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Sample records for childhood immunization programme

  1. Childhood immunization

    Science.gov (United States)

    Romain, Sandra; Schillaci, Michael A.

    2009-01-01

    ABSTRACT OBJECTIVE To examine childhood immunization levels relative to the number of family physicians, pediatricians, and public health nurses in Ontario. DESIGN Retrospective comparative analysis of publicly available data on immunization coverage levels and the relative number of family physicians, pediatricians, and public health nurses. SETTING Ontario. PARTICIPANTS Seven-year-old children, family physicians, pediatricians, and public health nurses in Ontario. MAIN OUTCOME MEASURES The association between immunization coverage levels and the relative number of family physicians, pediatricians, and public health nurses. RESULTS We found correlations between immunization coverage levels and the relative number (ie, per 1000 Ontario residents) of family physicians (ρ = 0.60) and pediatricians (ρ = 0.70) and a lower correlation with the relative number of public health nurses (ρ = 0.40), although none of these correlations was significant. A comparison of temporal trends illustrated that variation in the relative number of family physicians and pediatricians in Ontario was associated with similar variation in immunization coverage levels. CONCLUSION Increasing the number of family physicians and pediatricians might help to boost access to immunizations and perhaps other components of cost-saving childhood preventive care. PMID:19910599

  2. Instant Childhood Immunization Schedule

    Science.gov (United States)

    ... Recommendations Why Immunize? Vaccines: The Basics Instant Childhood Immunization Schedule Recommend on Facebook Tweet Share Compartir Get ... date. See Disclaimer for additional details. Based on Immunization Schedule for Children 0 through 6 Years of ...

  3. The Changing World of Childhood Immunizations

    Science.gov (United States)

    Graville, Iris

    2010-01-01

    Theories and practices in early childhood education continually evolve, and the same is true in the health field. Such change is especially apparent in the area of childhood immunizations. Since vaccination to prevent smallpox was first started in the late 1700s, recommendations for which immunizations to give and when to give them have been…

  4. Early Childhood Development and E-Learning in Africa: The Early Childhood Development Virtual University Programme

    Science.gov (United States)

    Pence, Alan

    2007-01-01

    This article explores the development and evaluation of the graduate-level Early Childhood Development Virtual University (ECDVU) programme in Sub-Saharan Africa from 2001 through to 2004. It outlines the history of the ECDVU and the establishing of a Sub-Saharan programme for future leaders in the early childhood field guided by the key principle…

  5. Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

    Science.gov (United States)

    Vonasek, Bryan J; Bajunirwe, Francis; Jacobson, Laura E; Twesigye, Leonidas; Dahm, James; Grant, Monica J; Sethi, Ajay K; Conway, James H

    2016-01-01

    Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents' understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers' knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018-1.802). When asked why vaccination rates may be low in their community, the two most common responses were "fearful of side effects" and "ignorance/disinterest/laziness" (44% each). The factors influencing caregivers' demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates.

  6. Knowledge, attitude and practice of childhood immunization among ...

    African Journals Online (AJOL)

    Background and Objectives: Vaccine preventable diseases cause significant morbidity ... This study determined childhood immunization uptake and associated factors ... The commonest immunizations missed were measles and yellow fever.

  7. Motivating consumers for National Programme on Immunization (NPI) and Oral Rehydration Therapy (ORT) in Nigeria.

    Science.gov (United States)

    Ekerete, P P

    1997-01-01

    The Expanded Programme on Immunization (EPI) (changed to National Programme on Immunization (NPI) in 1996) and Oral Rehydration Therapy (ORT) were launched in Nigeria in 1979. The goal of EPI was Universal Childhood Immunization (UCI) 1990, that is, to vaccinate 80% of all children age 0-2 years by 1990, and 80% of all pregnant women were also expected to be vaccinated with Tetanus Toxoid Vaccine. The Oral Rehydration Therapy was designed to teach parents with children age 0-5 years how to prepare and use a salt-sugar solution to rehydrate children dehydrated by diarrhoea. Nigeria set up Partners-in-Health to mobilize and motivate mothers to accept the programme. In 1990 a National coverage survey was conducted to assess the level of attainment. The results show that some states were able to reach the target and some were not. It therefore became necessary to evaluate the contribution of those promotional elements adopted by Partners-in-Health to motivate mothers to accept the programme. The respondents were therefore asked to state the degree to which these elements motivated them to accept the programme. The data were collected and processed through a Likert rating scale and t-test procedure for test of significance between two sample means. The study revealed that some elements motivated mothers very strongly, others strongly, and most moderately or low, with health workers as major sources of motivation. The study also revealed that health workers alone can not sufficiently motivate mothers without the help of religious leaders, traditional leaders and mass media, etc. It was therefore recommended that health workers should be intensively used along with other promotional elements to promote the NPI/ORT programme in Nigeria.

  8. The Role of Childhood Infections and Immunizations on Childhood Rhabdomyosarcoma: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Sankaran, Hari; Danysh, Heather E; Scheurer, Michael E; Okcu, M Fatih; Skapek, Stephen X; Hawkins, Douglas S; Spector, Logan G; Erhardt, Erik B; Grufferman, Seymour; Lupo, Philip J

    2016-09-01

    Rhabdomyosarcoma (RMS) is a rare, highly malignant tumor arising from primitive mesenchymal cells that differentiate into skeletal muscle. Relatively little is known about RMS susceptibility. Based on growing evidence regarding the role of early immunologic challenges on RMS development, we evaluated the role of infections and immunizations on this clinically significant pediatric malignancy. RMS cases (n = 322) were enrolled from the third trial coordinated by the Intergroup Rhabdomyosarcoma Study Group. Population-based controls (n = 322) were pair matched to cases on race, sex, and age. The following immunizations were assessed: diphtheria, pertussis, and tetanus (DPT); measles, mumps, and rubella; and oral polio vaccine. We also evaluated if immunizations were complete versus incomplete. We examined selected infections including chickenpox, mumps, pneumonia, scarlet fever, rubella, rubeola, pertussis, mononucleosis, and lung infections. Conditional logistic regression models were used to calculate an odds ratio (OR) and 95% confidence interval (CI) for each exposure, adjusted for maternal education and total annual income. Incomplete immunization schedules (OR = 5.30, 95% CI: 2.47-11.33) and incomplete DPT immunization (OR = 1.56, 95% CI: 1.06-2.29) were positively associated with childhood RMS. However, infections did not appear to be associated with childhood RMS. This is the largest study of RMS to date demonstrating a possible protective effect of immunizations against the development of childhood RMS. Further studies are needed to validate our findings. Our findings add to the growing body of literature, suggesting a protective role of routine vaccinations in childhood cancer and specifically in childhood RMS. © 2016 Wiley Periodicals, Inc.

  9. Childhood immunization: when physicians and parents disagree.

    Science.gov (United States)

    Gilmour, Joan; Harrison, Christine; Asadi, Leyla; Cohen, Michael H; Vohra, Sunita

    2011-11-01

    Persistent fears about the safety and efficacy of vaccines, and whether immunization programs are still needed, have led a significant minority of parents to refuse vaccination. Are parents within their rights when refusing to consent to vaccination? How ought physicians respond? Focusing on routine childhood immunization, we consider the ethical, legal, and clinical issues raised by 3 aspects of parental vaccine refusal: (1) physician counseling; (2) parental decision-making; and (3) continuing the physician-patient relationship despite disagreement. We also suggest initiatives that could increase confidence in immunization programs.

  10. Association of Childhood Obesity and the Immune System: A Systematic Review of Reviews.

    Science.gov (United States)

    Kelishadi, Roya; Roufarshbaf, Mohammad; Soheili, Sina; Payghambarzadeh, Farzaneh; Masjedi, Mohsen

    2017-08-01

    The growing prevalence of childhood obesity has become a serious health problem over the past decades. As the immune system is greatly affected by excess weight, in this review of reviews, we discuss the findings of review articles about the relationship between childhood/maternal obesity and children's immune system. We searched English-language articles in PubMed, Scopus, ISI Thomson Reuters, and Google Scholar databases. All relevant reviews, either systematic or narrative, were retrieved. Then their quality was assessed by using the Assessment of Multiple Systematic Reviews and International Narrative Systematic Assessment tools, respectively. In the final step, 26 reviews were included. Our review suggests that childhood obesity is associated with extensive changes in the serum levels of inflammatory and anti-inflammatory cytokines and proteins, as well as the number of immune cells and their behavior. Therefore, it might cause or exacerbate diseases such as asthma, allergy, atopic dermatitis (AD), and obstructive sleep apnea syndrome. Moreover, childhood obesity may reduce the immune system responsiveness to vaccines and microorganisms. Furthermore, studies suggest that maternal obesity increases the risk of asthma in offspring. Future studies are needed to determine different associations of childhood obesity with allergy, atophic dermatitis, and autoimmune diseases.

  11. Parents' knowledge, attitude, and practice on childhood immunization

    OpenAIRE

    Jolsna Joseph; Vijayalakshmi Devarashetty; S. Narayana Reddy; M. Sushma

    2015-01-01

    Background: The objective of present study was to determine the knowledge, attitude, and practices of parents regarding childhood immunization. Methods: A cross-sectional survey was conducted in immunization clinic at Vanivilas hospital, a government tertiary care center (G) attached to Bangalore Medical College and Research Institute and a private pediatric clinic (P) in Bengaluru. Data were collected from 200 parents/guardians (100 from each set up) using structured questionnaire adminis...

  12. A model immunization programme to control Japanese encephalitis in Viet Nam.

    Science.gov (United States)

    Yen, Nguyen Thu; Liu, Wei; Hanh, Hoang Duc; Chang, Na Yoon; Duong, Tran Nhu; Gibbons, Robert V; Marks, Florian; Thu, Nghiem Anh; Hong, Nguyen Minh; Park, Jin Kyung; Tuan, Pham Anh; Nisalak, Ananda; Clemens, John D; Xu, Zhi-Yi

    2015-03-01

    In Viet Nam, an inactivated, mouse brain-derived vaccine for Japanese encephalitis (JE) has been given exclusively to ≤ 5 years old children in 3 paediatric doses since 1997. However, JE incidence remained high, especially among children aged 5-9 years. We conducted a model JE immunization programme to assess the feasibility and impact of JE vaccine administered to 1-9 year(s) children in 3 standard-dose regimen: paediatric doses for children aged <3 years and adult doses for those aged ≥ 3 years. Of the targeted children, 96.2% were immunized with ≥ 2 doses of the vaccine. Compared to the national immunization programme, JE incidence rate declined sharply in districts with the model programme (11.32 to 0.87 per 100,000 in pre-versus post-vaccination period). The rate of reduction was most significant in the 5-9 years age-group. We recommend a policy change to include 5-9 years old children in the catch-up immunization campaign and administer a 4th dose to those aged 5-9 years, who had received 3 doses of the vaccine during the first 2-3 years of life.

  13. Perception of Childhood Immunization among Mothers of Under ...

    African Journals Online (AJOL)

    This work is distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 59. Perception of. Childhood .... these successes, immunization is an unfinished agenda. An estimated 19.3 million ...

  14. Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization.

    Science.gov (United States)

    Nabulsi, M M; Araj, G F; Nuwayhid, I; Ramadan, M; Ariss, M

    2001-04-01

    This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6.5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0.8% with increasing age-specific rates from 0% at 6 months to 1.3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2.9 %) and South Lebanon (1.6%). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitisB vaccine during the first year of life is needed.

  15. Maternal nutritional status during pregnancy and infant immune response to routine childhood vaccinations.

    Science.gov (United States)

    Obanewa, Olayinka; Newell, Marie-Louise

    2017-09-01

    To systematically review the association between maternal nutritional status in pregnancy and infant immune response to childhood vaccines. We reviewed literature on maternal nutrition during pregnancy, fetal immune system and vaccines and possible relationships. Thereafter, we undertook a systematic review of the literature of maternal nutritional status and infant vaccine response, extracted relevant information, assessed quality of the nine papers identified and present findings in a narrative format. From limited evidence of average quality, intrauterine nutrition deficiency could lead to functional deficit in the infant's immune function; child vaccine response may thus be negatively affected by maternal malnutrition. Response to childhood vaccination may be associated with fetal and early life environment; evaluation of programs should take this into account.

  16. Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

    OpenAIRE

    Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.

    2015-01-01

    Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether record...

  17. Inequity in childhood immunization in India: a systematic review.

    Science.gov (United States)

    Mathew, Joseph L

    2012-03-01

    Despite a reduction in disease burden of vaccine preventable diseases through childhood immunization, considerable progress needs to be made in terms of ensuring efficiency and equity of vaccination coverage. To conduct a systematic review to identify and explore factors associated with inequities in routine vaccination of children in India. Publications reporting vaccination inequity were retrieved through a systematic search of Medline and websites of the WHO, UNICEF and demographic health surveys in India. No restrictions were applied in terms of study designs. The primary outcome measure was complete vaccination or immunization defined as per the standard WHO definition. There were three nationwide data sets viz. the three National Family Health Surveys (NFHS), a research study conducted by the Indian Council of Medical Research (ICMR) and a UNICEF coverage evaluation survey. In addition, several publications representing different population groups or geographic regions were available. A small number of publications were reanalyses of data from the NFHS series. There is considerable inequity in vaccination coverage in different states. Within states, traditionally poor performing states have greater inequities, although there are significant inequities even within better performing states. There are significant inequities in childhood vaccination based on various factors related to individual (gender, birth order), family (area of residence, wealth, parental education), demography (religion, caste), and the society (access to health-care, community literacy level) characteristics. Girls fare uniformly worse than boys and higher birth order infants have lower vaccination coverage. Urban infants have higher coverage than rural infants and those living in urban slums. There is an almost direct relationship between household wealth and vaccination rates. The vaccination rates are lower among infants with mothers having no or low literacy, and families with

  18. The puzzle of immune phenotypes of childhood asthma.

    Science.gov (United States)

    Landgraf-Rauf, Katja; Anselm, Bettina; Schaub, Bianca

    2016-12-01

    Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully. This review summarizes recent key findings on the complex mechanisms of the development and manifestation of childhood asthma. Whereas traditional classification of childhood asthma is primarily based on clinical symptoms like wheezing and atopy, novel approaches to specify asthma phenotypes are under way and face challenges such as including the stability of phenotypes over time and transition into adulthood. Epidemiological studies enclose more information on the patient's disease history and environmental influences. Latest studies define endotypes based on molecular and cellular mechanisms, for example defining risk and protective single nucleotide polymorphisms (SNPs) and new immune phenotypes, showing promising results. Also, regulatory T cells and recently discovered T helper cell subtypes such as Th9 and Th17 cells were shown to be important for the development of asthma. Innate lymphoid cells (ILC) could play a critical role in asthma patients as they produce different cytokines associated with asthma. Epigenetic findings showed different acetylation and methylation patterns for children with allergic and non-allergic asthma. On a posttranscriptional level, miRNAs are regulating factors identified to differ between asthma patients and healthy controls and also indicate differences within asthma phenotypes. Metabolomics is another exciting chapter important for endotyping asthmatic children. Despite the development of new biomarkers and the discovery of

  19. A GROUP INTERVENTION PROGRAMME FOR ADULT SURVIVORS OF CHILDHOOD SEXUAL ABUSE

    Directory of Open Access Journals (Sweden)

    Fouché, Ansie

    2016-10-01

    Full Text Available This study reports on the core components of the Survivor to Thriver strengths-based group intervention programme for women who experienced childhood sexual abuse. It advocates a balanced approach and draws on an eclectic mix of theories, and has been field tested with two groups of women. An exposition of the philosophical and theoretical underpinnings, a description of the context, the role of the expert companion, outcomes and activities of the programme, evaluation methods and standard of care is provided. Finally, critical reflections on the intervention are discussed as well as limitations and the way forward.

