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Last Build Date: Sat, 23 Sep 2017 11:32:18 GMT

 



Viral vector vaccine

Sat, 23 Sep 2017 11:30:09 GMT

another type of vaccination

New page

{{SubjectBox}}
A [[viral vector vaccine]] uses a virus with negligible immunogenicity to deliver genetic material of a pathogenic organism which is used to induce immunity against that organism. Disadvantages include that associated with potential incorporation of parts of the infecting virial genome into the host genome and that the vaccine will only be capable of boosting if a different vector is used next time.[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=28754493 Warrell M. Is there a future for mRNAs as viral vaccines? Lancet (London, England). 2017 Jul.](Print-Electronic) ([http://dx.doi.org/10.1016/s0140-6736(17)31964-5 Link to article] – subscription may be required.)
{{refsec}}
[[Category:Vaccination]]



MRNA vaccine

Sat, 23 Sep 2017 11:24:28 GMT

typo

New page

{{SubjectBox}}
[[mRNA vaccine]]s utilise [[mRNA]] to generate a antigen protein within the cytosol of an eukaryote cell. Although they work well in animal models experience with these in man suggest low ability to induce immunity. They were first developed as a form of immunotherapy against some cancers[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=19609242 Weide B, Pascolo S, Scheel B, Derhovanessian E, Pflugfelder A, Eigentler TK, Pawelec G, Hoerr I, Rammensee HG, Garbe C. Direct injection of protamine-protected mRNA: results of a phase 1/2 vaccination trial in metastatic melanoma patients. Journal of immunotherapy (Hagerstown, Md. : 1997). 2009 Jun; 32(5):498-507.](Print) ([http://dx.doi.org/10.1097/cji.0b013e3181a00068 Link to article] – subscription may be required.)[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=26082837 Kübler H, Scheel B, Gnad-Vogt U, Miller K, Schultze-Seemann W, Vom Dorp F, Parmiani G, Hampel C, Wedel S, Trojan L, Jocham D, Maurer T, Rippin G, Fotin-Mleczek M, von der Mülbe F, Probst J, Hoerr I, Kallen KJ, Lander T, Stenzl A. Self-adjuvanted mRNA vaccination in advanced prostate cancer patients: a first-in-man phase I/IIa study. Journal for immunotherapy of cancer. 2015 ; 3:26.](Electronic-eCollection) ([http://dx.doi.org/10.1186/s40425-015-0068-y Link to article] – subscription may be required.), and then directed at virus surface proteins such as with the development of a mRNA-based vaccine encoding [[rabies virus]] glycoprotein (CV7201)[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=28754494 Alberer M, Gnad-Vogt U, Hong HS, Mehr KT, Backert L, Finak G, Gottardo R, Bica MA, Garofano A, Koch SD, Fotin-Mleczek M, Hoerr I, Clemens R, von Sonnenburg F. Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial. Lancet (London, England). 2017 Jul.](Print-Electronic) ([http://dx.doi.org/10.1016/s0140-6736(17)31665-3 Link to article] – subscription may be required.). Development suggests to date that injector devices may create better immunogenicity than the classic IM or s/c injection technique of other vaccines and the vaccine technology allows rapid development cycles and negligible risk of incorporation into the genome as with [[DNA vaccine]]s or the one shot implication of [[viral vector vaccine]]s.[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=28754493 Warrell M. Is there a future for mRNAs as viral vaccines? Lancet (London, England). 2017 Jul.](Print-Electronic) ([http://dx.doi.org/10.1016/s0140-6736(17)31964-5 Link to article] – subscription may be required.)
{{refsec}}
[[Category:Vaccination]]



Chimera

Sat, 23 Sep 2017 10:59:16 GMT

subclude

← Older revision Revision as of 10:59, 23 September 2017
Line 1: Line 1:
{{stub}}
{{stub}}
-
[[Category:Vaccination]]
+
[[Category:Queen's english]]
Also chimaera or chimæra.
Also chimaera or chimæra.
{{EtymologyBox| Greek khimaira, meaning a female goat}}
{{EtymologyBox| Greek khimaira, meaning a female goat}}
Line 6: Line 6:
==Chimeric vaccines==
==Chimeric vaccines==
-
Produced by genetically modifying a harmless organism (such as a bacteria or virus) to express the antigens expressed by a pathogenic organism, in order to generate immunity to the pathogen. See e.g. [https://travelreadymd.com/chimeric-vaccines-need-know/ this web article].
+
{{:Chimeric vaccine}}



