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At least 451 records · Page 25Linked to original sources
PubMed2000

Measles epidemic in Israel-successful containment in the military.

BACKGROUND: Measles vaccination at ages 12-15 months is a routine part of standard health care in developed countries. Nonetheless, the prevention and control of measles outbreaks remain a challenge, owing to incomplete or variable compliance with immunization programs and primary vaccine failure (approximately 5%). In Israel, vaccination coverage against measles is high, yet sero-epidemiological studies conducted in the early 1990s showed that 15% of 18-year-olds were unprotected. METHODS: 1994 there was a countrywide epidemic of measles, which spread to the military. The Israel Defense Forces Medical Corps immediately launched a wide-scale vaccination campaign, targeting primarily field units and training bases, where crowded living conditions are the rule. RESULTS: The immunization campaign led to an abrupt cessation of morbidity in the military. In the civilian sector, where no intervention was undertaken, the epidemic continued for another 4 months. CONCLUSIONS: Institutional measles outbreaks, especially in the presence of crowded conditions or high contact rates, may be effectively controlled by mass vaccination.

Incidence↗
PubMedDate not supplied

Injection safety: knowledge and practice among health workers.

The increase in the spread of human immune-deficiency virus (HIV) infection among our population calls for measures to check its transmission. Health workers are at risk especially those in clinical practice who work with needles and other sharp objects that could aid transmission of the virus. Professionalism is at its lowest at Primary Health Care level and workers responsible for giving immunization with injections need clear understanding of principles of safe injection. To appreciate how to formulate a training programme, the knowledge and practice of injection safety among the workers were assessed through the use of a questionnaire. Fifty eight percent thought only children receiving immunization were at risk of a disease, 58.3% know the diseases transmissible by needle stick injury. On reasons for prevalence of unsafe injection practices, 27% suggested inadequate provision, 18.3% poverty, 17.7% ignorance, 17.2% improper disposal, 11.8% lack of surveillance and health supervision for workers and 8% negligence. On syringes and needles disposal, 53.2% suggested burning only, 2.1% burying and 44.7% both burning and burying. Less than 9% knew that auto-destruct syringes exist while 38.9% were aware of the joint WHO and UNICEF statement on "bundling approach" in vaccine packaging. Only about 50% of respondents had facilities for disposal of needles and syringes in their health centers, 45.6% wear protective clothing during service delivery. On making injection safer 33.7% suggested re-training of health workers, 22% retraining of workers and public re-education, 16.8% suggested planning budgeting and purchasing of auto-destruct syringes, 16.5% social mobilization and advocacy and 11% suggested the provision of facilities for disposal. It was concluded that awareness on safe injection practices was low among the health workers and that their practices could put them at greater risk of needles stick injury and hence the spread of HIV and other infection among them. Training on safe injection practices is therefore recommended.

Disposable Equipment↗
PubMed2006

Public health professionals' perceptions toward provision of health protection in England: a survey of expectations of Primary Care Trusts and Health Protection Units in the delivery of health protection.

BACKGROUND: Effective health protection requires systematised responses with clear accountabilities. In England, Primary Care Trusts and the Health Protection Agency both have statutory responsibilities for health protection. A Memorandum of Understanding identifies responsibilities of both parties, but there is a potential lack of clarity about responsibility for specific health protection functions. We aimed to investigate professionals' perceptions of responsibility for different health protection functions, to inform future guidance for, and organisation of, health protection in England. METHODS: We sent a postal questionnaire to all health protection professionals in England from the following groups: (a) Directors of Public Health in Primary Care Trusts; (b) Directors of Health Protection Units within the Health Protection Agency; (c) Directors of Public Health in Strategic Health Authorities and; (d) Regional Directors of the Health Protection Agency RESULTS: The response rate exceeded 70%. Variations in perceptions of who should be, and who is, delivering health protection functions were observed within, and between, the professional groups (a)-(d). Concordance in views of which organisation should, and which does deliver was high (> or =90%) for 6 of 18 health protection functions, but much lower (< or =80%) for 6 other functions, including managing the implications of a case of meningitis out of hours, of landfill environmental contamination, vaccination in response to mumps outbreaks, nursing home infection control, monitoring sexually transmitted infections and immunisation training for primary care staff. The proportion of respondents reporting that they felt confident most or all of the time in the safe delivery of a health protection function was strongly correlated with the concordance (r = 0.65, P = 0.0038). CONCLUSION: Whilst we studied professionals' perceptions, rather than actual responses to incidents, our study suggests that there are important areas of health protection where consistent understanding of responsibility for delivery is lacking. There are opportunities to clarify the responsibility for health protection in England, perhaps learning from the approaches used for those health protection functions where we found consistent perceptions of accountability.

