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News Article | May 14, 2017
Site: www.techradar.com

Update: Organizations and individuals across the UK, Europe and beyond are scrambling to restore their computer systems after a ransomware program called WannaCry caused an unprecedented level of disruption over the weekend. In the traditional ransomware style, WannaCry demands bitcoin payments before it will unlock files that have been encrypted on users' machines, as well as spreading itself automatically to other networked computers. It's believed that the malware exploits a security hole in unpatched, older versions of Windows, including Windows XP. On Sunday, Europol said 200,000 victims in 150 countries were believed to be hit so far, with another wave of attacks potentially on the way as people begin to switch their office computers back on on Monday morning - giving the ransomware new ways to spread. The National Cyber Security Centre in the UK is warning both businesses and individuals to be on their guard, especially those running older versions of Windows. The NCSC site also includes some smart advice for protecting your computers against ransomware of this kind. The NHS in the UK, Telefónica in Spain, Renault in France and dozens of other companies are believed to be affected, with reports that WannaCry has now spread to more than a hundred countries. Microsoft has taken the unusual step of pushing out a Windows XP security patch for the bug, some three years after official support for XP ended. As of Sunday afternoom, the scale of the damage was still being assessed, and it'll be some time yet before affected systems can be cleaned up and put back on their feet. It's safe to say if you're struggling to connect with any kind of computer system this weekend, anything from train times to doctor appointments, WannaCry could be to blame. The NHS in the UK was one of the first organizations to raise the alarm, and our original report continues below. The NHS has confirmed that a number of hospitals across England have been the victims of a large scale cyberattack, with NHS employees taking to social media claiming that PCs in their hospitals were displaying a message saying "your computers are now under their control and pay a certain amount of money. And now everything is gone.” Taking over a PC and threatening to delete its data unless money is paid is a classic move of ransomware viruses, and while they can cause anguish and disruption when infecting home and business machines, when it comes to hospitals lives could be at stake. Affected hospitals are postponing all non-urgent activity and are asking people not to come to A&E. Instead people should dial 111 for urgent medical advice, or 999 if it is a life-threatening emergency. A statement released by East and North Hertfordshire NHS trust, which covers some of the hospitals affected, says that “today (Friday, 12 May 2017), the trust has experienced a major IT problem, believed to be caused by a cyber attack. “Immediately on discovery of the problem, the trust acted to protect its IT systems by shutting them down; it also meant that the trust’s telephone system is not able to accept incoming calls.” According to the BBC, the attack has also spread across Europe, hitting mobile brand Telefonica too. It increasingly appears to be a sophisticated, coordinated attack. Unfortunately, it was only a matter of time before a cyberattack of this scale would hit hospitals, with a warning from Andrew Avanessian, vice president at Avecto, a global security software company, circulating a few days ago that said that “hospitals are often targets due to the value of the data they hold. Not only does patient data have a resale value, it’s sensitive enough that NHS Trusts are likely to pay a ransom to get it back if it becomes encrypted.” While we’d often advise people infected by ransomware to contact the police before paying any sort of ransom – mainly because there’s no guarantee that the malicious users behind the malware will release your data even if they get paid – the NHS doesn’t have that luxury considering lives could be at stake. Avanessian suggested that it could be outdated software that caused the problem here, saying “outdated systems can often be to blame, and it’s bad news for patients that 90% of Trusts are running old versions of Windows that are riddled with security holes.” He suggested NHS trusts update their software as soon as possible, but sadly it looks like it’s too late. "We commend NHS England on reacting so quickly, and for being open about this attack," said Chris Ross, Senior Vice President, International at storage giants Barracuda. "Healthcare records holding sensitive and personal data are 100 times more valuable than stolen credit card details, so it comes as no surprise to see that NHS England has been targeted in this way. "Having been attacked the focus now must be to recover with minimal disruption. We would hope that the hospitals that have been hit have already devised and implemented a comprehensive backup recovery plan that will allow them to recover all encrypted files with minimal effort.  "This just goes to prove that cybercriminals don’t care who they target with ransomware, as long as the victim is willing to pay. All sizes of organisations have been targeted, and the impact is far reaching. It’s not just your hard-earned money that is at risk, it’s also your reputation, viability, and jobs." We’ll update this story as more information comes in.


