Of these, most, 339(74.1%), involved the lack of access in all regions of Brazil. The main accessconstraint was the prolonged waiting time for surgery. Other constraints were theexcessive waiting for medical appointment with experts, doing examinations andcancellation of surgeries. the access to surgical assistance, by users of the Brazilian health system, is notwidely guaranteed, reinforcing the need for integrated governmental actions,organization of the health care network, management of health care and humanresources to overcome the challenges imposed to achieve the Universal Access toHealth and Universal Health Coverage. This is because, often, it is the only solution to avoid them in case ofinjuries, traffic accidents, burns, disasters, violence, obstetrical complications,emergency abdominal and non-abdominal conditions, and others that may significantlyaffect the quality of life, such as cataract and congenital malformations.Surgical condition is essential for prevention of chronic disabilities andmortality-2. Thrmations..Surgery is at the end of the spectrum of the classic curative model. Thus, regardless ofsuccessful prevention strategies, surgical conditions will always be responsible for asignificant portion of the burden of disease in a population. In developing countries,in particular, where conservative treatment is not readily available, the incidence oftrauma and obstetric complications are high and with significant accumulation ofuntreated surgical diseases.(-). As a result, surgical pathologies are aggravated, affect the socioeconomiccondition of the active population, impair the quality of life, and become potentiallylethal.However, the access and coverage of essential surgical care, as part of the human rightto health, are not widely guaranteed-3. Asylethal..In addition to improve the quality of life, the quality of surgical interventions, andincrease access to surgery, it can assist in achieving the United Nations Millenniumgoals for 2015; considering that surgery enhances the reduction of child mortality goal4) and improves maternal health  for obstetric complications treatment. Inaddition, surgery may contribute to reduce the number of people living in poverty , since surgical conditions can keep people outside the labor market and imprThus, considering the importance of the global surgical assistance, its impact on thequality of life of patients, limitation of access and health care coverage, and interestin answering some emerging challenges in nursing, this study aimed to characterize theaccess to surgical assistance in Brazil.Caixa Preta da Saúde[HealthBlack Box] database.Documentary study, with a quantitative approach, carried out from a secondary source ofdata, of public domain, of the electronic .This database, created in March 12, 2014, is the result of a non-governmental initiativeof the Brazilian Medical Association. It is an electronic communication channel withusers of health care that aims to receive and compile, into a database,complaints/records on the issues that affect the public and private health in Brazil.Voluntarily, anyone, from anywhere and at any time, can send photos and videos,complaining failures and describing the difficulties faced in the search for healthcare. Complaints are forwarded to the Public Prosecution for formal verification of thefacts reported, thus contributing to the government and managers to take the necessaryprecautions.We considered as an inclusion criterion the records containing information aboutsurgical assistance in Brazil. To select them, we used the following descriptors:surgery, surgeon, surgery center, to operate, operation, preoperative, postoperative,surgical, anesthesia, and anesthesiologist.The data were collected in March, 2015. In the electronic database (accessed by theaddress http://www.caixapretadasaude.org.br) all records were selected for the period of12 months , of each Brazilian municipality. After readingeach record, we selected those that contained the descriptors previously defined. Forthe collection, we used a structured instrument, with the following variables: lack ofaccess, waiting time for surgery, waiting time for appointment with a specialist,waiting time for examinations, cancellation of surgery, and surgical specialty.Statistical analyses were carried out using the Statistica software 12.0. The resultswere expressed as mean and standard deviation for the quantitative variables and infrequency and percentage for the qualitative variables. We used the Chi-square test toverify differences in the proportions between regions of the country, and the one-wayAnalysis of Variance (ANOVA) for comparison between average values. For all theanalyses, a p<0.05 significance level was considered.Regarding ethical aspects, we used information from the public domain, present on theInternet. Thus, we obtained an authorization of the responsible people for the database,since they are the trustee of the information. In addition, we followed all ethicalprinciples required for analysis and dissemination of data.There are 3773 (100%) records related to health care in Brazil. Of these, 458 (12.3%)involved surgical assistance. Most of the surgical records, 339 (74.1%), involved lackof access in all Brazilian regions, according to Other records about surgical assistance, 119 (25.9%), comprised hospital care regardingphysical structure, such as precarious conditions of hospital facilities and poorhygiene; the given assistance, which included the lack of information about users,humanization and quality regarding the services related to human resources, includingmedical malpractice and negligence, and also negligence of health professionals with theusers and their families (data not shown). We found that the main access constraint wasthe waiting time for care, at different points of the health care network, with apredominance of waiting list for surgery, according toCaixa Preta da Saúde, the critical center of surgical assistanceis predominantly the lack of access of the user to surgery. For users, the prolongedwaiting time is the main access constraint to primary health care.Surgical assistance is essential. However, in this study, we noted that, accordingtoCaixa Preta da Saúde database. This is a provocative and relevanttool, which gives voice to the Brazilian health system users, and has the potential toconstitute an important mechanism of ombudsman. Indeed, it is a tool which exposes theweakness of the public health system in Brazil, illustrating with dramatic tones thedifficulty of many people to at least have their complaints heard, and much lessmet.According to the indexed literature, this is the first study that uses information fromthe . Moreover, it is a powerful means of promoting health, well-being, andhuman development.On these findings, it is believed that health care in Brazil is often against thefundamental assumptions of Universal Health Coverage, in which all people should haveequal access to health actions and services of quality, according to their needs overlife. The Universal Health Coverage should be the main objective and guideline of healthsystems, and its fundamental premise is the right everyone has to the highest standardof health care. Moreovelopment.. Additionally, regarding Internet access in Brazil, there is a markedinequality between regions. Regions with more access, Mid-West, South and Southeast,surpass the North and Northeast regions. Thus, this disparity may have limited the use of the tool by Brazilians,particularly in the Northern region.Regarding the number of records, it was observed that the Southeast region significantlysurpassed other regions. This greater potential of use of the tool in this region can bedue to the higher population density. On the other hand, the Northern region, withsmaller number of records, has the lowest population density (3.9 people perkm²). Additi.It is noted that the Southeast, as the main user of the tool, faces limitations to theUniversal Health Access and Coverage, similar to other regions, even with highersocioeconomic development and better welfare conditions, regarding the number of beds,specialized hospitals available, and operations per inhabitant when compared to theNorth and Northeast..Regarding the lack of surgical access, this is not a new problem: health systemsworldwide, regardless of the socioeconomic status of the countries, deal with it. InBrazil, the waiting list for elective surgeries is a reality with regional nuances as toprocedures with longer or shorter lists, whether measured in number of patients orwaiting time..We noted that the waiting comprised all the course of the user in the health carenetwork. Considering that the user, due to the presence of signs and symptoms, accessesthe network searching for medical care in the basic care. Once acknowledged the need,there is the referral to the specialist in the outpatient care. After a long process ofappointments, research, expert evaluation, and the need for surgical treatment, the useris placed in a waiting list for surgery, which will occur in the hospital careinstance..Similarly, a study conducted to verify the barriers to the access to the treatment ofcataracts showed a gap between the search for specialized medical care and surgicalresolution. The contributing factors were the difficulty in preoperative examinations,number of times the patient needed return to the service (3.2±1.5) as well as thewaiting time between the first consultation and the surgery (3.2±2.6 months). The amountspent on the preoperative examinations ranged from 5 to 170 BRL.. It is recognized that the incorporation of records is voluntary anddepends on the users with access to Internet. Thus, we should be cautious ininterpreting this result, because official data from health services can scale moreprecisely the reality of the waiting list for the service in the regions of the country.Despite this constraint, this result shows a cruel and legitimate reality, complained byusers who were drastically underserved.In this study, we showed an excessive waiting time, over one year, to surgical care inall regions of the country. In the South region, there was a longer waiting time, withsignificant difference in relation to the Mid-West, North, and Northeast regions.However, studies show variations from 3 to 6-month in waiting time, with more accessibleservices in the South and Southeast regions,12. I.It should be noted that the prolonged waiting for care occurs when demand is greaterthan the capacity of the public system. Often, the list reflects the inadequacy ofpublic funding for health. And is one of the main problems of public health systems,being a permanent source of political and social discontent.. Data from Caixa Preta da Saúde show that, in addition tothe predominance of lack of access, in certain situations, the prolonged waiting time onthe list for surgery does not ensure the care. Eventually, the user deals with a newobstacle, the cancellation of surgery as a result of inadequate infrastructure. Inaddition, when users access the hospital care, the infrastructure is precarious, andthere is no quality in the assistance offered.Achieve Universal Access to Health and Universal Health Coverage is a permanent, complexand challenging task. Data f.In Brazil, despite the urgent need for tackling the current challenges relating toachieve Universal Access to Health and Universal Health Coverage, it should berecognized that, in health, an advance landmark was the health reform, which culminatedin the creation of the Unified Health System (SUS). The result of the struggle ofBrazilian society, politics and government actions, provided a significant expansion ofaccess to health care, through the Family Health Strategy..Following this direction, from 2014, member states of the World Health Organization/PanAmerican Health Organization have been focusing on concurrent and independent actions toexpand the equitable access to complete health services, of quality, and focusing on thepeople and communities, to promote the expansion of Universal Access to Health andUniversal Health Coverage.. However, what was supposed to be an emergency strategy has become themodus operandi for access, being a palliative measure, costly to thesystem and that does not guarantee the access to surgical assistance in a sustainableway, since the extended waiting time in the list for surgery persists, with negativeimpact on health and quality of life of patients.More specifically on access to surgery, we highlight the mutual-aid group of surgeries,government-funded, through allocation of extra resources. The mutual-aid group aims tomeet the repressed surgical demands through concentration of efforts of the healthservices to accomplish a significant number of surgeries in a short time. Howevepatients.. This ensures a gap favorable to the offer of a private health system,which firmly established in a neoliberal policy guarantees the access to who can affordit, increased the fact that, at the highest level of power, it is used as lobby andpolitical influence to perpetuate a cycle of abandonment of the public health system andfavoring the private initiative. In summary, it is said that the State deserts itsfunction as provider of the citizens' health, to deliver it as a consumer or customer toprivate agents.In relation to the political and economic aspects, constraints to the access to healthin Brazil, we noted that the public investment in health system remains, unacceptably,below the desired levels and, significantly, lower than international standards. Thus,the public spending on health care was responsible for only 48% of total healthexpenditure, accounting for only 7.2% of the total public expenditure, significantlyless than the total value of 14.3%. The total expenditure on health per capita per yearis, on average, 427 USD. From this amount, only 204 USD were invested by the government,a much lower value when compared to an overall expenditure of 429 USD per capita or forinvestment from developed countries such as the United States of America  or Europe .When it comes to surgery, there are public investment restrictions similar to thosementioned above, confirming the finding of a government practice of severe public healthunder-funding. From 1995 to 2007, 32,659.513 non-cardiac surgeries were analyzed. Therewas substantial increment of 20.42% in the number of surgical procedures. However, theepidemiology of surgeries in Brazil differs considerably, from international standards.Annually, about 38 million surgeries are held in the United States of America, and 7million in Europe. In Brazil, there were approximately 3 million non-cardiac surgeries.Additionally, it was noted that the costs of the procedures are lower, and the mortalityrate is higher in developed countries. Thus, we concluded that the access to surgicalinterventions is poor and uneven, with insufficient number of surgeries accomplished,and surgical results are even worse when compared to international standards(-). Thus, it is believed that an integrated approach, which includes endlessjoint efforts in the political and economic aspects, in the organization of the healthcare network, management of health services and human resources, will enable to overcomethese challenges, in such a way that health and other social rights of Braziliancitizens are widely guaranteed.Therefore, only a systemic change is able to overcome the challenges imposed to achievethe Universal Access to Health and Universal Health Coverage-15. T. Furthermore, given the social determination of health, the economic crisisand social inequality must confront, education must be improved, the environment must bepreserved, and the increasing demands of an ageing population must be met. Equally important, the influence of the medical and pharmaceuticalindustry in the health sector must be mitigated, which is often subservient to theinterests of the market, to the detriment of the interests of the population, amongothers.Regarding the political aspect, it is imperative that government policies face thechallenges related to the macroestructure complexity, so that they can overcome thechallenges imposed to health. Thus, for improving health, it is necessary to improvegovernance, i.e., a greater degree of responsibility of the public sector, lesscorruption, and assumption that provide the public health system is a constitutionalduty of the State,14. F.Regarding the health care network, to optimize the deployment of mechanisms andstrategies of organization and integration of assistance network contributes to promotethe capacity of health systems to provide more coordinated care, minimize accessbarriers between assistance levels, and a health care more synchronized and in a propertime. However, it should be recognized that one of the main obstacles to the integrationof the health services network is the prolonged waiting time for the care.(-).Regarding the organization of the network to surgical assistance, aiming to improve theaccess and qualification of social assistance practices, the access to specialized andhospital services should occur, predominantly, through reference of Family HealthStrategy. Additional actions include the development of protocols to facilitate theaccess to specialized and hospital care. To undertake efforts along with otherprofessionals, to further integration, exchange and information continuity between basicand specialized care. Definition of access measures, such as the waiting time forprimary care, consultations with specialists, diagnostic tests, and waiting for surgeryand, based on these indicators, to establish strategies for better management ofwaiting-17..In outpatient level, we recommend instituting careful research about the needs of theusers in a waiting list situation, namely: clinical criteria such as health statusdeterioration, disease evolution, disabling pain, and mobility limitations;socioeconomic criteria concerning the ability to live and work independently, inaddition to the emotional aspects. This allows the user the re-evaluation of prioritywhile in the waiting list, and reconducting the family health team, for continuousmonitoring,17.(17).In addition, encouraging the development of guidelines for determining safe andacceptable waiting period, development of prioritization tools of assistance to considerthe psychosocial characteristics, definition of responsibilities to operationalize theprioritization process, being a surgeon, nurse or other healthprofessional.Strictly regarding to the management of resources, comparisons show that greater supplyof beds, health professionals and health expenses are effective strategies, inlong-term, in management of the waiting. Thus, the ability of the health services can beoptimized. We suggest the payment for productivity, quantitative and qualitativeinvestment in human resources, evidence-based practice support, and use of idle capacityof surgical center on weekends, among others,17.. Especially nursing, due to the constraint potential in completely meetingthe needs of the population, in the different points of the health care network.However, deep imbalances and gaps remain in the availability, distribution, composition,competence and productivity of health human resources, especially in primary healthcare.Human resources are considered one of the central pillars for Universal Access to Healthand Universal Health Coverage. Especilthcare..Thus, enhancing the scope of nursing practice requires political will for change.Notably, in the political field, it is essential the development of infrastructurepolicies that support the nursing profession, including regulation, scope of practice,certification, undergraduate studies, graduate studies, continuing education and wagereform.In the field of professional performance, nursing, in partnership with other healthprofessions, must assume the commitment to public health, through the construction andconsolidation of the SUS. To make this commitment involves overcoming Cartesian healthassistance practices, aiming the completeness of the care, introjecting the premises ofhealth policy in force, incorporate them into your practice, and act in the organizationof health care networks, with emphasis on primary health care..In the field of training, nursing must have the commitment to the construction of valuesthat structure it as a social practice, provided through the interpretative looks of itshistory and open to the current reality, considering the political, economic and socialstructure in force in the country, health care models and their coverage, as well as theinternal struggles of workers in the process of work and future challenges.Caixa Preta da Saúde database, most records aboutsurgical assistance involved the lack of access in all regions of Brazil. The mainaccess constraint was the prolonged waiting time for surgery. Thus, we observed that theaccess to surgical assistance, by the Brazilian health system users, is not widelyguaranteed. This reinforces the need for integrated governmental actions, organizationof the health care network, management of health care and human resources to overcomethe challenges imposed to achieve the Universal Access to Health and Universal HealthCoverage.According to the Therefore, if Universal Health Coverage is assumed as a government priority and also ofhealth services, it will stimulate the nursing to expand its role in the construction ofa system of universal, equitable and complete public health.


