All GAVI support is held in a separate Ministry of Health account with the cashier in the Ministry of Health as a signatory. Cash from the injection safety account, the new vaccine introduction account and the ISS account are all kept in the same bank account. At the NIP, a full-time administrator and accountant handles all donor cash funding CVP PATH, UNICEF, WHO, Rotary ; and is responsible for the disbursement of cash and the reconciliation of expenditures. The NIP prepares a request for ISS funds showing the proposed activities and the budget required for the activity. The Director General receives the request, approves it and passes it to the Minister of Health who then approves the request to withdraw cash from the MOH GAVI account. The NIP receives the requested amount in cash from the bank. For activities at the district level, the districts come to the NIP in Phnom Penh to receive the cash advance for the immunization activity. When the activity is completed, receipts are forwarded back to NIP where they are reconciled with the monthly bank statement by the NIP accountant. There has not been any external audit of this bank account. There have been no problems with disbursements of GAVI ISS funds, and ISS funds have been regarded as particularly useful for fast disbursements of cash needed for outreach activities at the OD level. Subsequent to the development of the Financial Sustainability Plan, CVP PATH and the World Bank sponsored the NIP administrator to obtain further training in accounting. As a result, the NIP has detailed information about each donor participating in immunizations, their funding level, and adjust the NIP's use of ISS funds in certain districts so as not to duplicate activities and funding at the district level. Since 2002, the NIP has maintained detailed records on immunization expenditures by each donor that has given cash support to the NIP. By keeping detailed records of the actual expenditures at the district level, the NIP has also been able to conduct their own internal analyses to assess the effectiveness of the ISS funds at the district level. The GAVI team was particularly impressed about the availability of the information and how the NIP was using the data it was collecting to reassess its strategies to improve immunization coverage.
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Imiquimod-induced CD4 + T cell responses lead to long lasting erythema after regression of basal cell carcinomas and actinic keratoses C Wolber, 1 B Feuerstein, 1 F Offner2 and R Strohal1 1 Dermatology, Federal Academic Hospital of Feldkirch, Feldkirch, Austria and 2 Pathology, Federal Academic Hospital of Feldkich, Feldkirch, Austria Therapeutic options for basal cell carcinomas BCC ; and actinic keratoses AK ; including kryo ; surgery and photodynamic therapy are still not fully satisfactory. Based on preliminary reports, we have initiated topical treatment of BCC and AK by 5% imiquimod cream Aldara, 3M, Cergy Pontoise Cedex, France ; , an immune response modifier that induces the local release of various cytokines IFN-, TNF-, IL- 1, 5, 6, and 12 ; . To date, 10 patients 6 BCC, 4 AK, age range: 40-60yrs ; have been treated once daily either 5 times a week BCC ; , or 3 times a week AK ; for up to 6 weeks. All patients experienced local erythema which in 9 out of 10 exception 1 AK ; progressed to erosions at the site of imiquimod application. No systemic side effects, either with regard to clinical symptoms or laboratory value changes were observed. After 3-6 weeks, 100% of lesions presented with histologic clearence. Clinically, the process of tumor regression was accompanied by spontaneous scar-free healing of erosions leaving a persistant erythema for more than 4 weeks. Immunohistochemical analysis of biopsies of these post-treatment erythemas n 3 ; identified a quite homogeneous picture. Located at the upper dermis, the inflammatory infiltrate mainly consisted of CD3 + T-cells and a significant proportion of CD68 + mononuclear cells. There were only small numbers of CD20 + B-cells. CD56 + NK- ; cells were absent. With regard to T-cell subsets, activated CD45RO + ; CD4 + helper inducer cells clearly dominated in all specimens over the CD8 + T-cell phenotype. Taken together, 5% imiquimod cream represents an efficient and largely safe BCC AK therapy seemingly working via the induction of a local, tumor-specific CD4 + T-helper response. However, post-treatment erythema is cosmetically irritating and, at least at this point, we cannot decide on the natural course of this long-lasting imiquimode effect.
