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Cadeia de frio da distribuição farmacêutica

Amaral, Celso Gaspar de Freitas
Fonte: [s.n.] Publicador: [s.n.]
Tipo: Dissertação de Mestrado
Publicado em //2013 POR
Relevância na Pesquisa
46.14%
Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas; A distribuição de medicamentos e produtos farmacêuticos sensíveis à temperatura num panorama de mercado globalizado, constitui um grande desafio para a gestão da cadeia de frio. A preocupação com a qualidade e segurança dos produtos farmacêuticos vai além dos indicadores logísticos de eficiência. O problema reside na manutenção de produtos termoláveis dentro de intervalos de temperatura seguros ao longo do processo de transporte e armazenamento. Daí a necessidade de controlo e monitorização da variação da temperatura dos produtos em todas as etapas da distribuição. Esta dissertação considera a hipótese de que a estabilidade térmica na cadeia de frio depende diretamente da eficiência da gestão logística e dos seus intervenientes. A qualidade na distribuição farmacêutica pode ser melhorada com técnicas inovadoras estimulando um serviço diferenciado e atrativo. A utilização da tecnologia RDIF é uma solução não invasiva que representa uma experiência de sucesso em sistemas de monitorização de transporte, sendo uma solução competitiva...

Teste do cometa como ferramenta de controle da cadeia do frio; COMET ASSAY AS A COLD CHAIN CONTROL TOOL

Duarte, Renato César
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 25/06/2009 PT
Relevância na Pesquisa
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Tendo em vista um mercado cada vez mais exigente na qualidade dos alimentos, faz-se necessário o desenvolvimento de processos que atendam às expectativas do consumidor. Dentre os processos existentes, destacam-se a cadeia do frio e a irradiação. A cadeia do frio compreende todas as etapas de conservação do alimento, desde a produção, resfriamento, congelamento, armazenamento, e transporte até o consumidor final. A irradiação, como processo de conservação de alimentos, estende a vida de prateleira, inibe o brotamento e reduz a contaminação por patógenos, entre outros benefícios. É importante a identificação da degradação dos alimentos em função de falhas nos processos a que foram submetidos. O teste do cometa (DNA Comet Assay) é um método de varredura largamente estudado, considerado rápido e de baixo custo, pelo fato de identificar quebras no DNA, é possível considerar sua utilização como mais uma ferramenta no controle de falhas na cadeia do frio que podem degradar e prejudicar os alimentos. Algumas etiquetas e selos usados no controle dos processos do frio não consideram a situação anterior do alimento, indicando falhas a partir do momento em que forem colocadas em contato com o mesmo, já o teste do cometa verifica a degradação ocorrida no alimento até o momento de sua realização podendo ainda...

The impact of cold chain temperature abuses on the quality of frozen strawberries (Fragaria x ananassa)

Cruz, Rui M. S.; Vieira, Margarida C.; Silva, Cristina L. M.
Fonte: ISEKI-Food Association Publicador: ISEKI-Food Association
Tipo: Artigo de Revista Científica
Publicado em //2013 ENG
Relevância na Pesquisa
46.06%
The quality of frozen foods can be negatively a ected if improper storage and distribution temperatures are allowed. The objective of this study was to investigate the e ect of freeze-thaw cycles, which may occur in the cold chain, on colour (Lab, Total Colour Di erences (TCD), chroma and hue angle) and vitamin C (ascorbic and dehydroascorbic acids) content of frozen strawberries (Fragaria ananassa, Duschesne, cv. Selva). A plan of temperature abuses (TAs) was established, based on a real situation, and applied to frozen strawberries during a four month frozen storage period. The results showed that the lightness (L) was the only parameter that was not signi cantly a ected by range of TAs studied. The colour showed some variation on the parameters a, b, TCD, chroma and hue angle. During TAs, ascorbic acid decreased about 75% and dehydroascorbic acid increased 73%. The non-abused strawberry samples showed better overall appearance than the abused samples. This work contributes to an understanding of the quality changes of frozen strawberries that might occur during frozen storage and cold chain distribution.

Monitoring the vaccine cold chain.

Cheriyan, E
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1993 EN
Relevância na Pesquisa
46.06%
Maintaining the vaccine cold chain is an essential part of a successful immunisation programme. A continuous electronic temperature monitor helped to identify breaks in the cold chain in the community and the study led to the issue of proper guidelines and replacement of faulty equipment.

