When leaving Zadar for the ceremony of declaring the best European destination, the director of the Belgian “European Best Destinations” (EBD) portal Maximilien Lejenue, who designed and organized the selection, told all Zadar tourism workers: “Use the EBD logo freely and as much as possible. That is why the reward exists”.Transferring the experiences of the previous winners – Porto and Bordeaux – Lejenue aimed at a significant increase in total tourist traffic and the ubiquity of EBD visuals in the Portuguese and French destinations. So, at airports, billboards, city streets, restaurants, coffee bars, hotels, campsites, apartment accommodation, chocolate shops, patisseries, boutiques, in fact, wherever possible. The activities of the Zadar Tourist Board, which led the campaign for the selection of the best European destination, and then offered the most beautiful Zadar tourist story to the world public, speak about the same thing. The first estimates of the direct effect of winning the EBD election are more than obvious: world media announced about Zadar, it is visited by television crews, journalists from all over the world and, especially importantly, domestic and foreign tour operators.”I think this is a true indicator of what is yet to be written or watched about Zadar during this year in the foreign media, and what has largely come about for this award. Such a media presence and interest of travel agencies and tour operators, our Office could not afford or provide”, Says the director of the Zadar Tourist Board Ante Rados.Such interest of domestic and foreign guests, business partners and the tourist profession as a free marketing candy and as an additional tool of self-promotion, was first recognized by the most serious Zadar tourist players. In “Arsenal”, for example, everyday business communication or so-called newsletters are decorated with the logo “Zadar, European Best Destination 2016.”, while every conference, festival, congress or any significant event in the historic ambience of the multifunctional center is organized with the EBD logo . Arsenal conducts the same type of promotion on the Internet and on social networks with the aim of advertising the destination and, indirectly, its own content within the destination offer.”The EBD award is really welcome in Zadar, because without a strong destination there is no successful work. First of all, people choose a destination according to some criteria, and then the content that exists in it. “, says Anamarija Portada from Arsenal, stating that this fact was immediately recognized as a unique opportunity: “When we advertise the organization of business groups or congresses, which we also deal with, we invite everyone first to Zadar as the best European destination, and then with us.”.The EBD logo and the marketing advantages that result from its use, however, are not only present in the city, but also in the entire Zadar region. Hotel “Pinija” in Petrčane immediately after the proclamation of Zadar as the best European destination on its new tourist brochures printed the EBD logo and – went to Berlin. After visiting the largest European tourist fair, Pinija’s brochure visited some other fairs, introducing future guests to the fact that they will come to the best European destination. “I think this is an extremely good thing for Zadar. The reactions of people at the fairs are positive and contribute to a better perception of the entire region”, Points out the director of Pinija, Hrvoje Anić.Apartments Victoria: occupancy higher by 20 percent!The direct benefit of advertising with the EBD logo and sticker was quickly felt by Jasna Barančić, the owner of the “Victoria” apartment in the city center. Compared to last year, Barančić tells us, there is a significantly higher occupancy rate. “This year I have 20 percent more guests than last year! I knew immediately after the proclamation of Zadar as the best tourist destination that we will have an even better season than last year“. She picked up the sticker at the Tourist Information Center, and she followed the selection for the best destination from day one. “S I gladly followed the choice and rejoiced in the success of Zadar. I think this is an important thing for all of us in the tourism business”, Said Barančić.Zadar as a brand drives the whole countyWhen a group of Portuguese travel agents and journalists arrives in Zadar at the end of May – organized by the Croatian Embassy in Portugal – it will be thanks to the fact that Zadar has been chosen as the best European destination. Although Zadar was not included in their original itinerary, the Portuguese had the winner of the EBD election two years ago, so the best destinations are extremely appreciated. And not just them.In the last three weeks alone, Zadar has hosted several study groups, namely German, Polish and Dutch travel agents, then a journalist-agency group from Luxembourg, and two Belgian groups, thanks primarily to the popularity that the EBD portal enjoys in the Benelux countries. That’s not all: Zadar was still visited by Russian travel agents through the domestic “Atlantis Travel”, and just these days through the Split “Gulliver” the beauties of Zadar are admired by a group of Japanese agents, while a group of Canadian agents will soon be brought by “Uniline”. Agents and journalists are not only interested in the city, say the Zadar Tourist Board, but the entire region with an offer of active tourism, cultural tourism, then beaches, wellness, yachting and the increasingly popular birdwatching, or bird watching.”This means that the city as a brand and engine in terms of tourism drives the entire Zadar County. The interest is really great, because we are the focus of media study groups through the system of the Croatian Tourist Board. In March, April and early May alone, we had almost 50 studio visits by television crews, journalists from around the world and well-known bloggers”, Points out the director of the Zadar Tourist Board Rados. How to get EBD labels and logos? Indoor and outdoor stickers “Zadar, the best European destination 2016.” It is possible to get it free of charge at the Tourist Information Center on Narodni trg, while the EBD logo for free use for marketing purposes can be downloaded from the website Tourist boards of the City of Zadar or Facebook “Like Zadar”. “It doesn’t matter what you do, it is important to greet the guest or customer with a smile and offer him the best of yourself”- they say in the Zadar Tourist Board.
