H1N1 Flu Vaccine Requires Pediatricians To Change EMR Software System Requirements
With initial shipments of the much anticipated H1N1 vaccine arriving in doctors’ offices last week, Connexin Software announced it is delivering an expedited update of its Office Practicum™ pediatric EMR with features to support the special forecasting, administration, and billing requirements of the new vaccine. The Centers for Disease Control and Prevention (CDC) has targeted children for the first wave of immunizations, causing grave concern in pediatric offices across the country about how to handle unprecedented demand for a vaccine.
“The new features were developed in conjunction with our physician Advisory Board to handle large volumes of patients while ensuring attention to detail and quality associated with the patient experience,” stated Gregory H. Anderson, Connexin CFO. “We added forecasting rules to ensure vaccines are given on the correct schedule, administrative tools to manage inventory and report to public health agencies, and billing templates to ensure correct coding of medical claims.”
“We have been swamped with parents calling and bringing in their children,” said Dr. Edna A. Pytlak of Brooklyn, NY. “On Monday we administered over 125 flu immunizations in our three-doctor office. The new features help us handle patients quickly without sacrificing medical safety or quality. We are required to report all immunizations promptly to the Department of Health, and the system sends them electronically so we don’t have to do it by hand. At these volumes, it’s a huge time-saver.”
H1N1 vaccine forecasting is complicated because doses are available in multiple forms (shots and nasal spray), and patients under the age of ten must return for a second dose 21-28 days later. In addition, attention must be paid to other vaccines given recently – including seasonal flu – that may interfere with this schedule. Otherwise the immunization may be less effective.
H1N1 billing rules are equally complicated because the American Medical Association and Centers for Medicare/Medicaid Services only defined special codes for this purpose on September 28. By that time, many insurance payers had already announced their own rules. Doctors must follow correct guidelines for each payer in order to get paid for administering the vaccine. (The vaccine is given to doctors free of charge by the Federal government and cannot be resold.)
“It was quite a whirlwind around here for the past two weeks,” said Anderson, “but it was worth it. Pediatrics First™ is more than a mission statement to us; it’s a way of life. We knew our clients would be inundated early, and we wanted to be sure they were prepared. We’re proud to be doing our part to help doctors respond to this public health crisis.”
Source
Connexin Software, Inc.
Chlamydia: Teenage Boys Take Less Responsibility For Preventing The Spread Of The Disease
Teenage boys in Sweden take less responsibility than girls for preventing the spread of chlamydia and other sexually transmitted infections, according to a new study from the Sahlgrenska Academy at the University of Gothenburg, Sweden.
The study was published in the journal Midwifery and was carried out in primary care in the Västra Götaland region of Sweden.
“We have seen a major increase in the number of cases of chlamydia in Sweden over the last few years, and must find new ways of reaching out to boys with information if we are to reverse this trend,” says midwife Gun Rembeck, one of the researchers behind the study.
The study involved almost 500 17-year-old high-school pupils in western Sweden attending classes on risks, sexual behaviour, responsibility, condoms and Swedish law in respect of sexually transmitted infections (STIs). They were then invited to fill out a questionnaire anonymously.
“The most striking thing is that a very high proportion of the boys state that they will not be following the advice given during the classes, and that almost as many think that sex education has no impact whatsoever on their sexual behaviour,” says Rembeck.
The responses also showed that more teenage girls had had sexual intercourse than boys, and that it was also more common for the girls to have been tested for STIs. While the boys had more experience of using condoms than the girls, other studies have shown that the responsibility for the prevention of unwanted pregnancy is more important to girls than boys.
“Many young girls go to youth clinics at an early stage for contraception, and are also given information there on the importance of protecting themselves against infections,” says Rembeck. “We need to use other methods to reach boys and perhaps develop our partnerships with other professional groups who work with young people.”
