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Notification
Kinds of Notification Terms modified by Notification Selected AbstractsWATCHING THE DETECTIVES: SEASONAL STUDENT EMPLOYEE REACTIONS TO ELECTRONIC MONITORING WITH AND WITHOUT ADVANCE NOTIFICATIONPERSONNEL PSYCHOLOGY, Issue 2 2002AUDRA D. HOVORKA-MEAD The present paper tested procedural justice hypotheses about seasonal high school and college student employees' reactions to electronic monitoring with video cameras. Study 1, a field study, explored (a) whether employees receiving advance notification of monitoring offered more favorable justice judgments than employees who did not, and (b) whether employees who saw monitoring procedures and/or consequences as fair returned to the organization the following summer. Results supported the hypotheses: employees viewed monitoring procedures as fairer if they received advance notice. Fairness judgments predicted reemployment Study 2, a scenario-based laboratory experiment, also found that advance notice elicited greater justice beliefs. In addition, Study 2 examined how variations in justification for the monitoring affected justice beliefs. Either strong or weak justifications produced greater procedural justice beliefs than no justification. [source] Ensuring fairness among ECN and non-ECN TCP over the InternetINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 5 2003Salahuddin Muhammad Salim Zabir Explicit Congestion Notification (ECN) has been proved to provide a fast indication of incipient congestion and thus better the performance of a TCP/IP network. In this work, we carry out investigations on gateway or router performance in providing fairnesss when both FIM ECN-capable and non-ECN-capable connections are employed. We propose a new packet-dropping scheme called Fair In-time Dropping (FID) which drops packets from a connection upon detecting an incipient indication of congestion depending on its share of gateway or router buffer occupancy. We also show that a combination of FIM and FID offers the best fairness compared with a combination of FIM along with other dropping schemes.,Copyright © 2003 John Wiley & Sons, Ltd. [source] Notification of patients with acute flaccid paralysis since certification of Australia as polio-freeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2004K Whitfield Objective: Surveillance of patients presenting with acute flaccid paralysis (AFP) is the World Health Organization (WHO) recommended method for the detection of incident cases of poliovirus infection. Australia was certified free of circulating poliovirus in 2000 but is required to continue AFP surveillance until global certification. Although Australia reached the WHO nominated surveillance target in 2000 and 2001, it was not reached in 2002. Notification rates between states have been variable. We aim to investigate the difference in notification rates by state to determine whether different rates reflect different patterns of disease or different approaches to reporting. Methods: Notification rates were reviewed by state for the years 1997,2002. The completeness of case ascertainment was reviewed from published studies. Key informants described differences in AFP reporting in states with consistent differences in notification rates. Results: Australia achieved 75% of the WHO surveillance target for AFP cases between 1997 and 1999 and 98% between 2000 and 2002. After 2000, Queensland achieved 150% of its target while Victoria achieved less than 50%. New South Wales reached its target over the entire 6 years but other states and territories were not as consistent. Although the formal process for AFP reporting is uniform throughout Australia, many differences in approach were identified between Victoria and Queensland. Conclusion: Maintaining AFP surveillance at the required WHO standard will be more likely in Australia if the populous states are able to notify cases at the same rate as Queensland (since 2000) and New South Wales (in general). [source] Japanese Guidance for Ventricular Assist Devices/Total Artificial HeartsARTIFICIAL ORGANS, Issue 9 2010Takashi Yamane Abstract To facilitate research and development (R&D) and to expedite the review processes of medical devices, the Ministry of Health, Labor and Welfare (MHLW) and the Ministry of Economy, Trade and Industry (METI) founded a joint committee to establish guidance for newly emerging technology. From 2005 to 2007, two working groups held discussions on ventricular assist devices and total artificial hearts, including out-of-hospital programs, based on previous guidance documents and standards. Based on this discussion, the METI published the R&D Guidelines for innovative artificial hearts in 2007, and in 2008 the MHLW published a Notification by Director regarding the evaluation criteria for emerging technology. [source] The epidemiology of hepatitis C in Australia: Notifications, treatment uptake and liver transplantations, 1997,2006JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2009Heather F Gidding Abstract Background and Aim:, Regular monitoring of hepatitis C (HCV)-related surveillance data is essential to inform and evaluate strategies to reduce the expanding HCV burden. The aim of this study was to examine trends in the epidemiology and treatment of HCV in Australia. Methods:, We reviewed data about HCV notifications, treatment of HCV infection through the Highly Specialised Drugs (s100) Program, and liver transplants (Australia and New Zealand Liver Transplant Registry) for the period 1997,2006. Results:, HCV case notification rates declined by almost 50% between 1999 and 2006, with the greatest reductions between 2001 and 2002 and amongst young adults. For newly acquired HCV cases, 89% were Australian-born and 90% reported injecting drug use as a risk factor for infection. Overall, 30% of liver transplant recipients had HCV-related