Parental financial incentives and quasi- mandatory interventions e. Even if confirmed to be effective, widespread implementation of these interventions is dependent on acceptability to parents, professionals and other stakeholders. Here we use Triangulation Protocol to synthesise findings from the three studies.
There was a consistent recognition that incentives and quasi- mandatory interventions could be effective, particularly in more disadvantaged groups. Universal incentives were consistently preferred to targeted ones, but relative preferences for quasi- mandatory interventions and universal incentives varied between studies.
The qualitative work revealed a consistent belief that financial incentives were not considered an appropriate motivation for vaccinating children. The costs of financial incentive interventions appeared particularly salient and there were consistent concerns in the qualitative work that incentives did not represent the best use of resources for promoting preschool vaccinations. Various suggestions for improving delivery of the current UK vaccination programme as an alternative to incentives and quasi-mandates were made.
Parental financial incentives and quasi- mandatory. Background Childhood vaccinations are a core component of public health programmes globally. Results There was a consistent recognition that incentives and quasi- mandatory interventions could be effective, particularly in more disadvantaged groups. What do dental students think about mandatory laptop programs?
In spite of efforts by many dental schools to provide information technology resources for students, only a handful of studies have been conducted to determine what dental students think about these initiatives. There are no reports in the literature describing students' perceptions of mandatory laptop programs , which are now being implemented by at least 25 percent of North American dental schools. In schools that have implemented laptop programs , students are required either to enroll with their own laptops that meet specifications or to purchase a laptop from the school at matriculation.
In some schools, students are also required to purchase curriculum support software that is bundled with the laptop. This study was conducted to determine students' opinions at U. Responses of students at schools that purchased packaged curriculum support software from a commercial vendor were compared with students' responses at schools where faculty provided their own educational software. Responses were also compared among freshmen, sophomores, and upperclassmen in a cross-sectional sample.
In , approximately dental students at fourteen dental schools responded to eleven questions that requested their impressions and evaluation of mandatory laptop programs and associated educational software. The new Italian mandatory vaccine Law as a health policy instrument against the anti- vaccination movement. In Italy, the Parliament granted recently the final approval to a law introducing a long list of childhood vaccinations mandatory for preschool and school-age children. Before the approval, a vibrant public debate took place on the traditional media, in the social networks and among policymakers because of the so called "anti- vaccination movement".
In this paper, we discuss about ethical aspects and relationship between individual rights and public health. The role of social networks and the Internet is also essential to disseminate correct informations, influencing health behaviours and contributing to educating people about this major public health issue in a right way.
Finally, new and specific educational programmes are needed in order to transmit the young generation the means to correctly understand scientific research about this controversial issue. To examine how demographic, general health, religious, and political characteristics influenced beliefs about mandatory school vaccinations and history of vaccination refusal for children among Ohio Appalachian parents.
Multivariate logistic regression models were used to identify correlates of parental beliefs about mandatory school vaccinations and history of refusing a doctor-recommended vaccine for their child ren. The study findings provide information to better understand factors related to vaccination refusal among parents in Appalachia Ohio that can be used to design interventions to improve vaccination uptake.
Federal Register , , , , Mandatory vaccination : understanding the common good in the midst of the global polio eradication campaign. Shelly Kamin-Friedman explored the legal and ethical dimensions of this policy. This commentary makes three claims: 1 Mandatory vaccination is a valid exercise of the state's police powers to protect the common good. This commentary offers grounds to support state powers to protect the public's health and safety.
It shows why governments have both the duty and power to safeguard the collective good. State powers also have limits, whose boundaries are determined by the public health necessity. If the state is reasonably using the least restrictive intervention to achieve an important public health objective, it is well within the limits of its authority. The commentary uses legal and ethical norms and evidence to support its conclusions. Finding the most effective, least invasive intervention is fact-specific.
The essence of public health law is to recognize the state's power and duty to safeguard the public's health and safety, and to establish and enforce limits on those powers. SETTING This study took place at 3 university medical centers with mandatory influenza vaccination policies and 4 Veterans Affairs VA healthcare systems with nonmandatory influenza vaccination policies. METHODS To determine the incidence and duration of absenteeism in outpatient settings, HCP participating in the Respiratory Protection Effectiveness Clinical Trial at both mandatory and nonmandatory vaccination sites over 3 viral respiratory illness VRI seasons reported their influenza vaccination status and symptomatic days absent from work weekly throughout a week period during the peak VRI season each year.
The adjusted effects of vaccination and other modulating factors on absenteeism rates were estimated using multivariable regression models. These findings should be considered in formulating HCP influenza vaccination policies. Infect Control Hosp Epidemiol ; Drug Testing Programs Mandatory Guidelines which took effect on October 1, address the role and Federal employee drug testing results that seek approval by the Secretary must submit their qualifications Although vaccines have had a tremendous impact in public health they are questioned by certain groups that consider them unnecessary or unsafe and argue in favor of the right to decide to be vaccinated or not.
However vaccines must have special considerations because unlike other medical decisions, not vaccinating has consequences not only for the individual but also for other members of the community. Immunizing a high proportion of the population limits the circulation of an infectious agent attaining what is called herd immunity that protects the susceptible members of the group. For this reason many countries consider vaccination mandatory as a responsibility of every citizen.
