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Division of Vector-Borne Diseases (DVBD)
DVBD Spotlights
Most Recent Spotlight
2021 Spotlights
Partnerships for tribal RMSF prevention
Figure 1. Image from RMSF curriculum for kids in Arizona tribal communities
Rocky Mountain spotted fever (RMSF) is a deadly tickborne disease. While RMSF cases occur throughout the Western Hemisphere, certain tribal communities in Arizona have been heavily impacted by RMSF with incidence rates of spotted fever rickettsiosis (including RMSF) 150 times the national average. In Arizona and parts of Mexico, the RMSF bacteria is spread by brown dog ticks which live in and around people's homes. Free-roaming dogs carry brown dog ticks from house to house, making them the key driver of RMSF infections on tribal lands.
Despite the availability of proven prevention practices, RMSF continues to threaten Arizona tribal communities. RMSF is deeply intertwined with social determinants of health. Many impacted communities are in rural locations with limited resources for animal wellness and vector control services; therefore, preventing RMSF requires investments in local training and infrastructure. Beginning in 2018, CDC increased its efforts to build tribal capacity for RMSF prevention through funding, dedicated staff, training, technical assistance, and expanded partnerships. This program is designed to ensure that impacted tribes have the tools and resources to build strong, sustainable RMSF prevention programs using evidence-based principles.
Figure 2 CDC staff supporting RMSF prevention campaigns
CDC's funding opportunities provide support to help tribes build local resources, however long-term RMSF prevention requires public and private partnerships. In 2020, CDC built new partnerships with the CDC Foundation and PetSmart Charities to provide health communication support to tribal communities. Dedicated communication resources ensure the building of culturally- and locally-relevant messages. One of the key products developed in 2021 was a school curriculum for elementary aged students. This fun and engaging curriculum provides information on tick biology, RMSF signs and symptoms, and RMSF prevention. The dynamic, interactive curriculum may be used for in-person or online learning. The curriculum has already been shared with the Arizona RMSF tribal partners, and CDC plans to support the implementation of this learning tool in at least two tribal communities in the next year.
In 2021, these partnerships were further expanded to provided vital animal wellness resources to tribes impacted by RMSF.
"Many of the tribes that we work with have limited access to animal wellness services as it is, but during the COVID-19 pandemic these services became even more scarce," says Naomi Drexler, lead of CDC's RMSF prevention efforts. "With the help of CDC Foundation and PetSmart Charities, three tribal communities received support for animal wellness including spay and neuter services, vaccinations, tick preventives, and animal care products. Partnerships like these will help bridge resource disparities and support sustainable RMSF prevention."
Students in Ponce, Puerto Rico Celebrate World Mosquito Day
To address mosquito-borne diseases spread by Aedes aegypti mosquitoes in Puerto Rico, CDC established the Communities Organized to Prevent Arboviruses (COPA) project. COPA was established through a cooperative agreement between the Ponce Health Sciences University (PHSU) and CDC's Dengue Branch in collaboration with the Puerto Rico Vector Control Unit. COPA staff are conducting a multi-year study to understand how many people are newly infected with mosquito-borne diseases and to determine how well disease prevention activities are working in Ponce, Puerto Rico.
This year on World Mosquito Day, August 20, COPA staff visited the San Judas Tadeo school to educate more than 700 students about mosquitoes that spread dengue. The students began the day watching an educational video playing on classroom smartboards.
"The students were closely paying attention. They kept repeating, 'The girl mosquito is the one that bites us!'" shared Ana Echevarria, COPA research assistant.
The school is in one of the 38 participating COPA communities, serving students from all regions of Ponce. The COPA team knew this was the right place to celebrate this important day.
"We will be visiting this community in September for their annual COPA follow-up. We thought visiting the school would be a great way of engaging the community beforehand," said Mariely Linares, COPA project field coordinator.
Educational Activities for All Ages
COPA staff explain the mosquito life cycle to students.
"Educating the younger generation about mosquitoes and mosquito-borne diseases has been an objective of the COPA project since day one," said Nicole Medina-Lopes from CDC's Dengue Branch. "This was an excellent opportunity for us. We hope the students will be agents of change, sharing this newly acquired knowledge with their family, friends, and community. We know they will remember and share what they learned today. We could see the excitement in their eyes."
Students in preschool and first grade participated in story time and learned about mosquitoes, the mosquito life cycle, and how mosquito bites can spread viruses. Older children used microscopes to learn about the mosquito life cycle. Children reviewed what they learned through games and puzzles and competitions to eliminate fake mosquitoes. High schoolers painted banners identifying containers with water where female mosquitoes can lay eggs, watched educational videos, and participated in a trivia competition.
Teaching in the context of COVID-19
Students from the PHSU Epidemiology Program explained the differences and similarities between illness with COVID-19 and dengue.
"After being locked up for the COVID-19 pandemic, watching children participate with joy and enthusiasm was contagious and refreshing. I like connecting with people and watching their faces as they learn something new about Ae. aegypti mosquitoes. This event was a great opportunity to share our mosquito prevention messages with well planned activities in a fun way," commented Carmen Perez- Guerra from CDC's Dengue Branch.
"On World Mosquito Day and every day, we would like to motivate this community to continue participating in COPA and to keep educating themselves about how to prevent mosquito-borne diseases," said Nelvin Borrero, COPA research assistant. "We hope that other schools will host a similar education day."
DVBD Innovations: A Mobile Application for Field Work Data Collection Needs
A COPA staff member uses HTrack on a mobile device to record data during a home visit in Ponce, Puerto Rico.
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Mobile technology allows community health workers to easily capture and store data as they go from house to house for community-based research studies. However, no single mobile data application provides everything needed to conduct a home visit. Community health workers end up using multiple mobile devices and applications, paper maps, and personal knowledge of a community. This disjointed approach presents data collection challenges and logistical difficulties, particularly for large studies. Further, many mobile applications do not comply with strict agency and U.S. government data security requirements.
Data collected during home visits are crucial to the success of the DVBD-led Communities to Prevent Arboviruses (COPA) project in Ponce, Puerto Rico. COPA project staff visit 3,800 participants annually to determine how many got infected with a virus spread by mosquitoes and to assess disease outcomes. For this big task, Dania Rodriguez from DVBD's Dengue Branch Data Team created HTrack (Household Tracking), a mobile application that provides COPA staff with integrated components needed for a successful home visit.
