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This assistance may entail the coordination of supplies and services for response and recovery activities, the deployment of the Canadian Forces to aid civil authorities or the allocation of fnancial assistance to the provinces and territories (P/Ts). The Government of Canada also works with local or regional authorities and coordinates the national response when the impacts of an emergency are mainly in areas that are clearly under federal jurisdiction, or when an event is clearly of national interest and interjurisdictional and/or international in nature. At the federal level, the Emergency Preparedness Act establishes the inherent responsibility of each federal minister to develop and implement emergency preparedness measures. Each of the P/Ts has its own emergency preparedness legislation that deals comprehensively with emergency management issues within their boundaries. Events in recent years have challenged governments at all levels and the private sector, stretching their abilities to cope with emergencies. The Agency will provide a clear focal point for federal leadership and accountability in managing public health emergencies and improved collaboration within and among jurisdictions. The policy sets out processes for engaging these partners in the development of coordinated plans to support the overall framework. Emergencies that are large and/or complex or that transcend provincial or international boundaries, such as a pandemic infuenza, call for shared responsibilities. They also highlight the need for different or increased capacities and collaboration on all components of emergency management: mitigation, preparedness, response and recovery. An event, such as pandemic infuenza, will require a response that goes far beyond the health sector. The government of Canada has created a Deputy Ministers Committee on Pandemic Infuenza Planning to examine what is being done in terms of planning for a potential infuenza pandemic. The Committee provides direction to six working groups, ensuring that all key issues and gaps are identifed and addressed. The six working groups will look at International issues, Federal Business Continuity and Human Resources Public Health and Emergency management, Communications, Economic and Social Impacts, and the Private Sector. From a national perspective, ensuring that authorities at all levels have a complementary framework for dealing with emergencies is a key preparedness objective. For the federal health portfolio, the Minister of health is primarily accountable for developing and maintaining civil emergency plans for: fi public health protection, emergency health services and the well-being of Canadians; and fi coordination of the federal preparedness and response to nuclear emergencies not involving the hostile use of nuclear weapons in a declared war. The Centre for Emergency Preparedness and Response will support organizational units2 in the development of its plans to address emergencies that fall within its program areas. It also provides connecting arrangements to hazard-specifc plans and procedural guidelines for emergency staff. However, this does not circumvent organizational units from making their branch specifc all-hazards preparedness, planning and training, and response operations. This reserve of medical resources such as hospital equipment and pharmaceuticals could be critically important in a major response effort. The overall goals of infuenza pandemic preparedness and response are: First, to minimize serious illness and overall deaths, and second to minimize societal disruption among Canadians as a result of an infuenza pandemic. The strategies used to reach this goal will vary according to the phase of the pandemic, the availability of resources. Given the many possible combinations of these variables, this document endeavours to provide overall guidance. It is expected that the provided recommendations will be considered and modifed as necessary when responding to a specifc pandemic or pandemic threat. Therefore in developing this document, the Public Health Measures Working Group of the Pandemic Infuenza Committee (the Working Group) has relied mainly on expert consultation to form the recommendations. In the absence of scientifc effcacy data for many of the potential public health measures, the Working Group presents these recommendations to help facilitate a common approach to community disease control. This will reduce the need to explain and justify divergent approaches at the time of a pandemic and may also optimize public confdence at a time of much uncertainty. Many of the recommendations are contingent upon local triggers; therefore, the timing of their implementation will not necessarily be simultaneous across the country, but ideally the types of measures and public health messages will be consistent. In general, there is global agreement that, when cases infected with a novel virus frst appear, aggressive measures will be valuable in delaying the impact or possibly containing an evolving pandemic.

