Search

Background: Vaccine stockouts contribute to millions of children missing their routine immunizations globally. This is often due to inadequate forecasting and management of vaccine stocks, especially in low and middle-income countries, such as Pakistan, already characterized by suboptimal coverage. Tracking vaccines via 2D barcodes on each vial, could improve management of vaccine stocks. Vial level data can then be linked to Electronic Immunisation Registry (EIR) data (2D Bar codes already used), facilitating data quality improvements which could unlock programmatic gains. Our aim was to test feasibility and acceptability of scanning vaccine vials in a ‘‘live’’ setting. Methods: We conducted a pilot in 12 vaccination sites in Karachi/Pakistan. Vaccinators were divided into 3 groups and allocated to use one of the following: their existing android phone (government of Sindh’s Zindagi Mehfooz [Safe life; ZM-EIR]); a Zebra touch computer; a handheld scanner. The box of dummy vaccine vials of pneumococcal conjugate vaccine (PCV) and oral polio vaccine (OPV) each with a 2D barcode on it, was scanned by the stockroom manager prior to deployment. Vaccinators were required to scan the corresponding dummy vial and immunization cards while working. We integrated the OneScanTM API on the ZM-EIR to link vial to child data and evaluated the vaccinator’s experience through thematic analysis of interviews. Results: 2,310 vaccine vials were scanned and linked to immunized children (Zebra Touch Computer 72.6%, Android phone 19%, Handheld device 8.4%). Overall, vaccinators gave positive feedback and highlighted that scanning vials would simplify their work and save time, contingent on the program going paperless. Likewise, managers outlined digitally tracked vials would greatly reduce stock mismanagement. Conclusions: Linking vaccine vial to child is a feasible and effective solution for vaccine stock management, acceptable by both vaccinators and stock managers. Key messages: Linking vial to child is an acceptable method for accurate vaccine stock management and usage, improving forecasting and reducing stock outs. Linking vial to child will better facilitate rapid tracking of reported adverse events from vaccinated child back to the exact vaccine vial. [ABSTRACT FROM AUTHOR]

- An open, prospective, randomised, comparative study of 'Trisdine' and kanamycincolistin bladder instillations in reducing significant bacteriuria during intermittent urethral catheterisation was conducted. Trisdine is an aqueous solution of chlorhexidine gluconate 0.01% with added ethylenediaminetetra-acetic acid disodium salt and TRIS buffer at final concentrations of 1.34 mMoles and 0.01 Molar respectively. All patients (15 males and 3 females) admitted with acute spinal cord trauma and bladder involvement requiring intermittent catheterisation for more than 5 days during a 12-month period were studied. There was no significant difference in the mean incidence of significant bacteriuria during intermittent catheterisation in the 7 males who had kanamycin-colistin bladder instillations compared with the 8 males who had Trisdine instillations. A comparison could not be made in the females because there were only 3 patients. Because Trisdine is more stable at ambient temperatures, is less likely to select antibiotic-resistant bacteria and is less expensive, it is concluded that Trisdine is preferable to kanamycin-colistin solution for bladder instillations during intermittent catheterisation. [ABSTRACT FROM AUTHOR]

- Two groups of patients with acute spinal cord trauma had initial bladder management by standard non-touch techniques of intermittent catheterisation. Twenty-two patients (17 males and 5 females) had kanamycin-colistin solution instilled into the bladder at the end of each catheterisation, and 25 patients (21 males and 4 females) were not given these instillations. The incidence of significant bacteriuria during intermittent catheterisation of both males and females receiving the instillations was only half the incidence of those not receiving the instillations. Also, a significantly higher proportion of males receiving the instillations did not have any episodes of significant bacteriuria compared with those not receiving the instillations, and the same trend was evident in the small number of female patients. It is recommended that patients should have kanamycin-colistin bladder instillations when they are being intermittently catheterised. [ABSTRACT FROM AUTHOR]

The article discusses professional implications for social work in a cybernetic state. Cultural growth and improved levels of living are products of innovation and diffusion. The increased speed of diffusion yields more rapid change, and is accompanied by confusion and conflict. Time-honoured theory is challenged. The most dramatic and disruptive, yet potentially corrective, technological change of the current age is cybernation. Cybernetics has brought a need for adjustment in both broad and limited social systems.

The article focuses on new approaches to agricultural policies in the United States. Low farm prices present a problem despite the fact that agricultural productivity has been increasing at the rate of 3.5 per cent per year, because farm costs have also risen. Much of the failure to find politically and economically acceptable solutions to farm problems may be traced to sociological and economic characteristics of agriculture which are at variance with conditions prevailing in industry. Political solutions to the farmer's problems have focused largely on control of supply as the road to obtaining price parity, with a secondary interest in farm income and the causative factors of farm income and price problems other than supply. In the Nineteen Twenties, legislation was passed to encourage cooperation in the marketing of farm products and to extend special credit facilities to farmers. The Agricultural Adjustment Act of 1933 sought to limit the supply of certain crops by limiting production. Further weakening of a program of rigid price supports occurred in 1949. Farm programs of the past three decades have emphasized control of production, price supports and acreage allotments and marketing agreements.