Chimeric vaccine

Sat, 23 Sep 2017 10:59:10 GMT

for subclusion

New page


{{SubjectBox}}

Chimeric vaccines are produced by genetically modifying a harmless organism (such as a bacteria or virus) to express the antigens expressed by a pathogenic organism, in order to generate immunity to the pathogen. See e.g. [https://travelreadymd.com/chimeric-vaccines-need-know/ this web article].
[[Category:Vaccination]]



Information about GP practices

Fri, 22 Sep 2017 18:38:59 GMT

Policies that might be covered in a practice leaflet and web site:

← Older revision Revision as of 18:38, 22 September 2017
(One intermediate revision not shown)
Line 25: Line 25:
*[[Home visits]]
*[[Home visits]]
*Patients with [[dental problems]]
*Patients with [[dental problems]]
 +
*Lost or stolen drugs/prescriptions, especially for controlled drugs and others that may be misused. (Do you require a police number? Or never replace them? Or…)
*Making best use of the limited consultation time available, e.g.
*Making best use of the limited consultation time available, e.g.
:*Practice policy on [[late arrivals and missed appointments]]
:*Practice policy on [[late arrivals and missed appointments]]



Notifiable diseases

Fri, 22 Sep 2017 15:22:15 GMT

External links: ← Older revision Revision as of 15:22, 22 September 2017 Line 456: Line 456: According to this ProMED report,[http://www.promedmail.org/direct.php?id=20130303.1568573 ProMED-mail. MEASLES UPDATE (09). 2013; 20130303.1568573: ProMED-mail, Updated 3 March; Accessed: 2013 (3 March)] ''"Swedes are required by law to report falling ill to their doctor."'' It is not clear from the report which illnesses need to be reported, or how ''"illness"'' is defined. According to this ProMED report,[http://www.promedmail.org/direct.php?id=20130303.1568573 ProMED-mail. MEASLES UPDATE (09). 2013; 20130303.1568573: ProMED-mail, Updated 3 March; Accessed: 2013 (3 March)] ''"Swedes are required by law to report falling ill to their doctor."'' It is not clear from the report which illnesses need to be reported, or how ''"illness"'' is defined.  +==Conditions for which there is no charge for NHS treatment==  +It used to be the case that there was no charge for the treatment of notifiable diseases in the UK, even for [[Eligibility for NHS secondary care|overseas visitors who would otherwise have to pay for NHS treatment]].  +  +This link may no longer be the case, formally at least; although (for obvious reasons) there remains a huge overlap between them.  +  +{{England|Conditions for which treatment is free in England}}  +The definitive list of conditions which can be treated at no charge (largely because of their public health implications) is included in chapter 4 of the guidance on charges for overseas visitors.[https://www.gov.uk/government/publications/guidance-on-overseas-visitors-hospital-charging-regulations Department of Health International Health and Public Health Policy Division. Guidance on implementing the overseas visitor hospital charging regulations 2015: Department of Health,, 2016 (February 2016); 1-128.] ==External links== ==External links== *[http://www.opsi.gov.uk/si/si2010/uksi_20100657_en_1 Health Protection (LA powers) Regulations 2010] *[http://www.opsi.gov.uk/si/si2010/uksi_20100657_en_1 Health Protection (LA powers) Regulations 2010] [...]



