In 1970, Dr. William Haddon wrote a brilliant editorial that changed forever how we evaluate accidents and other failures in complex systems. The paper was titled, On the Escape of Tigers: An Ecological Note, and it looked at accidents through an etiological rather than descriptive approach. The work was immediately applied to automotive and aviation safety, beginning the enormous reduction in accidents in both fields that continues to this day. In 1990, Dr. James T. Reason published his first work on the role of barriers to sequential failure, and how they fail in truly catastrophic accidents. Together, their combined work forms the basis for much of the best practice for risk mitigation in the automotive, airline, oil & gas and healthcare industries. In this article, I take a look at the failed efforts to control the Ebola outbreak relative to the concepts of Drs. Haddon and Reason.
inform consent form before participate in clinical trials.for purpose of understanding the nature of research,risk,benefits,and decision about participation
The Declaration of Helsinki is a set of ethical principles and guidelines for conducting medical research involving human subjects. It was adopted by the World Medical Association (WMA) in 1964 and has been revised multiple times since then, with the most recent revision occurring in 2013.
The Declaration of Helsinki outlines several key principles and considerations for researchers and physicians involved in human research, with a focus on protecting the rights, safety, and well-being of research participants. Some of the core principles and points covered in the Declaration of Helsinki include:
Informed Consent: Research participants must provide voluntary, informed, and written consent to participate in a study. They should be fully informed about the nature of the research, its purpose, risks, benefits, and alternatives.
Beneficence and Non-Maleficence: Researchers should aim to maximize the benefits of research while minimizing harm to participants. The well-being of the research subjects should be the primary concern.
Research Ethics Committee Review: All research involving human subjects should undergo ethical review by an independent committee. This review ensures that the study meets ethical and scientific standards.
Scientific Validity and Ethical Conduct: Research should be scientifically rigorous and designed to answer important questions. Researchers must conduct their work with integrity and honesty.
Privacy and Confidentiality: Participants' privacy should be protected, and their data should be kept confidential. Personal information should not be disclosed without informed consent.
Equitable Distribution of Benefits and Burdens: Research should benefit society, and the selection of research subjects should be fair, without exploitation or discrimination.
Continuing Review: Ethical review of research should continue throughout the duration of the study, with particular attention to any new information that may affect the research's ethical considerations.
Access to Medical Care: Participants should have access to medical care and treatment, and they should be compensated for any injuries resulting from their participation in research.
inform consent form before participate in clinical trials.for purpose of understanding the nature of research,risk,benefits,and decision about participation
The Declaration of Helsinki is a set of ethical principles and guidelines for conducting medical research involving human subjects. It was adopted by the World Medical Association (WMA) in 1964 and has been revised multiple times since then, with the most recent revision occurring in 2013.
The Declaration of Helsinki outlines several key principles and considerations for researchers and physicians involved in human research, with a focus on protecting the rights, safety, and well-being of research participants. Some of the core principles and points covered in the Declaration of Helsinki include:
Informed Consent: Research participants must provide voluntary, informed, and written consent to participate in a study. They should be fully informed about the nature of the research, its purpose, risks, benefits, and alternatives.
Beneficence and Non-Maleficence: Researchers should aim to maximize the benefits of research while minimizing harm to participants. The well-being of the research subjects should be the primary concern.
Research Ethics Committee Review: All research involving human subjects should undergo ethical review by an independent committee. This review ensures that the study meets ethical and scientific standards.
Scientific Validity and Ethical Conduct: Research should be scientifically rigorous and designed to answer important questions. Researchers must conduct their work with integrity and honesty.
Privacy and Confidentiality: Participants' privacy should be protected, and their data should be kept confidential. Personal information should not be disclosed without informed consent.
Equitable Distribution of Benefits and Burdens: Research should benefit society, and the selection of research subjects should be fair, without exploitation or discrimination.
Continuing Review: Ethical review of research should continue throughout the duration of the study, with particular attention to any new information that may affect the research's ethical considerations.
Access to Medical Care: Participants should have access to medical care and treatment, and they should be compensated for any injuries resulting from their participation in research.
Thalidomide was first developed by CIBA, a Swiss pharmaceutical company in the early 1950s, and subsequently introduced as Contergan by Chemi Grunenthal.
The drug was initially advertised as a sedative which would allow users to undergo a deep sleep in the absence of a hangover and with a reduced risk of developing drug dependency. At the time, basic testing was done on the drug, and it was considered not to have any toxic effects on humans.
However, unlike today’s level of rigorous testing, the drug was not analyzed for any potentially dangerous teratogenic effects.
In the 1950s, scientists did not know that the effects of a drug could be passed through the placental barrier and harm a foetus in the womb, so the use of medications during pregnancy was not strictly controlled. And in the case of thalidomide, no tests were done involving pregnant women.
As the drug was traded under so many different names in 49 countries, it took five years for the connection between thalidomide taken by pregnant women and the impact on their children to be made. A UK Government warning was not issued until May 1962.
One reason why researchers and doctors were slow to make this connection was due to the wide range of changes to foetal development. Limbs, internal organs including the brain, eyesight and hearing could all be affected.The first time the link between thalidomide and its impact on development was made public in a letter published in The Lancet from an Australian doctor William McBride, in 1961.
The drug was formally withdrawn by Chemie Grünenthal on 26 November 1961 and a few days later, on 2 December 1961, the UK distributors followed suit. However, it remained in many medicine cabinets under many different names.
In the few short years that thalidomide was available, it's estimated that over 10,000 babies were affected by the drug worldwide. Around half died within months of being born. The thalidomide babies who survived and their families live with the effects of the drug.
The Thalidomide Society was formed in 1962 by the parents of children affected by the drug thalidomide. The original aim of the Society was to provide mutual support and a social network as well as to seek compensation.
In 1972, a highly publicised campaign led by the Sunday Times newspaper helped to secure a further settlement for children affected by thalidomide in the UK.