  20. Evaluation of a clinical decision support algorithm for patient-specific childhood immunization.

    Science.gov (United States)

    Zhu, Vivienne J; Grannis, Shaun J; Tu, Wanzhu; Rosenman, Marc B; Downs, Stephen M

    2012-09-01

    To evaluate the effectiveness of a clinical decision support system (CDSS) implementing standard childhood immunization guidelines, using real-world patient data from the Regenstrief Medical Record System (RMRS). Study subjects were age 6-years or younger in 2008 and had visited the pediatric clinic on the campus of Wishard Memorial Hospital. Immunization records were retrieved from the RMRS for 135 randomly selected pediatric patients. We compared vaccine recommendations from the CDSS for both eligible and recommended timelines, based on the child's date of birth and vaccine history, to recommendations from registered nurses who routinely selected vaccines for administration in a busy inner city hospital, using the same date of birth and vaccine history. Aggregated and stratified agreement and Kappa statistics were reported. The reasons for disagreement between suggestions from the CDSS and nurses were also identified. For the 135 children, a total of 1215 vaccination suggestions were generated by nurses and were compared to the recommendations of the CDSS. The overall agreement rates were 81.3% and 90.6% for the eligible and recommended timelines, respectively. The overall Kappa values were 0.63 for the eligible timeline and 0.80 for the recommended timeline. Common reasons for disagreement between the CDSS and nurses were: (1) missed vaccination opportunities by nurses, (2) nurses sometimes suggested a vaccination before the minimal age and minimal waiting interval, (3) nurses usually did not validate patient immunization history, and (4) nurses sometimes gave an extra vaccine dose. Our childhood immunization CDSS can assist providers in delivering accurate childhood vaccinations. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Improving Latino Children's Early Language and Literacy Development: Key Features of Early Childhood Education within Family Literacy Programmes

    Science.gov (United States)

    Jung, Youngok; Zuniga, Stephen; Howes, Carollee; Jeon, Hyun-Joo; Parrish, Deborah; Quick, Heather; Manship, Karen; Hauser, Alison

    2016-01-01

    Noting the lack of research on how early childhood education (ECE) programmes within family literacy programmes influence Latino children's early language and literacy development, this study examined key features of ECE programmes, specifically teacher-child interactions and child engagement in language and literacy activities and how these…

  2. Individual, household, programme and community effects on childhood malnutrition in rural India.

    Science.gov (United States)

    Rajaram, S; Zottarelli, Lisa K; Sunil, T S

    2007-04-01

    The children living in rural areas of India disproportionately suffer from malnutrition compared with their urban counterparts. The present article analyses the individual, household, community and programme factors on nutritional status of children in rural India. Additionally, we consider the random variances at village and state levels after introducing various observed individual-, household- and programme-level characteristics in the model. A multilevel model is conducted using data from the National Family and Health Survey 2. The results show that maternal characteristics, such as socio-economic and behavioural factors, are more influential in determining childhood nutritional status than the prevalence of programme factors. Also, it was found that individual factors show evidence of state- and village-level clustering of malnutrition.

  3. Childhood Immunizations: First-Time Expectant Mothers' Knowledge, Beliefs, Intentions, and Behaviors.

    Science.gov (United States)

    Weiner, Judith L; Fisher, Allison M; Nowak, Glen J; Basket, Michelle M; Gellin, Bruce G

    2015-12-01

    This study focused on how first-time mothers decide or intend to decide with respect to the recommended childhood immunization schedule. This was the baseline survey of a larger longitudinal survey. Data were collected between June and September 2014 from 200 first-time mothers in their second trimester of pregnancy to examine vaccine-related knowledge, perceptions, intentions, and information-seeking behavior. Data were analyzed between January and June 2015. Seventy-five percent planned to have their child receive all the vaccinations consistent with the recommended childhood immunization schedule. Although participants expressed interest in childhood vaccine information, most had not received information directly from a primary care provider. One third reported receiving such information from their obstetrician/gynecologist but only about half of those were "very satisfied" with the information they received. About 70% indicated they were not familiar with the recommended vaccination schedule and number of routinely recommended vaccines. Familiarity with common vaccine education messages varied widely. Women who indicated they were planning to delay one or more recommended vaccinations were most likely to rely on Internet searches for childhood vaccine information. Overall, respondents had relatively positive beliefs and perceptions regarding childhood vaccines, which were associated with intentions to get their newborn vaccinated as recommended. However, most who were planning to delay recommended vaccinations or were undecided relied primarily on socially available sources of vaccine information, rather than information provided by a healthcare professional. Improved access to vaccine information from healthcare professionals could foster better vaccine-related knowledge and favorably impact vaccination decisions. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Childhood immunization, vaccine hesitancy, and provaccination policy in high-income countries

    DEFF Research Database (Denmark)

    Thomsen, Frej Klem

    2017-01-01

    Increasing vaccine hesitancy among parents in high-income countries and the resulting drop in early childhood immunization constitute an important public health problem, and raise the issue of what policies might be taken to promote higher rates of vaccination. This article first outlines the bac...

  5. Incomplete Early Childhood Immunization Series and Missing Fourth DTaP Immunizations; Missed Opportunities or Missed Visits?

    Science.gov (United States)

    Robison, Steve G

    2013-01-01

    The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limited by missing fourth DTaP-containing immunizations (diphtheria/tetanus/pertussis) due at 15 to 18 months of age. Missing 4th DTaP immunizations are associated either with a lack of visits at 15 to 18 months of age, or to visits without immunizations. Typical immunization data however cannot distinguish between these two reasons. This study compared immunization records from the Oregon ALERT IIS with medical encounter records for two-year olds in the Oregon Health Plan. Among those with 3 valid DTaPs by 9 months of age, 31.6% failed to receive a timely 4th DTaP; of those without a 4th DTaP, 42.1% did not have any provider visits from 15 through 18 months of age, while 57.9% had at least one provider visit. Those with a 4th DTaP averaged 2.45 encounters, while those with encounters but without 4th DTaPs averaged 2.23 encounters.

  6. Childhood Immunization

    Science.gov (United States)

    ... lowest levels in history, thanks to years of immunization. Children must get at least some vaccines before ... child provide protection for many years, adults need immunizations too. Centers for Disease Control and Prevention

  7. Latin American immigrant parents and their children's teachers in U.S. early childhood education programmes.

    Science.gov (United States)

    Crosnoe, Robert; Ansari, Arya

    2015-12-01

    For many immigrants, their children's schools offer their first sustained interaction with the major societal institutions of their new countries, and so exploring the ways in which immigrant parents manage their children's educational experiences offers insight into how they adapt to new cultural norms, customs and expectations and how they are treated in return. This study delved into the involvement of Latin American immigrant parents in U.S. education, shifting the traditional focus down from elementary and secondary school to early childhood education. Statistical analysis of nationally representative data revealed that Latina immigrants had lower frequencies of most home- and community-based involvement behaviours than U.S.-born and foreign-born parents of varying racial/ethnic backgrounds but higher frequencies of involvement behaviours requiring participation in early childhood education programmes. As a window into these national patterns, qualitative data from an early childhood programme in an immigration-heavy state revealed that Latina immigrant mothers and their children's teachers often talked about each other as partners in supporting children's educational experiences but that their actual interactions tended to socialise mothers into being more passive recipients of teachers' directives. © 2015 International Union of Psychological Science.

  8. Limited availability of childhood overweight and obesity treatment programmes in Danish paediatric departments

    DEFF Research Database (Denmark)

    Eg, Marianne; Cortes, Dina; Johansen, Anders

    2016-01-01

    INTRODUCTION: The prevalence of children and adolescents with overweight and obesity has tripled over the past 30 years. One in five children in Denmark is overweight, a condition which is accompanied by serious medical and psychosocial complications. So far, an overview of the Danish treatment...... of departments offered less comprehensive programmes. The final third offered no multidisciplinary treatment programme for the target group. The criteria for referral to the paediatric departments that offered obesity programmes were heterogeneous. FUNDING: Funding for this study was received from Region...... of childhood overweight and obesity has been lacking. METHODS: Telephone interviews with all Danish paediatric departments were conducted in 2014. The results, constituting a baseline, were analysed using the clinical guidelines for overweight and obesity published by the Danish Paediatric Society's Overweight...

  9. Limited availability of childhood overweight and obesity treatment programmes in Danish paediatric departments

    DEFF Research Database (Denmark)

    Eg, Marianne; Cortes, Dina; Johansen, Anders

    2016-01-01

    INTRODUCTION: The prevalence of children and adolescents with overweight and obesity has tripled over the past 30 years. One in five children in Denmark is overweight, a condition which is accompanied by serious medical and psychosocial complications. So far, an overview of the Danish treatment...... of departments offered less comprehensive programmes. The final third offered no multidisciplinary treatment programme for the target group. The criteria for referral to the paediatric departments that offered obesity programmes were heterogeneous. FUNDING: Funding for this study was received from Region...... of childhood overweight and obesity has been lacking. METHODS: Telephone interviews with all Danish paediatric departments were conducted in 2014. The results, constituting a baseline, were analysed using the clinical guidelines for overweight and obesity published by the Danish Paediatric Society’s Overweight...

  10. Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India.

    Science.gov (United States)

    Mohanan, Manoj; Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

    2017-05-01

    To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers' performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. The programme did not significantly improve health-care providers' knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up.

  11. Monitoring and Evaluation of an Early Childhood Development Programme: Implications for Leadership and Management

    Science.gov (United States)

    Hodgson, Sarah; Papatheodorou, Theodora; James, Mary

    2014-01-01

    The article aims to discuss preliminary findings from a participatory monitoring and evaluation (M&E) framework, used in a community-based early childhood development (ECD) programme in KwaZulu-Natal South Africa, and their implications for leadership and management. The purposes of the M&E were for LETCEE, the implementing organization,…

  12. The Relations Between Immunity, Oxidative Stress and Inflammation Markers, in Childhood Obesity.

    Science.gov (United States)

    Laura Anca, Popescu; Bogdana, Virgolici; Olivia, Timnea; Horia, Virgolici; Dumitru, Oraseanu; Leon, Zagrean

    2014-10-01

    Oxidative stress, inflammation and insulin resistance are the principal culprits in childhood obesity. Immune modifications are also important in the development of the obesity complications.The aim of this study is to find the relations for some immunity parameters with markers for oxidative stress and inflammation. Sixty obese children (10-16 years old) and thirty age and sex matched lean children were involved. The activities for erythrocyte superoxid dismutase (SOD), for erythrocyte glutathione peroxidase (GPx) and serum thioredoxin level were measured by ELISA, as oxidative stress markers. Circulating immune complexes (CIC), complement fractions C3, C4 and the self-antibodies, antismooth muscle antibodies (ASMA), antiliver-kidney microsome antibodies (LKM1) were measured by ELISA methods. Ceruloplasmin, haptoglobin and C reactive protein (CRP) were measured as inflammatory markers by immunoturbidimetric methods. ceruloplasmin (pLKM1 and ASMA and GPx activity were not modified between groups. Positive correlations (for pLKM1 (r=0.37), GPx activity and ASMA (r=0.27), haptoglobin and C3 (r=0.33), ceruloplasmin and CIC (r=0.41), CRP and C3 (p<0.27) and negative correlations were calculated for C4 both with GPx activity (r= -0.28) and with thioredoxin level (r= -0.27). In the obese children versus the lean ones, higher levels for C3 (p<0.001), C4(p<0.001), CIC (p<0.05), In conclusion, this study demonstrates that immune modifications, inflammation and oxidative stress are related and they act in cluster in childhood obesity. Copyright © 2014. Published by Elsevier Inc.

  13. Recommendations for pneumococcal immunization outside routine childhood immunization programs in Western Europe.

    Science.gov (United States)

    Castiglia, Paolo

    2014-10-01

    The global burden of pneumococcal diseases is high, with young children and adults≥50 years of age at highest risk of infection. Two types of vaccine are available for the prevention of pneumococcal diseases caused by specific Streptococcus pneumoniae serotypes: the pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccine (PCV7, PCV10, and PCV13). Despite pneumococcal immunization programs in adults and children, the burden in adults has remained high. Most European countries have national or local/regional vaccination recommendations. The objective of this review was to provide an overview of the government recommendations for pneumococcal vaccination outside routine childhood vaccination programs for 16 Western European countries as of August 2014. We found that recommendations for pneumococcal immunization across Europe are complex and vary greatly among countries in terms of age groups and risk groups recommended for vaccination, as well as which vaccine should be administered. Clarifying or simplifying these recommendations and improving their dissemination could help to increase pneumococcal vaccine uptake and decrease the high burden of pneumococcal diseases in adults, both through a direct effect of the vaccine and via a herd effect in unvaccinated individuals.