HTrack offers offline navigation using pre-loaded maps, pre-populated data collection forms to eliminate data reentry after each visit, and additional data visualization components. HTrack also allows COPA staff to track their progress and pending home visits in real time. These features save COPA staff time and resources during home visits. Additionally, data are stored locally in the mobile device in compliance with data security requirements. Finally, HTrack can securely link to other popular data collection platforms used by community health workers. Therefore, other public health studies requiring home visits and navigation, particularly in remote settings, may benefit from using HTrack for data collection and logistics management.
Q fever on U.S. Goat Farms
Goat ownership is increasing in the United States, however 76% of goat producers are not familiar with a germ goats can carry that can make goats and people sick1. Goats are one of the main sources of Coxiella burnetii, the cause of Q fever. In goats, Q fever can cause loss of pregnancy and affect the overall health of the herd. People can get infected by breathing in dust that has been contaminated by infected goat feces, urine, milk, and birth products. Therefore, certain professions, such as goat producers, are at increased risk for exposure to C. burnetii. Signs and symptoms of Q fever in people include fever, chills, fatigue, and muscle pain. Not everyone who is infected may get sick.
The National Animal Health Monitoring System (NAHMS) Goat Study looked at the presence of C. burnetii among goats in the United States in 2019. About 779 goat producers from 25 states were eligible to participate.
DVBD's Rickettsial Zoonoses Branch (RZB) Q fever team has been supporting the NAHMS study by providing laboratory testing for animal samples collected in 2019 and early 2020. More than 2,000 serum samples have been tested for antibodies against C. burnetii. More than 4,200 swabs collected from goats have been tested for the presence of C. burnetii. A positive swab indicates that a goat is spreading bacteria into the environment. These results are currently being analyzed to better describe C. burnetii positive herds in the United States.
The results of this NAHMS study supports goat producers in understanding the impact of Q fever on herd health. "This work is [also] important for public health because most cases and outbreaks of Q fever in the United States are associated with goats," explains RZB scientist Halie Miller. Continued surveillance of Q fever in both goats and people may allow public health and agricultural officials to promote Q fever prevention and control efforts more precisely. To learn more about preventing Q fever in people, see RZB's Q fever fact sheets, available in 6 languages. For more details about the NAHMS Goat Study visit the USDA APHIS websiteexternal icon.
1U.S. Department of Agriculture, Animal and Plant Health Inspection Service. Disease and Mortality on US Goat Operationspdf iconexternal icon [online]. 2012. [cited 2021 March 1].
Finding new data sources to estimate burden of Lyme disease
One of the most commonly asked questions about Lyme disease is, "How many people are diagnosed and treated each year?" In the February issue of Emerging Infectious Diseases, researchers from DVBD's Bacterial Diseases Branch (BDB) explore the potential for commercial insurance claims to provide reliable data on Lyme disease diagnoses (Schwartz et al.), and then use those data to estimate the number of people who are diagnosed with Lyme disease annually in the United States (Kugeler et al.). Although 30,000–40,000 cases of Lyme disease are reported through surveillance each year, substantial underreporting occurs, as is typical for passively reported surveillance data. Because Lyme disease is so common and not all cases are captured by traditional surveillance, BDB researchers look for alternate ways to get this information.
Using data from anonymous insurance claims is one of these ways. A previous analysis of insurance claims data for 2005-2010 that estimated Lyme disease was diagnosed in about 329,000 people annually in the United States. With this new effort, CDC researchers use similar though updated methods to estimate that an average of 476,000 people were diagnosed with and treated for Lyme disease annually in the United States during 2010-2018.
Although direct comparison with the prior estimate is limited by differences in methodology, this new estimate underscores that Lyme disease is an important public health issue and suggests that the number of Americans diagnosed with Lyme disease is increasing. The authors also note that diagnoses may not all be true infections, and that the estimate likely includes some degree of overdiagnosis.
The high frequency of people being diagnosed with Lyme disease underscores the need for effective and widely acceptable tick bite prevention techniques, as well as increasing awareness about tick bite prevention.
Yellow Fever Vaccination Campaigns Continue Safely During COVID-19 Pandemic
DVBD's Arboviral Diseases Branch (ADB) works globally to combat the threat of mosquito-borne diseases, including yellow fever which kills an estimated 30,000 people annually. As a World Health Organization (WHO) Collaborating Centre for Arboviral Reference and Research, ADB contributes to the WHO's Eliminate Yellow Fever Epidemics strategy (EYE). This strategy aims to end yellow fever outbreaks by 2026 through improved laboratory and epidemiologic surveillance as well as routine vaccinations. ADB staff provide technical assistance, conduct training and research, and seek funding for yellow fever vaccination campaigns in endemic countries, as needed.
Partners at CDC Ghana receive needed supplies for the yellow fever vaccination campaign thanks to work by DVBD and funding from CDC Foundation.
Dr. Kwame Amponsah-Achiano (Ghana Health Service), Fred Osei-Sarpong (WHO Ghana Country Office), Joseph Asamoah Frimpong (CDC Ghana), Dr. Fadinding Manneh (WHO Ghana Country Office)
In 2020, the COVID-19 pandemic threatened yellow fever prevention campaigns in many at-risk countries. As the pandemic continued to spread among resource poor countries in Africa, preventing a secondary disease outbreak became increasingly important. However, safety precautions due to COVID-19 presented an additional hurdle for WHO and its partners.
For example, a campaign targeting 5.6 million people in Ghana was planned for November 2020, but an assessment before the campaign start date showed inadequate personal protective equipment (PPE) and infection prevention and control (IPC) supplies to prevent COVID-19. An upcoming election further complicated the situation. Ghana uses a semi-permanent stamp to indicate who has already voted, which is similar to the stamp typically used during yellow fever vaccination campaigns. To avoid confusion, officials decided to use "yellow cards" to note who was vaccinated; however, this required additional supplies the country did not have.
Fulfilling their role as a partner in EYE, ADB worked with Division and Center personnel to quickly secure over $7 million in internal funds and funds from CDC Foundation to purchase the needed PPE, IPC, and yellow cards. The vaccination campaign in Ghana was successfully carried out at the end of November 2020. The funding will also allow more yellow fever vaccination campaigns to move forward in Nigeria and the Democratic Republic of the Congo. The ability to carry out a vaccination campaign safely during the COVID-19 pandemic is critical. A yellow fever outbreak amidst a pandemic would devastate the already strained healthcare systems of these countries and lead to unnecessary lives lost.
