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At least 1,549 records · Page 86Linked to original sources
PubMed1999

Evaluation of a community-based program to improve infant immunization rates in rural Minnesota.

OBJECTIVE: The purpose of this study was to evaluate the effects of enrollment in a community-based public health nursing program, Communities Caring for Children (CCC), on infant immunization rates in rural Minnesota. The program involved health education, a registry, and a reminder system. DESIGN: The evaluation was a collaborative effort of university, public health agency, and private managed-care personnel. Two data sources were used to assess the association of program enrollment and immunization compliance; public birth certificates and a telephone survey of 421 CCC enrollees and non-enrollees. RESULTS: Birth certificate and survey data showed that CCC enrollees were significantly younger, less educated, more likely to be white, and of lower parity than non-enrollees. The average age of subjects' infants was eight months. The survey data showed that, overall, CCC enrollees perceived less danger in infant immunizations than did non-enrollees and were more likely than non-enrollees to have access to infant immunization reminder cards. CCC enrollees reported significantly higher immunization compliance for their infants than did non-enrollees. CONCLUSIONS: The area served by this program is relatively low-income and rural. Infant immunization status was among the lowest in Minnesota prior to the implementation of CCC. The evaluation suggested that enrollment in CCC was one of the most powerful predictors of infant immunization compliance.

Age Factors↗
PubMed2000

Epidemic diphtheria in Ukraine, 1991-1997.

In 1991, Ukraine experienced a return of epidemic diphtheria after decades of control that had resulted in <40 sporadic cases reported every year. Increased incidence was first recorded in Kiev, Lviv, and Odessa. By 1993, the epidemic had spread to >50% of the oblasts (provinces) in the country, and by 1995, all regions were affected. In 1995, at the peak of the epidemic, >5,000 cases and >200 deaths were reported. As in Russia, >80% of these cases were diagnosed in persons 16-59 years old. In 1993, the government of Ukraine initiated a program of increased immunization among children and at-risk adults, and by 1995, a mass immunization strategy was adopted in an effort to arrest the epidemic, which was increasing exponentially. In 1996, the number of cases started to decrease, and data from 1998 indicate that the downward trend has continued. It is likely that the diphtheria epidemic in Ukraine started among children, who had been left vulnerable due to inadequate childhood immunizations, and then quickly spread to inadequately protected adults.

Adolescent↗
PubMed1999

Effectiveness and cost-effectiveness of linking the special supplemental program for women, infants, and children (WIC) and immunization activities.

OBJECTIVE: To raise immunization coverage among children at risk for underimmunization, we evaluated the effectiveness and cost-effectiveness of immunization activities in the Special Supplemental Program for Women, Infants and Children (WIC). METHOD: A controlled intervention trial was conducted in seven WIC sites in Chicago between October 1990 and March 1994. At intervention sites, staff screened children for vaccination status at every visit, referred vaccine-eligible children to either an on-site WIC nurse, on-site clinic, or off-site community provider, and issued either a 3-month supply of food vouchers to up-to-date children or a 1-month supply to children not up-to-date--a usual practice for high-risk WIC children. Our primary measure of effectiveness was the change in the baseline percentage of up-to-date children at the second birthday; cost-effectiveness was approximated for each of the three referral interventions. RESULTS: After one year, up-to-date vaccination coverage increased 23% above baseline for intervention groups and decreased 9% in the control group. After the second year, up-to-date vaccination further increased to 38% above baseline in intervention groups and did not change in the control group. The total cost per additional up-to-date child ranged from $30 for sites referring children off-site to $73 for sites referring children on-site to a nurse. CONCLUSION: This controlled intervention trial of screening, referral, and a voucher incentive in the WIC program demonstrated a substantial increase in immunization coverage at a low cost. Continuing to design linkages between WIC and immunization programs by building on WIC's access to at-risk populations is worth the investment.

Chicago↗
PubMed2026

Environmental benzene exposure induces a conserved neutrophil degranulation program across species.

Immune systems have evolved under constant pressure from pathogens and environmental challenges, leading to the emergence of conserved defense mechanisms across diverse organisms. Evidence indicates that environmental exposures perturb immune regulatory networks, particularly during development, when transcriptional programs governing hematopoiesis, immune cell differentiation, and inflammatory signaling are highly dynamic and sensitive to external stressors. Volatile organic compounds represent an important but incompletely understood source of immunological perturbation. Among these, benzene is a ubiquitous environmental contaminant associated with hematotoxicity and immune dysregulation; however, transcriptional responses to environmentally relevant low-level exposures during development remain poorly characterized. To determine whether benzene exposure engages conserved cross-species immune regulatory pathways, we performed a comparative transcriptomic analysis integrating developmental tissues from 3 vertebrate systems: human placenta, murine placenta, and zebrafish larvae. Bulk RNA sequencing datasets were analyzed to identify transcriptional responses associated with benzene exposure in experimental models (&#x2264;5&#x2009;ppm) and with benzene adduct levels in maternal plasma for human samples. Because placental gene expression exhibits strong sexual dimorphism, murine datasets were stratified by fetal sex. Pathway- and network-level analyses were used to identify conserved biological responses. We observed a striking convergence on activation of innate immune pathways associated with neutrophil degranulation, IL-8 signaling, and Rho GTPase-mediated inflammatory responses. Further, network analyses identified CXCL8 and ERK1/2 as shared regulatory hubs linking transcriptional responses across datasets. Together, these findings uncover an evolutionarily conserved innate immune signature associated with benzene exposure during vertebrate development, suggesting that environmental chemical perturbations may disrupt fundamental immune regulatory programs across species.

