IgM-Immunofluorescence Test as a Diagnostic Tool for Epidemiologic Studies of Schistosomiasis in Low Endemic Areas

The high sensitivity and the ability to diagnose schistosomiasis in a very early phase after infection have indicated the detection of IgM antibodies to Schistosoma mansoni gut antigens by the immunofluorescence test (IgM-IFT) as a useful serological test for epidemiological studies in low endemic areas. When applied in a follow-up study for two years, higher rates of seroconversion from IFT negative to positive were observed during the summer months, suggesting seasonal transmission of schistosomiasis in the rural area of the municipality of Itariri (São Paulo, Brazil). In each survey, blood samples from about 600 schoolchildren were collected on filter paper and submitted to IgM-IFT. When the blood samples were classified for the IgM antibody levels, according to the intensity of fluorescent reaction observed at fluorescence microscopy, and correlated to the egg counts in the Kato-Katz positive patients, no association was observed. This observation might suggest that the intensity of fluorescence observed in the IgM-IFT, as an indicator of IgM antibody levels, could not be an useful seroepidemiological marker for classifying areas of low endemicity according to degrees of infection.

A Framework for Quality in Long-Term Residential Care for Older People in Ireland

The National Council on Ageing and Older People has long been concerned about the quality of long-term residential care for older people in Ireland. In 1986, its predecessor, the National Council for the Aged published “It’s Our Home”. The Quality of Life in Private and Voluntary Nursing Homes. In 1999 the Council commissioned a postal survey of all long-term residential care facilities in the country to determine whether facilities had quality initiatives in operation; providers’ views and aspirations for future provision of long-term care; providers’ views on the introduction of a national quality monitoring policy Download the Report here

Towards a Standardised Framework for Inter-Country Adoption - Report of the Implementation Group

The report contains Background to the commissioning of the Report â?~â?~Towards a Standardised Framework for Intercountry Adoption Assessment Proceduresâ?Tâ?T; the Government decision arising; and the principal findings and recommendations of the Report (Chapter 1); Detailed information on progress made in relation to the recommendations contained in the Report (Chapters 2-5); Statistical data in relation to intercountry adoption services at June, 2000 (Chapter 6); A summary of key findings of the Implementation Group (Chapter 7); and The Implementation Groupâ?Ts recommendations regarding the future of intercountry adoption services (Chapter 8). Download the Report here

Towards a Standardised Framework for Inter-Country Adoption - Assessment Procedures

In the first part the background on inter-country adoption and assessment of prospective adopters are considered in general terms in Chapters Two and Three respectively. The second chapter places the objectives of the research into context. Due to the declining numbers of children being put forward for domestic adoption, there is increasing recourse to inter-country adoption. An overview of the situation is outlined. The legislation section outlines both Irish legislation and the pivotal international agreement relevant to inter-country adoption, namely the Hague Convention. The implications for inter-country adoption processes are described Download the Report here

Test de sobrecarga acuosa y manometría de alta resolución para valoración de la resistencia al flujo esófago-gástrico en paciente s con acalasia

La manometría convencional es el “gold standard” para diagnosticar trastornos motores del esófago, pero la información que da sobre la repercusión funcional de estas alteraciones es escasa. La manometría de alta resolución permite estudiar con detalle la motilidad esofagogástrica mediante la generación de mapas topográficos de presiones desde la orofaringe hasta el estómago. Hipótesis: Si la generación de mapas topográficos de presiones en el esófago mediante manometría de alta resolución demuestra la resistencia al flujo esofagogástrico. Objetivo: Comprobar si un test con sobrecarga de agua puede mostrar la presencia de resistencia al flujo esofagogástrico en pacientes con acalasia. Método: Estudiamos 2 grupos de pacientes con alteración de la motilidad esofágica. Un grupo de 8 pacientes que cumplen criterios manométricos de acalasia y, como grupo control, 8 pacientes con disfunción del peristaltismo esofágico ( DPE). A cada paciente se le realizó un test de sobrecarga que consistía en la ingesta rápida de 200 ml de agua mientras se registraban las presiones esofágicas. Resultados: Los pacientes con acalasia ingirieron el agua más lentamente que los pacientes con DPE (82± 14 seg vs 34± 6 seg, p&0,05). Mientras la unión gastroesofágica (UGE) permaneció contraída en el grupo de pacientes con acalasia (46,6± 6 mm Hg; p&0,05), permaneció relajada durante el tiempo del ingesta en pacientes con DPE ( 16,6 ± 4,7 mm Hg). La unión esófago-gástrica (UGE) experimentó una migración proximal en pacientes con acalasia de 1,3 ± 0 cm mientras que en el grupo control no migró (0 cm; p&0,05). La ingesta de agua se asoció a un incremento de la presión del esófago distal (2 cm por encima de la UGE) significativamente mayor en los pacientes con acalasia que en los pacientes con DPE (42,2 ± 20 vs 9,5± 7,9 mm Hg respectivamente, p&0,05) lo que produjo un incremento del gradiente de presión esófago-gástrico en pacientes con acalasia (16± 0,9 mmHg) que no se observó en los pacientes con DPE (0,1 ± 0,4 mmHg ; p&0,05). Conclusión: Un test con sobrecarga de agua durante la medición de la topografía y de las presiones esofágicas demuestra obstrucción al flujo esofagogástrico en los pacientes con acalasia. Este test podría contribuir a valorar la repercusión funcional en pacientes con acalasia y podría servir para el seguimiento de pacientes con acalasia tratados.