Reports for the police

Fri, 22 Sep 2017 12:36:01 GMT

Message from the BMA Professional Fees Committee, 20 June 2017: ← Older revision Revision as of 12:36, 22 September 2017 Line 68: Line 68: ====Message from the BMA Professional Fees Committee, 20 June 2017==== ====Message from the BMA Professional Fees Committee, 20 June 2017==== -The following message was sent out by the [[British Medical Association|BMA's]] Professional Fees Committee on 20 June [[2017]]:+The following message information was posted at the [[British Medical Association|BMA's]] [https://www.bma.org.uk/advice/employment/fees/medical-records website] in June [[2017]]:[https://www.bma.org.uk/advice/employment/fees/medical-records BMA. Medical records access and copying fees. 2017; Updated 28 June 2017; Accessed: 2017 (22 September)] :"The BMA professional fees committee has received new legal advice regarding medical note requests received from the police, which are detailed below. :"The BMA professional fees committee has received new legal advice regarding medical note requests received from the police, which are detailed below. Line 85: Line 85: :"In order for you to proceed with the police request, please find attached a pro forma that we recommend you complete and send to the police authority. We recommend that you obtain each of the following: :"In order for you to proceed with the police request, please find attached a pro forma that we recommend you complete and send to the police authority. We recommend that you obtain each of the following:         -:#"Provide written patient consent to release of their records OR provide written confirmation as to the nature of the serious crime allegedly committed by the patient and an explanation as to why the patient’s records, or other information requested, are considered necessary for the specific purpose you are pursuing. You will require one of these in order to fulfil your responsibilities as the Caldicott Guardian.+:1.  "Provide written patient consent to release of their records OR provide written confirmation as to the nature of the serious crime allegedly committed by the patient and an explanation as to why the patient’s records, or other information requested, are considered necessary for the specific purpose you are pursuing. You will require one of these in order to fulfil your responsibilities as the Caldicott Guardian.         -:#"Confirmation in writing that the fee of £xx will be paid within 28 days of the police receiving the record. This fee is due to the disproportionate effort placed on an already overburdened GP practice to provide these notes which recognises the need to support the police in their investigation of a crime, where appropriate to do so.+:2.  "Confirmation in writing that the fee of £xx will be paid within 28 days of the police receiving the record. This fee is due to the disproportionate effort placed on an already overburdened GP practice to provide these notes which recognises the need to support the police in their investigation of a crime, where appropriate to do so.         -:#"Written confirmation from a senior police officer – ranked Superintendent or above – that he or she considers that the crime being investigated is a serious crime in line with the examples provided above.+:3.  "Written confirmation from a senior police officer – ranked Superintendent or above – that he or she considers that the crime being investigated is a serious crime in line with the examples provided above.         :"Once you are in receipt of both of these at the practice, and have checked the appropriateness of release of the records, you should respond to the police authority as soon as possible. :"Once you are in receipt of both of these at [...]



Chimera

Fri, 22 Sep 2017 10:58:38 GMT

Created page with "{{stub}} Category:Vaccination Also chimaera or chimæra. {{EtymologyBox| Greek khimaira, meaning a female goat}} {{QuotationBox|'''Medical Definition of Chimera.''' Chimera: ..."

New page

{{stub}}
[[Category:Vaccination]]
Also chimaera or chimæra.
{{EtymologyBox| Greek khimaira, meaning a female goat}}
{{QuotationBox|'''Medical Definition of Chimera.''' Chimera: In medicine, a person composed of two genetically distinct types of cells. Human chimeras were first discovered with the advent of blood typing when it was found that some people had more than one blood type. Most of them proved to be "blood chimeras" -- non-identical twins who shared a blood supply in the uterus. Those who were not twins are thought to have blood cells from a twin that died early in gestation. Twin embryos often share a blood supply in the placenta, allowing blood stem cells to pass from one and settle in the bone marrow of the other. About 8% of non-identical twin pairs are chimeras. Many more people are microchimeras and carry smaller numbers of foreign blood cells that may have passed from mother across the placenta, or persist from a blood transfusion.|From [http://www.medicinenet.com/script/main/art.asp?articlekey=8905 MedicineNet]}}

==Chimeric vaccines==
Produced by genetically modifying a harmless organism (such as a bacteria or virus) to express the antigens expressed by a pathogenic organism, in order to generate immunity to the pathogen. See e.g. [https://travelreadymd.com/chimeric-vaccines-need-know/ this web article].



