Earlier Recommendation Research Articles

Modelling of optimal timing for influenza vaccination as a function of intraseasonal waning of immunity and vaccine coverage

The influenza season in Australia usually peaks in August. Vaccination is recommended beginning in March-April. Recent studies suggest that vaccine effectiveness may wane over a given influenza season, leading to reduced effectiveness at the peak of the season. We aimed to quantify how changes in timing of influenza vaccination and declining vaccine coverage could change the percentages of prevented cases.Results from a systematic review were used to inform calculation of a waning function over time from vaccination. Age specific notification data and vaccine effectiveness and coverage estimates from 2007 to 2016 (2009 influenza pandemic year excluded) were used to model a new notification series where vaccine effectiveness is shifted in time to account for delayed vaccination by month from March to August. A sensitivity analysis was done on possible vaccine coverage changes and considering time gap between vaccine uptake and recommendation.Delaying vaccination from March to end of May prevents more cases over a season, but the variation in cases prevented by month of vaccination is not large. If delaying vaccination results in missed or forgotten vaccination and decrease coverage, delaying vaccination could have a net negative impact. Furthermore, considering a time gap between recommendation and uptake, earlier recommendation is more effective in preventing cases. The results are sensitive to assumptions of intra-seasonal waning of effectiveness. More research is required on intra-seasonal vaccine effectiveness waning and the effect of delayed vaccination on overall uptake to inform any potential changes to current vaccine scheduling recommendations.

English

Appropriate spacing enables the farmers to keep appropriate plant population in the field. Hence, it can avoid over or less population in a given plot of land which has negative effect on yield and quality of onion. Spacing of 40 × 20 × 10 cm between furrow, row and plants, respectively has been used for onion production in Ethiopia. But producers complain 10 cm intra row spacing produces large bulb size which is not preferred by consumer for home consumption. To optimize onion productivity, full package of information is required. To fill this gap field experiment was conducted to study the effect of inter and intra row spacing on the bulb yield and yield components of onion at Ribb in Fogera, Woramit in Bahir Dar and Koga in Mecha districts in 2014. The interaction of the lowest inter and intra row spacing mature earlier by 15 days compared to highest inter and intra row spacing. Forty nine percent of medium sized bulbs were produced with the interaction of 15 and 6 cm inter and intra row spacing while only 32% of medium sized bulbs were produced by the interaction of 25 and 8 cm inter and intra row spacing. Small sized bulb distribution decreased as intra row spacing increased while large bulb sized distribution increased when intra row spacing increased. The highest bulb weight (102 g) was produced by the interaction of highest inter and intra row spacing while the lowest bulb weight (45 g) was produced by the lowest inter and intra row spacing. Interaction of inter and intra row spacing of 15 and 4 cm respectively, scored the 1st highest marketable bulb yield (39 ton ha-1) and interaction of 15 and 6 cm inter and intra row spacing scored the 2st highest marketable bulb yield (36 ton ha-1). The result revealed that the earlier recommendation (20 and 10 cm inter and intra row spacing) produced more number of medium and large sized bulbs with a yield penalty of 8.0 and 10 ton per ha-1 compared to interaction of inter row spacing of 15 cm with intra row spacing of 6 and 4 cm, respectively. Therefore, the interaction of inter and intra row spacing of 15 with 6 cm is recommended as a first option for producers who wishes to produce maximum bulb yield with maximum medium sized bulbs. It is also confirmed that earlier recommendation is better as a second option for producers who wishes to produce for export market which requires medium and large sized bulbs of onion. Key words: Onion, inter, intra, spacing, bulb, yield.

Child Labour and the Global Economy: Abolition or Acceptance?

This article traces the evolution of international attitudes toward child labour, and outlines its relationship to the global economy. It examines the way in which international treaties promulgated by the International Labor Organization (ilo) have conceived of child labour over time. At the national level, the most extreme pro-child labour position may be found in recent Bolivian legislation that recognizes work performed by children as young as ten years old. Much has been written on the problem of conflicting global values on child labour, but all agree that exploitative forms should be eliminated. The author updates her earlier recommendation that the World Trade Organization should place conditions on participation in the global economy by requiring its member states to honour core ilo standards. Eliminating exploitative child labour could thus be linked indirectly to the global economy, by requiring the elimination of children’s work detrimental to the child’s full development.

