resulting from direct and conductive electrical patterns of injury are disabling and extremely challenging to manage. We report a patient who suffered acute onset of right-hand weakness and decreased sensation following a radar equipment-related electrical injury. He received a carpal and Guyon tunnel release, regaining sensation and strength to his right hand by the first postoperative day.

Clinical sociology is an action-oriented field that seeks to prevent, reduce, or resolve the seemingly overwhelming number of social problems confronting modern society. In an extensive revision of the first edition of this classic text and reference, published by Plenum in 1990, the editors have assembled a distinguished roster of contributors to address such topics as theory and practice; intervention at various levels of social organization; specific kinds of sociological practice; social problems; and the process of becoming a clinical sociologist

In many countries in sub-Saharan Africa (sSA) whole blood is more commonly available from blood transfusion services than red cell concentrates. Although in recent years many countries have made significant progress in the implementing component preparation, this has largely been facilitated by external funding support. None of the sSA countries are leucocyte-reducing or irradiating blood for transfusion. Systems for the routine detection of adverse consequences of blood transfusions (hemovigilance) only exist where transfusion safety has been identified as a health priority by the government. As a resource the availability of blood transfusion in these countries is limited since less than 5 units of blood were donated per 1000 population far below the recommended requirement of 20 units/1000 per year. Young children are the main users of blood for transfusion in these sSA regions, largely due severe anaemia secondary to infection and sickle cell anaemia. Outcomes for children with severe anaemia are poor, even in those receiving a transfusion. Although it has been speculated that this may be due to transfusion-related cardiac or pulmonary events available data from observational studies and clinical trials indicates that these are rare complications of transfusion. Evidence from clinical physiology studies including those examining myocardial function before and after the receipt of whole blood provide reassuring evidence that volume overload is rare and clinical trials reporting outcomes in children receiving whole blood transfusion, including a Phase II trial examining higher volumes, indicate that there is no evidence of cardiac or pulmonary overload events.

Last year, there was an increase in the amount of manpower in Malaysia, especially in terms of the numbers of neurosurgeons, cognitive neuroscientists and clinical psychologists. One way to increase the number of cognitive neurotechnologists in the country in 2021 is to allow neuroscientists to register as neurotechnologists with the Malaysian Board of Technologists (MBOT). The Malaysian Brain Mapping project has risen from its humble beginnings as an initiative of the Universiti Sains Malaysia Brain Mapping Group in 2017. There is currently a proposal for its entry into the national arena via the Precision Medicine Initiative with the Academy Science Malaysia, the Ministry of Science, Technology and Innovation, Ministry of Higher Education and Ministry of Health. The current Malaysian Government's Science, Technology, Innovation and Economy (STIE) plan was launched in 2020, leading to the establishment of neurotechnology as one of 10 STIE drivers.

Intro -- Preface -- How to Use This Book -- How to Use Each Chapter -- Embrace Curiosity -- Stay in Touch -- Acknowledgments -- Contents -- Notes on Contributors -- The Framework for This Book: The Socioecological Model -- The Socioecological Model -- The Academic Three-Legged Stool and the SEM -- Mentorship: It Takes a Village (or a SEM) -- Transformational Leadership: Women and Context -- The Third Person for This Book -- Take-Home Points -- Homework -- You as a Scientist -- Unique Strengths of Women Scientists -- What Is Your Passion? -- WHAT and WHY -- HOW -- WHO -- I.CAN'T.EVEN. -- When Things Do Not Go as Planned -- What Do You Value? What Are Your Strengths? -- Tools to Consider -- What Is Your Work Style? Daily Time Management and Long-Term Tasks -- Do Not Forget Self-Care -- A Note About Haters -- Your Mission Statement -- Take-Home Points -- Homework -- Your Team: Mentors, Staff, Colleagues, and Mentees -- Your Mentors -- Finding Your Mentors -- What Are You Seeking in a Mentor? -- You Have Found Some Mentors, Now What? -- Risks of Mentorship -- Your Research Lab and Team -- Setting Expectations for Your Team -- Developing Your Own Manager Skills -- Your Colleagues -- Your Close Collaborators -- Your Mentees -- Take-Home Points -- Homework -- Your Institutional Support/Academic Environment -- What Is Your "Institution?" -- What Does Your Institution Offer to You? -- What Should Your Institution Offer to You? -- How Does Your Institution Assure Their Faculty Advance? -- Where Do You Find Your Institution's Resources? -- What Is Your Academic Environment? How Is that Different than Your Institution? -- Take-Home Points -- Homework -- Your Scientific Community -- Joining Professional Societies -- What Can You Get Out of a Professional Society? -- Why Would You Not Join a Professional Society? -- What Can You Do in a Professional Society?.