Mitchell P. Fink, MD Fig. , one of Mitch graduated from the Washington University School of Medicine in St. Louis, MO, in 1976 and completed general surgery training at the National Naval Medical Center in Bethesda, MD, in 1981. Thereafter, he held faculty positions at the Bethesda Naval Center and the University of Massachusetts, where he worked as surgeon and intensivist. In 1992 he moved to the Harvard Medical School, eventually becoming the Johnson and Johnson Professor in Surgery and surgeon-in-chief at the Beth Israel Deaconess Medical Center. He moved to the University of Pittsburgh in 1999, where he subsequently became the inaugural chair of the Department of Critical Care Medicine. He founded several companies based on discoveries from his laboratory and, in 2007, left the university to oversee the formation of one of these ventures. In 2009 Mitch returned to academia, joining the faculty at University of California Los Angeles where he held the title of Professor of Surgery and Vice Chair for Critical Care.During his career, Mitch cared for thousands of patients with skill and compassion, amassed a great body of experimental and clinical research, trained and mentored hundreds of physicians and scientists, demonstrated wonderful entrepreneurship, and carved a vision of modern multidisciplinary critical care with lasting benefits for our entire field. For decades, academic medicine has praised the rare individual who excels as the so-called triple threat: teacher, clinician, and scientist. Mitch was all three and more, adding to these triple roles the rare gift of visionary leader in both academia and industry. I have never known anyone quite like Mitch.Nature while still in medical school. While working in Bethesda, he forged close relationships with the National Institutes of Health critical care group, conducting a number of seminal experimental studies that both helped to establish the utility of animal models to probe the host response to sepsis, trauma, and shock and to inform our current understanding of these syndromes. Later, Mitch would conduct pioneering work using cell-based models of organ dysfunction to tease out the cellular response to stress from hypoxia and endogenous and exogenous danger signals, exploring key concepts of mitochondrial dysfunction and dysoxia. In addition to his passion for experimental research, Mitch also conducted many highly cited clinical studies, co-wrote the Textbook of Critical Care, and served on the editorial boards of numerous journals including Critical Care, Critical Care Medicine, and Intensive Care Medicine.His extraordinary career began early with a first author paper in To all of his work, Mitch brought four enduring characteristics: knowledge, logic, creativity, and focus. He maintained an encyclopedic knowledge of the world, able to quote relevant papers, data, and information off the top of his head from a dizzyingly wide range of art, science, politics, and history. He also exercised crystal-clear logic, distilling the most complex problem into a series of simple steps, whether this was a complicated piece of basic science or a tough business decision facing a start-up biotechnology company. Having concisely summarized any problem, he then brought great creativity and inventiveness to probe and tackle its solution. Finally, he always kept a clear sense of purpose, making sure neither he nor his colleagues ever lost sight of the larger goals of advancing medical knowledge and saving lives.I came to know Mitch during his tenure in Pittsburgh when he oversaw one of the most prolific and successful eras in our history, serving as a wonderful mentor and colleague, and launching the first multidisciplinary department of critical care medicine in a US medical school. In our daily contact with Mitch, we saw not only his intellect and drive, but also his warmth, compassion, wit, and grace. His door was always open, ready to listen to everyone from senior colleagues to junior residents and new staff. He had words of kindness and advice to coach us through every disappointment and words of praise and respect for every accomplishment. For me, as for many, Mitch was unquestionably one of the most supportive and influential people we have ever known. Through both his words and actions, he taught us not just about medicine and science, but about life, relationships, honor, duty, and service. We have lost an immense presence. Mitch is survived by his wife, Judy, and children, Matt and Emily. We extend our deepest condolences to them. He will be deeply missed.