The Rise in Chlamydia
The last decade has seen new cases of chlamydia in Sweden almost triple: in 2007 more than 47,000 people were diagnosed with chlamydia, compared with fewer than 14,000 in 1997. The infection is increasing primarily in females aged between 15 and 25. The increase is due to several factors, including more sexual partners, more casual sexual liaisons and reduced use of condoms.
Source:
Elin Lindström Claessen
University of Gothenburg
During Pregnancy A High Fat Diet Can Lead To Severe Liver Disease In Offspring
Scientists have discovered a previously unknown link between a mother’s diet in pregnancy and a severe form of liver disease in her child.
In a study, published in the journal Hepatology, researchers at the University of Southampton found that a high fat diet during a woman’s pregnancy makes her offspring more likely to develop a severe form of fatty liver disease when they reach adulthood. The findings are another piece in the jigsaw for scientists who believe diets containing too high levels of saturated fat may have an adverse effect on our health.
Non-alcoholic fatty liver disease (NAFLD) is a condition associated with obesity and caused by the build up of fat in the liver. The condition advances in some people and it is important to understand the factors that contribute to disease progression. Until recently, NAFLD was considered rare and relatively harmless but now it is one of the most common forms of liver disease that may progress to cirrhosis a serious life threatening chronic liver disease.
Professor Christopher Byrne, with colleagues Dr Felino Cagampang and Dr Kim Bruce, of the University’s School of Medicine and researchers at King’s College London, conducted the study, funded by the BBSRC. Prof Byrne explained: “This research shows that too much saturated fat in a mother’s diet can affect the developing liver of a fetus, making it more susceptible to developing fatty liver disease later in life. An unhealthy saturated fat-enriched diet in the child and young adult compounds the problem further causing a severe form of the fatty liver disease later in adult life.”
The next stage of this research, also funded by the BBSRC, will be to understand, more precisely, the reason why fatty liver disease develops and to intervene to prevent the fatty liver disease occurring.
The University’s School of Medicine has a worldwide reputation for its pioneering research into the relationship between mothers’ diets in pregnancy and future health problems in their offspring.
Notes:
The paper is available on Hepatology’s website by visiting: www3.interscience.wiley/journal/106570044/home Ref: DOI 10.1002/hep.23205
Source:
Sophie Docker
University of Southampton
New Report Gives 7-Point Plan To Reduce The 1.5 Million Child Deaths Globally Caused By Diarrhoea
Nearly one in every five child deaths- around 1.5 million a year-is due to diarrhoea, which kills more children than AIDS, malaria, and measles combined. A new report released by UNICEF and WHO (Diarrhoea: why children are still dying and what can be done) provides a seven-point plan for comprehensive diarrhoea control. The plan, and the momentum behind it, are discussed in a Comment published Online First and in an upcoming edition of The Lancet. The Comment is Dr Tessa Wardlaw, UNICEF, New York, USA, and Dr Elizabeth Mason, Director, Department of Child and Adolescent Health and Development, WHO, Switzerland, and colleagues.
Today, only 39% of children with diarrhoea in developing countries receive the recommended treatment, and limited trend data suggest little progress since 2000. Zinc supplements are largely unavailable in most developing countries, and low-osmolarity oral rehydration salts have been slow to roll out, even 5 years after UNICEF and WHO recommended their use in programmes.
On the prevention side, progress has been made in many areas, notably vitamin A supplementation, measles immunisation, access to safe drinking water, and exclusive breastfeeding. But in other areas much work remains. Rotavirus vaccine is not available in most developing countries, and improving drinking water, sanitation, and breast-feeding rates remain key issues.
The authors say: “Vaccination against rotavirus, which causes 40% of hospital admissions from diarrhoea in children under 5 worldwide, has recently been recommended for inclusion in all national immunisation programmes. Accelerating its introduction in Africa and Asia, where the rotavirus burden is greatest, needs to become an international priority.”