cirrhosis, but the number and proportion of HCV diagnoses increased between 1997 and 2006. HCV treatment also increased over the review period. However, only 1.4% of the 202 400 people estimated to be living with chronic HCV at the end of 2006 received treatment that year. Conclusion:, The decline in HCV notifications is consistent with a decline in HCV incidence in Australia. However, the burden of advanced HCV disease continues to expand. To reduce this burden, treatment uptake needs to increase. Consistent and sensitive surveillance mechanisms are required to detect newly acquired cases together with an expansion of surveillance for chronic HCV infections. [source] An application portal for collaborative coastal modelingCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 12 2007Chongjie Zhang Abstract We describe the background, architecture and implementation of a user portal for the SCOOP coastal ocean observing and modeling community. SCOOP is engaged in the real-time prediction of severe weather events, including tropical storms and hurricanes, and provides operational information including wind, storm surge and resulting inundation, which are important for emergency management. The SCOOP portal, built with the GridSphere Framework, currently integrates customized Grid portlet components for data access, job submission, resource management and notification. Copyright © 2007 John Wiley & Sons, Ltd. [source] Providers' Beliefs, Attitudes, and Behaviors before Implementing a Computerized Pneumococcal Vaccination ReminderACADEMIC EMERGENCY MEDICINE, Issue 12 2006Judith W. Dexheimer MS Abstract Background The emergency department (ED) has been recommended as a suitable setting for offering pneumococcal vaccination; however, implementations of ED vaccination programs remain scarce. Objectives To understand beliefs, attitudes, and behaviors of ED providers before implementing a computerized reminder system. Methods An anonymous, five-point Likert-scale, 46-item survey was administered to emergency physicians and nurses at an academic medical center. The survey included aspects of ordering patterns, implementation strategies, barriers, and factors considered important for an ED-based vaccination initiative as well as aspects of implementing a computerized vaccine-reminder system. Results Among 160 eligible ED providers, the survey was returned by 64 of 67 physicians (96%), and all 93 nurses (100%). The vaccine was considered to be cost effective by 71% of physicians, but only 2% recommended it to their patients. Although 98% of physicians accessed the computerized problem list before examining the patient, only 28% reviewed the patient's health-maintenance section. Physicians and nurses preferred a computerized vaccination-reminder system in 93% and 82%, respectively. Physicians' preferred implementation approach included a nurse standing order, combined with physician notification; nurses, however, favored a physician order. Factors for improving vaccination rates included improved computerized documentation, whereas increasing the number of ED staff was less important. Relevant implementation barriers for physicians were not remembering to offer vaccination, time constraints, and insufficient time to counsel patients. The ED was believed to be an appropriate setting in which to offer vaccination. Conclusions Emergency department staff had favorable attitudes toward an ED-based pneumococcal vaccination program; however, considerable barriers inherent to the ED setting may challenge such a program. Applying information technology may overcome some barriers and facilitate an ED-based vaccination initiative. [source] ETHICAL PROBLEMS IN CONDUCTING RESEARCH IN ACUTE EPIDEMICS: THE PFIZER MENINGITIS STUDY IN NIGERIA AS AN ILLUSTRATIONDEVELOPING WORLD BIOETHICS, Issue 1 2010EMMANUEL R. EZEOME ABSTRACT The ethics of conducting research in epidemic situations have yet to account fully for differences in the proportion and acuteness of epidemics, among other factors. While epidemics most often arise from infectious diseases, not all infectious diseases are of epidemic proportions, and not all epidemics occur acutely. These and other variations constrain the generalization of ethical decision-making and impose ethical demands on the individual researcher in a way not previously highlighted. This paper discusses a number of such constraints and impositions. It applies the ethical principles enunciated by Emmanuel et al.1 to the controversial Pfizer study in Nigeria in order to highlight the particular ethical concerns of acute epidemic research, and suggest ways of meeting such challenges. The paper recommends that research during epidemics should be partly evaluated on its own merits in order to determine its ethical appropriateness to the specific situation. Snap decisions to conduct research during acute epidemics should be resisted. Community engagement, public notification and good information management are needed to promote the ethics of conducting research during acute epidemics. Individual consent is most at risk of being compromised, and every effort should be made to ensure that it is maintained and valid. Use of data safety management boards should be routine. Acute epidemics also present opportunities to enhance the social value of research and maximize its benefits to communities. Ethical research is possible in acute epidemics, if the potential challenges are thought of ahead of time and appropriate precautions taken. [source] Does the Emergency Exception from Informed Consent Process Protect Research Subjects?ACADEMIC EMERGENCY MEDICINE, Issue 11 2005Nicole M. Delorio MD Abstract Although subject protection is the cornerstone of medical ethics, when considered in the context of research using emergency exception from informed consent, its success is debatable. The participants of a breakout session at the 2005 Academic Emergency Medicine Consensus Conference discussed the issues surrounding subject protection and advanced the following recommendations. 