A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in rural communities in North Carolina. Using a conceptual framework created by Handler, Issel, and Turnock, this study compared 3 modalities of instruction (MOI) to seek the best predictor of success in retaining learned bioterrorism skills. The research question focused on whether MOI for BTT/all-hazards training courses significantly predicted the degree of retention of emergency knowledge/skills for PHNs working in public health agencies in North Carolina. A multiple choice survey was used to test 103 PHNs' level of knowledge retention on a bioterrorism quiz. The results of this study were ultimately inconclusive in that no MOI was found to be a statistically significant predictor of retention. Factors such as age were found to be successful predictors of knowledge retention. The readiness issues identified in this study have a potential for positive social change if community decision makers use this information to prioritize future funding for public health professionals or enhance communitywide emergency preparedness education programs.

No description available.

Thesis (M.A.) -- University of Texas Southwestern Medical Center at Dallas, 2004. / Vita. Bibliography: 71-73.

Thesis (M.A. in International Security and Civil-Military Relations)--Naval Postgraduate School, March 2005. / Thesis Advisor(s): Donald Abenheim, Maria Rasmussen. Includes bibliographical references (p. 57-60). Also available online.

Les anticorps recombinants représentent une approche prometteuse pour améliorer le traitement et la prophylaxie des maladies causées par les armes biologiques. De tels anticorps peuvent être isolés à partir de primates non humains, dont l'immunisation est plus facile à concevoir et à réaliser que l'immunisation d'humains. Des chimpanzés (Pan troglodytes) et des macaques (Macaca mulatta et M. fascicularis) ont été utilisés pour de tels travaux, et notre analyse de séquences a démontré que l'utilisation de chimpanzés n'apporte pas d'avantage significatif malgré leur plus grande proximité phylogénétique avec l'Homme. La suite de ce travail a donc utilisé des macaques, plus facilement accessibles en France que les chimpanzés. Dans le cadre du projet européen AntiBotABE, des banques immunes exposées àla surface de phages ont été construites à partir de macaques (M. fascicularis) immunisés puis criblées, et des scFv neutralisant simultanément les toxines botuliques (BoNT) A1 et A2 en ciblant leurs chaines lourdes, et BoNT/E3 en ciblant sa chaine légère ont été isolés. D'autre part, un anticorps neutralisant de façon croisée la toxine létale et la toxine oedémateuse de Bacillus anthracis avait été précédemment isolé. Ses épitopes ont été localisés au cours de la présente thèse par une méthode tirant partie de cette réactivité croisée. Ils correspondent à la région [229-230]-[234-236] de la sous-unité LF (Lethal Factor) et à la région [229-230]-[234-236] de la sous-unité EF (Edema Factor). Le principe de cette localisation d'épitope pourrait être ré-employé pour localiser les épitopes des scFv neutralisant les BoNT. / Recombinant antibodies represent a promising approach to improve the treatment andprophylaxis of diseases caused by bioweapons. Such antibodies may be isolated from nonhumanprimates, whose immunization is much easier to conceive and realized thanimmunization of humans. Chimpanzees (Pan troglodytes) and macaques (Macaca mulattaand M. fascicularis, particularly) have been utilized for such purposes, and our sequenceanalysis has demonstrated that using chimpanzees does not bring a significant advantagedespite their closer phylogenetic proximity with humans. The rest of this thesis has thusutilized macaques, easier to access in France than chimpanzees. In the context of theEuropean AntiBotABE project, phage-displayed immune libraries have been constructed fromimmunized macaques (M. fascicularis) then screened, and scFv simultaneously neutralizingbotulinum toxins (BoNT) A1 and A2 by targeting their heavy chains, and BoNT/E3 bytargeting its light chain were isolated. On the other side, an antibody cross-neutralizing thelethal toxin and the edema toxin of Bacillus anthracis had been formerly isolated. Its epitopeshave been mapped in the course of the present thesis by a method taking advantage of itscross-reactivity. They correspond to the [229-230]-[234-236] region of LF (Lethal Factor)subunit and to the [229-230]-[234-236] region of EF (Edema Factor) subunit. The principle ofthis epitope mapping could be re-employed to map the epitopes of BoNT-neutralizing scFv.