The 7-point plan is made up of two treatment and five prevention strategies. For treatment, children need fluid replacement to prevent dehydration, and zinc supplements. Oral rehydration therapy is the cornerstone of fluid replacement, and the gold standard is low-osmolarity oral rehydration solution. Important additional components include continued feeding, including breastfeeding, and use of appropriate fluids in the home if oral rehydration solution is not available, along with increased fluids in general. The prevention package consists of: i) Rotavirus and measles vaccinations; ii) Promotion of early and exclusive breastfeeding and vitamin A supplementation; iii) Promotion of handwashing with soap; iv) Improvement of water quantity and quality, including treatment and safe storage of household water; and v) Promotion of community-wide sanitation.
The authors conclude: “We know what works to reduce child deaths from diarrhoea and what actions will make a lasting reduction in the burden of diarrhoea. We need to make the prevention and treatment of diarrhoea everybody’s business, from families and communities to government leaders to the global community.”
Source
The Lancet
Over Half Of Cot Deaths Occur Whilst Co-sleeping
More than half of sudden unexplained infant deaths occur while the infant is sharing a bed or a sofa with a parent (co-sleeping) and may be related to parents drinking alcohol or taking drugs, suggests a study published on bmj.
Although the rate of cot death in the UK has fallen dramatically since the early 1990s, specific advice to avoid dangerous co-sleeping arrangements is needed to help reduce these deaths even further, say the researchers.
The term sudden infant death syndrome (SIDS) was introduced in 1969 as a recognised category of natural death that carried no implication of blame for bereaved parents.
Since then, a lot has been learnt about risk factors, and parents are now advised to reduce the risk of death by placing infants on their back to sleep, placing infants in the “feet to foot” position at the bottom of the cot, and keeping infants in a smoke-free environment.
But it is not clear which risk messages have been taken on board in different social or cultural groups, and little is known about the emergence of new or previously unrecognised risk factors.
So a team of researchers at the Universities of Bristol and Warwick studied all unexpected infant deaths from birth to two years in the southwest region of England from January 2003 to December 2006.
To investigate a possible link between SIDS and socioeconomic deprivation, they compared these deaths with a control group at ‘high risk’ for SIDS (young, socially deprived mothers who smoked) as well as a randomly selected control group.
Parents were interviewed shortly after the death and information was collected on alcohol and drug use. A detailed investigation of the scene and circumstances of death was also conducted by trained professionals.
Of the 80 SIDS deaths analysed, more than half (54%) occurred whilst co-sleeping compared to 20% co-sleeping rate amongst both control groups.
Much of this risk may be explained by the combination of parental alcohol or drug use prior to co-sleeping (31% compared with 3% random controls), and the high proportion of co-sleeping deaths on a sofa (17% compared with 1% random controls), say the authors.
A fifth of SIDS infants were found with a pillow for the last sleep and a quarter were swaddled, suggesting potentially new risk factors emerging.
The risk factors were similar whichever group the SIDS cases were compared with, suggesting that these risk factors for SIDS apply to all sections of the community and are not just a consequence of social deprivation.
Some of the risk reduction messages seem to be getting across and may have contributed to the continued fall in the SIDS rate, say the authors. However, the majority of the co-sleeping SIDS deaths occurred in a hazardous sleeping environment. The safest place for an infant to sleep is in a cot beside the parental bed in the first six months of life, they write.
Parents need to be advised to never put themselves in a situation where they might fall asleep with a young infant on a sofa. They also need to be reminded that they should never co-sleep with an infant in any environment if they have been drinking or taking drugs.
We have learnt that SIDS is largely preventable, says Edwin Mitchell, Professor of Child Health Research at the University of Auckland, in an accompanying editorial. It is important to monitor parents’ knowledge and infant care practices to inform health education and promotion.
Implementing what we already know has the potential to eliminate SIDS, the challenge now is how to change behaviour, he concludes.
Link to paper
Link to editorial
Source
British Medical Journal
Babies Safest In Own Cots – Experts Confirm But Survey Shows Too Many Mums Still Sceptical
Latest findings by researchers from Bristol University published online in the British Medical Journal, confirm that “the safest place for a baby to sleep is in its own cot.”
