SUBTYPE A/H7N9 INFLUENZA: PATHOGENICITY AND PREVENTIVE MEASURES

2013 ◽  
pp. 95-100
Author(s):  
Dinh Binh Tran
Keyword(s):  
H7n9 Virus ◽  
Disease Symptoms ◽  
The People ◽  
High Risk Disease ◽  
Before And After ◽  
H7n9 Infection ◽  
Risk Of Disease ◽  
Tract Infections ◽  
Subtype A ◽  
Avian Populations

H7N9 is a serotype of the species Influenzavirus A. H7 virus normally circulates amongst avian populations with some variants known to occasionally infect humans. A H7N9 virus was first reported to have infected humans in 2013. The people with H7N9 virus are respiratory tract infections leading to pneumonia and can be death. To cope with H7N9 virus should strengthen supervision, strengthening management and treatment, epidemiological investigation and observe who has been exposed to the fatal cases. To limit the risk of disease, WHO recommends that people should be clean, safe eating, wash the hands often, especially before and after eating, after using the toilet, after contact with animals, after contact with sick people, use a mask when in contact with human or environmental exposure to the high-risk disease. Symptoms of influenza H7N9 infection are fever and cough then switch to pneumonia. Therefore, if having the symptoms like this, and then have the cough and shortness of breath, chest pain that should be early come the health facilities to diagnose and treat.

scholarly journals 216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
Christina Maguire ◽  
Dusten T Rose ◽  
Theresa Jaso
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Source Control ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Before And After ◽  
The Difference ◽  
Tract Infections ◽  
Length Of Therapy ◽  
The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

scholarly journals Inappropriate Azithromycin Use in Nine Primary-Care Clinics Before and After Implementation of Provider Guidance in the EMR

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s293
Author(s):  
Alexandria May ◽  
Allison Hester ◽  
Kristi Quairoli ◽  
Sheetal Kandiah
Keyword(s):  
Primary Care ◽  
Retrospective Chart Review ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Targeted Interventions ◽  
Primary Care Clinics ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Background: According to the CDC Core Elements of Outpatient Stewardship, the first step in optimizing outpatient antibiotic use the identification of high-priority conditions in which antibiotics are commonly used inappropriately. Azithromycin is a broad-spectrum antimicrobial commonly used inappropriately in clinical practice for nonspecific upper respiratory infections (URIs). In 2017, a medication use evaluation at Grady Health System (GHS) revealed that 81.4% of outpatient azithromycin prescriptions were inappropriate. In an attempt to optimize outpatient azithromycin prescribing at GHS, a tool was designed to direct the prescriber toward evidence-based therapy; it was implemented in the electronic medical record (EMR) in January 2019. Objective: We evaluated the effect of this tool on the rate of inappropriate azithromycin prescribing, with the goal of identifying where interventions to improve prescribing are most needed and to measure progress. Methods: This retrospective chart review of adult patients prescribed oral azithromycin was conducted in 9 primary care clinics at GHS between February 1, 2019, and April 30, 2019, to compare data with that already collected over a 6-month period in 2017 before implementation of the antibiotic prescribing guidance tool. The primary outcome of this study was the change in the rate of inappropriate azithromycin prescribing before and after guidance tool implementation. Appropriateness was based on GHS internal guidelines and national guidelines. Inappropriate prescriptions were classified as inappropriate indication, unnecessary prescription, excessive or insufficient treatment duration, and/or incorrect drug. Results: Of the 560 azithromycin prescriptions identified during the study period, 263 prescriptions were included in the analysis. Overall, 181 (68.8%) of azithromycin prescriptions were considered inappropriate, representing a 12.4% reduction in the primary composite outcome of inappropriate azithromycin prescriptions. Bronchitis and unspecified upper respiratory tract infections (URI) were the most common indications where azithromycin was considered inappropriate. Attending physicians prescribed more inappropriate azithromycin prescriptions (78.1%) than resident physicians (37.0%) or midlevel providers (37.0%). Also, 76% of azithromycin prescriptions from nonacademic clinics were considered inappropriate, compared with 46% from academic clinics. Conclusions: Implementation of a provider guidance tool in the EMR lead to a reduction in the percentage of inappropriate outpatient azithromycin prescriptions. Future targeted interventions and stewardship initiatives are needed to achieve the stewardship program’s goal of reducing inappropriate outpatient azithromycin prescriptions by 20% by 1 year after implementation.Funding: NoneDisclosures: None

scholarly journals Intervention with educational outreach at large scale to reduce antibiotics for respiratory tract infections: a controlled before and after study