1) There are no outcome measures that define "protection"; therefore, it is not currently known whether or not subjects are protected under the current rules. 2) Care must be taken to protect not only the individual from harm during research but also to protect society from unregulated research in other countries and an inability to appropriately advance medical knowledge. 3) Some surrogate markers/methods of protection whose efficacies are debatable include data safety monitoring board activity, the community consultation and public notification (CC/PN) process, and institutional review board approval. 4) Minimal-risk studies should be held to different standards of protection than those that involve more significant risk to the subject. 5) A handful of studies have been published regarding community consultation and notification, and the majority are case studies. Those that are specifically designed to discover the most successful methods are hindered by a lack of formal outcomes measures and tend to have negative results. 6) Follow-up data from the CC/PN process should be disclosed to the Food and Drug Administration and incorporated into study designs. 7) Focus groups and/or random-digit dialing have been suggested as promising methods for fulfilling the CC/PN requirements. 8) Studies need to be funded and performed that formally investigate the best means of CC/PN. 9) More funding for this research should be a priority in the emergency medicine and critical care communities. More data regarding terminated studies should be made available to the research community. 10) Quantifiable markers of success for CC/PN must be validated so that research may determine the most successful methods. 11) Data regarding subjects' and family members' experiences with exception from informed consent studies need to be obtained. [source] Incentive-elicited striatal activation in adolescent children of alcoholicsADDICTION, Issue 8 2008James M. Bjork ABSTRACT Aims Deficient recruitment of motivational circuitry by non-drug rewards has been postulated as a pre-morbid risk factor for substance dependence (SD). We tested whether parental alcoholism, which confers risk of SD, is correlated with altered recruitment of ventral striatum (VS) by non-drug rewards in adolescence. Design During functional magnetic resonance imaging, adolescent children of alcoholics (COA; age 12,16 years) with no psychiatric disorders (including substance abuse) and similarly aged children with no risk factors responded to targets to win or avoid losing $0, $0.20, $1, $5 or a variable amount (ranging from $0.20 to $5). Results In general, brain activation by either reward anticipation or outcome notification did not differ between COA and age/gender-matched controls. Cue-elicited reward anticipation activated portions of VS in both COA and controls. In nucleus accumbens (NAcc), signal change increased with anticipated reward magnitude (with intermediate recruitment by variable incentives) but not with loss magnitudes. Reward deliveries activated the NAcc and mesofrontal cortex in both COA and controls. Losses activated anterior insula bilaterally in both groups, with more extensive right anterior insula activation by losses in controls. NAcc signal change during anticipation of maximum rewards (relative to non-reward) correlated positively with both Brief Sensation-Seeking Scale scores and with self-reported excitement in response to maximum reward cues (relative to cues for non-reward). Conclusions Among adolescents with no psychiatric disorders, incentive-elicited VS activation may relate more to individual differences in sensation-seeking personality than to presence of parental alcoholism alone. Future research could focus on adolescents with behavior disorders or additional risk factors. [source] The Free Movement of Goods as a Possible ,Community' Limitation on Industrial ConflictEUROPEAN LAW JOURNAL, Issue 4 2000Giovanni Orlandini The aim of this essay is to underline the fact that the process of achieving single market integration is very likely to influence the regulation of industrial conflict. In this perspective, the Commission v France judgment is analysed, in which the ECJ,through a combined interpretation of Article 30 (now 28) and Article 5 (now 10) of the Treaty,states that a Member State is obliged to adopt all ,appropriate measures' to remove any ,obstacles' impeding the free circulation of goods caused by private persons. A new Regulation (n. 2679/98) has followed the ECJ decision, instituting a system of notification of such obstacles arising, or the threat of them, and the right of the Commission to demand a formal reply from a State on whether it has taken, or will be taking the necessary and proportionate measures. The analysis of the principles adopted by the ECJ and of the Regulation shows that, at Community level, pressure is exerted on States to prevent the exercise of collective action as effectively as possible, if this damages inter-State trade. A transnational limit on industrial conflict thus emerges in the Community order, which may well affect the equilibria of national industrial relations in various ways. [source] Reorder notifying TCP (RN-TCP) with explicit packet drop notification (EPDN)INTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 6 2006Arjuna Sathiaseelan Abstract Numerous studies have shown that packet reordering is common, especially in networks where there is high degree of parallelism and different link speeds. Reordering of packets decrease the TCP performance of a network, mainly because it leads to overestimation of the congestion in the network. In this paper, we analyse the performance of networks when reordering of packets occur. We propose a proactive solution that could