试述餐饮业和集体用餐配送单位卫生规范的制定与施行

我国首部《餐饮业和集体用餐配送单位卫生规范》于2005年6月27日由卫生部发布,并于同年10月1日起施行。该规范规定了餐饮业人员、建筑、设施、设备、工用具等的设置和卫生管理、加工操作等方面应达到的标准或要求,适用于有固定加工场所的餐饮业经营者,也适用于单位和学校的集体食堂和集体供餐企业。本文是作者对该规范的研制说明和实施建议与讨论。     

Randomized,double-blind,placebo-controlled,safety and immunogenicity study of 4 formulations of Anthrax Vaccine Adsorbed plus CPG 7909 (AV7909) in healthy adult volunteers

A new anthrax vaccine that could accelerate the immune response and possibly reduce the number of injections needed for protection would be desirable in a post-exposure setting.     

Substitute Consent for Research Involving the Elderly: A Comparison Between Quebec and France

The authors first describe the rules enacted in Quebec and France to protect adults with decisional impairment who may be approached by investigators to participate in research protocols. They then present two consecutive postal surveys conducted among Quebec and French researchers in aging and designed to (1) assess their knowledge of the legal provisions implemented to protect decisionally incapable adults, (2) elicit their opinions regarding the person best suited to provide substitute consent for research participation, and (3) document their conduct related to obtaining consent for prospective subjects with impaired decisional capacity. Knowledge of the legislation governing substitute consent was poor, even more so among French than Quebec researchers (p < 0.001). In both samples, the majority of respondents felt that the substitute decision-maker does not have to be legally appointed when the study poses little risk to the participant. Practice data revealed a certain discrepancy between the conduct of researchers in aging and the legal provisions regarding consent for research purposes that prevail in their jurisdictions. These findings underscore the need to better educate clinical investigators about existing measures to protect prospective subjects who lack decisional capacity. They also provide some support for allowing close relatives to consent to research participation on behalf of older adults who are unable to consent by themselves and have not been appointed a legal representative.     

Rotavirus vaccination compliance and completion in a Medicaid infant population

We examined completion and compliance rates of rotavirus (RV) vaccination according to the recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Food and Drug Administration approved Prescribing Information (PI) for Rotarix^® (RV1, GlaxoSmithKline Vaccines) and RotaTeq^® (RV5, Merck and Co.) among infants under one year of age covered by Medicaid programs. Healthcare claims data from state Medicaid programs that constituted the Truven Health MarketScan^® Multi-State Medicaid Database were retrieved from May 2008–June 2012. Infants were grouped under PI and ACIP cohorts based on the dosing regimens followed. The overall compliance per PI (n = 673,956) and ACIP (n = 695,612) recommendations were 24.5% and 28.2%, respectively; completion rates were 30.3% and 32.6%, respectively. In the PI cohort, infants who received RV1 had significantly higher compliance as compared with infants who received RV5 (65.2% vs. 31.3%; p < 0.0001); completion rates among infants receiving RV1 and RV5 were 65.3% and 46.4%, respectively (p < 0.0001). In the ACIP cohort, compliance with RV1 was significantly higher than RV5 (68.8% vs. 45.9%; p < 0.0001) as was the overall completion rate (73.5% vs. 48.8%; p < 0.0001). While compliance is increasing year over year, overall compliance of RV vaccines is suboptimal, with over 40% of eligible infants unvaccinated in both populations. The 2-dose RV vaccine showed better completion rates and higher compliance than the 3-dose RV vaccine in the United States. Public health initiatives focusing on suboptimal compliance and completion rates of RV vaccination in the Medicaid population could improve these metrics, thereby offering protection against RV infection.     

The development and validation of methods for evaluating the immune system in preweaning piglets

The preweaning piglet has been found to be a valuable research model for testing ingredients used in infant formula. As part of the safety assessment, the neonates' immune system is an important component that has to be evaluated. In this study three concurrent strategies were developed to assess immune system status. The methods included (1) immunophenotying to assess circulating innate immune cell populations, (2) monitoring of circulating cytokines, particularly in response to a positive control agent, and (3) monitoring of localized gastrointestinal tissue cytokines using immunohistochemistry (IHC), particularly in response to a positive control agent. All assays were validated using white papers and regulatory guidance within a GLP environment. To validate the assays precision, accuracy and sample stability were evaluated as needed using a fit for purpose approach. In addition animals were treated with proinflammtory substances to detect a positive versus negative signal. In conclusion, these three methods were confirmed to be robust assays to evaluate the immune system and GIT-specific immune responses of preweaning piglets.     