BRISTOL, 05-May-2017 — /EuropaWire/ — A new drug combination that could help thousands of children with arthritis and prevent them from serious complications, including blindness, has been discovered by researchers and thanks to a trial funded by Arthritis Research UK and the National Institute for Health Research (NIHR). Over 5,000 children and adolescents with juvenile idiopathic arthritis (JIA) in the UK are likely to develop uveitis, a condition that causes inflammation in the middle layer of the eye. The trial, the first of its kind in the world, and the findings are a major step forward for children with JIA. The drug therapy has already been approved for use and the study is published in The New England Journal of Medicine. The trial’s co-chief investigators, Professors A. V. Ramanan from the University of Bristol’s School of Clinical Sciences and Michael Beresford from the University of Liverpool and Alder Hey Children’s NHS Foundation Trust, and colleagues from across the UK, found that a drug called adalimumab, in combination with methotrexate, was an effective therapy in children and adolescents with JIA-associated uveitis. The majority (75 per cent) of those children treated with adalimumab experienced a significant reduction in eye inflammation. An early analysis of the data was so convincing that the trial was stopped early. In this randomised, placebo-controlled trial on review of 90 of the target 149 patients with JIA-associated uveitis, the data and safety monitoring committee noted that the adalimumab group had evidence of a significantly lower risk of treatment failure than the placebo group. This multi-centre trial involved extremely close collaboration between paediatric rheumatology and ophthalmology colleagues across the country and was sponsored by University Hospitals Bristol NHS Foundation Trust, and co-ordinated by the Clinical Trials Research Centre at the University of Liverpool. The trial outcomes directly led to the changes in commissioning guidelines and resulted in NHS England approving the use of adalimumab in children with uveitis that threatens their sight, and for whom other treatments have proven ineffective. Professor Ramanan from University Hospitals Bristol NHS Foundation Trust and University of Bristol said: “Uveitis in children is an important cause of loss of vision. This study demonstrates the benefit of adalimumab in children with uveitis. This is the first randomised trial of its kind worldwide and the results will have a major impact in children with uveitis all around the world.” Professor Beresford from University of Liverpool and Alder Hey Children’s NHS Foundation Trust said: “This landmark trial has demonstrated the commitment and leadership of colleagues across the UK in working closely with patients and parents in tackling a key priority of finding the very best way of caring for children with arthritis and this serious problem of uveitis. “It has shown the UK to be extremely well placed to deliver challenging trials in children, with the support of the NIHR Clinical Research Network and other research networks that are in place across the UK.” There are 15,000 children and adolescents in the UK with the auto-immune disease JIA. One third of those are likely to develop uveitis, leading to more serious visual impairments and may be registered as blind. Stephen Simpson, director of research and programmes at Arthritis Research UK, said: “We’re thrilled of the outcome of this trial and the huge promise it heralds for transforming the quality of life for the large numbers of children with JIA-associated uveitis. “This trial is an impressive example of how investing in exceptional science can ultimately help change how treatment is delivered with direct and immediate benefit for patients.” Further informatio Paper ‘Adalimumab plus Methotrexate for Uveitis in Juvenile Idiopathic Arthritis’ by Athimalaipet V. Ramanan et al in The New England Journal of Medicine.


