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PubMed2006

International cooperation and preparedness in responding to accidental or deliberate biological disasters: lessons and future directions.

Preparations for international cooperation in response to disease disasters at the regional or continental levels are poorly coordinated and cooperation is limited, although intergovernmental and international organisations have been advocating for years that emergency responses to infectious disease outbreaks should be planned for and prepared at the national level. National governments are responsible for contingency planning to protect the public; however, this responsibility needs to be broadened to encompass regional and international approaches. Little public domain information is available on international coordinated responses to the deliberate introduction of biological pathogens. Terrorist events in the early 21st Century have increased awareness of the risks, but solid commitment and internationally resourced initiatives are still lacking. The current avian influenza disaster has largely been addressed by the three global agencies: Food and Agriculture Organization (FAO), World Organisation for Animal Health (OIE) and World Health Organization (WHO), using the underlying precepts that shape the Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs). The GF-TADs offers a substantial base to improve regional epidemiological and environmental information, diagnostic networking, trend analysis and intervention against the important epidemic animal diseases. International prevention, preparedness and response require multidisciplinary teams working in an environment of intergovernmental cooperation that encompasses numerous ministries and agencies. This paper focuses on known international aspects of collaboration on emergency preparedness and addresses the FAO/OIE initiative to strengthen veterinary and public health systems involved in controlling and preventing serious health threats.

Animal Welfare↗
PubMedDate not supplied

[The first 15 years of FICOSSER (Federation for International Cooperation of Health Services and Systems Research Centers): 1987-2002].

The Federation for International Cooperation of Health Services and Systems Research Centers (FICOSSER) has been established for promoting interchange and cooperation across the borders of nations, scientific disciplines or institutional settings. During the period 1987-2002, the Federation has convened 4 general conferences--large forums for assessing the state-of-the-art--and 11 research meetings, each dealing with a specific research topic. The proceedings of each conference or research meeting were published by a volunteering member-center, with its own resources, on behalf of FICOSSER. One of the salient features of FICOSSER activities was the continuity of the efforts deployed by its member-centers for working together and furthering certain research areas: heath care financing, human resources of the health system, rural health issues, health care reform in the former socialist countries, research for appropriate health response to disasters and major emergencies, etc. Certain activities of FICOSSER were carried out in close collaboration with the World Health Organization. Since its inception, FICOSSER has highlighted two principles--self-help and mutual enrichment--for the involvement of its members-centers.

Disaster Planning↗
PubMed1972

A second international cooperative investigation into tioacetazone side effects.

As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia.It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances.

Adult↗
PubMed1995

[Phenotypical diagnosis of Japanese chronic lymphocytic leukemia--an international cooperative study based on the French-American-British classification of mature B-cell leukemias].

To better understand the accuracy in the diagnosis of chronic lymphocytic leukemia (CLL) and characterize the clinical features of CLL in Japan, where the disease is extremely rare, an international cooperative study was conducted by hematologists between Japan and UK. Blood and bone marrow films from 36 patients with a possible-diagnosis of CLL were referred to two laboratories of Nagasaki University Hospital (Nagasaki) and Royal Marsden Hospital (London). According to the FAB criteria, typical CLL 16 and CLL/PL 2, a subtype of atypical CLL, were completely accordant in diagnosis. However, phenotypical diagnosis of CLL mixed, the other of atypical CLL, and intermediate lymphocytic leukemia (ILL) in leukemic phase often gave inconsistent results. Especially, 8 cases of atypical CLL designated as likely CLL were equivocal between CLL and ILL, suggesting clinical feature more close to typical CLL than ILL. This indicates the presence of a relatively high incidence of atypical CLL in Japan which dose not exactly fit with the FAB Criteria. Finally, we would like to emphasize that an international cooperative study allows improvement of accuracy in diagnosis and better understanding of the disease entity of lymphoid malignancies, having on ethnically different morbidity.

Aged↗
PubMed2002

Application of the International Cooperative Ataxia Scale rating in multiple system atrophy.

We assessed the International Cooperative Ataxia Scale (ICARS) as a means of extracting and rating cerebellar signs in multiple system atrophy (MSA). Cross-sectional analysis of internal consistency, factor structure, and correlation with parkinsonism severity (Unified Parkinson's Disease Rating Scale [UPDRS] III) of the ICARS, in 50 unselected MSA patients (mean age, 67.6 years; mean disease duration, 5.5 years), 50 age-matched and disease duration-matched Parkinson' disease (PD) patients, and 50 control subjects. Fifteen patients (30%) had MSA-C (cerebellar subtype) and 35 (70%) MSA-P (parkinsonism subtype), and 66% had at least one cerebellar sign. The total ICARS score was much higher (fivefold) in MSA compared to PD patients. The ICARS score was twofold higher in MSA-C than in MSA-P patients. MSA-C patients had a higher score than MSA-P mainly on posture and gait disturbances and kinetic functions subscores. All the ICARS items were significantly more severe in MSA than in PD patients, who in turn scored higher than the controls. In MSA, internal consistency was excellent (Cronbach = 0.93). Factor structure analysis revealed four clinically distinct subscores, in accordance with the scale structure, which accounted for 70% of the variance. The ICARS showed less consistency and accuracy in PD patients; however, the ICARS scores significantly correlated with the UPDRS-III scores in both MSA and PD patients. The ICARS appears a useful tool to extract and rate the severity of cerebellar signs in MSA; however, it is clearly contaminated by parkinsonian features.

Aged↗
PubMed1993

International cooperation in analytical chemistry: experience of antidoping control at the XI Pan American Games.