This four-year study*, funded by The Foundation for the Study of Infant Deaths (FSID), found that in half of all unexpected deaths of children in the South West of England, babies had died sleeping with a parent or carer.
However, it is worrying that results of a separate survey published in the latest edition of Community Practitioner reveal that a quarter of mums were not persuaded that bedsharing can increase the risk of cot death.
This survey of infant care practices in the UK**, carried out by Ipsos MORI for FSID, questioned 506 mothers of children aged from six months to three years.
Results also showed a high degree of disbelief in other key ‘Reduce the Risk’ messages***.
FSID’s director, Joyce Epstein, said: “Since 2000 FSID and the Department of Health have been advising parents to sleep their babies in a separate cot in a room with them, and we are pleased that the most up-to-date research confirms that this advice is correct.
“But the survey results are alarming. We know that those at greatest risk of experiencing a cot death are very young mums, often single, and still in their teens, and this group is the most likely to reject safe sleep advice.”
In order to protect the most vulnerable babies, FSID has launched a new and innovative way to reach teenage parents: www.bubbalicious, a baby-care focussed, social networking site for both mums and dads under 20.
*Case-control study of SIDS in Southwest England dangerous co-sleeping environments and risk factors amenable to change
Fleming et al January 2003 – December 2006
**Ipsos MORI interviewed 506 mothers in their homes during November 2007. Social grade E respondents were strategically oversampled to at least one-third of the total sample, in an attempt to increase the overall base of those perceived as the most economically disadvantaged.
***Sleep baby on the back, not side or front; don’t expose babies to tobacco smoke
Source
University of Bristol
Sanofi Pasteur Announces Results Of U.S. Clinical Trials Of Influenza A (H1N1) Vaccine In Infants And Children
Sanofi Pasteur, the vaccines division of the sanofi-aventis Group (EURONEXT: SAN and NYSE: SNY), announced an interim analysis of data from clinical trials of the U.S. licensed Influenza A (H1N1) 2009 Monovalent Vaccine in infants and children 6 months through 9 years of age. The data indicate the vaccine is immunogenic and that one dose may protect many children. However, the study suggests that two doses of vaccine will be required for optimal protection of children under the age of 10 years. This is consistent with the recommendations for seasonal influenza immunization in children of this age. Clinical trials are ongoing to evaluate the immunogenicity and safety in children following two doses of vaccine.
“According to the Centers for Disease Control and Prevention young children are among those of highest priority for immunization with the Influenza A (H1N1) 2009 Monovalent Vaccine, given the relatively high disease incidence and potential for transmission in this population,” said Wayne Pisano, President and Chief Executive Officer of Sanofi Pasteur. “As the only company licensed in the U.S. to produce a pediatric influenza vaccine which is licensed for children as young as 6 months of age, it was the highest priority for Sanofi Pasteur to conduct clinical trials to evaluate the safety and immunogenicity of the pandemic vaccine in children to support decisions on vaccine administration.”
This randomized, placebo-controlled, multicenter trial was conducted by Sanofi Pasteur to determine the immunogenicity and safety of the vaccine, given as a two-dose schedule, 21 days apart. A total of 474 children were enrolled in the trial in two age cohorts: 229 children 6 months through 35 months of age; and 245 children 3 years through 9 years of age. The trial evaluated two antigen doses: formulated as 7.5 mcg and 15 mcg hemagglutinin in each cohort (ClinicalTrials registration number NCT00952419). The interim results reported today are the first data available from children under the age of 10 years. Previously, Sanofi Pasteur reported that 98 percent of adults 18 years through 64 years of age had an immune response considered protective following one 15 mcg dose of vaccine.
