Improving the safety and security of the pharmaceutical supply chain

This paper discusses various techniques that may be used to combat counterfeiting in the pharmaceutical supply chain. These include the use of electronic pedigrees (to ensure the integrity of the supply chain), together with mass-serialization (to provide for a unique lifecycle history of each individual package) and authentication of the product (to check for any discrepancies in the various attributes of the product and its packaging are as intended for that individual package). Management of the pedigree process and product authentication is discussed in some detail, together with various other learnings from the Drug Security Network, including identification of some remaining vulnerabilities and suggestions for tightening these loopholes. © 2008 Springer-Verlag Berlin Heidelberg.

Safety of tetanus toxoid in pregnant women: A hospital-based case-control study of congenital anomalies

Reported are the results of the Latin American Collaborative Study of Congenital Malformations (ECLAMC), a hospital-based case-control study of 34 293 malformed and 34 477 matched nonmalformed newborn controls. No statistical differences were found between the malformed and control groups, exposed or not exposed to tetanus toroid.

注意对驾驶场景客体-位置联系内隐学习的影响

The purpose of this study is to investigate the influence of attention resourse requirement and allocation on implicit memory and explicit memory for object-location associations in driving situation based on Adams theory on the function of implicit knowledge in the Situation Awareness(SA). This study adopted Musen’s implicit learning of object-location associations, sysmemtly manipulated the type and difficuty of the naming task. This research includes three studies and ten experiments. Their aim are separately to explore the influence of attention on implicit and explicit memory for object-loction assocaitons in simple stimulus and the driving situation. And it is needed to confirme the condition and the influencing factors of implicit memory for car-location association in different condition. It is also our aim to explore the feasibility of introduce of implicit learning methods in SA measurement. The results indicted that: ⑴ The influence of attention resourse allocation ,the difficulty of naming task , the deepness of processing on on implicit memory for object-location associations in driving situation are different . the dissociated results support the standpoint that there are two independent knowledge system; ⑵ The type of naming task more influenced the implicit and explicit memory for object-location associations than the difficulty of the naming task. The attention resourse requirement of the different type can not be compared; ⑶ The implicit memory seldom appears in the location naming task resulted from the defiency of processing on object-location association, and not as a results of the overtaxed; ⑷ The reaction time methods in the implicit learning could be used in SA measurement , it is a complementarity of the existing explicit SA measurement. These findings not only contribute to resolve ongoing debates about the process of cognition and mechanism of SA structure, but also have significant practical application in traffic safety.

Processamento mínimo de mandioquinha-salsa.

Escolha da matéria prima e cuidados no pré-processamento; Seleção da matéria-prima; Pré-lavagem; Processamento; Enxágue 1; Sanitização; Enxágue 2; Centrifugação; Embalagem; Armazenamento; Comercialização.

Avaliação de acessos do banco de germoplasma de mandioquinha-salsa da Embrapa Hortaliças para resistência a Meloidogyne spp. no campo.

2007

Nematoides na cultura da mandioquinha-salsa

Esta Circular Técnica tem como objetivos descrever os principais aspectos relacionados ao nematoide-das-galhas e nematoide-das-lesõesradiculares, como etiologia, sintomas, ciclo de vida e as principais medidas de controle recomendadas para o manejo correto destes microrganismos em áreas de cultivo de mandioquinha-salsa.

Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature

Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL PEDro, SportDiscus, CINAHL, LILACS (June 2013). the primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. the methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. the risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). the limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews. (C) 2014 Elsevier B.V. All rights reserved.

Development of process control methodology for tracking the quality and safety of pain, agitation and sedation management in critical care units

Objective: To develop sedation, pain, and agitation quality measures using process control methodology and evaluate their properties in clinical practice. Design: A Sedation Quality Assessment Tool was developed and validated to capture data for 12-hour periods of nursing care. Domains included pain/discomfort and sedation-agitation behaviors; sedative, analgesic, and neuromuscular blocking drug administration; ventilation status; and conditions potentially justifying deep sedation. Predefined sedation-related adverse events were recorded daily. Using an iterative process, algorithms were developed to describe the proportion of care periods with poor limb relaxation, poor ventilator synchronization, unnecessary deep sedation, agitation, and an overall optimum sedation metric. Proportion charts described processes over time (2 monthly intervals) for each ICU. The numbers of patients treated between sedation-related adverse events were described with G charts. Automated algorithms generated charts for 12 months of sequential data. Mean values for each process were calculated, and variation within and between ICUs explored qualitatively. Setting: Eight Scottish ICUs over a 12-month period. Patients: Mechanically ventilated patients. Interventions: None. Measurements and Main Results: The Sedation Quality Assessment Tool agitation-sedation domains correlated with the Richmond Sedation Agitation Scale score (Spearman [rho] = 0.75) and were reliable in clinician-clinician (weighted kappa; [kappa] = 0.66) and clinician-researcher ([kappa] = 0.82) comparisons. The limb movement domain had fair correlation with Behavioral Pain Scale ([rho] = 0.24) and was reliable in clinician-clinician ([kappa] = 0.58) and clinician-researcher ([kappa] = 0.45) comparisons. Ventilator synchronization correlated with Behavioral Pain Scale ([rho] = 0.54), and reliability in clinician-clinician ([kappa] = 0.29) and clinician-researcher ([kappa] = 0.42) comparisons was fair-moderate. Eight hundred twenty-five patients were enrolled (range, 59-235 across ICUs), providing 12,385 care periods for evaluation (range 655-3,481 across ICUs). The mean proportion of care periods with each quality metric varied between ICUs: excessive sedation 12-38%; agitation 4-17%; poor relaxation 13-21%; poor ventilator synchronization 8-17%; and overall optimum sedation 45-70%. Mean adverse event intervals ranged from 1.5 to 10.3 patients treated. The quality measures appeared relatively stable during the observation period. Conclusions: Process control methodology can be used to simultaneously monitor multiple aspects of pain-sedation-agitation management within ICUs. Variation within and between ICUs could be used as triggers to explore practice variation, improve quality, and monitor this over time

Combining Functional and Structural Reasoning for Safety Analysis of Electrical Designs

C.J.Price, D.R.Pugh, N.A.Snooke, J.E.Hunt, M.S.Wilson, Combining Functional and Structural Reasoning for Safety Analysis of Electrical Designs, Knowledge Engineering Review, vol 12:3, pp.271-287, 1997.

A European Perspective on the Precautionary Principle, Food Safety and the Free Trade Imperative of the WTO

A European Perspective on the Precautionary Principle, Food Safety and the Free Trade Imperative of the WTO. European Law Review, Vol.27, No.2. April 2002, pp.138-155. RAE2008