Thalidomide forced governments and medical authorities to review their pharmaceutical licencing policies. As a result, changes were made to the way drugs were marketed, tested and approved both in the UK and across the world.
One key change was that drugs intended for human use could no longer be approved purely on the basis of animal testing. And drug trials for substances marketed to pregnant women also had to provide evidence that they were safe for use in pregnancy.
Turacoz Healthcare Solutions provides clinical research and regulatory writing services for pharmaceutical companies. We tell you about the different components of a clinical study protocol, the document which is prepared before beginning of any clinical trial. To know more info, visit- goo.gl/C1ec0L or write to us at hello@turacoz.in and call us 011-40584280.
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
ETHICS COMMITTEE
MEMBERS OF ETHICS COMMITTEE
SOME ETHICS COMMITTEE AROUND THE WORLD
What authority does EC/IRB have?
.
.
.
FOR ENROLLMENT CALL US ON - 9028839789
https://pristynresearch.com/
MAIL ID - pristynresearch@gmail.com
FACEBOOK- https://www.facebook.com/pristynsolutions
INSTAGRAM- https://www.instagram.com/pristyn_res...
TWITTER- https://twitter.com/Pristynresearch
SLIDESHARE- https://www.slideshare.net/azherkhan5916
LINKEDIN- https://www.linkedin.com/in/pristyn-research-191072119/
ADDRESS-
1) Parmar Trade Centre, A-wing,105/106, Sadhu Vaswani Chowk, Pune, 411001. Email: info@pristynresearch.com Phone: 09028839789
2)T-21/4 ,Opposite To Expert Global, Garware Stadium Road , Software Technology Park of India(STPI), MIDC, Aurangabad-431001. Email: info@pristynresearch.com Call us: 09607709586
Essential documents are those documents which individually and collectively permit evaluation of the conduct of a study and the quality of the data produced.
Essential documents serve to demonstrate compliance with the standards of Good Clinical Practice (GCP) and with all applicable regulatory requirements. These document files may be audited by the sponsor and regulatory authorities to confirm the validity of the clinical research conduct and integrity of the data.
The essential documents for clinical trials are the following: Investigator's Brochure. Clinical Study Protocol. Subject Information and Informed Consent Form.
Essential documents are commonly referred to as regulatory documents. ICH GCP guidance defines essential documents as “those documents which individually and collectively permit evaluation of the conduct of the clinical trial and the quality of the data produced.
The most important purpose of source documentation in a clinical trial is to reconstruct the trial as it happened. It should enable an independent observer to reconfirm the data. Documentation should be such that it is able to provide audit trail to permit investigation if and when required.
Siro Clinical Research Institute
Siro Clinpharm initiative
www.siroinstitute.com
Post Graduate Diploma in Clinical Research. Pharmacovigilance, Clinical Trials, Clinical Data Management, Clinical Operation, Medical writing.
#Pharmacovigilance #CDM #data #Clinicalresearch, #regulatoryaffairs, #medicalcoding, #clinicalSAS #management #health #comment #pune
#clinicalresearch #medicaldevices #career #opportunity #oncology
#safety #pharmajobs #gpat #pharmacy #mbbs #jobs #jobsearch #training #healthandsafety #nowhiring #healthcare #clinical #opportunities #doctor #medicine #hiring #bpharmajobs #coding #regulatoryaffairs #medical #nursing
#clinicalresearch #medicaldevices #career #opportunity #oncology #safety #pharmajobs #gpat #pharmacy #mbbs #jobs #jobsearch # #training #healthandsafety #nowhiring #healthcare #clinical #opportunities #doctor #medicine #hiring #bpharmajobs #coding #regulatoryaffairs #medical #nursing #pharmacovigilance #statistics #biostatistician #opportunity #interview #biostatistics #statisticalprogramming #team #fresher #project #students #development #projects #work #leaders #people #learning #culture #productivity #leader #event #clinicalresearch #clinicaloperations #clinicaldatamanagement #cdm
#clinicalresearchassociate #clinicalresearchcoordinator #pharmacovigilance ,#medicalcoders ,#sas ,#SASprogrammers #Biosatisticians, #Clinicaltrialdesign, #eTMF #lifescience
#medicaldevices,#scdmindia,#societyforclinicaldata
#lifesciencemanagement,#pharmaceuticals,#medicalwriting
#clinicalresearchinstitute #CRA #CRC #Databasedesign
#pharmacovigilanceindia #CTA #pharmacist #EDC , #GCP #pharmacovigilance #clinicalresearch #quality #clinicalresearchassociate #clinicalresearchcoordinator #clinicalresearchjobs #clinicaltrialmanagement #clinicaltrials #clinicaltraining #pharm
Observational analytical study: Cross-sectional, Case-control and Cohort stu...Prabesh Ghimire
This presentation provides overview of three observational analytical studies: cross-sectional study design, case-control study design and cohort study design
Clinical research is a branch of healthcare science that determines the safety and effectiveness (efficacy) of medications, devices, diagnostic products, and treatment regimens intended for human use. These may be used for prevention, treatment, diagnosis, or for relieving symptoms of a disease. here some basic terms associated with clinical research are mentioned in the presentation, which proves helpful to understand the basic knowledge about research.
ROLE OF COMMUNITY PHARMACIST IN MALARIAL CONTROL PROGRAMMALINIR14
Malaria is a serious or fatal disease caused by plasmodium parasite transmitted by the bite of infective female mosquitoes.
The term MALARIA is derived two italian words i.e mal means bad aria means air.
MALARIA is most important parasitic disease of the world.
Malaria in humans is caused by four Plasmodium species:
Plasmodium falciparum,
Plasmodium vivax,
Plasmodium malariae, and
Plasmodium ovale.
blood smear and Rapid Diagnostic Tests. India became independent, several measures have been taken under National Government to improve the health of people.Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, Cand improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government.