Epidemic Forecasting Challenges Move Research Into Action
What if public health experts could accurately forecast the next epidemic much like a weather forecast? Epidemic forecasting aims to predict the trajectory, peak, and intensity of epidemics using statistical and mathematical models. Forecasting researchers develop and refine models using historical data to create a forecasting model. The more precise forecast models become, the more they can help public health officials determine when and where diseases spread.
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CDC's Division of Vector-Borne Diseases (DVBD) forecasting and modeling researchers Michael Johansson, Talia Quandelacy, Sarah Kada, and Velma Lopez, with the help of Sarabeth Mathis and Juan Sanchez Montalvo, are improving the science of forecasting and modeling to predict the spread of mosquito-borne diseases. In 2014, DVBD joined forces with CDC's Influenza Division to drive innovation in dengue and influenza forecasting, creating the CDC Epidemic Prediction Initiative. The initiative was founded to address barriers to the implementation of forecasts in public health such as variable data access, the absence of systems for real-time forecasting, and limited assessment and comparison of forecast methods.
In 2015, the Dengue Fever Forecasting Challenge received approximately 10,000 forecasts for dengue epidemics in Iquitos, Peru and San Juan, Puerto Rico. The 2019 and 2020 Aedes Forecasting Challenges aim to predict the presence of these mosquitoes and where their geographic range may be expanding. The 2020 West Nile virus (WNV) Forecasting Challenge aims to predict the total number of neuroinvasive WNV cases using county level data from across the United States.
These annual challenges open new research opportunities offering extensive long-term datasets from multiple jurisdictions, allowing forecasting researchers to improve their models and share methodologies. The challenges also asses level of forecast skill and utility of forecasting for public health by engaging public health stakeholders directly in the development of next generation tools that support their work.
Forecasting has the potential to help predict and prevent more illnesses, including mosquito-borne diseases. Promoting modeling and forecasting research collaboration and access to datasets can help to improve the precision of forecasting models. In turn, models can help direct interventions to save and better target limited public health prevention and control resources.
CDC's Yellow Fever Diagnostic Kit Could Lead to Faster Outbreak Response, Fewer Deaths
Yellow fever is one of the oldest-recognized mosquito-borne diseases in the world. Those who become infected are at risk for severe liver disease with bleeding and jaundice. Between 30 to 60% of those who develop this severe form of the disease will die. Despite having an effective vaccine since the 1930s, outbreaks continue to occur, particularly in Africa and South America.
Being able to quickly identify yellow fever infections is crucial to stopping an outbreak. However, recognizing cases of yellow fever can be difficult. Not everyone has symptoms. For those who do, symptoms are similar to other diseases that cause fever, aches, and pains.
Diagnosing yellow fever can be difficult. Traditional diagnostic testing is technically challenging, particularly in resource-limited settings. The traditional test requires skilled staff and takes days to perform. To address these technical challenges, Jane Basile and Christin Goodman led a team of DVBD researchers to create pre-measured, calibrated test components that allow the traditional serologic test (YF IgM ELISA) to be performed easily in resource-limited settings. This new diagnostic kit, the Yellow Fever M-antibody Capture-half Day (YF MAC-HD), cuts processing time from 3 days to just 4 hours. The most critical kit components are freeze dried to improve stability, and the user simply adds water. Each kit can test up to 24 samples and can be refrigerated for at least one year.
CDC validated the new YF MAC-HD test kits during the 2016 Angola outbreak. Professional laboratory staff found the test easy to use and provided results comparable to the serologic test. Recent trainings in both Africa and South America included attendees from 46 countries. Trainings are crucial for national laboratories across Africa and South America. As a result, laboratories are better prepared to assist with surveillance efforts across the continents.
Since most yellow fever outbreaks occur in resource-limited countries, where electricity, water, and even reliable shipping can be an issue, this new diagnostic kit is a valuable tool in combatting yellow fever outbreaks. Basile hopes when the next outbreak happens, laboratory staff will not only have easy-to-use tests but also the training to use them. CDC is working with an external manufacturer to create a consistent supply of the YF MAC-HD kits. Now the biggest hurdle researchers have is how to distribute large numbers of kits.
DVBD Uses Advanced Molecular Detection to Better Understand Tickborne Diseases
Advanced molecular detection (AMD) integrates the latest next-generation genomic sequencing technologies with bioinformatics and epidemiology expertise across CDC and the nation to help us find, track, and stop disease-causing pathogens faster than ever before. Scientists at DVBD are using AMD to uncover, detect more of, and advance knowledge of pathogens spread through tick bites and about the ticks that are responsible for spreading these pathogens.
DVBD scientists, Luke Kingry, Stephanie Oatman, Sarah Sheldon, and partners used an AMD method called 16S metagenomics to analyze over 13,000 samples from patients who were suspected of having a tickborne illness. Twelve tickborne species of bacteria that cause illness in people were detected, including two not previously known to cause illness in people. The AMD method increased the number of tickborne bacteria identified by 100 percent as compared to using typical diagnostic testing methods.
DVBD scientists, Maria Galletti, Joy Hecht, and Chris Paddock, are using another AMD method to reveal new information about ticks that could help us better understand tickborne pathogens and how ticks spread those pathogens. The AMD method is known as MALDI-TOF, matrix-assisted laser desorption/ionization time-of-flight. This method will complement currently used methods and expand understanding of tick life stages and how certain germs adapt to become more or less capable of infecting people. The data collected will be used to establish a database of genetic information about the pathogens spread by ticks; the first of its kind in the Western Hemisphere. Scientists worldwide can use the database to improve the accuracy and speed of tick identification and tickborne disease surveillance. The team says, "We are excited to see what new information MALDI will reveal about the identification of medically relevant ticks that could be associated to pathogen prevalence in geographical areas with important disease burden. The results might help us better understand tick-borne disease dynamics in those areas."
AMD activities at DVBD are improving tickborne disease detection, discovery, and surveillance, and are improving our understanding of how ticks spread germs. For more information about AMD activities across CDC, visit the CDC AMD website.
Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD)
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text:
1970 births, Consultants in emergency medicine, Male consultants,
People who left the ED in 2011
People with claustrophobia
Adam Trueman
You may wish to consult Adam (disambiguation) for other, similarly-named pages.
Jessica Harrison (m. 2010; div. 2010)
