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51.
52.

Purpose

In the United States, the Center for Biologics Evaluation and Research at the US Food and Drug Administration (FDA) is responsible for licensure of vaccines. The Advisory Committee on Immunization Practices (ACIP) is a federal advisory committee that provides guidance to the Centers for Disease Control and Prevention (CDC) on use of vaccines. Discrepancies between FDA licensure indications and ACIP/CDC vaccine recommendations exist, challenging health care providers. The objectives of this study were: (1) to categorize differences between FDA vaccine licensure indications and ACIP/CDC vaccine recommendations for vaccines; and (2) to assess knowledge, attitudes, and practices of pediatricians, family physicians, and obstetrician-gynecologists regarding their understanding of differences.

Methods

Information was extracted from FDAvaccine package inserts, and corresponding information was collected for ACIP/CDC vaccine recommendations (2000–2014) for vaccines in the childhood and adult immunization schedules. Surveys regarding knowledge of discrepancies were distributed electronically to members of the Georgia chapters of the American Academy of Pediatrics (GA-AAP) and the American Academy of Family Physicians (GA-AAFP), and the national American College of Obstetricians and Gynecologists (ACOG) in 2014.

Findings

Differences were identified in 20 instances: differences in age group indications were identified in 6, in dosing administration schedules in 4, and in immunocompromised hosts and pregnant women in 10. We received 145 (8.5%) responses from GA-AAP, 237 (9.5%) from GA-AAFP, and 869 (1.5%) from national ACOG members. A total of 105 (72%) GA-AAP respondents reported that they follow AAP recommendations and 168 (71%) GA-AAFP respondents follow ACIP recommendations. GA-AAP and GA-AAFP respondents generally were not aware of data the FDA considers for vaccine licensure or data that pharmaceutical company representatives are permitted to discuss. Respondents remain current with vaccine recommendations through review of materials from professional organizations, the CDC, and package inserts; Continuing Medical Education; and information from pharmaceutical representatives. A total of 780 (90%) ACOG respondents had no concerns regarding routinely recommended reduced diphtheria toxoid and acellular pertussis vaccines (n?=?730 [84%]) and influenza during pregnancy vaccines (n?=?852 [98%]) to pregnant patients. However, these findings must be interpreted within the context of a low overall ACOG survey response rate.

Implications

Education regarding existence of and reasons for discrepancies between FDA licensure of and ACIP/CDC recommendations for vaccines and reasons for these differences could optimize immunization delivery.  相似文献   
53.
BackgroundBreastfeeding has several benefits for both the infants and mothers. This study assessed breastfeeding knowledge, attitudes, and practices (KAP) among mothers of infants with Retinopathy of Prematurity (ROP).MethodsA cross-sectional study was conducted among mothers of infants with ROP visiting the ROP clinic in a selected tertiary care centre. A total of 100 mothers were selected through the convenience sampling method and interviewed using a structured questionnaire.ResultA significant number of mothers had average to poor knowledge (81%) with a mean score of 8.32 ± 2.7. More than half of the mothers had poor practices related to breastfeeding with a mean score of 7.6 ± 2.4. The attitudes of the mothers towards breastfeeding was either neutral or positive towards formula feeding.ConclusionThe KAPs of mothers regarding breastfeeding were inadequate. Intervention measures are recommended for promoting breastfeeding practices among the mothers of infants with ROP.  相似文献   
54.
ERDMANN A.L., DE ANDRADE S.R., FERREIRA DE MELLO A.L., KLOCK P., DO NASCIMENTO K.C., SANTOS KOERICH M. & STEIN BACKES D. (2011) Practices for caring in nursing: Brazilian research groups. International Nursing Review 58 , 379–385 Background: The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. Aim: To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. Methods: The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south‐east of Brazil, distributed in sample groups, were interviewed. Findings: The core phenomenon ‘research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing’ was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. Conclusions: The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community.  相似文献   
55.
Emergency contraception (EC) has the potential to reduce unwanted pregnancy significantly, in Mexico as elsewhere. Recent years have seen tremendous growth in programs and research devoted to expanding access to emergency methods worldwide. In Mexico City, we conducted a pre-intervention/post-intervention research study of one way to introduce EC. Following a baseline survey of family planning providers and clients in 1997, we organized and implemented a three-year program of training for health care providers and a multi-faceted information campaign for the general public, including a national toll-free hotline and website. In 2000, we again surveyed family planning clinic providers and clients, using instruments similar to those employed in the baseline study. EC awareness increased significantly from 13% of clients to 32%, and support jumped from 73% to 83%. Providers at study clinics improved method recognition from 88% to 100%.  相似文献   
56.
吴永佩  颜青 《中国药房》2010,(38):3553-3557
目的:释义《医院处方点评管理规范(试行)》(简称《规范》)。方法:通过对制定《规范》的背景、目的与意义进行分析,深入理解《规范》的主要内容。结果与结论:明确《规范》的主要内容和"专项处方点评"范围、内容与标准,可为有效组织开展处方点评提供依据,促进和提高临床合理用药水平。  相似文献   
57.
本文主要论述了面瘫的中医特色诊疗,并着重论述了面瘫针刺的时机和手法问题。  相似文献   
58.