Preparing for Microbial Threats to Health: What Every Professional Should KnowTomas J. Aragon
In this presentation I introduce the "SFDPH Population Health Division Controlling Infectious Diseases Model." This model integrates concepts from understanding transmission mechanisms, transmission dynamics, and transmission containment. The Model is most useful when facing novel microbial threats and we need simple framework for public health action.
Thalidomide was first developed by CIBA, a Swiss pharmaceutical company in the early 1950s, and subsequently introduced as Contergan by Chemi Grunenthal.
The drug was initially advertised as a sedative which would allow users to undergo a deep sleep in the absence of a hangover and with a reduced risk of developing drug dependency. At the time, basic testing was done on the drug, and it was considered not to have any toxic effects on humans.
However, unlike today’s level of rigorous testing, the drug was not analyzed for any potentially dangerous teratogenic effects.
In the 1950s, scientists did not know that the effects of a drug could be passed through the placental barrier and harm a foetus in the womb, so the use of medications during pregnancy was not strictly controlled. And in the case of thalidomide, no tests were done involving pregnant women.
As the drug was traded under so many different names in 49 countries, it took five years for the connection between thalidomide taken by pregnant women and the impact on their children to be made. A UK Government warning was not issued until May 1962.
One reason why researchers and doctors were slow to make this connection was due to the wide range of changes to foetal development. Limbs, internal organs including the brain, eyesight and hearing could all be affected.The first time the link between thalidomide and its impact on development was made public in a letter published in The Lancet from an Australian doctor William McBride, in 1961.
The drug was formally withdrawn by Chemie Grünenthal on 26 November 1961 and a few days later, on 2 December 1961, the UK distributors followed suit. However, it remained in many medicine cabinets under many different names.
In the few short years that thalidomide was available, it's estimated that over 10,000 babies were affected by the drug worldwide. Around half died within months of being born. The thalidomide babies who survived and their families live with the effects of the drug.
The Thalidomide Society was formed in 1962 by the parents of children affected by the drug thalidomide. The original aim of the Society was to provide mutual support and a social network as well as to seek compensation.
In 1972, a highly publicised campaign led by the Sunday Times newspaper helped to secure a further settlement for children affected by thalidomide in the UK.
Thalidomide forced governments and medical authorities to review their pharmaceutical licencing policies. As a result, changes were made to the way drugs were marketed, tested and approved both in the UK and across the world.
One key change was that drugs intended for human use could no longer be approved purely on the basis of animal testing. And drug trials for substances marketed to pregnant women also had to provide evidence that they were safe for use in pregnancy.
Turacoz Healthcare Solutions provides clinical research and regulatory writing services for pharmaceutical companies. We tell you about the different components of a clinical study protocol, the document which is prepared before beginning of any clinical trial. To know more info, visit- goo.gl/C1ec0L or write to us at hello@turacoz.in and call us 011-40584280.
a brief overview about how and why to practice evidence based medicine, its clinical application, what it is and what it is not? benefits and challenges
ETHICS COMMITTEE
MEMBERS OF ETHICS COMMITTEE
SOME ETHICS COMMITTEE AROUND THE WORLD
What authority does EC/IRB have?
.
.
.
FOR ENROLLMENT CALL US ON - 9028839789
https://pristynresearch.com/
MAIL ID - pristynresearch@gmail.com
FACEBOOK- https://www.facebook.com/pristynsolutions
INSTAGRAM- https://www.instagram.com/pristyn_res...
TWITTER- https://twitter.com/Pristynresearch
SLIDESHARE- https://www.slideshare.net/azherkhan5916
LINKEDIN- https://www.linkedin.com/in/pristyn-research-191072119/
ADDRESS-
1) Parmar Trade Centre, A-wing,105/106, Sadhu Vaswani Chowk, Pune, 411001. Email: info@pristynresearch.com Phone: 09028839789
2)T-21/4 ,Opposite To Expert Global, Garware Stadium Road , Software Technology Park of India(STPI), MIDC, Aurangabad-431001. Email: info@pristynresearch.com Call us: 09607709586
Essential documents are those documents which individually and collectively permit evaluation of the conduct of a study and the quality of the data produced.
Essential documents serve to demonstrate compliance with the standards of Good Clinical Practice (GCP) and with all applicable regulatory requirements. These document files may be audited by the sponsor and regulatory authorities to confirm the validity of the clinical research conduct and integrity of the data.
The essential documents for clinical trials are the following: Investigator's Brochure. Clinical Study Protocol. Subject Information and Informed Consent Form.
Essential documents are commonly referred to as regulatory documents. ICH GCP guidance defines essential documents as “those documents which individually and collectively permit evaluation of the conduct of the clinical trial and the quality of the data produced.
The most important purpose of source documentation in a clinical trial is to reconstruct the trial as it happened. It should enable an independent observer to reconfirm the data. Documentation should be such that it is able to provide audit trail to permit investigation if and when required.
Siro Clinical Research Institute
Siro Clinpharm initiative
www.siroinstitute.com
Post Graduate Diploma in Clinical Research. Pharmacovigilance, Clinical Trials, Clinical Data Management, Clinical Operation, Medical writing.