The largest Croatian blues festival, created in honor of Philadelphia Jerry Ricks, one of the most famous representatives of traditional blues (country-blues), who chose Kastav as his last resting place, this year offers an attractive multi-day program.Kastav Blues Festival it is slowly approaching and there are less than 15 days left until its start, and we definitely recommend that you experience real blues in Kastav from 04.-08.August.2016.g. Ulaz je bestplana te će se u sklopu festivala održati i izložbe kao i glazbeno-kreativne radionice.Apart from Kastav, part of the blues festival is also held in Kostrena, Matulji, Viškovo and Čavle, which will once again host eminent domestic and international blues imena, te zasigurno publici pružiti nezaobilazan glazbeni doživljaj ispunjen dobrim vibracijama i kvalitetnim blues. The ninth edition of this memorial festival will present the names of renowned musicians from Italy, Cuba, Senegal, USA, Slovakia, Slovenia, Serbia, Great Britain and of course, Croatia.You can see the entire program and the list of performers on the official ones festival website. Invitation to this year’s edition Kastav Blues arranged by one of the most esteemed slide – guitarist and honorary citizen of Kastav, Michael Messer
This year, winemakers in Croatia can be very satisfied with both the turnover and quality of wine, and at the end of the year they were all pleasantly surprised by the quick reaction of the Ministry of Agriculture, which finally brought order to the market with foreign wine in bulk to our market.Namely, at the beginning of December, the Ministry of Agriculture adopted a new Ordinance on the vineyard register, mandatory declarations, accompanying documents, cellar records and production potential, which prescribes a uniform procedure for controlling the quality of wine when placing wine on the market. With the new Ordinance, all foreign wines that come to our market in bulk will now have to be registered and reported to the agricultural inspection for control and quality. So now everyone will have equal treatment on the market, both domestic and foreign wines, which is the first and basic rule of fair market competition, but also the protection of domestic wine producers.2016 marked a lower yield, but better wine quality This year was also marked by the harvest of the “decade”, as the winemakers point out, despite the lower yield of about 20-25 percent due to bad weather during flowering, weather and temperatures during the day and overnight were ideal in the further process. growth of sugar and sugar while the acid level was ideal. All this favored the exceptional quality as well as the health condition of the grapes that arrived in the cellars, and thus the exceptional quality of the wine that will come out of our cellars. Lower yield, but much better wine quality.Total domestic consumption in Croatia is about 1.207.000 hectolitersIn the marketing year 2015/2016 total domestic wine consumption in Croatia is about 1.207. 000 hectoliters stand out from the Central Bureau of Statistics, while wines with a protected designation of origin (53,3%) were the most represented in production. Production of wine with a protected designation of origin in the marketing year 2015/2016 is 529. 130 hectoliters, and in the marketing year 2015/2016. the Croatian citizen consumed on average about 26 liters of wine, while the degree of self-sufficiency is about 82%.HGK estimate: Holiday spending will amount to more than 12 billion kuna”The growth of retail trade turnover in 2016, with consumer optimism, will amount to 3,2 percent, while in 2015 this growth was 2,4 percent,” said the director of the Sector for Trade of the Croatian Chamber of Commerce Ema Culi on the occasion of the holiday assessment. consumption in the Croatian Chamber of Commerce. Thus, according to the Croatian Chamber of Commerce, spending will amount to more than 12 billion kuna, which is an increase of half a billion kuna than last year at the same time. Certainly, a part of the increased consumption will be felt by winemakers in December, both through increased wine sales and through the HoReCa channel.One of the solutions is branding of wine regions in CroatiaOne of the big problems on the market is the lack of a unique marketing strategy for branding Croatia as a wine destination – “Vina Croatia – Vina Mosaica.” Đuro Horvat, consultant for marketing and wine market for Agrobiz.hr, adds that Croatia will produce wines of excellent quality this year, but placement problems still remain. ” One of the disadvantages is the non-integration of wine as a strategic reference Croatian product in the national strategy and the excessive share of international varieties in relation to indigenous ones. One of the solutions is certainly to force one’s own Croatian label, and not umbrella brands. We must connect winemakers with each other through the concept of “Vina Croatia – Vina Mosaica”, ie brand our four wine regions: Dalmatia, Slavonia and the Croatian Danube region, Istria and Kvarner and Hilly Croatia. For our recognition as wine countries, that is the imperative of competitiveness. ” Horvat concludes.Wine Institute: Croats drink the most wine per capita in the world”Croatian wines are increasingly attracting the attention of world experts, and it is rare in the world for those wines for which restaurants with three Michelin stars arrange their menus.”, States the research of the Wine Institute, and thus Croatia is the third in the amount of wine consumed per capita in the world, just behind the Vatican and Andorra. According to the survey results, Croats drink per capita annually 44,2 liters of wine, while behind us is neighboring Slovenia, whose resident drinks 44,07 liters of wine a year. Only behind Croatia and Slovenia are the world wine superpowers France (42,51), followed by Portugal, Switzerland, Macedonia, Moldova and Italy.