Varicella zoster

Fri, 22 Sep 2017 10:33:27 GMT

Sub-unit vaccines:

← Older revision Revision as of 10:33, 22 September 2017
Line 145: Line 145:
====Other shingles vaccines====
====Other shingles vaccines====
=====Sub-unit vaccines=====
=====Sub-unit vaccines=====
-
In [[2017]] an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].[https://www.gsk.com/en-gb/media/press-releases/fda-advisory-committee-votes-unanimously-for-shingrix-hzsu-in-the-us-for-prevention-of-herpes-zoster-shingles-in-adults-ages-50-and-over/ GlaxoSmithKline plc. FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over. Press releases 2017; Updated 13 September 2017; Accessed:  (2017): 22 September]]
+
In [[2017]] an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].[https://www.gsk.com/en-gb/media/press-releases/fda-advisory-committee-votes-unanimously-for-shingrix-hzsu-in-the-us-for-prevention-of-herpes-zoster-shingles-in-adults-ages-50-and-over/ GlaxoSmithKline plc. FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over. Press releases 2017; Updated 13 September 2017; Accessed:  (2017): 22 September]
===Post exposure prophylaxis===
===Post exposure prophylaxis===



Chickenpox

Fri, 22 Sep 2017 10:32:37 GMT

Vaccination: ← Older revision Revision as of 10:32, 22 September 2017 Line 94: Line 94: Some also worry about possible vaccine-related complications. The live attenuated vaccine can - like the wild virus - persist in dorsal route ganglia and in some cases it can cause shingles. We know that some vaccine recipients get vaccine-virus related zoster: probably not as many, and not as serious, as from wild infection. But we don’t really know – the main burden of zoster disease is in older people, and until we’ve been using the vaccine for 80 years or more, we really won’t know what its effects will be. Some also worry about possible vaccine-related complications. The live attenuated vaccine can - like the wild virus - persist in dorsal route ganglia and in some cases it can cause shingles. We know that some vaccine recipients get vaccine-virus related zoster: probably not as many, and not as serious, as from wild infection. But we don’t really know – the main burden of zoster disease is in older people, and until we’ve been using the vaccine for 80 years or more, we really won’t know what its effects will be. -In the meantime, there is a possibility that other vaccines will be developed that do not have this possibility. In [[2017]], for example, an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].[https://www.gsk.com/en-gb/media/press-releases/fda-advisory-committee-votes-unanimously-for-shingrix-hzsu-in-the-us-for-prevention-of-herpes-zoster-shingles-in-adults-ages-50-and-over/ GlaxoSmithKline plc. FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over. Press releases 2017; Updated 13 September 2017; Accessed:  (2017): 22 September]] It is conceivable that the vaccine might be adapted for use in infants and children to prevent chickenpox. As it is not a live virus vaccine, this is unlikely to pose any subsequent risk of vaccine-type shingles. Other vaccines may also be in development - a [https://travelreadymd.com/chimeric-vaccines-need-know/ chimeric vaccine], for example, in which the DNA for the viral antigens is presented by a safe vaccine, without including the parts of the virus that make it pathogenic.+In the meantime, there is a possibility that other vaccines will be developed that do not have this possibility. In [[2017]], for example, an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].[https://www.gsk.com/en-gb/media/press-releases/fda-advisory-committee-votes-unanimously-for-shingrix-hzsu-in-the-us-for-prevention-of-herpes-zoster-shingles-in-adults-ages-50-and-over/ GlaxoSmithKline plc. FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over. Press releases 2017; Updated 13 September 2017; Accessed:  (2017): 22 September] It is conceivable that the vaccine might be adapted for use in infants and children to prevent chickenpox. As it is not a live virus vaccine, this is unlikely to pose any subsequent risk of vaccine-type shingles. Other vaccines may also be in development - a [https://travelreadymd.com/chimeric-vaccines-need-know/ chimeric vaccine], for example, in which the DNA for the viral antigens is presented by a safe vaccine, without including the parts of the virus that make it pathogenic. UPDATE, February [[2013]] UPDATE, February [[2013]] [...]