The clinical trial in children evaluated immune responses to Sanofi Pasteur’s Influenza A (H1N1) 2009 Monovalent Vaccine compared with placebo, based on rates of seroprotection and seroconversion. Two doses of vaccine were administered, the second dose 21 days after the first. Immunogenicity was measured at day 21, just prior to administration of the second dose, and will be measured again 21 days after the second dose at day 42. In both age groups, immune responses 21 days after one dose of the 15 mcg vaccine satisfied the criteria for seroconversion. The criteria for seroprotection were not met with only one 15 mcg dose of vaccine in either age group. In this clinical trial 76 percent of children 3 years through 9 years of age and 50 percent of children 6 months through 35 months of age had immune responses considered seroprotective following one 15 mcg dose of vaccine. An antibody titer of 1:40 or greater is generally considered a marker of seroprotection. A lower rise in antibody titers following vaccination may minimize the occurrence of disease and its consequences but is not considered seroprotective. Final data from these clinical trials, following a second dose of vaccine, will provide additional information to guide recommendations on the optimal dosage, number of doses and schedule.
Adverse events are being monitored throughout the clinical trial and will continue for six months after the second dose of vaccine. No serious adverse events have been reported in the trial to date. Local reactions reported have been similar to those observed with the seasonal influenza vaccine.
About Influenza A (H1N1) 2009 Monovalent Vaccine
The U.S. licensed Influenza A (H1N1) 2009 Monovalent Vaccine manufactured by Sanofi Pasteur is an inactivated influenza virus vaccine indicated for active immunization of persons 6 months of age and older against influenza disease caused by pandemic (H1N1) 2009 virus. Influenza A (H1N1) 2009 Monovalent Vaccine was licensed by the U.S. Food and Drug Administration on September 15 as a monovalent strain change to Sanofi Pasteur’s licensed seasonal influenza vaccine.
The Influenza A (H1N1) 2009 Monovalent Vaccine is manufactured by the same process as Sanofi Pasteur’s seasonal trivalent influenza virus vaccine licensed in the U.S. Influenza A (H1N1) 2009 Monovalent Vaccine is formulated to contain 15 mcg hemagglutinin (HA) of influenza A/California/07/2009 (H1N1) v-like virus. Influenza A (H1N1) 2009 Monovalent Vaccine is licensed for single-dose presentations in syringes and vials and in multi-dose vials. There is no preservative used in the single-dose presentations. Multi-dose vials contain a preservative.
Safety Information for Influenza A (H1N1) 2009 Monovalent Vaccine
Influenza vaccine should not be administered to anyone with a known severe hypersensitivity to egg proteins, any vaccine component or life-threatening reactions after previous administration of any influenza vaccine. Recurrence of Guillain-Barre syndrome (GBS) has been temporally associated with the administration of influenza vaccine. The decision to give Influenza A (H1N1) 2009 Monovalent Vaccine to individuals who have a prior history of GBS should be based on careful consideration of the potential benefits and risks. Vaccination with Influenza A (H1N1) 2009 Monovalent Vaccine may not protect all individuals.
About Influenza Vaccine Production at Sanofi Pasteur
Sanofi Pasteur operates influenza vaccine production facilities in Val de Reuil, France and in Swiftwater, Pa. (U.S.). All Sanofi Pasteur influenza vaccine facilities have been designed and built to be able to switch from seasonal influenza vaccine production to pandemic influenza vaccine production.
Sanofi Pasteur produces approximately 40 percent of the influenza vaccines distributed worldwide and more than 45 percent of the influenza vaccines distributed in the U.S. for the 2008-2009 influenza season.
About Sanofi Aventis
Sanofi-aventis, a leading global pharmaceutical company, discovers, develops and distributes therapeutic solutions to improve the lives of everyone. Sanofi-aventis is listed in Paris (EURONEXT: SAN) and in New York (NYSE: SNY).
Sanofi Pasteur, the vaccines division of the sanofi-aventis Group, provided more than 1.6 billion doses of vaccine in 2008, making it possible to immunize more than 500 million people across the globe. A world leader in the vaccine industry, Sanofi Pasteur offers the broadest range of vaccines protecting against 20 infectious diseases. The company’s heritage, to create vaccines that protect life, dates back more than a century. Sanofi Pasteur is the largest company entirely dedicated to vaccines.