#Pharmacovigilance #CDM #data #Clinicalresearch, #regulatoryaffairs, #medicalcoding, #clinicalSAS #management #health #comment #pune
#clinicalresearch #medicaldevices #career #opportunity #oncology
#safety #pharmajobs #gpat #pharmacy #mbbs #jobs #jobsearch #training #healthandsafety #nowhiring #healthcare #clinical #opportunities #doctor #medicine #hiring #bpharmajobs #coding #regulatoryaffairs #medical #nursing
#clinicalresearch #medicaldevices #career #opportunity #oncology #safety #pharmajobs #gpat #pharmacy #mbbs #jobs #jobsearch # #training #healthandsafety #nowhiring #healthcare #clinical #opportunities #doctor #medicine #hiring #bpharmajobs #coding #regulatoryaffairs #medical #nursing #pharmacovigilance #statistics #biostatistician #opportunity #interview #biostatistics #statisticalprogramming #team #fresher #project #students #development #projects #work #leaders #people #learning #culture #productivity #leader #event #clinicalresearch #clinicaloperations #clinicaldatamanagement #cdm
#clinicalresearchassociate #clinicalresearchcoordinator #pharmacovigilance ,#medicalcoders ,#sas ,#SASprogrammers #Biosatisticians, #Clinicaltrialdesign, #eTMF #lifescience
#medicaldevices,#scdmindia,#societyforclinicaldata
#lifesciencemanagement,#pharmaceuticals,#medicalwriting
#clinicalresearchinstitute #CRA #CRC #Databasedesign
#pharmacovigilanceindia #CTA #pharmacist #EDC , #GCP #pharmacovigilance #clinicalresearch #quality #clinicalresearchassociate #clinicalresearchcoordinator #clinicalresearchjobs #clinicaltrialmanagement #clinicaltrials #clinicaltraining #pharm
Observational analytical study: Cross-sectional, Case-control and Cohort stu...Prabesh Ghimire
This presentation provides overview of three observational analytical studies: cross-sectional study design, case-control study design and cohort study design
Clinical research is a branch of healthcare science that determines the safety and effectiveness (efficacy) of medications, devices, diagnostic products, and treatment regimens intended for human use. These may be used for prevention, treatment, diagnosis, or for relieving symptoms of a disease. here some basic terms associated with clinical research are mentioned in the presentation, which proves helpful to understand the basic knowledge about research.
ROLE OF COMMUNITY PHARMACIST IN MALARIAL CONTROL PROGRAMMALINIR14
Malaria is a serious or fatal disease caused by plasmodium parasite transmitted by the bite of infective female mosquitoes.
The term MALARIA is derived two italian words i.e mal means bad aria means air.
MALARIA is most important parasitic disease of the world.
Malaria in humans is caused by four Plasmodium species:
Plasmodium falciparum,
Plasmodium vivax,
Plasmodium malariae, and
Plasmodium ovale.
blood smear and Rapid Diagnostic Tests. India became independent, several measures have been taken under National Government to improve the health of people.Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, Cand improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health.
Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government.
Preparing for Microbial Threats to Health: What Every Professional Should KnowTomas J. Aragon
In this presentation I introduce the "SFDPH Population Health Division Controlling Infectious Diseases Model." This model integrates concepts from understanding transmission mechanisms, transmission dynamics, and transmission containment. The Model is most useful when facing novel microbial threats and we need simple framework for public health action.
A World United Against Infectious Diseases: Connecting Organizations for Regi...The Rockefeller Foundation
The world has made significant strides in tackling major public health challenges over the last several decades. We have eradicated one disease, smallpox, and are close to doing so with polio and guinea worm. We continue to make significant progress on other debilitating illnesses, including malaria, tuberculosis and HIV/AIDS. Yet, even as our technology and practices improve, new threats arise. In the last two decades, we have seen some 30 new zoonotic diseases emerge, from SARS to hantavirus to Ebola and more. Population pressures and economic growth push humans into ever closer contact with animals, disturbing ecosystems, and creating ripe conditions for new pathogens to jump from animals to humans. Add to this the incredible growth in global travel and trade and the risk of new diseases quickly spreading worldwide has never been greater. So while our ability to respond continually improves, the challenges we face increase as well.
Many factors make up the successful fight against emerging infectious diseases. But one factor trumps all* early detection and rapid identification of novel infections. If we can find a new pathogen early, we can often isolate it to the area in which it emerges. Conversely, failure to find the disease early allows the pathogen to propagate to new regions, countries and continents, making the response much more difficult and costly. Imagine if we had found HIV/AIDS when it was still contained to its region of origin*many of today’s 35 million people infected worldwide would have never been exposed. Our tools of detection, including point-of-care diagnostics and digital surveillance, continue to improve. However, the global infectious disease surveillance system is disjointed. Practices and protocols vary, and inefficiencies abound. The initiative we are jointly supporting*Connecting Organizations for Regional Disease Surveillance (CORDS)*tackles this challenge by building trust and collaboration across national borders.
CORDS unites regional disease surveillance networks from critical hotspots around the world to promote exchanges of best practices in surveillance and catalyze innovation in early disease detection. By working together with international bodies, including the World Health Organization (WHO), World Organization for Animal Health (IOE), and the Food and Agriculture Organization of the United Nations (FAO), CORDS will speed the development, capabilities and sustainability of all its network members to improve global surveillance and mitigate the potential impact of disease outbreaks both from epidemic diseases and from the recrudescence of endemic diseases.
Each of our organizations comes to this issue with equal commitment but different perspectives ranging from global health to disaster management to biosecurity and more. We are all united in our dedication to this effort, which fills a critical gap in global public health capacity. We look forward to CORDS contributing to improve health o
Towards a malaria-free world - Background informationXplore Health
This guide provides background information on malaria, the most important parasitic disease in the world. Explore all aspects of malaria from the causes to treatment. Investigate the latest research and uncover the ethical, legal and social issues surrounding this disease.
Global Health Security Webinar 12_3_2014TridentCADC
The Preparing for a Career in Global Health Security outlines the program of study at Trident University International, and careers and opportunities in GHS. This informative webinar was presented by Drs. Hegamin, Anglin, and Taylor
This is a CLC assigment, I have attached topic 1, 2 and 3 , APA form.docxgasciognecaren
This is a CLC assigment, I have attached topic 1, 2 and 3 , APA format, 3 references, 500 words
This is a Collaborative Learning Community (CLC) assignment.
In your Collaborative Learning Community, write a formal paper of 500-1,000 words that examines the previously addressed aspects of health policies, finance, global/national prevention, or treatment initiatives related to the health issue by identifying applicable ethics principles.
Differentiate how application of the identified ethics principles to the health issue has resulted in population disparities.
Hypothesize how existing disparities might be eliminated using alternate ethics principles.
Critique whether the applicable ethics principles are consistent with the ANA's Code of Ethics for Nurses.