In the period from 9 to 12 May, the Croatian National Tourist Board organized a study trip for tourism professionals on the topic of health tourism, ie strengthening the capacity and offer of health tourism.The trip was held in Hungary, and in addition to employees of the Croatian National Tourist Board, this four-day trip was attended by representatives of the tourism industry, ie spas, spas, wellness hotels, travel agencies specializing in health tourism and associations, as well as Croatian media. Thus, the participants of the first day of the study tour visited the city of Hévíz and the lake of the same name, the largest biologically active, natural healing lake in the world and learned about the comparative advantages of Lake Hévíz and its use in the context of health tourism. An expert presentation on the topic of health tourism in Hungary was held by Adam Ruszinkó, President of Marketing at the Hungarian Health Tourism Association.During the second day of the study trip in the city of Sárvár, an expert presentation was held on the development and offer of health tourism Sárvár, known for its springs of healing thermal water, and those present were greeted by Mayor István Kondora. The third day of the study trip was held in Budapest, where Gordan Grlić Radman, the Ambassador of the Republic of Croatia to Hungary, joined the study group. Thus, a tour of Terme Szechenyi, one of the most famous and largest thermal baths in Europe, was organized in Budapest. The last day of the study trip was also held in Budapest with a tour of the Aquaworld Budapest water attraction and an expert presentation on the development, comparative advantages and potential of dental tourism in Hungary. The presentation was held in the congress hall of the Aquaworld Hotel Budapest by Peter Takács, Marketing Director of the Hungarian State Agency for Dental Tourism.Photo: Aquaworld Resort BudapestThe experiences of health tourism in Hungary, presented during this trip, will certainly be of great help to Croatia and Croatian tourism workers. Namely, having in mind that Hungary is a country that realizes 40 percent of European dental tourism and a country where a quarter of total tourism takes place in SPA and wellness hotels, it is clear that many examples of good practice and experience can be applied in certain Croatian destinations. Although the role of the Croatian National Tourist Board, when it comes to health tourism, is primarily viewed from the perspective of promotion, we remind you that this product, according to estimates at the global level, is growing at a rate of between 15 and 20 percent per year. Thus, in accordance with the Annual Work Program of the Croatian National Tourist Board, in 2017 special attention is paid to the development and promotion of health tourism, as a highly growing product that is a significant motive for arrival in the pre- and post-season periods.In Hungary, a quarter of the total tourist traffic takes place in SPA and wellness hotelsThe Croatian National Tourist Board, as a national institution in charge of tourism promotion, will continue to make a strong contribution to the even stronger positioning of this product, which has a strong resource base and great potential in Croatia. It is certain that the activities of the Croatian National Tourist Board and other key stakeholders in developing a new offer and improving the quality of health tourism services will position Croatia in the near future as a renowned health tourism destination.Source: CNTB
Share on Facebook Email A brief period of postnatal visual deprivation, when early in life, drives a rewiring of the brain areas involved in visual processing, even if the visual restoration is completed well before the baby reaches one year of age, researchers at the University of Trento, McMaster University, and the University of Montreal revealed today in Current Biology.Scientists have long known that the functional neural architecture for perception and cognition strongly depends upon plasticity: in other words, our brain has the capacity to change and adapt as a result of experience. As a number of neuroimaging studies show, the early onset of permanent blindness alters the response of the neurons of the visual cortex and causes a cortical compensatory re-organization in the occipital lobe. This lobe, where visual functions are typically located, becomes active during the processing of auditory stimuli. The recruitment of visual areas for auditory tasks is sometimes thought to underlie the better performance in processing inputs from other senses observed in congenitally blind people.What was not clear yet was whether a short and transient period of postnatal visual deprivation is sufficient to trigger crossmodal reorganization that persists after years of visual experience. In order to answer that question, the researchers characterized the brain responses