Accelerated process development and stockpile for MERS, LASSA AND NIPAH viral vaccine

CEPI (the Coalition for Epidemic Preparedness Innovation) was launched in January 2017. The global need for CEPI emerged after the devastating Ebola crisis in 2014/15 that caused over 11,000 deaths and had an economic impact of at least $2.8 billion in the worst-affected countries alone[1]. The collective response to Ebola had fallen short, and it was evident we needed a better system to produce proven vaccines against known epidemic threats. A year ago at Davos, the governments of India and Norway and Guinea; the Bill & Melinda Gates Foundation, Wellcome and the World Economic Forum backed the creation of CEPI, an innovative partnership of public, private, philanthropic and civil society organizations, to provide a global insurance policy to defend against future epidemics. Through a call for proposal to vaccine developers, CEPI launched a portfolio of projects covering the development of MERS, Lassa and Nipah viral vaccines, based on WHO blueprint list of pathogens and in addition, a number of platform technologies are currently evaluated for the development of rapid response against unknown pathogens. In this paper, we introduce the CEPI process development, the vaccine technologies and stockpile strategies for MERS, Lassa and Nipah candidates in the CEPI portfolio. The cell lines, process and scale up portfolio strategies will be reviewed for emergency settings vs conventional vaccine process development. The emergency stockpile development strategy will be presented in this paper. In addition, we also highlight the critical areas of dialogue with regulatory authorities for the enhancement of use of experimental vaccine candidates in emergency settings for efficacy trials. [1] http://www.worldbank.org/en/topic/macroeconomics/publication/2014-2015-west-africa-ebola-crisis-impact-updat

Ny medikamentell behandling av brystkreft Adjuvant behandling med trastuzumab ved tidlig stadium av brystkreft - en helseøkonomisk analyse

Source at https://www.helsebiblioteket.no/Denne rapporten er andre del av et oppdrag fra Sosial- og helsedirektoratet og RHF - fagdirektørene med fokus på virkestoffet trastuzumab ved adjuvant behandling av brystkreft. Adjuvant behandling gis i tillegg til hovedbehandlingen (for eksempel kirurgi) for å påvirke eventuelt gjenværende kreftceller hos pasienten. Denne delen av oppdraget vurderer de helseøkonomiske konsekvensene av adjuvant behandling av brystkreft med dette virkestoffet. Trastuzumab markedsføres i Norge under produktnavnet Herceptin ®

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Et hjem for små barn - En kvalitativ analyse av hvordan foreldre i den norske utdanningsmiddelklassen konstituerer hjem og hjemlighet for små barn. Masteroppgave i

Denne studien handler om småbarnsfamilier og deres hjem. Foreldrenes forestillinger og praksiser som konstituerer hjem og hjemlighet for små barn utforskes. Hva et hjem for små barn er og hvordan hjemmet til små barn er utformet, er knyttet til hva foreldrene tenker om barns behov. Bourdieus begreper om symbolsk kapital, habitus og doxa belyser det usynlige og selvfølgelige i småbarnshjemmet, det som i hverdagen tas for gitt. Empirien består av intervjumateriale der åtte småbarnsforeldre, seks kvinner og to menn ble dybdeintervjuet. Samtlige hadde 5-årig høyere utdanning og kan derfor sies å ha en forankring i utdanningsmiddelklassen. Analysen av hjem og hjemlighet viser at et hjem for små barn består av kulturelle koder for hva et hjem er, hvordan hjemmet skal se ut og hvilken praksis som gjøres i hjemmet. Foreldrene endret hjemmet sitt til et utviklingspsykologisk hjem når de fikk barn. Foreldrenes mentale skjemaer legger føringer for deres familie-og foreldrepraksis. Heteronormativiteten i kjernefamilien ser ut til å legge føringer der kjønn fungerte som kulturell kode i hjemmet, en kode som leder til ulik praksis. Det kan dermed virke som diskursen om den heteronormative kjernefamilien har klare posisjoner som foreldrene går inn i, i kraft av sitt kjønn. Kombinert med den utviklingspsykologiske forståelsen av barns behov, ser det ut til å lede til en kjønnet foreldrepraksis som foreldrene anser som naturlig og som de tar for gitt. Ved barnets ankomst i hjemmet ble samtlige mødre hjemlighetsskapere. En posisjon som mødrene tar og som fedrene overlater til mødrene. Hun fungerer som det emosjonelle og administrative senter i hjemmet, den som holder familien samlet. Kvinnen som hjemlighetsskaper blir underkommunisert og dermed undervurdert i hjemmet, men også i terapirommet. En mor har en annen form for hjemlighet. Hun har en annen familieform og står utenfor den heteronormative diskursen om kjernefamilien. Hennes fortelling fremstår som en ny og kreativ måte å skape et trygt og godt hjem for små barn på. Analysen viser at et hjem for små barn består av fem tatt-for-gitt-heter som det er enighet om blant foreldrene: den utviklingspsykologiske forståelsen av barns behov; kjønnsposisjonene i kjernefamilien der mor blir hjemlighetsskaper; mors emosjonelle arbeid i hjemmet; forståelsen av hva som er et vanlig hjem; og vaskedama som bidrar til lykke i hjemmet