No description available.

Rates and coverage levels of immunizations of African-American children are reduced compared to other races. Few studies have identified factors that influence vaccination decisions of African-American mothers. This study assessed the mothers' vaccination decisions using a self-administered questionnaire and a screening instrument for determining health literacy. This instrument is called Rapid Estimate of Adult Literacy in Medicine (REALM). The sample was 92 African American mothers, recruited from a large metropolitan church in Jacksonville, Florida, who had at least one child under the age of seven. A cross-sectional research design was used to administer survey instruments to identify and interpret parental barriers and decision-making regarding childhood vaccination. The results of this study showed that the there was a decrease in scores across the levels of education which indicated that education had a significant impact on the parental perception for the vaccination of their children. Interventions can now be tailored to improve the childhood immunization rates and provide a foundation for developing effective childhood vaccination educational materials for this population.

Class of 2017 Abstract / Objectives: To determine whether pharmacy students were more willing to receive, administer, recommend and counsel patients about vaccinations after completing an immunization training program Methods: Anonymous and voluntary questionnaires administered on paper during a regularly scheduled class collected ratings of confidence on the willingness of first year pharmacy students to receive, administer, recommend and counsel about vaccinations prior to and after the completion of an immunization training program. Data on gender, age range, status of completion and source of the immunization training program completed was also collected. This study was approved by the University of Arizona Institutional Review Board (IRB). Results: Questionnaires were completed by 110 students at the Tucson and Phoenix campus. Students were equally willing (p=0.235) to receive all vaccinations, even if they were not required to by the UA COP, before and after the immunization training program.There was a statistically significant difference in the willingness to administer (p<0.001), to recommend (p=0.024) and to counsel (p<0.001) about vaccinations after completion of an immunization training program. Conclusions: Completing an immunization training program did not have influence on the willingness of pharmacy students to receive vaccinations. However, the results suggest pharmacy students are more willing to administer, recommend and counsel about vaccinations after the completion of an immunization training program.

Many communicable diseases can be prevented with the use of immunizations. The issue this study addressed was the use of vaccinations and the rise of continued preventable communicable disease. Researchers have recommended that children be vaccinated, a recommendation that is bolstered by the readily available supply of vaccinations worldwide. However, even with vaccine promotions, availability, and education, children continue to be unvaccinated and outbreaks have continued to occur. For this study, data will be collected from the Iowa Registry of Immunization Records and a local community health center pediatric clinic. Examples of data that will be collected are vaccine records, race, and language spoken. Also, data from questionnaires given to parents, caregivers, and medical staff will be obtained to discover their beliefs, misconceptions, and thoughts on vaccines. The sample size will be 35, with recruitment occurring when the parent brings a child into the clinic for a well child or sick visit. The questionnaires will be collected and analyzed by totaling the responses from a pre-existing Likert scale questionnaire.The purposes of the project are to (a) discuss with health care providers a project, that consists of reasons children are not vaccinated; (b) develop a plan to determine those reasons and how to educate parents, the community being served by this health care facility and health care staff on the importance of immunizations; (c) and promote vaccinations for the this community.