International collaboration is growing exponentially  and reseRecognizing the value of research networking, Cedars-Sinai Medical Center (CSMC) started building in 2002 a regional research organization in CEE by establishing International Research and Innovation Management program. During the first four years of the program, CSMC established partnerships with research institutions in Croatia, Czech Republic, Hungary, Romania, Slovakia, and Ukraine. CMSC provided training on research and innovation management, technology transfer infrastructure, and management capacity. In 2006, it formed the Regional Cooperation for Health, Science and Technology (RECOOP HST) Consortium with eleven CEE universities and research organizations from the following countries: Croatia, Czech Republic, Hungary, Romania, Slovakia, Ukraine, and the USA .In 2012, CSMC registered with the Consortium the Association for Regional Cooperation in the Fields of Health, Science and Technology at the Court of Debrecen in Hungary. The newly established Association included members from 8 countries, adding Denmark and Poland to the consortium, and involving 14 higher education or research organizations.The Association promotes creative thinking and helps its members to make decision whether they want to “publish and disclose” or “protect and publish.” Special attention is paid to young scientists and their education on scientific communication and technology transfer. In 2012, it carried out several integrated multidisciplinary, multicenter research studies within the joint RECOOP Life Science Research Platform and formed 18 CSMC RECOOP Research Centers (CRRC) in 7 countries  to facilitate the cooperation on translational and clinical research in the field of genomics-proteomics, epigenetics, metagenomics, molecular biology, metabolomics, and nano-biotechnology. Besides that, among its highest priorities is the involvement of medical and PhD students into the CRRCs’ research programs.RECOOP Life Science Research Platform already completed a number of short term (1-2 years) pilot research studies, which are now being converted to midterm (5 years) projects. The clinical studies are planned to continue for a minimum of 20-30 years and follow up the women, men and newborns registered in the Electronic Data Entry Forms, started in 2011 .The RECOOP HST Association annually organizes the Bridges in Life Sciences Conferences to review the scientific progress in the Association. At the annual meeting, the Scientific Advisory Board selects the top ten young scientists, for whom the Association covers the attendance costs of summer schools and workshops on manuscript writing and intellectual property protection.RECOOP plays a significant role in the integration of life science research activities in member countries of Visegrad Four European Macro-Region  and their neighboring countries . The Association paves the way for GLOBAL Research Programs of the National Institutes of Health and the World Health Organization, and private funds such as Bill & Melinda Gates Foundation and Clinton Foundation .In Croatia, the RECOOP HST Association includes researchers from the J. J. Strossmayer University School of Medicine in Osijek and University of Split School of Medicine. Professor Ana Marušić from the University of Split School of Medicine, who has extensive experience in teaching and studying research methodology ,9, contiSince CEE countries are considered a scientific periphery, there must be an even stronger impetus to increase their participation in international research consortia. Sustained engagement in training programs and joint applications to research funding can stimulate research network development . RECOOP As part of the ongoing process of European integration , the REC


CDC and Emory University’s Rollins School of Public Health will cosponsor a 6-day course on Environmental Microbiology: Control of Foodborne and Waterborne Diseases at Emory University, Rollins School of Public Health. This course on the surveillance of foodborne and waterborne diseases is designed for public health practitioners and other students interested in the safety of food and water. It provides a broad overview of the major foodborne and waterborne diseases.This course describes how information from surveillance is used to improve public health policy and practice in ways that contribute to food and water safety. Discussions focus on the microorganisms and chemical agents responsible for food and water-transmitted diseases, the diseases they cause, pathogenesis, clinical manifestations, reservoirs, modes of transmission, and surveillance systems. The transport, survival, and fate of pathogens in the environment, the concept of indicator organisms as surrogates for pathogens, and the removal and inactivation of pathogens and indicators by water and wastewater treatment processes will be analyzed. Examples of the public health impact of quality assurance programs, such as hazard analysis and critical control points, on control foodborne and waterborne diseases in industrialized and developing countries will be highlighted.http://www.sph.emory.edu/epicourses), or by e-mail .This course is offered to matriculating students at Emory University and to nonmatriculating public health professionals. Tuition will be charged. The application deadline is December 15, 2013, or until all slots have been filled. Additional information and applications are available by mail , by telephone (404-727-3485), online (