Topic 1
Influenza CLC group essay 11-28-2017
Introduction
Influenza commonly known as flu is a contagious respiratory infection that attacks the general respiratory system that is, the nose, throat, and even the lungs. It is caused by the two types of influenza viruses which are influenza A, influenza B and influenza C (Wang & Tao, 2010). Attacks from both viruses are epidemic and seasonal as they are common within specific periods within a year. Attack mechanisms for influenza A viruses depends on the genes on the surface protein of a patient. They are normally spread through sneezing and coughing from an infected individual to the surrounding air (Wang & Tao, 2010).
The flu can also attack an individual in case they get into direct body tissue contact with an infected individual for example handshaking. Health professionals argue that the flu virus is stubborn and spreads mainly over tiny droplets which are produced when the infected individuals’ cough, talk, and sneeze (Wang & Tao, 2010). Such droplets are easily carried by the surrounding air and can be landed in the nose and mouths of the immediate persons. Additionally, it can enter into one’s system if he or she gets into direct contact with a surface or object that has the influenza bacteria and consequently rubs or touches their nose, mouth or even eyes (Wang & Tao, 2010).
Health departments have overtime identified initiative to address the problem of influenza, such initiatives include:
Reducing human exposure to the flu viruses, this initiative works by notifying the public on the safe ways to prevent and control the spread of the virus and it actively works to reduce infection opportunities and curbs the spread of the pandemic virus (Abramson, 2011).
They have built able capacities to cope with the pandemic, measures have been taken and put in place to cope with the virus since helping the society to stay free from the virus (Abramson, 2011).
They have innovated much on early warning and acknowledgments, information about influenza and its impacts to the society are made clear since it is effective for the society to stay free from the influenza virus (Abramson, 2011).
Necessary global scientific researches ...
Risk assessment of potential health threats – Enhancing disease surveillance ...Global Risk Forum GRFDavos
GRF One Health Summit 2012, Davos: Presentation by Nicole ROSENKÖTTER,
Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School of Public Health, Netherlands, Kingdom of the
Scientific Facts on Global Public Health ThreatsGreenFacts
Global public health security depends on actions to prevent and respond to threats that endanger the collective health of the global population. Those threats have an impact on economic or political stability, trade, tourism, access to goods and services and, if they occur repeatedly, on demographic stability.
Global public health security covers a wide range of complex and daunting issues, including the health consequences of human behavior, climate change, weather-related events and infectious diseases, as well as natural catastrophes and man-made disasters, all of which are discussed here.
In your Collaborative Learning Community, write a paper of 500-1,000.docxlanagore871
In your Collaborative Learning Community, write a paper of 500-1,000 words and include the following:
Assess the past and present impact nurses, including advanced professional/advanced practice nurses, have made in addressing this health issue.
Describe how nurses can become more broadly involved with influencing health policy related to this issue. Include resources available.
Hypothesize how nurses can positively impact future outcomes related to the provision of care for persons affected by the health issue.
Synthesize all aspects of the health care issue through a summary conclusion, concisely tying up Parts 1-6 of the CLC - Health Issue Analysis.
This is APA format, 3 references, I have attached topics 1-5 that is needed for this CLC project
Topic 1
Influenza CLC group essay 11-28-2017
Introduction
Influenza commonly known as flu is a contagious respiratory infection that attacks the general respiratory system that is, the nose, throat, and even the lungs. It is caused by the two types of influenza viruses which are influenza A, influenza B and influenza C (Wang & Tao, 2010). Attacks from both viruses are epidemic and seasonal as they are common within specific periods within a year. Attack mechanisms for influenza A viruses depends on the genes on the surface protein of a patient. They are normally spread through sneezing and coughing from an infected individual to the surrounding air (Wang & Tao, 2010).
The flu can also attack an individual in case they get into direct body tissue contact with an infected individual for example handshaking. Health professionals argue that the flu virus is stubborn and spreads mainly over tiny droplets which are produced when the infected individuals’ cough, talk, and sneeze (Wang & Tao, 2010). Such droplets are easily carried by the surrounding air and can be landed in the nose and mouths of the immediate persons. Additionally, it can enter into one’s system if he or she gets into direct contact with a surface or object that has the influenza bacteria and consequently rubs or touches their nose, mouth or even eyes (Wang & Tao, 2010).
Health departments have overtime identified initiative to address the problem of influenza, such initiatives include:
Reducing human exposure to the flu viruses, this initiative works by notifying the public on the safe ways to prevent and control the spread of the virus and it actively works to reduce infection opportunities and curbs the spread of the pandemic virus (Abramson, 2011).
They have built able capacities to cope with the pandemic, measures have been taken and put in place to cope with the virus since helping the society to stay free from the virus (Abramson, 2011).
They have innovated much on early warning and acknowledgments, information about influenza and its impacts to the society are made clear since it is effective for the society to stay free from the influenza virus (Abramson, 2011).
Necessary global scientific researches are being ...
This is a Collaborative Learning Community (CLC) assignment.In y.docxgasciognecaren
This is a Collaborative Learning Community (CLC) assignment.
In your Collaborative Learning Community, write a paper of 500-1,000 words and include the following:
Discuss cultural beliefs and influences relative to the health issue.
Differentiate any religious/spiritual beliefs and values relative to the issue.
Appraise how religious/spiritual beliefs and values have influenced progress in addressing the issue–either negatively or positively.
Compare differences in ideologies related to the issue across political party lines, geographic regions, and countries of the world.
This is APA format aqt least 500 word, references. I have added all the topics that have been added so far, I have topics 1-4 added. the one that will worked on is Topic 5
Topic 1
Influenza CLC group essay 11-28-2017
Introduction
Influenza commonly known as flu is a contagious respiratory infection that attacks the general respiratory system that is, the nose, throat, and even the lungs. It is caused by the two types of influenza viruses which are influenza A, influenza B and influenza C (Wang & Tao, 2010). Attacks from both viruses are epidemic and seasonal as they are common within specific periods within a year. Attack mechanisms for influenza A viruses depends on the genes on the surface protein of a patient. They are normally spread through sneezing and coughing from an infected individual to the surrounding air (Wang & Tao, 2010).