Is the cold chain for vaccines maintained in general practice?

Haworth, E A; Booy, R; Stirzaker, L; Wilkes, S; Battersby, A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 24/07/1993 EN
Relevância na Pesquisa
46.27%
OBJECTIVE--To investigate the cold chain for vaccines and compliance with the local code of practice for storage. DESIGN--In a random sample of general practices orders for live vaccines (oral polio and measles, mumps, and rubella) were accompanied by a cold chain monitor which was activated on leaving the supplying pharmacy. The monitors were read at specified intervals and when all vaccines in the order had been used. Structured interview was used to check compliance with the local code of practice on storage. SETTING--West Berkshire and Aylesbury Vale district health authorities. SUBJECTS--16 (25%) general practices in West Berkshire, and 13 (50%) in Aylesbury Vale. MAIN OUTCOME MEASURES--Compliance with code of practice. Changes in the cold chain monitor. RESULTS--For six key requirements within the code of practice compliance varied from 70% to 0%. Only 16 of 29 practices had a named person responsible for vaccine storage and only four were aware of the local code of practice. Vaccine was stored for longer and more breaks in the cold chain occurred in West Berkshire than in Aylesbury Vale. The potency of some vaccines in 10 of 26 orders became suspect before use. CONCLUSIONS--Knowledge of appropriate management of the cold chain in two districts was poor. Breaks in the chain were more frequent and compromised potency more likely when vaccine had been stored for more than eight weeks. Problems in maintaining the cold chain indicate the need for continuing audit...

Evaluation of cold chain monitoring in Kelantan, Malaysia.

Hanjeet, K.; Lye, M. S.; Sinniah, M.; Schnur, A.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1996 EN
Relevância na Pesquisa
46.06%
An analysis was carried out on a total of 883 cold chain monitor (CCM) cards, which had been attached to batches of poliomyelitis, measles, DPT (diphtheria, pertussis, tetanus) and hepatitis B vaccines, during their transport and storage from the central store in Kuala Lumpur to Kelantan, a state in north-eastern Malaysia; 234 freeze watches attached to hepatitis B vaccines were also analysed. The monitor cards and freeze watches were observed at six levels between the central store and the periphery during distribution of the vaccines, and a colour change in any of the four windows (A, B, C, D) on the CCM cards or the freeze watches was recorded. In addition, 33 unopened vials of oral poliovirus vaccine (OPV), collected from refrigerators in 29 health facilities in Kelantan, were tested for potency using the tissue culture infective dose 50 (TCID50) method; 14 of them (42%) did not meet the WHO criteria for potent vaccines. The results showed that at the final destination 13.4% of all cards remained white while a colour change to blue was observed in 65% in window A, 16.6% in window B, and 4.4% in window C; none had turned blue in window D indicating that the vaccine had not been subjected to temperatures > or = 34 degrees C for 2 hours. All but 2 of the 234 freeze watches had turned purple...

Hepatitis B vaccine freezing in the Indonesian cold chain: evidence and solutions.

Nelson, Carib M.; Wibisono, Hariadi; Purwanto, Hary; Mansyur, Isa; Moniaga, Vanda; Widjaya, Anton
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
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OBJECTIVES: To document and characterize freezing temperatures in the Indonesian vaccine cold chain and to evaluate the feasibility of changes designed to reduce the occurrence of freezing. METHODS: Data loggers were used to measure temperatures of shipments of hepatitis B vaccine from manufacturer to point of use. Baseline conditions and three intervention phases were monitored. During each of the intervention phases, vaccines were removed progressively from the standard 2-8 degrees C cold chain. FINDINGS: Freezing temperatures were recorded in 75% of baseline shipments. The highest rates of freezing occurred during transport from province to district, storage in district-level ice-lined refrigerators, and storage in refrigerators in health centres. Interventions reduced freezing, without excessive heat exposure. CONCLUSIONS: Inadvertent freezing of freeze-sensitive vaccines is widespread in Indonesia. Simple strategies exist to reduce freezing - for example, selective transport and storage of vaccines at ambient temperatures. The use of vaccine vial monitors reduces the risk associated with heat-damaged vaccines in these scenarios. Policy changes that allow limited storage of freeze-sensitive vaccines at temperatures >2-8 degrees C would enable flexible vaccine distribution strategies that could reduce vaccine freezing...