Immunogenicity test of tetanus component in adsorbed vaccines by toxin binding inhibition test

Samples from 20 lots of diphtheria-tetanus (adult use dT) vaccine and from 20 lots of diphtheria-tetanus-pertussis (DTP) vaccine were used to standardize and validate the in vitro toxin binding inhibition (ToBI) test for the immunogenicity test of the tetanus component. The levels of tetanus antitoxin obtained by ToBI test were compared to those obtained using the toxin neutralization (TN) test in mice routinely employed to perform the quality control of the tetanus component in adsorbed vaccines. The results ranged from 1.8 to 3.5 IU/ml for dT and 2 to 4 IU/ml for DTP by ToBI test and 1.4 to 3 IU/ml for dT and 1.8 to 3.5 IU/ml for DTP by TN in mice. These results were significantly correlated. From this study, it is concluded that the ToBI test is an alternative to the in vivo neutralization procedure in the immunogenicity test of the tetanus component in adsorbed vaccines. A substantial refinement and a reduction in use of animals can be achieved.

Evaluation of the direct agglutination test and the rK39 dipstick test for the sero-diagnosis of visceral leishmaniasis

The direct agglutination test (DAT) based on a freeze-dried antigen and the rK39 dipstick test were evaluated for the sero-diagnosis of visceral leishmaniasis (VL). The sensitivity and specificity of both tests were determined using sera from confirmed VL patients (n = 21), healthy controls (n = 19) and from patients with other confirmed infectious diseases (n = 42). The DAT had a sensitivity and a specificity of 100%. The rK39 had a sensitivity of 85.7% and a specificity of 82%. Both tests were also used to screen blood samples of confirmed VL patients (n = 15) and serum samples of VL suspects (n = 61). The DAT found all blood samples of confirmed VL patients positive and tested 98.4% of the serum samples of the VL suspects positive. In contrast, rK39 detected in 9/15 blood samples (60%) antibodies against Leishmania chagasi and found 85.3% of the serum samples of the suspected patients positive. Although the rK39 dipstick is more rapid and user friendlier than the DAT, the latter has a superior sensitivity and specificity. Furthermore, the reagents used for DAT do not require cold storage, whereas the buffer of the rK39 must be stored at 4ºC. Therefore, the DAT is the most suitable test for the sero-diagnosis of VL under field conditions.

Where will conflicts between alien and rare species occur after climate and land-use change? A test with a novel combined modelling approach

Protecting native biodiversity against alien invasive species requires powerful methods to anticipate these invasions and to protect native species assumed to be at risk. Here, we describe how species distribution models (SDMs) can be used to identify areas predicted as suitable for rare native species and also predicted as highly susceptible to invasion by alien species, at present and under future climate and land-use scenarios. To assess the condition and dynamics of such conflicts, we developed a combined predictive modelling (CPM) approach, which predicts species distributions by combining two SDMs fitted using subsets of predictors classified as acting at either regional or local scales. We illustrate the CPM approach for an alien invader and a rare species associated to similar habitats in northwest Portugal. Combined models predict a wider variety of potential species responses, providing more informative projections of species distributions and future dynamics than traditional, non-combined models. They also provide more informative insight regarding current and future rare-invasive conflict areas. For our studied species, conflict areas of highest conservation relevance are predicted to decrease over the next decade, supporting previous reports that some invasive species may contract their geographic range and impact due to climate change. More generally, our results highlight the more informative character of the combined approach to address practical issues in conservation and management programs, especially those aimed at mitigating the impact of invasive plants, land-use and climate changes in sensitive regions

Comparison of the clientele of an anonymous HIV test centre and persons tested in the general population.