The flu can also attack an individual in case they get into direct body tissue contact with an infected individual for example handshaking. Health professionals argue that the flu virus is stubborn and spreads mainly over tiny droplets which are produced when the infected individuals’ cough, talk, and sneeze (Wang & Tao, 2010). Such droplets are easily carried by the surrounding air and can be landed in the nose and mouths of the immediate persons. Additionally, it can enter into one’s system if he or she gets into direct contact with a surface or object that has the influenza bacteria and consequently rubs or touches their nose, mouth or even eyes (Wang & Tao, 2010).
Health departments have overtime identified initiative to address the problem of influenza, such initiatives include:
Reducing human exposure to the flu viruses, this initiative works by notifying the public on the safe ways to prevent and control the spread of the virus and it actively works to reduce infection opportunities and curbs the spread of the pandemic virus (Abramson, 2011).
They have built able capacities to cope with the pandemic, measures have been taken and put in place to cope with the virus since helping the society to stay free from the virus (Abramson, 2011).
They have innovated much on early warning and acknowledgments, information about influenza and its impacts to the society are made clear since it is effective for the society to stay free from the influenza virus (Abramson, 2011).
Necessary global scientific researches are being ca ...
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
How many patients does case series should have In comparison to case reports.pdfpubrica101
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M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
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The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
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QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
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India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...
Considerations of the Ebola Outbreak, Haddon's Matrix and Reason's Swiss Cheese Model
1. On the Escape of Tigers & Other Public Health Hazards
Considering the Ebola Outbreak in Haddon’s Matrix and Reason’s Swiss Cheese Model
October 16, 2014
Wes Chapman
Preface: In 1970, Dr. William Haddon wrote a brilliant editorial that changed forever how we
evaluate accidents and other failures in complex systems. The paper was titled, On the Escape of
Tigers: An Ecological Note, and it looked at accidents through an etiological rather than
descriptive approach. The work was immediately applied to automotive and aviation safety,
beginning the enormous reduction in accidents in both fields that continues to this day. In 1990,
Dr. James T. Reason published his first work on the role of barriers to sequential failure, and
how they fail in truly catastrophic accidents. Together, their combined work forms the basis for
much of the best practice for risk mitigation in the automotive, airline, oil & gas and healthcare
industries. In this article, I take a look at the failed efforts to control the Ebola outbreak relative
to the concepts of Drs. Haddon and Reason.
Escaping Tiger
2. Haddon’s Strategies and Matrix
Haddon focused his original work on accident prevention, specifically focusing on the reduction
in the amount and structural impact of energy released in a harmful way in an accident. He
promulgated 10 strategies specifically targeted at this goal (see table below). The first four of
these strategies were designed to be implemented before an accident or other untoward outcome
(“pre-event”) to prevent events from happening or minimize the potential negative outcome
(“effect”), the second four strategies are design to protect the party subject to the effect (“host”)
in the course of the event, and the final two were designed to mitigate the negative consequences
post event. Reducing these to a more generalized format we get:
Strategy
Number
Strategy Examples
(Ebola strategies bold)
1 Prevent creation of the
hazard
Ban 3-wheel ATVs, restrict access to explosives,
Design effective Ebola strategy
2 Reduce the amount of the
hazard
Limit pills per container, decrease water
temperature, strict reductions on travel to and
from areas impacted by the virus
3 Prevent release of the hazard Improved brakes, puncture resistant gas tanks,
Quarantines, travel limitations
4 Alter release of the hazard Blister packaging on pills, public health
restrictions of travel for potentially infected
patients
5 Separate person and hazard
in time and space
Child restraints, Quarantines, travel restrictions
6 Place barrier between person
and hazard
Bike helmets, pool fences, Protective clothing &
gear for care givers
7 Modify basic qualities of the
hazard
Breakaway light poles, Protective clothing &
gear for potentially infected patients
8 Strengthen resistance to the
hazard
Earthquake building codes, Special hospital units
for Ebola patients
9 Detect quickly Smoke detectors, Effective blood tests and
screening based on physical characteristics
10 Repair the damage EMS, treatment & rehabilitation, Effective and
timely treatment for Ebola patients
Adapted from slides by Carolyn Fowler, PhD
What makes Haddon’s strategies so compelling is their common sense simplicity, and that they
are fundamentally hopeful; we can alter the frequency and impact of terrible events through
simple and thoughtful actions. Haddon started a revolution in accident prevention by looking at
the causes of accidents and the effects of accidents on victims. These techniques have been
broadly adopted by regulatory authorities around the world, with a long term trend in the
reduction in both number of accidents and resulting injuries and fatalities. It is a method for
optimists, and it really works.
3. Reasons to be Optimistic about Airline Safety
Happy Motoring
4. When later reduced to practice, these strategies were combined into a matrix format.
Influencing Factors
Environment
Strategies
Numbered
Human Agent &
Carrier
Physical Social
1-4 Pre-Event
5-8 Event
9-10 Post Event
Will an event - with the potential to cause
injury occur?
Will an injury, disease or death occur?
What will the outcome be?
Adapted from slide presentation by Carolyn Fowler, PhD
It is instructive to look at the use of Haddon’s Matrix and related tools in the control of the
SARS (Severe Acute Respiratory Syndrome) outbreak in Toronto in the time period of February
to July of 2003. There are a couple of important differences between SARS and Ebola that are
worth noting from the outset. On first blush, SARS is much more communicable (being capable
of airborne transmission), and Ebola is much more fatal (50% fatality rates in Ebola vs. less than
10% for SARS). A slightly deeper examination of the facts suggests that in both cases, these are
primarily nosocomial infections, and that the vast amount of risk of both infection and
transmission lies at the patient/caregiver interface. This was clearly the case in SARS (although
not immediately expected), and the early evidence in the US and Europe certainly points to this
interface as the greatest point of risk for Ebola.