News Article | April 27, 2017
Site: www.eurekalert.org

A clinical trial funded by Arthritis Research UK and the National Institute for Health Research (NIHR) led by professors from the Universities of Liverpool and Bristol has discovered a drug combination that could help thousands of children with arthritis. Over 5,000 children and adolescents with Juvenile Idiopathic Arthritis (JIA) in the UK are likely to develop uveitis, a condition that causes inflammation in the middle layer of the eye. The drug combination discovery will help preventing them from serious complications, including blindness. The trial was first of its kind in the world and the findings are a major step forward for children with JIA. The drug therapy has already been approved for use and the study is published today in The New England Journal of Medicine. The trial's Co-Chief Investigators, Professors Michael Beresford and A. V. Ramanan, and colleagues from across the UK, found that a drug called Adalimumab, in combination with Methotrexate, was an effective therapy in children and adolescents with JIA-associated uveitis. The majority (75 per cent) of those children treated with Adalimumab experienced a significant reduction in eye inflammation. An early analysis of the data was so convincing that the trial was stopped early. In this randomised, placebo controlled trial on review of 90 of the target 149 patients with JIA-associated uveitis, the data and safety monitoring committee noted that the Adalimumab group had evidence of a significantly lower risk of treatment failure than the placebo group. This multi-centre trial involved extremely close collaboration between paediatric rheumatology and ophthalmology colleagues across the country and was sponsored by University Hospitals Bristol NHS Foundation Trust, and co-ordinated by the Clinical Trials Research Centre at the University of Liverpool. The trial outcomes directly led to the changes in commissioning guidelines and resulted NHS England approving the use of Adalimumab in children with uveitis that threatens their sight, and for whom other treatments have proven ineffective. Professor Beresford from University of Liverpool's Institute of Translational Medicine and Alder Hey Children's NHS Foundation Trust said: "This landmark trial has demonstrated the commitment and leadership of colleagues across the UK in working closely with patients and parents in tackling a key priority of finding the very best way of caring for children with arthritis and this serious problem of uveitis. "It has shown the UK to be extremely well placed to deliver challenging trials in children, with the support of the NIHR Clinical Research Network and networks that are in place across the UK." Professor Ramanan from University Hospitals Bristol NHS Foundation Trust and University of Bristol said, "Uveitis in children is an important cause of loss of vision. This study demonstrates the benefit of Adalimumab in children with uveitis. This is the first randomised trial of its kind worldwide and the results will have a major impact in children with uveitis all around the world." There are 15,000 children and adolescents in the UK with the auto-immune disease JIA. One third of those are likely to develop uveitis, leading to more serious visual impairments and may be registered as blind. Stephen Simpson, director of research and programmes at Arthritis Research UK, said: "We are thrilled of the outcome of this trial and the huge promise it heralds for transforming the quality of life for the large numbers of children with JIA-associated uveitis. "This trial is an impressive example of how investing in exceptional science can ultimately help change how treatment is delivered with direct and immediate benefit for patients." The full study, entitled 'Adalimumab plus Methotrexate for Uveitis in Juvenile Idiopathic Arthritis' can be found here http://www.


LONDON--(BUSINESS WIRE)--Infinity Health, a health-tech startup delivering secure task management solutions for healthcare professionals, today announced the launch of Infinity. The app is designed to help clinicians, care workers and other health professionals manage their caseload and improve care in hospitals, care homes and the community. Handover is known to be ‘one of the most perilous procedures in healthcare’, according to The Royal College of Surgeons, where patient safety incidents do occur, ‘poor communication at handover’ was identified as a major risk in 33% of incidents” NHS England 2015. Healthcare teams still rely heavily on paper, pagers and verbal communication for handover at shift change. These channels of communication are inefficient and are often unsafe. Healthcare teams using Infinity can seamlessly manage their caseloads and tasks. Updates are sent to team members in real-time, making it easier to collaborate and release more time to care. “Infinity provides a patient centric view with the most up-to-date clinical information. The whole team can prioritise and act on what needs to be done for their patients without delay” says Adam Benton, Co-Founder at Infinity and Hospital Doctor. “Changing behaviour and clinical practice requires a sincere understanding of the issues faced by healthcare professionals every day,” says Elliott Engers, Co-Founder and CEO at Infinity Health. “In order to develop Infinity, our team has taken an entirely user-centered approach. We have the privilege of working with some of the most experienced clinicians at leading institutions in order to create a seamless and intuitive solution.” Infinity Health is planning to rollout several pilots at leading UK hospitals and care homes. The Infinity app is free to download for iPhone, iPad, and iPod touch with a web app for Android, Windows, and Mac coming soon. Infinity Health is currently offering a three-month, free trial. Download the app for free here: https://itunes.apple.com/app/apple-store/id1222636506?pt=118456276&ct=33c9be2&mt=8 Follow us on Twitter, Facebook, and Linkedin. Infinity Health is a digital health company transforming clinical collaboration and task management, with a mission to improve healthcare outcomes and efficiency. Infinity delivers secure mobile solutions that help healthcare teams communicate, so they can release more time to care and provide the best possible care for their patients. Learn more at www.infinityhealth.io