Administrative Personnel↗
PubMed2006

A survey of knowledge, attitudes, and behavior of Italian dentists toward immunization.

This study assessed the knowledge, attitude, and compliance to immunization guidelines among dental health-care professionals in Italy. A questionnaire was mailed to a random sample of 1000 dentists on demographic and professional characteristics; knowledge regarding infectious diseases that can be acquired/transmitted by the dentist and the vaccinations recommended; attitudes regarding the vaccinations; self-assessed information about previous vaccinations. A total of 369 dentists responded. Only 44.1 and 32.4% correctly indicated all infections that can be acquired or transmitted during their activity. Half of the dentists knew that they should be vaccinated against hepatitis B and influenza and this knowledge was significantly higher in those older, who correctly indicated that hepatitis B and influenza can be acquired and transmitted during their activity, and in those with a positive attitude towards vaccinations. Those younger, involved in specialties with low blood contact, and who did not know that hepatitis B and influenza are vaccinations recommended, were more likely to believe that is important for them to receive vaccinations. A large proportion (85.7%) reported receiving the hepatitis B vaccine, but only 56.2% the three doses. Those with a lower number of years of activity, those who knew that hepatitis B can be acquired by the dentist, those who did not need information, and those who were informed from guidelines, educational courses, and dental associations were more likely to have received the three doses or to be natural immunizated. Training and educational interventions are needed to improve knowledge and immunization coverage.

Adult↗
PubMed1995

Safety, effectiveness and ease of use of a non-reusable syringe in a developing country immunization programme.

Unsterile needles and syringes may transmit blood-borne infectious agents such as HIV and hepatitis B virus. The emergence of these diseases as major public health concerns and the risk of nosocomial transmission has heightened interest in the development of single-use injection devices. WHO and UNICEF embarked on a programme to develop and introduce these devices in 1987. We report on a field trial in Karachi, Pakistan, of the SoloShot (SS) plastic disposable syringe, which has a metal clip in the syringe barrel to prevent second-time withdrawal of the plunger. A conventional disposable syringe (CS) was used as a comparison. We observed 48 vaccinators giving 2400 injections with the SS and 1440 with the CS; 98.7% of SS performed as designed. The average volume required per delivered dose was comparable for the two syringes and was delivered more quickly with SS. Training and experience had a small but statistically significant effect on several aspects of SS use. Vaccinators who indicated a syringe preference preferred SS on 7 out of 9 indicators. SS is safe and effective in preventing reuse and is easier and quicker to use than the CS. Vaccinators require little, if any, special training. It could directly replace disposable syringes in expanded programmes on immunization (EPI) in countries where use of unsterile disposable devices occurs or when sterilization is not practical.

Allied Health Personnel↗
PubMed2000

The Indian child and the new millennium--hope or hype?

The challenges for childcare in the new millennium are outlined. The highly successful polio immunization strategy needs to be extended to other activities. The training programs developed for neonatal resuscitation, intensive care and care in oncology should be extended to other specialties. The journal will provide more fellowships and aid in the development of sub specialties in pediatrics. It will be published monthly and will also go online from January 2000.

Child↗
PubMed2006

Global FMD control--is it an option?

The outbreaks of foot-and-mouth disease (FMD) in Europe in 2001 identified the vulnerability of the intensive agricultural industries in Europe and North America to the economic consequences of the introduction of a highly infectious animal disease. The very large illegal international trade in animal products bypasses the safeguards recommended by World Animal Health Organization (OIE) and put in place by governments to prevent the importation of foreign pathogens. If it is not possible to stop the entry of FMD virus, what are the options to mitigate the risk by reducing the area of the globe in which FMD is endemic? There are a number of constraints that would prevent global control of FMD; current vaccines are expensive, have a narrow antigenic spectrum, provide only short term immunity and are very fragile; diagnostics are also expensive, require training to use and if not handled properly lose sensitivity and specificity; we still do not understand the significance of carrier animals in the epidemiology of FMD, and whether it is necessary or possible to prevent the carrier state; and many decision support tools, such as models are currently more dangerous than useful in that they fail to fully accommodate all the complexities of the disease. The four national foreign animal disease laboratories in USA, Canada, UK and Australia together with the International Livestock Research Institute have put forward a proposal to address some of these constraints (the Global FMD Research Alliance, GFRA), not only to protect their own national livestock industries, but also to support FMD control programs in countries in which the disease is present.

Animals↗
PubMed2004

The role of mobile phones in improving vaccination rates in travelers.

