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PubMed2000

Antibiotic resistance monitoring: the Spanish programme. The VAV Network. Red de Vigilancia de Resistencias Antibióticas en Bacterias de Origen Veterinario.

Antimicrobial resistance is a problem in modern public health and antimicrobial use and especially misuse, the most important selecting force for bacterial antibiotic resistance. As this resistance must be monitored we have designed the Spanish network 'Red de Vigilancia de Resistencias Antibióticas en Bacterias de Origen Veterinario'. This network covers the three critical points of veterinary responsibility, bacteria from sick animals, bacteria from healthy animals and bacteria from food animals. Key bacteria, antimicrobials and animal species have been defined for each of these groups along with laboratory methods for testing antimicrobial susceptibility and for data analysis and reporting. Surveillance of sick animals was first implemented using Escherichia coli as the sentinel bacterium. Surveillance of E. coli and Enterococcus faecium from healthy pigs was implemented in 1998. In July 1999, data collection on Salmonella spp. was initiated in poultry slaughterhouses. Additionally, the prevalence of vancomycin resistant E. faecium was also monitored. This network has specific topics of interest related to methods of determining resistance, analysis and reporting of data, methods of use for veterinary practitioners and collaboration with public health authorities.

Animals↗
PubMed2000

Antibiotic resistance monitoring in bacteria of animal origin: analysis of national monitoring programmes.

Methods of antibiotic resistance monitoring of bacteria from animals in 12 European countries were surveyed in 1998. Most laboratories used disk diffusion methods, usually expressing results qualitatively, although a few also expressed the results either as MICs or zone diameters. The number of antibiotics used ranged from 5 to 37 (mean 15) and the most common antibacterials were streptomycin, gentamicin, neomycin, ampicillin, tetracyclines, chloramphenicol and sulphonamides. Salmonellae were monitored by most centres but few-tested campylobacter regularly. Escherichia coli from a wide range of animal species were tested in nine countries. Enterococci were tested on a limited ad hoc basis in six countries. Staphylococci, streptococci and pasteurellae were also frequently monitored but the number of isolates tested showed wide variation. Overall the presentation of the results differed, but most programmes used disk diffusion, control strains and monitored similar bacteria. Thus, it may be possible to harmonise monitoring programmes within the EU.

Animal Population Groups↗
PubMed2000

Epidemiology and ecology of enterococci, with special reference to antibiotic resistant strains, in animals, humans and the environment. Example of an ongoing project within the European research programme.

The objectives of the present study are to generate knowledge of the ecology and epidemiology of enterococci in the food chain by studying the following: (1) the population structure (in measures of abundance, number of vancomycin resistant strains, antibiotic resistance patterns, diversity, and stability) among enterococcal populations in different geographical regions and in different links of the food chain (2) possible transmission of strains through the food chain and between hospital environments and the food chain (3) the association between vancomycin resistance and individual strains of enterococci and (4) the diversity of the drug resistance genes in enterococci. So far, 1578 samples have been collected from different countries within the EU (Sweden, Denmark, UK and Spain), and from different habitats (pig farms, carcasses in slaughter houses, soil, manure, water, sewage, and humans). Total and vancomycin resistant enterococcal populations in each sample have been enumerated and more than 12000 isolates have been characterised by phenotyping. Representative isolates are further species identified and characterised by genotyping and MIC determination and from antibiotic resistant isolates the resistance genes are characterised.

Animals↗
PubMed2001

Challenges faced by the pharmaceutical industry: training graduates for employment in pharmaceutical R&D.

There is a shortfall between output from universities and demand by the pharmaceutical and health care industries for science and engineering graduates able to rapidly contribute to success in the business environment. Against a changing infrastructure of pharmaceutical research, the development of new chemical entities by major companies accounts for a high proportion of R&D expenditure. Allocation of staff is divided fairly evenly between discovery, non-clinical and clinical research activities and in all categories the new sciences are likely to be used extensively. In dealing with the shortfall the challenge comes from balancing education in basic science with training in the emerging areas of science and technology. There is a need for a 'partnership' that includes not only industry and academia but also government, since these three bodies have both synergistic and diverging interests in scientific education. On the education-training continuum, industry should recognise what it most values from academia and provide as much input and support as possible. At the same time universities must question their ability to fulfil their traditional educational role in the face of current rates of adoption of new sciences and technology. While disciplinary excellence remains vital for PhD students, multi-disciplinary programmes are becoming increasingly important to enable graduates to function effectively in the modern, globalised pharmaceutical industry.