  14. Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

    Science.gov (United States)

    Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

    2017-01-01

    Abstract Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme – the World Health Partners’ Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were assessed using hypothetical patient vignettes and the standardized patient method both before and after programme implementation, in 2011 and 2014, respectively. Differences in providers’ performance between implementation and nonimplementation areas were assessed using multivariate difference-in-difference linear regression models. Findings The programme did not significantly improve health-care providers’ knowledge or performance with regard to childhood diarrhoea or pneumonia in Bihar. There was a persistent large gap between knowledge of appropriate care and the care actually delivered. Conclusion Social franchising has received attention globally as a model for delivering high-quality care in rural areas in the developing world but supporting data are scarce. Our findings emphasize the need for sound empirical evidence before social franchising programmes are scaled up. PMID:28479635

  15. Internet Exposure Associated With Canadian Parents' Perception of Risk on Childhood Immunization: Cross-Sectional Study.

    Science.gov (United States)

    Tustin, Jordan Lee; Crowcroft, Natasha Sarah; Gesink, Dionne; Johnson, Ian; Keelan, Jennifer

    2018-01-19

    There is a large presence of provaccination and antivaccination content on the Internet. The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment. No other studies have investigated the association between seeking vaccine information online and Canadian parents' perception of risk on childhood immunization. We aimed to investigate the potential association between seeking vaccine information on the Internet and Canadian parents' perception of risk on childhood immunization in order to quantify the perceived association and increase our understanding on the impact of the Internet to help guide public health interventions. We analyzed this association in two population samples: a self-selecting Web-based sample of Canadian parents recruited through Facebook (n=966) and a population-based sample of parents recruited by random digit dialing (RDD; n=951). The outcome was parental perception of vaccine safety on a seven-point ordinal scale from "not safe" to "extremely safe." An ordinal regression model was used to investigate if Internet information seeking on childhood vaccination predicted parental perception of vaccine safety. After adjusting for income level, Internet reliability, age of parent, and region, the odds of perceiving vaccines as less safe rather than more safe were 1.6 times higher (95% CI 1.3-2.1) for parents who used the Internet to search for vaccination information compared to parents who did not search the Internet in the Web-based sample, and 2.0 times higher (95% CI 1.6-2.5) in the population-based RDD sample. The results suggest the Internet is significantly associated with Canadian parents' negative perception of vaccine risk. Governmental and scientific sectors should consider the development and implementation of

  16. Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India.

    OpenAIRE

    Mohanan, M.; Giardili, S.; Das, V.; Rabin, T. L.; Raj, S. S.; Schwartz, J. I.; Seth, A.; Goldhaber-Fiebert, J. D.; Miller, G.; Vera-Hernández, M.

    2017-01-01

    OBJECTIVE: To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme - the World Health Partners' Sky Program. METHODS: We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Providers were ...

  17. Evaluation of a social franchising and telemedicine programme and the care provided for childhood diarrhoea and pneumonia, Bihar, India

    OpenAIRE

    Mohanan, Manoj; Giardili, Soledad; Das, Veena; Rabin, Tracy L; Raj, Sunil S; Schwartz, Jeremy I; Seth, Aparna; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hern?ndez, Marcos

    2017-01-01

    Abstract Objective To evaluate the impact on the quality of the care provided for childhood diarrhoea and pneumonia in Bihar, India, of a large-scale, social franchising and telemedicine programme ? the World Health Partners? Sky Program. Methods We investigated changes associated with the programme in the knowledge and performance of health-care providers by carrying out 810 assessments in a representative sample of providers in areas where the programme was and was not implemented. Provider...

  18. Tradeoffs between immune function and childhood growth among Amazonian forager-horticulturalists.

    Science.gov (United States)

    Urlacher, Samuel S; Ellison, Peter T; Sugiyama, Lawrence S; Pontzer, Herman; Eick, Geeta; Liebert, Melissa A; Cepon-Robins, Tara J; Gildner, Theresa E; Snodgrass, J Josh

    2018-04-24

    Immune function is an energetically costly physiological activity that potentially diverts calories away from less immediately essential life tasks. Among developing organisms, the allocation of energy toward immune function may lead to tradeoffs with physical growth, particularly in high-pathogen, low-resource environments. The present study tests this hypothesis across diverse timeframes, branches of immunity, and conditions of energy availability among humans. Using a prospective mixed-longitudinal design, we collected anthropometric and blood immune biomarker data from 261 Amazonian forager-horticulturalist Shuar children (age 4-11 y old). This strategy provided baseline measures of participant stature, s.c. body fat, and humoral and cell-mediated immune activity as well as subsample longitudinal measures of linear growth (1 wk, 3 mo, 20 mo) and acute inflammation. Multilevel analyses demonstrate consistent negative effects of immune function on growth, with children experiencing up to 49% growth reduction during periods of mildly elevated immune activity. The direct energetic nature of these relationships is indicated by ( i ) the manifestation of biomarker-specific negative immune effects only when examining growth over timeframes capturing active competition for energetic resources, ( ii ) the exaggerated impact of particularly costly inflammation on growth, and ( iii ) the ability of children with greater levels of body fat (i.e., energy reserves) to completely avoid the growth-inhibiting effects of acute inflammation. These findings provide evidence for immunologically and temporally diverse body fat-dependent tradeoffs between immune function and growth during childhood. We discuss the implications of this work for understanding human developmental energetics and the biological mechanisms regulating variation in human ontogeny, life history, and health.

  19. Lot quality assurance sampling for monitoring immunization programmes: cost-efficient or quick and dirty?

    Science.gov (United States)

    Sandiford, P

    1993-09-01

    In recent years Lot quality assurance sampling (LQAS), a method derived from production-line industry, has been advocated as an efficient means to evaluate the coverage rates achieved by child immunization programmes. This paper examines the assumptions on which LQAS is based and the effect that these assumptions have on its utility as a management tool. It shows that the attractively low sample sizes used in LQAS are achieved at the expense of specificity unless unrealistic assumptions are made about the distribution of coverage rates amongst the immunization programmes to which the method is applied. Although it is a very sensitive test and its negative predictive value is probably high in most settings, its specificity and positive predictive value are likely to be low. The implications of these strengths and weaknesses with regard to management decision-making are discussed.

  20. Immune system development during early childhood in tropical Latin America: evidence for the age-dependent down regulation of the innate immune response.

    Science.gov (United States)

    Teran, Rommy; Mitre, Edward; Vaca, Maritza; Erazo, Silvia; Oviedo, Gisela; Hübner, Marc P; Chico, Martha E; Mattapallil, Joseph J; Bickle, Quentin; Rodrigues, Laura C; Cooper, Philip J

    2011-03-01

    The immune response that develops in early childhood underlies the development of inflammatory diseases such as asthma and there are few data from tropical Latin America (LA). This study investigated the effects of age on the development of immunity during the first 5 years of life by comparing innate and adaptive immune responses in Ecuadorian children aged 6-9 months, 22-26 months, and 48-60 months. Percentages of naïve CD4+ T cells declined with age while those of memory CD4(+) and CD8(+) T cells increased indicating active development of the immune system throughout the first five years. Young infants had greater innate immune responses to TLR agonists compared to older children while regulatory responses including SEB-induced IL-10 and percentages of FoxP3(+) T-regulatory cells decreased with age. Enhanced innate immunity in early life may be important for host defense against pathogens but may increase the risk of immunopathology. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. Childhood life events, immune activation and the development of mood and anxiety disorders: the TRAILS study.

    Science.gov (United States)

    Jonker, I; Rosmalen, J G M; Schoevers, R A

    2017-05-02

    The experience of childhood life events is associated with higher vulnerability to develop psychiatric disorders. One of the pathways suggested to lead to this vulnerability is activation of the immune system. The aim of this study is to find out whether the association between childhood life events and the development of mood and anxiety disorders is predicted by the activation of the immune system. This study was performed in TRAILS, a large prospective population cohort, from which a subgroup was selected (N=1084, 54.3% female, mean age 19.0 (s.d., 0.6)). Childhood life events before age 16 were assessed using questionnaires at age 12, 14, 16 and 19. Immune activation was assessed at age 16 by elevated high-sensitive C-reactive protein (hsCRP) and by levels of immunoglobulin G antibodies against the herpes viruses herpes simplex virus 1, cytomegalovirus and Epstein-Barr virus. At age 19, the presence of mood and anxiety disorders was determined using the World Health Organization Composite International Diagnostic Interview Version 3.0. Regression analyses were used to study the association between life events, the inflammatory markers and mental health. We found that childhood life events score was associated with risk of mood disorders (B=0.269, P<0.001) and anxiety disorders (B=0.129, P<0.001). Childhood life events score was marginally associated with elevated hsCRP (B=0.076, P=0.006), but not with the antibody levels. This was especially due to separation trauma (P=0.015) and sexual abuse (P=0.019). Associations lost significance after correcting for lifestyle factors such as body mass index and substance abuse (P=0.042). None of the inflammatory markers were associated with development of anxiety disorders or mood disorders. In conclusion, the life event scores predicted the development of anxiety disorders and mood disorders at age 19. Life event scores were associated with elevated hsCRP, which was partly explained by lifestyle factors. Elevated hs

  2. District-level variations in childhood immunizations in India: The role of socio-economic factors and health infrastructure.

    Science.gov (United States)

    Rammohan, Anu; Awofeso, Niyi

    2015-11-01

    Routine childhood immunizations against measles and DPT are part of the World Health Organization's (WHO) Expanded Program on Immunization (EPI) set up in 1974, with the aim of reducing childhood morbidity and mortality. Despite this, immunization rates are sub-optimal in developing countries such as India, with wide heterogeneity observed across districts and socio-economic characteristics. The aim of this paper is to examine district-level variations in the propensity to vaccinate a child in India for measles and DPT3, and analyse the extent to which these immunizations are given age-inappropriately, either prematurely or delayed. The present study uses data from the Indian District Level Household Survey (DLHS-3) collected in 2008, and the final sample contains detailed information on 42157 children aged between 12 and 60 months, across 549 Indian districts for whom we have complete information on immunization history. Our empirical study analyses: (i) the district-level average immunization rates for measles and DPT3, and (ii) the extent to which these immunizations have been given age-appropriately. A key contribution of this paper is that we link the household-level data at the district level to data on availability and proximity to health infrastructure and district-level socio-economic factors. Our results show that after controlling for an array of socio-economic characteristics, across all our models, the district's income per capita is a strong predictor of better immunization outcomes for children. Mother's education level at the district-level has a statistically significant and positive influence on immunization outcomes across all our models. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Promotional Model: A New Direction for National Program in Immunization (NPI) and Oral Rehydration Therapy (ORT) in Nigeria

    OpenAIRE

    P.EKERETE, Paulinus

    2000-01-01

    The National Program on Immunization (NPI), formerly known as the Expanded Program on Immunization (EPI) and Oral Rehydration Therapy (ORT), were relaunched in1984 after the problems of vaccine supply have been corrected. The NPI aimed to protect children against six childhood killer disease and ORT, to remedy dehydration. In order to achieve these objectives, Partner-in-Health strategy was set up to educate, convince and motivate mothers, pregnant women and community to accept the programme....

  4. What childhood obesity prevention programmes work? A systematic review and meta-analysis

    Science.gov (United States)

    Wang, Y.; Cai, L.; Wu, Y.; Wilson, R. F.; Weston, C.; Fawole, O.; Bleich, S. N.; Cheskin, L. J.; Showell, N. N.; Lau, B. D.; Chiu, D. T.; Zhang, A.; Segal, J.

    2015-01-01

    Summary Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school

  5. Life-threatening infectious diseases of childhood: single-gene inborn errors of immunity?

    Science.gov (United States)

    Alcaïs, Alexandre; Quintana-Murci, Lluis; Thaler, David S; Schurr, Erwin; Abel, Laurent; Casanova, Jean-Laurent

    2010-12-01

    The hypothesis that inborn errors of immunity underlie infectious diseases is gaining experimental support. However, the apparent modes of inheritance of predisposition or resistance differ considerably among diseases and among studies. A coherent genetic architecture of infectious diseases is lacking. We suggest here that life-threatening infectious diseases in childhood, occurring in the course of primary infection, result mostly from individually rare but collectively diverse single-gene variations of variable clinical penetrance, whereas the genetic component of predisposition to secondary or reactivation infections in adults is more complex. This model is consistent with (i) the high incidence of most infectious diseases in early childhood, followed by a steady decline; (ii) theoretical modeling of the impact of monogenic or polygenic predisposition on the incidence distribution of infectious diseases before reproductive age; (iii) available molecular evidence from both monogenic and complex genetics of infectious diseases in children and adults; (iv) current knowledge of immunity to primary and secondary or latent infections; (v) the state of the art in the clinical genetics of noninfectious pediatric and adult diseases; and (vi) evolutionary data for the genes underlying single-gene and complex disease risk. With the recent advent of new-generation deep resequencing, this model of single-gene variations underlying severe pediatric infectious diseases is experimentally testable. © 2010 New York Academy of Sciences.

  6. [Progress of childhood immunization information management system in China in 2008].

    Science.gov (United States)

    Cao, Ling-Sheng; Liu, Da-Wei; Guo, Biao

    2009-08-01

    To evaluate the coverage of childhood immunization information management system (CIIMS) in China (not include HongKong, Macao, and Taiwan) in 2008. Analyzing immunization cases and users' file record archives in CIIMS for china in 2008. These data indicated that 87.10% (27/31) of provinces and 30.36% (891/2935) of county level and 26.63% (11,512/43,231) of vaccination points of township level submitted immunization data to an CIIMS in 2008. The rate of implementation of the county > or = 90% are Fujian and Hubei. The rate of implementation of the township > or = 90% are Hubei, Fujian and Hebei. Coverage of eastern areas, middle areas and western areas were 28.91%, 43.20%, and 18.41% by county, 26.15%, 37.69%, and 16.44% by township respectively. The upload permissions against cases is in a total of 15,014 units, and the client software collect a total of 42,956,214 cases of immunization. 44.46% chinese children aged < 6 years old participated in an CIIMS in 2008. The vaccination point of township level submitted 8,793,334 cases to CIIMS, it accounted for 20.47% of client collection cases. To achieve the national CIIMS objectives for 2010, the extensive implementation must be promoted, the funding for system-building should be increased, an independent platform of CIIMS must be established, and admission of the issue of data exchange with the local information systems must be accelerated.