RATIONALE: Noncompliance with vaccination schedules undermines the potential benefits of immunization. The purpose of this study was to evaluate whether a reminder of the next vaccine dose sent by the Short Messaging Service (SMS) to the vaccinee's mobile phone increases compliance with hepatitis A + B and hepatitis A vaccination schedule. SUBJECTS AND METHODS: In this experimental, controlled study, the study group comprised travelers who went to the Internacional-Clínic Vaccination Centre between the 1st June and 30th September of 2001 for the standard immunization schedule against hepatitis A + B and against hepatitis A. Trained health-care workers entered the data into a computer to generate text messages reminding vaccinees of their scheduled doses. Two control groups, one from the same period of the same year including travelers from the third office (Control 2001) and the second, all travelers seen in the same period of the previous year (Control 2000), were used. RESULTS: For the second hepatitis A + B dose, compliance in the study group (Message Groups) was 88.4% (83.3-92.2); in the Control 2001, 80.7% (76.3-84.4, relative risk [RR] 1.10 [1.02-1.17]); and in the Control 2000, 77.2% (73.3-80.5, RR 1.15 [1.07-1.22]). For the third hepatitis A + B vaccine dose, results were 47.1% (40.5-53.8); 26.9% (22.8-31.7, RR 1.75 [1.41-2.17]); and 23.6% (20.1-27.4, RR 2.00 [1.63-2.45]), respectively. As for the hepatitis A vaccine, compliance rates for the second dose were 27.7% (23.9-31.9); 16.4% (14.4-18.6, RR 1.69 [1.40-2.04]); and 13.2% (11.6-14.9, RR 2.10 [1.75-2.54]); respectively. CONCLUSIONS: SMS seems to be an effective tool for increasing compliance with vaccination schedules.

Adult↗
PubMed2004

[Feasibility of administering Tegeline at home. Retrospective study of efficacy, safety and tolerance].

OBJECTIVE: To demonstrate the feasibility of administration Tegeline at home from a point of view of efficacy, safety, tolerance, to validate the pertinence of the selection and the training of patients who could benefit from this type of administration and to assess the long term efficacy and safety. METHOD: This retrospective study was conducted in patients exhibiting primary immune deficiency and formerly treated with intravenous immunoglobulins at least six months in hospital settings, trained by the centre for the training of children in the home (Centre de formation au traitement à domicile de l'enfant--CFTDE) and having received at least one administration of Tegeline at home from January 1st 2000. Tegeline contains a mean of 97.6% of whole IgG (58.8% of IgG1, 34.1% of IgG2, 5.4% of IgG3 and 1.7% of IgG4). RESULTS: Two hundred and eighteen follow-up sheets were completed by 13 patients in whom all the eligibility criteria were fulfilled. The total number of infusions per patient ranged from 4 to 41. No difficulty in administration was reported in 10 patients, difficulties in placing the needle were encountered in 3 other patients and motivating their return to the hospital for treatment (after 6 and 10 months) in 2 cases. The infusion flow rate was usually of 2 to 3 ml/kg/h. During the follow-up period, no episode of infection was noted in 5 patients and 8 presented infections that were treated with antibiotics. Regarding safety, the security 'kits' (corticosteroids, adrenalin) that were supplied to each patient were never used. Over time, the median duration of the infusions at home was of 5 years and 6 months. CONCLUSION: In trained and selected patients, this study demonstrated the efficacy, safety and tolerance to the administration of Tegeline at home.

Adolescent↗
PubMed1995

Attitudes toward and knowledge of AIDS among African American social work students.

Social work students can be trained to assume critical roles in response to the acquired immune deficiency syndrome (AIDS) epidemic in the African American community. To effectively prepare social work students for these roles, educators must ascertain the knowledge and attitudes of students toward the epidemic. Although several researchers have studied the AIDS knowledge and attitudes of social work students in general, none have reported on the knowledge and attitudes of African American social work students as a group. In the present study, 48 graduate-level African American social work students responded to a questionnaire to measure these characteristics. Many students had incomplete knowledge about AIDS, felt unprepared to handle AIDS practice situations, and felt apprehensive about contact with people with AIDS. Social work educators need to take steps to ensure that African American social work students are prepared to intervene effectively in the AIDS epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Care seeking behaviour for childhood illness--a questionnaire survey in western Nepal.