Ethnopharmacological relevance

PHY906, is a decoction of a mixture of the four herbs Scutellaria baicalensis Geori, Glycyrrhiza uralensis Fisch, Paeonia lactiflora Pall, and Ziziphus jujuba Mill. A combination of these four herbs has been in continuous use in traditional Chinese medicine for over 1800 years for treating a variety of gastrointestinal distress such as diarrhea, cramps, nausea, vomiting etc.

Aim of the study

Preclinical and clinical studies to find PHY906 enhances the therapeutic indices of a broad spectrum of anticancer agents.

Materials and methods

Using various mouse tumor xenograft and allograft models, PHY906 has been shown to enhance the chemotherapeutic efficacy of a variety of anticancer agents in various cancers. The PHY906 clinical program consists of five trials in three different types of cancers in both the United States and Taiwan. To date, approximately 150 subjects have received PHY906 in combination with chemotherapy in these five clinical studies.

Results

Preclinical studies have shown that PHY906 enhances the therapeutic indices of a broad spectrum of anticancer agents. These findings have been examined in clinical studies for colorectal, liver, and pancreatic cancers when PHY906 is used as an adjuvant to chemotherapy and the results were promising; i.e. PHY906 could reduce chemotherapy-induced toxicities and/or increase chemotherapeutic efficacy. Furthermore, PHY906 did not affect the pharmacokinetics of the chemotherapeutic agents used. Some information has been obtained regarding the mechanism of action of PHY906 in preclinical studies. A comprehensive platform, PhytomicsQC that integrates chemical and biological fingerprints together with a novel biostatistical methodology has been developed to assess the quality of different batches of PHY906.

Conclusions

Over a ten-year period, the multiplex technology “PhytomicsQC” has been used to show batch-to-batch consistency of PHY906 production. Advanced clinical trials are ongoing to demonstrate the effectiveness of PHY906 as adjuvant therapy for cancer patients undergoing chemotherapy.  相似文献   
59.
60.
Staat MA  Stadler LP  Donauer S  Trehan I  Rice M  Salisbury S 《Vaccine》2010,28(50):7947-7955
Definitive immunization guidelines for internationally adopted children are lacking. We examined whether these children had serologic evidence of protection against vaccine-preventable diseases. For children with ≥3 vaccine doses, overall protection was high for diphtheria (85%), tetanus (95%), polio (93%), hepatitis B (77%), and Hib (67%). For children ≥12 months of age with ≥1 dose of measles, mumps, or rubella vaccines, 95%, 72%, and 94% were immune, respectively. Children without immunization documentation had lower immunity. Serologic testing was useful in verifying the immunization status in internationally adopted children with and without documentation of immunizations.  相似文献   
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