2009 ◽  
Vol 26 (3) ◽  
pp. 183-187 ◽  
Author(s):  
H. Smeets ◽  
M. Kuyvenhoven ◽  
A. Akkerman ◽  
I Welschen ◽  
G. Schouten ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Large Scale ◽  
Educational Outreach ◽  
Before And After ◽  
Tract Infections ◽  
Before And After Study

scholarly journals KEDUDUKAN DAN TANGGUNGJAWAB PRESIDEN DALAM SISTEM PRESIDENSIAL DI INDONESIA

2018 ◽  
Vol 2 (2) ◽  
pp. 173-190
Author(s):  
Moh Hudi
Keyword(s):  
Rule Of Law ◽  
Chief Executive ◽  
The Rule Of Law ◽  
The People ◽  
Head Of State ◽  
Presidential System ◽  
Before And After ◽  
The Government ◽  
Head Of Government

The Government system greatly determines the position and responsibility of the president. Even in the same system of government, the president’s position and responsibility may change, depending  on   The  Rule  of   Law  in a particular country. The position and responsibility of the president in the presidential system in Indonesia has change several times. This can be seen before and after the amandement. President in presidential   System   as  Head  of  Government  and   Head  of   State. So that the president has broad authority. The president is not responsible to the parliament, because institutionally the parliament is not higher than the president as the chief executive, but is responsible to the people as voters.

scholarly journals Pemanfaatan bahan baku lokal dalam pengembangan wisata Pulau Cinta di Desa Teluk Kenidai Kecamatan Tambang Kabupaten Kampar Provinsi Riau

2020 ◽  
Vol 2 ◽  
pp. 38-43
Author(s):  
Trisla Warningsih ◽  
Kusai Kusai ◽  
Lamun Bathara ◽  
Andarini Diharmi ◽  
Deviasari Deviasari
Keyword(s):  
Natural Resources ◽  
Community Service ◽  
Added Value ◽  
Tourist Destinations ◽  
The People ◽  
Hands On ◽  
Before And After ◽  
Opening Up ◽  
Additional Income ◽  
Very High

Teluk Kenidai Village is located in Tambang District, Kampar Regency, Riau Province. Teluk Kenidai Village has the potential for natural tourism in the form of beaches, which are one of the alternative tourist destinations for the community. The activities carried out are playing various kinds of rides and swimming on the banks of the Kampar River. The visitors to the island of love in Kenidai Bay are the largest visitors of all tourist objects in Kampar Regency. The existence of the island of love tourism can develop the community's economy by providing special foods as souvenirs and drinks for tourist visitors. Alternative foods that can be done are processed crispy monitor fish and lime syrup drinks because these two things have very high potential in Kampar Regency, and can provide added value to people's lives. The purpose of the activity is to empower the people of Teluk Kenidai Village, to process various crispy monitoring fish and to increase the attractiveness of the island of love for visiting tourists. The benefits of the activity are opening up people's insights in increasing the potential of natural resources, gaining skills and abilities in making crispy monitor fish and lime syrup to improve the economy. The method is carried out by demonstration and hands-on practice in the manufacture of crispy monitoring fish and lime syrup. The target communities are the people living in Teluk Kenidai Village and village customary leaders and the Tourism Awareness Group (Pokdarwis) totaling 15 people. Evaluation is carried out by giving questionnaires to all participats before and after the delivery of counseling materials and practices. The results of the evaluation of the community service activities that have been carried out show that the increasing desire of the community in practicing extension activities to earn additional income by opening this bussines, especially in the tourist area of Pulau Cinta in Teluk Kenidai Village.