BACKGROUND: The World Health Organization estimates that seeking prompt and appropriate care could reduce child deaths due to acute respiratory infections by 20%. The purpose of our study was to assess care seeking behaviour of the mothers during childhood illness and to determine the predictors of mother's care seeking behaviour. METHODS: A cross-sectional survey was conducted in the immunization clinics of Pokhara city, Kaski district, western Nepal. A trained health worker interviewed the mothers of children suffering from illness during the preceding 15 days. RESULTS: A total of 292 mothers were interviewed. Pharmacies (46.2%) were the most common facilities where care was sought followed by allopathic medical practitioners (26.4%). No care was sought for 8 (2.7%) children and 26 (8.9%) children received traditional/home remedies. 'Appropriate', 'prompt' and 'appropriate and prompt' care was sought by 77 (26.4%), 166 (56.8%) and 33 (11.3%) mothers respectively. The mothers were aware of fever (51%), child becoming sicker (45.2%) and drinking poorly (42.5%) as the danger signs of childhood illness. By multiple logistic regression analysis total family income, number of symptoms, mothers' education and perceived severity of illness were the predictors of care seeking behaviour. CONCLUSION: The results of the present study show that the mothers were more likely to seek care when they perceived the illness as 'serious'. Poor maternal knowledge of danger signs of childhood illness warrants the need for a complementary introduction of community-based Integrated Management of Childhood Illness programmes to improve family's care seeking behaviour and their ability to recognize danger signs of childhood illness. Socioeconomic development of the urban poor may overcome their financial constraints to seek 'appropriate' and 'prompt' care during the childhood illness.

Journal Article↗
PubMed1994

Effect of growth hormone suppression on exercise training and growth responses in young rats.

Exercise training improves maximal oxygen uptake and endurance times in adult human beings and other animals. The mechanism of this improvement results in part from anabolic effects of exercise and may be mediated by growth hormone (GH). Little is known about the role of GH in the adaptation to exercise in younger, still-developing organisms. To examine this role, we began a 4-wk treadmill exercise training protocol in 14-d-old female rats. GH was suppressed by passive immunization with anti-GH releasing hormone antisera. There were four experimental groups: 1) GH-control (normal GH secretory capacity), untrained (n = 21); 2) GH-suppressed, untrained (n = 13); 3) GH-control, trained (n = 14); and 4) GH-suppressed; trained (n = 11). At the end of the training period, maximal oxygen uptake and treadmill endurance running time were measured. Serum GH and IGF-I were assessed using RIA, and whole hind limb musculature succinate dehydrogenase (an indicator of mitochondrial function) was measured with standard fluorometric technique. Body weight gain was markedly reduced in GH-suppressed rats (mean, 54% of GH-controls in untrained rats and 55% in trained; p < 0.05). No apparent effect of training on linear growth was observed. As expected, serum IGF-I was markedly reduced by GH suppression, but no exercise-induced increase occurred in IGF-I as a result of training in either the GH-control or GH-suppressed rats. In GH-control rats, maximal oxygen uptake and succinate dehydrogenase were 69% and 25% greater, respectively, in trained compared with untrained rats (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMedDate not supplied

Real compliance and how to achieve it.

Regulatory compliance is designed to comply with regulations and guidelines to avoid regulatory citations. While it is designed to minimize compliance problems, it can actually create them by causing a company to aim at constantly moving targets, domestically and internationally. This type of compliance substantially increases costs. Real compliance offers the advantages of regulatory compliance without the disadvantages at significantly reduced costs by increasing production and control efficiencies and reducing training expense. Real compliance is defined as a state of control. It is unconditional since it does not depend on compliance with a particular set of regulations and guidelines. Real compliance is product and process based and results from effective policies, procedures, processes, and warning systems. Real compliance can be achieved by designing systems and procedures to contain the characteristics outlined in the elements of a state of control listed above. The following points should be considered as you transform regulatory compliance to real compliance. Knowledge plus control equals compliance Build effective processes and monitor them Cease dependence on inspection to achieve quality Develop and implement effective quality systems Systems and procedures should be principle-based, not rule-based Hire the best people, train them and keep them Have enough staff Build an "immune system" Never guess.

Drug Industry↗
PubMed1989

Surveillance of neonatal tetanus in Thailand, 1977-1986.

Information on the morbidity and mortality of neonatal tetanus was reviewed to evaluate the impact of the immunization programme among pregnant women in Thailand from 1977. We also analysed the epidemiological characteristics of investigated neonatal tetanus cases during the period 1984-1986. The neonatal tetanus case rate declined from 72.1 per 100,000 livebirths in 1977 to 53.7 per 100,000 livebirths in 1986. Reduction in the incidence rate was inversely associated with increasing vaccination coverage of pregnant women with tetanus toxoid. The ratio of male to female neonatal tetanus was 1.5 to 1. Approximately 95 per cent of the cases occurred within the first 14 days of life, with the highest number recorded at 6-8 days of life. The majority of investigated cases were infants who became ill following delivery assisted by traditional birth attendants or relatives of mothers. About 88 per cent of these cases were infants whose mothers had no tetanus immunization. Razor blades and bamboo splits were the most frequently used instruments for cutting the umbilical cord. Strategies to control neonatal tetanus in Thailand should include immunization of pregnant women with tetanus toxoid, and more comprehensive training and supervision of untrained birth attendants.

Female↗