La réponse immunitaire, qu’elle soit générée suite à un contact naturel avec un agent infectieux ou après l’administration d’un vaccin, est sujette à des variations qui peuvent être dues à des facteurs environnementaux tels que les infections ou la malnutrition.Au cours de ce travail, nous avons étudié par une approche épidémiologique, l’influence des variations saisonnières et de la malnutrition sur la réponse immunitaire vis-à-vis de vaccins administrés aux enfants avant l’âge d’un an dans le cadre du Programme Elargi de Vaccination de l’Organisation Mondiale de la Santé (coqueluche, tétanos, diphtérie, tuberculose).Une étude longitudinale multidisciplinaire de terrain a été menée au nord du Sénégal, dans 5 villages de la vallée du Grand Fleuve, sur une cohorte de 410 enfants âgés de 1 à 9 ans. Des visites ont été réalisées dans l’ensemble des villages, à différents moments de l’année, englobant des périodes de saisons sèches et de saisons humides, afin de collecter des données parasitologiques, cliniques et anthropométriques, ainsi que des échantillons sérologiques. Dans le cadre de la santé publique, cette étude a permis d’apporter des données régionales sur la couverture vaccinale, la prévalence du paludisme et de l’état nutritionnel des enfants.La réponse immune à la coqueluche a été mesurée par le dosage d’anticorps dirigés contre la toxine de la coqueluche et l’hémagglutinine filamenteuse, deux antigènes de la bactérie Bordetella pertussis, l’agent principal de la coqueluche. Nos résultats concernant la réponse humorale à ces antigènes indiquent des variations du taux d’anticorps en fonction de l’âge des enfants ainsi que de leur village de résidence. La séroprévalence à B. pertussis a révélé la circulation endémique de la bactérie dans certains villages avec l’apparition d’un pic épidémique dans l’un d’entre eux. De plus, nos analyses suggèrent que la malnutrition est associée à une diminution de la réponse humorale aux antigènes de la coqueluche et que le retard de croissance influe sur la séroconversion vis-à-vis de cette infection bactérienne. Par ailleurs, le retard de croissance semble diminuer la capacité des cellules immunitaires des enfants à produire de l’interféron gamma, une cytokine clé intervenant dans la défense contre les infections, en réponse à des antigènes vaccinaux. Les conséquences à plus long terme de la malnutrition chronique infantile sur le maintien ou le développement des réponses immunes chez ces enfants lorsqu’ils seront plus âgés demeurent un point important à étudier.Mots-clés : anticorps, vaccination, coqueluche, Bordetella, malnutrition, Sénégal / Immune response, whether generated as a result of natural contact with an infectious agent or after the administration of a vaccine, is subject to changes, which may be due to environmental factors such as infections or malnutrition.In this work, we used an epidemiological approach to study the influence of seasonal variations and malnutrition on the immune response to vaccines administered to children before the age of one, in the frame of the Expanded Programme on Immunization set up by the World Health Organization (whooping cough, tetanus, diphtheria, tuberculosis).A longitudinal multidisciplinary study was conducted in northern Senegal in 5 villages of the Great River valley, on a cohort of 410 children aged 1 to 9. Visits were conducted in all villages at different times of the year, including periods of the dry season and wet season, to collect parasitological, clinical and anthropometric data, as well as serological samples. In the context of public health, this study provides regional data on immunization coverage, malaria prevalence, and nutritional status of children.

No description available.

Background: Celiac disease occurs worldwide in approximately 1% of the population, whereof the majority of cases are undiagnosed. Sweden experienced an epidemic (1984-1996) of clinically detected celiac disease in children below 2 years of age, partly attributed to changes in infant feeding. Whether the epidemic constituted a change in disease occurrence and/or a shift in the proportion of diagnosed cases remains unknown. Moreover, the cause of the epidemic is not fully understood. Objective: To increase the knowledge regarding the occurrence of celiac disease in Sweden, with focus on the epidemic period and thereafter, as well as the etiology of celiac disease in general, by investigating the Swedish epidemic and its potential causes. Methods: We performed a two-phased cross-sectional multicenter screening study investigating the total prevalence, including both clinically- and screening-detected cases, of celiac disease in 2 birth cohorts of 12-year-olds (n=13 279): 1 of the epidemic period (1993) and 1 of the post-epidemic period (1997). The screening strategy entailed serological markers analyses, with subsequent small intestinal biopsy when values were positive. Diagnosis was ascertained in clinical cases detected prior to screening. Infant feeding practices in the cohorts were ascertained via questionnaires. An ecological approach combined with an incident case-referent study (475 cases, 950 referents) performed during the epidemic were used for investigating environmental- and lifestyle factors other than infant feeding. Exposure information was obtained via register data, a questionnaire, and child health clinic records. All studies utilized the National Swedish Childhood Celiac Disease Register. Results: The total prevalences of celiac disease were 2.9% and 2.2% for the 1993 and 1997 cohorts, respectively, with 2/3 cases unrecognized prior to screening. Children born in 1997 had a significantly lower celiac disease prevalence compared to those born in 1993 (prevalence ratio, 0.75; 95% confidence interval [CI], 0.60-0.93). The cohorts differed in infant feeding; more specifically in the proportion of infants introduced to dietary gluten in small amounts during ongoing breastfeeding. Of the environmental and lifestyle factors investigated, no additional changes over time coincided with the epidemic. Early vaccinations within the Swedish program were not risk factors for celiac disease. Early infections (≥3 parental-reported episodes) were associated with increased risk for celiac disease (adjusted odds ratio [OR] 1.5; 95% CI, 1.1-2.0), a risk that increased synergistically if, in addition to having ≥3 infectious episodes, the child was introduced to gluten in large amounts, compared to small or medium amounts, after breastfeeding was discontinued (OR 5.6; 95% CI, 3.1-10). Early infections probably made a minor contribution to the Swedish epidemic through the synergistic effect with gluten, which changed concurrently. In total, approximately 48% of the epidemic could be explained by infant feeding and early infections. Conclusion: Celiac disease is both unexpectedly prevalent and mainly undiagnosed in Swedish children. Although the cause of the epidemic is still not fully understood, the significant difference in prevalence between the 2 cohorts indicates that the epidemic constituted a change in disease occurrence, and importantly, corroborates that celiac disease can be avoided in some children, at least up to 12 years of age. Our findings suggest that infant feeding and early infections, but not early vaccinations, have a causal role in the celiac disease etiology and that the infant feeding practice – gradually introducing gluten-containing foods from 4 months of age, preferably during ongoing breastfeeding – is favorable.

