International Primary Care Respiratory Group (IPCRG) Guidelines: dissemination and implementation--a proposed course of action.

There is growing evidence that good implementation of evidence-based guidelines can result in improvement in health outcomes. This paper on Dissemination and Implementation constitutes the final paper of the IPCRG Guidelines on the management of chronic respiratory diseases in primary care. It highlights the historical development of these guidelines following the formation of the International Primary Care Airways Group (IPAG) in 2001 together with its dissemination and implementation subgroup, and the subsequent transfer of this dissemination and implementation role to the IPCRG. It covers the main factors within the IPCRG workplan, including the issues of governance, launch, dissemination, implementation, and evaluation.     

Classical swine fever virus marker vaccine strain CP7_E2alf: Shedding and dissemination studies in boars

Over the last decade, pestivirus chimaera CP7_E2alf has proven to be a most promising marker vaccine candidate against classical swine fever (CSF). To provide further background data for the risk assessment towards licensing and release, especially on presence of the vaccine chimaera in faeces, urine, and organs of the male reproductive tract, supplementary studies were carried out under controlled laboratory conditions. In detail, the shedding and dissemination pattern of Suvaxyn^® CSF Marker (“CP7_E2alf”) was assessed in 12 adult boars after single intramuscular vaccination with a tenfold vaccine dose. Four and seven days post vaccination, six animals were subjected to necropsy and triplicate samples were obtained from reproductive and lymphatic organs as well as urine, faeces, blood, and several additional organs and matrices. The sampling days were chosen based on pre-existing data that indicated the highest probability of virus detection. Upon vaccination, neither local nor systemic adverse effects were observed in the experimental animals. It was confirmed that primary replication is restricted to the lymphatic tissues and especially the tonsil. While viral genome was detectable in several samples from lymphatic tissues at four and seven days post vaccination, infectious virus was only demonstrated at four days post vaccination in one tonsil sample and one parotid lymphnode. Sporadic detection at a very low level occurred in some replicates of liver, lung, bone marrow, and salivary gland samples. In contrast, viral genome was not detected in any sample from reproductive organs and accessory sex glands, in faeces, urine, or bile.The presented data on the dissemination of the vaccine virus CP7_E2alf in adult boars are supplementing existing safety and efficacy studies and indicate that the use of the vaccine is also safe in reproductive boars.     

宫腔镜辅助诊刮术对子宫内膜癌细胞播散及生存预后的影响

目的：探讨宫腔镜辅助下诊断性刮宫术对子宫内膜癌患者癌细胞播散以及患者生存预后的影响。方法：117例术后确诊子宫内膜癌患者根据术前是否行宫腔镜辅助诊刮术分为观察组（n ＝54）与对照组（n ＝63）,观察组术前给予宫腔镜辅助诊刮术,对照组术前给予常规诊刮术。两组患者均经手术治疗,对比术后腹腔冲洗液癌细胞阳性率、术后3年复发率、术后3年及5年生存率。结果：观察组术后腹腔冲洗液癌细胞阳性率为7．4％,术后3年复发率为9．3％,3年存活率为100．0％,5年存活率为96．3％;对照组上述指标分别为7．9％、12．7％、100．0％、93．7％,两组术后腹腔冲洗液癌细胞阳性率、3年复发率、3年存活率、5年存活率比较差异无统计学意义（P ＞0．05）。结论：宫腔镜辅助诊刮术用于子宫内膜癌术前诊断对癌细胞腹腔播散以及患者术后的生存预后无明显不良影响。     

Disseminating treatment for anxiety disorders step 2: Peer recommendations to seek help

Despite the high prevalence of and significant psychological burden caused by anxiety disorders, as few as 25% of individuals with these disorders seek treatment, and treatment seeking by African-Americans is particularly uncommon. This purpose of the current study was to gather information regarding the public's recommendations regarding help-seeking for several anxiety disorders and to compare Caucasian and African-American participants on these variables. A community sample of 577 US adults completed a telephone survey that included vignettes portraying individuals with generalized anxiety disorder (GAD), social phobia/social anxiety disorder (SP/SAD), panic disorder (PD), and for comparison, depression. The sample was ½ Caucasian and ½ African American. Respondents were significantly less likely to recommend help-seeking for SP/SAD and GAD (78.8% and 84.3%, respectively) than for depression (90.9%). In contrast, recommendations to seek help for panic disorder were common (93.6%) and similar to rates found for depression. The most common recommendations were to seek help from a primary care physician (PCP). African Americans were more likely to recommend help-seeking for GAD than Caucasians. Findings suggested that respondents believed individuals with anxiety disorders should seek treatment. Given that respondents often recommended consulting a PCP, we recommend educating PCPs about anxiety disorders and empirically-supported interventions.     

Application of real-time RT-PCR in vector surveillance and assessment of replication kinetics of an emerging novel ECSA genotype of Chikungunya virus in Aedes aegypti

Chikungunya has emerged as one of the most important arboviral infection of global significance. Expansion of Chikungunya virus endemic areas can be ascribed to naive population, increasing vector population and adaptability of virus to new vector. In this study, a SYBR Green I based quantitative RT-PCR assay was developed. The assay was found to be 10-fold more sensitive than conventional RT-PCR and no cross reactivity was observed with related alphaviruses and flaviviruses. The detection efficiency of the assay was impervious to mosquitoes of different pool sizes. Vector surveillance has resulted in detection of CHIKV RNA in Aedes aegypti, confirming its vectorial potential for CHIKV in northern India. The assessment of the assay was further carried out by studying the competence of Indian Ae. aegypti for CHIKV, which revealed 100% infection rate and dissemination rate with 60% transmission rate. The replication kinetics of CHIKV in different anatomical sites of Ae. aegypti revealed highest titre at day 6 post infection in midgut and at day 10 post infection in saliva, legs and wings. The implementation of the assay in detecting lower viral load makes it a remarkable tool for surveillance of virus activity in mosquitoes.     

Reflections on the Challenges of Effective Dissemination of Behavioural Family Intervention: Our Experience with the Triple P – Positive Parenting Program

This paper draws on learnings from dissemination and diffusion research to discuss predictors of dissemination outcomes, obstacles to effective dissemination, and phases of dissemination failure. A model is presented of effective dissemination of a multilevel system of intervention known as the Triple P-Positive Parenting Program (Triple P). This model takes a systems-contextual approach, addressing program design, skills training, practitioner confidence and self-regulation, and workplace support. Recommendations are made for agencies adopting evidence-based programs, particularly in relation to the selection, establishment and maintenance of new programs as well as guiding ongoing program development. Future directions for research into the dissemination of evidence-based practice are also discussed.     

Direct-to-consumer marketing of psychological treatments for anxiety disorders

Progress disseminating and implementing evidence-based psychological treatments (EBPTs) for the anxiety disorders has been gradual. To date, the dominant approach for promoting the uptake of EBPTs in clinical settings has been to target the education and training of mental health providers, with many consumers remaining unaware of the potential benefits of EBPTs for anxiety disorders. Direct-to-consumer (DTC) marketing may be a promising vehicle for increasing EBPT utilization rates in the treatment of anxiety disorders. This paper provides an overview of the rationale and important considerations for applying DTC efforts to promote evidence-based care in the treatment of anxiety disorders, and reviews current DTC efforts in this area, including resources on the Internet and other media and in-person events. We conclude with recommendations for future efforts in the DTC marketing of EBPTs for the anxiety disorders, including the need for increased funding and grassroots efforts to inform consumers about anxiety disorders and their most effective treatments.