Varicella zoster

Fri, 22 Sep 2017 10:28:32 GMT

Immunisation: ← Older revision Revision as of 10:28, 22 September 2017 Line 142: Line 142: This appears to have been the first announcement of any detail about this proposal. There had been no formal announcement from [[Joint Committee on Vaccination and Immunisation|JCVI]] since 2010;[http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@ab/documents/digitalasset/dh_133599.pdf Joint Committee on Vaccination and Immunisation (JCVI). ''Joint Committee on Vaccination and Immunisation Statement on varicella and herpes zoster vaccines.'' London: Joint Committee on Vaccination and Immunisation (JCVI), 2010 (29 March)] the document describing the new [[NHS commissioning board|NHS Commissioning Board's]] public health functions refers to the introduction of a zoster vaccine in 2013,[https://www.wp.dh.gov.uk/publications/files/2012/11/s7A-master-131114-final.pdf 1. DH, PH, PHPSU. ''Public health functions to be exercised by the NHS Commissioning Board.'' London: Department of Health, 2012 (15 November); 1-26 ] but with no details; and a letter from the [[Department of Health]] proposing changes to the [[General Medical Services - general practitioners' contract in England|General Practice contract]] included the paragraph (Annex A, para 43):[http://www.dh.gov.uk/health/2012/12/gp-contract-proposals/ Armstrong R. ''General Medical Services – Contractual Changes 2013/2014.'' Leeds: Department of Health, 2012 (6 December)] This appears to have been the first announcement of any detail about this proposal. There had been no formal announcement from [[Joint Committee on Vaccination and Immunisation|JCVI]] since 2010;[http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@ab/documents/digitalasset/dh_133599.pdf Joint Committee on Vaccination and Immunisation (JCVI). ''Joint Committee on Vaccination and Immunisation Statement on varicella and herpes zoster vaccines.'' London: Joint Committee on Vaccination and Immunisation (JCVI), 2010 (29 March)] the document describing the new [[NHS commissioning board|NHS Commissioning Board's]] public health functions refers to the introduction of a zoster vaccine in 2013,[https://www.wp.dh.gov.uk/publications/files/2012/11/s7A-master-131114-final.pdf 1. DH, PH, PHPSU. ''Public health functions to be exercised by the NHS Commissioning Board.'' London: Department of Health, 2012 (15 November); 1-26 ] but with no details; and a letter from the [[Department of Health]] proposing changes to the [[General Medical Services - general practitioners' contract in England|General Practice contract]] included the paragraph (Annex A, para 43):[http://www.dh.gov.uk/health/2012/12/gp-contract-proposals/ Armstrong R. ''General Medical Services – Contractual Changes 2013/2014.'' Leeds: Department of Health, 2012 (6 December)] *''"We propose to introduce a new item of service fee of £7.63 to make payments for routine shingles immunisation for patients aged 70. The NHS CB will be responsible for introducing any confirmed catch up programme for patients aged 71 to 79."'' *''"We propose to introduce a new item of service fee of £7.63 to make payments for routine shingles immunisation for patients aged 70. The NHS CB will be responsible for introducing any confirmed catch up programme for patients aged 71 to 79."''  +  +====Other shingles vaccines====  +=====Sub-unit vaccines=====  +In [[2017]] an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].