Background: Pasteur Institute of Iran was established in 1919 with the aim to produce vaccines and prevent communicable diseases in Iran. Over time, their activities extended into areas of research, education and services. Naturally, such a vast development begs establishment of a comprehensive management and monitoring system. With this outlook, the present study was carried out with the aim to design a performance assessment model for Pasteur Institute of Iran that, in addition to determining evaluation indicators, it could prepare the necessary grounds for providing a unified assessment model for the global network of the Pasteur Institutes. Method: This study was designed and performed in 4 stages: first; design of indicators and determining their scores. Second; editing indicators according to the outcome of discussions and debates held with members of Research Council of Pasteur Institute of Iran. Third; implementation of a pilot model based on the Institute’s activities in 2011. Fourth; providing the pilot model feedback to the stakeholders and finalizing the model according to an opinion survey. Results: Based on the results obtained, the developed indicators for Pasteur Institute of Iran evaluation were designed in 10 axes and 18 sub-axes, which included 101 major and 58 minor indicators. The axes included governance and leadership, resources and facilities, capacity building, knowledge production and collaborations, reference services, economic value of products and services, participation in industrial exhibitions, status of the institute, satisfaction and institute’s role in health promotion. Conclusion: The indicators presented in this article have been prepared based on the balance in the Institute’s four missions, to provide the basis for assessment of the Institute’s activities in consecutive years, and possibility of comparison with other institutes worldwide.  As one of the principle members of the health and research system, Pasteur Institute of Iran can play an important role in providing the community prevention and control of disease and in achieving the objective of Iran's national future outlook in 2025. Pasteur Institute of Iran is a longstanding member of the International Network of Pasteur Institutes. This network operates with membership of over 30 institutes across the five continents. It is a research, manufacturing, and educational organization that was established in 1919 with the aim of supporting public health and preventing communicable diseases. The necessity for establishing this scientific institution was initially to produce vaccines and to prevent communicable diseases. However, the current policies of this institute include implementing basic and applied research in diagnosis of diseases, providing prevention and control methods, manufacturing biologic and laboratory products, education and research in other medical science fields, holding independent practical units in various specialized areas, and conducting joint educational and research projects with similar centers in national and international levels [An overview of the global network of Pasteur Institutes reveals that, generally, activities of this network members involve in research, public health, education and production, national and international collaborations, interaction with the industry, community etc. . The annThe present study was conducted in 2011 in four stages as follows:Stage one. Available reports of other Pasteur Institutes as the members of global network of Pasteur Institutes, published reports of the Pasteur Institute in France (as the first in the world), and even the newest Pasteur Institute in China, national comprehensive scientific map and health scientific map in Iran as well as constitutional and strategic plan of Pasteur Institute of Iran were reviewed. Based on the reports from other Pasteur Institutes in the world, generally, activities of most institutes include research, education/training, production, clinical services, and providing professional health services, nutrition, food security, environment, and attention to the necessary infrastructures, such as the physical space, human resources and budget, cooperation with the community and industry, utilization of research findings, the institute’s role in public health, national and international collaborations, being a reference source at national and international levels given the previous history and prospects through outlining the vision, the mission, objectives, and defining strategies.Through analysis of the mentioned documents, a list of categories and sub-categories of indicators were listed based on the responsibilities, mission, and strategies of Pasteur Institute of Iran and the health research system model . At the Stage two. The developed indicators were discussed with the members of Research Council of Pasteur Institute of Iran, and the model provided was revised according to the members’ comments.Stage three. According to the values of each indicator and their axes, score of each indicator was determined. Furthermore, a pilot evaluation model was carried out to evaluate the applicability of each indicator in 2011.Stage four. The results of the pilot study were reported to the Research Council of Pasteur Institute of Iran with the aim of finalizing evaluation indicators and scores, assessing challenges and providing strategies to conduct annual performance evaluation based on the developed indicators. The evaluation model was then finalized.The indicators developed for performance evaluation of Pasteur Institute of Iran were designed in 10 axes and 18 sub-axes consisting of 101 major and 58 minor indicators. The axes included: 1) governance and leadership, 2) resources and facilities, 3) capacity building, 4) knowledge production and collaborations, 5) reference services, 6) economic value of products and services, 7) participation in industrial exhibitions, 8) status of the institute, and 9) satisfaction and institute’s role in health promotion. Each axis included a number of sub-axes, each sub-axis had some major indicators, and some major indicators contained one or more minor indicators.Based on Other governance criteria included the presence of clear policies and strategies for the Institute’s activities in the form of strategic program, with its indicators considered to consist of content, including having a vision, a mission, and a mission statement, objectives and an action plan, a monitoring and evaluation program, and the ways of other stakeholders participation of in program development.Finally, a clear ethical program includes ethical committee activity in terms of number of meetings, composition of members based on the approval of the Ministry of Health Research Department, supervision method of the committee on the referral projects in need of assessment and on its implementation process. In total, 159 marks were considered for this axis, which included 130 marks for autonomy of Pasteur Institute of Iran, 19 for strategic program, and 10 for ethics.According to The physical resources were analyzed in terms of the physical space and facilities. These assessment criteria were performed by the opinion of the head of training/research groups in terms of qualitative and quantitative indicators of laboratory commensurate with the groups/department objectives, quality of materials used, advanced equipments and finally quality and quantity of production and service units appropriate for the strategic program.In total, this axis scored 658 marks consisting of 50 marks for financial resources , 438 marks for human resources , and 170 marks for the physical resources.Based on According to the indicators in  Other sub-axes and the following indicators in this axis were included in a model for the first time. Thus, no information was available on these sub-axes. The sub-axis of communications and cooperation contained indicators of membership in science and technology parks, membership in international branches/networks, and collaborations with WHO as a “collaborating center”. For the publication of scientific/research journal, based on indexing databanks , full marks were allocated for first publication, or a percentage was allocated for subsequent years, depending on the type of profile. The indicator of “Awards” achieved in festivals was accounted according to the festival and national or international institutions (various agencies in the United Nations). The sub-axis of technology and innovation, through indicators of number of incubators, number of knowledge-based companies according to subject, number of spin-off companies according to subject, and time of establishment were awarded full marks for the first year, and a fifth of marks for subsequent years.The sub-axis of training and technical consultations was awarded marks according to type of organization such as other Pasteur Institutes in the world, other scientific/research organizations abroad, the World Health Organization, Ministry of Health and Medical Education, industry and other universities, research centers and scientific institutions of the country, and also according to type of presentation, correspondence, electronic mail, or in person. The sub-axis of regulated guidelines and summaries was considered from the end-user’s perspective  and type of guideline or summary  and means of information transfer . In terms of scoring, no limitation was implemented in the collaboration and knowledge production and publication, considering the nature of indicators.Other indicators are presented in The referential nature of services in terms of laboratory, specialty, and technology at national, international, and regional levels was considered according to the first year or subsequent years of services. The indicators of economic value of products and services and the value of knowledge generated were considered in terms of geographical spread of product and service utilization and marketable production project (inside and outside of the country). The presence in industry exhibitions was assessed in terms of number of pavilions of Pasteur Institute of Iran (in the country and abroad). The status of the institute at national and international levels was considered according to a written opinion of the public visiting the institute, opinion survey conducted in organizations interacting with the institute and other stakeholders. Finally, world ranking of the institute was considered. In terms of satisfaction, the level of satisfaction and loyalty to the organization among the personnel of Pasteur Institute of Iran as internal stakeholders (members of faculty and experts) was considered. The most important outlook of the institute, its role in health promotion, will be investigated through its role in promoting equity in health indicators according to the opinion of stakeholders in the Ministry of Health . All indicators in et al. [Based on the nature of Pasteur Institute of Iran, in the governance and leadership axis, in addition to strategic program indicators and the ethical committee activity considered by Jalalinia et al.  and conset al. , financiet al. [et al. [In the resources and facility axis, although Pazargadi et al. , 10 cons [et al.  emphasizIn relation to capacity building axis and the presence of structures, only managerial structures in areas of education, research, services, and production were active. Also, creation of other structures based on the discussed indicators will be effective in promotion of the institute in future.According to the existing evidence, missions of the world’s Pasteur Institutes, including Pasteur Institute of Iran, have been different from those of academic centers. Over the years, the role of Pasteur Institute of Iran in controlling fatal communicable diseases such as plague and rabies and more recently, hemorrhagic fevers support this claim. In recent years, two new responsibilities as education and production have been added to the previous research and service responsibilities of the institute. Of course, in the past, the institute had collaborations with universities and Ministry of Health in terms of professional education and training on the job, and even directly produced B.C.G. vaccines and other products used in prevention and control of communicable diseases. With new missions causing improvement in quality of research and services and eventually community health promotion and equity in health, the national and international credibility of Pasteur Institute of Iran will be enhanced. However, if the attraction of education and production retreats the institute from applied and targeted research and responding to the public health needs, and Pasteur Institute of Iran neglects its holistic and equitable role, undoubtedly, an interminable loss on the country’s healthcare system will ensue. Fortunately, the Board of Trustees of Pasteur Institute of Iran is fully aware of this issue, and has special supervision and attention to the strategic plans and evaluation indicators of Pasteur Institute of Iran. The indicators presented in this article have been produced in accordance with maintaining balance in four missions of the institute, so that, it can provide a basis for evaluation of activities of the institute in consecutive years, and perhaps, for comparison with other institutes in the world. The important point is that the presented indicators and scores are merely suitable for a beginning in evaluation and can be altered in future evaluations. Of course, this should not harm the old mission of the Pasteur Institute of Iran.


Morbidity and Mortality Weekly Report (MMWR) series of publications.Stephen B. Thacker, MD, MSc, a retired Assistant Surgeon General in the U.S. Public Health Service, and recent Director of the Office of Surveillance, Epidemiology, and Laboratory Services at CDC, died on February 15, 2013, in Atlanta, Georgia. He was 65. Dr. Thacker served with distinction in key CDC positions, including Deputy Director (Acting), during a career that spanned more than 36 years. He was the recipient of two of the U.S. Public Health Service’s highest individual honors, the Distinguished Service Medal and the Surgeon General’s Medal. Throughout his public service, he provided essential support to the Born in Independence, Missouri, Dr. Thacker was educated at Princeton University and the Mt. Sinai School of Medicine. He completed a residency in Family Medicine at Duke University and obtained an MSc degree at the London School of Hygiene and Tropical Medicine. He was board-certified in Family Medicine and Public Health and General Preventive Medicine. During his career, he published over 240 articles and book chapters on public health and health care.MMWR series: in 1983, Dr. Thacker conceived and helped to launch the Surveillance Summary component of the MMWR series to advance the science and effectiveness of this essential function in U.S. public health practice.Dr. Thacker joined CDC’s Epidemic Intelligence Service (EIS) Program in 1976 and was assigned to the Washington, DC, health department. Beginning with an early leadership role as director of CDC’s public health surveillance office and continuing throughout his career, he made substantive contributions to the public health practice of surveillance that have been institutionalized in the United States and globally. One example is the enduring effect of his influence on the MMWR through surveillance, Dr. Thacker provided ongoing, routine, senior-level review of the contents of each issue of the MMWR weekly throughout most of his career. His expertise in epidemiology, public health practice, and related disciplines, and his knowledge of and insights about CDC history were highly valued by MMWR editors and added substantially to the quality, accuracy, and integrity of the publication.In addition to his contributions to


Osorio.There are errors in the Competing Interests section and in the affiliations listed for 12The complete, correct Competing Interests information is as follows: Author Jorge E. Osorio is fully employed by Takeda Vaccines. He was a co-founder of lnviragen, Inc. a company that licensed the live attenuated dengue vaccine candidate from the CDC and that was later acquired by Takeda. He has actively worked in the preclinical and clinical development of this dengue vaccine and is also a patent holder on chemical formulations that provide increased stability to the vaccine. He has a direct financial interest in seeing the dengue vaccine developed, approved and commercialized.The correct affiliations for Jorge E. Osorio are as follows: Department of Pathobiological Sciences, University of Wisconsin, Madison, Madison, Wisconsin, United States of America, and Takeda Vaccines, Inc.