We describe the experience of the international cooperation carried out for antidoping control at the XI Pan American Games. A temporary accreditation was granted by the International Olympic Committee to the accredited laboratory of Barcelona (Spain) to set up a Doping Control Laboratory in Havana. Two other laboratories from Mexico and Cuba contributed personnel, materials, and instrumentation. The main issues associated with the preparation and organization of the project are described. During 16 days, 741 urine samples were tested for stimulants, narcotics, anabolic steroids, beta-blockers, diuretics, cannabinoids, local anesthetics, and human chorionic gonadotropin by gas-liquid chromatography, gas chromatography/mass spectrometry, high-performance liquid chromatography, and immunoassay techniques. Analytical methodologies, quality-control strategies, and the main results are reported.

Acebutolol↗
PubMed2004

[African research in odontostomatology and international cooperation].

In this study, the authors measure the efficacy of the African odonto-stomatologic research in the International Assocation for Dental Research (I.A.D.R.) and value the impact of the international cooperation upon that research. This evaluation is realized from the number of publications presented by the African countries at the congressess of I.A.D.R. The obtained results show: 1. The African odonto-stomatologic is the less successful in the world and produced, in 1997, 0.4% of the studies published on the world, 2. Some of the African countries are able to produce scientific results of International valour (South Africa, Egypt and Nigeria in a less degree). Generally, these countries work jointly with anglo-saxon universities. 3. During these last two years, Cameroon obtained very encouraging results thanks to his collaboration with the University of Bordeaux 2 (France), represented by the regretted Professeur Ph. NDOBO-EPOY.

Africa↗
PubMed2004

[Spanish international cooperation in health].

In this chapter, there is a view of the relationships between the Spanish policy for international cooperation aid and the main health problems of the developing world, with a gender perspective. The population health is a result of the development inequity between rich and poor countries. The international institutions have established the frame and priorities of the cooperation aid, being poverty eradication the main priority. The compromise of the Millennium Conference was to reduce in 2/3 child mortality and 3/4 maternal mortality before year 2015, to stop and reduce HIV-AIDS, malaria and others serious diseases as tuberculosis and to facilitate developing countries the access to drugs. Although the resources allocated, the total amount for cooperation has been reduced 30% during the last years. The Spanish AOD in health is difficult to account because it is considered among social basic services and it is not addressed to solve the main health problems in the poorest countries.

Developing Countries↗
PubMed1996

Promoting perioperative nursing through international cooperation.

Adequate development of human resources is a challenge facing all societies and nations, especially those in transition from one development stage to another. Through international cooperation programs, perioperative nurses can share and exchange knowledge, experience, and expertise. They also can expand their clinical horizons, fostering collegiality and friendships and further advancing nursing professionalism internationally. In Israel, we developed and implemented a special, short-term course for perioperative nurses from developing countries. Planners and participants found this course to be an outstanding experience.

Africa↗
PubMed1985

[International-cooperative studies on carcinogenicity evaluation of environmental chemicals].

Motivated by the epidemiological evidence suggesting that the majority of human cancers result from exposure to environmental carcinogens, an international cooperative project aiming at the primary prevention of cancers has been in progress to test a number of chemicals for potential carcinogenicity in animals. With accumulation of the test data, it has become apparent that for assessment of carcinogenic risk in humans, one sometimes needs, 2 kinds of additional information concerning the mechanism by which, and how intensely the test compounds can induce cancers in experimental animals. With regard to the mechanistic issues, extensive studies are now being conducted in various countries to establish a scientific basis for classifying chemical carcinogens into 3 categories, genotoxic (primary) carcinogens, epigenetic (secondary) carcinogens and promoters. As an approach to quantitative risk assessment of carcinogens, attempts have been made to estimate the "Virtually Safe Dose (VSD)" or carcinogenic doses at extremely low risk levels by downward extrapolation of animal dose-response data. Finally, it must be emphasized that most human cancers are probably etiologically attributable to a complex interaction of multiple factors. Therefore, the development of a methodology for evaluating the effect of combined or sequential exposure to 2 or more carcinogens is now regarded as an important project in cancer research.

Animals↗
PubMed1981

[10 years' experience of the activities of the WHO International Cooperative Center for Clinical Study of Ovarian Tumors].

The data are reported on the many-year activities of the WHO Collaborating Centre on clinical study of ovarian cancer with regard to international cooperation of 10 countries. The organization, main trends and extent of the work performed are referred to, which made it possible to give an idea of the state of diagnosis and treatment of ovarian cancer in the world and enriched the experience of scientific cooperation in this field.

Female↗
PubMed2006

Reliability and validity of the International Cooperative Ataxia Rating Scale: a study in 156 spinocerebellar ataxia patients.

To evaluate the efficacy of treatments in spinocerebellar ataxias (SCAs), appropriate clinical scales are required. This study evaluated metric properties of the International Cooperative Ataxia Rating Scale (ICARS) in 156 SCA patients and 8 controls. ICARS was found to be a reliable scale satisfying accepted criteria for interrater reliability, test-retest reliability, and internal consistency. Although validity testing was limited, we found evidence of validity of ICARS when ataxia disease stages and Barthel index were used as external criteria. On the other hand, our study revealed two major problems associated with the use of ICARS. First, the redundant and overlapping nature of several items gave rise to a considerable number of contradictory ratings. Second, a factorial analysis showed that the rating results were determined by four different factors that did not coincide with the ICARS subscales, thus questioning the justification of ICARS subscore analysis in clinical trials.

Adolescent↗