Stabilization of vaccines and antibiotics in silk and eliminating the cold chain

Zhang, Jeney; Pritchard, Eleanor; Hu, Xiao; Valentin, Thomas; Panilaitis, Bruce; Omenetto, Fiorenzo G.; Kaplan, David L.
Fonte: National Academy of Sciences Publicador: National Academy of Sciences
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.06%
Sensitive biological compounds, such as vaccines and antibiotics, traditionally require a time-dependent “cold chain” to maximize therapeutic activity. This flawed process results in billions of dollars worth of viable drug loss during shipping and storage, and severely limits distribution to developing nations with limited infrastructure. To address these major limitations, we demonstrate self-standing silk protein biomaterial matrices capable of stabilizing labile vaccines and antibiotics, even at temperatures up to 60 °C over more than 6 months. Initial insight into the mechanistic basis for these findings is provided. Importantly, these findings suggest a transformative approach to the cold chain to revolutionize the way many labile therapeutic drugs are stored and utilized throughout the world.

Comparative cost models of a liquid nitrogen vapor phase (LNVP) cold chain-distributed cryopreserved malaria vaccine vs. a conventional vaccine

Garcia, Cristina Reyes; Manzi, Fatuma; Tediosi, Fabrizio; Hoffman, Stephen L.; James, Eric R.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.31%
Typically, vaccines distributed through the Expanded Program on Immunization (EPI) use a 2–8 °C cold chain with 4–5 stops. The PfSPZ Vaccine comprises whole live-attenuated cryopreserved sporozoites stored in liquid nitrogen (LN2) vapor phase (LNVP) below −140 °C and would be distributed through a LNVP cold chain. The purpose of this study was to model LNVP cold chain distribution for the cryopreserved PfSPZ Vaccine in Tanzania, estimate the costs and compare these costs to those that would be incurred in distributing a ‘conventional’ malaria vaccine through the EPI. Capital and recurrent costs for storage, transportation, labor, energy usage and facilities were determined for the birth cohort in Tanzania over five years. Costs were calculated using WHO/UNESCO calculators. These were applied to a 2–8 °C distribution model with national, regional, district, and health facility levels, and for the cryopreserved vaccine using a ‘modified hub-and-spoke’ (MH-S) LNVP distribution system comprising a central national store, peripheral health facilities and an intermediate district-level transhipment stop. Estimated costs per fully immunized child (FIC) were $ 6.11 for the LNVP-distributed cryopreserved vaccine where the LN2 is generated...

Evaluation of Probiotic Survivability in Yogurt Exposed To Cold Chain Interruption

Ferdousi, Rohollah; Rouhi, Millad; Mohammadi, Reza; Mortazavian, Amir Mohamad; Khosravi-Darani, Kianosh; Homayouni Rad, Aziz
Fonte: Shaheed Beheshti University of Medical Sciences Publicador: Shaheed Beheshti University of Medical Sciences
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.13%
In this research, the survival of probiotic microorganisms in yogurts stored at room temperature (cold chain interruption conditions) was studied. Milk inoculated with yogurt bacteria (mixed culture of Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus) and a single probiotic culture (L. acidophilus LA-5 or Bifidobacterium lactis Bb- 12 or L. rhamnosus HN001 or L. paracasei Lpc-37) were incubated till pH of 4.5 was reached. Probiotic yogurts were stored at two different temperatures including cold (control) and room temperatures (5 and 20°C, respectively). Changes in pH decrease, titratable acidity increase and redox potential increase as well as the viability of probiotics per 6 h intervals during an assumptive interrupted cold storage (24 h) were monitored. The survival of probiotics was strongly dependent on the storage temperature and remarkable viability loss occurred in room temperature compared to refrigerated storage. In addition, the survivability was dependent on probiotic strain. Among our experimental strains, B. lactis Bb-12 showed the less resistance to be stored at 20°C (24 h) and referring to the recommended minimum numbers of 107 cfu mL- 1, L. rhamnosus HN001 was the most suitable probiotic strain to be used in probiotic yogurts especially in countries having high possibility of cold chain interruption during storage.