  7. ENHANCED IMMUNIZATION COVERAGE THROUGH INTERVENTIONS FOR CHILDHOOD CLUSTER DISEASES IN DEVELOPING COUNTRIES.

    Science.gov (United States)

    Mureed, Sheh; Somronghtong, Ratana; Kumar, Ramesh; Ghaffar, Abdul; Chapman, Robert S

    2015-01-01

    Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Systematic review by using PRISMA statement ("preferred reporting items for systematic reviews and meta-analyses") has been conducted in English. published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p 0.05) and full vaccination schedule (OR 1.342 and p>0.05). Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP an.d measles.

  8. Comparison of immune manifestations between refractory cytopenia of childhood and aplastic anemia in children: A single-center retrospective study.

    Science.gov (United States)

    Wu, Jun; Cheng, Yifei; Zhang, Leping

    2015-12-01

    This retrospective single-center study assessed the incidence and clinical features of immune manifestations of refractory cytopenia of childhood (RCC) and childhood aplastic anemia (AA). We evaluated 72 children with RCC and 123 with AA between February 2008 and March 2013. RCC was associated with autoimmune disease in 4 children, including 1 case each with autoimmune hemolytic anemia, rheumatoid arthritis, systemic lupus erythematosus, and anaphylactoid purpura. No children with AA were diagnosed with autoimmune diseases. Immune abnormalities were common in both RCC and AA; the most significant reductions were in the relative numbers of CD3-CD56+ subsets found in RCC. Despite the many similar immunologic abnormalities in AA and RCC, the rate of autoimmune disease was significantly lower in childhood AA than RCC (p=0.008, χ2=6.976). The relative numbers of natural killer cells were significantly lower in RCC patients than AA patients. By month 6, there was no significant difference in autoimmune manifestations between RCC and AA in relation to the response to immunosuppressive therapy (p=0.907, χ2=0.014). The large overlap of analogous immunologic abnormalities indicates that RCC and childhood AA may share the same pathogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Translating childhood tuberculosis case management research into operational policies.

    Science.gov (United States)

    Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

    2011-08-01

    The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality.

  10. Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma: a report from the Children's Oncology Group.

    Science.gov (United States)

    Lupo, Philip J; Zhou, Renke; Skapek, Stephen X; Hawkins, Douglas S; Spector, Logan G; Scheurer, Michael E; Fatih Okcu, M; Melin, Beatrice; Papworth, Karin; Erhardt, Erik B; Grufferman, Seymour

    2014-01-15

    Rhabdomyosarcoma (RMS) is a highly malignant tumor of developing muscle that can occur anywhere in the body. Due to its rarity, relatively little is known about the epidemiology of RMS. Atopic disease is hypothesized to be protective against several malignancies; however, to our knowledge, there have been no assessments of atopy and childhood RMS. Therefore, we explored this association in a case-control study of 322 childhood RMS cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Controls were matched to cases on race, sex and age. The following atopic conditions were assessed: allergies, asthma, eczema and hives; in addition, we examined other immune-related factors: birth order, day-care attendance and breastfeeding. Conditional logistic-regression models were used to calculate an odds ratio (OR) and 95% confidence interval (CI) for each exposure, adjusted for age, race, sex, household income and parental education. As the two most common histologic types of RMS are embryonal (n=215) and alveolar (n=66), we evaluated effect heterogeneity of these exposures. Allergies (OR=0.60, 95% CI: 0.41-0.87), hives (OR = 0.61, 95% CI: 0.38-0.97), day-care attendance (OR=0.48, 95% CI: 0.32-0.71) and breastfeeding for ≥ 12 months (OR=0.36, 95% CI: 0.18-0.70) were inversely associated with childhood RMS. These exposures did not display significant effect heterogeneity between histologic types (p>0.52 for all exposures). This is the first study indicating that atopic exposures may be protective against childhood RMS, suggesting additional studies are needed to evaluate the immune system's role in the development of this tumor. © 2013 UICC.

  11. Disparity in childhood immunizations

    NARCIS (Netherlands)

    Lemstra, Mark; Neudorf, Cory; Opondo, Johnmark; Toye, Jennifer; Kurji, Ayisha; Kunst, Anton; Tournier, Ceal

    2007-01-01

    BACKGROUND: Incomplete immunization coverage is common in low-income families and Aboriginal children in Canada. OBJECTIVE: To determine whether child immunization coverage rates at two years of age were lower in low-income neighbourhoods of Saskatoon, Saskatchewan. METHODS: Parents who were and

  12. The cognitive processing potential of infants: Exploring the impact of an early childhood development programme

    Directory of Open Access Journals (Sweden)

    René Van Eeden

    2017-12-01

    Full Text Available Background: Many South African learners seem unprepared for formal education, and a need for intervention during early childhood has been identified. Aim: The present study explored the effect of infant exposure to an early childhood development programme aimed at the sensory developmental stage of the infant’s brain. Setting: Participants were recruited through local baby clinics and nursery schools in the Western Cape. Participants were from the middle-income sector and the sample consisted of 63 infants between the ages of 3 and 12 months – gender representation was approximately equal and 17% of the infants were of mixed race, 8% black and 75% white. Methods: A pretest–posttest design was used involving an intervention group (N = 29 and a control group (N = 34 of infants. There was no known bias in group allocation. Intervention was provided in the form of the Numbers in Nappies programme and cognitive performance was assessed with the BSID (III before and after the intervention for both groups. Results: The intervention group showed theory expectant increases, most notably on the Cognitive Scale and the Social-Emotional Scale of the BSID (III. The performance of the intervention and the control group on the cognitive subscales (Cognitive, Language and Motor was compared before and after the intervention. The only significant difference was on the Cognitive Scale after the intervention. Conclusion: The findings indicate that appropriate intervention taps into the cognitive processing potential of infants, thus increasing their cognitive ability and enhancing their social–emotional functioning. The stimulation provided by parents and primary caregivers is essential in enhancing this experience-dependent development and the Numbers in Nappies programme provides a cost-effective intervention suitable for a home environment.

  13. Severe infectious diseases of childhood as monogenic inborn errors of immunity.

    Science.gov (United States)

    Casanova, Jean-Laurent

    2015-12-22

    This paper reviews the developments that have occurred in the field of human genetics of infectious diseases from the second half of the 20th century onward. In particular, it stresses and explains the importance of the recently described monogenic inborn errors of immunity underlying resistance or susceptibility to specific infections. The monogenic component of the genetic theory provides a plausible explanation for the occurrence of severe infectious diseases during primary infection. Over the last 20 y, increasing numbers of life-threatening infectious diseases striking otherwise healthy children, adolescents, and even young adults have been attributed to single-gene inborn errors of immunity. These studies were inspired by seminal but neglected findings in plant and animal infections. Infectious diseases typically manifest as sporadic traits because human genotypes often display incomplete penetrance (most genetically predisposed individuals remain healthy) and variable expressivity (different infections can be allelic at the same locus). Infectious diseases of childhood, once thought to be archetypal environmental diseases, actually may be among the most genetically determined conditions of mankind. This nascent and testable notion has interesting medical and biological implications.

  14. Health consequences of the US Deferred Action for Childhood Arrivals (DACA) immigration programme: a quasi-experimental study

    OpenAIRE

    Atheendar S Venkataramani, DrMD; Sachin J Shah, MD; Rourke O'Brien, PhD; Ichiro Kawachi, ProfPhD; Alexander C Tsai, MD

    2017-01-01

    Summary: Background: The effects of changes in immigration policy on health outcomes among undocumented immigrants are not well known. We aimed to examine the physical and mental health effects of the Deferred Action for Childhood Arrivals (DACA) programme, a 2012 US immigration policy that provided renewable work permits and freedom from deportation for a large number of undocumented immigrants. Methods: We did a retrospective, quasi-experimental study using nationally representative, repea...

  15. Effectiveness of rotavirus pentavalent vaccine under a universal immunization programme in Israel, 2011-2015: a case-control study.

    Science.gov (United States)

    Muhsen, K; Anis, E; Rubinstein, U; Kassem, E; Goren, S; Shulman, L M; Ephros, M; Cohen, D

    2018-01-01

    The use of rotavirus pentavalent vaccine (RotaTeq ® ) as a sole vaccine within rotavirus universal immunization programmes remains limited. We examined the effectiveness of RotaTeq in preventing rotavirus gastroenteritis (RVGE) hospitalization in Israel, after the introduction of universal immunization against the disease. A test-negative case-control study included age-eligible children for universal RotaTeq immunization (aged 2-59 months, born in 2011-2015). Cases (n = 98) were patients who tested positive for rotavirus by immunochromatography; those who tested negative (n = 628) comprised the control group. Information on rotavirus immunization history was obtained through linkage with a national immunization registry. Vaccination status was compared between cases and controls, adjusted odds ratios (aORs) were obtained from logistic regression models, and vaccine effectiveness calculated as (1 - aOR)*100. Immunization with RotaTeq was less frequent in RVGE cases (73.5%) than in controls (90.1%), p < 0.001; this association persisted after controlling for potential confounders. Effectiveness of the complete vaccine series was estimated at 77% (95% confidence interval (CI): 49-90) in children aged 6-59 months, and 86% (95% CI: 65-94) in children aged 6-23 months; whereas for the incomplete series, the respective estimates were 72% (95% CI: 28-89) and 75% (95% CI: 30-91). Vaccine effectiveness was estimated at 79% (95% CI: 45-92) against G1P[8]-associated RVGE hospitalizations and 69% (95% CI: 11-89) against other genotype-RVGE hospitalizations. High effectiveness of RotaTeq as the sole rotavirus vaccine in a universal immunization programme was demonstrated in a high-income country. Although partial vaccination conferred protection, completing the vaccine series is warranted to maximize the benefit. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

    Science.gov (United States)

    Oluoha, Chukwuemeka; Ahaneku, Hycienth

    2014-01-01

    The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

  17. Cord blood gene expression supports that prenatal exposure to perfluoroalkyl substances causes depressed immune functionality in early childhood.

    Science.gov (United States)

    Pennings, Jeroen L A; Jennen, Danyel G J; Nygaard, Unni C; Namork, Ellen; Haug, Line S; van Loveren, Henk; Granum, Berit

    2016-01-01

    Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are a class of synthetic compounds that have widespread use in consumer and industrial applications. PFAS are considered environmental pollutants that have various toxic properties, including effects on the immune system. Recent human studies indicate that prenatal exposure to PFAS leads to suppressed immune responses in early childhood. In this study, data from the Norwegian BraMat cohort was used to investigate transcriptomics profiles in neonatal cord blood and their association with maternal PFAS exposure, anti-rubella antibody levels at 3 years of age and the number of common cold episodes until 3 years. Genes associated with PFAS exposure showed enrichment for immunological and developmental functions. The analyses identified a toxicogenomics profile of 52 PFAS exposure-associated genes that were in common with genes associated with rubella titers and/or common cold episodes. This gene set contains several immunomodulatory genes (CYTL1, IL27) as well as other immune-associated genes (e.g. EMR4P, SHC4, ADORA2A). In addition, this study identified PPARD as a PFAS toxicogenomics marker. These markers can serve as the basis for further mechanistic or epidemiological studies. This study provides a transcriptomics connection between prenatal PFAS exposure and impaired immune function in early childhood and supports current views on PPAR- and NF-κB-mediated modes of action. The findings add to the available evidence that PFAS exposure is immunotoxic in humans and support regulatory policies to phase out these substances.

  18. Progress in Childhood Vaccination Data in Immunization Information Systems - United States, 2013-2016.

    Science.gov (United States)

    Murthy, Neil; Rodgers, Loren; Pabst, Laura; Fiebelkorn, Amy Parker; Ng, Terence

    2017-11-03

    In 2016, 55 jurisdictions in 49 states and six cities in the United States* used immunization information systems (IISs) to collect and manage immunization data and support vaccination providers and immunization programs. To monitor progress toward achieving IIS program goals, CDC surveys jurisdictions through an annual self-administered IIS Annual Report (IISAR). Data from the 2013-2016 IISARs were analyzed to assess progress made in four priority areas: 1) data completeness, 2) bidirectional exchange of data with electronic health record systems, 3) clinical decision support for immunizations, and 4) ability to generate childhood vaccination coverage estimates. IIS participation among children aged 4 months through 5 years increased from 90% in 2013 to 94% in 2016, and 33 jurisdictions reported ≥95% of children aged 4 months through 5 years participating in their IIS in 2016. Bidirectional messaging capacity in IISs increased from 25 jurisdictions in 2013 to 37 in 2016. In 2016, nearly all jurisdictions (52 of 55) could provide automated provider-level coverage reports, and 32 jurisdictions reported that their IISs could send vaccine forecasts to providers via Health Level 7 (HL7) messaging, up from 17 in 2013. Incremental progress was made in each area since 2013, but continued effort is needed to implement these critical functionalities among all IISs. Success in these priority areas, as defined by the IIS Functional Standards (1), bolsters clinicians' and public health practitioners' ability to attain high vaccination coverage in pediatric populations, and prepares IISs to develop more advanced functionalities to support state/local immunization services. Success in these priority areas also supports the achievement of federal immunization objectives, including the use of IISs as supplemental sampling frames for vaccination coverage surveys like the National Immunization Survey (NIS)-Child, reducing data collection costs, and supporting increased precision

  19. Childhood Acute Lymphoblastic Leukemia and Indicators of Early Immune Stimulation: A Childhood Leukemia International Consortium Study

    Science.gov (United States)

    Rudant, Jérémie; Lightfoot, Tracy; Urayama, Kevin Y.; Petridou, Eleni; Dockerty, John D.; Magnani, Corrado; Milne, Elizabeth; Spector, Logan G.; Ashton, Lesley J.; Dessypris, Nikolaos; Kang, Alice Y.; Miller, Margaret; Rondelli, Roberto; Simpson, Jill; Stiakaki, Eftichia; Orsi, Laurent; Roman, Eve; Metayer, Catherine; Infante-Rivard, Claire; Clavel, Jacqueline

    2015-01-01

    The associations between childhood acute lymphoblastic leukemia (ALL) and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980–2010). The sample included 7,399 ALL cases and 11,181 controls aged 2–14 years. The data were collected by questionnaires administered to the parents. Pooled odds ratios and 95% confidence intervals were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Day-care center attendance in the first year of life was associated with a reduced risk of ALL (odds ratio = 0.77, 95% confidence interval: 0.71, 0.84), with a marked inverse trend with earlier age at start (P < 0.0001). An inverse association was also observed with breastfeeding duration of 6 months or more (odds ratio = 0.86, 95% confidence interval: 0.79, 0.94). No significant relationship with a history of common infections in infancy was observed even though the odds ratio was less than 1 for more than 3 infections. The findings of this large pooled analysis reinforce the hypothesis that day-care center attendance in infancy and prolonged breastfeeding are associated with a decreased risk of ALL. PMID:25731888