to auditory stimuli in 11 adults who had been treated for congenital cataracts in both eyes. These adults had been deprived of all patterned vision from birth until the cataracts were removed surgically and the eyes fitted with appropriate contact lenses that restored nearly normal visual input. The age at treatment varied from 9 days to just under 8 months of age. The control group consisted of 11 visually normal adults. Share Share on Twitter LinkedIn Pinterest “The cataract-recovery participants had been blind for less than 8 months, but their blindness occurred at birth, during the most sensitive period for brain development. They showed enhanced auditory-driven activity in focal visual regions”, explained study leader Olivier Collignon, who undertook the work at University of Trento and the University of Montreal. “Thus, a short and transient period of visual deprivation early in life leads to enduring large-scale crossmodal reorganization of the brain circuitry typically dedicated to vision. This compellingly highlights the role early postnatal experience plays in shaping the functional architecture of the brain”.Crossmodal plasticity in the case of blindness is a vital brain mechanism for compensating for visual deprivation, but the mechanism can have also negative effects on visual restoration, because it might interfere, to a certain extend, with the optimal resettlement of the regained sensory inputs. “Crossmodal plasticity may therefore be considered as a two-edged sword”, Collignon added. The existence of auditory responses in the occipital cortex of cataract-recovery patients, as observed in the study, therefore poses crucial questions regarding how these non-visual inputs coexist or even interfere with visual functions. Olivier Collignon and his collaborators are now investigating further how this crossmodal reorganization might contribute to the impaired visual abilities observed in cataract-reversal patients. Resolving this crucial question may impact on how visual training programs are developed for visual restoration.
Previous studies in male rats have identified particular brain regions that are important for the stress relief, including the basolateral amygdala and prefrontal cortex. The researchers looked at protein markers of activity (FosB/deltaFosB and pCREB) in these brain regions to see if the sugar drink altered these protein levels similarly in male and female rats. FosB/deltaFosB was increased in the amygdala of males who were given the sugar drink compared to those drinking only water. Female rats also showed this increase in amygdala FosB/deltaFosB after the sugar drink, but only when they were in the proestrus/estrus stage of their cycle. In contrast, amygdala pCREB was increased by the sugar drink in males but not females. Instead amygdala pCREB varied across the estrous cycle in female rats and was unaffected by sugar drink. These different patterns show that comfort eating has some similar effects in male and female brains, but also has unique effects in the female brain that vary across the hormonal cycle. Pursuing these findings could lead to different strategies that could be useful for women and men who habitually eat to manage stress. Share on Twitter Share on Facebook LinkedIn Researchers at the University of Cincinnati have found that the brain networks that mediate stress relief after eating highly palatable foods may vary between males and females, and may also depend on the stage of the estrous cycle. The study performed by Ann Egan, a doctoral candidate in the University of Cincinnati Neuroscience Graduate Program in the laboratory of Dr. Yvonne Ulrich-Lai, PhD, used a rodent model of ‘comfort food’ to investigate the neurocircuitry behind this phenomenon. The research is to be presented this week at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for all aspects of eating and drinking behavior.“We know that both men and women eat tasty foods as a strategy to reduce stress, and in fact there is some evidence that suggests that women may be more prone to this ‘comfort food’ style of eating,” explained Egan. “This study is important because it suggests that males and females may be using slightly different brain regions, and the stress relief in females may also be affected by the stage of the estrous cycle. This can help us understand how eating behaviors can affect men and women differently, and how eating behaviors are affected by fluctuating hormone levels.”The researchers used a rodent model that is based on human snacking patterns. Female rats were given twice-daily access to a small amount of a sweet sugar drink for 14 days, while other female rats were only given water as a control. Then rats were subjected to a stress test, and their stress hormone response was measured. Similar to previous studies done in male rats, female rats that had been given the sugar solution had a lower stress hormone response to the stress challenge. However, in the female rats the reduced stress response only occurred if the rats were in the proestrus/estrus stage of their estrous cycle, when levels of estrogen are high. Email Pinterest Share