Drug Industry↗
PubMed1999

The effect of changing living standards on iron status in pregnancy in Calabar urban.

Reduced meat intake is often associated with iron deficiency anaemia. Reduced meat intake that arose from the frugality associated with a prolonged period of national economic reorientation policy, known as the "structural adjustment programme" (SAP), may have placed iron-stress on pregnancy in particular. Iron status of pre-SAP and SAP pregnancies were established from measurement of the haematological values of subjects. Indices such as haemoglobin (Hb), packed cell volume, serum Fe were lower in pregnancy especially during SAP. However, SAP pregnancy serum ferritin did not respond significantly to iron depletion. Unlike PCV, Total Iron Binding Capacity (TIBC) and serum transferrin values showed a reverse behaviour. The level of these values, however, portends a toll exerted on body iron status in pregnancy associated with reduced haem iron intake. The changes in these values did not, however, lead to any over symptoms of iron deficiency probably because increased sea food (molluscs) consumption ameliorates the iron-toll from low absorbed non-haem iron. For lower income rural women in non-coastal areas, the absence of seafood in their diets exacerbates the low iron status in Pregnancy.

Adolescent↗
PubMed2002

Local and interregional economic analysis of large US Department of Energy waste management projects.

An economic simulation model was used to understand the local and interregional economic impacts of four alternative waste management technologies proposed for the US Department of Energy's Savannah River nuclear weapons site. The simulations of the four technologies, each of which will cost at least a billion dollars, were done for the period 2000-2015. The analyses show that differences in project costs are not directly reflected in local economic impacts because of differences among the technologies during the design, testing and construction phases; differences in locations where the design and pilot-testing would occur; and choices about how any of the technologies would be funded.

Costs and Cost Analysis↗
PubMed2003

Nanotechnology: convergence with modern biology and medicine.

The worldwide emergence of nanoscale science and engineering was marked by the announcement of the National Nanotechnology Initiative (NNI) in January 2000. Recent research on biosystems at the nanoscale has created one of the most dynamic science and technology domains at the confluence of physical sciences, molecular engineering, biology, biotechnology and medicine. This domain includes better understanding of living and thinking systems, revolutionary biotechnology processes, the synthesis of new drugs and their targeted delivery, regenerative medicine, neuromorphic engineering and developing a sustainable environment. Nanobiosystems research is a priority in many countries and its relevance within nanotechnology is expected to increase in the future.

Biomedical Engineering↗
PubMed2005

A strategic assessment of the reproductive health and responsible parenthood programme of Buenos Aires, Argentina.

Since 1991, Argentina has had provincial reproductive health laws, a far-reaching national programme and strong public consensus in support of reproductive health policies. Nevertheless, the challenges of strengthening public services, increasing the number of programme sites and resisting conservative attacks remain. This article describes an assessment of the reproductive health programme of the city of Buenos Aires, passed in 2000, whose objectives are to prevent unwanted pregnancies and sexually transmitted diseases/HIV and to train health personnel. The programme operates in every public hospital and primary health care centre in the city. The assessment was conducted jointly by the Ombudsperson's Office of Buenos Aires and the Centre for the Study of State and Society (CEDES). Hormonal contraceptives, IUDs and male condoms were mostly available, but emergency contraception, female condoms and other barrier methods were not Some health professionals and service users were knowledgeable about the new laws and the reproductive rights recognised under the law. Over 90% were satisfied with quality of care in service delivery but many professionals described excessive workloads, deficient infrastructure, and shortages of supplies and staff. Wanting help to obtain a tubal ligation was the most frequent reason for the claims lodged with the Ombudsperson's Office, followed by HIV, quality of care, and abortion. Information and training for both health care providers and women's and human rights NGOs was carried out.

Adolescent↗
PubMed2000

The AMA clinical quality improvement forum on addressing patient safety.