  20. Severe infectious diseases of childhood as monogenic inborn errors of immunity

    Science.gov (United States)

    Casanova, Jean-Laurent

    2015-01-01

    This paper reviews the developments that have occurred in the field of human genetics of infectious diseases from the second half of the 20th century onward. In particular, it stresses and explains the importance of the recently described monogenic inborn errors of immunity underlying resistance or susceptibility to specific infections. The monogenic component of the genetic theory provides a plausible explanation for the occurrence of severe infectious diseases during primary infection. Over the last 20 y, increasing numbers of life-threatening infectious diseases striking otherwise healthy children, adolescents, and even young adults have been attributed to single-gene inborn errors of immunity. These studies were inspired by seminal but neglected findings in plant and animal infections. Infectious diseases typically manifest as sporadic traits because human genotypes often display incomplete penetrance (most genetically predisposed individuals remain healthy) and variable expressivity (different infections can be allelic at the same locus). Infectious diseases of childhood, once thought to be archetypal environmental diseases, actually may be among the most genetically determined conditions of mankind. This nascent and testable notion has interesting medical and biological implications. PMID:26621750

  1. Childhood immunizations in China: disparities in health care access in children born to North Korean refugees.

    Science.gov (United States)

    Chung, Hyun Jung; Han, Seung Hyun; Kim, Hyerang; Finkelstein, Julia L

    2016-04-13

    Childhood immunization rates are at an all-time high globally, and national data for China suggests close to universal coverage. Refugees from North Korea and their children may have more limited health care access in China due to their legal status. However, there is no data on immunization rates or barriers to coverage in this population. This study was conducted to determine the rates and correlates of immunizations in children (≥1 year) born to North Korean refugees in Yanbien, China. Child immunization data was obtained from vaccination cards and caregiver self-report for 7 vaccines and 1:3:3:3:1 series. Age-appropriate vaccination rates of refugee children were compared to Chinese and migrant children using a goodness-of-fit test. Logistic regression was used to determine correlates of immunization coverage for each vaccine and the 1:3:3:3:1 series. Age-appropriate immunization coverage rates were significantly lower in children born to North Korean refugees (12.1-97.8 %), compared to Chinese (99 %) and migrant (95 %) children. Increased father's age and having a sibling predicted significantly lower vaccination rates. Children born to North Korean refugees had significantly lower immunization rates, compared to Chinese or migrant children. Further research is needed to examine barriers of health care access in this high-risk population.

  2. Systematic review on effectiveness of interventional programmes in treating childhood obesity

    Directory of Open Access Journals (Sweden)

    Hasanain Faisal Ghazi

    2017-05-01

    Full Text Available Background: The prevalence of childhood obesity is alarming and studies have shown that overweight and obese children carry more risk of developing a range of related health problems when they become older. The aim of this systematic review was to evaluate the effectiveness of childhood obesity intervention programmes. Methods: Systematic review of published literature from 2008 to 2015. Articles were excluded if they were published before 2008, if they were not published in English; if they had incomplete statistical data; and if the participants did not belong to the age category of 6 to 12 years. All eligible articles were independently reviewed by two reviewers to assess study quality. Results: Ten studies met the inclusion criteria. Most were conducted in a health care setting (n = 5 or schoolbased setting (n = 4, including one in a rural area. Half of the articles were published in 2013 and all studies had an almost equal gender distribution. All studies sought reduction in anthropometric/ body composition as their main outcomes. Only three studies were rated as strong in quality while the others were moderate. Conclusions: Most of the interventional studies included in our review showed a significant improvement for obese children. Four out of 11 studies showed that physical activity and diet had a great impact on child obesity, while other studies showed that a hospital-care setting or school-based setting and parental involvement were more beneficial in treating obesity.

  3. Enhanced immunization coverage through interventions for childhood cluster diseases in developing countries

    International Nuclear Information System (INIS)

    Mureed, S.; Somronghtong, R.; Kumar, R.

    2015-01-01

    Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Methods: Systematic review by using PRISMA statement (preferred reporting items for systematic reviews and meta-analyses) has been conducted in English published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. Results: A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p <0.05).Furthermore, it has been proved that an effect was more prominent for DTP (OR 2.397 and p<0.05) and measles (OR 2.628 and p<0.05), not as much for polio (OR 2.284 and p>0.05) and full vaccination schedule (OR 1.342 and p>0.05). Conclusions: Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP and measles. (author)

  4. Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors

    Directory of Open Access Journals (Sweden)

    Sulaimon T. Adedokun

    2017-03-01

    Full Text Available Abstract Background Under-five mortality remains high in sub-Saharan Africa despite global decline. One quarter of these deaths are preventable through interventions such as immunization. The aim of this study was to examine the independent effects of individual-, community- and state-level factors on incomplete childhood immunization in Nigeria, which is one of the 10 countries where most of the incompletely immunised children in the world live. Methods The study was based on secondary analyses of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (DHS. Multilevel multivariable logistic regression models were applied to the data on 5,754 children aged 12–23 months who were fully immunized or not (level 1, nested within 896 communities (level 2 from 37 states (level 3. Results More than three-quarter of the children (76.3% were not completely immunized. About 83% of children of young mothers (15–24 years and 94% of those whose mothers are illiterate did not receive full immunization. In the fully adjusted model, the chances of not being fully immunized reduced for children whose mothers attended antenatal clinic (adjusted odds ratio [aOR] = 0.49; 95% credible interval [CrI] = 0.39–0.60, delivered in health facility (aOR = 0.62; 95% CrI = 0.51–0.74 and lived in urban area (aOR = 0.66; 95% CrI = 0.50–0.82. Children whose mothers had difficulty getting to health facility (aOR = 1.28; 95% CrI = 1.02–1.57 and lived in socioeconomically disadvantaged communities (aOR = 2.93; 95% CrI = 1.60–4.71 and states (aOR = 2.69; 955 CrI =1.37–4.73 were more likely to be incompletely immunized. Conclusions This study has revealed that the risk of children being incompletely immunized in Nigeria was influenced by not only individual factors but also community- and state-level factors. Interventions to improve child immunization uptake should take into consideration these contextual

  5. Childhood obesity treatment and prevention. Psychological perspectives of clinical approaches

    OpenAIRE

    Maria Catena Quattropani; Teresa Buccheri

    2013-01-01

    Objective: This work focuses on clinical psychologist’ presence within childhood obesity prevention programmes in several countries. Method: The Authors collected articles considering psychological, biological and social aspects linked to childhood obesity. Results: Studies reveal that childhood obesity prevention programmes are based on biological, medical and educational aspects; clinical psychologists up until now have been engaged almost exclusively in the treatment of obesity. Conclusion...

  6. Hygiene and other early childhood influences on the subsequent function of the immune system.

    Science.gov (United States)

    Rook, Graham A W; Lowry, Christopher A; Raison, Charles L

    2015-08-18

    The immune system influences brain development and function. Hygiene and other early childhood influences impact the subsequent function of the immune system during adulthood, with consequences for vulnerability to neurodevelopmental and psychiatric disorders. Inflammatory events during pregnancy can act directly to cause developmental problems in the central nervous system (CNS) that have been implicated in schizophrenia and autism. The immune system also acts indirectly by "farming" the intestinal microbiota, which then influences brain development and function via the multiple pathways that constitute the gut-brain axis. The gut microbiota also regulates the immune system. Regulation of the immune system is crucial because inflammatory states in pregnancy need to be limited, and throughout life inflammation needs to be terminated completely when not required; for example, persistently raised levels of background inflammation during adulthood (in the presence or absence of a clinically apparent inflammatory stimulus) correlate with an increased risk of depression. A number of factors in the perinatal period, notably immigration from rural low-income to rich developed settings, caesarean delivery, breastfeeding and antibiotic abuse have profound effects on the microbiota and on immunoregulation during early life that persist into adulthood. Many aspects of the modern western environment deprive the infant of the immunoregulatory organisms with which humans co-evolved, while encouraging exposure to non-immunoregulatory organisms, associated with more recently evolved "crowd" infections. Finally, there are complex interactions between perinatal psychosocial stressors, the microbiota, and the immune system that have significant additional effects on both physical and psychiatric wellbeing in subsequent adulthood. This article is part of a Special Issue entitled Neuroimmunology in Health And Disease. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights

  7. The evaluation of a standardized call/recall system for childhood immunizations in Wandsworth, England.

    Science.gov (United States)

    Atchison, Christina; Zvoc, Miro; Balakrishnan, Ravikumar

    2013-06-01

    To improve uptake of childhood immunizations in Wandsworth we developed a standardized call/recall system based on parents being sent three reminders and defaulters being referred to a Health Visitor. Thirty-two out of 44 primary care practices in the area implemented the intervention in September 2011. The aim of this study was to evaluate the implementation, delivery and impact on immunization uptake of the new call/recall system. To assess implementation and delivery, a mixed method approach was used including qualitative (structured interviews) and quantitative (data collected at three months post-implementation) assessment. To assess the impact, we used Student's t test to compare the difference in immunization uptake rates between intervention and non-intervention practices before and after implementation. The call/recall system was viewed positively by both parents and staff. Most children due or overdue immunizations were successfully captured by the 1st invitation reminder. After three invitations, between 87.3 % (MMR1) and 92.2 % (pre-school booster) of children identified as due or overdue immunizations successfully responded. Prior to implementation there was no difference in uptake rates between intervention and non-intervention practices. Post-implementation uptake rates for DTaP/IPV/Hib, MMR1, MMR2 and the pre-school booster were significantly greater in the intervention practices. Similar findings were seen for PCV and Hib/MenC boosters, although the differences were not statistically significant at the 5 % level. Following the successful implementation of a standardized call/recall system in Wandsworth, other regions or primary care practices may wish to consider introducing a similar system to help improve their immunization coverage levels.

  8. Results from a survey of national immunization programmes on home-based vaccination record practices in 2013.

    Science.gov (United States)

    Young, Stacy L; Gacic-Dobo, Marta; Brown, David W

    2015-07-01

    Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was work remains to improve forecasting where appropriate, to prevent HBR stock-outs, to identify and improve sustainable financing options and to explore viable market shaping opportunities. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  9. Overcoming Challenges to Childhood Immunizations Status.

    Science.gov (United States)

    Sabnis, Svapna S; Conway, James H

    2015-10-01

    Vaccines are one of the greatest public health achievements, preventing both mortality and morbidity. However, overall immunization rates are still below the 90% target for Healthy People 2020. There remain significant disparities in immunization rates between children of different racial/ethnic groups, as well as among economically disadvantaged populations. There are systemic issues and challenges in providing access to immunization opportunities. In addition, vaccine hesitancy contributes to underimmunization. Multiple strategies are needed to improve immunization rates, including improving access to vaccines and minimizing financial barriers to families. Vaccine status should be assessed and vaccines given at all possible opportunities. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Immunization history of children with inflammatory bowel disease.

    Science.gov (United States)

    Soon, Ing Shian; deBruyn, Jennifer C C; Wrobel, Iwona

    2013-04-01

    Protection against vaccine-preventable diseases is important in children with inflammatory bowel disease (IBD) due to frequent immunosuppressive therapy use. The chronic relapsing nature and treatment regimen of IBD may necessitate modified timing of immunizations. To evaluate the completeness of immunizations in children with IBD. Immunization records of all children with IBD followed at the Alberta Children's Hospital (Calgary, Alberta) were reviewed. For children with incomplete immunization according to the province of Alberta schedule, the reasons for such were clarified. Demographic data and age at diagnosis were also collected. Immunization records were obtained from 145 (79%) children with IBD. Fifteen children had incomplete routine childhood immunizations, including two with no previous immunizations. The most common incomplete immunizations included hepatitis B (n=9), diphtheria, tetanus, acellular pertussis at 14 to 16 years of age (n=7), and diphtheria, tetanus, acellular pertussis, inactivated polio at four to six years of age (n=6). The reasons for incomplete immunization included use of immunosuppressive therapy at time of scheduled immunization; IBD-related symptoms at time of scheduled immunization; parental refusal; recent move from elsewhere with different immunization schedule; unawareness of routine immunization; and needle phobia. Although the majority of children with IBD had complete childhood immunizations, suboptimal immunizations were present in 10%. With increasing use of immunosuppressive therapy in IBD, physicians caring for children with IBD must periodically evaluate immunization status and ensure the completeness of childhood immunizations.

  11. A childhood obesity prevention programme in Barcelona (POIBA Project): Study protocol of the intervention

    Science.gov (United States)

    Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles

    2018-01-01

    Background Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Design and methods Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. Expected impact for public health It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent. Significance for public health Overweight and obesity are a major public health concern that predispose affected individuals to the development of chronic diseases. Of importance, obesity is more common among

  12. Early life innate immune signatures of persistent food allergy.

    Science.gov (United States)

    Neeland, Melanie R; Koplin, Jennifer J; Dang, Thanh D; Dharmage, Shyamali C; Tang, Mimi L; Prescott, Susan L; Saffery, Richard; Martino, David J; Allen, Katrina J

    2017-11-14

    Food allergy naturally resolves in a proportion of food-allergic children without intervention; however the underlying mechanisms governing the persistence or resolution of food allergy in childhood are not understood. This study aimed to define the innate immune profiles associated with egg allergy at age 1 year, determine the phenotypic changes that occur with the development of natural tolerance in childhood, and explore the relationship between early life innate immune function and serum vitamin D. This study used longitudinally collected PBMC samples from a population-based cohort of challenge-confirmed egg-allergic infants with either persistent or transient egg allergy outcomes in childhood to phenotype and quantify the functional innate immune response associated with clinical phenotypes of egg allergy. We show that infants with persistent egg allergy exhibit a unique innate immune signature, characterized by increased numbers of circulating monocytes and dendritic cells that produce more inflammatory cytokines both at baseline and following endotoxin exposure when compared with infants with transient egg allergy. Follow-up analysis revealed that this unique innate immune signature continues into childhood in those with persistent egg allergy and that increased serum vitamin D levels correlate with changes in innate immune profiles observed in children who developed natural tolerance to egg. Early life innate immune dysfunction may represent a key immunological driver and predictor of persistent food allergy in childhood. Serum vitamin D may play an immune-modulatory role in the development of natural tolerance. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Ensuring childhood vaccination among slums dwellers under the National Immunization Program in India - Challenges and opportunities.