PTH-211 Improving standards of care for patients receiving total parental nutrition (tpn) at a district general hospital. a completed audit cycle: Abstract PTH-211 Table 1

<h3>Introduction</h3> Total parenteral nutrition (TPN) is an invasive feeding method, with stringent indications due to higher associated cost and morbidity. The National Confidentiality Enquiry into Patient Outcome and Death (NCEPOD) review – A Mixed Bag,¹identified good clinical practice in only 19% of patients receiving TPN as recently as 2010. We present improvements in standards of care for patients receiving TPN, which were found on completion of an audit cycle at our institution. <h3>Method</h3> Retrospective data collection was undertaken on all patients receiving TPN from December 2013–January 2014 at The Countess of Chester Hospital (Audit 2). This was compared to the same dataset extracted from November 2010–February 2011 (Audit 1). NCEPOD¹and NICE²guidance recommendations were used as gold standards. <h3>Results</h3> Over the 13 month period, 64 patients received TPN. The median age was 68 (range 23–89); male:female ratio 1.5:1. Median duration of TPN was 8 days (range 1–144 days). TPN was commenced in level 1 care in 59.4% of cases; level 2/3 40.6%. 36 patients (56%) received TPN via a dedicated PICC line and 28 (44%) through a central line. Data comparison between audit 1 and 2 is tabulated below. <h3>Conclusion</h3> Early involvement and supervision by the nutrition support team remained at a high standard. Following earlier recommendation, major improvements were seen in the monitoring of daily bloods, obtaining central venous access, and documentation of weekly weight measurements. A multi-disciplinary electronic referral and assessment proforma is now being developed to enable NCEPOD targets to continue to be met. <h3>Disclosure of interest</h3> None Declared.

On-Farm Participatory Technology Development Effects on Resource Conservation Technologies in Rainfed Upland Paddy in Himachal Pradesh, India

Rice is a major cereal crop in Himachal Pradesh, a Himalayan state of India, where paddy acreage is about 78,000 ha with a low average yield of 19.62 q ha−1 due to rainfed upland farming. High seeding rates and poor resource-use efficiency of conventional fertilizer nitrogen (N) management practices in rainfed upland paddy have also been major production constraints in rainfed upland ecosystems. To validate and refine the production technology on seed rate and fertilizer N management, the Farm Science Centre, Sundernagar, India, conducted numerous on-farm trials (OFTs) during 2006–2010 under an on-farm participatory technology development approach to enhance resource use efficiency through these resource conservation technologies and boost the paddy productivity in the region. Results of two OFTs conducted during Kharif 2006 in the Mandi District of Himachal Pradesh on different seed rates under different sowing methods on VL Dhan-221 and Sukaradhan-1 (HPR-1156) cultivars suitable for rainfed upland conditions revealed that the seed rate at 80 kg ha−1 sown in rows 20 cm apart resulted in the greatest average paddy productivity to the tune of 25.6 q ha−1 besides greater profitability, followed by a seed rate at 60 kg ha−1 sown in rows 20 cm apart (25.2 q ha−1), over the earlier State Agricultural University (SAU)–recommended practice, that is, seed rate at 100 kg ha−1 in rows 20 cm apart. This refinement in the seed rate was accepted by the participating farmers of the region. The greatest average benefit/cost (B/C) ratio was observed in plots with seed rate at 60 kg ha−1 sown in rows 20 cm apart. Based on these results and data compilation from other locations of the state, now the SAU has refined the seed rate from earlier recommendation of 100 kg ha−1 to 60 kg ha−1 in rows 20 cm apart as well as 80 kg ha−1 through broadcast method under rainfed upland paddy in Himachal Pradesh. Results of two OFTs conducted during Kharif 2009 on integrated nutrient management in rainfed upland paddy revealed that farmyard manure (FYM) at 10 t ha−1 + nitrogen, phosphorus, and potassium (N, P, K) at 15:30:30 kg ha−1 at sowing followed by 15 kg N ha−1 15 days after sowing (DAS) and remaining the N [i.e., 30 kg N ha−1] at tillering (45–50 DAS) resulted in the greatest grain yield of 29.85 and 31.67 q ha−1 in VL Dhan-221 and HPR-1156, respectively, with respective greater yields of 35.99 and 36.51% over farmers’ practice, besides better profitability. To further standardize fertilizer N split doses and assess their effect on paddy productivity, another OFT was conducted during Kharif 2010 under rainfed upland paddy conditions in HPR-1156. The results revealed that NPK at 60:30:30 kg ha−1 (whole of P and K as basal, 50% N at 15 DAS, 25% N each at 45–50 DAS and 70–75 DAS splits) resulted in better grain yield (34.3 q ha−1) and net profitability (₹29,786 ha−1) over other treatments. Overall, it is concluded that these resource conservation technologies developed under the OFT participatory approach can enhance the rainfed upland paddy productivity and strongly show that there is dire need to split the N requirement of rainfed upland paddy in 2–3 splits to reduce the fertilizer N losses, enhance resource-use efficiency, and increase productivity and profitability in Himachal Pradesh, India.

