The financial impact of a state adopting a personal/philosophical belief exemption policy: Modeling the cost of pertussis disease in infants, children and adolescents

State school immunization exemption policies help reduce the risk of individual and community disease. Assessing the costs of vaccine preventable disease associated with a state adding a philosophical/personal belief school exemption policy is useful for making future policy decisions. Two formulas were developed to estimate the infant, child and adolescent hospitalization and non-medical costs of pertussis disease that are associated with adding a philosophical/personal belief school exemption policy. The parameter estimates were obtained from peer reviewed literature and the Centers for Disease Control and Prevention. The state of Iowa was used as an example in order to demonstrate how the formulas can be applied. The annual projected impact of pertussis disease in Iowa is $273,365 without a philosophical/personal belief exemption policy and an average of $410,047 (range of $281,566-$582,267) with adding a personal belief exemption policy. We project that adding a philosophical/personal belief exemption will cost 50% more dollars annually.     

Immunization with high epitope density of M2e derived from 2009 pandemic H1N1 elicits protective immunity in mice

As highly conserved amongst human influenza A strains, the extracellular domain of influenza M2 protein (M2e) is considered and proved as a promising candidate for a universal influenza vaccine. However, there are four amino acid variations in the M2e sequence of the 2009 pandemic H1N1 (referred to as "swine flu M2e, SFM2e") compared with the conventional M2e consensus sequence. Whether the sequence variation alters the immunogenicity and protection of SFM2e epitope remains unclear. In our present study, we synthesized SFM2e peptide and constructed a series of GST fusion proteins containing various copies of the SFM2e epitope and immunized mice to evaluate their immunogenicity and protective activity. We found that although the amino acid variations have weakened the immunogenicity of the SFM2e peptide, the SFM2e fusion proteins with high epitope densities induced intense and diverse antibody response as well as T cell response. Moreover, mice immunized with high epitope density of SFM2e were nearly fully protected against a lethal challenge by the mouse-adapted influenza virus A/Porto Rico/8/34. Our study could provide new available data to improve the epitope vaccine strategy against influenza pandemic.     

医务人员血源性职业安全防护教育研究与实践

目的 探讨血源性职业安全防护教育培训方法,建立多途径、多形式、多层次的血源性职业防护教育培训体系.方法开展多途径、多形式、多层次的职业安全防护教育培训,采用问卷调查与实地督查、提问相结合的方法对培训前后的医务人员工作行为进行比较、统计分析.结果 培训后医务人员洗手、戴手套、使用备有锐器盒的治疗车、用锐器盒卡槽分离注射器针头、根据预期可能的暴露选择合适的防护用品、发生职业暴露后正确处理及时上报的依从性明显提高,系统培训前后比较差异有统计学意义(P＜0.05),但在接触不同患者之前洗手或手消毒、戴手套静脉穿刺抽血的依从性仍不容乐观,培训前后比较差异无统计学意义.结论 多途径、多形式、多层次的血源性职业防护教育培训体系,提高了医务人员职业安全防护能力,可改变医务人员职业暴露防护态度和行为,是有效减少医务人员职业暴露的重要措施.     

初级职称护理人员职业安全防护认知现状及培训需求调查

目的 了解初级职称护理人员职业安全防护认知现状及培训需求,为职业安全防护培训提供有效的依据.方法 采用自制问卷对100名护士进行调查.结果 初级职称护理人员职业安全防护意识不强,在职业暴露损伤后未上报的主要原因是不知道具体的上报流程,需求率最高的培训方法是经验交流占80.0％,需求率最高的培训内容是发生职业暴露后的应急处理及流程占70.0％.结论 加强对初级职称护理人员的职业安全防护培训,提高其自身防护能力及安全防护意识,从而减少职业暴露的危害.     

热休克蛋白72在青光眼视网膜神经节细胞中的保护机制研究进展

青光眼是以不可逆性、进行性视功能损害为特征的视神经退行性病变。研究认为,保护视网膜神经节细胞,使视神经免于继续受损已成为青光眼研究的重点。热休克蛋白72(HSP72)是热休克蛋白家族重要成员之一,是凋亡的抑制者,与神经保护有密切关系。研究HSP72在青光眼视网膜神经节细胞中的抗凋亡和细胞保护特性,对青光眼发病机制的理论研究和临床治疗具有重要的指导意义。就HSP72在青光眼视网膜神经节细胞中的保护作用进行综述。     