Project Funding
This project has been funded with Federal funds from the Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, under Contract No. HHSO100200900121C. The views expressed do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices or organizations imply endorsement by the U.S. Government.
Forward Looking Statements
This press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, as amended. Forward-looking statements are statements that are not historical facts. These statements include financial projections and estimates and their underlying assumptions, statements regarding plans, objectives, intentions and expectations with respect to future events, operations, products and services, and statements regarding future performance. Forward-looking statements are generally identified by the words “expects,” “anticipates,” “believes,” “intends,” “estimates,” “plans” and similar expressions. Although sanofi-aventis’ management believes that the expectations reflected in such forward-looking statements are reasonable, investors are cautioned that forward-looking information and statements are subject to various risks and uncertainties, many of which are difficult to predict and generally beyond the control of sanofi-aventis, that could cause actual results and developments to differ materially from those expressed in, or implied or projected by, the forward-looking information and statements. These risks and uncertainties include those discussed or identified in the public filings with the SEC and the AMF made by sanofi-aventis, including those listed under “Risk Factors” and “Cautionary Statement Regarding Forward-Looking Statements” in sanofi-aventis’ annual report on Form 20-F for the year ended December 31, 2008. Other than as required by applicable law, sanofi-aventis does not undertake any obligation to update or revise any forward-looking information or statements.
Source: Sanofi Pasteur
Houston Northwest Medical Center Becomes The First And Only Hospital In Houston To Receive Prestigious Cycle III Chest Pain Center Accreditation
In its continuous pursuit of quality cardiac care, Houston Northwest Medical Center was proudly recognized as the first accredited chest pain center in Houston and one of a handful in Texas to be named a Cycle III Chest Pain Center with PCI (percutaneous coronary intervention). Cycle III accreditation is the highest accreditation possible for treatment of chest pain — by the Society of Chest Pain Centers.
The Society of Chest Pain Centers (SCPC) is a patient centric non-profit international professional organization focused upon improving care for patients with acute coronary syndromes and other related maladies. The Society’s accreditation recognizes Chest Pain Centers who have demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and completing on-site evaluations by a review team from the Society of Chest Pain Centers.
“The high standards set by the society will benefit our patients, who can be certain that our goal with our heart attack patients is to save lives, improve patient outcomes, and provide an overall strategy for cardiac care,” says Pam Egan, Director of the Ed Roberson Heart Center at Houston Northwest Medical Center.
To earn Chest Pain Center accreditation, a facility must successfully meet the Society’s eight criteria:
– Integrating the emergency department with the local emergency medical system
– Assessing, diagnosing, and treating patients quickly
– Effectively treating patients with low risk for acute coronary syndrome and no assignable cause for their symptoms
– Continually seeking to improve processes and procedures
– Ensuring Chest Pain Center personnel competency and training
– Maintaining organizational structure and commitment
– Having a functional design that promotes optimal patient care
– Supporting community outreach programs that educate the public to promptly seek medical care if they display symptoms of a possible heart attack
“We collectively looked at the entire continuum of care and involved everyone who would impact how quickly and efficiently the patient could be treated,” says Catherine Bissell, RN, Chest Pain Center coordinator. “Everyone is vital to making this program work as a seamless system.”
Dedicated to quickly restoring blood flood to a patient suffering from a heart attack, Houston Northwest Medical Center and Cypress Creek EMS have joined forces to implement protocols that improve response mechanisms designed to decrease door-to-balloon time – the time that elapses from a patient’s arrival to treatment with angioplasty – for patients suffering from ST elevation myocardial infarction (STEMI), a severe heart attack in which an artery is significantly blocked. According to the American Heart Association and the American College of Cardiology the national recommendation for restoring blood flow is 90 minutes. In 2008, the average door-to-balloon time at Houston Northwest Medical Center was 62 minutes.
“Our program is successful because all members work together as a cohesive team and the program is supported by everyone from administration down,” Amilcar Avendano, M.D., Medical Director of the Chest Pain Center at Houston Northwest Medical Center.