significantly improve the performance of the network when reordering of packets occurs. We report results of our simulation experiments, which support this claim. Our solution is based on enabling the senders to distinguish between dropped packets and reordered packets. Copyright © 2005 John Wiley & Sons, Ltd. [source] Parental medical neglect in the treatment of adolescents with anorexia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2001Victor Fornari Abstract Objective Although childhood sexual abuse has been a frequent focus of research on eating disorders, other forms of maltreatment have been less commonly reported. Parental medical neglect is examined in this study as having serious consequences for the treatment and prognosis of patients with anorexia nervosa. Method Two case studies illustrate parental interference with treatment in which Child Protective Services (CPS) had to be involved in compliance with state law. Two adolescent females who were admitted for treatment for anorexia nervosa are presented. Results In both cases, the parents refused to comply with the recommendations of the treatment team, placing their children's health in jeopardy. In compliance with reporting guidelines, CPS was notified in both cases. Conclusions Clinicians who treat minors with anorexia nervosa must consider parental compliance with treatment. Indications for the involvement of CPS are outlined. Optimally, this notification can ensure that the patient and family receive the requisite treatment. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 358,362, 2001. [source] Adding a caveat to the urgent clinical notification of anaemia does not reduce inappropriate emergency room referral ratesINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2003P. Froom Summary Background: Urgent clinician notification of low haemoglobin values might influence the clinicians' decision to refer patients to the emergency room (ER). Methods: We compared the effects of urgent clinician notification for low haemoglobin values with and without an added statement, that an urgent visit to the ER is not required if the patient has a haemoglobin value of 50 g/l or more and is clinically stable. We compared the referral rates and outcomes of 100 consecutive cases reported previously to that of 99 consecutive new cases with the added caveat. Results: Overall 47 (47%) of the historical control patients were referred to the ER compared with 45 (45.5%) in the study group (relative risk, 0.97, 95% CI, 0.72,1.3). Five patients were inappropriately transfused and almost none of the ER visits were an emergency. Conclusions: Adding a caveat to the urgent clinician notification that anaemia in clinically stable patients is not a medical emergency does not decrease the rate of ER referrals. Further studies are needed in order to find ways to decrease the number of inappropriate ER referrals. [source] Stroke education: discrepancies among factors influencing prehospital delay and stroke knowledgeINTERNATIONAL JOURNAL OF STROKE, Issue 3 2010Yvonne Teuschl Background Time is essential for the treatment of acute stroke. Much time is lost outside the hospital, either due to failure in identifying stroke symptoms or due to a delay in notification or transport. We review studies reporting factors associated with better stroke knowledge and shorter time delays. We summarise the evidences for the effect of stroke knowledge and education on people's reaction in the acute situation of stroke. Methods We searched MEDLINE for studies reporting factors associated with prehospital time of stroke patients, or knowledge of stroke symptoms. Further, we searched for studies reporting educational interventions aimed at increasing stroke symptom knowledge in the population. Findings We included a total of 182 studies. Surprisingly, those factors associated with better stroke knowledge such as education and sociodemographic variables were not related to shorter time delays. Few studies report shorter time delays or better stroke knowledge in persons having suffered a previous stroke. Factors associated with shorter time delays were more severe stroke and symptoms regarded as serious, but not better knowledge about the most frequent symptoms such as hemiparesis or disorders of speech. Only 25,56% of patients recognised their own symptoms as stroke. While stroke education increases the knowledge of warning signs, a few population studies measured the impact of education on time delays; in such studies, time delays decreased after education. This may partly be mediated by better organisation of EMS and hospitals. Interpretation There is a discrepancy between theoretical stroke knowledge and the reaction in an acute situation. Help-seeking behaviour is more dependent on the perceived severity of symptoms than on symptom knowledge. Bystanders play an important role in the decision to call for help and should be included in stroke education. Education is effective and should be culturally adapted and presented in a social context. It is unclear which educational concept is best suited to enhance symptom recognition in the acute situation of stroke, especially in view of discrepancies between knowledge and action. [source] Rapid Emergency Department Intervention for Older People Reduces Risk of Functional Decline: Results of a Multicenter Randomized TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2001DrPH, Jane McCusker MD OBJECTIVES: To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes. DESIGN: Controlled trial, randomized by day of ED visit, with follow-up at 1 and 4 months. SETTING: Four university-affiliated hospitals in Montreal. PARTICIPANTS: Patients age 65 and older expected to be released from the ED to the community with a score of 2 or more on the Identification of Seniors At Risk (ISAR) screening tool and their primary family caregivers. One hundred seventy-eight