British HIV Association guidelines for the management ofHIVinfection in pregnant women 2012

British HIV Association guidelines for the management of<scp>HIV</scp>infection in pregnant women 2012

Zidovudine monotherapy in pregnancy: is it state of the art?

Sir, In their editorial ‘Zidovudine monotherapy in pregnancy: is it state of the art?’ Katzenstein and Gerstoft [1] suggest that the inclusion of zidovudine monotherapy (ZDVm) in the latest version of the British HIV Association (BHIVA) guidelines [2] for the management of HIV in pregnancy might be ‘a remnant from an earlier recommendation that has not been formally disqualified by clinical studies’. We would suggest that there is a more positive case and here consider their four aims of antiretroviral (ARV) therapy in pregnancy in this light.

Discrepancies between qualitative and quantitative analysis of cerebrospinal fluid IgG: densitometric comparison of nephelometry-silver versus immuno-enzymes

Detection of local synthesis of IgG within the central nervous system is important for the diagnosis of brain inflammatory diseases such as multiple sclerosis. This is typically done by comparing the amounts of IgG in serum and parallel cerebrospinal fluid (CSF). Although there have been well-described problems with qualitative versus quantitative measurements of abnormal IgG, such as in myeloma paraproteins, similar difficulties are also found with CSF IgG. Traditional quantitative analysis of IgG by rate nephelometry was followed by separation of the IgG using isoelectric focusing and then either silver stain or immunofixation. Finally, quantitative analysis was performed by scanning densitometry using public domain software downloaded from the National Institutes of Health. We report here the major discrepancies that can occur with CSF IgG between the silver stain versus the IgG stain. We concur with the earlier recommendation that qualitative separation followed by densitometric estimation of enzyme-linked immunofixation is also more useful than simple quantitative nephelometric analysis followed by silver staining in the detection of local synthesis of IgG, analogous to the earlier work on paraproteins.

Current status and future prospects of the Global Lymphatic Filariasis Programme.

Lymphatic filariasis is recognized as one of the world's most disabling diseases. Adult lymphatic filarial nematodes live for several years; they infest the lymphatic and blood systems, and are transmitted via mosquito vectors. Acute and chronic disease can develop, manifesting as acute inflammation, hydrocoele, lymphoedema and elephantiasis. The development of a global programme for the elimination of lymphatic filariasis (focusing on disease caused by Wuchereria bancrofti) followed a resolution by the World Health Assembly in 1997 that endemic countries should develop programmes to eliminate lymphatic filariasis as a public health problem. This developed from an earlier recommendation by the International Task Force for Disease Eradication in 1993 that lymphatic filariasis was one of six diseases that could, in theory, be eradicated. Herein we review the current status and future prospects of the Global Lymphatic Filariasis Programme, which was launched in 2000.

Preventing lead toxicosis of European waterfowl by regulatory and non-regulatory means

SummaryMany years of waterfowl hunting have added thousands of tonnes of lead shot to European wetlands. Effective and non-toxic substitutes for lead shot have been developed and are commercially available throughout Europe, but few nations (Denmark, Finland, Norway and the Netherlands) have statutory requirements for their use. Governments can induce hunters to use non-toxic shot by regulatory measures and/or non-regulatory steps, but economic incentives to increase the affordability of lead-free shot have never been used by any nation and might be politically inappropriate. Educational programmes to increase the hunting public's understanding of the poisoning problem, and to provide accurate information on the non-toxic shot, are the best long-term way for governments to focus their spending and induce change, whether on a voluntary or regulated basis. Each of the six nations which has moved to end lead poisoning of waterfowl has adopted a regulatory approach, but these nations have acted independently of each other, and yet the use of non-toxic shot should apply to all countries of a flyway.Several European treaty and policy precedents could form the basis of a pan-European regulation requiring the use of non-toxic shot. A proposal to eliminate the use of lead shot in wetlands has been made under the Bonn and Bern Conventions. An European Union-USA proposal to reduce the use of different categories of lead under an Organization of Economic Cooperation and Development Council Act has been made, but has deleted an earlier recommendation that lead shot be included. The substitution of lead shot by nontoxic alternatives is also consistent with the European Council Directive on the Conservation of Wild Birds of 1979. The passing of a European Council regulation, stipulating the minimal acceptable standards for shot used for waterfowl hunting, is seen as the most effective way to remediate this transboundary toxic problem. This type of action by the European Union, while recognizing the Principle of Subsidiarity, would still allow other member states to enact more rigorous legislation pertaining to the use of lead shot within their jurisdiction, as have Denmark and the Netherlands. Although responsibility to enact and enforce a European Council regulation is the prerogative of each member state, a single regulation would promote consistency of action amongst all states.

