Kleinasiatische Nachträge

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Utah Pandemic Influenza Response Plan

An influenza pandemic has the potential to cause widespread illness and death. Planning and preparedness before the next pandemic strikes are critical for an effective response. Utah’s Pandemic Influenza Response Plan describes a coordinated strategy to prepare for and respond to an influenza pandemic. Influenza causes seasonal worldwide epidemics of disease that result in an average of 36,000 deaths each year in the United States. A pandemic – or global epidemic – occurs when there is a major change in the influenza virus so that most or all people in the world’s population have no immunity against the virus. Three pandemics occurred during the 20th century; the most severe pandemic (1918) caused over 500,000 deaths in the U.S. and 20-100 million deaths worldwide. Recent outbreaks of human disease caused by avian influenza strains in Asia and Europe have highlighted the potential of new strains to be introduced into the population. An avian influenza (H5N1) virus capable of directly infecting humans was first detected in Hong Kong in 1997. That virus strain has been circulating widely in several Asian countries since 2003. Avian influenza H5N1 has caused 122 human cases and 62 deaths (WHO as of October 24, 2005) and has become enzootic in wild migratory birds. If these strains acquire the ability to be transmitted effectively from person to person a pandemic may occur. Regardless of whether the currently circulating avian influenza (H5N1) strains evolve so as to cause a pandemic or not, history indicates that we will experience another pandemic of influenza sooner or later. Characteristics of an influenza pandemic that must be considered in preparedness and response planning include: 1) simultaneous impacts in communities across the state and the U.S., limiting the ability of any jurisdiction to provide support and assistance to other areas; 2) an overwhelming burden of ill persons requiring hospitalization or outpatient medical care; 3) shortages and delays in the availability of vaccines and antiviral medications; 4) disruption of national and community infrastructures including health care, transportation, commerce, utilities and public safety; and 5) global spread of infection with outbreaks throughout the world. The Utah Department of Health is preparing to effectively respond to the issues mentioned above. This progress has been accomplished through programs specific for influenza as well as programs focused on increasing preparedness for bioterrorism and emerging infectious disease threats. In addition, resources have been allocated to improve statewide influenza surveillance, increase influenza testing capacity at the Utah Public Health Laboratory, assess the need for and potential uses of an antiviral drug stockpile, develop means to deliver vaccine against the pandemic influenza strain once it becomes available, and improve health care system readiness at the community level

Shifts in the architecture of the Nationwide Health Information Network

In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services. These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC's proposed changes in its strategy for the NwHIN

Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial.

Background: Oophorectomy reduces serum testosterone levels. We studied the efficacy and safety of transdermal testosterone in treating hypoactive sexual desire disorder in surgically menopausal women

Acetilkolinesteraza u eritrocitima i butirilkolinesteraza u plazmi - Važni pokazatelji za liječenje osoba otrovanih organofosfornim spojevima

Inhibition of acetylcholinesterase (AChE) is regarded as the primary toxic mechanism of organophosphorus compounds (OP). Therapeutic strategies are directed to antagonise overstimulation of muscarinic receptors with atropine and to reactivate inhibited AChE with oximes. Reactivation is crucial within the neuromuscular synapse, where atropine is ineffective, since peripheral neuromuscular block eventually leads to respiratory failure. Patients with OP intoxication have to be identified as early as possible. During an international NBC-defence exercise anesthetised pigs were poisoned with sarin, followed by treatment with atropine and oxime. Blood samples were drawn and red blood cell (RBC)-AChE activity determined with a fielded test system on-site. Within a few minutes the poisoning was verified. After administration of HI-6, RBC-AChE activity increased rapidly. Blood samples were reanalysed in our laboratory in Munich. Almost identical course of the AChE activities was recorded by both systems. The more comprehensive cholinesterase status was determined in Munich. Oxime administration can be stopped when AChE is aged completely, but has to be continued as long as poison is present in the body and reactivation is possible. To aid the on-site physician in optimising diagnosis and treatment, a fielded test system should be available to allow rapid determination of the complete cholinesterase status.Inhibicija acetilkolinesteraze (AChE) smatra se primarnim mehanizmom toksičnoga djelovanja organofosfornih spojeva (OP). Strategije liječenja idu za zaustavljanjem prekomjerne stimulacije muskarinskih receptora atropinom i reaktiviranjem inhibiranog AChE oksimima. Ključna je reaktivacija u neuromuskularnoj sinapsi, u kojoj atropin nije djelotvoran, budući da neuromuskularna blokada u konačnici vodi do prestanka disanja. Važno je što ranije prepoznati otrovanje organofosfornim spojem. U jednoj međunarodnoj vježbi zaštite od nuklearnog, biološkog i kemijskog napada svinje pod anestezijom otrovane su sarinom te liječene atropinom i oksimom. Uzeti su im uzorci krvi te s pomoću terenskoga testa na licu mjesta određena aktivnost AChE u eritrocitima. Otrovanje je potvrđeno za nekoliko minuta. Nakon primjene HI-6, aktivnost AChE brzo je porasla. Isti su uzorci krvi ponovno analizirani u našem laboratoriju u Münchenu. Oba su testa zabilježila gotovo istovjetan tijek aktivnosti AChE. U Münchenu je međutim napravljen potpuniji nalaz kolinesteraza. Liječenje oksimima može se prekinuti kada AChE potpuno “ostari” (tj. dealkilira), ali ga valja nastaviti dokle god je otrov u tijelu, a reaktivacija moguća. Liječnici na terenu trebali bi raspolagati terenskim testovima radi brzoga i potpunog utvrđivanja statusa kolinesteraza, a time i kvalitetnije dijagnoze

Inkludering i förskolan för barn i behov av särskilt stöd

Sammanfattning: Syfte Syftet med arbetet är att undersöka hur pedagoger och förskolechefer arbetar för att inkludera barn i behov av särskilt stöd i verksamheten. Metod Jag har använt mig av en kvalitativ undersökning. Jag valde att intervjua fyra pedagoger och två förskolechefer som alla är eller har varit verksamma i förskolor för barn i behov av särskilt stöd. Resultat Mitt resultat ledde fram till att det är förhållningssättet hos pedagogerna och förskolecheferna som har en stor betydelse för hur barn i behov av särskilt stöd blir inkluderade i förskolan. Utifrån mitt resultat anser jag att det är viktigt med ett samarbete inom arbetslaget för att kunna möta den variation av barn som finns i förskoleverksamheten. Arbetslaget ska utifrån barnens förutsättningar skapa en inkluderande förskolemilöj för alla barn som är deltagande i förskolan.      

Specimen academicum de principio ethices Kantianae venia amplissimae facultatis philosophicae in Academia Imperiali Aboënsi publico defert examini mag. Johannes Matthias Sundwall philosophiae theoreticae docens, respondente Petro Adolpho Hällfors stipendiario publico, Satacundensi in audit. philos. die XXIII Junii MDCCCXXIII. horis ante meridiem solitis.

Arkit: 1 arkintunnukseton lehti, A-B4 C3. - S. [2] ja [22] tyhjä.Painovuosi nimekkeestä