Evaluation of food-relevant chemicals in the ToxCast high-throughput screening program

Thousands of chemicals are directly added to or come in contact with food, many of which have undergone little to no toxicological evaluation. The landscape of the food-relevant chemical universe was evaluated using cheminformatics, and subsequently the bioactivity of food-relevant chemicals across the publicly available ToxCast highthroughput screening program was assessed. In total, 8659 food-relevant chemicals were compiled including direct food additives, food contact substances, and pesticides. Of these food-relevant chemicals, 4719 had curated structure definition files amenable to defining chemical fingerprints, which were used to cluster chemicals using a selforganizing map approach. Pesticides, and direct food additives clustered apart from one another with food contact substances generally in between, supporting that these categories not only reflect different uses but also distinct chemistries. Subsequently, 1530 food-relevant chemicals were identified in ToxCast comprising 616 direct food additives, 371 food contact substances, and 543 pesticides. Bioactivity across ToxCast was filtered for cytotoxicity to identify selective chemical effects. Initiating analyses from strictly chemical-based methodology or bioactivity/cytotoxicity-driven evaluation presents unbiased approaches for prioritizing chemicals. Although bioactivity in vitro is not necessarily predictive of adverse effects in vivo, these data provide insight into chemical properties and cellular targets through which foodrelevant chemicals elicit bioactivity.     

Classification schemes for carcinogenicity based on hazard-identification have become outmoded and serve neither science nor society

Classification schemes for carcinogenicity based solely on hazard-identification such as the IARC monograph process and the UN system adopted in the EU have become outmoded. They are based on a concept developed in the 1970s that chemicals could be divided into two classes: carcinogens and non-carcinogens. Categorization in this way places into the same category chemicals and agents with widely differing potencies and modes of action. This is how eating processed meat can fall into the same category as sulfur mustard gas. Approaches based on hazard and risk characterization present an integrated and balanced picture of hazard, dose response and exposure and allow informed risk management decisions to be taken. Because a risk-based decision framework fully considers hazard in the context of dose, potency, and exposure the unintended downsides of a hazard only approach are avoided, e.g., health scares, unnecessary economic costs, loss of beneficial products, adoption of strategies with greater health costs, and the diversion of public funds into unnecessary research. An initiative to agree upon a standardized, internationally acceptable methodology for carcinogen assessment is needed now. The approach should incorporate principles and concepts of existing international consensus-based frameworks including the WHO IPCS mode of action framework.     

香港重症监护病房职业安全防护特点与借鉴

2009年6月～2010年4月,笔者有幸参加广东省卫生厅与香港医院管理局合作的赴港重症监护专科护士培训项目,被安排到香港多家公立医院重症监护病房学习和参观,感受到香港重症监护同行在职业安全防护人性化、科学化、先进化等的理念和措施。现就在港期间ICU职业安全防护方面的所学所闻介绍如下。     

Use of personal digital assistants for data collection in a multi-site AIDS stigma study in rural south Nyanza, Kenya

Objectives

To describe the development, cost effectiveness and implementation of a PDA based electronic system to collect, verify and manage data from a multi-site study on HIV/AIDS stigma and pregnancy in a rural, resource-poor area.

Methods

We worked within a large prevention of mother-to-child-transmission (PMTCT) program in nine rural health facilities to implement a PDA-based data collection system and to study the feasibility of its use in a multisite HIV research study in rural Kenya. The PDAs were programmed for collecting screening and eligibility data, and responses to structured interviews on HIV/AIDS stigma and violence in three local languages.

Results

Between November 2007 and December 2008, nine PDAs were used by Clinic and Community Health Assistants to enrol 1,270 participants on to the PMTCT program. Successes included: capacity-building of interviewers, low cost of implementation, quick turnaround time of data entry with good data quality, and convenience.

Conclusion

Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote rural health facilities in Kenya. However, appropriate and frequent data backup protocols need to be established and paper forms are still needed as backup tools in resource-poor settings.     

肺缺血再灌注损伤时血浆中介素及其肺脏受体系统的变化

目的 观察大鼠肺缺血再灌注损伤中介素(IMD)及其受体的变化情况及其意义.方法 建立大鼠在体肺缺血再灌注模型.将健康雄性Wistar大鼠72只随机分为手术对照组(C组)、缺血再灌注组(IR组)、IMD1-53药物干预组(D组).每组分别在缺血45 min和再灌注60、120 min 3个时点处死8只大鼠,取血浆和右肺中...