Reason for Corrigendum:Due to an oversight, there was a mistake in the affiliation of the Corresponding Author Farhat Afrin, as published. Also, in the original article, we have neglected to thank our sponsors Deanship of Scientific Research, Taibah University, Medina, Saudi Arabia, grant number 7127 to FA and HH. The correct Acknowledgments should have been published as:donovani culture. Our thanks are due to Mr. T. A. Nagarjuna and Dr. V. Gupta, BD-JHFACS Academy, Jamia Hamdard, for their immense help and cooperation in flow cytometry work. We are also thankful to Mrs. F. Ahmad who extended help in plant collection and extraction. Our collaborative Microbiology Research Group at Faculty of Applied Medical Sciences, Taibah University, Kingdom of Saudi Arabia is gratefully acknowledged for meeting the publication cost and process apart from their significant roles and scientific participation in the work. The present study was supported by theDeanship of Scientific Research (grant number 7127), Taibah University, Medina, Saudi Arabia, Department of Science and Technology, Department of Biotechnology and Central Council for Research in Unani Medicine (CCRUM), Government of India.Present study was financially aided by Department of Science and Technology, Department of Biotechnology and Central Council for Research in Unani Medicine (CCRUM), Government of India. GC was formerly recipient of Senior Research Fellowship from CCRUM and Basic Research Fellowship from University Grants Commission (UGC), under UGC-Special Assistance Grant (SAP) received by Department of Biotechnology, Jamia Hamdard, during the period of study. We profoundly thank Dr. N. Ali, Indian Institute of Chemical Biology, Kolkata, India, for providing us L. The authors apologize for this oversight. This error does not change the scientific conclusions of the article in any way.GC, MI: Designed and conceived the study, performed experiments, analyzed, and interpreted the data. MW: aided in carrying out in vivo experiments. DS, HO, and HH: contributed to reviewing of manuscript. FA: conceived and supervised the work, and contributed to designing of experimental plan and execution of work along with analysis and interpretation of data, manuscript writing and reviewing the manuscript. All the authors approved final version of the research article.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The surge of the new interdisciplinary centers, the new titles and slogans, these days, are all a genuine attempt to lead a responsible change of the research and development as well as the treatment paradigm towards better healthcare in particular, and well being to ALL, in general. The goal is to change the paradigm in health care - from delayed interventional medicine to predictive personally tailored medicine, from reactive to preventive medicine and from disease to wellness, facing the major needs of society. Based on the remarkable achievements in the past decade, the CKTS  approach was presented by the NSF Dec. 2012) reflecting the series of workshops held around the world. The “Holistic approaches to wellness and human development", is one focus, among other wide range of recommendations in the broad area of science. That is fully aligned with the practice of medicine that is moving from a passive coincidence model to an active convergence model, including micro and macro environmental effects. At the center of this transformation is the intersection of physiology, molecular profiling and information technology, combined with a number of converging technologies that affected the human cognition, communication and quality of life. The common denominators were the availability and compatibility of technologies, functional imaging including brain imaging, enabling of big data analysis, etc. The practical goal is to provide inspired translational research from basic science to preventive, predictive and personalized medicine. As a practical enabling system, a Simultaneous Systematic Analysis (SSA) approach is suggested, to provide the broadest possible insight into the individual comprehensive functioning in the surroundings - as one refined complex system- over time and modes of actions. The targeted platform envisioned will enable and encourage an open, innovative systematic effort, sharing all findings and combining all acquired knowledge, technologies and expertise, focused on a specific phenomenon or disease. The approach suggests an operational mode for multilevel, multisource research that would reduce barriers, encourage creativity and innovative research, while enabling responsible and safe sharing of all findings. It can be envisioned as a matrix scheme, applied, for example, to drug efficacy, in which the rows represent the various levels of the patient  and the columns represents the various research and professionals working groups, each focusing on a specific aspect of the micro- and macro-environment (see figure 2 reflectThe iii-3 Cancer Center - (Infection-Immunity-Inflammation Driven Cancer Diseases), at Tel Aviv University, is another feasibility study, as an example, to the SSA approach - shortening the time-lag for patent administration - the regulatory scheme and procedures.- education paradigm change at all formal levels from childhood to graduate studies.- academic institute's structure and culture adaption at all levels: teaching and collaborative research paradigm including adjusting the personal evaluation and promotion schemes.


S. Department of Energy, Office of Science, Office of Biological and Environmental Research, through contract DE-AC02-05CH11231 between Lawrence Berkeley National Laboratory and the U. S. Department of Energy. The United States Government retains and the publisher, by accepting the article for publication, acknowledges that the United States Government retains a non-exclusive, paid-up, irrevocable, world-wide license to publish or reproduce the published form of this manuscript, or allow others to do so, for United States Government purposes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.There is information missing from the Funding section, specifically regarding the United States Department of Energy and the Lawrence Berkeley National Laboratory. The correct statement is as follows: This work was supported by a grant to PCR from NIH (GM59962) and NSF (1237975). This work was part of the DOE Joint BioEnergy Institute (


Investigators from University of Oulu, Finland, evaluated the diurnal and seasonal occurrence of the first febrile seizures (FS) in 461 children in a population-based study of 1522 children. Investigators from University of Oulu, Finland, evaluated the diurnal and seasonal occurrence of the first febrile seizures (FS) in 461 children in a population-based study of 1522 children. The first FS occurred most often in the evening, peaking between 6 and 10 PM (31%), and least often at night, in the early morning hours between 2 and 6 AM (8%) (P < 0.001). This diurnal pattern was repeated in different seasons according to the variance in daylight duration. FS occurred irregularly throughout the year, most frequently in the winter, concurrently with the febrile episodes, and least frequently in the summer. The diurnal and seasonal variations in the occurrence of FS did not follow the amount of daylight throughout the day or year or variation in the secretion of melatonin. Rather, FS are strongly associated with episodes of fever, infections, and elevated body temperature. The maximum temperature of the fever in patients with FS  was similar throughout the year. [COMMENTARY. The seasonal and diurnal variations in the occurrence of febrile seizures (FS) observed in children in Finland  are repoSeveral factors may be involved in the cause of FS, including age dependency , genetic susceptibility , cytokine and immune response to infection, fever and height of body temperature. The maximum height of a fever, not the rate of rise, is the main determinant of risk of FSs, a finding demonstrated in animals , 7. In a


The fourth International Conference on Family Planning (ICFP) was held in Nusa Dua, Indonesia, on January 25–28, 2016. Themed “Global Commitments, Local Actions,” the conference stressed the importance of global and local partnerships to shape and influence the role and contributions of family planning in attaining health and development goals, in particular the new Sustainable Development Goals. Hosted by the Bill & Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health and the National Population and Family Planning Board of Indonesia, the conference attracted more than 3,000 participants and featured more than 500 oral presentations, 400 posters, and 90 panels and plenaries.We conceived this special issue of GHSP, comprising articles presented at ICFP, in collaboration with the Gates Institute to help disseminate important findings and lessons learned beyond conference participants to the larger health and development community. When reviewing the individual oral presentations accepted to the conference, we found at least 64 (13% of those accepted) that focused on long-acting reversible contraceptives (LARCs). It was clear to us that LARCs were an important focus of the conference and had unparalleled potential to reduce unmet need for family planning and improve contraceptive prevalence around the world.This special issue includes 11 articles that focus specifically on programs that deliver LARCs and how they were implemented so that others can learn from their experience. The articles address a range of cross-cutting topics, from training, supervision, mentoring, and task sharing to quality of care , vouchers, postpartum family planning, postabortion family planning, and family planning service delivery in fragile environments. The countries featured in the articles include Bangladesh, Cambodia, Chad, the Democratic Republic of the Congo, Kenya, Pakistan, Senegal, Uganda, and Yemen.–Global Health: Science and PracticeThis special issue is by no means an exhaustive review of the issues related to LARCs, but the articles provide important insight into the benefits and challenges of delivering LARC services, yielding important lessons that can be applied in other settings and that are also applicable to delivery of family planning services in general.


The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the article. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.There are errors in the Funding section. The correct funding information is as follows: This project was supported by Bill and Melinda Gates Foundation , Antoinette Darville, MD, Maureen Maguire, PhD, and Grace Saguti, MD, who were generous with their time and advice and met before and during the study. The authors thank all of our colleagues in Niger at Programme National de Santé Oculaire who collected samples and data. We also thank the NTD support center, the Task Force for Global Health, and the 15 experts surveyed at the WHO NTD-STAG Monitoring and Evaluation Working Group meeting.


INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013. From October 23 to October 27, 2013 the 9th annual INDUS-EM conference entitled “Principles, Practices, and Patients,” was held in Thrissur, Kerala, India. The conference faculty was composed of physicians from India, the United States of America, Israel, and the United Kingdom. The conference had over 2,800 attendees and was aimed towards medical students, nursing students, residents, and junior faculty. The focus of the international faculty and participants at this conference was two-fold; The first portion of this effort was (1a) to provide a two day pre-conference research symposium (EM-LEADER--emergency medicine leadership in education and academic development via enterprising research), whereby students, residents and junior faculty would be introduced to concepts of how to conduct successful research through the acquisition of research funding by successful grant writing, and how to successfully navigate administrative quagmires, and (1b) to understand and be aware of the basic concepts of statistics, epidemiological methods, use of the electronic medical record, how to write a manuscript, and other scientific methods through specific examples, while at the same time attempting to imbue an ethical thread throughout the scientific curriculum; especially in regard to the protection of human subjects participating in clinical trials and studies, and the protection of their personal information. The second portion of international participation in regard to education and consultation was a trauma and critical care workshop where techniques of airway access, venous and arterial access, methods of monitoring, diagnostic methods, and clinical evaluation of the critically ill patient were highlighted. This curriculum was presented during the Summit Program  has made progress regarding emergency medicine (EM) 1). Medicine in India, and particularly EM, still faces an acute self-imposed ethical-societal challenge. While there have been improvements recently, India lacks an emergency service system that is responsive, effective, and time sensitive [. Medicinlden hour. Since tot exist .The INDO-US Joint Working Group (JWG) and like-minded, Indian-allied physicians have embarked on an educational journey through the vehicle of an annual INDUS-EM educational summit. With the hopes of reaching the hearts and minds of the medical and nursing students, residents, other young medical professionals, and faculty members, they intended to change the philosophy of the approach of the Indian medical community to modern EM. Furthermore, they hoped to make an ethical precedent to provide appropriate and outstanding care to India’s citizens and visitors by formally trained specialists in well-equipped facilities. This report of the 9th INDUS-EM LEADER conference summarizes the educational efforts made toward the above-mentioned philosophy and ethical precept.The meeting was broken into two specific portions, (1) a pre-summit meeting entitled, EM-LEADER (emergency medicine leadership in education and academic development via enterprising research), which covered academic leadership skills, clinical research, publication, the electronic medical record, and grant writing; and (2) the main summit.Dr. Mamta Swaroop, Assistant Professor of Surgery in Trauma and Critical Care from Northwestern University, Chicago, Illinois, USA and the Co-Chair of the OPUS 12 Foundation’s International Medicine Expert Group started the first day of the pre-summit research conference with a researcher’s perspective of the skills needed to publish in an academic medical center, focusing on leadership and mentorship aspects of the academia. She additionally lectured on the topics of patient and data confidentiality and their vital importance in conducting ethical research.Dr. Stanislaw P.A. Stawicki, Associate Professor of Surgery and Director of Research in the Division of Trauma, Critical Care, and Burn at The Ohio State University, Columbus, USA presented several lectures. His first lecture revolved around the need to pursue funding of research through sources in industry to alleviate the increasing lack of resources from local, state, and federal government. He advised the audience on how to pursue such finding, and the importance of the ethical standards that were needed when collaborating with the private sector in regard to presentation and publication of results. His second lecture was an examination of the necessary approach required to receive approval for research in academic medical centers from an organization’s Institutional Review Board (IRB) and from Ethics boards. The third lecture explained how to organize an original research manuscript. His final lecture of the day covered plagiarism and academic dishonesty and its implications regarding both individuals and institutions.Dr. David P. Bahner, Professor of EM from The Ohio State University, Columbus, OH, USA gave a perspective on the logistics of the use of office staff and trainees in pursuing research and education, especially in regard to their value and appreciation of collaborative efforts to pursue academic research and excellence. Dr. Bahner’s second lecture was a discourse on ethical authorship sharing and its importance to collaborative research efforts. His third lecture involved an explanation of how to write a review article.Dr. Thomas J. Papadimos, Professor of Anesthesiology, Vice Chair for Academic Affairs, Section Director of Anesthesiology Critical Care Medicine, and Director of Critical Care Service at the Ross Heart Hospital at The Ohio State University, Columbus, OH, USA started his lecture block with an important discussion regarding clinical colleagues and a faculty member’s relationship to the institution’s administration. His second lecture was on the topic of intellectual property; what it is, how it affects the academician-inventor, and to what to expect and not to expect from an institution’s office of technology. His third lecture involved the techniques of data collection and storage, the associated pitfalls, and the associated important and necessary ethical considerations. His final presentation of day one of the pre-summit explained how to write a letter to the editor and how to write case reports.Dr. Lorenzo Paladino, Assistant Director of Research at the State University of New York (SUNY)-Downstate, Brooklyn, New York, USA presented a lecture on researching overcrowding, violence, and abuse; its methods, and ethics. He provided a second lecture on the basics of data analysis regarding tests and software.Dr. Dimitrios Papanagnou, Assistant Professor of EM and the State University of New York (SUNY), Brooklyn, New York, USA and Mr. Kevin Pohlman, CHSE, NREMT-P, a simulation specialist, presented an informative session on the evaluation of educational tools to improvise teaching, especially the ultrasound use.The first lecture was presented by Dr. Sanjeev Bhoi of the All India Institute of Medical Sciences (AIIMS), New Dehli, India. His presentation on the use of electronic medical records in the process of development and research in EM and Trauma was well received. He further delivered an update on the progress of the electronic medical record in India.Asking the Right Research Question. He followed later in the afternoon with a lecture on patient safety and how to design and conduct patient safety research. Dr. Papadimos then gave an extensive lecture on grantsmanship which included the idea/hypothesis process, searching for funding, content of a proposal, writing skills, alliances to strengthen the application, budget and justification, support letters, and building a resume. This was followed by a panel discussion with Dr. Papadimos, Dr. Stawicki, Dr. Bhoi, and Dr. Galwankar.Dr. Sagar C. Galwankar, Chief of EM, Global Hospitals, India, Assistant Professor, University of South Florida, Tampa and the Scientific Chairman of the INDUS-EM 2013 Conference, then gave a detailed lecture on ethical animal research and how the US medical system handles animals in its biomedical investigative processes. Dr. Stawicki then began the grantsmanship seminar with a lecture entitled Dr. Bonnie Arquilla, Associate Professor of EM, State University of New York (SUNY), Brooklyn, New York gave a session focusing on mass casualty situations research. Dr. Arquilla was followed by Dr. Tracy Sanson, Associate Professor of EM and Emergency Residency Program Director at the University of South Florida, Tampa, Florida, who gave a lecture on presentation and communications skills.The EM-LEADER session ended with a round table discussion of research ideas for the Indian network of Critical Illness and Injury Translational Trial Experts (INCIITTE) led by Dr. Sagar Galwankar and Dr. Sanjeev Bhoi of AIIMS, New Delhi, India.The summit program was expansive and varied regarding topics of discussion. Due to the limited scope of this article, the reader is referred to the INDUS-EM 2013 Internet Website for further details regarding the Summit . HoweverThe Future of Predictive Modeling and its Contribution to Patient Safety. Dr. Stawicki also presented a special lecture titled Advanced Imaging in Post Mortem Setting: Is Autopsy Going Digital?On the first day of the Summit, Dr. Papadimos was the Shri. Tarsem Kurmar Garg Oration Inaugural Endowed Keynote speaker, and delivered a lecture entitled: Day one of the summit continued with a lecture series entitled the Adult ABC of resuscitation, although not required for the trauma and critical care certification course, it set the tone. The lectures discussed ACLS, stroke care guidelines, rapid sequence intubation and fluid and blood product resuscitation by Indian and US faculty. It served to introduce the attendees for the next 3- day Trauma and Critical Care Resuscitation Course (TCCRC) starting in the ED and continuing on to the operating room or the ICU.The certification course started with the FORT  the afternoon of day one. The room was overflowing with medical students, nurses, and junior and senior level faculty from all disciplines to take part in this ATLS based trauma approach that was to be the foundation of the TCCRC.Dr. Swaroop started the afternoon with a warm up case and discussion of the importance of collaboration which set the stage for the ABCs of Trauma.Dr. Harry L. Anderson III, co-director of the Surgical Intensive Care unit and Surgical Critical Care Fellowship Program Director at St. Joseph Mercy Medical Center, Ann Arbor, Michigan, USA, then addressed the secondary survey and engaged the audience with interactive questions.The course then focused on injuries by body system. Dr. Moshe Michaelson, Director Emeritus of the Trauma Unit and Department of EM at the Rambam Health Care Campus, Haifa, Israel started with the lecture on injuries specific to the head, intra and extradural, the face and the neck. Dr. Vineet Kumar, an Assistant Professor of Department of General Surgery at Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India then continued with a lecture on chest trauma. Dr. Colin G. Kaide, an Associate Professor of EM from The Ohio State University, Columbus, Ohio, USA then gave a dynamic lecture on abdominal trauma intermingled with EM residency photographs. Dr. Stawicki then lectured about the extremes of age and the pregnant patient and the cautions that must be taken with each group.The next speaker, Dr. Tamara Worlton, an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA, with active duty military experience as a member of a forward surgical team to care for critically wounded personnel in Afghanistan lectured about extremity blast and burn injuries that she has seen and that are common in many parts of India with domestic and international terrorism.Dr. Himanshu Kataria, a Consultant in EM at St. Helens and Knowsley Teaching Hospitals NHS Trust and Dr. Ram Manohar, a Consultant in EM at Wirral University Hospitals NHS Trust in the North West region of the United Kingdom then led the skills session and the simulation. The audience was divided into 4 rotating groups. A trauma scenario simulation, pelvic binding, logrolling, and helmet removal were the skills performed at the stations. Trauma faculty manned each station, which allowed the audience one on one time and an opportunity to practice their comprehension of the didactics and ask questions.Day two focused on resuscitation in the emergency room and more in-depth perspectives of critical care related to the EM patient. Dr. Kaide began the morning series with a presentation on trauma resuscitation. He presented landmark studies and evidenced-based guidelines, highlighting the clinical application. His lecture covered a variety of topics from airway management to massive transfusion in trauma.Dr. Ravi S. Tripathi, an Assistant Professor of Anesthesiology and Critical Care from The Ohio State University, Columbus, Ohio, USA then presented a discussion of trauma specific to cardiac injury. His presentation on fundamentals of cardiac resuscitation focused on blunt cardiac injury as well as life threatening cardiac conditions such as cardiac rupture, fatal arrhythmias, and acute coronary syndrome leading to trauma.In continuing with a hemodynamic focus, Dr. Anderson addressed managing patients with life-threatening infections, sepsis, and septic shock. Dr. Anderson highlighted key trials and publications that played heavily in the recent update of the Surviving Sepsis Campaign recommendations and their application to trauma patients.The morning then changed focus to neurologic injury and trauma with a joint discussion by Dr. Stawicki and Dr. Tripathi. Dr. Stawicki laid the groundwork for the discussion in his presentation that focused on neurophysiologic principles and their practical application. The discussion of management of intracranial hypertension was especially useful. Dr. Tripathi followed Dr. Stawicki with a review of stroke care, both ischemic and hemorrhagic. The lecture focused on initial management of the stroke patients, stabilization, and establishing infrastructure for stroke care.The morning concluded with a presentation by Dr. Michaelson. After the morning focused on individual organ injuries, Dr. Michaelson offered insight into patient triage, for both mass casualty as well as in a busy emergency department.During the afternoon, workshops were hosted by both local medical school and visiting programs. These hand-on seminars focused on diagnostic modalities such as emergency and trauma ultrasound as well as therapeutic modalities integral to trauma care such as airway management, wound care, suturing, splinting, as well as toxicology life support.The critical care course has evolved significantly since its 2012 iteration at the 8th INDUS-EM Summit in Nashik, Maharasthra, India. Conceived by the OPUS 12 Foundation faculty, the course now includes international faculty from several high-profile academic institutions.The 2013 course started with Dr. Anderson who addressed bedside and advanced diagnostics used to evaluate patients in the ICU. He was followed by Dr. Bahner who provided a perspective on the usage of ultrasonography at the bedside, with numerous video cases to highlight a plethora of abnormal findings. Dr. Kaide then presented a series of vignettes to emphasize disease processes that can be deadly if missed.Dr. Swaroop continued the curriculum with a concise and comprehensive presentation on mechanical ventilatory support. There was a significant amount of discussion from the audience regarding the benefits and actual usage of rescue therapy in ARDS, focusing on capabilities of local hospitals to handle such complex patients.Dr. Kapil Dev Soni, an Assistant Professor of Critical & Intensive Care at Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi then followed with a lecture about basic and advanced hemodynamic support. He discussed the theoretical and practical uses of various hemodynamic monitoring devices and vasoactive medications. This was followed by Dr. Worlton, who conducted a video presentation and a discussion of key techniques for performing bedside procedures, focusing on practical tips for safe and effective conduct of each respective procedure.Dr. Stawicki ended the morning and concluded the course with a lecture on blast injury management, followed by a discussion of pitfalls and pearls in ICU care. The last session focused on common errors in trauma and critical care management, as well as on patient safety topics. The course ended with certificates given to the attendees of all three days of the course. Certificates of appreciation were also given to course faculty and directors.EM-Leader accomplishments included dissemination and instruction in techniques of scientific inquiry, including epidemiology and statistics and data acquisition; instruction on how to write grants and the administrative processes related to research and grant funding; the advantages of the electronic record and its potential uses in research; the ethical pitfalls in the scientific method, the funding of projects generally, and the protection of human subjects. In the trauma and critical care education portion, established life saving techniques in regard to monitoring, diagnosis, evaluation, and treatment were taught and this course was followed by a certification examination.India has limited educational and clinical resources in regard to emergency medicine, trauma, and critical care. The medical educational value that was added to this population of students, residents, and young faculty included preparation for scientific inquiry and techniques of clinical intervention for successful care of the seriously ill patient. This curriculum will be presented through the next decade of INDUS-EM conferences. While the topic and themes of the Summit Program will change from year to year, the EM-leader preconference education and the trauma critical care portion will continue. As the conference changes its venue each year, a different portion of the country will be exposed to the above-mentioned  concepts.Crucial next steps in the provision of appropriate emergency, trauma, and critical care in India will be the expansion of true emergency rooms that are staffed by competent practitioners in properly equipped facilities. “Casualty areas” must be replaced by state-of-the-art emergency facilities, and manned by appropriately trained physicians. For this to happen India and her friends such as the United Kingdom and the United States of America must assist in the training of Indian residents. In this vein, emergency medicine residents in India will now be admitted to the examination in Emergency Medicine by the appropriate medical educational organizations of the UK, and even permitted a minimal amount of training time in the UK. Thus, there will be training and some confirmation of minimal expertise as an expectation for those manning emergency facilities. These educational efforts must be persistent and consistent.Money, Management, and Manpower in Medicine. It will be held in Lucknow, the capital city of Uttar Pradesh from October 15 to the 19th 2014. The focus will be the business of medicine with 15 tracks, 16 workshops and over 200 national and international faculty. A multifaceted topic that is sure to stimulate many controversial and enlightening conversations. The discussion of the business economics of medical practice in India, and the associated ethics, will involve a series of wide-ranging discourses that are currently in evolution. Such an intellectual intercourse will require the serious application of scientific, social, and ethical precepts to an evolving and growing technological marketplace in one the largest economies of the world.The next meeting will be the 10th anniversary of INDUS-EM and will be entitled, The safe, effective, and ethical delivery of healthcare  to all populations in India is what the Indian and international participants of INDUS-EM strive to promote and augment. Such an enterprise requires intense, repetitive, and inclusive efforts among all members of the medical and public health community, both in India and the greater global community.The authors declare that they have no competing interests.All authors contributed equally. All authors read and approved the final manuscript.All authors were lecturers at the conference as representatives of their particular institutions.