    Science.gov (United States)

    Singh, Sanjeev; Sahu, Damodar; Agrawal, Ashish; Vashi, Meeta Dhaval

    2018-04-04

    Almost, one third of the world's urban population resides in slums and the number would double by 2030. Slums denotes collection of people from various communities having a meagre income and living in unhygienic conditions thus making themselves most vulnerable for outbreaks of communicable diseases. India contributes substantially to the global disease burden and under-five mortality rates i.e. 20% attributable to vaccine preventable diseases. Immunization plays a crucial role in combating high childhood mortality rates attributable to vaccine preventable diseases across the globe. This systematic review, provides insights on immunization status in slums, identifies various factors influencing it thus, exploring opportunities that may be available to improve vaccination coverage under the National Immunization Program. Taking into account the above aspects, a review of literature was undertaken in various databases that included studies published between 2006 and 2017. In India, ~33% of the urban population lives in slums with suboptimal vaccination coverage ranging from 14% to upto 90%. Few of the important causes for low coverage included socioeconomic factors such as poor community participation, lack of awareness, frequent migration, and loss of daily income. Hence, mere presence of vaccines in the National Immunization Program doesn't do the job, there is a definite unmet need to emphasize upon the importance of immunization among slums dwellers and take necessary steps. For instance, delivering immunization services at the doorstep (e.g. pulse polio program), community-based education, text messaging as reminders and incentivized immunization services are some of the opportunities that can be explored and implemented to improve immunization status in the slums. Thus, in addition to inclusion of more and more vaccines in the National Immunization Program, there is a definite need to focus on people living in high risk areas in order to improve coverage and

  14. A French national breast and thyroid cancer screening programme for survivors of childhood, adolescent and young adult (CAYA) cancers - DeNaCaPST programme.

    Science.gov (United States)

    Demoor-Goldschmidt, Charlotte; Drui, Delphine; Doutriaux, Isabelle; Michel, Gérard; Auquier, Pascal; Dumas, Agnès; Berger, Claire; Bernier, Valérie; Bohrer, Sandrine; Bondiau, Pierre-Yves; Filhon, Bruno; Fresneau, Brice; Freycon, Claire; Stefan, Dinu; Helfre, Sylvie; Jackson, Angela; Kerr, Christine; Laprie, Anne; Leseur, Julie; Mahé, Marc-André; Oudot, Caroline; Pluchard, Claire; Proust, Stéphanie; Sudour-Bonnange, Hélène; Vigneron, Céline; Lassau, Nathalie; Schlumberger, Martin; Conter, Cécile Faure; de Vathaire, Florent

    2017-05-12

    Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening. DeNaCaPST trial is coordinated by the INSERM 1018 unit in cooperation with the LEA (French Childhood Cancer Survivor Study for Leukaemia) study's coordinators, the long term follow up committee and the paediatric radiation committee of the SFCE (French Society of Childhood Cancers). A total of 35 centres spread across metropolitan France and la Reunion will participate. FCCSS (French Childhood Cancer Survivor Study), LEA and central registry will be interrogated to identify eligible patients. To participate, centers agreed to perform a complete "long-term follow-up consultations" according to good clinical practice and the guidelines of the SFCE (French Society of Children Cancers). As survival has greatly improved in childhood cancers, detection of therapy-related malignancies has become a priority even if new radiation techniques will lead to better protection for organs at risk. International guidelines have been put in place because of the evidence for increased lifetime risk of breast and thyroid cancer. DeNaCaPST is based on these international recommendations but it is important to recognize that they are based on expert consensus opinion and are supported by neither nonrandomized observational studies nor prospective randomized trials in this specific population. Over-diagnosis is a phenomenon inherent in any screening program and

  15. The impact of changing medicaid enrollments on New Mexico's Immunization Program.

    Directory of Open Access Journals (Sweden)

    Michael A Schillaci

    Full Text Available Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico's immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices.This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment.New Mexico's improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state's efforts to change immunization practices. Maintaining high Medicaid enrollment levels may be important for achieving high childhood immunization levels.

  16. The Impact of Changing Medicaid Enrollments on New Mexico's Immunization Program

    Science.gov (United States)

    Schillaci, Michael A.; Waitzkin, Howard; Sharmen, Tom; Romain, Sandra J.

    2008-01-01

    Background Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico's immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices. Methods and Findings This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF) in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment. Conclusions New Mexico's improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state's efforts to change immunization practices. Maintaining high Medicaid enrollment levels may be important for achieving high childhood immunization levels. PMID:19107189

  17. Plan voor evaluatie van het Rijksvaccinatieprogramma. Een discussienota

    NARCIS (Netherlands)

    Rumke HC; Conyn-van Spaendonck MAE; Plantinga AD; MCI; CIE; LLV

    1994-01-01

    The Netherlands Immunization Programme has greatly reduced the incidence of target childhood diseases and their complications. However, continuous vigilance is required. In this report we propose an integrated approach for surveillance of the Netherlands Immunization Programme. Data collection

  18. The impact of vaccine side effects on the natural history of immunization programmes: an imitation-game approach.

    Science.gov (United States)

    d'Onofrio, Alberto; Manfredi, Piero; Poletti, Piero

    2011-03-21

    When the incidence and prevalence of most common vaccine preventable childhood infectious diseases are constantly low, as is the case in many industrialized countries, the incidence of vaccine-associated side effects might become a key determinant in vaccine demand. We study an SIR transmission model with dynamic vaccine demand based on an imitation mechanism where the perceived risk of vaccination is modelled as a function of the incidence of vaccine side effects. The model shows some important differences compared to previous game dynamic models of vaccination, and allows noteworthy inferences as regards both the past and future lifetime of vaccination programmes. In particular it is suggested that a huge disproportion between the perceived risk of disease and vaccination is necessary in order to achieve high coverages. This disproportion is further increased in highly industrialised countries. Such considerations represent serious challenges for future vaccination programmes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Immunization Dropout Rates in Ihe, Awgu Local Government Area ...

    African Journals Online (AJOL)

    Background: Immunization against childhood diseases is one of the most important ways of preventing childhood morbidity and mortality. Aims: The objective of this study is to review the dropout rates of immunization of children in a health center using a single dose of diphtheria‑pertussis‑tetanus (DPT1) and three doses of ...

  20. Psychoneuroimmunology of Early-Life Stress: The Hidden Wounds of Childhood Trauma?

    Science.gov (United States)

    Danese, Andrea; J Lewis, Stephanie

    2017-01-01

    The brain and the immune system are not fully formed at birth, but rather continue to mature in response to the postnatal environment. The two-way interaction between the brain and the immune system makes it possible for childhood psychosocial stressors to affect immune system development, which in turn can affect brain development and its long-term functioning. Drawing from experimental animal models and observational human studies, we propose that the psychoneuroimmunology of early-life stress can offer an innovative framework to understand and treat psychopathology linked to childhood trauma. Early-life stress predicts later inflammation, and there are striking analogies between the neurobiological correlates of early-life stress and of inflammation. Furthermore, there are overlapping trans-diagnostic patterns of association of childhood trauma and inflammation with clinical outcomes. These findings suggest new strategies to remediate the effect of childhood trauma before the onset of clinical symptoms, such as anti-inflammatory interventions and potentiation of adaptive immunity. Similar strategies might be used to ameliorate the unfavorable treatment response described in psychiatric patients with a history of childhood trauma. PMID:27629365

  1. Financial sustainability planning for immunization services in Cambodia.

    Science.gov (United States)

    Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann

    2006-07-01

    The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

  2. Impact of the introduction of the pneumococcal conjugate vaccine in the Brazilian routine childhood national immunization program.

    Science.gov (United States)

    Moreira, Marta; Cintra, Otavio; Harriague, Julie; Hausdorff, William P; Hoet, Bernard

    2016-05-27

    Brazil introduced the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix™, GSK Vaccines) in the routine childhood immunization program in 2010 with a 3+1 schedule (with catch-up for children media. Nasopharyngeal carriage of vaccine-type and any-type pneumococci decreased after the primary doses, with no early signs of replacement with other pathogens. Finally, herd protection against vaccine-type invasive pneumococcal disease and pneumonia in unvaccinated subjects was shown in some studies for some age groups. In conclusion, pneumococcal disease decreased after the introduction of PHiD-CV into the Brazilian national immunization program. Further follow-up is needed to evaluate the long-term overall impact of PHiD-CV in the Brazilian population. Copyright © 2016 GlaxoSmithKline Biologicals SA. Published by Elsevier Ltd.. All rights reserved.

  3. Economic evaluation of pediatric influenza immunization program compared with other pediatric immunization programs: A systematic review.

    Science.gov (United States)

    Gibson, Edward; Begum, Najida; Sigmundsson, Birgir; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-05-03

    This study compared the economic value of pediatric immunisation programmes for influenza to those for rotavirus (RV), meningococcal disease (MD), pneumococcal disease (PD), human papillomavirus (HPV), hepatitis B (Hep B), and varicella reported in recent (2000 onwards) cost-effectiveness (CE) studies identified in a systematic review of PubMed, health technology, and vaccination databases. The systematic review yielded 51 economic evaluation studies of pediatric immunisation - 10 (20%) for influenza and 41 (80%) for the other selected diseases. The quality of the eligible articles was assessed using Drummond's checklist. Although inherent challenges and limitations exist when comparing economic evaluations of immunisation programmes, an overall comparison of the included studies demonstrated cost-effectiveness/cost saving for influenza from a European-Union-Five (EU5) and United States (US) perspective; point estimates for cost/quality-adjusted life-years (QALY) from dominance (cost-saving with more effect) to ≤45,444 were reported. The economic value of influenza programmes was comparable to the other vaccines of interest, with cost/QALY in general considerably lower than RV, Hep B, MD and PD. Independent of the perspective and type of analysis, the economic impact of a pediatric influenza immunisation program was influenced by vaccine efficacy, immunisation coverage, costs, and most significantly by herd immunity. This review suggests that pediatric influenza immunisation may offer a cost effective strategy when compared with HPV and varicella and possibly more value compared with other childhood vaccines (RV, Hep B, MD and PD).

  4. Long-term persistence of immunity and B-cell memory following Haemophilus influenzae type B conjugate vaccination in early childhood and response to booster.

    Science.gov (United States)

    Perrett, K P; John, T M; Jin, C; Kibwana, E; Yu, L-M; Curtis, N; Pollard, A J

    2014-04-01

    Protection against Haemophilus influenzae type b (Hib), a rapidly invading encapsulated bacteria, is dependent on maintenance of an adequate level of serum antibody through early childhood. In many countries, Hib vaccine booster doses have been implemented after infant immunization to sustain immunity. We investigated the long-term persistence of antibody and immunological memory in primary-school children following infant (with or without booster) Hib vaccination. Anti-polyribosylribitol phosphate (PRP) immunoglobulin G (IgG) concentration and the frequency of circulating Hib-specific memory B cells were measured before a booster of a Hib-serogroup C meningococcal (MenC) conjugate vaccine and again 1 week, 1 month, and 1 year after the booster in 250 healthy children aged 6-12 years in an open-label phase 4 clinical study. Six to 12 years following infant priming with 3 doses of Hib conjugate vaccine, anti-PRP IgG geometric mean concentrations were 3.11 µg/mL and 0.71 µg/mL and proportions with anti-PRP IgG ≥1.0 µg/mL were 79% and 43% in children who had or had not, respectively, received a fourth Hib conjugate vaccine dose (mean age, 3.9 years). Higher baseline and post-Hib-MenC booster responses (anti-PRP IgG and memory B cells) were found in younger children and in those who had received a fourth Hib dose. Sustained Hib conjugate vaccine-induced immunity in children is dependent on time since infant priming and receipt of a booster. Understanding the relationship between humoral and cellular immunity following immunization with conjugate vaccines may direct vaccine design and boosting strategies to sustain individual and population immunity against encapsulated bacteria in early childhood. Clinical Trials Registration ISRCTN728588998.

  5. Advancing Early Childhood Development: from Science to Scale 1

    Science.gov (United States)

    Black, Maureen M; Walker, Susan P; Fernald, Lia C H; Andersen, Christopher T; DiGirolamo, Ann M; Lu, Chunling; McCoy, Dana C; Fink, Günther; Shawar, Yusra R; Shiffman, Prof Jeremy; Devercelli, Amanda E; Wodon, Quentin T; Vargas-Barón, Emily; Grantham-McGregor, Sally

    2018-01-01

    Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course. PMID:27717614

  6. Implementing a Health and Wellbeing Programme for Children in Early Childhood: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Karen Munday

    2017-09-01

    Full Text Available In New Zealand, there is a high prevalence of childhood poverty and food insecurity, which can impact a family’s ability to provide high quality, nutrient dense foods for their children. In an attempt to increase the quality of the food consumed by children attending a decile two (low socio-economic kindergarten and to address food insecurity issues, an educational health and wellness initiative, in conjunction with a free lunch programme, was introduced. The impact of the lunches and the effectiveness of the programme were evaluated. Baseline and end-intervention 24-h modified dietary recall questionnaire data and a vegetable- and fruit-specific food frequency questionnaire (FFQ were collected. A follow-up FFQ was administered six months after the end of the intervention. The nutrient composition of the foods recorded in the 24-h recall questionnaires were analysed using FoodWorks8™. Whilst no significant differences were observed with the intakes of individual nutrients, there was a significant decrease in the consumption of ultra-processed snack foods (p = 0.015. The results of the follow-up FFQ, including the comments collected from the parents, suggested that the intervention had a longer-term positive impact on not only the children involved in the study but also on their whānau (wider family members

  7. Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bryant, Maria; Burton, Wendy; Cundill, Bonnie; Farrin, Amanda J; Nixon, Jane; Stevens, June; Roberts, Kim; Foy, Robbie; Rutter, Harry; Hartley, Suzanne; Tubeuf, Sandy; Collinson, Michelle; Brown, Julia

    2017-01-24

    Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot

  8. ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    G Taneja

    2013-08-01

    Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

  9. Teachers' perceptions about children's movement and learning in early childhood education programmes.

    Science.gov (United States)