were randomized to the intervention, 210 to usual care. INTERVENTION: The intervention consisted of disclosure of results of the ISAR screen, a brief standardized nursing assessment in the ED, notification of the primary care physician and home care providers, and other referrals as needed. The control group received usual care, without disclosure of the screening result. MEASUREMENTS: Patient outcomes assessed at 4 months after enrollment included functional decline (increased dependence on the Older American Resources and Services activities of daily living scale or death) and depressive symptoms (as assessed by the short Geriatric Depression Scale). Caregiver outcomes, also assessed at baseline and 4 months, included the physical and mental summary scales of the Medical Outcomes Study Short Form-36. Patient and caregiver satisfaction with care were assessed 1 month after enrollment. RESULTS: The intervention increased the rate of referral to the primary care physician and to home care services. The intervention was associated with a significantly reduced rate of functional decline at 4 months, in both unadjusted (odds ratio (OR) = 0.60, 95% confidence interval (CI) = 0.36,0.99) and adjusted (OR = 0.53, 95% CI = 0.31,0.91) analyses. There was no intervention effect on patient depressive symptoms, caregiver outcomes, or satisfaction with care. CONCLUSION: A two-stage ED intervention, consisting of screening with the ISAR tool followed by a brief, standardized nursing assessment and referral to primary and home care services, significantly reduced the rate of subsequent functional decline. J Am Geriatr Soc 49:1272,1281, 2001. [source] Risk management of extravasation of cytostatic drugs at the Adult Chemotherapy Outpatient Clinic of a university hospitalJOURNAL OF CLINICAL NURSING, Issue 7 2005Nilce Piva Adami PhD Aims and objectives., To verify the incidence of extravasation of cytostatic drugs in patients treated on an outpatient basis at a university hospital in the city of São Paulo, Brazil, during the period from 1998 to 2002, and to assess the quality of care provided by the nursing team using a protocol adopted for the treatment of this adverse event as a parameter. Background., The movement for quality in healthcare services has been a recent event in Brazil, mainly as the result of the Brazilian Program of Hospital Accreditation instituted in 1998. Considering the emphasis on risk management, it is important to mention the monitoring of the occurrence of extravasations of cytostatic drugs in order to improve the quality of nursing care provided to cancer patients. Design and methods., An evaluative study with a descriptive, prospective and longitudinal design was conducted, based on the documentary analysis of the notification of 216 extravasations of vesicant and irritant drugs that occurred between 1998 and 2002 and the corresponding prescriptions of cold or hot compresses. Results., The mean incidence of extravasations ranged from 0·2 to 1·4% over the five years of the study. Incorrect prescription of the type of compress was observed for three patients. Undesired effects were ulcers caused by the extravasation of vinblastine and dacarbazine in two cases. Conclusions., The low incidence of both extravasation and tissue damage demonstrates the adequate quality of nursing care provided to cancer patients at the outpatient clinic studied. However, the identification of the lack of 12 records of thermal treatment and of three erroneous prescriptions requires the implementation of educational measures to prevent these types of incident. Relevance to clinical practice., The relevance of this study to clinical practice is to increase the awareness and involvement of the nursing team in the maintenance of a continuous surveillance system of the process and results of chemotherapy administration in order to increase the quality of care and the safety of the patient. [source] Human immunodeficiency virus serotyping on dried serum spots as a screening tool for the surveillance of the AIDS epidemicJOURNAL OF MEDICAL VIROLOGY, Issue S1 2006Francis Barin Abstract Many studies have demonstrated the utility of the dried blood spot (DBS) or dried plasma/serum spot (DSS) method for serological and molecular diagnosis of HIV infection. Here, we report on the description of a serotyping assay performed on DSS, and its application to a national surveillance program of HIV variants. We combined serotyping assays that we developed previously to discriminate between HIV-1 and HIV-2, between HIV-1 group O and HIV-1 group M, and between B and non-B subtypes of HIV-1 group M. The assays are based on antibody binding to either the immunodominant epitope of gp41 or the V3 domain of gp120 of these various types, groups and subtypes. Therefore, a unique enzyme-linked immunosorbent assay (ELISA) format applied to serum eluted from DSS allowed the simultaneous discrimination between infections caused by HIV-1 B, HIV-1 non-B, HIV-1 group O, and HIV-2. Together, this serotyping assay and an immunoassay for recent infection were used for a virological surveillance linked to the anonymous mandatory notification of HIV infection in France. The preliminary results of this virological surveillance allowed us to obtain estimates of the prevalence of the rare variants HIV-2 and HIV-1 group O. It also allowed identification of the two first cases of M/O dual infections reported outside the endemic group O region of the western part of equatorial Africa, and showed that non-B subtypes circulate widely in France, almost 50% of new HIV diagnoses in 2003 being due to these variants. J. Med. Virol. 