This study compares the clientele of a Swiss anonymous test centre with the general population tested. Information was obtained through similar questionnaires submitted to two samples of HIV-tested people aged from 17 to 45 years: the first administered in the context of a general population telephone survey (n = 245) and the second completed during face-to-face interviews of the clientele of an anonymous test centre (n = 250). The test centre sample has higher proportions of younger and single people. Attenders for anonymous testing were more likely to have acquired a new regular partner during the year preceding the interview (48.0% versus 14.4%). These differences remain when controlling for age and gender. Decision to test comes mostly from the respondent's own initiative, but suggestion from a doctor is more frequent in the general population (23.8% versus 0.8%), whereas suggestion from partner or friends is more frequent in the anonymous centre (44.4% versus 3.0%). The anonymous test centre clientele is not different from the general population tested except for the relational situation and origin of decision for testing. The test centre has become a place where the general population finds a response to a situation-specific need for HIV testing.

A Framework for Major Emergency Management

Major emergency management is a key challenge and a priority issue for Government. Clearly, the world in which we live is constantly changing and we need to develop our major emergency management architecture to enable us to deal effectively with the possibility of new risks and threats. In the last few years most European Countries have engaged in review and development of their major emergency or civil protection arrangements. This new Framework for Major Emergency Management moves in line with international trends in this field. Read the document (PDF, 1.9mb) Read the Appendices document (PDF, 1.3mb) A series of additional Framework Guidance Documents designed to support specific areas of major emergency management are currently under development. These documents will initially be posted here as Working Drafts for comment by practitioners involved in the implementation process. The first two guides: A Guide to Risk Assessment in Major Emergency Management and A Guide to Preparing a Major Emergency Plan are now available and further guides will emerge at intervals during the development programme. A Guide to Risk Assessment in Major Emergency Management (PDF, 387kb) A Guide to Preparing a Major Emergency Plan (PDF, 158kb)

Framework for Corporate and Financial Governance for Regulatory Bodies under the aegis of the Department of Health and Children

The document should be read as supplementary to existing requirements as set out both in statute â?" particularly legislation specific to your organisation, the Health Acts 1947-2004, Ombudsman Act, 1980, Data Protection Acts 1988 & 2003, Freedom of Information Acts 1997-2003, Ethics in Public Office Acts 1995 & 2001, Ombudsman for Children Act, 2002 and the Comptroller and Auditor General (Amendment) Act, 1993 – and in Government approved guidelines, including the Code of Practice for the Governance of State Bodies (2001), Public Financial Procedures, The Role and Responsibilities of Accounting Officers (2003) and Risk Management Guidance for Government Departments and Offices (2004). Read the report (PDF, 1.4mb)  

Framework for Corporate and Financial Governance for Agencies funded by the Department of Health and Children

Corporate governance is the system by which organisations direct and control their functions and relate to their stakeholders in order to manage their business, achieve their mission and objectives and meet the necessary standards of accountability, integrity and propriety. It is a key element in improving efficiency and accountability as well as enhancing openness and transparency. A significant element of the Governmentâ?Ts programme for health service reform is the strengthening of governance and accountability arrangements across the health system. Read the Report (PDF, 1mb)

Tackling Chronic Disease - A Policy Framework for the Management of Chronic Diseases

Tackling Chronic Disease – A Policy Framework for the Management of Chronic Diseases Chronic diseases are recognised as a major health challenge. In the healthcare system, they represent the major component of service activity and expenditure, as well as the major contributor to mortality and ill-health in this country. Given the population projections which predict a doubling of the elderly population over the next 30 years, this will give rise to a significant increase in chronic diseases with the consequent burden on society, the healthcare system and individuals. Click here to download PDF 1.8mb

A Review Of Practice Development In Nursing And Midwifery In The Republic Of Ireland And The Development Of A Strategic Framework

A Review Of Practice Development In Nursing And Midwifery In The Republic Of Ireland And The Development Of A Strategic Framework Click here to download PDF 1.52MB