Objective: To measure the impact of an automated outbound telephone messaging system on herpes zoster (HZ) vaccinations among older adults in the community pharmacy setting. Design: Randomized controlled trial. Setting: 16 grocery store chain community pharmacies in Georgia and Tennessee, between December 2006 and May 2007. Patients: Adults 60 years or older who filled at least one prescription at a participating study pharmacy. Intervention: A 30-second automated outbound telephone message was delivered to patient households monthly during the first week of March through May 2007. The message advertised that older adults should speak with their pharmacist about the risk for HZ and the availability of a new vaccine. Main outcome measure: HZ vaccinations based on pharmacy profile records. Results: After 3 months, 146 and 46 vaccinations were administered to older adults among the study cohort populations, translating into HZ vaccination rates of 2.60% and 0.72% at intervention and control pharmacies, respectively (odds ratio 3.69 [95% CI 2.64-5.15], P < 0.001). Conclusion: Use of an automated outbound telephone messaging tool to inform older adults about their risk for HZ and the availability of a vaccine significantly improved vaccination rates in the community pharmacy setting.

Objective: To measure the impact of an automated outbound telephone messaging system on herpes zoster (HZ) vaccinations among older adults in the community pharmacy setting. Design: Randomized controlled trial. Setting: 16 grocery store chain community pharmacies in Georgia and Tennessee, between December 2006 and May 2007. Patients: Adults 60 years or older who filled at least one prescription at a participating study pharmacy. Intervention: A 30-second automated outbound telephone message was delivered to patient households monthly during the first week of March through May 2007. The message advertised that older adults should speak with their pharmacist about the risk for HZ and the availability of a new vaccine. Main outcome measure: HZ vaccinations based on pharmacy profile records. Results: After 3 months, 146 and 46 vaccinations were administered to older adults among the study cohort populations, translating into HZ vaccination rates of 2.60% and 0.72% at intervention and control pharmacies, respectively (odds ratio 3.69 [95% CI 2.64-5.15], P < 0.001). Conclusion: Use of an automated outbound telephone messaging tool to inform older adults about their risk for HZ and the availability of a vaccine significantly improved vaccination rates in the community pharmacy setting.

The purpose of this study was to investigate whether mandatory universal precautions changed nurses' body fluid exposure and reporting rates, hepatitis B vaccination rates, and human immunodeficiency virus (HIV) testing rates. Random cross-sectional surveys of nurses in Tennessee were conducted in 1991 and 1993 (n = 145 in 1991; n = 143 in 1993). The questionnaire in both surveys included frequency of body fluid exposures and reporting in the past year, and whether or not the respondent had received the hepatitis B vaccine or had been HIV tested. Findings indicated that self reported needlestick injuries decreased by 69%, and other sharps injuries decreased by 81%. Only 4.1% of all exposure incidents reported on this anonymous survey were reported to employee health officials, as required. Body fluid exposure incidents were the most common form of exposure (81%) and the most underreported. Hepatitis B vaccinations significantly increased (61.4% to 82.5%), with a nonsignificant increase in HIV testing (47.2% to 55.6%) from 1991 to 1993. Findings of this study suggest that the universal precautions regulatory mandate has been effective in increasing nurses' compliance to universal precautions. Body fluid contacts were significantly underreported and showed no decrease between 1991 and 1993.