Quantification of Gallium-67 Citrate in Breast Milk

A woman, 6 months postpartum and nursing her child, had a Ga-67 scintigram. A sample of breast milk obtained at day 2 revealed 2.8% of the injected dose (ID) per liter. The percent ID/L was compared with literature values; the highest concentration was in a report of galactorrhea. Similarity of the gallate ion to phosphate, as a possible explanation for accumulation in the breast, was pointed out. An earlier recommendation that a patient given Ga-67 citrate should discontinue breast feeding for at least 2 weeks was re-examined.

FDA Committee: No Support for Pill-Breast Cancer Link, But Cervical Cancer Connection More Ambiguous

This article highlights the deliberations of the US Food and Drug Administration (FDA) on the link between oral contraceptive (OC) use and both breast cancer and cervical cancer. The FDA Committee rejected the recent finding that longterm use by young women of high-potency progestogens can cause breast cancer; it urged however that OC users receive annual breast examinations. Subsequent studies have failed to detect an increased risk of breast cancer among OC users either overall or in relation to particular types of OCs or particular ages at use. The Committee reaffirmed an earlier recommendation for changes in OC package inserts including removal of a warning that women with a strong family history of breast cancer avoid OC use. On the other hand the FDA indicated concern about a possible link between prolonged OC use and cervical cancer. Further research in this area with rigorous controls for possible confounding factors such as sexual activity is needed to resolve ambiguities in current research findings. Although the increased risk of developing cervical intraepithelial neoplasia observed among OC users may be due to differences in sexual exposure between users and nonusers the Committee advised that warnings about the possibility of such a link continued to be inserted in pill packages. Finally the FDA reaffirmed its earlier recommendation that OC users receive annual examinations including vaginal cytology smears. These conclusions regarding the risk of breast and cervical cancer among OC users are similar to those reached earlier by the British Committee on Safety of Medicines.

A new Silurian Hemiarges (Trilobita) from North Greenland and the question of the Polaris Harbour Formation

Trilobites collected nearly 60 years ago by Lauge Koch at Newmann Bugt, North Greenland, and said to be probably derived from the so-called Polaris Harbour Formation, are described as Hemiarges ethnikos n. sp. Comparisons with Canadian species suggest a possibie Pridoli (Late Silurian) age. The history of the Polaris Harbour Formation is reviewed in the light of the recent publication of a geological map prepared by Koch in 1931 showing the distribution of the formation. However, on account of difficulties concerning the type locality and the supposed lithology, an earlier recommendation that use of the formation name be discontinued is supported.

The Scott Polar Research Institute, 1920–70

By a Grace, dated 26 November 1920, the Senate of the University of Cambridge approved an earlier recommendation of the Council of the Senate “That the University would welcome the establishment of the proposed Polar Research Institute at Cambridge.…” Frank Debenham's “Retrospect”, written to mark the twenty-fifth anniversary of this date, told of the circumstances that led to the formation of the Institute, and of its aims and facilities. Now, to mark the fiftieth anniversary of that date, a brief note seems appropriate.

Effects of Preconditioning Humidity on the Equilibrium Regain of Various Fibers, in the Standard Atmosphere for Testing

The range of relative humidity from 5% to 25% has been found satisfactory for preconditioning cotton, wool, rayon, and nylon prior to bringing specimens to moisture equilibrium for testing in the standard atmosphere. The data were obtained for ASTM Committee D-13 on textiles. Part of the data reported here was used by the American delegates at the meeting of the ISO Technical Committee 38 on Textiles in London, Eng land, May 1960. Based in part on the data presented, ISO/TC 38 has now recommended preconditioning in an atmosphere of 10% to 25% RH [3], in place of the earlier recom mendation, viz., an atmosphere having a relative humidity below 10%. Preconditioning is carried out at temperatures below 50° C in both cases.