Harry (b. 2009)
Peter Trueman
Alex Trueman
St Peter's Medical School
"Meltdown"
"Thanks for Today"
Adam Trueman (born 14 August 1970) is a consultant in emergency medicine who worked in the emergency department of Holby City Hospital from 2007 to 2011.
1.2 Arrival at Holby City ED
1.3 Developing relationship with Jessica
1.4 Apartment block fire
1.5 Conflict with Nick Jordan
When Adam was a child, his parents were killed in a road accident. (CAS: "Bricks and Daughters")
Adam graduated from St Peter's Medical School. (CAS: "A House Divided") At some point, Adam had a relationship with a woman named Sarah. When she and her family emigrated to Melbourne, they eventually ended up losing contact. (CAS: "Silent All These Years") Some time before September 2007, Adam started writing a book about his experience working as a consultant in NHS emergency departments. (CAS: "Meltdown")
Arrival at Holby City ED
On 15 September 2007, while Adam was jogging to Holby City Hospital's emergency department for his first shift, he encountered a woman named Lauren preparing to jump off the Lee Lane multistorey and managed to talk her out of it. Later that day, Adam shared a passionate kiss with Tanya Healy, a journalist for News Today and a witness to Lauren's suicide attempt, (CAS: "Meltdown") and divulged information regarding the department's handling of the bombing the week before. The next day, Tanya published an article that was highly critical of the department's performance which resulted in a visit from St James' Hospital's director of nursing and a colleague being pressured in resigning. (CAS: "No End of Blame")
In October, an online blog named Toxic Shark which disparaged the ED's staff surfaced, and Adam's colleagues believed that he was responsible. (CAS: "As One Door Closes...") Adam was determined to exonerate himself and reviewed recent patient cases to find the culprit. The evidence pointed towards F2 Toby De Silva, (CAS: "A House Divided") but it was eventually revealed that receptionist Terence "TC" Cockleton was responsible. (CAS: "How Soon Is Now")
On New Year's Eve, while Adam and HCA Alice Chantrey were taking a woman in labour named Marta to obs and gynae, the lift they were in stopped moving. As a result of Adam's claustrophobia, he was unable to assist in delivering Marta's baby and managed to talk Alice through the procedure. (CAS: "For Auld Lang Syne")
Developing relationship with Jessica
Adam and Jessica spend the night together in the former's flat. (CAS: "Leave Me Alone")
In January 2008, Adam met Jessica Harrison at his friend Thomas' engagement party and had a one-night stand. (CAS: "Adrenaline Rush", "Leave Me Alone") The next day, Adam was surprised to discover that Jessica was working in the ED as an agency nurse. After clinical nurse manager Tess Bateman asked the nursing agency to schedule Jessica for additional shifts in the department, Adam and Jessica agreed to maintain a professional relationship and forget about their one-night stand. (CAS: "Take It Back")
Despite this, their working relationship remained frosty, and their one-night stand continued to hang over their heads. (CAS: "Before a Fall", "To Thine Own Self Be True") However, in the middle of a difficult shift in April, Adam and Jessica had a heart-to-heart, and Adam invited Jessica out for breakfast. When Adam voiced his concerns about remarks that orthopaedic surgeon Sean Anderson had made towards Jessica, the two almost kissed, but Jessica pushed him away; unbeknownst to Adam, Sean was Jessica's husband. Nevertheless, Jessica accepted Adam's invitation, but she quickly changed her mind (CAS: "Someone's Lucky Night") and decided not to get involved with Adam any further. In spite of Jessica's declaration, and with the help of Alice Chantrey, Adam treated Jessica to engine-cooked brunch, and the two kissed. However, upon spotting Sean nearby, Jessica pulled herself away. Feeling played with, Adam demanded to know if there was something between them, and a tearful Jessica insisted that there wasn't. (CAS: "Walk the Line")
Following the incident, tension continued to build between Adam and Jessica, culminating in a devastated Adam weeping in the on-call room. Adam was confused about their incompatibility; Jessica kissed him and told him that they could not be a couple. Later that day, Adam was crushed when Sean revealed that he and Jessica were married. (CAS: "Love Is...") Jessica suggested that they move on, but Adam was unsatisfied by her lack of an explanation for deceiving him. After sniping at each other throughout their shift, Adam recommended that they keep out of each other's way, but the two ended up in each other's arms, marking the beginning of their affair. (CAS: "When Love Came to Town")
In June, while sleeping with Adam, Jessica missed a call from her childminder explaining that they were not available to pick her son Lucas up from school; when Jessica finally arrived to pick Lucas up, he was not there. In resus, Adam identified a young boy who had been involved in a road accident as Lucas and called a panicking Jessica in. Adam managed to reduce Lucas' displaced fracture, but Lucas' condition continued to deteriorate. Believing that God was punishing her for her affair, Jessica was willing to give Adam up so Lucas could live. (CAS: "Paradise Lost") The next day, after Lucas regained consciousness, Jessica pushed Adam away and told him that they could not continue their relationship. (CAS: "The Things We Do For...") However, after Zoe Hanna admitted at the inquest into Kris Kemp's death that she had been having an affair with Sean, Jessica told Adam that she still loved him, but she needed some time to process the revelation. (CAS: "This Mess We're In - Part Two") Jessica ultimately decided to stay with Sean for her children's sake. (CAS: "Farmead Menace - Part Two")
Apartment block fire
"Down, down, down!" (CAS: "Farmead Menace - Part One")
On 13 September, Adam was called to treat an elderly woman in a flat after she fractured her femur. However, a fire in the flat beneath caused a collection of gas canisters to explode, trapping Adam, paramedics Jeff and Dixie, and a documentary filming crew. Adam managed to rescue the burning flat's occupant and led the party up the apartment block, but they were forced back into the flat by an explosion. There, Adam and Jeff carried the woman on a stretcher while negotiating a fiery hole in the floor. Once they reached the flat window, they were rescued by the fire service. (CAS: "Farmead Menace - Part One")
Conflict with Nick Jordan
Once Adam returned to the ED from the burning apartment block, he decided to apply for the role of clinical lead, (CAS: "Farmead Menace - Part One") and Henry Williams — the hospital's director of critical care — assured him that he would get the job if he applied; Adam ultimately decided not to. (CAS: "Farmead Menace - Part Two") The following week, Nick Jordan was appointed the ED's new clinical lead and was immediately unimpressed by Adam arguing with other members of staff. (CAS: "Interventions")
Adam is a fan of watching ballet. (CAS: "Silent All These Years")
Adam is not a fan of doughnuts. (CAS: "Someone's Lucky Night")
Tristan Gemmill portrayed Adam Trueman from his arrival in 2007 until 2011 on Casualty. In 2012, he appeared in a photograph.
Portrayed by Tristan Gemmill
Alex Trueman • Harry Trueman
"Meltdown" • "My Aim Is True" • "Finding the Words" • "Behind Closed Doors" • "For Auld Lang Syne" • "Adrenaline Rush" • "Take It Back" • "Before a Fall" • "Sex and Death" • "Thicker than Water" • "Bricks and Daughters" • "Someone's Lucky Night" • "Walk the Line" • "Love Is..." • "Farmead Menace - Part One"
Clinical Lead • Consultant • August 14
Retrieved from "https://holby.fandom.com/wiki/Adam_Trueman?oldid=109849"
Male consultants