BIRMINGHAM, United Kingdom--(BUSINESS WIRE)--Genesis Automation, a leading provider of healthcare value-chain solutions which improve patient safety, cut cost and eliminate waste for healthcare providers, today announced that Royal Free London NHS Foundation Trust has selected the Genesis platform. Under the agreement, Genesis Automation will provide Royal Free London NHS Foundation Trust with integrated supply chain management technology to increase traceability of medical supplies, resulting in significant cost reductions, effective device recall execution and increased visibility into procedure costs. Based in London, UK, Royal Free London NHS Foundation Trust is one of the largest Trusts in the UK, employing more than 9,000 staff and providing services to more than a million patients. The Trust runs three hospitals in London: Barnet Hospital, Chase Farm Hospital and Royal Free Hospital as well as clinics at Edgware Community Hospital and Hadley Wood Hospital. “Genesis Automation is the most comprehensive and easy to use, Trust-wide solution on the market,” said Natalie Forrest, newly appointed Chief Executive of Chase Farm Hospital. “It was important for us to select a supportive, flexible partner that understands the current and future landscape of the Trust and NHS.” Royal Free London NHS Foundation Trust is the most recent Trust to select Genesis Automation. In recent months, Royal Liverpool and Broadgreen University Hospitals NHS Trust and Hull and East Yorkshire NHS Trust have also joined the fast-growing list of healthcare providers that have selected Genesis to apply traceability principles and clinically integrate their supply chains. “By working with Genesis, we hope to gain valuable data and insights pertaining to our supply chain and inventory challenges that will help us to achieve cost efficiencies that will then fuel our longer-term initiatives,” said Tony Gaynor, Divisional Strategy Lead for Royal Liverpool and Broadgreen. “The fact that the system was built from the ground up for—and by—hospitals is a huge plus.” Royal Liverpool and Broadgreen University Hospitals NHS Trust was selected by NHS England as one of twelve Global Digital Exemplars to spearhead NHS’s Digital Revolution and is one of the busiest university teaching hospital trusts in North West England. “As a Trust, we are always looking at ways to increase efficiencies and do more with less. By implementing a system like Genesis Automation, we aim to enable significant savings, while implementing solid traceability in our operations and increasing patient safety,” said Lee Bond, Chief Financial Officer for the Hull and East Yorkshire Hospitals NHS Trust. The Hull and East Yorkshire Hospitals NHS Trust operates in the city of Hull and the East Riding of Yorkshire, England. Comprised of two sites, Hull Royal Infirmary and Castle Hill Hospital, it provides acute care for a local population of 600,000 and over 1.2 million people for tertiary services. Genesis Automation is a leading provider of innovative supplies management, traceability and analytics solutions featuring clinically-integrated technology that redefines what supply chain means for value-based healthcare. Genesis provides hospitals and healthcare providers with affordable, innovative solutions that improve patient safety, cut costs and eliminate waste. For more information, visit Genesis Automation at http://genesisautomation.healthcare.


News Article | May 4, 2017
Site: www.prweb.com

Genesis Automation, a leading provider of healthcare value-chain solutions which improve patient safety, cut cost and eliminate waste for healthcare providers, today announced that Royal Free London NHS Foundation Trust has selected the Genesis platform. Under the agreement, Genesis Automation will provide Royal Free London NHS Foundation Trust with integrated supply chain management technology to increase traceability of medical supplies, resulting in significant cost reductions, effective device recall execution and increased visibility into procedure costs. Based in London, UK, Royal Free London NHS Foundation Trust is one of the largest Trusts in the UK, employing more than 9,000 staff and providing services to more than a million patients. The Trust runs three hospitals in London: Barnet Hospital, Chase Farm Hospital and Royal Free Hospital as well as clinics at Edgware Community Hospital and Hadley Wood Hospital. "Genesis Automation is the most comprehensive and easy to use, Trust-wide solution on the market,” said Natalie Forrest, newly appointed Chief Executive of Chase Farm Hospital. “It was important for us to select a supportive, flexible partner that understands the current and future landscape of the Trust and NHS.” Royal Free London NHS Foundation Trust is the most recent Trust to select Genesis Automation. In recent months, Royal Liverpool and Broadgreen University Hospitals NHS Trust and Hull and East Yorkshire NHS Trust have also joined the fast-growing list of healthcare providers that have selected Genesis to apply traceability principles and clinically integrate their supply chains. “By working with Genesis, we hope to gain valuable data and insights pertaining to our supply chain and inventory challenges that will help us to achieve cost efficiencies that will then fuel our longer-term initiatives,” said Tony Gaynor, Divisional Strategy Lead for Royal Liverpool and Broadgreen. “The fact that the system was built from the ground up for—and by—hospitals is a huge plus.” Royal Liverpool and Broadgreen University Hospitals NHS Trust was selected by NHS England as one of twelve Global Digital Exemplars to spearhead NHS’s Digital Revolution and is one of the busiest university teaching hospital trusts in North West England. "As a Trust, we are always looking at ways to increase efficiencies and do more with less. By implementing a system like Genesis Automation, we aim to enable significant savings, while implementing solid traceability in our operations and increasing patient safety,” said Lee Bond, Chief Financial Officer for the Hull and East Yorkshire Hospitals NHS Trust. The Hull and East Yorkshire Hospitals NHS Trust operates in the city of Hull and the East Riding of Yorkshire, England. Comprised of two sites, Hull Royal Infirmary and Castle Hill Hospital, it provides acute care for a local population of 600,000 and over 1.2 million people for tertiary services. About Genesis Automation Genesis Automation is a leading provider of innovative supplies management, traceability and analytics solutions featuring clinically-integrated technology that redefines what supply chain means for value-based healthcare. Genesis provides hospitals and healthcare providers with affordable, innovative solutions that improve patient safety, cut costs and eliminate waste. For more information, visit Genesis Automation at http://genesisautomation.healthcare.