Elimination of the cold-chain dependence of a nanoemulsion adjuvanted vaccine against tuberculosis by lyophilization

Orr, Mark T.; Kramer, Ryan M.; Barnes, Lucien V; Dowling, Quinton M.; Desbien, Anthony L.; Beebe, Elyse A.; Laurance, John D.; Fox, Christopher B.; Reed, Steven G.; Coler, Rhea N.; Vedvick, Thomas S.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.06%
Next-generation rationally-designed vaccine adjuvants represent a significant breakthrough to enable development of vaccines against challenging diseases including tuberculosis, HIV, and malaria. New vaccine candidates often require maintenance of a cold-chain process to ensure long-term stability and separate vials to enable bedside mixing of antigen and adjuvant. This presents a significant financial and technological barrier to worldwide implementation of such vaccines. Herein we describe the development and characterization of a tuberculosis vaccine comprised of both antigen and adjuvant components that are stable in a single vial at sustained elevated temperatures. Further this vaccine retains the ability to elicit both antibody and TH1 responses against the vaccine antigen and protect against experimental challenge with Mycobacterium tuberculosis. These results represent a significant breakthrough in the development of vaccine candidates that can be implemented throughout the world without being hampered by the necessity of a continuous cold chain or separate adjuvant and antigen vials.

Reducing the loss of vaccines from accidental freezing in the cold chain: The experience of continuous temperature monitoring in Tunisia

Lloyd, John; Lydon, Patrick; Ouhichi, Ramzi; Zaffran, Michel
Fonte: Elsevier Science Publicador: Elsevier Science
Tipo: Artigo de Revista Científica
Publicado em 11/02/2015 EN
Relevância na Pesquisa
46.19%
Accidental freezing of vaccines is a growing threat and a real risk for national immunization programs when the potency of many vaccines can be compromised if these are exposed to sub-zero temperatures in the cold chain. In Tunisia, this issue is compounded by using sub-standard domestic cold chain equipment instead of equipping the program with medical refrigerators designed specifically for storing vaccines and temperature sensitive pharmaceuticals. Against this backdrop, this paper presents the findings of a demonstration project conducted in Tunisia in 2012 that tested the impact of introducing several freeze prevention solutions to mitigate the risk of accidental freezing of vaccines. The main finding is that, despite the continued use of underperforming domestic refrigerators, continuous temperature monitoring using new technologies combined with other technological interventions significantly reduced the prevalence of accidental exposure to freezing temperatures. These improvements were noticed for cold chain storage at regional, district and health center levels, and during the transport legs that were part of the demonstration conducted in the regions of Kasserine in the South-Eastern part of Tunisia. Subsequent to introducing these freeze prevention solutions...

Cost-effectiveness and Financial Consequences of New Vaccine Introduction in Pakistan

Brenzel, Logan; Sanderson, Colin; Galayda, Victor; Masud, Tayyeb; Haq, Inaaml ul
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
46.06%
Pakistan has one of the highest infant mortality rates in the world, and over 50 percent of deaths in post-neonatal children are attributable to pneumonia, diarrhea, or meningitis diseases that can be prevented through vaccination. The purpose of the study is to compare the cost-effectiveness and financial implications of introducing pneumococcal (PCV-10), rotavirus (Rota-Teq), and Homophiles influenza type B (Hib) vaccines in Pakistan. The cost-effectiveness analysis was conducted using the Tri-Vac model, which is a static model that estimates the burden of disease and the costs of treatment and for the immunization program of children up to five years old in ten annual birth cohorts (2010 to 2019). Sensitivity analyses were conducted testing key assumptions related to disease burden, vaccine efficacy, and vaccine cost. The analysis of financial implications included a projection of cold chain needs and costs associated with the introduction of each new vaccine, as well as the financial outlays required by the government. Sensitivity testing was also conducted on major assumptions. All three vaccines were found to be cost-effective...