78:S13,S18, 2006. © 2006 Wiley-Liss, Inc. [source] Polioviruses and other enteroviruses isolated from faecal samples of patients with acute flaccid paralysis in Australia, 1996,2004JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2006Heath Kelly Background: Acute flaccid paralysis (AFP) is the most common clinical presentation of acute poliovirus infection, occurring in 0.1,1% of infected cases. AFP surveillance has been used world-wide to monitor the control and eradication of circulating wild poliovirus. This study aims to review the significance of all enteroviruses, including polioviruses, isolated from patients with AFP in Australia between 1996 and 2004. Methods: We undertook a retrospective review of all notified cases of AFP, aged 0,15 years and resident in Australia at the time of notification. We reviewed all available clinical and virological data for these cases and all records of the Polio Expert Committee, which determined the final classification for all cases. Results: There were 335 notified cases that satisfied the case definition for AFP, 162 (48%) of whom had at least one faecal sample tested. Enteroviruses isolated from the faeces of 26 (16%) of the 162 cases were Coxsackie A24, Coxsackie B5, enterovirus 71, enterovirus 75, echovirus 9, echovirus 11 and echovirus 18. In addition, one or more polioviruses were isolated from the faeces of seven patients. Six of seven polioviruses were characterised as Sabin-like, one was not characterised, but all were considered to be incidental isolates. Five of these cases were classified as infant botulism, one case as transverse myelitis and one as a focal mononeuropathy. Conclusion: With the eradication of circulating wild polioviruses, other enteroviruses are being more commonly identified as the cause of polio-like illnesses. In the polio end game, when there is increased testing for polioviruses, it is important to consider infant botulism as a differential diagnosis in cases presenting with AFP. [source] Validation study of the Victorian Birth Defects RegisterJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9-10 2004M Riley Objective: To determine whether there has been an improvement in ascertainment of birth defects cases (,case validity') by the Victorian Birth Defects Register (BDR) since an earlier study (conducted in 1993), to ascertain the accuracy of registered data (,item validity') and to investigate another possible source of notification. Methods: The medical records were reviewed of 500 children born after 1 January 1993 who were consecutively admitted after 1 January 1999 to two paediatric teaching hospitals in Victoria. In addition, records of 200 children referred to a clinical genetics service were reviewed for children born after 1 January 1993 and who were seen in two periods: 2 months after 1 January 2001 and 2 months after 1 January 2002. The records from the hospitals and clinical genetics service were reviewed separately to determine whether children recorded as having a birth defect had previously been notified to the BDR. Results: Twenty percent of the hospital records related to a child with a birth defect, as did 70% of the clinical genetics service records. Overall case validity for birth defect cases from the hospitals was 88%. There was 100% ascertainment for three of five categories. Sixty per cent of birth defects cases from the clinical genetics service had been notified to the BDR. When all diagnoses in matched cases were considered, item validity was 54%, however, if only primary diagnoses were included then 92% of cases had the same diagnosis. Conclusions: Overall case validity from the two paediatric teaching hospitals has significantly improved since our previous study. The addition of an extra data source from a clinical genetics service would identify new cases, particularly genetic disorders and developmental delay, as well as adding new diagnoses to existing ones. This study has highlighted the need to improve item validity, perhaps through routine education for all coders and notifiers on the inclusion and exclusion of specific associated conditions when notifying major birth defects. [source] Importation of Dengue by Soldiers Returning from East Timor to North Queensland, AustraliaJOURNAL OF TRAVEL MEDICINE, Issue 4 2002Scott Kitchener Background: Soldiers based in Townsville, Australia, returned from East Timor following peacekeeping operations during the wet season of 1999 to 2000. This represented the potential to import dengue virus into north Queensland, a dengue receptive area of Australia. This article seeks to outline the measures taken by the Australian Defence Force (ADF) to prevent local transmission and to present the outcomes. Methods: Soldiers returning to north Queensland were provided with education on dengue fever and in the fortnight before return, their living areas were subjected to intensive vector control measures, in order to reduce the risk of acquisition of dengue. They were further encouraged to present early with any febrile illness following their return to Townsville. Provisionally diagnosed dengue cases were notified to the state public health authorities immediately and cases were isolated until suitable vector control programs were implemented or the potentially viremic period exceeded. Serologic and virologic investigations were undertaken to identify the passage and probable serotype or confirm the presence and serotype of dengue virus. Results: Nine serologically confirmed cases of dengue were identified as viremic in north Queensland. Six cases were identified as arising from dengue serotype 2, two were from serotype 3, and one case was ill defined. No dengue cases have been reported in the local population 4 months following these ADF cases. Conclusions: Local outbreaks of dengue fever have occurred in north Queensland following the importation of dengue virus in returned travelers. The successful prevention of local transmission in these circumstances was contributed to by early notification of cases and prevention of transmission through isolation of cases and collaboration between ADF and state and local public health authorities