Health care worker opinions on use of isolation precautions in long-term care facilities

To address controversies surrounding contact isolation precautions in skilled nursing facilities (SNF), we surveyed 356 nurses and nurses' aides from 7 SNFs on their opinions regarding benefits and harms of contact isolation precautions. Whereas a majority of health care workers believed that contact isolation reduces transmission of antibiotic-resistant organisms, they were also concerned about potentially harmful consequences to the SNF residents including depression and isolation.     

The relation of parental practices and self-conceptions to young adolescent problem behaviors and substance use

The object of the present research was to examine the role of parenting practices for young adolescent psychosocial adjustment and self-regulation problems. The sample included 287 sixth- and seventh-grade subjects from intact families. The participants completed a questionnaire that measured variables including family interaction, parental involvement in children's activities, parental support, joint decision-making, and monitoring of children's behavior. Children's involvement with friends, after-school activities, school achievement, and self-reported externalizing behaviors (problem behaviors, cigarette and alcohol use) were also measured. Self-concept domains (scholastic competence, social acceptance, and behavioral conduct) were assessed with Harter's Self-Perception Profile. The findings indicated that self-conceptions of positive behavioral conduct and higher parental monitoring of children's activities were consistently negatively related to young girls' and boys' behavior problems and substance use. Parental monitoring was higher for girls and for younger children. Lower monitoring was also related to children's pattern of after-school activities that were connected to at-risk behavior. Parental involvement and supervision of children's day-to-day activities seem particularly important in socializing children's behavior at the time of early adolescence.     

通过GLP和AAALACi认证的新药安全评价实验动物管理

随着医药研发的全球化发展,国内新药安全评价机构获得药物非临床研究质量管理规范（GLP）和国际实验动物评估和认可管理委员会（AAALACi）双认证的越来越多。实验动物作为药物安全性评价的载体,其生存状态和动物福利将直接影响到试验结果,处理好两种体系下实验动物的饲养管理工作,是保证实验数据准确的必要条件。以天津药物研究院新药评价有限公司通过GLP和AAALACi两种体系认证的实际工作经验为基础,辅以与同行们的交流经验,探讨两种认证体系在实验动物管理工作中的关系,以期通过加强实验动物管理工作来保障新药安全评价工作的顺利进行。     

Survey of antidoping knowledge,attitudes and practices amongst elite Indian sportsmen and the way forward

BackgroundIndian sportspersons have reported several antidoping rule violations with several cases suggesting inadvertent use of prohibited substances. This study was designed to evaluate the anti-doping knowledge, attitudes and practices amongst elite Indian sportsmen to suggest future interventions.MethodsThis study conducted at a Sports institute used an anonymized questionnaire to survey 181 male (18–35 years old) elite young athletes' attitudes toward performance-enhancing substances and anti-doping rules.ResultsAthlete awareness regarding antidoping agencies and antidoping rule violations was poor. 40% or less reported receiving antidoping updates. All reported improvement in antidoping knowledge and attitude changes after attending updates. Health is more important than sporting performance for 80% or more. Very low percentage reported consumption of banned substances amongst themselves and team mates. One-third of these athletes reported not having being tested for banned substances. Athletes who have attended antidoping sessions exhibit significantly higher knowledge levels and a significantly higher 80% reported consulting their Team doctor before any therapeutic drug use as compared with non-attendees.ConclusionIndian elite athletes report low awareness about anti-doping rules and prohibited substances with low proportion of athletes reporting doping and being tested for doping. Grass root level education, supplement regulation, trained athlete support personnel and accessible reference material seems to be the way forward.     

Preferences for health economics presentations among vaccine policymakers and researchers

PurposeMeasure the preferences of decision makers and researchers associated with the Advisory Committee on Immunization Practices (ACIP) regarding the recommended format for presenting health economics studies to the ACIP.MethodsWe conducted key informant interviews and an online survey of current ACIP work group members, and current and previous ACIP voting members, liaison representatives, and ex-officio members to understand preferences for health economics presentations. These preferences included the presentation of results and sensitivity analyses, the role of health economics studies in decision making, and strategies to improve guidelines for presenting health economics studies. Best-worst scaling was used to measure the relative value of seven attributes of health economics presentations in vaccine decision making.ResultsThe best-worst scaling survey had a response rate of 51% (n = 93). Results showed that summary results were the most important attribute for decision making (mean importance score: 0.69) and intermediate outcomes and disaggregated results were least important (mean importance score: −0.71). Respondents without previous health economics experience assigned sensitivity analysis lower importance and relationship of the results to other studies higher importance than the experienced group (sensitivity analysis scores: −0.15 vs. 0.15 respectively; relationship of the results: 0.13 vs. −0.12 respectively). Key informant interviews identified areas for improvement to include additional information on the quality of the analysis and increased role for liaisons familiar with health economics.ConclusionAdditional specificity in health economics presentations could allow for more effective presentations of evidence for vaccine decision making.