This committee agrees with this view but thinks other strategies should be implemented as well, such as special educational efforts for the public and parents addressing benefits and real risks of vaccinating. Also health care professionals should be trained in vaccines. The notification system for adverse events currently available should be improved and be more accessible. Persons truly affected by adverse events due to vaccination should receive on time responses and be offered psychological and financial support.
Finally all stakeholders should make coordinated efforts to work together to deliver messages that answer concerns on vaccines and bring confidence back to the public. Defensible space features: impact of voluntary versus mandatory programs on a homeowner's attitudes and actions. Our research examined homeowner responses to local efforts that encourage mitigation of wildland fire risks on private property. We were specifically interested in whether there were different attitudes toward, and different compliance responses to, voluntary versus mandatory programs aimed at managing vegetation for fire risks.
We chose four sites for the diversity of Discusses mandatory continuing professional education MCPE in Australia for the legal and accountancy professions. Considers whether the main concern is continuing education or the certification by professional bodies of their members as competent to practice.
Concludes that program designers should recognize that there are educational as well…. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center.
Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests.
For patients who were prescribed pain medications, Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain. Effectiveness and acceptability of parental financial incentives and quasi- mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment.
Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi- mandatory policies restricting access to child care or educational settings to fully vaccinated children have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi- mandatory schemes for increasing the uptake of preschool vaccinations.
Systematic review, qualitative study and discrete choice experiment DCE with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations , or quasi- mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention.
Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi- mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives.
Quasi- mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi- mandatory interventions, which were preferred to targeted. We analyzed both data sources to describe the varicella epidemiology related to vaccination coverage after initiation of routine childhood varicella vaccination and to evaluate both notification systems regarding informative value and data quality.
We looked at trends, age distribution and incidences using Microsoft Excel and Stata Vaccination coverage data were available from health insurance claims data. The incidence in the NFS declined from 32 to 12 out of , Increasing vaccination coverage and decreasing varicella cases demonstrate the success of routine childhood varicella vaccination.
Mandatory notification data allow incidence calculation; The sentinel system has been providing more detailed information about vaccination status, better data quality and continuous national data since , irrespective of the Infectious disease protection act.
Objectives Transmission of polio poses a threat to military forces when deploying to regions where such viruses are endemic. US-born soldiers generally enter service with immunity resulting from childhood immunization against polio; moreover, new recruits are routinely vaccinated with inactivated poliovirus vaccine IPV , supplemented based upon deployment circumstances. Given residual protection from childhood vaccination , risk-based vaccination may sufficiently protect troops from polio transmission.
Methods This analysis employed a mathematical system for polio transmission within military populations interacting with locals in a polio-endemic region to evaluate changes in vaccination policy. The overall number of new infections among nondeployed populations was negligible for both scenarios due to high childhood immunization rates, partial protection against transmission conferred by IPV, and low global disease incidence levels. Conclusion Risk-based immunization driven by deployment to polio-endemic regions is sufficient to prevent transmission among both deployed and nondeployed US military populations.
Transmission of polio poses a threat to military forces when deploying to regions where such viruses are endemic. This analysis employed a mathematical system for polio transmission within military populations interacting with locals in a polio-endemic region to evaluate changes in vaccination policy.
Risk-based immunization driven by deployment to polio-endemic regions is sufficient to prevent transmission among both deployed and nondeployed US military populations. Mandatory presuit mediation: 5-year results of a medical malpractice resolution program. The Florida Patient Safety and Presuit Mediation Program FLPSMP is a mandatory mediation program designed to provide deserving patients with fast, fair compensation while limiting the healthcare provider expenses incurred during traditional litigation.
Mediation occurs before litigation begins; therefore, patients with meritorious claims receive compensation often years earlier than they would with extended litigation. This early mediation fosters confidential and candid communication between doctors and patients, which promotes early fact-finding and candid discussion.
In an article previously published in this journal, we discussed the positive trend observed 2 years after the implementation of the FLPSMP. This article incorporates 5 years of data, which includes new benchmarks with state and national data, to demonstrate that the program can be used successfully as a medical malpractice solution.
Influenza vaccination program for elderly outpatients. The effect of pharmacist interventions on the rate at which elderly outpatients were offered influenza vaccination was studied. Pharmacists at a university-based ambulatory-care facility reviewed the medical records of a random sample of control patients over the age of 65 who had been seen during the influenza vaccination months in or or both years.
The purpose was to estimate the percentage of patients who had been documented as being offered influenza vaccination. In an intervention program was undertaken consisting of inservice presentations to the facility's nursing staff, dissemination of influenza information sheets to patients upon check-in, placement of wall posters, placement of reminders in patient charts, and institution and advertisement of a vaccination clinic.
At the end of the vaccination season, the records of a random sample of intervention group patients were reviewed to determine the proportion of patients who had been offered influenza virus vaccine. A combination of pharmacist-initiated interventions significantly increased the number of elderly patients who were offered vaccinations during scheduled clinic visits.
Two vaccination systems have been employed in Japan, the routine vaccination and the voluntary vaccination. Claims after the routine vaccination are demanded to the Ministry of Health, Labour and Welfare through local governments, and compensation is more expenses. Meanwhile, claims after the voluntary vaccination are demanded to the Pharmaceuticals and Medical Device Agency directly, and compensation is less compared with the routine vaccination.