The Haddon Matrix & SARS Hospital Infection Control
Environment
Human Agent & Carrier
(Vector)
Physical and Social
Pre-
Event
1) Staff Training in infection
control, 2) Case mix of patients,
3) Surveillance for SARS by
health care providers, 4) Public
health risk communication
1) Level of contagiousness, 2)
Incubation period, 3) Subclinical
infection potential, 4) Lethality, 5)
Potential modes of transmission
1) Employee awareness of daily
infection control practice, 2) Staff
adherence to infection directives and
protocols, 3) Risk communication to
staff, 4) Budget allocations 5) Plans for
surge requirements, 6) Proximity to
borders, airports and access points, 7)
Availability of Protective gear, 8)
Infection control checklists and forms,
9) Hospital infection control
infrastructure, 10) Lab facilities
5. Event 1) Mental health for staff during
event, 2) Staff adherence to
infection controls, 3) Isolation and
quarantine implementation, 4)
Risk communication to staff and
patients.
1) Modes of dissemination of
virus during actual outbreak.
1) Hospital surge capacity, 2) Trust in
administration crisis management
performance, 3) Availability of
designated SARS hospitals, 4) Budget,
5) Communication network and
capacity, 6) Effective incident
command system, 7) Crisis command
center, 8) Efficiency of medication and
equipment delivery, 9) Positive bias
toward healthcare providers and media
accuracy, 10) Accurate and appropriate
messages to staff and patients, 11)
Moral support to healthcare
community, 12) Patient and family
compliance.
Post
Event
1) Risk communication, 2) Post-mortem
management, 3)
Psychology of post-event reaction,
4) Surveillance
1) persistence of agent in the
environment
1) Decontamination, 2) messaging, 3)
Government financial support, 4)
Restoration of stockpiled medication
and equipment, 5) Mental health
support, 6) economic impact on
affected community.
Source: Environmental health Perspectives, May 2005; 113(5): 561-566
The current Ebola outbreak began in March of this year and now totals 8,997 cases in 7 countries
(WHO bulletin 10/15/2014), dwarfing the next largest (425 cases in Uganda in 2000), of the 22
outbreaks since 1976. This is fundamentally a different scale and risk profile than the world has
witnessed since the SARS outbreak in 2003. It is unclear if the US, the EU or any member of the
G20 has made any special preparations to deal with the Ebola outbreak in the 7 months since it
began.
The control of SARS in Toronto ultimately required a ratio of 100 persons quarantined for every
confirmed case. In Canada alone, this was a total of 23,000 people in quarantine during the
course of the crisis. The premature declaration of victory in the SARS case, resulted in what was
in reality back-to-back pandemics, with a doubling of the cost of illness, lives and economic loss.
Based on the SARS Matrix as an example, and the facts and circumstances of the current Ebola
outbreak, it is worth taking a minute to sketch out an ideal response matrix, and then compare it
to the actual response – at least as far as it has been made public.
Ebola Pandemic – an Ideal Haddon Matrix
Environment
Human Agent & Carrier
(Vector)
Physical and Social
Pre-
Event
1) Direct and permanent
intervention in West
Africa, 2) Extensive drug
research and testing, 3)
1) Ebola is moderately
contagious, with a long
and variable incubation
period, is highly lethal
1) Education is key to public
health in the endemic
countries, 2) Mass
elimination of other
6. Education regarding risks
in animal transmission.
and is easily confused
with other diseases –
active testing and public
health are a requirement,
2) Every attempt must be
made to support curative
therapies and vaccines.
mammalian hosts is a
necessity, 3) Alternative
foods must be available, 4)
Development of
multinational response teams,
5) Stockpiling of equipment
and supplies, 6) Checklists
and extensive “in-country”
training, 7) Rapid response
for burial training and
practice in-country.
Event 1) Mental health for staff
during event, 2) Staff
adherence to infection
controls, 3) Isolation and
quarantine
implementation, 4) Risk
communication to staff
and patients.
1) Modes of
dissemination of virus
during actual outbreak
must be weakened and
eliminated, 2) Every
effort must be made to
limit dispersion of virus,
3) Healthcare workers are
particularly vulnerable to
contagion and need
special prophylactic
therapy where available.
1) Hospital surge capacity, 2)
Trust in administration crisis
management performance, 3)
Availability of designated
Ebola hospitals, 4) Budget, 5)
Communication network and
capacity, 6) Effective
incident command system, 7)
Crisis command center, 8)
Efficiency of medication and
equipment delivery, 9)
Positive bias toward
healthcare providers and
media accuracy, 10) Accurate
and appropriate messages to
staff and patients, 11) Moral
support to healthcare
community, 12) Patient and
family compliance.
Post
Event
1) Risk communication,
2) Post-mortem
management, 3)
Psychology of post-event
reaction, 4) Surveillance,
5) rapid return to pre-event
priorities
1) Persistence of agent in
the environment must be
eliminated wherever
possible to prevent the
double pandemic seen in
SARS.
1) Decontamination, 2)
messaging, 3) Government
financial support, 4)
Restoration of stockpiled
medication and equipment, 5)
Mental health support, 6)
economic impact on affected
community.
7. Ebola Pandemic – Actual Haddon Matrix to date
Environment
Human Agent & Carrier
(Vector)
Physical and Social
Pre-
Event
1) No meaningful or
successful strategy or
intervention, 2) Limited
drug research and testing,
3) Limited education
regarding risks in animal
transmission.
1) Ebola is moderately
contagious, with a long
and variable incubation
period, is highly lethal
and is easily confused
with other diseases –
despite this, no testing
and public health took
place, 2) No meaningful
attempt was made to
support curative therapies
and vaccines.
1) No Education in the
endemic countries, 2) No
systematic elimination of
other mammalian hosts, 3)
No alternative foods
available, 4) No development
of multinational response
teams, 5) Limited stockpiling
of equipment and supplies, 6)
No plans or “in-country”
training, 7) No cultural
changes.