in vector control. The management of potentially viremic returning service personnel represents a future challenge for the ADF. [source] Partner Notification Methods for African American Men Being Treated for Trichomoniasis: A Consideration of Main Men, Second Hitters, and Third PlayersMEDICAL ANTHROPOLOGY QUARTERLY, Issue 4 2005Bronwen Lichtenstein This pilot study sought information on African American men's preferences for partner notification methods for a common sexually transmitted infection called trichomoniasis. Two focus groups of African American men were convened at a public STI clinic where they were being treated for trichomoniasis. The groups identified a sexual hierarchy in men's preferences for methods of partner notification. The hierarchy consisted of main men (Cake Daddies), second men (Second Hitters), and third or fourth men (Third Players), with placement depending on age, income, and social status. Health department employees affirmed the existence of a sexual hierarchy in a separate focus group. Sexual and economic bartering formed the basis of the hierarchy, and the secrecy involved in such arrangements presented a considerable challenge for STI control. Disease intervention specialists who were responsible for contact tracing spoke of cat-and-mouse methods in contacting the men without understanding fully exactly how the hierarchy influenced men's responses to partner notification. The findings suggest that STI control efforts must take the sexual hierarchy and its privacy implications into account if partner notification methods are to be acceptable to African American men. [source] Impact of UK academic foundation programmes on aspirations to pursue a career in academiaMEDICAL EDUCATION, Issue 10 2010Oliver T A Lyons Medical Education 2010: 44: 996,1005 Objectives, This study aimed to determine the role played by academic foundation programmes in influencing junior doctors' desire to pursue a career in academic medicine. Methods, We conducted an online questionnaire-based study of doctors who were enrolled on or had completed academic foundation programmes in the UK. There were 92 respondents (44 men, 48 women). Of these, 32 (35%) possessed a higher degree and 73 (79%) had undertaken a 4-month academic placement during Foundation Year 2. Outcomes were measured using Likert scale-based ordinal response data. Results, From a cohort of 115 academic foundation trainees directly contacted, 46 replies were obtained (40% response rate). A further 46 responses were obtained via indirect notification through local programme directors. From the combined responses, the majority (77%) wished to pursue a career in academia at the end of the academic Foundation Year (acFY) programme. Feeling well informed about academic careers (odds ratio [OR] 16.9, p = 0.005) and possessing a higher degree (OR 31.1, p = 0.013) were independently associated with an increased desire to continue in academia. Concern about reduced clinical experience whilst in academic training dissuaded from continuing in academia (OR 0.15, p = 0.026). Many respondents expressed concerns about autonomy, the organisation of the programme and the quantity and quality of academic teaching received. However, choice of work carried out during the academic block was the only variable independently associated with increasing the desire of respondents to pursue a career in academia following their experiences in the acFY programme (OR 6.3, p = 0.007). Conclusions, The results support the provision of well-organised academic training programmes that assist junior clinical academics in achieving clinical competencies whilst providing protected academic time, information about further academic training pathways and autonomy in their choice of academic work. [source] Characterization of autonomic dysfunction in patients with irritable bowel syndrome using fingertip blood flowNEUROGASTROENTEROLOGY & MOTILITY, Issue 5 2008T. Tanaka Abstract, Fingertip blood flow (FTBF) as measured by laser Doppler flowmetry (LDF) measurement is considered an indicator of sympathetic nerve function. We evaluated autonomic function in patients with irritable bowel syndrome (IBS) by assessing FTBF with both LDF and continuous-wave (cw) Doppler sonography. Firstly, the two methods were compared in 40 healthy volunteers. Next, 59 patients with IBS as well as 118 healthy volunteer controls were studied. In the supine position, FTBF in the right index finger was measured with cw Doppler sonography, whereas FTBF in the left index finger was assessed with LDF. After baseline measurement for at least 5 min, the volunteers received sympathetic stimulation from cold stress applied without notification in the form of an icebag (0 °C) upon the left forearm for 1 min. The new cw Doppler sonography method can be used in place of the old LDF method for clinical purposes. FTBF velocity before stimulation (Vpre) was significantly lower in the IBS group than that in the healthy volunteers (P < 0.01). In addition, the time required for FTBF to return to Vpre after stimulation was significantly longer in the IBS group than that in the control group. (P = 0.02). Thus, measurement of FTBF with cw Doppler sonography can be useful in the assessment of sympathetic nerve function. The IBS patients showed an abnormal FTBF response suggesting the presence of excess sympathetic activity. [source] Annual General Meeting notificationNURSING IN CRITICAL CARE, Issue 4 2008Karen Hill National Secretary No abstract is available for this article. [source] Annual General Meeting notificationNURSING IN CRITICAL CARE, Issue 3 2007Mandy Odell National Secretary [source] Safety of the Canadian blood supply in 1980,85: using a paediatric cohort for risk assessment of human immunodeficiency virus (HIV) infectionPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2001King The risk of HIV from transfusions in Canada