There are 81 accredited Chest Pain Centers in Texas and out of 81 only 4 including Houston Northwest Medical Center are Cycle III accredited. Cycle III accreditation involves more extensive involvement in chest pain quality improvement projects, extensive staff education training in dealing with chest pain, higher staff credentials in cardiovascular diseases, and more outreach and community education about chest pain.
“We are very proud of this accomplishment and would like to congratulate the emergency physicians, cardiologists, nurses and other members of the Chest Pain Center team whose hard work and dedication to quality helped achieve this honor,” says Drew Kahn, Chief Executive Officer at Houston Northwest Medical Center.
About Houston Northwest Medical Center
Houston Northwest Medical Center is located at 710 F.M. 1960 West in Houston. Houston Northwest Medical Center has been serving the North Houston community for 35 years. The hospital is an Accredited Chest Pain Center by the Society of Chest Pain Centers. Houston Northwest Medical Center ranks among the nation’s top hospitals for several service lines including critical care, stroke and general surgery by HealthGrades, an independent health care ratings company. Houston Northwest Medical Center is also a designated Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery.
About the Society of Chest Pain Centers (SCPC)
The Society of Chest Pain Centers is a patient centric non-profit international professional organization focused upon improving care for patients with acute coronary syndromes and other related maladies. Established in 1998, the Society is dedicated to patient advocacy and focusing on ischemic heart disease. Central to its mission is the question, “What is right for the patient?” In answer, the Society promotes protocol based medicine, often delivered through a Chest Pain Center model to address the diagnosis and treatment of acute coronary syndromes, heart failure, and to promote the adoption of process improvement science by healthcare providers. To best fulfill this mission, the Society of Chest Pain Centers provides accreditation to facilities striving for optimum Chest Pain Center care. SCPC is headquartered in Columbus, Ohio.
Source: Houston Northwest Medical Center
Diarrhoea – Why Children Are Still Dying And What Can Be Done: UNICEF And WHO Launch Report On The Second Greatest Killer Of Children
Despite the existence of inexpensive and efficient means of treatment, diarrhoea kills more children than AIDS, malaria and measles combined, according to a report issued today by UNICEF and the World Health Organization (WHO).
View report: Diarrhoea – Why children are still dying and what can be done (PDF)
The report, titled Diarrhoea: Why Children Are Still Dying and What Can Be Done, includes information on the causes of diarrhoea, data on access to means of prevention and treatment, and a seven-point plan to reduce diarrhoea deaths.
“It is a tragedy that diarrhoea, which is little more than an inconvenience in the developed world, kills an estimated 1.5 million children each year,” said UNICEF Executive Director, Ann M. Veneman. “Inexpensive and effective treatments for diarrhoea exist, but in developing countries only 39 per cent of children with diarrhoea receive the recommended treatment.”
Dr Margaret Chan, Director-General of WHO, said: “We know where children are dying of diarrhoea. We know what must be done to prevent those deaths. We must work with governments and partners to put this seven-point plan into action.”
Diarrhoea is a common symptom of gastrointestinal infection, which can have a variety of sources. However just a handful of organisms are responsible for most acute cases of diarrhoea and one, Rotavirus, is responsible for more than 40 per cent of all diarrhoea-related hospital admissions of children under five. A new vaccine for Rotavirus has been found to be safe and effective but is still largely unavailable in most developing countries.
Though most episodes of childhood diarrhoea are mild, acute cases can lead to significant fluid loss and dehydration. This dehydration can lead to death unless fluids are quickly replaced. Oral rehydration therapy is the cornerstone of fluid replacement and the new low-osmolarity formula of oral rehydration salts (ORS) is a simple, inexpensive and life-saving remedy that prevents dehydration in children suffering diarrhoea.
Some 88 percent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. As of 2006, an estimated 2.5 billion people around the world were not using adequate sanitation facilities, and about 1 in 4 people in developing countries practiced open defecation.