There is a wide time gap between the publication of evidence and the application of new knowledge into routine clinical practice. The consequence is sub-optimal outcomes, particularly concerning for long-term relapsing/remitting conditions such as allergic diseases. In response, there has been a proliferation of published guidelines which systematically review evidence for the gold-standard management of most allergic disorders. However, this has not necessarily been followed by improved outcomes, partly due to a lack of coordination across the patient pathway. This has become known as the "second translational gap". A proposed solution is the development and implementation of integrated care pathways (ICPs) to optimize patient outcomes, with the notion that evidence-based medicine requires evidence-based implementation. ICP implementation is shown to improve short-term outcomes for acute conditions and routine surgery, including reduced length of hospital stay, improved documentation and improved patient safety. However, this improvement is not reflected in patient experience or patient-centered functional outcomes. The implementation of life-long, cost-effective interventions within comprehensive pathways requires a deep appreciation for complexity within allergy care. We promote an evidence-based methodology for the implementation of ICPs for allergic disorders in which all stakeholders in allergy care are positioned equally and encouraged to contribute, particularly patients and their caregivers. This evidence-based process commences with scoping the unmet needs, followed by stakeholder mapping. All stakeholders are invited to meetings to develop a common vision and mission through the generation of action/effect diagrams which helps build concordance across the agencies. Dividing the interventions into achievable steps and reviewing with plan/do/study/act cycles will gradually modify the pathway to achieve the best outcomes. While the management guidelines provide the core knowledge, the key component of implementation involves education, training, and support of all healthcare professionals (HCPs), patients and their caregivers. The pathways should define the level of competence required for each clinical task. It may be useful to leave the setting of care delivery or the specific HCP involved undefined to account for variable patterns of health service delivery as well as local socioeconomic, ethnic, environmental, and political imperatives. In all cases, where competence is exceeded, it is necessary to refer to the next stage in the pathway. The success and sustainability of ICPs would ideally be judged by patient experience, health outcomes, and health economics. We provide examples of successful programs, most notably from Finland, but recommend that further research is required in diverse settings to optimize outcomes worldwide.

Objective. The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. Background Data. The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. Methods. An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries. The differences between countries and levels of experience were analyzed using a logistic regression model. Results. The mean respondent age, out of the 358 completed questionnaires, was 46 years. Ninety-seven percent of the respondents were plastic surgeons, who practiced AFT mostly in breast surgery and considered themselves experienced with the technique. The thigh and abdomen were less favored harvest locations by the Belgium and French respondents, respectively, and both the French and Austrian respondents preferred manual aspiration over liposuction in harvesting the fat. Despite minor differences between countries and experience, the intraglandular space was injected in all subgroups. Conclusions. The expanding use of AFT in Europe will lead to more experience and heterogeneity regarding the technique. However, despite an obvious adherence to Coleman's method, deviations thereof become more apparent. An important example of such a deviation is the ongoing practice of intraglandular AFT despite being a contraindication in various European guidelines. These unsafe practices should be avoided until scientific clarification regarding oncological safety is obtained and should therefore be the focus of surgeon education in Europe.

"Community Intervention: Clinical Sociology Perspectives showcases important efforts to improve the quality of life in communities around the world. The book, a project of the clinical sociology division of the International Sociological Association, describes the interdisciplinary field of clinical sociology in relation to community improvement. The first part of the book covers important concepts and tools for community intervention and identifies a variety of approaches to community research with an emphasis on research that centrally involves community members. The chapters in the second part of the volume focus on projects in a broad range of countries, covering topics such as involving residents in urban renewal projects, developing healthy communities, encouraging socioeconomic development, improving the life of immigrants, helping communities deal with climate change, establishing human rights cities, encouraging empowerment and creating an inclusive community. A unique feature of the book is the inclusion of profiles about some of the outstanding work in community intervention over the last 100 years. These profiles are of Nobel Peace Prize winner Jane Addams; community activist Saul Alinsky; human rights and environmental activist Wangari Maathai and participatory action research pioneer Orlando Fals Borda. Written by scholar-practitioners as well as analysts, the book provides essential commentary regarding community intervention efforts."--Page [4] of cover