    Gehris, J S; Gooze, R A; Whitaker, R C

    2015-01-01

    Efforts to improve the academic skills of preschool-aged children have resulted in approaches that tend to limit children's movement. However, movement experiences have long been considered important to children's learning and have received increased attention because of the obesity epidemic. Early childhood educators are important sources of information about if and how to promote learning and school readiness through movement, but little effort has been made to understand teachers' views on this topic. We conducted six focus groups with 37 teachers from a Head Start programme with centres in three cities in eastern Pennsylvania. We inquired about: (1) how movement influences children's learning; (2) what types of movement experiences are most beneficial for children; (3) what settings best support children's movement; and (4) challenges related to children's movement. To identify key themes from the focus groups, transcripts were analysed using an inductive method of coding. Teachers' views were expressed in four major themes. First, young children have an innate need to move, and teachers respond to this need by using movement experiences to prepare children to learn and to teach academic concepts and spatial awareness. However, teachers wanted more training in these areas. Second, movement prepares children for school and for life by building children's confidence and social skills. Third, teachers and children benefit from moving together because it motivates children and promotes teacher-child relationships. Finally, moving outdoors promotes learning by engaging children's senses and promoting community interaction. More training may be required to help early childhood educators use movement experiences to teach academic concepts and improve children's spatial awareness. Future interventions could examine the impacts on children's movement and learning of having teachers move with children during outdoor free play and including more natural features in the

  10. Impact of a community-based integrated management of childhood illnesses (IMCI) programme in Gegharkunik, Armenia.

    Science.gov (United States)

    Thompson, Michael E; Harutyunyan, Tsovinar L

    2009-03-01

    Maternal and child health status in the Martuni region of Gegharkunik marz, Armenia, precipitously declined following Armenia's independence in 1991. In response, the American Red Cross (ARC) and the Armenian Red Cross Society (ARCS) implemented the WHO community-level Integrated Management of Childhood Illnesses (IMCI) strategy, complementing recent clinical IMCI training in the region in which 387 community health volunteers from 16 villages were trained as peer educators, and approximately 5000 caretakers of children under age 5 were counselled on key nutrition and health practices. A pre-post independent sample design was used to assess the programme's impact. The evaluation instrument collected respondent demographic characteristics and knowledge, attitudes and practices consistent with 10 health indicators typical of child survival interventions. At baseline and at follow-up, 300 mothers were interviewed using a stratified simple random sampling of households with at least one child less than age 2. The assessment confirmed the population's poor health status and limited knowledge and application of recommended child care practices. The campaign reached its target: at follow-up, 67% had seen media messages within the past month, 82% had received the IMCI informational booklet, and 30% had seen other materials. Evidence of the success of the programme included the following: exclusive breastfeeding increased 31.4%, maternal knowledge of child illness signs increased 30%, knowledge of HIV increased 28.5%, and physician attended deliveries increased 15%. This evaluation documented the significant and substantial impact of the community IMCI programme on both knowledge and practice in rural areas of Armenia. Consideration should be given to continuing and expanding this project as a complement to health sector development activities in this region.

  11. Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study.

    Science.gov (United States)

    Taylor, Natalie J; Sahota, Pinki; Sargent, Judith; Barber, Sally; Loach, Jackie; Louch, Gemma; Wright, John

    2013-12-28

    Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother's diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

  12. Attitudes of Swiss Health Care Providers Toward Childhood Immunizations.

    Science.gov (United States)

    Schuler, Marianne; Schaedelin, Sabine; Aebi, Christoph; Berger, Christoph; Crisinel, Pierre-Alex; Diana, Alessandro; Niederer-Loher, Anita; Siegrist, Claire-Anne; Vaudaux, Bernard; Heininger, Ulrich

    2017-06-01

    INFOVAC is a network providing information about immunization issues to health professionals. The aim of this study was to assess the attitude of INFOVAC subscribers toward the current Swiss immunization schedule, potential modifications, and current and hypothetical immunization practices regarding their own children. In March 2015, a Web-based survey was sent to 4260 physicians and pharmacists subscribed to INFOVAC. Participation was anonymous and voluntary. The following information was obtained: (1) current immunization status of own children; (2) which immunizations would currently be accepted for a hypothetical own child and (3) attitudes toward potential modifications of the Swiss immunization schedule. Descriptive methods and multivariate models to correct for covariables were used for data analysis. Nine hundred and fifty-five valid questionnaires were received: 886/3704 (23.9%) from physicians and 69/556 (12.4%) from pharmacists. Current (>95%) and hypothetical (>99%) immunization rates were high for diphtheria, tetanus, pertussis, poliomyelitis and measles-mumps-rubella. Most pediatricians (61%) would support more vaccines for their children than currently recommended by the Swiss immunization advisory committee, whereas about 50% of other physicians and pharmacists would decline at least one of the recommended immunizations, most frequently varicella, pneumococcal or meningococcal C conjugate vaccines. Strong general support was expressed for the expansion of human papillomavirus immunization to males, acceleration of the measles-mumps-rubella schedule and a 2 + 1 instead of 3 + 1 diphtheria-tetanus-pertussis, acellular-inactivated poliomyelitis vaccine (DTPa-IPV)/Haemophilus influenzae type b ± hepatitis B virus (HBV) schedule. Survey participants generally demonstrated a positive attitude toward immunization, with pediatricians being the most progressive subgroup with the largest percentage of participants (63.1%) neither declining nor postponing any

  13. Early childhood development coming of age: science through the life course.

    Science.gov (United States)

    Black, Maureen M; Walker, Susan P; Fernald, Lia C H; Andersen, Christopher T; DiGirolamo, Ann M; Lu, Chunling; McCoy, Dana C; Fink, Günther; Shawar, Yusra R; Shiffman, Jeremy; Devercelli, Amanda E; Wodon, Quentin T; Vargas-Barón, Emily; Grantham-McGregor, Sally

    2017-01-07

    Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Asthma in childhood: a complex, heterogeneous disease

    Directory of Open Access Journals (Sweden)

    Hai Lee Chung

    2011-01-01

    Full Text Available Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

  15. Expanded programme on immunization and primary health care.

    Science.gov (United States)

    Basu, R N

    1982-09-01

    The ultimate objective of the Expanded Program on Immunication, better known as EPI, is to reduce the morbidity of the diseases for which vaccine is available. The EPI is a key component of the country effort to provide Health for All by the year 2000. It is planned that by 1990 immunization services will be available for all infants against diphtheria, whooping cough, tetanus, tuberculosis, and poliomyelitis and for all school children for diptheria, tetanus, and typhoid, and for all pregnant women against tetanus. The immunization services will be a part of the comprehensive health care and will be integrated with all hospitals and dispensaries in urban areas and primary health centers/subcenters in the rural areas. Outreach operations are encouraged to bring these services as close to the mother and children as possible. Steps have already been taken to make the country self-sufficient in the production of different quality vaccines to meet the program requirements. New vaccines will be added where found to be epidemiologically necessary and administratively feasible. The vaccination program is effective only if given at the right age. A national immunization schedule has been prepared which emphasizes vaccination of all infants with 1 dose of BCG, 3 doses of DPT and polio at a minimum interval of 1 month, by the 1st birthday. School entrants are given a booster dose of DT and 2 doses of typhoid vaccine at an interval of 1 month. The children leaving primary school and leaving high school are given 1 booster dose of tetanus toxoid. In case of history of tetanus toxoid immunization in the earlier preganancy, 1 booster dose is adequate. Important components of management of EPI are cold chain maintenance, record keeping and evaluation, uniform vaccination coverage standards, and communication with the public through various media. A table gives the number of children/women proposed to be covered with full course of vaccine during each year of the 6th Plan. Disease

  16. The Influence of Maternal Prenatal and Early Childhood Nutrition and Maternal Prenatal Stress on Offspring Immune System Development and Neurodevelopmental Disorders

    Directory of Open Access Journals (Sweden)

    Andrea Horvath Marques

    2013-07-01

    Full Text Available The developing immune system and central nervous system in the fetus and child are extremely sensitive to both exogenous and endogenous signals. Early immune system programming, leading to changes that can persist over the life course, has been suggested, and other evidence suggests that immune dysregulation in the early developing brain may play a role in neurodevelopmental disorders such as autism spectrum disorder and schizophrenia. The timing of immune dysregulation with respect to gestational age and neurologic development of the fetus may shape the elicited response. This creates a possible sensitive window of programming or vulnerability. This review will explore the effects of prenatal maternal and infant nutritional status (from conception until early childhood as well as prenatal maternal stress and anxiety on early programming of immune function, and how this might influence neurodevelopment. We will describe fetal immune system development and maternal-fetal immune interactions to provide a better context for understanding the influence of nutrition and stress on the immune system. Finally, we will discuss the implications for prevention of neurodevelopmental disorders, with a focus on nutrition. Although certain micronutrient supplements have shown to both reduce the risk of neurodevelopmental disorders and enhance fetal immune development, we do not know whether their impact on immune development contributes to the preventive effect on neurodevelopmental disorders. Future studies are needed to elucidate this relationship, which may contribute to a better understanding of preventative mechanisms. Integrating studies of neurodevelopmental disorders and prenatal exposures with the simultaneous evaluation of neural and immune systems will shed light on mechanisms that underlie individual vulnerability or resilience to neurodevelopmental disorders and ultimately contribute to the development of primary preventions and early

  17. Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

    Science.gov (United States)

    Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

    2015-01-01

    Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

  18. Imaging findings in systemic childhood diseases presenting with dermatologic manifestations.

    Science.gov (United States)

    Fink, Adam Z; Gittler, Julia K; Nakrani, Radhika N; Alis, Jonathan; Blumfield, Einat; Levin, Terry L

    Many childhood diseases often present with skin abnormalities with which radiologists are largely unfamiliar. Knowledge of associated dermatologic manifestations may aid the radiologist in confirming the diagnosis and recommending targeted imaging of affected organs. We review the imaging findings in childhood diseases associated with dermatologic manifestations. Diseases include dermatologic findings which herald underlying malignancy (Neuroblastoma, leukemia/lymphoma, Langerhans cell histiocytosis),are associated with risk of malignancy (Epidermolysis Bullosa, basal cell nevus syndrome, Cowden's syndrome, Tuberous Sclerosis),or indicate a systemic inflammatory/immune disorder (Kawasaki's disease, Henoch Schonlein Purpura, systemic lupus erythematosus, scleroderma, sarcoidosis, dermatomyositis and immune thrombocytopenic purpura). Familiarity with pertinent findings in childhood diseases presenting with dermatologic manifestations in childhood diseases aids the radiologist in confirming the diagnosis and guiding imaging workup. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Building human capacity through early childhood intervention: the Child Development Research Programme at the Tropical Medicine Research Institute, the University of the West Indies, Kingston, Jamaica.

    Science.gov (United States)

    Walker, S P; Chang, S M; Powell, C A; Baker-Henningham, H

    2012-07-01

    Research conducted by the Child Development Research Group in the Tropical Medicine Research Institute has made significant contributions to the understanding of the importance of early nutrition and the home environment for children's development and the impact of psychosocial stimulation for disadvantaged and/or undernourished children. The work has provided critical evidence that has contributed to the increasing attention given to early childhood development in the work and policies of agencies such as the World Bank, World Health Organization (WHO) and United Nations Children Fund (UNICEF). This review concerns research which documented the impact of malnutrition on children's development and for the first time demonstrated the benefits and necessity of psychosocial stimulation for improvement in development. Subsequent research was critical in establishing the importance of linear growth retardation (stunting) as a risk factor for poor child development. A twenty-two-year study of stunted children has demonstrated benefits through to adulthood in areas such as educational attainment, mental health and reduced violent behaviour from an early childhood home visiting programme that works through mothers to promote their children's development. The group's research has also demonstrated that it is feasible and effective to integrate the stimulation intervention into primary care services with benefits to children's development and mothers'child rearing knowledge and practices. The group is currently conducting a study to provide information needed for scaling-up of parenting programmes through evaluation of a new approach to improving parenting through health centres and a modified home visit programme.

  20. Parent Attitudes Toward Pain Management for Childhood Immunizations.

    Science.gov (United States)

    Connelly, Mark; Wallace, Dustin P; Williams, Kristi; Parker, JoLynn; Schurman, Jennifer V

    2016-08-01

    Evidence-based pain-limiting strategies for pediatric immunizations remain underutilized, with barriers identified to date mostly pertaining to health care providers and systems of care. The present study sought to quantify and investigate parent attitudes toward pain management as another potential barrier to the routine use of pain-mitigating strategies during immunizations. Questionnaires measuring parent attitudes, willingness to pay, and perceived barriers for using pain management for immunizations were completed by 259 parent/guardians of children ages 0 to 5 years attending appointments at an urban primary care clinic in the Midwestern United States. Parent attitudes toward pain management for immunization were relatively normally distributed and varied from strongly positive to negative, with 33% of parents disagreeing that they were concerned about the pain their child may experience and 50% agreeing that there are no lasting negative effects from immunization pain. Negative parent attitudes were associated with willingness to spend less in money or time for pain management and with greater perceived significance of cost, time, and other barriers for using pain-mitigating strategies. Some parents perceive limited value in trying to reduce pain during immunizations such that they may be hesitant to invest much time or effort in interventions. Greater success of translating evidence-based pain management into practice therefore may require accounting for differences in parent attitudes by tailoring educational efforts and pain management options accordingly.

  1. Cesarean Section and Chronic Immune Disorders

    DEFF Research Database (Denmark)

    Sevelsted, Astrid; Stokholm, Jakob; Bønnelykke, Klaus

    2015-01-01

    OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated with the develo......OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated...... with the development of some of these diseases. METHODS: Mature children born by cesarean delivery were analyzed for risk of hospital contact for chronic immune diseases recorded in the Danish national registries in the 35-year period 1977-2012. Two million term children participated in the primary analysis. We...... studied childhood diseases with a suspected relation to a deviant immune-maturation and a debut at young age. The effect of cesarean delivery on childhood disease incidences were estimated by means of confounder-adjusted incidence rate ratios with 95% confidence intervals obtained in Poisson regression...

  2. Deficient innate immunity, thymopoiesis, and gene expression response to radiation in survivors of childhood acute lymphoblastic leukemia.