Access to clean water and good hygiene practices are extremely effective in preventing childhood diarrhoea. Hand washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent, making it one of the most cost-effective interventions for reducing child deaths caused by this neglected killer. Thursday October 15 is annual Global Handwashing Day when millions of children and adults in over 80 countries will take part in activities to highlight this key intervention.
The overall health and nutrition of children is also critical to their susceptibility to diarrhoea and the damage it can cause. Undernourished children are at higher risk of suffering more frequent, severe and prolonged episodes of diarrhoea, and repeated bouts of diarrhoea also place children at greater risk of worsening nutritional status.
The seven point plan to save the lives of children stricken by diarrhoea includes two treatment and five prevention elements.
The two treatment elements are:
1. fluid replacement to prevent dehydration; and
2. zinc treatments, which decrease the severity and duration of the attack.
The five prevention elements are:
1. immunization against rotavirus and measles;
2. early and exclusive breastfeeding and vitamin A supplementation;
3. handwashing with soap;
4. improved water supply quantity and quality; and
5. promoting community-wide sanitation.
Campaigns targeting childhood diarrhoea in the 1970s and 1980s achieved success by educating caregivers and scaling up oral rehydration therapy to prevent dehydration. The campaigns delivered promising results but following that success, focus shifted to other health problems. There is now an urgent need to shift attention and resources back to treating and preventing diarrhoea.
Source
UNICEF
Stricter Hand Hygiene In Schools Only A Short-Term Measure For Fighting Swine Flu
Increased hand hygiene in primary schools is only a short-term measure in preventing infections such as H1N1 from spreading. Researchers writing in the open access journal, BMC Public Health, found stricter hand hygiene practices are difficult to maintain in a school setting.
School children may be twice as likely to catch H1N1 influenza as adults, as such health policies often stress hand hygiene among school children as one low cost intervention that may prevent influenza from spreading.
A research team led by Wolf-Peter Schmidt at the London School of Hygiene and Tropical Medicine, London, UK used qualitative methods to explore teachers’ and students’ views on different hand hygiene protocols, as well as interviewing school nurses. Their pilot study in four East London primary schools examined both practical issues and attitudes, and included class exercises in hand washing or lining up to use hand sanitizer.
The researchers found that staff are motivated to contribute to hygiene education over and above what children learn from their parents, provided that expectations are realistic for the school environment. But very frequent and highly monitored hand washing would be hard to keep up over the longer term without the motivation of a major perceived public health threat like the current influenza pandemic. During a busy school day, time was a major factor in deciding what level of hand hygiene could be achieved.
School nurses were more focused on reducing infection, whereas teachers saw hygiene as an important education topic – particularly among the younger age groups. Rinse-free alcohol gel hand sanitizer was the fastest and least messy option. But teachers highlighted to children that this was only for situations where soap and water was in short supply.
“Intensive hand hygiene interventions are feasible and acceptable but only temporarily during a period of a particular health threat like an influenza pandemic and only if rinse-free hand sanitizers are used,” according to Schmidt. “In many settings there may be logistical issues in providing all schools with an adequate supply,” he added. “Hand hygiene is important in particular for the prevention of gastro-intestinal infections. The effect of hand hygiene on the spread of influenza is less clear, but may be promoted as a precautionary measure, even in the absence of evidence. Our study highlights the practical issues of bringing improved hand hygiene to scale.”
Notes:
To increase awareness of the importance of handwashing, the 15th of October will mark the 2nd Global Handwashing Day. Global Handwashing Day 2009 will be the centerpiece of a week of activities that will mobilize millions of people in more than 70 countries across all five continents to wash their hands with soap.
Formative research on the feasibility of hygiene interventions for influenza control in UK primary schools
Wolf-Peter Schmidt, Catherine Wloch, Adam Biran, Val Curtis and Punam Pangtani
BMC Public Health (in press)
biomedcentral/bmcpublichealth/
Source:
Charlotte Webber
BioMed Central