Made available in DSpace on 2016-08-17T18:39:52Z (GMT). No. of bitstreams: 1 6567.pdf: 3917127 bytes, checksum: 48f84dc67217b287fab990b1a19e15fb (MD5) Previous issue date: 2014-10-01 / The proposed work for this research, entitled Biotechnology, bioethics, biolaw,biosecurity and biodefense in the DCBRNE context: actuality, challenges and perspectives is considered controversial, and in the language of national defense, it is a sensitive issue because it is related to the different interface controversial fields of legal, military, political and religious content within the scientific-technological context of biotechnology, biosafety, bioethics and biolaw. This dissertation is intended in particular to reflect the related issues and their applicability in the Brazilian legal system, as well as in the relationship between public agencies in their conduct, in order to elucidate the best possible way some of the many questions of Biotechnology trinomial bioethics-biolaw when applied to areas of biodefense and biosecurity in the context of defense CBRNE (Chemical, Biological, Radiological, Nuclear and Explosives). There is no doubt that in this universe of areas, biotechnology plays probably the main role. The present study is based on digital, booklets, handbooks, journals and medicalscientific publications and research knowledge gained in the course of the profession of Military State Police as a Lieutenant of that force, having several courses of area as well as in civil training of Bachelor of Law with as a member of the Order of Lawyers of Brazil. Among other conclusions, it appears the lack of disclosure over actions against CBRNE incidents, operations centers to assume coordination of events and training, and training materials for this type of threats especially those conducting the first calls (responsiveness), not to mention the health situation in the hospitals and medical care, which also unaware of how to individualize the onset of diseases, which are very similar. Throughout the realization of this project, it was possible to verify that all the material gathered here, analyzed and discussed there, as far as we know, does not exist neither in Portuguese nor English. Thus, we believe that it will become an important reference material and consultation mainly by the various agencies that deal with public safety and national defense, in particular, those related to CBRNE defense. / O tema proposto para este trabalho de mestrado, intitulado Biotecnologia, Bioética, Biodireito, Biossegurança e Biodefesa no contexto DQBRNE: atualidade, perspectivas e desafios é considerado polêmico e, na linguagem da defesa nacional, é um assunto sensível por estar relacionado à interface de diversos campos controversos de teor jurídico, militar, político e religioso dentro do contexto científico-tecnológico da biotecnologia, da biossegurança, da bioética e do biodireito. A presente dissertação destina-se em especial a uma reflexão dos temas correlatos e sua aplicabilidade no ordenamento jurídico brasileiro, bem como, na relação dos Órgãos Públicos em sua conduta, a fim de elucidar da melhor maneira possível alguns dos muitos questionamentos do trinômio biotecnologia-bioética-biodireito quando aplicado às áreas de biossegurança e biodefesa no contexto de defesa QBRNE (Quimica, Biológica, Radiológica, Nuclear e Explosivos). Não há dúvidas que nesse universo de áreas, a biotecnologia joga, provavelmente, o papel principal. O presente estudo baseia-se em pesquisas digitais, apostilas, manuais, periódicos e publicações medicas-científicas e no conhecimento adquirido no transcorrer da profissão de Servidor Público Militar do Estado, na formação profissional na graduação de Subtenente da Policia Militar, possuindo diversos cursos da área, bem como, na formação civil de Bacharel em Direito e com aprovação no exame da Ordem dos Advogados do Brasil. Dentre outras conclusões, constata-se a falta mais divulgação de ações contra incidentes QBRNE, centros de operações que assumam coordenação de eventos e treinamento, capacitação e materiais para este tipo de ameaças em especial as pessoas que realizam os primeiros atendimentos (capacidade de resposta), isto sem falar da situação de saúde nos hospitais e atendimento médico, que também desconhecem como individualizar o inicio de doenças, que em muito são semelhantes. Ao longo da realização deste projeto, foi possível verificar que o conjunto do material aqui reunido, analisado e discutido não existe, até onde nós sabemos, nem em português nem em inglês. Dessa maneira, consideramos que ele se tornará importante material de referência e consulta principalmente pelas diversas agências que lidam com segurança pública e defesa nacional, em particular, aquelas vinculadas à defesa QBRNE.