Chickenpox

Fri, 22 Sep 2017 10:25:47 GMT

Vaccination: ← Older revision Revision as of 10:25, 22 September 2017 Line 91: Line 91: *Hope-Simpson hypothesis See [[#The Hope-Simpson hypothesis|below]].   *Hope-Simpson hypothesis See [[#The Hope-Simpson hypothesis|below]].   *Antivaxxers. Following the ill-founded scares about MMR vaccine - and the outbreaks of measles that are now occurring as a result - there is a concern that switching from MMR to MMRV might excite another wave of anti-vaccine publicity, and possibility of the sort of anti-vaccine hysteria that caused the drop in MMR uptake. It is possible - though there is no evidence for this - that this might have been an important consideration for DH when considering whether to swap MMR for MMRV. *Antivaxxers. Following the ill-founded scares about MMR vaccine - and the outbreaks of measles that are now occurring as a result - there is a concern that switching from MMR to MMRV might excite another wave of anti-vaccine publicity, and possibility of the sort of anti-vaccine hysteria that caused the drop in MMR uptake. It is possible - though there is no evidence for this - that this might have been an important consideration for DH when considering whether to swap MMR for MMRV.  +  +Some also worry about possible vaccine-related complications. The live attenuated vaccine can - like the wild virus - persist in dorsal route ganglia and in some cases it can cause shingles. We know that some vaccine recipients get vaccine-virus related zoster: probably not as many, and not as serious, as from wild infection. But we don’t really know – the main burden of zoster disease is in older people, and until we’ve been using the vaccine for 80 years or more, we really won’t know what its effects will be.  +  +In the meantime, there is a possibility that other vaccines will be developed that do not have this possibility. In [[2017]], for example, an adjuvanted Herpes zoster sub-unit (hence its short generic name ''"HZ/su"'') vaccine was endorsed by a US advisory committee - suggesting that it might soon be licensed to prevent [[Varicella zoster|shingles]].[https://www.gsk.com/en-gb/media/press-releases/fda-advisory-committee-votes-unanimously-for-shingrix-hzsu-in-the-us-for-prevention-of-herpes-zoster-shingles-in-adults-ages-50-and-over/ GlaxoSmithKline plc. FDA Advisory Committee votes unanimously for Shingrix (HZ/su) in the US for prevention of herpes zoster (shingles) in adults ages 50 and over. Press releases 2017; Updated 13 September 2017; Accessed:  (2017): 22 September]] It is conceivable that the vaccine might be adapted for use in infants and children to prevent chickenpox. As it is not a live virus vaccine, this is unlikely to pose any subsequent risk of vaccine-type shingles. Other vaccines may also be in development - a [https://travelreadymd.com/chimeric-vaccines-need-know/ chimeric vaccine], for example, in which the DNA for the viral antigens is presented by a safe vaccine, without including the parts of the virus that make it pathogenic. UPDATE, February [[2013]] UPDATE, February [[2013]] [...]



Parental responsibility and parental rights

Thu, 21 Sep 2017 14:31:47 GMT

Consent for treatment when those with parental responsibility do not agree:

← Older revision Revision as of 14:31, 21 September 2017
Line 33: Line 33:
The unwillingness of one parent to permit treatment that is thought to be in the best interests of the child could in itself be a factor held against that parent in child protection proceedings. (It has been suggested that a refusal to vaccinate a child might be considered a child protection issues - although many people have grave reservations about the possible consequences of going down this path.)
The unwillingness of one parent to permit treatment that is thought to be in the best interests of the child could in itself be a factor held against that parent in child protection proceedings. (It has been suggested that a refusal to vaccinate a child might be considered a child protection issues - although many people have grave reservations about the possible consequences of going down this path.)
 +
 +
For more detail, see [[Minors#What to do when parents disagree about a treatment|What to do when parents disagree about a treatment]]
==External Links==
==External Links==



Exclusion from school or nursery on health grounds

Thu, 21 Sep 2017 14:22:14 GMT

Exclusion from school or nursery because a child may be a risk to others: ← Older revision Revision as of 14:22, 21 September 2017 (One intermediate revision not shown)Line 4: Line 4: If a child has an infectious disease, their attendance at school may present a risk to others. If a child has an infectious disease, their attendance at school may present a risk to others. -Guidance on when a child should be excluded from school or nursery in order to prevent the spread of communicable diseases has been developed as by the [[Health Protection Agency]][http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1194947358374 ''Guidance on Infection Control in Schools and other Child Care Settings''. 2006. Updated December 2006. Last viewed 20 June 2008.] (available via the [http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733741705 HPA's guidance for schools page]). They give guidance on the most common infectious diseases and school attendance.+Guidance on when a child should be excluded from school or nursery in order to prevent the spread of communicable diseases has been developed as by [[Public Health England]] (formerly the [[Health Protection Agency]]).[https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities  Public Health England. Health protection in schools and other childcare facilities. 2017; Updated 18 September; Accessed: 2017 (21 September).]   -The guidance is fairly widely accepted, although not everybody would agree that the guidance that verrucas should be kept covered when e.g. swimming is evidence-based or appropriate. See [[Verruca#Prevention|''Prevention'' section of verruca page]] for more details.  {{refsec}} {{refsec}} [[Category:Education]] [[Category:Education]] [[Category:School medicine]] [[Category:School medicine]] [...]