Current biodefense vaccine programs and challenges. The Joint Science and Technology Office's mission is to invest in transformational ideas, innovative people and actionable technology development for Chemical and Biological Defense solutions, with the primary goal to deliver Science and Technology products and capabilities to the warfighter and civilian population that outpace the threat.
This commentary focuses on one thrust area within this mission: the Vaccine program of the Joint Science and Technology Office's Translational Medical Division. US school morbidity and mortality, mandatory vaccination , institution closure, and interventions implemented during the influenza A H1N1 pandemic. The H1N1 pandemic disproportionately affected school-aged children, but only school-based outbreak case studies have been conducted.
The purposes of this study were to evaluate US academic institutions' experiences during the H1N1 pandemic in terms of infection prevention interventions implemented and to examine factors associated with school closure during the pandemic. An online survey was sent to school nurses in May through July Hierarchical logistic regressions were used to determine predictive models for having a mandatory H1N1 vaccination policy for school nurses and school closure.
In all, 1, nurses from 26 states participated. Very few nurses 3. Determinants of having a mandatory H1N1 vaccination policy were being employed by a hospital or public health agency, and the school being located in a western or northeastern state. Schools should develop and continue to improve their pandemic plans, including collaborating with community response agencies.
Since January 1, , Government legislation in Western Australia required all workers in construction to complete mandatory safety awareness training before they began work on site. During the implementation of this new legislation there was considerable resistance from the construction sector due to the mandatory nature of the training. Mandatory criteria for cardiac rehabilitation programs : guidelines from the Portuguese Society of Cardiology.
Cardiac rehabilitation CR is a multidisciplinary process for patients recovering after an acute cardiac event or with chronic cardiovascular disease that reduces mortality and morbidity and improves quality of life. It is considered a cost-effective intervention and is expressly indicated in the guidelines of the major medical societies.
In view of the underuse of CR in Portugal, we call the attention of the health authorities to the need to increase the number and national coverage of CR programs , while maintaining high quality standards. The aim is for all patients resident in Portugal who are eligible for CR programs to have the same opportunities for access and attendance.
In order to preserve the benefits and safety of this intervention, CR needs to be performed according to international guidelines. The fact that various initiatives in this field have been developed by different professional groups, some of them non-medical, that do not follow the European guidelines, has prompted us to prepare a series of norms defining mandatory criteria for CR, based on current knowledge and evidence.
In this way we aim to ensure that the required increase in the number of CR programs , linked in a national network of CR centers, does not detract from the need to maintain their efficacy and quality. These criteria should serve as the basis for the future accreditation of CR centers in Portugal.
Alcohol violations and aviation accidents: findings from the U. Mandatory alcohol testing has been implemented in the U. This study documents the prevalence of alcohol violations and the association between alcohol violations and aviation accidents among aviation employees with safety-sensitive functions.
Data from the random alcohol testing and post-accident alcohol testing programs reported by major airlines to the Federal Aviation Administration for the years through were analyzed. Relative and attributable risks of accident involvement associated with alcohol violations were estimated using the case-control method.
During the study period, random alcohol testing yielded a total of violations, with an overall prevalence rate of 0. Alcohol violations were associated with an increased yet not statistically significant risk of accident involvement odds ratio 2. Alcohol violations among U. Mandatory Alcohol Testing Program. Introduction: Mandatory alcohol testing has been implemented in the U. Methods: Data from the random alcohol testing and post-accident alcohol testing programs reported by major airlines to the Federal Aviation Administration for the years through were analyzed.
Results: During the study period, random alcohol testing yielded a total of violations, with an overall prevalence rate of 0. Discussion: Alcohol violations among U. The first approved dengue vaccine , CYD-TDV, a chimeric, live-attenuated, tetravalent dengue virus vaccine , was recently licensed in 13 countries, including Brazil. In light of recent vaccine approval, we modeled the cost-effectiveness of potential vaccination policies mathematically based on data from recent vaccine efficacy trials that indicated that vaccine efficacy was lower in seronegative individuals than in seropositive individuals.
In our analysis, we investigated several vaccination programs , including routine vaccination , with various vaccine coverage levels and those with and without large catch-up campaigns. As it is unclear whether the vaccine protects against infection or just against disease, our model incorporated both direct and indirect effects of vaccination. We found that in the presence of vaccine -induced indirect protection, the cost-effectiveness of dengue vaccination decreased with increasing vaccine coverage levels because the marginal returns of herd immunity decreases with vaccine coverage.
All routine dengue vaccination programs that we considered were cost-effective, reducing dengue incidence significantly. Our results show that dengue vaccination would be cost-effective in Brazil even with a relatively low vaccine efficacy in seronegative individuals. Vaccine cold chain: Part 2. Training personnel and program management. The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine , leading to insufficient immunity of vaccinated individuals.
Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Prior to this publication, trivalent Evaluation of the mandatory construction induction training program in Western Australia: unanticipated consequences.
The construction industry viewed this as an unnecessary impost as they considered that there was already sufficient safety training delivered through individual company and site inductions. In , we evaluated the new Construction Induction Training CIT in the commercial construction sector in Western Australia to find that since there has been an unanticipated change in support for the mandatory training.