WHO alerts to the epidemic behavior of diabetes (DM): more than 190 million people worldwide suffer from diabetes and this number will double by 2030 . In Brazil, IDF estimated in 2014 that the number of diabetics was 11.6 million. Aging, urbanization, sedentary lifestyle, high fat diet and obesity are seen as responsible for this situation. In addition to the cost of treatment, complications of the syndrome, overtax and overwhelm the health care system. Thus, only public policies are insufficient, being essential the efforts of researchers and health teams to carry out projects for the guidance of the population, who often have no basic knowledge, compromising the effectiveness of treatment.Carry out actions, especially for the elderly, involving students in the selection and placement of information about etiology, symptoms, diagnosis, treatment, side effects and drug interactions of DM.This project is part of an extension program with continued actions, involving 20 volunteers students, per event, and Uninorte and UFAM teachers. The activities have multivariate approaches, are cyclical and redundant, ensuring maximum participants. In the first half of 2015, the subjects were: pharmaceutical and nutritional guidance, physical activity and risks of alcohol consumption and smoking. Diabetic people interested in the Monitoring Group, scheduled for Sep/2015, were registered. These people will receive glucometer and a data collection form for monitoring capillary blood glucose and receive guidelines. Also will be offered, the molecular test for the registered ones with a possible diagnosis of MODY 2 or 3 .The activities took place in the Dr. Thomas Foundation and Senior Park/Vieiralves, Manaus, AM. 70 people were served. Of these, 4 diabetic female, have registered. The accession of the elderly, especially women is a goal, as they generally are more receptive to information, make appropriate medical monitoring, influencing your partner and being an example to children and grandchildren.The project confirms the importance of university extension for the formation of a professional who recognizes in their proactive actions a way to benefit the community. The exchange of experiences promote changes in habits and learning, whose expected benefit is to prevent and/or minimize the complications of diabetes by improving the quality of life.