Master of Science / Department of Clinical Sciences / Michael Sanderson / Biosecurity, biocontainment and security practices are important in production animal agriculture. Procuring cattle from multiple sources and commingling them into a single confinement operation increases risk of disease introduction. The large concentration of animals makes a feedyard a more likely target of a domestic or international terror group. Controlling or eradicating an intentionally introduced pathogen or toxin would be costly. The aim of these surveys was to gather information from experts about perceived risks and mitigation strategies and to assess current practices of biosecurity, biocontainment and security in Central Plains feedyards. Consulting veterinarians and feedyard managers shared similar views on the likelihood of disease caused by terrorism, natural introduction or accidental introduction, and on the importance of on-site security. They disagreed on the importance of preventative products, disease transmission control, and environmental control. Generally speaking, feedyard managers believed environmental control to be more important than consulting veterinarians. In reference to a survey of current practices, some feedyards use equipment for both manure and feed handling. Many feedyards are not cleaning and disinfecting oral treatment equipment, treatment facilities, or unloading facilities on a regular basis which may increases their risk for indirect disease transmission of endemic agents such as Salmonella or BVDV. Most feedyards in this survey import some cattle directly from an auction market, do not require clean boots or foot covering to be worn by visitors, and do not require trailers to be cleaned. Smaller feedyards were more likely to require trailers to be cleaned before loading incoming cattle. Less than half of the feedyards reported having a fence that will stop humans or kept protein supplements or micro-nutrients secured from access. Some feedyards enforced a visitor log or employed a night watchman. Most feedyards learned about a future employee by calling references listed in resume, but some performed a criminal background check. A cost-benefit analysis should be done on all management practices to determine economic benefits. More research is needed to better understand which practices are most beneficial.

The 2001 anthrax attacks heightened awareness of the possibility of weaponizing biological agents such as Ebola, anthrax, and smallpox and hence, the Bioterrorism Act of 2002 to prevent biological attacks and reduce bioterrorism threats and vulnerabilities. However, the 2014 Ebola epidemic raised concerns about unpreparedness for bioterrorism within the healthcare community and about secondary infections from healthcare workers. Using Kingdon's conceptualization of multiple streams as the foundation, the purpose of this case study was to explore the nature of bioterrorism threats and the level of preparedness of Emergency Medical Technicians (EMTs) who were involved in the 2014 Ebola epidemic in a New Jersey County for biological attacks and avoidance or reduction of secondary infections. Data were collected from 18 individuals through interviews and from emergency response documents. The data were inductively coded and subjected to thematic analysis. The emergent themes indicated that although there was an abundance of bioterrorism preparedness policies and programs dating back to the 2001 anthrax attacks, the response to the 2014 Ebola epidemic revealed inadequate bioterrorism preparedness practices. The study participants identified insufficient knowledge of bioagents and lack of regular training as factors that prevented enhanced preparedness practices. Participants suggested that improved training opportunities, interagency collaborations, and better funding would improve bioterrorism preparedness practices. The social change implications of this study include increased funding for bioterrorism preparedness to harden EMTs and the creation of public awareness of bioagents for improved 911 calls and emergency response practices.

In the event of a bioterrorist attack, emergency departments are considered the first line of response for all acute levels of care. This study focused on hospital emergency departments in Florida and the activities, policies, and procedures involved in preparing for a bioterrorist attack. Hospital size, location, and system affiliation were related to attaining these levels, and their impact was assessed. Through a cross-sectional survey design, the physical properties of the 77 hospitals (i.e. facilities, equipment, communication systems, etc.), and the social characteristics of the organizations (managerial functions including: planning, training, financial, and environmental characteristics) were examined. One-way analysis of variance and t-tests revealed that bed size was a significant predictor of mean levels of preparedness. In addition, although more hospitals are conducting training activities, a disconnect between plans and communications of said plans still exists along with many deficiencies still needing to be corrected. Study limitations are discussed and important policy implications are presented. Suggestions for improving preparedness levels and implementing new policies include: conducting training exercises, developing community ties and mutual aid agreements, and using information technology with detection of an event and communication of the information garnered from these efforts.

The terrorist attacks of September 11th, 2001 and the subsequent anthrax mail attack have forced health care administrators and policy makers to place a new emphasis on disaster planning at hospital facilities--specifically bioterrorism planning. Yet how does one truly "prepare" for the unpredictable? In spite of accreditation requirements, which demand hospitals put in to place preparations to deal with bioterrorism events, a recent study from the General Accounting Office (GAO) concluded that most hospitals are still not capable of dealing with such threats (Gonzalez, 2004). This dissertation uses computer simulation modeling to test the effectiveness of bioterrorism planning at a local hospital facility in Central Florida, Winter Park Memorial Hospital. It is limited to the response plan developed by the hospital's Emergency Department. It evaluates the plan's effectiveness in dealing with an inhalational anthrax attack. Using Arena computer simulation software, and grounded within the theoretical framework of Complexity Science, we were able to test the effectiveness of the response plan in relation to Emergency Department bed capacity. Our results indicated that the response plan's flexibility was able to accommodate an increased patient load due to an attack, including an influx of the "worried well." Topics of future work and study are proposed.