redpajama_set_name: RedPajamaCommonCrawl


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The Amyloidosis Forum
Formed in 2019, The Amyloidosis Forum has been developed through a public-private partnership between the Amyloidosis Research Consortium (ARC) and the US Food and Drug Administration (FDA). The overarching goal of the Forum is to optimize innovation and accelerate the advancement of new therapeutics by addressing scientific gaps and needs through the conduct of mutually beneficial scientific activities in the pre-competitive domain.
PPPs and Precompetitive Research
A public–private partnership (PPP) is a cooperative arrangement between two or more public and private sectors, typically of a long-term nature. In 2019, a PPP was formed between the nonprofit Amyloidosis Research Consortium (ARC) and the US Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER). The goal of this PPP is to identify and bridge the scientific gaps that are acting as barriers to drug discovery and development for the treatment of AL amyloidosis. The PPP seeks to leverage expertise and resources of all stakeholders (academia, industry, patients, and regulatory agencies) for the conduct of mutually beneficial scientific activities in the precompetitive domain to support bringing new, safe and efficacious therapies to patients with AL and ATTR amyloidosis.
Rosalyn, Adigun, MD, Pharm D
Cardiologist, Division of Cardiology and Nephrology, US Food and Drug Administration
Sarah Cairns-Smith, PhD, MBA
Chairman, ARC; Senior Partner and Managing Director, Boston Consulting Group
Angela Dispenzieri, MD
Consultant, Division of Hematology; Serene M. and Frances C. Durling Professor of Medicine and of Laboratory Medicine and Pathology; Hematology Research Chair, Mayo Clinic College of Medicine
Preston Dunnmon, MD, MBA, FACP, FACC
Vice President, Janssen R&D Data Sciences, Cardiovascular/Metabolic & Pulmonary Hypertension, Former Medical Team Leader (acting) in the Division of Cardiology and Nephrology, CDER, US Food and Drug Administration
Kristen Hsu
Executive Director of Clinical Research, ARC
Mathew S. Maurer, MD
Cardiologist and Medical Director, The HCM Center at NewYork-Presbyterian Hospital/Columbia University Medical Center
Vaishali Sanchorawala, MD
Professor of Medicine. Director, Amyloidosis Center, Boston University School of Medicine and Boston Medical Center
James Signorovitch, PhD
Managing Principal, Health Economics and Outcomes Research, Epidemiology and Biostatistics, Analysis Group, Inc.
Isabelle Lousada
Founder and CEO, Amyloidosis Research Consortium
The Amyloidosis Research Consortium
The Amyloidosis Research Consortium (ARC) is a nonprofit organization dedicated to driving advances in the awareness, science, and treatment of amyloid diseases. ARC's mission is to improve and extend the lives of those with amyloidosis. ARC is committed to collaborative efforts that accelerate the pace of discovery, expand patient access to the most effective care, and improve short- and long-term outcomes. Working with partners in industry, government, and academia, ARC seeks to spark innovation and to bring promising treatments from labs to clinics. ARC's outreach and education inform and empower patients, families, caregivers, physicians, and researchers.
Visit the ARC Website
Thank You to Our Supporters
Sign Up For the ARC Newsletter
Copyright © 2023 AMYLOIDOSIS RESEARCH CONSORTIUM, INC.
320 NEVADA STREET, SUITE 210
NEWTON, MA 02460 USA
617-467-5170 | ARC@ARCI.ORG
ARC is a 501(c)(3) nonprofit organization


Gorgeous transparent fuchsia chunky carved Czech pressed glass square beads with fancy gold finish around the edges. Antique looking style. Beads are 14mm square. 6 beads to a strand! Radiant orchid palette! These would make beautiful earrings!!
Love these beads. So pretty!