in the period 1980,85 was estimated, using the information from a transfused paediatric cohort. Children who were transfused between January 1980 and November 1985 at a tertiary care paediatric hospital were contacted by letter. With this notification, HIV testing for recipients was recommended. HIV testing histories were obtained. The number tested for HIV was estimated from the questionnaire responses and from data matching with the HIV-testing laboratory. Cases of HIV infection were identified through multiple sources. In this cohort, 11 028 children were transfused a mean of 21 units. Of the 10 220 living recipients, the estimated proportion tested for HIV was 86% to 91%. Thirty-one cases of HIV infection were identified, representing 0.28% of the cohort but 0.34% of those expected to have been tested. The estimated HIV incidence per 1000 units transfused ranged from 0.028 [95% CI 0.0007, 0.155] in 1980 to 0.445 [95% CI 0.2592, 0.712] in 1985. This suggests that the risk of HIV from transfusions in Canada continued to rise until the implementation of HIV testing of donors in November 1985. [source] WATCHING THE DETECTIVES: SEASONAL STUDENT EMPLOYEE REACTIONS TO ELECTRONIC MONITORING WITH AND WITHOUT ADVANCE NOTIFICATIONPERSONNEL PSYCHOLOGY, Issue 2 2002AUDRA D. HOVORKA-MEAD The present paper tested procedural justice hypotheses about seasonal high school and college student employees' reactions to electronic monitoring with video cameras. Study 1, a field study, explored (a) whether employees receiving advance notification of monitoring offered more favorable justice judgments than employees who did not, and (b) whether employees who saw monitoring procedures and/or consequences as fair returned to the organization the following summer. Results supported the hypotheses: employees viewed monitoring procedures as fairer if they received advance notice. Fairness judgments predicted reemployment Study 2, a scenario-based laboratory experiment, also found that advance notice elicited greater justice beliefs. In addition, Study 2 examined how variations in justification for the monitoring affected justice beliefs. Either strong or weak justifications produced greater procedural justice beliefs than no justification. [source] Confidential Reproductive Health Services for Minors: The Potential Impact of Mandated Parental Involvement for ContraceptionPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 5 2004Rachel K. Jones CONTEXT: Recent legislative efforts to implement mandated parental involvement for minor adolescents seeking family planning services threaten the rights of adolescents younger than 18 to access reproductive health care. METHODS: State and federal laws and policies pertaining to minor adolescents' rights to access services for contraception and sexually transmitted diseases are reviewed, and research examining issues of parental involvement among adolescents using clinic-based reproductive health services is synthesized. RESULTS: Attempts to mandate parental involvement for reproductive health care often focus on contraceptive services and are typically linked to federal or state funding. Studies of teenagers using clinic-based family planning services suggest that slightly more than one-half would obtain contraceptives at family planning clinics even if parental notification were required. Mandated parental involvement for contraception would discourage few teenagers from having sex, but would likely result in more teenagers' using the least effective methods, such as withdrawal, or no method at all. Family planning clinics encourage teenagers to voluntarily talk to their parents, but relatively little information is available about the extent to which activities to promote parent-child communication have been adopted. CONCLUSIONS: Mandated parental involvement for teenagers seeking contraceptive care would likely contribute to increases in rates of teenage pregnancy. Research that will help clinics implement and improve efforts to encourage voluntary parental involvement is urgently needed. [source] Reported occupational respiratory diseases in three spanish regionsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Ramon Orriols Abstract Background In 2002, a voluntary registry of occupational respiratory diseases was initiated in the test phase in Asturias, Catalonia, and Navarre (Spain). Based on data from the fully implemented voluntary registry, we assessed the differences in the incidence and characteristics of the diseases reported in the three regions studied and compared them with those notified to the compulsory official system. Methods Physicians whose daily practice includes patients with occupational respiratory diseases were invited to participate. Newly diagnosed cases occurring during 2003 in the work force of the three regions studied were reported on a notification form every 2 months. Data from the compulsory official notification system were obtained from statistics on work-related diseases for possible disability benefits. Results Five hundred thirty-three new cases, representing a cumulative incidence of 183.52 (168.27,199.78) per million workers per year, were reported. The number of cases and the incidence, overall and for each disease, causes of the diseases, and the occupations varied considerably between regions. The number of cases reported to the voluntary system was more than threefold greater than the number reported to the compulsory official system. Conclusions The compulsory scheme for reporting occupational respiratory diseases is seriously under-reporting in the three Spanish regions studied. Our voluntary surveillance program, which showed considerable differences in the characteristics and incidence of these diseases among the regions, appears to be more effective. Am. J. Ind. Med. 53:922,930, 2010. © 2010 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||||||||