Animals↗
PubMedDate not supplied

Multimodal chronic pain rehabilitation program: its effect on immune function, depression, and health behaviors.

This pilot study examined the effects of a multimodal pain rehabilitation program on the immune function, self-reported pain, depression levels, and health behaviors of patients with chronic back pain. It also estimated the relationships between self-reported pain levels, immune function, depression, and health behaviors. Data were collected at week 1 (baseline) and at week 4 (last week of treatment program) on a convenience sample of 23 patients. In general, the patients' mean T lymphocyte proliferation levels showed a decline from baseline to week 4, while natural killer cell activity showed a slight increase in cell lysis. None of the findings were statistically significant. Failure to detect significant differences may be attributed to a small effect size due to the relatively small sample size. The depression levels dropped significantly during the treatment program (p = .001). Reported levels of pain and health behaviors did not significantly change. More research is needed to determine treatment effects on immune function as well as relationships between pain levels, immune function, depression, and health behaviors in this patient population.

Adolescent↗
PubMed1995

Medicaid free distribution programs and availability of childhood immunizations in rural practices.

BACKGROUND: The impact of a federal program that provides free childhood immunizations to private physicians for their Medicaid patients was examined. The aim of the study was to find out whether the program affected the availability of immunizations in rural and urban family physicians' practices. METHODS: A survey form about physician practice policies was sent to a stratified sample of 1,184 urban and rural family physicians in six states. States that participated in the federal free vaccine program were matched with states in the same region that did not participate in this program. RESULTS: States with no free vaccine distribution program showed a significant difference in the availability of immunizations from rural family physicians, compared with urban physicians (52% vs 87%, P < .001). However, in states with free distribution programs, no difference was found between rural and urban physicians (90% vs 94%, P = .18). In states without free distribution programs, immunization availability showed a positive and significant correlation with the size of the community where the physician practiced (Pearson correlation coefficient = .48, P < .001), whereas no correlation between community size and immunization availability existed in states with a free distribution program (Pearson correlation coefficient = .04, P = .53). CONCLUSION: Federal programs that offer free childhood immunizations to physicians for use in Medicaid populations have a dramatic effect on increasing immunization availability in rural areas.

Child↗
PubMed1999

Evaluation of a campaign to improve immunization in a rural headstart program.

This study evaluated an intervention to improve immunization rates in a high poverty, medically underserved rural area employing a pretest-posttest design. The intervention expanded immunization availability, established walk-in appointment policies, and introduced intensified parent education. Formative evaluation indicated specific messages with high salience to parents. As a result, the susceptibility and severity of childhood infectious disease, the outcome efficacy of vaccines, and methods to reduce barriers to immunization were emphasized in communications with parents. Data on DTP1-4, OPV1-3, and MMR were obtained from preschools, local health departments and private medical practices before (n = 567) and after the intervention (n = 331). Following adjustment for birth order and demographics, at post-intervention a significantly greater proportion of children received 6 of 8 vaccines on time. Effect sizes were large. For example, post MMR rates were at least 2X greater than pre rates. Time-series analysis of trend data on local newspaper coverage of child health topics suggested history was not a major threat to the internal validity of this pre-post only design. The findings indicate that comprehensive intervention, targeting improvements in the availability of pediatric care, health system policies and parent behavior, can improve immunization.

Attitude to Health↗
PubMed1994

Childhood immunizations and the Vaccines for Children program.

The use of vaccines to prevent infectious diseases is a hallmark of modern preventive medicine and public health. During this century, improvements in immunization practices have dramatically reduced the number of reported cases of potentially serious diseases such as diphtheria, measles, mumps, pertussis, poliomyelitis, rubella, and tetanus. Yet, despite such reductions, outbreaks of vaccine-preventable diseases continue to occur. Recent outbreaks of measles and pertussis, particularly in underimmunized and unimmunized children, raise concern regarding the effectiveness of existing childhood immunization practices. Such concern is stimulating action from policymakers, physicians, and public health professionals to improve childhood immunization programs in this country. This article discusses one of these programs, the Vaccines for Children (VFC) program, which is part of a new federal initiative to improve childhood immunization levels. Enlisting the support and participation of private physicians is crucial to the success of this national immunization strategy.

Child↗
PubMed1994

Measles-mumps-rubella immunization of susceptible hospital employees during a community measles outbreak: cost-effectiveness and protective efficacy.

OBJECTIVE: To determine cost-effectiveness and protective efficacy of a program to identify and immunize susceptible hospital employees during a measles outbreak. DESIGN: A cost analysis was made of blind measles-mumps-rubella (MMR) immunization versus directed MMR immunization based on 2,000 employees born after December 31, 1956. A directed MMR immunization program for susceptible employees was instituted. Actual costs of the program were calculated at the conclusion of the program. SETTING: A medical center complex with more than 4,000 employees, two acute care community hospitals, and a tertiary care children's hospital. RESULTS: A directed MMR immunization program was projected to be less expensive than blind immunization ($23,106 versus $70,720). MMR vaccine was administered to 169 of 188 susceptible employees. Actual cost of the directed MMR immunization program was $25,384. CONCLUSIONS: The directed MMR immunization program was cost-effective and prevented secondary cases among hospital employees during a community measles outbreak.

Community-Acquired Infections↗