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text:
Michael Brown: Civil Rights and Racial Justice for All
Michael Brown's picture in his graduation cap and gown, holding his Normandy High School diploma, from this online article.
Darren Wilson, has been named as the police officer who shot Michael Brown, an unarmed teenager, on August 9, 2014. This shooting occurred 2 years, 5 months, and 14 days after an unarmed, teenaged Trayvon Martin was shot and killed by George Zimmerman, a neighborhood watch coordinator. Unfortunately, this scenario has become commonplace; an African American being subjected to police brutality, excessive force, and even death.
Perhaps this is why 42 U.S.C. § 1983, referred to as "Section 1983," which is part of the Civil Rights Act of 1871, is still in use today. Section 1983 allows governmental actors, including police officers, to be liable for damages, declaratory, or injunctive relief for violating a citizen's rights, such as the Freedom from Excessive Force under the Eighth and Fourteenth Amendments. Sadly, this legislation, also known as the "Ku Klux Klan Act," which was used to prevent racial hate crimes in the 1800s, is still needed today to deter racial injustices, often at the hands of the police, who are supposed to protect us.
Functionally, Section 1983 serves as a method to deter governmental officers from violating citizens' rights. This often comes in the form of making governmental officers pay money for inflicting personal injuries, including wrongful deaths, on citizens, when it was not warranted. Is any amount of money going to lessen the loss of the Brown family? Understandably not. And what good is deterrence after the fact? Unfortunately, this is just how our judicial system works in our society that values money.
Below are excerpts from articles involving Michael Brown:
"The ghost of Dred Scott haunts the streets of Ferguson," was written by Amy Goodman with Denis Moynihan (ellipses omitted and bracketed information added):
Thousands have been protesting the police killing of Michael Brown, an unarmed African-American teenager in the St. Louis suburb of Ferguson. He was due to start college just days after he was shot dead in broad daylight. Police left his bleeding corpse in the middle of the street for over four hours, behind police tape, as neighbors gathered and looked on in horror. Outraged citizens protested, and police brutally cracked down on them. Clad in paramilitary gear and using armored vehicles, they shot tear gas, rubber-coated steel bullets and flash-bang grenades, aiming automatic weapons at protesters. Scores of peaceful protesters as well as journalists have been arrested.
Portrait of Dred Scott from this Wiki article.
The protests have raged along Ferguson's West Florissant Avenue. Four miles south of the protest's ground zero, along the same street, in the quietude of Calvary Cemetery, lies Dred Scott, the man born a slave who famously fought for his freedom in the courts. The Dred Scott decision of 1857 [Scott v. Sandford, 60 U.S. 19 How. 393 393 (1856)] ruled that African-Americans, whether slave or free, could not be citizens, ever.
Scott was born into slavery in Virginia around 1799. Scott's owner moved from Virginia, taking him to Missouri, a slave state. He was sold to John Emerson, a surgeon in the U.S. Army [and was subsequently taken to free states and territories]. In 1847, Scott sued Emerson for his freedom in a St. Louis court. In the U.S. Supreme Court's majority opinion, Chief Justice Roger Taney, a supporter of slavery, wrote, "A free negro of the African race, whose ancestors were brought to this country and sold as slaves, is not a 'citizen' within the meaning of the Constitution of the United States." Thus, the court ruled that all African-Americans, whether slave or free, were not citizens, and never would be.
The people of Ferguson demand justice for Michael Brown, including the arrest of Ferguson Police Officer Darren Wilson, who killed Brown. A number of groups are calling for a special prosecutor to take over the case, the removal of the National Guard and a Justice Department investigation into every shooting of an unarmed person of color.
On Monday, August 18, 2014, Democracy Now reported that 1,300 people packed the Greater Grace Church for a rally attended by Michael Brown's parents. Brown's cousin Ty Pruitt addressed the crowd: "So, before I say anything, [raises hands in air]. I just wanted to kick it off like that, because what I want you all to remember is that Michael Brown was not just some young black boy. He was a human being. He was a younger cousin. He was a son. He was an uncle, a nephew. He was not a suspect. He was not an object. He was not an animal. But that's how he was killed."
While the verdict is still a whiles away for Darren Wilson after a jury hears all of the evidence presented for the case, I fear that justice will get lost in our deeply rooted history of racial inequalities, that Michael Brown will not be portrayed as a human being, and that this will lead to race riots (like the 1992 Los Angeles Riots after the acquittal of the police officers, who beat Rodney King). I wish there were solutions to end racial injustices and oppressive policing. I wish that we didn't need Section 1983 to remedy the wrongs that our government commits on our citizens. I wish our society would finally treat all of its citizens as citizens. For now, let's keep our eyes on the prize and keep on marching towards our Civil Rights and racial justice for all.
Posted in Civil Rights, Racial Justice, Section 1983	/ Tagged Civil Rights, Dred Scott, Michael Brown, Michael Brown's cousin Ty Pruitt, Racial Justice, Section 1983, Ty Pruitt	/ 1 Comment
Remembering Robin and Rethinking Mental Illnesses
When my sister told me that she saw on Facebook that Robin Williams died this past Monday, I thought it was a hoax. Robin Williams? Severe depression?? Addict??? Suicide by hanging????? No way, not the dramatic comedian we grew up watching. Not the man behind the English teacher inspiring students to love poetry and seize the day in Dead Poets Society (1989); not the DJ finding humanity during a war in Good Morning Vietnam (1987); not the medical student/doctor who saw the person and not the condition in Patch Adams (1998); not Mrs. Doubtfire (1993)!
Red Eye article on Robin Williams.
Walking (or in my case, rolling) to work Tuesday confirmed Robin's death, as we passed by newspaper racks with his face on the covers. I learned more of the circumstances from Facebook, the news, and my sister. Apparently, he was public about his addiction and sought treatment. I began reflecting… Was there anything I could have done to prevent his suicide? I realize that this is illogical since I never knew him personally, but that is how my mind works.
1999 picture of Robin Williams from this online article.
I had a similar reaction, except more intensified, when I learned that my able-bodied friend from middle school attempted suicide. She loved Elvis and would tell me the gossip on the popular girl, who lived next door to her. She wanted to live in Southern Illinois on a farm, because that's where her dad lived. I offered to join her. She attempted suicide during our freshman year; we went to different high schools and we lost touch. I beat myself over this. I knew that she was having a tough time after losing her dad. If only I stayed in touch with her, maybe she wouldn't have tried to kill herself. Was her transition to high school as lonely as mine? Perhaps hers was lonelier.