Cold-chain logistics: a study of the Department of Defense Oconus pre-pandemic influenza vaccine distribution network

Jones, Daniel "Travis"; Tecmire, Christopher "Craig"
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
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MBA Professional Report; The purpose of this MBA project is to suggest a standardized distribution process for the DoD of the Pandemic Influenza vaccine, filling an existing void in the National Strategy for Pandemic Influenza. Also, this project is intended to foster the communication and planning process for vaccine distribution between all stakeholders, including the DLA, COCOMs, and regional commanders. Currently, no DoD pre-pandemic vaccine distribution plan exists. This project identifies the essential infrastructure assets needed to develop a cold-chain distribution network for vaccine in a military application. Furthermore, the key communication and transportation elements needed for successful execution of this network are identified, including a discussion on information and vaccine flow through the distribution network. These ideas are organized into a model to provide an easily usable decision-making tool for cold-chain network design. Finally, an example using the model is provided, with PACOM as the example area of operation.

Transport and storage of vaccines in Hungary: the first cold chain monitor study in Europe.

Lugosi, L.; Battersby, A.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1990 EN
Relevância na Pesquisa
46.19%
With assistance from WHO the Hungarian Ministry of Health organized two cold chain studies: the first in three counties in summer (1 July to 30 September 1987), the second in six counties (including the previous three) in winter (1 January to 31 March 1988). The counties were chosen according to their distance (50-300 km) from Budapest, individual districts and child health centres being selected randomly. All participants were trained before beginning the studies. The vaccines (DPT, measles and BCG) for immunization, with attached cold chain monitors, were transported from the manufacturers to the child health centres using the normal distribution systems in the country. The whole cold chain process was analysed with regard to (1) actual exposures to adverse temperatures and delays in distribution; (2) the places where such exposure or delay occurred; (3) the percentage of vaccines at risk of deterioration (actual and predicted) at the end of the study; and (4) the performance of refrigerators of different types. Evaluation of the results (using WHO's EPIC software) showed significant deviations from acceptable standards. This first cold chain study in a European country proves that even in a temperate climate and with a reasonably well-organized public health service there can be significant weaknesses in the transportation and storage of vaccines. Recommendations to overcome these deficiencies are given.

Logística, conservação e fatores relacionados às perdas de imunobiológicos

Dias, Cherly Dayane Ribeiro; Severino, Jéssica Nathalia Silva
Fonte: Universidade Católica de Brasília Publicador: Universidade Católica de Brasília
Tipo: Trabalho de Conclusão de Curso Formato: Texto
PT_BR
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46.14%
A Rede de Frio é um setor que armazena, conserva, distribui e transporta imunobiológicos, desde a saída do laboratório até o momento em que é administrado em postos de saúde. O objetivo desta pesquisa é identificar os principais fatores causais das perdas dos imunobiológicos, como é realizado o transporte, armazenamento e controle térmico desde o nível nacional até o nível local de consumo da rede pública de saúde do Distrito Federal. Trata-se de uma pesquisa qualiquantitativo de caráter descritivo. Os questionários foram aplicados na central de rede de frio e na vigilância epidemiológica de Ceilândia e do Gama e em dois centros de saúde de cada regional citada anteriormente. Foram entrevistados um enfermeiro chefe da rede de frio do Distrito Federal; um de cada vigilância epidemiológica (VE) das 2 regionais e um servidor de cada sala de vacinação dos centros de saúde pesquisados. O presente estudo revela que o maior motivo das perdas de imunobiológicos é por frascos multidoses, que são abertos e não utilizados e tem o prazo de validade expirado. Portanto são doses perdidas, pois sua capacidade imunizante após o prazo de validade não é garantido.; The Cold Chain is a sector which stores, keeps, transports and distributes immunobiological from the output of the laboratory to the time it is administered in clinics. The objective of this research is to identify the main causal factors of immunobiological losses...

La cadena del frío de productos farmacéuticos; The cold chain of pharmaceutical products

Domínguez Alonso, Manuel; García Rodríguez, Carmen; Arias Carrillo, José Maria
Fonte: Conselho Superior de Investigações Científicas Publicador: Conselho Superior de Investigações Científicas
Tipo: Artículo Formato: 4347904 bytes; application/msword
SPA
Relevância na Pesquisa
66.19%
Realizado en el Instituto del Frío CSIC; Se analizan los elementos básicos de la cadena del frío para los medicamentos, vacunas y materiales para análisis clínicos, que requieren mantenerse en frío. Se estudian los elementos más importantes que se deben tener presentes, tales como: continuidad de la cadena, sistemas de transporte, indicadores, buenas prácticas y aseguramiento de la calidad. Se presta atención a los contenedores y a los materiales de cambio de fase, que permiten asegurar que no se rompa la cadena de frío en el transporte, principal problema que se puede presentar con este tipo de productos. Basic elements of the cold chain for medicines, vaccines and materials for clinical analyses - which need to be kept cold- are analyzed. It has also been analyzed the most important elements that must be present such: continuity of the chain, systems of transport, indicators, good practices and quality assurance. Attention is paid to containers and materials of the change of phase, that ensure that the cold chain is not broken during the transportation, which is the main problem that this type of products presents.; Peer reviewed