Grant
Agency: GTR | Branch: EPSRC | Program: | Phase: Training Grant | Award Amount: 4.93M | Year: 2014

The global Robotics and Autonomous Systems (RAS) market was $25.5bn in 2001 and is growing. The market potential for future robotics and autonomous systems is of huge value to the UK. The need for expansion in this important sector is well recognised, as evidenced by the Chancellor of the Exchequers announcement of £35m investment in the sector in 2012, the highlighting of this sector in the 2012 BIS Foresight report Technology and Innovation Futures and the identification of robotics and autonomous systems by the Minister for Universities and Science in 2013 as one of the 8 great technologies that will drive future growth. This expansion will be fuelled by a step change in RAS capability, the key to which is their increased adaptability. For example, a home care robot must adapt safely to its owners unpredictable behaviour; micro air vehicles will be sent into damaged buildings without knowing the layout or obstructions; a high value manufacturing robot will need to manufacture small batches of different components. The key to achieving increased adaptability is that the innovators who develop them must, themselves, be very adaptable people. FARSCOPE, the Future Autonomous and Robotic Systems Centre for PhD Education, aims to meet the need for a new generation of innovators who will drive the robotics and autonomous systems sector in the coming decade and beyond. The Centre will train over 50 students in the essential RAS technical underpinning skills, the ability to integrate RAS knowledge and technologies to address real-world problems, and the understanding of wider implications and applications of RAS and the ability to innovate within, and beyond, this sector. FARSCOPE will be delivered by a partnership between the University of Bristol (UoB) and the University of the West of England (UWE). It will bring together the dedicated 3000 square metre Bristol Robotics Laboratory (BRL), one of the largest robotics laboratories in Europe, with a trainin and supervising team drawn from UoB and UWE offering a wide breadth of experience and depth of expertise in autonomous systems and related topics. The FARSCOPE centre will exploit the strengths of BRL, including medical and healthcare robotics, energy autonomous robotics, safe human-robot interactions, soft robotics, unconventional computing, experimental psychology, biomimicry, machine vision including vision-based navigation and medical imaging and an extensive aerial robotics portfolio including unmanned air vehicles and autonomous flight control. Throughout the four-year training programme industry and stakeholder partners will actively engage with the CDT, helping to deliver the programme and sharing both their domain expertise and their commercial experience with FARSCOPE students. This includes regular seminar series, industrial placements, group grand challenge project, enterprise training and the three-year individual research project. Engaged partners include BAE Systems, DSTL, Blue Bear Systems, SciSys, National Composites Centre, Rolls Royce, Toshiba, NHS SouthWest and OC Robotics. FARSCOPE also has commitment from a range of international partners from across Europe, the Americas and Asia who are offering student exchange placements and who will enhance the global perspective of the programme.


Grant
Agency: GTR | Branch: EPSRC | Program: | Phase: Research Grant | Award Amount: 573.84K | Year: 2015