What can we do as a society to equip people experiencing depression and suicidal feelings to survive? I do not claim to be a medical or psychological expert. However, in my non-expert opinion, there must be other options besides institutionalization, short-term rehabilitation programs, peer counseling programs like Alcoholics Anonymous, gun control, and our current options that don't seem to be working well. Perhaps we can start by improving access to mental health care and eliminating stigma attached to mental illness.
There also seems to be an unspoken tension between the disability rights community, embracing our disabilities, and mental health, including the consequences of mental illness. While the term "mentally ill" clearly is inappropriate, "mental illness" seems like commonly use terminology, which I use here for lack of better language. Additionally, it seems like mental health advocacy has been more of an afterthought in the disability rights community. Logistically, it may have made sense to focus on physical access and integration since many of the first disability rights activists were people with physical disabilities and their families. But that shouldn't be the case today. If the disability community did more to include people experiencing mental illnesses, who may already feel isolated, this may foster a sense of belonging for the individuals experiencing mental illness and bring diverse perspectives for the disability community.
In case someone reading this is contemplating suicide or knows someone who is, please call the National Suicide Prevention Lifeline at 800-273-8255 or via TTY at 800-799-4889. If you're not in a crisis but just need to talk to someone, call the Illinois Warm Line at 866-359-7983 or find your state's Warm Line at warmline.org and follow the prompts to speak with a recovery support specialist with mental health recovery experience.
It is problematic that we have so much sympathy and sadness for Robin Williams (although his national/global iconic status and contributions to the entertainment industry are major factors) and people like him, but we get angry and vengeful, towards people with untreated mental illnesses or other disabilities that may have been a factor in their violent actions, like mass shootings.
Adam and his father, Peter Lanza, on a hike when Adam was about ten from The New Yorker article from Peter's perspective.
Adam Lanza was a young man on the autism spectrum, who refused getting therapy and stopped taking his Lexapro medication, commonly used to treat depression and generalized anxiety disorder. You may know him as the 2012 Sandy Hook Elementary School shooter, responsible for 28 deaths, including his own. I am not justifying Adam's actions, or the actions of other shooters, but the disability or disabilities involved should be considerations (this is why we have the insanity defense in criminal cases, despite its criticisms). I am not saying that all people with autism or mental illness have a tendency to commit harm to others or themselves, which I have heard said in light of the Sandy Hook shootings. As the public reacted to Newtown, Connecticut, demanding mental health reform and gun control, I grew concerned at the repercussions for people with mental illness. Would we become a Minority Report (1996) kind of society, imprisoning people with mental illness for crimes we think that they will commit in the future? Fortunately, we have not.
Adam's story is becoming all too familiar, with other incidents of people who are untreated for mental illnesses committing mass shootings, like Aaron Alexis in the 2013 Washington Navy Yard shooting, who heard voices but never received mental health treatment besides for insomnia. As my neuroscientist friend explained, "Our mental health as a society is really struggling. Whether it is environmental or genetic I am not really sure, but we need to find a way for our brains to be healthier."
It's outrageous to lump people who commit suicide, who just injure themselves and presumably scar their loved ones, with people who commit mass shootings, you say? Well, the society that failed to provide the services and supports for the people committing suicide also failed to provide the services and supports for the people committing mass shootings. I think that until we, as a society, develop better strategies, services, supports, and a better understanding and acceptance of mental health, we are just as responsible for the killings as the person who pulled the trigger or ties a belt around his neck. Improving our mental health care system and our culture involving mental illnesses will improve our society for everyone, including people experiencing mental illnesses and those living in communities with them. Hopefully, then we will be able to provide better community to people who have been isolated, who will in turn, be able to provide better community to others.
Alice Park, Don't Blame Adam Lanza's Violence on Asperger's, Time, Mar. 11, 2014 available at http://time.com/19957/adam-lanzas-violence-wasnt-typical-of-aspergers/.
Andrew Solomon, The Reckoning: The father of the Sandy Hook killer searches for answers, The New Yorker, Mar. 17, 2014 available at http://www.newyorker.com/magazine/2014/03/17/the-reckoning.
Maggot Fox, VA: Aaron Alexis never sought mental health treatment, NBC News, Sept. 19, 2013 available at http://www.nbcnews.com/health/mental-health/va-aaron-alexis-never-sought-mental-health-treatment-f4B11199522.
Posted in disAbilities, Mental Health	/ Tagged Adam Lanza's untreated mental illness, call to improve our society and our mental health, improving our mental health, mental health, Mental Illnesses, Robin Williams, Robin Williams suicide, suicide, suicide prevention	/ 2 Comments
Shout Out to GimpyLaw Readers: You Guys Blow My Mind!
Posted on August 8, 2014 by gimpylaw
I am amazed that the mad rantings of this Gimpy Law attorney actually has readers, let alone that it has so many readers around the world. Here's a summary of the Top Views by Country in the history of GimpyLaw, as of today:
253 United States views. 6 Canada views. 4 South Korea views. 2 Malaysia views. 1 Morocco view. 1 Philippines view.
In one of my college Rhetoric classes, Expository Writing, we read an essay about how a writer wanted to hand deliver individualized messages to each of her readers, old school Pony Express style. I wish I could get to know each of GimpyLaw's readers, their unique stories, what draws them to this GimpyLaw blog, and our communities, whether they be disabilities or ties to advancing justice.
But perhaps I should introduce myself first. I'm a 30ish Korean American women with a disability. I'm originally from the Northwest suburbs of Chicago, but lived in California for 9 years, where I went to law school at UC Davis. I recently moved back to Illinois to participate in a program that will help me start my own law practice. I'm also starting a non-profit housing cooperative, called Able Community.
That's enough of a dating service description about me; I do not like long walks on the beach, by the way. I'd like to hear about you, my readers. Feel free to drop me a line in the comment section below!
Posted in GimpyLaw readers, shout outs	/ Tagged GimpyLaw, GimpyLaw readers, shout out	/ 2 Comments