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Continued from page 4 the number of products available for the two programs. 2. Customer service and support reputation - Ask friends and acquaintances about their experiences. Remember that it is very likely that you will drop or break your PDA at some point. When that happens, you don't want to be stuck with a device that is not easily and quickly replaceable or repairable. 3. Memory - Know how much you will need. Most PDAs come with 16 to 128 megabytes MB ; of memory in addition to memory expansion slots, such as compact flash cards or memory sticks. Most of the popular medical software titles for PDAs are 4 to 6 size each, so you should determine the amount of extra memory you need to purchase to allow enough space to add programs. Memory cards or sticks can be purchased in retail stores or on the Internet. 4. Display - Virtually all PDAs sold today offer a color screen, with the difference lying in the size of the screen. Some PDAs offer the ability to change the screen from a portrait to a landscape format. Others have the ability to display high-resolution color pictures or movies. The best bet here is to actually hold the different models in your hand and determine if the screen size is adequate for your needs. 5. Transfer of information Traditionally, there have been compatibility issues with the transfer of information from desktop computers to PDAs, especially when Microsoft and Mac OS are being used together. However, most of these problems have been resolved with the development of new software programs. You should, however, take into consideration your hospital's mainframe or electronic medical records system to reduce the possibility of compatibility issues. Talk to your hospital's information technology staff and the residents and physicians on the wards to find out which OS would be best for your needs. 6. Size and weight - There are many different sized PDAs available. It is understandable that most healthcare professionals will not be happy with a large PDA, because they are heavy and difficult to carry throughout the day. Palm OS PDAs usually have smaller screens and sizes than Pocket PCs. Large screens are nice and are easier to read but may not be worth the bulk. It comes down to personal preference on this matter. 7. Extras - If you are looking for "perks" you will have to pay a little extra. Some PDAs, such as the Treo, allow Internet and e-mail access for a monthly fee. Some PDAs have built-in digital cameras or voice recorders. For those of you who need a constant connection to the Internet, many PDAs come with built-in wireless technology, such as Bluetooth or wi-fi cards. The new Palm LifeDrive even has a built-in 4 gigabyte hard drive. Modules are also available that allow the handheld to carry a global positioning system GPS ; , act as a cell phone, or even scan barcodes. Comparisons The handheld market is rapidly changing. New models and features are introduced to the market every few months, and prices continually fall. This decreasing trend in cost is true of all brands as newer models replace older models. Since there are so many models of handhelds available, we cannot list all of the models and their features in this article. Consequently, we will refer you to the Web sites below, where you can obtain information about the details and specifications for each model, including the latest price. : cnet Click on "Handhelds" after loading the homepage. The handhelds section allows you to find information on models by brand name or by cost range. This site also provides expert reviews and the dealers with the lowest prices. : pcworld In the left column, select PDAs from the pull-down menu. This site contains expert reviews of the top handhelds and the ability to compare features of different models. Conclusion We recommend you purchase a PDA that costs in the $250 to $500 range. Spending more or less than that will leave you with a device that either doesn't do anything, or that has extraneous features you probably won't use anyway. Remember that you will have to spend an additional $100 to $200 on software after you purchase your PDA, so don't go overboard on the hardware costs. The PDA software market has exploded, perhaps even more so than the PDA hardware market. These programs become valuable tools in the wards when time is of the essence, and students need to research a disease or look up drug dosages on the go. We encourage you to visit the list of software titles in our E-learning Resource Manual, which can be found at : acponline srf e-learning manual . You can also find out more about PDAs at the PDA Portal on ACP Online : acponline pda index ; . The future is looking bright for the handheld market. University hospitals and some private hospitals are incorporating PDAs into everyday physician use. 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Aaron Wong; Mehran Ghoreishi; Jan P. Dutz, Departments of Dermatology and Medicine, Child & Family Research Institute, University of British Columbia, Vancouver, BC, Canada Background: The role of interferon- IFN- ; , ultraviolet B light UVB ; , keratinocyte cell death in the development of systemic lupus erythematosus SLE ; were explored in an in vivo NOD murine model. Topical imiquimod Xldara r ; , 3M ; , a Toll-like receptor 7 agonist, was used to induce a pro-inflammatory environment through the synthesis of IFN-, while UVB was used to cause keratinocyte cell death. 5-fluorouracil 5FU ; was used to promote cell death and also for its photo-sensitizing effects. Methods: Thirty mice were split into groups of six with the following treatment protocols: imiquimod alone, imiquimod UVB 5FU, UVB and imiquimod, UVB only, and a control group. Sera were then sampled bi-weekly and analyzed for anti-nuclear ANA ; and anti-dsDNA antibodies. Results: Treatment with either UVB alone, in combination with 5FU & imiquimod ; or imiquimod alone resulted in ANA serovconversion. At higher ANA titres, mice treated with 5FU UVB imiquimod and UVB imiquimod showed the highest rates of ANA seroconversion at titres of 1: 160 and 1: 320 p 0.05 ; . In addition, mice given both imiquimod and UVB therapy and imiquimod in combination with UVB and 5FU showed greater rates of anti-dsDNA serconversion at rates of 100% and 83%, respectively p 0.01.
Should help reduce losses from marine quakes and the tidal waves they produce, said Luo Zude, professor of disaster research at East China Normal University. Luo warned that coastal areas including Shanghai should keep improving their capabilities of combating maritime disasters and prepare for all kinds of marine disasters. Academician Wang admitted that in terms of basic ocean research, China only leads the world in the ancient environment, but many aspects of the ocean research had remained a blank in the country owing to limited funding. According to Wang, China has allocated 5 billion yuan about US$602 million ; for ocean research during the tenth five- year-plan period 2001-2005 ; . A center for experimental primates to be set up in Guangdong CAS, 2005-01-04 ; The CAS Guangzhou Institute of Biomedicine and Health will team up with the Guangzhou Entomological Institute in establishing a research center for experimental primates. According to an agreement signed by the directors of the two institutes on Dec. 30 in Guangzhou, a 500 m lab in line with the international standards will be set up during the first phase of the project. State-level wetland preserve set up in East China Xinhua Net, 2005-01-06 ; East China's Shandong Province has established a state-level wetland preserve in province capital Jinan Wednesday, a local source said. The Shell Dike Wetland Preserve in the county of Wudi has been upgraded to a state-level preserve from a provincial one, making it the second one in the Yellow River Delta. Regarded as a natural biological museum, the 2000-year-old dike has 459 wildlife species including some rare clams, conches and seals. In addition to these, the saline meadows and some swamp and wetland vegetation are also seen in the preserve. It is one of world's three biggest ancient shell dikes. The other two are located in North America and South America's Surinam. The Yellow River Delta Preserve, the first natural preserve of wetlands and endangered birds in the area, was founded in 1987. It was upgraded to the state level in 1992. 'Soil Dams' to be built in the Loess Plateau China Net, 2005-01-07.
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