Event 1) Mass confusion and in
action at the government
level. Mental health for
staff during event
ignored, 2) Infection
controls incorrect or not
specified, 3) Isolation and
quarantine
implementation late,
ineffective or non-existent,
4) No risk
communication to staff
and patients.
1) Modes of
dissemination of virus
during actual outbreak
neither weakened nor
eliminated, 2) No effort
made to limit dispersion
of virus, 3) Healthcare
workers are particularly
vulnerable to contagion –
grossly inadequate
training and protective
gear.
1) No hospital surge
capacity, 2) No trust in
administration crisis
management performance, 3)
No designated Ebola
hospitals, 4) Budget?, 5)
Communication network and
capacity wholly inadequate,
6) Ineffective incident
command system, 7) No
crisis command center, 8)
Efficiency of medication and
equipment delivery?, 9)
Positive bias toward
healthcare providers and
media accuracy?, 10)
Inaccurate and inappropriate
messages to staff and
8. patients, 11) Limited moral
support to healthcare
community, 12) No patient
and family compliance, 13)
Command and control turned
over to untrained political
representative, 14) Legal and
financial protection afforded
all quarantined persons at
Federal, State and local
levels.
Post
Event
? 1) Persistence of agent in
the environment must be
eliminated wherever
possible to prevent the
double pandemic seen in
SARS.
?
The entire response US to the Ebola crisis has been done without an articulated strategy,
seemingly responding to political imperatives rather than public health best practice. None of the
obvious strategies or methods that would fit Haddon’s 10 strategic categories has been
employed, and the discourse has taken an alarming political tone. The appointment of Ron Klain,
a political operative and lawyer as administrative chief of the effort begs the question of
credentials, and is certain to further politicize this public health fiasco.
The motivations for sending 3,000 US troops to aid in the Ebola fight is equally mystifying. Our
military is just exiting two decade long wars, and is now being drawn back into further conflict
with ISIS. The putative purpose of this deployment is to build treatment facilities and operate
mobile labs. Surely there are contractors more capable and with fewer agenda conflicts than the
101 Airborne. Sending untrained and poorly equipped US troops in to fight Ebola may be
politically expedient, but I struggle to understand how it fits into any of Haddon’s strategic
framework.
It is interesting to note that Nigeria, a poor West African neighbor to the primarily impacted
countries (Guinea, Sierra Leone and Liberia) successfully turned back Ebola using a well-articulated
and systematically applied strategy that did not include armed combatants. Nigeria’s
Emergency Operations Center sat down with representatives from the World Health
Organization, UNICEF, CDC, Doctors Without Borders and the Red Cross and designed a plan
focused on four teams:
9. 1) A point-of-entry team to monitor and screen passengers entering and departing the
country,
2) An information dissemination team,
3) A case management team, and
4) A contact-tracing group to track down, monitor and quarantine people who had been in
contact with patients suffering with active Ebola.
And it did involve closing the borders.
Ebola virus – the new target of the 101st Airborne
Reason’s Swiss Cheese Model and a Just Culture
James T. Reason is the father of Swiss Cheese Human Error model. This model is based on the
concept that 90% of errors are caused by systemic (latent) rather than simple human factors
(active). Models based on blame, normally miss the fundamental element of passive failure of
accident prevention barriers – much like lining up the holes in Swiss cheese.
10. Combining these work of Haddon and Reason, we get Haddon’s strategies as the slices of cheese
(barriers to failure), and failure occurring when the holes line up, due to chance, poor planning or
systematic strategic failure. Reason proposed a concept of a “Just Culture” as an integral part of
the model of Human Error. Reason’s human Error Model postulates that the vast majority of
errors happen despite the good intentions of the person “causing” the error. In Reason’s just
culture, failed systems rather than failed people are normally the cause of errors, and we need to
investigate how to improve systems rather than blame and punish people if we want to improve
outcomes.
11. Considerations of the US Response to Ebola
Relative to Haddon’s strategies and matrix, the US failed to have any viable strategy for dealing
with Ebola either before or after the outbreak. Prior to the outbreak, we took no steps to combat
the virus through vaccines or drugs, and did nothing to reduce the contact between the virus and
human hosts. This is consistent with the cold blooded calculus that this is a strictly African
problem and of no direct concern to the US, but the spread of the arrival of Ebola in the Dallas
proves this to be short sighted and stupid (as well as callous).
Relative to Reason’s Swiss Cheese model, the barriers to the spread of Ebola that existed prior to
the outbreak were few and full of holes. No vaccine, and no effective drug therapies were
developed, and no coordinated response was initiated when the disease first took root in March.
When the disease finally arrived in the US, we had no training and no protective clothing for our
front line medical staffs.
Our Nation’s response to date gives not even the slightest thought to the plight of people forced
to stop their lives and go into isolation or quarantine because of innocent exposure to the virus.
The forced isolation of quarantine can result in loss of jobs and income, and there is not a single
discussion on any front regarding protecting these people – which will only influence them to
avoid quarantine. This is a national disgrace, and the antithesis of just culture.
The arrival of Ebola into the heartland of America did nothing to stimulate a viable strategic
response. The response of sending armed troops to battle a virus in Africa seems silly, except
when considered as a political rather than a public health action. The best research that I have
found indicates that cutting off flights from the afflicted nations would prevent the spread of the
virus by up to 8 weeks, but when considered politically it is apparently untenable.
The intra-outbreak excellence shown in Toronto by quarantine of patients (as well as potentially
impacted people), has been totally ignored in our country; where we put our potentially infected
people on airplanes and fly them around the country – approved by the CDC. Finally, when the
public has finally had enough, we put a political operative in charge – a man with no background
in public health.
My Grandmother used to say that God watches out for fools and drunks – by her criteria we
should be able to depend on divine intervention in this crisis – it’s as good as any strategy that
we’ve had to date.