scholarly journals Impact of Internal Political-Military Crisis on Feeling of Insecurity: Case of Abidjan Metropolis

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Daboné Inoussa
Keyword(s):  
Bad Faith ◽  
Center Stage ◽  
The People ◽  
Before And After ◽  
Experimental Plan

Some experiences of violence directly or indirectly lived by the population during the Ivorian political-military crisis, helped put center stage the issue of the feeling of insecurity, particularly in Abidjan. This work addresses the question of crisis’ impact by comparing the before and after crisis feelings of insecurity. From 354 individuals surveyed before the crisis 93 were re-interviewed during an after crisis investigation. The sample was built according to an experimental plan of eight groups and interviewed by means of a multidimensional questionnaire. Results indicate an increase of after crisis feeling of insecurity as well as a rise of “bad faith of the people” and “Ineffectiveness of the judiciary” among the perceived main elements of insecurity.

scholarly journals DAMPAK PEMBANGUNAN PEMBANGKIT LISTRIK TENAGA UAP (PLTU) TANJUNG JATI B TERHADAP PERUBAHAN MATA PENCAHARIAN DAN TINGKAT PENDAPATAN (Desa Tubanan Kecamatan Kembang Kabupaten Jepara)

2020 ◽  
Vol 5 (2) ◽  
pp. 155-164
Author(s):  
Ayuuk Nooraliza ◽  
Rudi Salam
Keyword(s):  
Power Plant ◽  
Steam Power ◽  
Income Levels ◽  
Steam Power Plant ◽  
The People ◽  
Before And After ◽  
Negative Impacts

Tanjung Jati B Steam Power Plant (PLTU) is a power plant located in Tubanan Village, Kembang District, Jepara Regency. The existence of the PLTU construction causes various impacts on the surrounding community, such as changes in livelihoods and income levels. This article aims to 1) Describe the livelihoods of the people of Tubanan Village before and after the construction of PLTU Tanjung Jati B, 2) Describe the level of income of the people of Tubanan Village before and after the construction of PLTU Tanjung Jati B, (3) to describe the impacts caused by the existence of development of PLTU Tanjung Jati B. The results of this study found that 1) There were changes in livelihoods due to the construction of PLTU Tanjung Jati B such as housewives becoming parking guards, 2) Increased income of the people of Tubanan Village, 3) There were positive and negative impacts felt by the people of Tubanan Village. Pembangkit Listrik Tenaga Uap (PLTU) Tanjung Jati B merupakan salah satu pembangkit listrik yang berada di Desa Tubanan Kecamatan Kembang Kabupaten Jepara. Adanya pembangunan PLTU menyebabkan berbagai dampak terhadap masyarakat sekitar seperti perubahan mata pencaharian dan tingkat pendapatan. Artikel ini bertujuan untuk 1) Mendeskripsikan mata pencaharian masyarakat Desa Tubanan sebelum dan sesudah adanya pembangunan PLTU Tanjung Jati B, 2) Mendeskripsikan tingkat pendapatan masyarakat Desa Tubanan sebelum dan sesudah adanya pembangunan PLTU Tanjung Jati B, (3) untuk mendeskripsikan dampak yang diakibatkan oleh adanya pembangunan PLTU Tanjung Jati B. Hasil penelitian ini menemukan bahwa 1) Adanya perubahan mata pencaharian akibat pembangunan PLTU Tanjung Jati B, 2) Peningkatan pendapatan masyarakat Desa Tubanan, 3) Adanya dampak positif dan dampak negatif yang dirasakan oleh masyarakat Desa Tubanan.

scholarly journals Using a Foreign Language Changes Medical Judgments of Preventative Care