The study shows a shift in the values of the safety culture for the commercial sector of the construction industry. In , the industry not only supports the mandatory CIT, but is very vocal in its request to re-institute the refresher courses that were withdrawn in This study indicates that in this case, mandatory training has had a positive effect on safety culture change and gradually reduced work-related injury in the industry since to the present.
The paper uses data from two studies conducted in and to highlight the unanticipated change in perception of the value of mandatory safety training in the WA construction industry to one which is positive and supportive. Published by Elsevier Ltd. The Reauthorization Act directed the Secretary to engage in negotiated rulemaking to make required regulatory changes for mandatory wholesale pork reporting and establish a negotiated Iodine nutrition status in lactating mothers residing in countries with mandatory and voluntary iodine fortification programs : an updated systematic review.
Forty-two studies met the inclusion criteria. Although universal salt iodization is still the. Three years after the introduction of a voluntary hepatitis B vaccination program , the Harvard School of Dental Medicine has achieved a high vaccination rate among predoctoral students and a moderate rate among postdoctoral students and faculty.
However, an unexpectedly low immunity was achieved, even among vaccinated individuals. Cost-effectiveness of an influenza vaccination program offering intramuscular and intradermal vaccines versus intramuscular vaccine alone for elderly. Intradermal ID injection is an alternative route for influenza vaccine administration in elderly with potential improvement of vaccine coverage.
This study aimed to investigate the cost-effectiveness of an influenza vaccination program offering ID vaccine to elderly who had declined intramuscular IM vaccine from the perspective of Hong Kong public healthcare provider. Model inputs were derived from literature.
Sensitivity analyses evaluated the impact of uncertainty of model variables. An influenza vaccination program offering ID vaccine to elderly who had declined IM vaccine appears to be a highly cost-effective option. Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination? Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated.
Given the high efficacy and immunogenicity of the vaccine , the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination.
A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined.
We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated , then the possibility of eradication of targeted types becomes much more favourable.
We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible.
However, the level of adult vaccination coverage required is modest and may be achieved. Ragonnet, Romain; Trauer, James M. Vaccine effect, as measured in clinical trials, may not accurately reflect population-level impact. Furthermore, little is known about how sensitive apparent or real vaccine impacts are to factors such as the risk of re-infection or the mechanism of protection.
We present a dynamic compartmental model to simulate vaccination for endemic infections. Several measures of effectiveness are calculated to compare the real and apparent impact of vaccination , and assess the effect of a range of infection and vaccine characteristics on these measures. Although broadly correlated, measures of real and apparent vaccine effectiveness can differ widely. Vaccine impact is markedly underestimated when primary infection provides partial natural immunity, when coverage is high and when post- vaccination infectiousness is reduced.
Latent periods result in greater real impacts when risk of re-infection is high, but this effect diminishes if partial natural immunity is assumed. Assessments of population-level vaccine effects against endemic infections from clinical trials may be significantly biased, and vaccine and infection characteristics should be considered when modelling outcomes of vaccination programs , as their impact may be dramatic.
Vaccination uptake and awareness of a free hepatitis B vaccination program among female commercial sex workers. We sought to explore the reach of a free hepatitis B vaccination program among female commercial sex workers CSWs within a legalized prostitution setting in the Netherlands. We also investigated the reasons for nonparticipation and noncompliance.
In this cross-sectional study based on ethnographic mapping and targeted sampling, CSWs were interviewed at their work in 3 regions in the Netherlands. The semistructured interviews contained questions on sociodemographics, sexual risk behavior, sex work, awareness of the opportunity to obtain free hepatitis B vaccination , vaccination uptake, and compliance with the full vaccination schedule.
A personal approach by health professionals or was associated with vaccination uptake, when specific sociodemographic variables, sexual behavior, and sex work related covariates were controlled for in the analysis. Window prostitution and the duration of working in the region were associated with awareness of the opportunity to obtain free hepatitis B vaccination.
The results of this study suggest that outreach activities i. Transient CSWs are more difficult to reach within the current vaccination program. These results can be used to increase the success of future health programs among this risk group. Implementing a province-wide mandatory vaccinate -or-mask policy at healthcare facilities in British Columbia, Canada. In , British Columbia BC became the first Canadian province to implement an influenza prevention policy requiring healthcare workers HCW to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season.
Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. Implementation of a vaccinate -or-mask influenza policy is complex.
This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities. High efficacy and students' satisfaction after voluntary vs mandatory use of an e-learning program in traumatology and orthopedics--a follow-up study.
Within the last decade, e-learning has gained a consistent place in surgical teaching. However, as the use of new programs is often voluntary, more information on the implications of the data regarding user acceptance and knowledge with mandatory use is desirable, especially in the context of the long-term developments of courses. Starting in , the e-learning program Network for Students in Traumatology and Orthopedics was offered in a voluntary blended learning context.
Students' satisfaction and increase in knowledge were evaluated using questionnaires and written tests. With proven effectiveness, the program became a mandatory part of the curriculum, and students' attitudes and gain of knowledge were re-evaluated in and to detect differences in voluntary vs mandatory use. Significantly more students felt better prepared for clinical situations p mandatory use. The presented blended learning concept was an efficient way to teach students orthopedics and traumatology.