Physical pain can sometimes be as effective as other strategies in reducing psychological distress, according to new research published in the journal Emotion.Self-injurious behavior among adolescents with mental health problems is a serious public health concern around the world, but the new findings indicate that the use of benign physical pain to regulate emotion is common outside of this population as well.“I had been studying body-based coping skills for people who struggle with regulating their emotions, such as smiling, rhythmic tapping, and deep breathing. I became interested in the topic of pain because a great deal of the literature on non-suicidal self-injury (NSSI) indicates that one reason people engage in self-injurious behavior is to regulate extreme emotional states,” said study author Ashley Doukas, a clinical instructor at NYU Langone Health. Share Email LinkedIn Share on Facebook Share on Twitter Pinterest “An incidental finding in many of the studies looking at NSSI proxies (such as non-harmful pressure, heat, and cold) is that the healthy ‘control’ populations also report reductions in negative emotion after receiving a painful stimulus. This got me thinking that pain itself might be the primary mechanism in self-regulation, rather than the injurious component, per se.”“Furthermore, it made me think that benign forms of pain might be used to self-regulate more widely by the general population, yet go unnoticed due to the lack of a shock factor that NSSI has. We wanted to see if, given the choice, people without NSSI histories would voluntarily inflict pain to cope with negative emotions,” Doukas explained.In the study, the researchers exposed 60 individuals to upsetting images and provided them with two cognitive strategies and two physical methods to cope with negative emotion. The participants were told they could reduce distress by either thinking of something other than the picture, changing the meaning of the picture in their mind, self-administering a painful shock, or self-administering a painless electrical stimulation.Doukas and her colleagues found that 67.5% of participants elected for the painful shock at least once. During 16 trials, the participants chose the painful stimulation between 0 to 13 times, with an average of twice per person. In addition, the painful stimulation as rated as equally effective in regulating negative emotion compared with other coping strategies.Doukas hopes that the findings “de-stigmatize those who engage in self-injurious behavior. There is a lot of shame and hiding when people engage in self-injurious behavior, and well-meaning people might not understand why people do it.”“While of course we do not want people to put themselves at risk for infection or accidental death, the fact is that human beings use pain to manage their emotions all the time — think of an intense massages to relax, and putting extra hot sauce on tacos to make them more intense and enjoyable. While the injurious aspect of NSSI can be alarming to many, the infliction of pain on oneself may not be inherently pathological, and may actually be making good use of some basic biological responses to pain, such as endorphins,” she told PsyPost.In a replication of previous research, the researchers also had the participants sit alone in an empty room for 10 minutes, and instructed them not to sleep, read, or use their cell phone. The participants were, however, allowed to self-administer painful or painless electrical stimulation as frequently as they wished.Approximately 60% of the participants decided to painfully shock themselves at least once. The number of times participants chose to receive the painful electrical stimulation ranged from 0 to 69, with an average of about 13.“In understanding the self-regulatory function of pain to either reduce intense negative emotions, or induce emotions during an unpleasant state of emotional numbing (such as boredom), we can better understand how clinical and non-clinical populations cope with negative emotions,” Doukas said.“Perhaps voluntarily inflicting pain exists on a spectrum from ‘healthy’ to ‘unhealthy’, and it is the behavior (e.g. cutting), and not the mechanism of action (i.e., pain) that might determine where that boundary lies. In destigmatizing pain and recognizing its potential to be helpful, we can broaden our understanding of now clinical and non-clinical populations might use the biological response to pain to help them get through the day a bit better.”Of course, the researchers are not endorsing self-injury as a method of coping with emotional distress.“Our hope is that our research, and research like it, can expand treatment options for those who do engage in dangerous NSSI behavior like cutting or burning skin. For example, one possibility might be integrating TENS units (electrical stimulation devices which are often used in physical therapy settings) into a harm reduction treatment plan,” Doukas explained.“By removing stigma, and looking at the behavior from a neutral scientific standpoint, we hope that both clinicians and the lay public can understand not only why clinical populations engage in NSSI, but how to treat it more effectively. I would also caution people against purchasing a TENS unit and/or self-inflicting pain without first consulting their physician about whether it is safe for them.”The study, “Hurts So Good: Pain as an Emotion Regulation Strategy“, was authored by Ashley M. Doukas, Wendy M. D’Andrea, Wesley E. Gregory, Brandon Joachim, Kellie A. Lee, Gabriella Robinson, Steven J. Freed, Vivian Khedari-DePierro, Kendall A. Pfeffer, McWelling Todman, and Greg J. Siegle.