text:
Q: Validar campo com valor inteiro, em formato decimal (verificar se valor é menor que) Olá, minha questão é sobre uma validação de campo para valor decímal.  Se o valor for menor que 500,00 mostro uma mensagem de erro, senão passo para o segundo campo, assim que a pessoa digita o valor já vai adicionando a máscara.
Estou usando desta maneira:
function valid_simulation(form1) {

if(parseInt($("#selector").val()) < 500) {
alert("valor não é valido");
    return false;
}

}

Dessa forma consigo validar um valor inferior a 500,00, mas se for superior a 1.000,00 ele mostra a mensagem de erro.

A: O erro está acontecendo pois em linguagem javascript os decimais são separados por . e não por ,. Logo, se você "parsear" uma string que contém um ponto para int, o número se torna um inteiro diferente, pois neste caso ele ignora a vírgula:
parseInt("1.000,00"); //mostra 1
parseInt("10.000,00"); //mostra 10
parseInt("100.000,00"); //mostra 100

Você precisa retirar os pontos para realizar o parseInt de maneira correta.
parseInt("1.000,00".replace(".","")); // mostra 1000
parseInt("10.000,00".replace(".","")); // mostra 10000
parseInt("100.000,00".replace(".","")); // mostra 100000

No seu código:
function valid_simulation(form1) {

    if(parseInt($("#selector").val().toString().replace(".", "")) < 500) {
        alert("valor não é valido");
        return false;
    }

}

redpajama_set_name: RedPajamaStackExchange


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text:
Cassy promoted at Sky 3D
April 18, 2011 11.36 Europe/London By Julian Clover
John Cassy has been appointed to the newly created position of director, Sky 3D. He will be replaced as director, Sky Arts, by James Hunt, the channel's current head of programming.
Although it is inevitably the sports coverage that has received the headlines, Sky has been building a significant portfolio of 3D content in the arts. Upcoming highlights include the Isle of Wight Festival – the world's first ever live 3D music festival; a recording of Kylie Minogue's Aphrodite tour and the ballet Swan Lake. Cassy will look to further expand the 3D offering across film, live sports, factual, music, kids and event entertainment programming as well as working with Sky's channel partners as they further embrace the 3D format.
"Everyone at Sky is extremely excited about the long-term opportunities of 3D and we're intent on giving customers a whole new viewing experience," said Cassy. "I'm delighted to be at the forefront of such an innovative and creatively exciting opportunity for Sky. Sky Arts has some fantastic plans in the pipeline and it will be a wrench to leave seven thoroughly enjoyable years but I'll be cheering from the sidelines as it goes on to bigger and better things."
Cassy will report to Barney Francis, managing director of Sky Sports, who oversees 3D on Sky's executive board.
Filed Under: 3D, Newsline, People Tagged With: Sky 3D, Sky Arts Edited: 18 April 2011 13:12


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Over the weekend, I received an appeal from Mozilla Foundation to support them in their fight for an open web and against the constant attempt to end net neutrality. Their efficient online giving process: From Email to the Donation page to Thank you page to Social sharing was very streamlined and convenient for me as a donor. Not only are they fighting a cause we – all nonprofits and consumers- need to get behind, they also did it very well. Textbook.
Originally, I saw the appeal on my mobile phone, but I didn't know my PayPal password. I had to come back to the site from my desktop. I am one of the 55% of the US population who open their emails on the phone. The desktop version almost like the mobile version. It was all very neat and beautiful. I created a short video with the different parts of the process.
You see the very simplistic layout of the email with one call to action in various forms always with the color blue. The little box on top, which looks quite awkward on the desktop is the first content you see when looking at the email on your phone. Very brief the cause, and the call to action.
Text link: Will you chip in to help keep the Internet free and open for all of us?
Text link: Can you donate now?
The blue buttons are the only color in the otherwise black on white email. No other links distract me from its focus: Donate.
Close to the end: .. won't be possible without your donation today.
Each bold sentence is immediately followed by a blue donation button.
When I clicked I went to the donation page, which is also very nicely done. Big buttons nice defaults and again blue buttons for the important touch or click. The buttons are big enough for mobile screen touch interaction. I used the PayPal one-click payment after I logged in and then arrived at the Thank-you Page. The page itself is fairly distraction free. No website menu, no sidebar, not other links other than alternative payment methods and tiny links in the footer.
The Thank-you-Page has a different look at feel with a different color scheme. And it displayed the second Ask to sign-up for their newsletter so they can keep me in the loop.
They should have known, that I am already on the subscribers' list. A different second Ask, for example, "help us spreading the message via social media", would have made more sense to me.
Now take a look at the visuals of this Rich Snippet of the Donation Page, that make the sharer look good!
I just donated to @mozilla's campaign supporting their fight for the open web and for net neutrality. https://t.co/FE44tkKljz You can too!
Because of the very efficient, fast and simple way to donate, I was happy to give. I trust Mozilla will use my money wisely in our fight for the open internet.
What do you think? Did you see other great minimalistic donation processes? Share it with us in the comment section!


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PERFORMING ANIMALS PROTECTION ACT NO 24 OF 1935 An Act to regulate the exhibition and training of performing animals and the use of dogs for safeguarding.
"No person shall exhibit or train or cause or permit to be exhibited has the lawful custody or use any dog for safeguarding unless such person is the holder of a licence".
It is a legal requirement that an animal trainer, with a valid license covering the envisaged animal action as well as the appropriate quantity & species, must be present whenever animals work on films anywhere in South Africa.
There is no legal requirement to involve any animal welfare NGO (Animal Anti-Cruelty League, SPCA or NSPCA) in the making of a film or commercial. Nor is there any legal obligation on the part of the Production Company to get script approval, storyboard approval or notify any animal NGO of a planned shoot.
However, the presence of an animal welfare monitor does serve a very useful role and is recommended (and often insisted upon by international clients). Whilst not a legal requirement, it is a sensible voluntary, self -regulatory measure that protects animals and safeguards trainers and the Production from unfounded allegations of animal mistreatment.
Production Companies are expected to cover the travel and accommodation costs of such Inspectors and to make a donation based on the number of called days supervised.Information.