Data can support the assumption that even if the voluntary evaluation of e-learning offerings might be subject to a selection bias, the results can serve as a representative impression for the students' overall mood and their gain in knowledge. However, as changes would have to be anticipated when shifting to mandatory use, users' perceptions should be constantly evaluated. We estimated sudden deaths over 10 years based on published attributable risk of exercise-related sudden death due to SCT.
Conclusion Universal sickle cell screening of NCAA Division I student-athletes will identify a substantial number of sickle cell carriers. A successful intervention could prevent about seven deaths over a decade. Vaccines for human papillomavirus infection: a critical analysis. This article takes a critical look at the pros and cons of human papillomavirus HPV vaccines. There is enough evidence to suggest that the prophylactic vaccines are efficacious in preventing various benign and malignant conditions including cervical cancers caused by HPV.
Even though the vaccine is costly, hypothetical analysis has shown that HPV vaccination will be cost effective in the long run. Therapeutic HPV vaccines used to treat established disease are still undergoing evaluation in clinical studies, and results seem to be encouraging. Although several countries have started mandatory vaccination programs with the prophylactic HPV vaccines , conservatives have voiced concerns regarding the moral impact of such vaccination programs.
The cross-sectional study gathered descriptive data through a survey research design. Providers of healthcare were recruited through an email containing a link to an question online survey. Ninety eight percent of the responding facilities reported that they offered the HPV vaccine. The majority of respondents The most common barrier to HPV vaccination was identified as the parental misconception that HPV vaccination is associated with sexual activity.
Providers believed that the best way to increase HPV vaccination is through counseling parents and adolescents on the benefits of HPV vaccination and to correct misconceptions and change attitudes. Providers are desirous of receiving HPV web-based or workplace training.
Four years have passed since HPV vaccination "crisis" occurred in June In Japan,a publicly funded HPV vaccination program for adolescent females aged years began in December However,the Japanese government withdrew its recommendation for HPV vaccination in June, because news reports on potential adverse effects of HPV vaccines without any medical evidence appeared repeatedly.
The suspension of recommendation for vaccination has continued to the present,though there is no scientific or epidemiologic evidence to demonstrate the causal linkage between post- vaccination symptoms and the HPV vaccines.
Very recently,an ecological investigation reported that similar symptoms also occur in unvaccinated adolescents in Japan. Medical organizations in Japan are also calling for a resumption of the HPV vaccination program. Now,the resumption of the recommendation needs a political judgment.
The VICP went into effect on October 1, and is a Federal "no-fault" system designed to compensate individuals, or families of individuals, who have been injured by covered vaccines. On the basis of the deaths and extensive suffering to patients and families from the adverse reactions to vaccines , all physicians must provide detailed information in the Vaccine Information Statement to the patient or the parent or legal guardian of the child about the potential dangers of vaccines as well as the VICP.
Designed to guide those who want to replicate a similar program at their institutions, this article examines Xavier University's experience with The Business Profession, a required, noncredit series of career-related events that business majors take over a 4-year period.
This program was developed in response to research indicating that early…. We explored potential cost-effectiveness of a chlamydia vaccine for young women in the United States by using a compartmental heterosexual transmission model. We tracked health outcomes acute infections and sequelae measured in quality-adjusted life-years [QALYs] and determined incremental cost-effectiveness ratios ICERs over a year analytic horizon.
We assessed vaccination of year-old girls and catch-up vaccination for 15—year-old women in the context of an existing chlamydia screening program and assumed 2 prevaccination prevalences of 3. The ICER was most sensitive to prevaccination prevalence for women, followed by cost of vaccination , duration of vaccine -conferred immunity, and vaccine efficacy.
Our results suggest that a successful chlamydia vaccine could be cost-effective. India has the highest number of deaths among children younger than 5 years of age globally; the majority are from vaccine preventable diseases. Untimely vaccination unnecessarily prolongs susceptibility to disease and contributes to the burden of childhood morbidity and mortality, yet there is scarce literature on vaccination delays. The aim of this study is to characterize the timeliness of childhood vaccinations administered under India's routine immunization program using a novel application of an existing statistical methodology.
This study utilized the district level household and facility survey data, from India using vaccination data from children with and without immunization cards. Turnbull estimator of the cumulative distribution function was used to estimate the probability of vaccination at each age.
Lack of timely administration of key childhood vaccines , especially DPT3 and MCV, remains a major challenge in India and likely contributes to the significant burden of vaccine preventable disease-related morbidity and mortality in children. Vaccines are an extraordinary instrument of immunization of the population against infectious diseases. Around them there are many ethical issues. One of the most debated is what to do with certain groups opposition to vaccination of their children.
States have managed in different ways the conflict between the duty of vaccination and the refusal to use vaccines : some impose the vaccination and others simply promote it. In this article we deal with which of these two approaches is the most suitable from an ethical and legal point of view. We stand up for the second option, which is the current one in Spain, and we propose some measures which should be kept in mind to improve immunization programs.