Email LinkedIn Share on Facebook Pinterest Share on Twitter Share A new study suggests that engaging with negative content on social media can lead to reduced activation of the prefrontal cortex and impairments in executive functioning. The findings were published in Social and Affective Neuroscience.While it has been established that emotional stimuli can affect cognition, little is known about the neural consequences of consuming emotionally-arousing content on social media. Researchers Sarah M. Tashjian and Adriana Galván set out to explore this topic, by examining the cognitive consequences of reading negative, discriminatory tweets published by President Trump.“As political attitudes in the United States become more polarized, the potential for engaging with perceived negative content on social media increases. A New York Times analysis estimated over half of President Trump’s 11,000+ tweets since becoming President involved attacks, with 1,421 of those 5,889 attacks levied against minority groups and immigrants (Shear et al., 2019),” Tashjian and Galván say. An experimental study was conducted among 57 adults between the ages of 18 and 29. The participants were selected if they belonged to at least one historically marginalized group by way of ethnicity, gender identity, or sexual orientation. The subjects were assigned to read either a set of real tweets published by Trump that were discriminatory in nature (negative tweet condition) or a set of real tweets that discussed neutral topics and appeared to come from a fictitious account (neutral tweet condition).Both before and after reading the tweets, subjects completed 30 trials of a spatial reasoning task involving mental rotation, while whole-brain functional magnetic resonance imaging (fMRI) data was recorded. Participants also rated their affect across several states including anger, depression, disgust, and fear/anxiety.As was expected, those reading the negative tweets experienced worsening affect after reading the tweets compared to those who read the neutral tweets.Interestingly, it was found that those who read the neutral tweets showed improvements on the mental rotation task as they completed more trials. Those who read Trump’s discriminatory tweets, however, showed no improvements throughout the trials following exposure to the tweets.Using fixed-effects general linear models, the researchers compared the subjects’ whole-brain activation following the tweet exposure to whole-brain activation at baseline. Then, researchers estimated neural habituation, that is, “greater response decrement over the course of stimuli presentation.”The brain scans showed decreased activation in the dorsolateral prefrontal cortex (dlPFC) throughout tweet exposure.(Photo credit: National Institutes of Health)Importantly, subjects who reported worsening negative affect after reading the tweets displayed increased dlPFC habituation. Moreover, participants who displayed greater dlPFC habituation did not improve on the mental rotation task throughout the post-tweet trials, while those who showed less habituation did.As the researchers explain, the dorsolateral prefrontal cortex is a region associated with cognition and the control of emotions, and emotional distraction has been found to disrupt activation of the dlPFC. “There are several mechanisms by which emotionally charged information can interfere with executive resources. First, threats elicit attempts to regulate negative emotions, taxing resources like the dlPFC through implicit and automatic emotion regulation (Braunstein et al., 2017),” the authors relate.Although their study focused on negative affect, the researchers acknowledge that positive emotions can also affect executive functioning — an interesting topic for future research.As Tashjian and Galván remark, “Results demonstrate that widely read tweets may have deleterious effects on executive functioning in a large segment of the population: historically marginalized identity groups.”The study, “Dorsolateral prefrontal cortex response to negative tweets relates to executive functioning”, was authored by Sarah M. Tashjian and Adriana Galván.