By 2018, it is estimated that the number of people in the UK with three or more long-term conditions, also known as multimorbidity , will have grown from 1.9 million to 2.9 million. Various chronic diseases develop simultaneously in response to common risk factors such as smoking, diet, ageing and inactivity. The four most common chronic diseases are cancer, chronic obstructive pulmonary disease (COPD), coronary heart disease and diabetes. A recent study found that over 97% of patients with moderate to severe COPD had at least one concomitant chronic disease. In clinical settings processes are complex and are influenced by a number of social, technical and organisational factors. This complexity can result in variation in how physicians practice, appropriate care is documented, and healthcare costs managed. To reduce inconsistencies, clinical guidelines have emerged based on the best existing evidence, with the aim to support clinical staff and improve the quality of healthcare. Current guidelines almost entirely focus on single conditions. As a result, applying multiple guidelines to a patient may potentially result in conflicting recommendations for care. In software system design and development, we create computer systems capable to support diverse interactions between the environment/users and the system. These interactions often reflect different and possibly conflicting viewpoints, such as those presented by different users or stakeholders. Although software system specification and patient care guidelines seem different, inherently they have something in common. In both cases we have procedures and executions of (partially) ordered sequence of actions (aka activities or tasks) called traces of execution in computer science or pathways in clinical practice. In the case of computer-based systems, actions are carried out by users or computers (more specifically individual components or objects in the system). In the case of care guidelines, actions are carried out by physicians, patients and carers. In both cases, conflict may arise when individual executions and pathways are incompatible. In this proposal, we investigate automated methods of detection of conflicts in clinical pathways for multimorbidities and propose solutions that resolve them .


In people with type 2 diabetes mellitus (T2DM), the incretin effect is reduced, but the recent advent of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide (GLP)-1 agonists/analogues has enabled restoration of at least some of the function of the incretin system, with accompanying improvements in glycaemic control. Two GLP-1 receptor agonists/analogues are currently approved for the treatment of T2DM-exenatide (Byetta®, Eli Lilly & Co., Indianapolis, IN, US) and liraglutide (Victoza®, Novo Nordisk, Bagsvaerd, Denmark); a once-weekly formulation of exenatide (Bydureon®, Eli Lilly & Co.) has also been approved by the European Medicines Agency. The National Institute for Health and Clinical Excellence (NICE) has recently published guidance on the use of liraglutide in T2DM, based on evidence from the Liraglutide Effect and Action in Diabetes (LEAD) Phase III trial programme, which compared liraglutide with existing glucose-lowering therapies, such as exenatide and insulin glargine. The LEAD programme reported HbA1c reductions from 0.8 to 1.5% with liraglutide (1.2 and 1.8 mg), accompanied by low rates of hypoglycaemia and some weight loss; side effects were primarily gastrointestinal in nature (e.g. nausea and diarrhoea). Based on the findings of the LEAD studies and the NICE recommendation, liraglutide now represents an important therapy widely available in the UK for certain patient groups, including those with a body mass index (BMI) ≥35.0 kg/m2, and patients with a BMI <35 kg/m2 who are considered unsuitable for insulin and are failing to meet targets for glycaemic control with oral agents. NICE guidelines still suggest that most patients without considerable obesity (BMI <35 kg/m2) are probably best managed using insulin therapy. Evidence also suggests a future role for GLP-1 mimetics in combination with basal insulin. © 2011 Blackwell Publishing Ltd.


Daniels R.,NHS England
Journal of Antimicrobial Chemotherapy | Year: 2011

Severe sepsis is a major cause of morbidity and mortality, claiming between 36000 and 64000 lives annually in the UK, with a mortality rate of 35%. International guidelines for the management of severe sepsis were published in 2004 by the Surviving Sepsis Campaign and condensed into two Care Bundles. In 2010, the Campaign published results from its improvement programme showing that, although an absolute mortality reduction of 5.4% was seen over a 2 year period in line with increasing compliance with the Bundles, reliability was not achieved and Bundle compliance reached only 31%. This article explores current challenges in sepsis care and opportunities for further improvements. Basic care tasks [microbiological sampling and antibiotic delivery within 1 h, fluid resuscitation, and risk stratification using serum lactate (or alternative)] are likely to benefit patients most, yet are unreliably performed. Barriers include lack of awareness and robust process, the lack of supporting controlled trials, and complex diagnostic criteria leading to recognition delays. Reliable, timely delivery of more complex life-saving tasks (such as early goal-directed therapy) demands greater awareness, faster recognition and initiation of basic care, and more effective collaboration between clinicians and nurses on the front line, in critical care and in specialist support services, such as microbiology and infectious diseases. Organizations such as Survive Sepsis, the Surviving Sepsis Campaign and the Global Sepsis Alliance are working to raise awareness and promote further improvement initiatives. Future developments will focus on sepsis biomarkers and microarray techniques to rapidly screen for pathogens, risk stratification using genetic profiling, and the development of novel therapeutic agents targeting immunomodulation. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

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