The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.The Funding section is incorrect. The complete, correct Funding statement is: The Joyce W. Vickery Scientific Research Fund from the Linnean Society of NSW (


In the economy of knowledge, ingenuity and dynamism, innovation and technology are considered essential levers, and knowledge and creativity key factors. Globalization and liberalization have generated a new dynamic of competition, a dynamic competitiveness, in which the focus is on the ability of performing, including in related fields. Today we are witnessing a moment when a strong emphasis is placed on the development of some new theoretical models in communication and on the development of innovative methods of observing and measuring the communication behavior. The social interaction, interpersonal communication, mass communication, intercultural communication, research of physical and chemical mechanisms of brain activity, observing in real time some processes which take place at the cellular and molecular level, interest for research and knowledge of the element which offers significance to the human being, the brain, etc., elements which seem to be more often under the “magnifier” of progresses in understanding the human symbolical processes. That is why Neurosciences have shaped as a distinct field. The dynamics of neuroscientific research had an exponential development and the social impact is considered very powerful. “However, what makes a brand strong is the collective nature of the perceptions about it” – affirmed the Marketing specialists. In addition, the perceptions regarding an incontestable personality in the field of research in neurosciences and the echo of its performing and high quality research activity impressed the target public. So, this kind of recognition took place on the occasion of the exceptional medical scientific and educational event organized by the Foundation of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), together with the Romanian Society of Neurology (RSN) and “Iuliu Haţieganu” University of Medicine and Pharmacy in Cluj-Napoca, under the aegis of the European Federation of NeuroRehabilitation Societies (EFNRS) and the  World Federation for NeuroRehabilitation (WFNR), - RoNeuro Brain Days, which hosted the 5th Edition of the European Teaching Course on Neurorehabilitation which took place in the period 1-4 June 2015, in Cluj-Napoca, in “Gheorghe Marinescu” Amphitheater of “Iuliu Haţieganu” University of Medicine and Pharmacy, and, which managed to reunite under one single roof important personalities in the medical field and world scientific research from countries such as Germany, USA, Austria, Italy, United Kingdom, Ukraine and Romania. Prof. Michael Chopp, PhD, was awarded “Doctor Honoris Causa” title at the proposal of Prof. Dafin F. Mureşanu, MD, President of the Romanian Society of Neurology (SNR) and President of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), “Iuliu Haţieganu” University of Medicine and Pharmacy in Cluj-Napoca. On this occasion, distinguished Michael Chopp, PhD, joined the Henry Ford Health System in Detroit in 1983. He was appointed Vice Chairman for Research of the Department of Neurology in 1991, Scientific Director of the Henry Ford Neuroscience Institute in 1999, and is the Zoltan J. Kovacs Chair in Neuroscience Research. Dr. Chopp is also Distinguished Professor of Physics at Oakland University in Rochester, MI.He received his MS and doctorate degrees in Mathematical and Solid State Physics from New York University. After nearly 10 years of working as a Physicist and as a Professor of Physics, Dr. Chopp made a career change and turned his interest to translational research in neuroscience.Dr. Chopp’s research has primarily focused on: 1) cellular and molecular biology of ischemic cell injury, 2) the pathophysiology of stroke, traumatic brain injury, peripheral neuropathy, multiple sclerosis, and glioma, 3) combination thrombolytic and neuro and vascular protective therapies for stroke, 4) mechanisms of neuroprotection, 5) cell-based and pharmacological neuro-restorative therapies for stroke, traumatic brain injury and neurodegenerative disease, 6) molecular and cellular mechanisms underlying neurogenesis and angiogenesis and the induction of brain plasticity leading to functional and behavioral recovery after neural injury, 7) treatment of glioma, 8) exosomes/ microRNA for the treatment of neurological injury and disease, and 9) magnetic resonance imaging.Dr. Chopp has received multiple awards and recognitions for his research efforts, including the American Heart Association Thomas Willis Lecture Award, the Abraham White Distinguished Science Award, and the Lecture of Excellence and World Stroke Organization Award. Dr. Chopp has 623 peer-reviewed publications and has given 414 plenary lectures and invited presentations. He has served on and chaired National Institutes of Health (NIH) study sections and has served as a consultant to government agencies, the U.S. National Institutes of Health, and the pharmaceutical industry. Prof. Michael Chopp, PhD is first his great curiosity, knowledge assimilation through a profound understanding of the facts and data, which at first, were filtrated by his reasoning. What is very impressive is his power of perception, organizing skills and knowledge deepening, as well as the presentation of the most abstract problems in simple and easy to understand forms, especially the high quality and performance of his research activities. A distinctive feature of Executive EditorAssoc. Prof. Dr. Eng. Victor Lorin Purcarea


PLOS Neglected Tropical Diseases more than six years ago, I have written about the interface between disease and geopolitics. The neglected tropical diseases (NTDs) are the world's most common infections of people living in poverty Since the founding of In the Americas, there are at least three major zones where NTDs concentrate.In 2008, I found that Brazil has the largest number of NTDs in the Western hemisphere; they are particularly common among the millions of Brazilians who live on less than US$2 per day Almost 10 million people inhabit the Gran Chaco, an area that spans eastern Bolivia, Paraguay, northern Argentina, and portions of two Brazilian states—Mato Grosso and Mato Grosso do Sul Mesoamerica includes Mexico's poorest states in the southern region, such as Chiapas, Guerrero, and Oaxaca SSA has a high concentration of NTDs globally, accounting for approximately one-quarter to one-third of the world's cases of the three major intestinal helminth infections , more than one-third of the LF, one-half of the trachoma, and all or most of the schistosomiasis, onchocerciasis, loiasis, and human African trypanosomaisis (HAT) I have referred to Nigeria as “ground zero” for the NTDs because it ranks first in SSA in terms of the number of cases of all three intestinal helminth infections, schistosomiasis, LF, and onchocerciasis DRC ranks closely behind Nigeria in terms of the total number of NTD cases, ranking second or third in most of the NTD disease categories and first in HAT and leprosy These three adjoining nations have also suffered from widespread conflict and NTDs in recent years, and with it high rates of trachoma, schistosomiasis, and intestinal helminth infections The largest number of NTDs currently occurs in Asia, led by the large emerging market economies of India, Indonesia, and China Indonesia alone has approximately 10% of the world's cases of intestinal helminth infections, LF, and leprosy, in addition to more than one-half of the dengue deaths in Southeast Asia and a significant problem with other arbovirus infections and yaws Nearly one-half or more of the cases of visceral leishmaniasis, LF, and leprosy occur in India and South Asia, in addition to one-third of the rabies deaths, one-quarter of the cases of intestinal helminth infections, and a massive but still ill-defined burden of disease from dengue and Japanese encephalitis Rapid economic growth in eastern China has left behind high levels of disease and poverty in China's southwestern provinces of Sichuan, Guizhou, and Yunnan, where some of the highest rates of intestinal helminth infections are found Approximately 65 million people live on less than US$2 per day in the Middle East and North Africa. These impoverished individuals suffer from high rates of intestinal helminthiases, LF, schistosomiasis, fascioloiasis, leishmaniasis, leprosy, and trachoma These ten areas exhibit some of the world's highest concentrations of NTDs, although they vary with respect to having a modest prevalence among a large population versus hyperendemicity among a smaller population. Of interest is the finding that, with the important exception of SSA, they mostly include middle-income countries and nations belonging to the G20 This list represents a personal view of what I consider some of the most important NTD-affected areas in the world. I welcome comments and opinions from the NTD community on other regions and parts of the world I might have missed or where the readers believe there should be renewed emphasis for control and elimination.


There is an error in the Funding statement. Please view the correct Funding statement here.This work was supported by academic research funds of Konkuk University in 2013, Seoul, South Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


The health systems in the Americas region are characterized by fragmentation and segmentation that constitute an important barrier for expanding coverage, achieving integrated primary health care, and reducing the inefficiency and discontinuity of care.An assessment of the HRH programmes that have been implemented at country level was developed as part of the measurement of the 20 Human Resources for Health ).The exercise was a combination of academic research and the development/application of an advocacy tool, involving policy makers and stakeholders to influence decision-making on the development, implementation or change the HRH programmes, while building evidence through a structured approach based on qualitative and quantitative information, and exchange and dissemination of best practices.Chile and Peru in the Andean region and Argentina, Paraguay and Uruguay in the Mercosur.The presentation will cover the methodological challenges, as well as a summary of the main findings of the study that included 15 countries: El Salvador, Costa Rica, Guatemala, Honduras, Nicaragua, Panama, Dominican Republic and Belize in Central America, Ecuador, Colombia,