Minors

Thu, 21 Sep 2017 12:41:03 GMT

What to do when parents disagree about a treatment: ← Older revision Revision as of 12:41, 21 September 2017 (One intermediate revision not shown)Line 69: Line 69: A [https://ukhumanrightsblog.com/2017/02/08/should-courts-order-vaccination-against-parents-wishes/ more recent case] reached a similar conclusion. The child was apparently in care, so with the local authority having [[Parental responsibility and parental rights|parental responsibility]], and the mother did not want the child to receive its routine vaccinations; but the court found that the child's best interests were to be vaccinated.[https://ukhumanrightsblog.com/2017/02/08/should-courts-order-vaccination-against-parents-wishes/ English R. Should courts order vaccination against parents’ wishes? ''UK Human Rights Blog'' 2017; Updated 08 February 2017; Accessed: 2017 (08 February)][http://www.bmj.com/content/356/bmj.j633 Dyer C. Baby in joint care with local authority to be vaccinated despite mother’s objections. ''BMJ'' 2017;356.] A [https://ukhumanrightsblog.com/2017/02/08/should-courts-order-vaccination-against-parents-wishes/ more recent case] reached a similar conclusion. The child was apparently in care, so with the local authority having [[Parental responsibility and parental rights|parental responsibility]], and the mother did not want the child to receive its routine vaccinations; but the court found that the child's best interests were to be vaccinated.[https://ukhumanrightsblog.com/2017/02/08/should-courts-order-vaccination-against-parents-wishes/ English R. Should courts order vaccination against parents’ wishes? ''UK Human Rights Blog'' 2017; Updated 08 February 2017; Accessed: 2017 (08 February)][http://www.bmj.com/content/356/bmj.j633 Dyer C. Baby in joint care with local authority to be vaccinated despite mother’s objections. ''BMJ'' 2017;356.]  +  +Please don't rely on this as legal advice, but we understand that if there is a disagreement about vaccination and the courts are to be involved, the process is that one of the parents (or a [[Parental responsibility and parental rights|"person" with parental responsibility]], to be pedantic about it) would apply to do this under S 8 of Children Act - a ''Specific issue application'', if they want the child vaccinated, or a ''prohibitive steps order'' application if don't. they don't. in effect, one parent takes the other to court. It is possible (perhaps likely) that the local social services would be involved at some point. ==Parental responsibility== ==Parental responsibility== [...]



Sanitary protection

Wed, 20 Sep 2017 15:53:30 GMT

New page

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Sanitary protection is a somewhat euphemistic expression referring to methods used to manage the [[Menstrual cycle|menstrual flow]].

Sanitary protection includes eg:
*''"pads"'' or ''"towels"'' designed to be placed in the underwear, to absorb menstrual flow.
*''"tampons"'' - absorbent materials designed to be inserted into the vagina, to absorb the menstrual flow.
*other devices such as the [[http://www.mooncup.co.uk ''"Moon Cup"'']] designed not to absorb the menstrual flow, but to contain it until it can be released appropriately.

==Removal of a retained tampon==
A "retained tampon" commonly occurs when a woman is unable, or forgets, to remove a tampon, leading to its removal being undertaken in a healthcare setting.

Removal is usually straightforward. Don't forget to ensure good ventilation - the room is likely to smell unpleasantly for some hours afterwards.

Provide [[Safety netting|safety-netting]] advice re symptoms that might indicate a need for antimicrobial treatment: antibiotics are probably not required unless the woman has signs of infection prior to removal of the tampon (are there guidelines on this???).