Assessment of a strain 19 brucellosis vaccination program in elk. Maichak, Eric J. Zoonotic diseases in wildlife present substantial challenges and risks to host populations, susceptible domestic livestock populations, and affected stakeholders.
Brucellosis, a disease caused by the bacterium Brucella abortus, is endemic among elk Cervus canadensis attending winter feedgrounds and adjacent areas of western Wyoming, USA. To minimize transmission of brucellosis from elk to elk and elk to livestock, managers initiated a B. We used brucellosis prevalence — and reproductive outcome — data collected from female elk attending feedgrounds to assess efficacy of the strain 19 program while controlling for potentially confounding factors such as site and age.
From our generalized linear models, we found that seroprevalence of brucellosis was 1 not lower following inception of vaccination ; 2 not inversely associated with proportion of juveniles vaccinated over time; 3 not inversely associated with additional yearlings and adults vaccinated over time; and 4 associated more with feeding end-date than proportion of juveniles vaccinated. Using vaginal implant transmitters in adult females that were seropositive for brucellosis, we found little effect of vaccination coverage at reducing reproductive failures i.
Because we found limited support for efficacy of the strain 19 program , we support research to develop an oral vaccine and suggest that continuing other spatio-temporal management actions will be most effective to minimize transmission of brucellosis and reduce dependency of elk on supplemental winter feeding.
The early effects of Medicare's mandatory hospital pay-for-performance program. To evaluate the impact of hospital value-based purchasing HVBP on clinical quality and patient experience during its initial implementation period July March We performed a difference-in-differences analysis, comparing performance on 12 incentivized clinical process and 8 incentivized patient experience measures between hospitals exposed to the program and a matched comparison group of nonexposed hospitals.
We also evaluated whether hospitals that were ultimately exposed to HVBP may have anticipated the program by improving quality in advance of its introduction. Difference-in-differences estimates indicated that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program 's first implementation period.
Estimates from our preferred specification showed that HVBP was associated with a 0. We found some evidence that hospitals improved performance on clinical process measures prior to the start of HVBP, but no evidence of this phenomenon for the patient experience measures. The timing of the financial incentives in HVBP was not associated with improved quality of care.
It is unclear whether improvement for the clinical process measures prior to the start of HVBP was driven by the expectation of the program or was the result of other factors. Mandatory Drug Testing Programs. Li, Guohua; Baker, Susan P. Aims To assess the role of drug violations in aviation accidents. Design Case-control analysis. Setting Commercial aviation in the United States. Measurements Point prevalence of drug violations, odds ratio of accident involvement, and attributable risk in the population.
Findings The prevalence of drug violations was 0. The odds of accident involvement for employees who tested positive for drugs was almost three times the odds for those who tested negative odds ratio 2. Marijuana accounted for The proportion of illicit drugs represented by amphetamines increased progressively during the study period, from 3.
Rotavirus diarrhea is one of the most important vaccine -preventable causes of severe diarrhea in children worldwide. This study aim was to evaluate the cost-effectiveness of the utilization of RV1 compared with RV5 in Argentina. A deterministic Markov model based on the lifetime follow up of a static cohort was used. A review of the literature to obtain epidemiologic and resources utilization of rotavirus diarrhea was performed.
The sources used to estimate epidemiologic parameters were the National Health Surveillance System, the national mortality statistics and national database of hospital discharges records. Costs were obtained from different health subsectors and are expressed in local currency. When comparing RV1 vs. This information is a valuable input regarding the incorporation of this kind of vaccines into the national vaccination programs.
To estimate the societal economic and health impacts of Maine's school-based influenza vaccination SIV program during the A H1N1 influenza pandemic. Primary and secondary data covering the and influenza seasons. We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program 's impact on immunization among six age groups.
We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis. We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain.
Economic benefits were positive in 98 percent of Monte Carlo simulations. SIV may be a cost-beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups. Sustainability of school-located influenza vaccination programs in Florida.
Tran, Cuc H. Paul; Small, Parker A. Background School-located influenza vaccination SLIV programs are a promising strategy for increasing vaccination coverage among schoolchildren. However, questions of economic sustainability have dampened enthusiasm for this approach in the United States. We collected programmatic expenditures and volunteer hours to calculate fixed and variable costs for two different implementation costs with or without in-kind costs included.
We project program sustainability for Florida using publicly available county-specific student populations and health insurance enrollment data. Finding optimal vaccination strategies under parameter uncertainty using stochastic programming. We present a stochastic programming framework for finding the optimal vaccination policy for controlling infectious disease epidemics under parameter uncertainty.
Stochastic programming is a popular framework for including the effects of parameter uncertainty in a mathematical optimization model. The problem is initially formulated to find the minimum cost vaccination policy under a chance-constraint. We also show how to formulate the problem in two additional cases: a finding the optimal vaccination policy when vaccine supply is limited and b a cost-benefit scenario. The class of epidemic models for which this method can be used is described and we present an example formulation for which the resulting problem is a mixed-integer program.
A short numerical example based on plausible parameter values and distributions is given to illustrate how including parameter uncertainty improves the robustness of the optimal strategy at the cost of higher coverage of the population. Results derived from a stochastic programming analysis can also help to guide decisions about how much effort and resources to focus on collecting data needed to provide better estimates of key parameters.