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Tumor flare none mild pain not interfering moderate pain; pain or severe pain; pain or Disabling with function analgesics interfering analgesics interfering with function, but not with function and interfering with interfering with activities of daily living activities of daily living Also consider Hypercalcemia. Note: Tumor flare is characterized by a constellation of symptoms and signs in direct relation to initiation of therapy. The symptoms/signs include tumor pain, inflammation of visible tumor, hypercalcemia, diffuse bone pain, and other electrolyte disturbances. Syndromes Other none mild moderate severe life-threatening or (Specify, ) disabling Cancer Therapy Evaluation Program 27 Revised March 23, 1998 Common Toxicity Criteria, Version 2. Adverse Event: Date of Treatment: Course Number: Date of onset: Grade at onset: Date of first change in grade: Grade: Date of next change in grade: Grade: Date of next change in grade: Grade: Date of next change in grade: Grade: Date of next change in grade: Grade: Date of next change in grade: Grade: Did adverse event resolvefi Yes No If so, date of resolution of adverse event: Date of last observation (if prior to recovery): Reason(s) observations stopped (if prior to recovery): Was patient retreatedfi Use the Common Toxicity Criteria definitions to grade the severity of the infection. Prophylactic antibiotic, antifungal, or antiviral therapy administration Yes No If prophylaxis was given prior to infection, please specify below: Antibiotic prophylaxis Antifungal prophylaxis Antiviral prophylaxis Other prophylaxis Cancer Therapy Evaluation Program 29 Revised March 23, 1998 Common Toxicity Criteria, Version 2. Up and about more than 50% of 50 Requires considerable 50 Gets dressed, but lies around much of waking hours. Capable of only limited 3 selfcare, confined to bed or chair more than 50% of 30 Severely disabled, 30 In bed; needs assistance even for quiet waking hours. Cancer Therapy Evaluation Program 30 Revised March 23, 1998 Common Toxicity Criteria, Version 2. They are listed here for the convenience of investigators writing transplant protocols. Any decision regarding claims eligibility or benefits, or acquisition or use of a health technology is solely within the discretion of your organization. Hayes employees and contractors do not have material, professional, familial, or financial affiliations that create actual or potential conflicts of interest related to the preparation of this report. Hyperbaric oxygen was introduced as a medical treatment more than 200 years ago and has been advocated as a treatment for a wide variety of conditions over the years. Foot wounds are one of the most common complications of diabetes and are responsible for substantial morbidity. At any given time, lower extremity ulcers affect approximately 1 million diabetics. It is purported to reverse anaerobic infection, improve blood supply, and reduce ischemic nerve damage. Chronic wounds other than those related to diabetes include venous and pressure sores, with causes that are related to venous insufficiency, pressure, trauma, vascular disease, and immobilization. Although the causes of chronic wounds vary, in all cases, at least one of the phases of wound healing is compromised. Surgical wounds present a medical problem if they are large in size, especially if bones and tendons are exposed and therefore are not amenable to primary closure. Thermal burns are the third largest cause of accidental death, with 300,000 serious burns and 6000 fatalities occurring annually in the United States. Chronic osteomyelitis can develop when bacterial or fungal infection within bone deprives the bone of its blood supply, and the resulting ischemia causes bone tissue necrosis. Cerebral palsy is a neuromuscular disorder that arises in children due to damage of the developing brain. More than 45 million individuals in the United States suffer from chronic, recurring headaches. Approximately 90% of headaches are primary headaches, which do not arise from an underlying medical condition.

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Acta Psychiatr Scand 138(4):289-299, 2018 29974451 Donnelly K, Bracchi R, Hewitt J, et al: Benzodiazepines, Z-drugs and the risk of hip fracture: a systematic review and meta-analysis. Psychiatry Res 215(3):528-532, 2014 24461684 38 Donohoe G, Dillon R, Hargreaves A, et al: Effectiveness of a low support, remotely accessible, cognitive remediation training programme for chronic psychosis: cognitive, functional and cortical outcomes from a single blind randomised controlled trial. Psychiatr Serv 69(3):254-256, 2018 29385957 Durbin J, Selick A, Langill G, et al: Using fidelity measurement to assess quality of early psychosis intervention services in Ontario. Psychiatr Serv 68(7):717-723, 2017 28366114 Ekstrom J, Godoy T, Riva A: Clozapine: agonistic and antagonistic salivary secretory actions. 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There are several types of infiuenza, and of these, humans are a natural reservoir for types A and B. These two types share many common properties, but all known pandemics to date, and the worst seasonal epidemics, are caused by type A, and so for the remainder of this thesis I focus primarily on this type. Both of these proteins are present on the surface of the virion, and together they provide a molecular signature that is recognizable by the human immune system. In humans, infiuenza infects epithelial cells of the upper and lower respiratory system, most fi often causing symptoms of fever and cough. To understand why this is of concern, it is necessary to understand a little bit about the biologi- cal process of genomic replication. At the most basic level, the same molecular machinery is required to replicate either form of nucleic acid. As with all biological processes, mistakes, how- ever rare, are possible and do occasionally occur. In this context, the process of continual mutation over time is known as antigenic drift, and it is the source from which new strains of infiuenza continually arise. More generally, the gradual accumulation of mutations throughout the entire genome (as opposed to just regions encoding epitopes) is termed genetic drift. This process is called reassortment, and it is the way in which pandemic strains arise. As a result, infiuenza can be extremely contagious and can rapidly spread through- out a population. With the relatively recent advent of human air travel, and given the increasingly interconnected global population, infiuenza has the potential now to spread throughout the world in record time. Historically, this data was collected and distributed by independently acting government and health departments. As a result of differences in reporting practices and case definitions, this data can be difficult to aggregate on a national level. As a result, these first seasons are especially noisy (particularly in the smaller regions), and data is missing for weeks outside of the official fiu season. The fiu season is officially defined as epiweeks 40 through 20, roughly spanning October to May of adjacent calendar years. This, too, is to be expected; providers are asked to report their case counts within a few days, but understandably, delays arise from time to time. In light of this, my thesis can be summarized thusly: With the computational tools and varied datasets currently available, we can better understand the role of human immunity in shaping viral evolution, estimate disease incidence in real-time, and predict the trajectory of disease outbreaks. While the methods developed in this thesis are inspired by, and specifically attempt to address, the challenges associated with infiuenza, they are readily generalizable to other viruses, diseases, and domains. As a demonstration of the 4 general applicability of these methods, I provide case studies for two other diseases: dengue and chikungunya. Infectious disease surveillance is not a new development, but it has often been sporadic, coarse-grained, and non-standardized.