Second in a series marking the 1-year anniversary of novel H1N1 pandemic influenza. The first, on the virus itself, appeared Apr 23.Apr 26, 2010 (CIDRAP News) – Among the many surprises of the 2009 H1N1 flu pandemic—its emergence at the end of a flu season, its unexpected toll of mild illness, its almost-complete replacement of circulating seasonal strains—was its reversal of years of received wisdom on how vaccines would be needed to respond.Researchers had predicted, for instance, that to be protected against a novel strain, most members of the population would require two doses of vaccine containing the new pandemic strain. And because that many doses of vaccine would stress the existing vaccine-manufacturing system, other researchers had predicted that the addition of dose-sparing adjuvants to the new vaccine would be crucial to stretch out scarce supplies of newly made antigen.Neither turned out to be true.To the great relief of health authorities, most members of the population turned out to need only one dose of the novel vaccine, though whether the youngest children needed two became a matter for international disagreement. And because that move freed up so many doses of antigen, the United States’ long reluctance to test and license adjuvants used in flu vaccines in Europe did not become the bad bet that many flu experts had feared.By September 2009, Australian researchers were reporting in the New England Journal of Medicine that—contrary to predictions—one dose of a 15-microgram vaccine made from the novel strain produced an acceptable immune response in 97% of adults who received it.By November, the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) was reporting that the single-dose regimen was equally protective for pregnant women, who were emerging as one of the groups at highest risk of serious complications from the novel virus.But US health authorities continued to caution that children younger than 10, another group at higher risk for pandemic complications, should continue to receive two doses of the new vaccine, because only 55% of children in those age-groups had produced a protective immune response after one dose.That recommendation brought the United States into conflict with the World Health Organization (WHO), which only 3 days earlier had recommended giving young children a single dose as a way of extending the vaccine to as many children as possible. When asked about the discrepancy, Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), said: “If the data show a difference, we will reconsider our recommendations. . . . We’re sticking with what the [Advisory Committee on Immunization Practices] has recommended.”A second report by the same Australian group, published in late December, found an adequate immune response in infants and young children after one dose, but that finding did not change US policy.Other long-held predictions, however, turned out to be all too accurate. The fragile egg-based manufacturing system for flu vaccine, which had gone without significant innovation for 50 years, proved inadequate to manufacturing the new vaccine. The newly isolated pandemic strain did not grow well in chicken eggs—something that also had happened in the past for seasonal vaccine strains—and the resulting slowdown in manufacturing and delivery strained public confidence and allowed anti-vaccine sentiment to build.At the same time, long-recognized bottlenecks in flu-vaccine production, including lack of capacity in the post-manufacturing “fill and finish” step that puts vaccine into vials, slowed the industry’s process for getting the new antigen out to the marketplace.In mid-summer 2009, federal officials had predicted they would be able to release 120 million doses of novel vaccine by October, with millions more doses to follow each week. By mid-August, that prediction was scaled back to 45 million doses by mid-October. And on Oct. 21, Health and Human Services (HHS) Secretary Kathleen Sebelius was grilled by Congress regarding the slow start to vaccine delivery: Only 12.8 million doses had become available.In testimony, Sebelius blamed both the new virus’s slow growth in eggs, and also production problems on some new manufacturing lines. “We anticipate that number [of doses] growing exponentially as we move into the season,” she said. By early November we’re confident that vaccine will be far more widely available. There’ll be enough vaccine so every American who wants to can be vaccinated.”But by the end of 2009, Americans who had urgently pursued the vaccine when it was supposed to be delivered had turned away from seeking it. By this February, the CDC said in April, 229 million doses of antigen had been ordered, about 162 million had been “fill-finished,” about 126 million had been put into distribution, and somewhere between 81 and 91 million doses had been administered.That accounting made it clear that some millions of doses—the CDC could not, by April 1, say how many—were likely to be discarded because they are subject to strict expiration dates once packaged. (The Washington Post estimated