Planning influenza vaccination programs : a cost benefit model. Background Although annual influenza vaccination could decrease the significant economic and humanistic burden of influenza in the United States, immunization rates are below recommended levels, and concerns remain whether immunization programs can be cost beneficial. The research objective was to compare cost benefit of various immunization strategies from employer, employee, and societal perspectives.
Methods An actuarial model was developed based on the published literature to estimate the costs and benefits of influenza immunization programs. Useful features of the model included customization by population age and risk-level, potential pandemic risk, and projection year.
Various immunization strategies were modelled for an average U. The primary outcome measure reported net cost savings per vaccinated PV from the perspective of various stakeholders. Results Given a typical U. Sensitivity analysis confirmed the scenario-based findings. Conclusions Both universal and targeted vaccination programs can be cost beneficial. Proper planning with cost models can help employers and policy makers develop strategies to improve the impact of immunization programs.
Public awareness regarding children vaccination in Jordan. Immunization can contribute to a dramatic reduction in number of vaccine -preventable diseases among children. The aim of this study is to investigate mothers' awareness about child vaccines and vaccination in Jordan. This study was a community-based, cross-sectional study that was performed at public places in Irbid City. Data was collected from mothers. After verbal approval, mothers were interviewed to assess their knowledge, attitudes, and practice toward vaccination.
Results show that majority of mothers had acceptable knowledge and positive attitude toward vaccination. Most of mothers Lower knowledge was observed among mothers Most mothers Vaccination delay was reported by about In conclusion, vaccination coverage rate is high; however, some aspects of knowledge, attitudes, and practice of vaccination need to be improved.
Knowledge and attitudes of mothers were directly associated with their practice of vaccination. Medical staff education about vaccination during each visit seems to be the most effective tool that directly reflects on better practice of vaccination such as reducing the possibility for vaccination delay. The US Court of Federal Claims, which adjudicates cases for the National Vaccine Injury Compensation Program , has been confronted with more than cases submitted on behalf of children with autism spectrum disorders, seeking to link the condition to vaccination.
Through a test case process, the Omnibus Autism Proceedings have in every instance found no association between autism spectrum disorders and vaccines. However, vaccine advocates have criticized the courts for having an overly permissive evidentiary test for causation and for granting credence to insupportable accusations of vaccine harm. In fact, the courts have functioned as intended and have allowed for a fair hearing of vaccine concerns while maintaining confidence in vaccines and providing protection to vaccine manufacturers.
Plaspohl, Sara S. Literature provides evidence that school attendance correlates with academic performance and student success. Influenza is a contributing factor to school absences. Primary prevention for influenza includes immunization. School-located influenza vaccine SLIV programs provide greater access for students to be immunized. Contributor James Y. Contributor Gerald A. Contributor Thomas C. Contributor Milton S. Contributor Michael P. Contributor Linda L. Contributor Michael F.
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Law DOI: Scheifele and Shelly A. McNeil and Brian J. Bettinger and Scott A. Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory policies American Journal of Infection Control Susan Quach and Jennifer A. Pereira and Jeffrey C. Pereira and Christine L. Heidebrecht and Jeffrey C. Vaccine hesitancy: An overview.
Scheifele and Tobias R. Kollmann and Scott A. Halperin and Joanne M. Langley and Julie A. Al-Dabbagh and K. Lapphra and D. Halperin and J. Langley and P. Cho and T. Kollmann and Y. Li and G. Fortuno and J. Measuring influenza immunization coverage among health care workers in acute care hospitals and continuing care organizations in Canada American Journal of Infection Control Susan Quach and Jennifer A.
Pereira and Jemila S. Hamid and Lois Crowe and Christine L. Kwong and Maryse Guay and Natasha S. Chambers and Sherman D. Quan and Julie A. How best to describe the risk of meningococcal B infection? Determinants of parents' decision to vaccinate their children against rotavirus: results of a longitudinal study Health Education Research E.
Dube and J. Bettinger and B. Halperin and R. Bradet and F. Lavoie and C. Sauvageau and V. Gilca and N. Boulianne DOI: Evaluation of meningococcal serogroup C conjugate vaccine programs in Canadian children: Interim analysis Vaccine Julie A. Kellner and Otto G. Gilca and C. Sauvageau and J. Bettinger and F.
Boucher and S. McNeil and I. Gemmill and F. Lavoie and M. Ouakki and N. Slogrove and B. Reikie and S. Naidoo and C. De Beer and K. Ho and M. Cotton and J. Bettinger and D. Speert and M. Esser and T. Kollmann DOI: The changing and dynamic epidemiology of meningococcal disease Vaccine Scott A. Bettinger and Brian Greenwood and Lee H. Harrison and Jane Jelfs and Shamez N. Ramsay and Marco A.
Exploring the feasibility of integrating barcode scanning technology into vaccine inventory recording in seasonal influenza vaccination clinics Vaccine Jennifer A. Pereira and Susan Quach and Jemila S. Hamid and Christine L. Heidebrecht and Sherman D. Buckeridge and Julie A. Bettinger and Donna Kalailieff and Jeffrey C. Kwong DOI: Sauvageau and R. Bradet and J. Boulianne and F. Lavoie DOI: Boucher and Julie A. Time and motion study to compare electronic and hybrid data collection systems during the pandemic H1N1 influenza vaccination campaign Vaccine Susan Quach and Jemila S.