2021 ◽  
Vol 11 (10) ◽  
pp. 1309
Author(s):  
Sayuri Hayakawa ◽  
Yue Pan ◽  
Viorica Marian
Keyword(s):  
Adverse Effects ◽  
Foreign Language ◽  
Native Language ◽  
Medical Condition ◽  
Preventative Care ◽  
Preventative Treatment ◽  
Disease Symptoms ◽  
Treatment Side Effects ◽  
Risk Of Disease ◽  
Native Tongue

Every day, multilinguals around the world make important healthcare decisions while using a foreign language. The present study examined how the use of a native vs. non-native language shapes evaluations and decisions about preventative care. Bilinguals were randomly assigned to evaluate a series of medical scenarios in either their native or non-native language. Each scenario described potential adverse effects of a medical condition and a preventative treatment, as well as the population risk of disease- or treatment-related complications. Participants judged the perceived negativity and likelihood of experiencing adverse effects and indicated how willing they would be to accept the preventative treatment. We found that bilinguals using a foreign language perceived disease symptoms and treatment side effects to be less negative than those using their native tongue. Foreign language users were also more likely to account for the objective risks associated with medical conditions and treatments when making decisions about preventative care. We conclude that the use of a native vs. foreign language changes how people evaluate the consequences of accepting and declining preventative treatment, with potential implications for millions of providers and patients who routinely make medical choices in their non-native tongue.

scholarly journals Prolonged Evolution of Virus-Specific Memory T Cell Immunity after Severe Avian Influenza A (H7N9) Virus Infection

2018 ◽  
Vol 92 (17) ◽  
Author(s):  
Min Zhao ◽  
Junbo Chen ◽  
Shuguang Tan ◽  
Tao Dong ◽  
Hui Jiang ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Avian Influenza ◽  
Influenza A ◽  
T Cell Immunity ◽  
H7n9 Virus ◽  
Specific Memory ◽  
Cell Immunity ◽  
H7n9 Infection ◽  
Over Time

ABSTRACT Since 2013, influenza A H7N9 virus has emerged as the most common avian influenza virus subtype causing human infection, and it is associated with a high fatality risk. However, the characteristics of immune memory in patients who have recovered from H7N9 infection are not well understood. We assembled a cohort of 45 H7N9 survivors followed for up to 15 months after infection. Humoral and cellular immune responses were analyzed in sequential samples obtained at 1.5 to 4 months, 6 to 8 months, and 12 to 15 months postinfection. H7N9-specific antibody concentrations declined over time, and protective antibodies persisted longer in severely ill patients admitted to the intensive care unit (ICU) and patients presenting with acute respiratory distress syndrome (ARDS) than in patients with mild disease. Frequencies of virus-specific gamma interferon (IFN-γ)-secreting T cells were lower in critically ill patients requiring ventilation than in patients without ventilation within 4 months after infection. The percentages of H7N9-specific IFN-γ-secreting T cells tended to increase over time in patients ≥60 years or in critically ill patients requiring ventilation. Elevated levels of antigen-specific CD8+ T cells expressing the lung-homing marker CD49a were observed at 6 to 8 months after H7N9 infection compared to those in samples obtained at 1.5 to 4 months. Our findings indicate the prolonged reconstruction and evolution of virus-specific T cell immunity in older or critically ill patients and have implications for T cell-directed immunization strategies. IMPORTANCE Avian influenza A H7N9 virus remains a major threat to public health. However, no previous studies have determined the characteristics and dynamics of virus-specific T cell immune memory in patients who have recovered from H7N9 infection. Our findings showed that establishment of H7N9-specific T cell memory after H7N9 infection was prolonged in older and severely affected patients. Severely ill patients mounted lower T cell responses in the first 4 months after infection, while T cell responses tended to increase over time in older and severely ill patients. Higher levels of antigen-specific CD8+ T cells expressing the lung-homing marker CD49a were detected at 6 to 8 months after infection. Our results indicated a long-term impact of H7N9 infection on virus-specific memory T cells. These findings advance our understanding of the dynamics of virus-specific memory T cell immunity after H7N9 infection, which is relevant to the development of T cell-based universal influenza vaccines.

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