==Possibly relevant hits==
*[https://www.evidence.nhs.uk/Search?ps=20&q=retained+tampon possibly relevant guidelines] from [[National institute for health and care excellence|NICE]]
*[http://www.emedicinehealth.com/foreign_body_vagina/article_em.htm emedicine page on vaginal foreign bodies]
*[https://www.bashh.org/documents/4264.pdf guidance from] [[British Association for Sexual Health and HIV|BASHH]] and the Faculty of Sexual and Reproductive Healthcare[https://www.bashh.org/documents/4264.pdf ''Management of Vaginal Discharge in Non-Genitourinary Medicine Settings'' British Association for Sexual Health and HIV and Faculty of Sexual & Reproductive Healthcare, 2012.]

{{Refsec}}



Talk:Main Page

Tue, 19 Sep 2017 19:11:57 GMT

Succession: new section

← Older revision Revision as of 19:11, 19 September 2017
Line 217: Line 217:
Trying some deep maintenance to make server appear more robust then it really is. Chance could all fall over but think I understand what I am doing after keeping it limping for 2 months. Backups should exist [[User:Mlj|Mlj]] 21:58, 28 July 2017 (BST).
Trying some deep maintenance to make server appear more robust then it really is. Chance could all fall over but think I understand what I am doing after keeping it limping for 2 months. Backups should exist [[User:Mlj|Mlj]] 21:58, 28 July 2017 (BST).
:All went well, only one process is now creating files that need manual removal as would otherwise use up about 5% of disk space in 3 months. Hopefully should be stable for weeks more. Any other administrators should read '''InfoToRestartGANFYD''' file in /home to understand naughty and potentially annoying hacks if in due course a server migration takes place[[User:Mlj|Mlj]] 08:35, 29 July 2017 (BST)
:All went well, only one process is now creating files that need manual removal as would otherwise use up about 5% of disk space in 3 months. Hopefully should be stable for weeks more. Any other administrators should read '''InfoToRestartGANFYD''' file in /home to understand naughty and potentially annoying hacks if in due course a server migration takes place[[User:Mlj|Mlj]] 08:35, 29 July 2017 (BST)
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 +
== Succession ==
 +
 +
I'm getting steadily more and more retired, and need to hand the management, and paying for, the hosting on.  [[User:Midgley|Midgley]] 20:11, 19 September 2017 (BST)



Hormone replacement therapy

Sat, 16 Sep 2017 20:21:38 GMT

mortality ← Older revision Revision as of 20:21, 16 September 2017 Line 5: Line 5: #That women with a uterus given exogenous [[oestrogen]] will always need a progestagen to prevent endometrial hyperplasia. #That women with a uterus given exogenous [[oestrogen]] will always need a progestagen to prevent endometrial hyperplasia. #Within 2 years of the menopause there is a still a risk of fertility and HRT is not effective as [[contraception]] in this circumstance. #Within 2 years of the menopause there is a still a risk of fertility and HRT is not effective as [[contraception]] in this circumstance. -#Harms in long term<[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=16034922  Farquhar CM, Marjoribanks J, Lethaby A, Lamberts Q, Suckling JA. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane database of systematic reviews (Online). 2005; (3):CD004143.](Epub) ([http://dx.doi.org/10.1002/14651858.CD004143.pub2 Link to article] – subscription may be required.) and late primary and secondary prevention in osteoporosis outweigh benefits+#Mortality in long term use is in equipoise[https://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=28899851  Wise J. No overall increase in all cause mortality with HRT, study finds. BMJ : British Medical Journal. 2017 Sep; 358:j4230.](Electronic) ([http://dx.doi.org/10.1136/bmj.j4230 Link to article] – subscription may be required.).  +#Morbidity in long term<[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=16034922  Farquhar CM, Marjoribanks J, Lethaby A, Lamberts Q, Suckling JA. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane database of systematic reviews (Online). 2005; (3):CD004143.](Epub) ([http://dx.doi.org/10.1002/14651858.CD004143.pub2 Link to article] – subscription may be required.) and late primary and secondary prevention in osteoporosis appear to outweigh benefits. }} }} ==Use== ==Use== [...]