Food Cold Chain Equilibrium Based on Collaborative Replenishment

Lan,H.J.; Zhao,L.; Su',L.; Liu,Z.G.
Fonte: UNAM, Centro de Ciencias Aplicadas y Desarrollo Tecnológico Publicador: UNAM, Centro de Ciencias Aplicadas y Desarrollo Tecnológico
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
Relevância na Pesquisa
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This article analyzes the food cold chain (FCC) equilibrium based on collaborative replenishment policy. The entirety of collaborative replenishment (ECR) includes one supplier, one retailer and one consumer. The two players join in the non-cooperative game. Both of them pursue their own ideal benefits and achieve the equilibrium in terms of food quantity and price. A new iterative algorithm based on the theory of fixed point is designed to improve the equilibrium model. A numeric example was set to identify the applicability of the model. The parameter sensitivity analysis shows that the overall profit of ECR will increase with consumers' demand, while the customer satisfaction will decrease to some extent when the food deterioration rate and shortage cost increase, the overall profit of ECR will decrease. We find that the former leads to decreasing of the customer satisfactory and the latter do the opposite. Appropriate strategies should be chosen based on the actual situation for each equilibrium subject.

A Flexsim-based Optimization for the Operation Process of Cold-Chain Logistics Distribution Centre

Zhu,X.; Zhang,R.; Chu,F.; He,Z.; Li,J.
Fonte: UNAM, Centro de Ciencias Aplicadas y Desarrollo Tecnológico Publicador: UNAM, Centro de Ciencias Aplicadas y Desarrollo Tecnológico
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
Relevância na Pesquisa
66.23%
With people's increasing concern about food safety, cold-chain logistics distribution centre is playing an important role in preventing food from going bad. Now cold-chain logistics distribution centres have the problems of too much transportation, low degree of automation, unreasonable layout planning, complex distribution process etc. It is important to solve these problems in order to achieve efficient distribution. Firstly the modeling and simulation for the operation process of a fruits and vegetables cold-chain logistics distribution centre by using Flexsim software is realized. Then the paper analyses the preliminary output data and finds out the bottleneck and idle resources. Finally this paper makes adjustments for the system to get a better result which hopes to give a reference for the modeling and simulation for the operation process of other cold-chain logistics distribution centres.

Hepatitis B vaccination of newborn infants in rural China: evaluation of a village-based, out-of-cold-chain delivery strategy

Wang,Lixia; Li,Junhua; Chen,Haiping; Li,Fangjun; Armstrong,Gregory L; Nelson,Carib; Ze,Wenyuan; Shapiro,Craig N
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2007 EN
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46.19%
OBJECTIVE: To prevent perinatal transmission of hepatitis B virus (HBV), WHO recommends that the first dose of hepatitis B (HepB) vaccine be given within 24 hours after birth. This presents a challenge in remote areas with limited cold-chain infrastructure and where many children are born at home. METHODS: Rural townships in three counties in China's Hunan Province were randomized into three groups with different strategies for delivery of the first dose of HepB vaccine. In group 1, vaccine was stored within the cold chain and administered in township hospitals. In group 2, vaccine was stored out of the cold chain in villages and administered by village-based health workers to infants at home. Group 3 used the same strategy as group 2, but vaccine was packaged in a prefilled injection device. Training of immunization providers and public communication conveying the importance of the birth dose was performed for all groups. FINDINGS: Among children born at home, timely administration (within 24 hours after birth) of the first dose of HepB vaccine increased in all groups after the study: group 1, from 2.4% to 25.2%; group 2, from 2.6% to 51.8%; and group 3, from 0.6% to 66.7%; P < 0.001 in each case. No significant difference in antibody response to vaccine was observed between the groups. CONCLUSION: Timely administration of the first dose of HepB vaccine was improved by communication and training activities...