the amount of vaccine discarded could reach more than 71 million doses.)In a speech last week, Sebelius called the overpromising of vaccine one of the pandemic’s “teachable moments” for her department. “We wanted to make sure the American people knew what we knew when we knew it, but we raised expectations too high,” she said. Sebelius did not, however, specify how HHS would alter its approach in the future.But additional millions of doses that remain in bulk form may last long enough to be combined into next fall’s seasonal vaccine, giving manufacturers a head start on that always-unpredictable process—provided the circulating virus does not mutate over the summer to make the retained antigen unusable.”It is theoretically possible that some of that antigen could be the H1N1 component of a trivalent vaccine,” Dr. Anne Schuchat, director of the CDC’s National Center for Immunizations and Respiratory Diseases, said in a briefing April 1. “Plans around that particular decision are under discussion between the Department of Health and Human Services and the individual manufacturers.”See also:Apr 23 CIDRAP News story “H1N1 LESSONS LEARNED: Pandemic underscored influenza’s unpredictability”Greenberg ME, Lai MH, Hartel GF, et al. Response to a monovalent 2009 influenza A (H1N1) vaccine. N Engl J Med 2009 Dec 17;361(25):2405-13 Epub 2009 Sep 10. [Full text]Nov 2, 2009, NIAID statement “Initial results show pregnant women mount strong immune response to one dose of 2009 H1N1 flu vaccine”Nov 2, 2009, NIAID statement “Updated results: In youngest children, a second dose of 2009 H1N1 influenza vaccine elicits robust immune response”Oct 30, 2009, WHO Pandemic (H1N1) 2009 briefing note 14: “Experts advise WHO on pandemic vaccine policies and strategies” http://www.who.int/csr/disease/swineflu/notes/briefing_20091030/en/index.htmlNolan T, McVernon J, Skeljo M, et al. Immunogenicity of a monovalent 2009 influenza A(H1N1) vaccine in infants and children. JAMA 2010;303(1) Epub 2009 Dec 21 [Full text]Aug 14, 2009, CIDRAP News story “http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/aug1409vaccine.html”Oct 21, 2009, Senate Committee on Homeland Security and Governmental Affairs, “H1N1 flu: monitoring the nation’s response” (includes Sebelius testimony).Apr 1 CDC press briefing transcript
Oct 6, 2010One fourth of kids under 2 received full seasonal flu vaccinationOnly about a quarter of children under 2 years old were fully vaccinated against influenza during the most recent non-pandemic flu season, according to US Centers for Disease Control and Prevention (CDC) statistics released today. The CDC’s Advisory Committee on Immunization Practices in 2002 first encouraged seasonal flu vaccination in children aged 6 to 23 months, and then in 2004 recommended vaccination for this age-group. From September through December 2008, 41.5% of children in that age-group received at least one dose of the vaccine, with only 24.7% receiving complete two-dose protection. States with more than 40% receiving full vaccine coverage were Massachusetts, 45.9%; Rhode Island, 43.9%; Vermont, 43.6%; New Hampshire, 43.3%; Wisconsin, 41.2%; and Minnesota, 41.1%. Full coverage fell below 15% in three states: California, 14.9%; Arkansas, 14.2%; and Mississippi, 8.7%.Oct 6 CDC reportOrgan-transplant patients hit hard by pandemic H1N1Organ transplant recipients who were infected with pandemic 2009 H1N1 flu had higher mortality rates than the general population, with poorer outcomes in those whose treatment was delayed, according to a recent study. Researchers studied 77 transplant patients from 10 centers, 35 of whom were suspected novel H1N1 cases, 19 probable, and 23 confirmed. Six of them (7.8%) died, compared with CDC estimates of much less than 1% mortality in the general population and about 5% in hospitalized patients. Time from the onset of symptoms to the first visit and treatment was “significantly longer” in 34 patients who were admitted to a medical ward and 10 admitted to intensive care, compared with the 33 ambulatory patients.Oct 1 Transplantation abstractMRSA stalks Maine lobstering villageHealth officials in Maine suspect that lobster fishing activities have contributed to a methicillin-resistant Staphylococcus aureus (MRSA) outbreak that has affected about 30 people in an island fishing community over the past two summers, the Associated Press (AP) reported today. Dr Stephen Sears, Maine’s state epidemiologist, told the AP that there’s no indication that MRSA is linked to lobsters but that multiple small hand traumas that occur in activities such as hauling lobster traps and cutting bait could allow the pathogen to gain a foothold on the island. Some fishermen and other island residents have been treated multiple times, but no deaths have been reported, according to the AP. Sears said it’s difficult to determine how MRSA came to the island community of Vinalhaven. He told the AP that the pathogen isn’t transmitted by seafood and that it doesn’t usually survive in sea water or on beaches at levels high enough to cause human infections.Oct 6 AP story