BACKGROUND: More than 200 health care policy makers and researchers, clinicians, quality professionals, and other representatives of health care organizations, government, and academia attended the Division of American Medical Association Clinical Quality Improvement's conference, "Addressing Patient Safety," April 28, 2000, in Chicago--the first national conference to respond to the recent Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System. ADDRESSING PATIENT SAFETY--PUBLIC AND PRIVATE PERSPECTIVES: John M. Eisenberg, MD, stated that research on errors is needed to describe the scope and nature of the problem, understand the barriers to and benefits of improvement, and develop and test strategies for improvement. Kenneth W. Kizer, MD, MPH, stated that the National Quality Forum will develop a compendium of best practices and will develop core measures for serious adverse events, and health care organizations and government health programs should act now to make a clear organizational commitment to patient safety, create a nonpunitive health care culture of safety, and implement known safe medication practices. Alan R. Nelson, MD, stated that the IOM report places its emphasis on continuous quality improvement and technology that can be used to mitigate the risks in a complex health system. HOSPITAL AND ACCREDITATION AGENCY ACTIVITIES ON PATIENT SAFETY ISSUES: Donald M. Nielsen, MD, discussed the American Hospital Association's (AHA's) Medication Safety Initiative, which promised to provide its members with successful practices, tools, and resources and to track progress of implementation of the recommended successful practices. Dennis S. O'Leary, MD, stated that when a hospital reports a sentinel event, the hospital is expected to implement improvements to reduce risk and monitor their effectiveness. The National Committee for Quality Assurance is considering changes to its accreditation standards to further address patient safety.

Accreditation↗
PubMed2002

What good old days?

Explore the source record for details and available documents.

Financial Support↗
PubMed2006

From research to reality: from the National Cooperative Inner-City Asthma Study to the inner-city asthma implementation.

Several themes emerged from the information provided in this supplement. 1. Implementation of the protocol was feasible, although retention of participants was challenging and customization at each site was essential. 2. Master's degree level social workers were well suited to partnering with health care professionals to address the many issues involved in caring for children with asthma and their families. 3. Collaboration between team members and community partners was critical to successful implementation. 4. Sustainability beyond external funding is attainable if local funding is sought and outcome measures that are considered important to the community are measured and reported.

Asthma↗
PubMed2001

Discriminatory public policies and the New York City tuberculosis epidemic, 1975-1993.

Discriminatory public policies removed over ten percent of the fire companies in New York City from 1972-1975, mainly from poor communities of color with very old multiple-dwellings. Hundreds of thousands of housing units were destroyed between 1972 and 1978. Patterns of housing overcrowding changed rapidly and social networks were broken. Tuberculosis went into obvious epidemic in 1979. The temporal and geographic dynamics of the TB epidemic is described here as are the lessons for Europe with respect to treatment of marginalized populations.

Disease Outbreaks↗
PubMed2005

Progress in vaccination against hepatitis B in the Americas.

Hepatitis B is a serious public health problem leading to chronic infection, liver cirrhosis, and hepatocellular carcinoma. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) recommend routine universal infant vaccination against hepatitis B as the main strategy for the control hepatitis B and its severe consequences. PAHO additionally recommends routinely vaccinating healthcare workers. As of 2005, all countries in the Americas, except Haiti and Dominica, have hepatitis B vaccine in their childhood immunization schedule; 13 countries/territories include a hepatitis B dose given at birth. Hepatitis B vaccine has been incorporated into national schedules using different modalities; notably, 28 countries use it as a combination vaccine diphtheria tetanus pertussis + Haemophilus influenzae type b + hepatitis B (DTP+Hib+Hep B) for infants. Coverage levels for the third dose of hepatitis B are usually over 80%; however, hepatitis B vaccine coverage overall is lower than for the third dose of DTP. Insufficient information is available at this time to assess the use of hepatitis B vaccine in healthcare workers in the Americas. The most important factor associated with the success in the implementation of hepatitis B vaccination has been the strong commitment of country governments. This experience can be used as a model when implementing new technologies in health as they become available. However, much still needs to be done to improve hepatitis B coverage.

Bacterial Capsules↗