Background: Chemoprophylaxis is an effective tool for individuals to minimize their risk of contracting malaria and serves an important public health role in preventing imported malaria. Yet, it is only effective if the traveller is fully compliant with the prescribed regimen. For many destinations, a choice of prophylactic agents is available, so historical compliance data can be helpful for both physicians and travellers to make an informed decision. Methods: We analyzed the historical self-reported compliance data for six chemoprophy-lactic agents currently recommended by CDC for primary malaria chemoprophylaxis by searching PubMed, Embase, CINAHL, Web of Science, and Scopus for observational studies reporting on travelers within the last 25 years. The quality of data was graded as "good" or "poor" using the NIH quality assessment tool for cohort and cross-sectional studies. Cumulative compliance data were compiled for all studies (gross compliance) and the subgroup of studies with "good" quality evidence (refined compliance). Subgroup analyses were performed for weekly vs daily administered regimens, between military and civilian travelers, and across each prophylactic agent. Results: Twenty-four eligible studies assessed compliance for mefloquine (n=20), atova-quone-proguanil (n=11), doxycycline (n=13), and chloroquine (n=3). No studies were found for primaquine or tafenoquine. Both gross and refined compliance were significantly better for weekly regimens than daily regimens (P<0.0001). Stopping chemoprophylaxis due to adverse events was significantly more for doxycycline (P<0.0001) compared to other drugs. Compliance was significantly worse in military travelers, but they were also more likely to be prescribed doxycycline. Conclusion: Malaria chemoprophylaxis for a traveler should depend on prevailing resis-tance patterns at destination, current national guidelines, and patient preferences. However, when there is a choice, historical compliance data are useful to select a regimen that the traveler is more likely to comply with.

Background: The massive scale-up of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) has led to a substantial increase in malaria vector insecticide resistance as well as in increased outdoor transmission, both of which hamper the effectiveness and efficiency of ITN and IRS. Long-lasting microbial larvicide can be a cost-effective new supplemental intervention tool for malaria control. Methods/design: We will implement the long-lasting microbial larvicide intervention in 28 clusters in two counties in western Kenya. We will test FourStar controlled release larvicide (6% by weight Bacillus thuringiensis israelensis and 1% Bacillus sphaerius) by applying FourStar controlled release granule formulation, 90-day briquettes, and 180-day briquettes in different habitat types. The primary endpoint is clinical malaria incidence rate and the secondary endpoint is malaria vector abundance and transmission intensity. The intervention will be conducted as a two-step approach. First, we will conduct a four-cluster trial (two clusters per county, with one of the two clusters randomly assigned to the intervention arm) to optimize the larvicide application scheme. Second, we will conduct an open-label, cluster-randomized trial to evaluate the effectiveness and cost-effectiveness of the larvicide. Fourteen clusters in each county will be assigned to intervention (treatment) or no intervention (control) by a block randomization on the basis of clinical malaria incidence, vector density, and human population size per site. We will treat each treatment cluster with larvicide for three rounds at 4-month intervals, followed by no treatment for the following 8months. Next, we will switch the control and treatment sites. The former control sites will receive three rounds of larvicide treatment at appropriate time intervals, and former treatment sites will receive no larvicide. We will monitor indoor and outdoor vector abundance using CO2-baited CDC light traps equipped with collection bottle rotators. Clinical malaria data will be aggregated from government-run malaria treatment centers. Discussion: Since current first-line vector intervention methods do not target outdoor transmission and will select for higher insecticide resistance, new methods beyond bed nets and IRS should be considered. Long-lasting microbial larviciding represents a promising new tool that can target both indoor and outdoor transmission and alleviate the problem of pyrethroid resistance. It also has the potential to diminish costs by reducing larvicide reapplications. If successful, it could revolutionize malaria vector control in Africa, just as long-lasting bed nets have done. Trial registration: U.S. National Institute of Health, study ID NCT02392832. Registered on 3 February 2015.

A companion to the authors' Handbook of Clinical Sociology (Plenum Press, 1991), this pioneering text provides an introduction to this new field, covering its development, methods and tools, and illustrates the applications of sociological concepts to current social problems. Drs. Bruhn and Rebach present numerous examples to enable practitioners to apply their problem-solving skills. Key discussions address the values held by clients and practitioners and issues relating to sociological assessment and evaluation. This indispensable resource is enhanced by case illustrations, annotated bibliographies, and a glossary of terms