Hamid and Jennifer A. Heidebrecht and Julie Foisy and Julie A. Bettinger and Laura Rosella and Natasha S. Crowcroft and Shelley L. Deeks and Sherman D. Quan DOI: Approaches to immunization data collection employed across Canada during the Pandemic H1N1 influenza vaccination campaign Canadian Journal of Public Health Halperin and Wendy Vaudry and David W. Acceptability of Internet adverse event self-reporting for pandemic and seasonal influenza immunization among health care workers Vaccine Keswadee Lapphra and Simon Dobson and Julie A.
Bettinger and Laura J. Greenberg and Martha Doemland and Julie A. The effect of routine vaccination on invasive pneumococcal infections in Canadian children, Immunization Monitoring Program, Active — Vaccine Julie A. Scheifele and James D. Kellner and Scott A. Why collect individual-level vaccination data? Rotavirus vaccination: results of a longitudinal study on determinants of Canadian parents' decision Canadian Journal of Infectious Diseases and Medical Microbiology Canadian family physicians' and paediatricians' opinions and intentions regarding hepatitis A and B infection and their prevention by vaccination Canadian Journal of Infectious Diseases and Medical Microbiology Surveillance for adverse events following adjuvanted pandemic influenza vaccine in Canadian children Canadian Journal of Infectious Diseases and Medical Microbiology Priorities for new vaccination programs implementation: paediatricians' and family physicians' opinions Canadian Journal of Infectious Diseases and Medical Microbiology Rotavirus serotypes results from an impact emergency department study Canadian Journal of Infectious Diseases and Medical Microbiology Canadian family physicians' and paediatricians' opinions toward A H1N1 pandemic vaccine before and after vaccination campaign onset Canadian Journal of Infectious Diseases and Medical Microbiology Clinic staff perceptions of data collection methodologies used during the H1N1 influenza campaign in Canada Canadian Journal of Infectious Diseases and Medical Microbiology Approaches to immunization data collection employed across Canada during the H1N1 vaccination campaign Canadian Journal of Infectious Diseases and Medical Microbiology Time and motion study to compare electronic and hybrid data collection systems during the pandemic H1N1 influenza vaccination campaign Canadian Journal of Infectious Diseases and Medical Microbiology Acceptability of web-based influenza immunization adverse event self-reporting among health care workers American Journal of Epidemiology Rotavirus testing and admitting practices in 12 pediatric hospitals: implications for surveillance American Journal of Epidemiology Hospital acquired rotavirus infections: substantial disease burden in Canadian Pediatric hospitals Child: care, health, and development Scheifele and Julie A.
Influenza vaccination in paediatric nurses: Cross-sectional study of coverage, refusal, and factors in acceptance Vaccine Seamus P. Norton and David W. Bettinger and Robert M. West DOI: Burgess and Aaron F. Hirschfeld and Gregory J. Tyrrell and Julie A. Bettinger and Stuart E.
Turvey DOI: Scheifele and Julie Bettinger and David M. Tyrrell DOI: Prevalence of Toll-like receptor signalling defects in apparently healthy children who developed invasive pneumococcal infection Clinical Immunology Aaron F. Hirschfeld and Julie A. Bettinger and Rachel E. Victor and Donald J. Davidson and Andrew J. Currie and J. Mark Ansermino and David W. Scheifele and Jordan S.
Orange and Stuart E. Bettinger and Phyllis E. Kozarsky DOI: Morbidity and mortality of invasive meningococcal disease in Canada Canadian Journal of Infectious Diseases and Medical Microbiology Effectiveness of influenza vaccine in preventing hospitalization of children months of age Canadian Journal of Infectious Diseases and Medical Microbiology Bettinger and Nancy E.
Adler and Frank C. Curriero and Jonathan M. Ellen DOI: Bettinger and David D. Celentano and Frank C. Curriero and Nancy E. Adler and Susan G. They are absolutely ridiculous and, I can't stand how they have the nerve to ask for these tests to be completed prior to even knowing whether you're accepted to the position or not Would they get real arealdy? They've got to be kidding One recruiter drilled me so much about a job - I thought she was desperate to sell me on it and it was not all that!
Avoid like the plague or Consumer beware — Do your homework when selecting an agency. Let us start with the positive; the accounting and payroll departments are very good. Negative aspects: Do you want assignments? Do you want good paying assignments? Do you want staffing counselors who are respectful and take time to answer your questions? If these are your expectations of a good agency, then do not look at Bettingers.
Assignments: after the initial one, it usual takes weeks to receive another one and that is after some badgering of staff. Staffing counselors are not as courteous as they would appear after the initial meeting it is down hill , and usually do not call you back for days as well as seem to be for the client and not the temporary worker. Example: If temporary worker is having an issue with the client, they do not usually investigate or immediately give temporary worker support.
The counselor usually advises to quit or tells them to lump it or leave it! Come on you earned it Why isn't it automatically given? That leads me to my final point: this agency is out strictly for every dollar and do not really push temporary-to-hire. I am not the only one of the same opinion other former and present workers have the same complaints.
You ask who I am. I am a Bettinger's Temp.
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