    Science.gov (United States)

    Leung, Wing; Neale, Geoffrey; Behm, Fred; Iyengar, Rekha; Finkelstein, David; Kastan, Michael B; Pui, Ching-Hon

    2010-06-01

    Survivors of childhood acute lymphoblastic leukemia (ALL) are at an increased risk of developing secondary malignant neoplasms. Radiation and chemotherapy can cause mutations and cytogenetic abnormalities and induce genomic instability. Host immunity and appropriate DNA damage responses are critical inhibitors of carcinogenesis. Therefore, we sought to determine the long-term effects of ALL treatment on immune function and response to DNA damage. Comparative studies on 14 survivors in first complete remission and 16 siblings were conducted. In comparison to siblings on the cells that were involved in adaptive immunity, the patients had either higher numbers (CD19+ B cells and CD4+CD25+ T regulatory cells) or similar numbers (alphabetaT cells and CD45RO+/RA- memory T cells) in the blood. In contrast, patients had lower numbers of all lymphocyte subsets involved in innate immunity (gammadeltaT cells and all NK subsets, including KIR2DL1+ cells, KIR2DL2/L3+ cells, and CD16+ cells), and lower natural cytotoxicity against K562 leukemia cells. Thymopoiesis was lower in patients, as demonstrated by less CD45RO-/RA+ naïve T cell and less SjTREC levels in the blood, whereas the Vbeta spectratype complexity score was similar. Array of gene expression response to low-dose radiation showed that about 70% of the probesets had a reduced response in patients. One of these genes, SCHIP-1, was also among the top-ranked single nucleotide polymorphisms (SNPs) during the whole-genome scanning by SNP microarray analysis. ALL survivors were deficient in innate immunity, thymopoiesis, and DNA damage responses to radiation. These defects may contribute to their increased likelihood of second malignancy. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  3. Implementation of Early Childhood Development Education Service Standard Guidelines on Physical Facilities in Public and Private Early Childhood Education Centres Kakamega County, Kenya

    Science.gov (United States)

    Sitati, Emmily M.; Ndirangu, Mwangi; Kennedy, Bota; Rapongo, George S.

    2016-01-01

    In 2006, the Kenyan Ministry of Education (MoE) developed an early childhood development education (ECDE) service standard guidelines to guide the ECDE stakeholders in provision of early childhood education (ECE) programmes. The study sought to investigate the implementation of the ECDE service standard guidelines on provision of physical…

  4. Kids just wanna have fun: Children's experiences of a weight management programme.

    Science.gov (United States)

    Watson, Libby A; Baker, Martyn C; Chadwick, Paul M

    2016-05-01

    To explore children's accounts of their experiences of the UK's largest childhood obesity programme, MEND (Mind, Exercise, Nutrition...Do it!) (See www.mendprogramme.org). Semi-structured interviews were conducted with children who had completed the MEND obesity programme. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA). Fourteen children spanning diverse areas of London comprised this study (eight male, six female), aged between 11 and 14 years and in secondary school. Participants were interviewed a year after completing one of the London-based MEND obesity programmes. This article focuses on the most common and striking theme to emerge from the original dataset (The complete analysis may be found in L. Watson, Unpublished doctoral thesis): Fun. Subthemes were: 'going with the flow'; active participation in activities that led to new experiences ('actually doing it' - seeing the fun side); the importance of others in the experience of fun ('you do games in unity' - 'it's not as fun on your own'). Children have fun when engaged in interactive and varied activities with opportunity for individual feedback and improvement. When designing childhood obesity programmes, conditions that optimise children's experience of fun should be emphasised over didactic and risk-heavy information pertaining to childhood obesity. What is already known on this subject? Continued growth in childhood obesity and its associated health problems, psychological effects, and economic burden make tackling childhood obesity a public health priority. Multicomponent lifestyle interventions to treat childhood obesity within the community have been shown to reduce overweight and obesity from pre- to post-treatment, increase self-esteem, and are found to be acceptable by parents. MEND is the most widely disseminated evidence-based programme of this kind in the United Kingdom. What does this study add? This study is the first qualitative study

  5. The impact of a home visitation programme on household hazards associated with unintentional childhood injuries: a randomised controlled trial.

    Science.gov (United States)

    Odendaal, Willem; van Niekerk, Ashley; Jordaan, Esme; Seedat, Mohamed

    2009-01-01

    The continued high mortality and morbidity rates for unintentional childhood injuries remain a public health concern. This article reports on the influence of a home visitation programme (HVP) on household hazards associated with unintentional childhood injuries in a South African low-income setting. A randomised controlled trial (n=211 households) was conducted in a South African informal settlement. Community members were recruited and trained as paraprofessional visitors. Four intervention visits were conducted over 3 months, focusing on child development, and the prevention of burn, poison, and fall injuries. The HVP, a multi-component intervention, included educational inputs, provision of safety devices, and an implicit enforcement strategy. The intervention effect (IE) was measured with a standardised risk assessment index that compared post-intervention scores for intervention and control households. A significant reduction was observed in the hazards associated with electrical and paraffin appliances, as well as in hazards related to poisoning. Non-significant changes were observed for burn safety household practices and fall injury hazards. This study confirmed that a multi-component HVP effectively reduced household hazards associated with electrical and paraffin appliances and poisoning among children in a low-income South African setting.

  6. Rural-urban disparities in maternal immunization knowledge and ...

    African Journals Online (AJOL)

    Background: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths. Objectives: To compare maternal knowledge about immunization, use of growth chart and childhood health-seeking behavior in rural and urban areas. Methods: A cross-sectional comparative study done in ...

  7. Perspectives on the causes of childhood leukemia.

    Science.gov (United States)

    Wiemels, Joseph

    2012-04-05

    Acute leukemia is the most common cancer in children but the causes of the disease in the majority of cases are not known. About 80% are precursor-B cell in origin (CD19+, CD10+), and this immunophenotype has increased in incidence over the past several decades in the Western world. Part of this increase may be due to the introduction of new chemical exposures into the child's environment including parental smoking, pesticides, traffic fumes, paint and household chemicals. However, much of the increase in leukemia rates is likely linked to altered patterns of infection during early childhood development, mirroring causal pathways responsible for a similarly increased incidence of other childhood-diagnosed immune-related illnesses including allergy, asthma, and type 1 diabetes. Factors linked to childhood leukemia that are likely surrogates for immune stimulation include exposure to childcare settings, parity status and birth order, vaccination history, and population mixing. In case-control studies, acute lymphoblastic leukemia (ALL) is consistently inversely associated with greater exposure to infections, via daycare and later birth order. New evidence suggests also that children who contract leukemia may harbor a congenital defect in immune responder status, as indicated by lower levels of the immunosuppressive cytokine IL-10 at birth in children who grow up to contract leukemia, as well as higher need for clinical care for infections within the first year of life despite having lower levels of exposure to infections. One manifestation of this phenomenon may be leukemia clusters which tend to appear as a leukemia "outbreak" among populations with low herd immunity to a new infection. Critical answers to the etiology of childhood leukemia will require incorporating new tools into traditional epidemiologic approaches - including the classification of leukemia at a molecular scale, better exposure assessments at all points in a child's life, a comprehensive

  8. Breast milk IL-1β level associates with development of eczema during early childhood

    DEFF Research Database (Denmark)

    Jepsen, A. A.; Chawes, B. L. K.; Carson, C. G.

    2015-01-01

    We recently demonstrated adual effect of breastfeeding with increasedrisk of eczema and decreased risk ofwheezing in early childhood. We hypothesizethat maternal immune constitutioncharacterized by breast milk mediatorsmay explain such association.......We recently demonstrated adual effect of breastfeeding with increasedrisk of eczema and decreased risk ofwheezing in early childhood. We hypothesizethat maternal immune constitutioncharacterized by breast milk mediatorsmay explain such association....

  9. Budget impact of polio immunization strategy for India: introduction of one dose of inactivated poliomyelitis vaccine and reductions in supplemental polio immunization.

    Science.gov (United States)

    Khan, M M; Sharma, S; Tripathi, B; Alvarez, F P

    2017-01-01

    To conduct a budget impact analysis (BIA) of introducing the immunization recommendations of India Expert Advisory Group (IEAG) for the years 2015-2017. The recommendations include introduction of one inactivated poliomyelitis vaccine (IPV) dose in the regular child immunization programme along with reductions in oral polio vaccine (OPV) doses in supplemental programmes. This is a national level analysis of budget impact of new polio immunization recommendations. Since the states of India vary widely in terms of size, vaccine coverage and supplemental vaccine needs, the study estimated the budget impact for each of the states of India separately to derive the national level budget impact. Based on the recommendations of IEAG, the BIA assumes that all children in India will get an IPV dose at 14 weeks of age in addition to the OPV and DPT (or Pentavalent-3) doses. Cost of introducing the IPV dose was estimated by considering vaccine price and vaccine delivery and administration costs. The cost savings associated with the reduction in number of doses of OPV in supplemental immunization were also estimated. The analysis used India-specific or international cost parameters to estimate the budget impact. Introduction of one IPV dose will increase the cost of vaccines in the regular immunization programme from $20 million to $47 million. Since IEAG recommends lower intensity of supplemental OPV vaccination, polio vaccine cost of supplemental programme is expected to decline from $72 million to $53 million. Cost of administering polio vaccines will also decline from $124 million to $105 million mainly due to the significantly lower intensity of supplemental polio vaccination. The net effect of adopting IEAG's recommendations on polio immunization turns out to be cost saving for India, reducing total polio immunization cost by $6 million. Additional savings could be achieved if India adopts the new policy regarding the handling of multi-dose vials after opening

  10. Systematic review of the effect of immunization mandates on uptake of routine childhood immunizations.

    Science.gov (United States)

    Lee, Cecilia; Robinson, Joan L

    2016-06-01

    The efficacy of immunization mandates for childcare or school entry is a long-standing controversy. The United States (US) adopted school entry immunization mandates in the 1800s, while most countries still do not have mandates. The objective of this systematic review was to analyze the evidence that immunization uptake increases with mandates. A search was conducted for studies that compared immunization uptake in a population prior to and after mandates, or in similar populations with one group having and the other not having mandates. Data were extracted and synthesized qualitatively due to the heterogeneity of study design. Eleven before-and-after studies and ten studies comparing uptake in similar populations with and without mandates were included. Studies were from the US (n = 18), France (n = 1) and Canada (n = 2). Eleven of the 21 studies looked at middle school mandates. All but two studies showed at least a trend towards increased uptake with mandates. Higher uptake was associated with a more long-standing mandate. Immunization mandates have generally led to increased short-term and long-term uptake in the group to whom the mandate applies. Many studies have centered around middle school mandates in the US and there is a paucity of studies of childcare mandates or of studies of mandates in other countries or in settings with relatively high baseline immunization uptake. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  11. Humoral Immunity to Primary Smallpox Vaccination: Impact of Childhood versus Adult Immunization on Vaccinia Vector Vaccine Development in Military Populations.

    Directory of Open Access Journals (Sweden)

    Bonnie M Slike

    Full Text Available Modified Vaccinia virus has been shown to be a safe and immunogenic vector platform for delivery of HIV vaccines. Use of this vector is of particular importance to the military, with the implementation of a large scale smallpox vaccination campaign in 2002 in active duty and key civilian personnel in response to potential bioterrorist activities. Humoral immunity to smallpox vaccination was previously shown to be long lasting (up to 75 years and protective. However, using vaccinia-vectored vaccine delivery for other diseases on a background of anti-vector antibodies (i.e. pre-existing immunity may limit their use as a vaccine platform, especially in the military. In this pilot study, we examined the durability of vaccinia antibody responses in adult primary vaccinees in a healthy military population using a standard ELISA assay and a novel dendritic cell neutralization assay. We found binding and neutralizing antibody (NAb responses to vaccinia waned after 5-10 years in a group of 475 active duty military, born after 1972, who were vaccinated as adults with Dryvax®. These responses decreased from a geometric mean titer (GMT of 250 to baseline (30 years with a GMT of 210 (range 112-3234. This data suggests limited durability of antibody responses in adult vaccinees compared to those vaccinated in childhood and further that adult vaccinia recipients may benefit similarly from receipt of a vaccinia based vaccine as those who are vaccinia naïve. Our findings may have implications for the smallpox vaccination schedule and support the ongoing development of this promising viral vector in a military vaccination program.

  12. Early Childhood Care and Education: A Child Perspective Paradigm

    Science.gov (United States)

    Sommer, Dion; Pramling Samuelsson, Ingrid; Hundeide, Karsten

    2013-01-01

    From research we know that there is no specific early childhood education programme that is superior to other approaches (National Research Council. 2001). At the same time, historically it looks like people think there is a specific programme that will solve all problems and guarantee a high quality in early years education, since different…

  13. Bone marrow immunophenotyping by flow cytometry in refractory cytopenia of childhood

    NARCIS (Netherlands)

    A.M. Aalbers (Anna Maartje); M.M. van den Heuvel-Eibrink (Marry); I. Baumann (Irith); M.N. Dworzak (Michael); H. Hasle (Henrik); F. Locatelli (Franco); B. de Moerloose (Barbara); M. Schmugge; E. Mejstříková (Ester); M. Nováková (Michaela); M. Zecca (Marco); C.M. Zwaan (Christian Michel); J.G. te Marvelde (Jeroen); A.W. Langerak (Anton); J.J.M. van Dongen (Jacques); R. Pieters (Rob); C.M. Niemeyer (Charlotte); V.H.J. van der Velden (Vincent)

    2015-01-01

    textabstractRefractory cytopenia of childhood is the most common type of childhood myelodysplastic syndrome. Because the majority of children with refractory cytopenia have a normal karyotype and a hypocellular bone marrow, differentiating refractory cytopenia from the immune-mediated bone marrow

  14. Assessment of nutrition and physical activity education programmes in children.

    Science.gov (United States)

    Burke, V; Beilin, L J; Milligan, R; Thompson, C

    1995-03-01

    1. Studies in children relating blood lipids to the extent of atherosclerosis at post-mortem suggest a link between risk factors for cardiovascular disease in childhood and adult life. Tracking of blood pressure (BP) and cholesterol from childhood also supports this association. However, prospective studies have not yet established the outcome in children with increased levels of risk factors. 2. In a controlled trial in Perth, Western Australia, involving over 1000 10-12 year old children, fitness was improved by physical activity programmes which were associated with a greater fall in diastolic BP and triceps skinfolds in girls compared with controls. Sugar intake decreased in boys and fat intake fell in girls, mainly affecting participants in home nutrition programmes. 3. In higher risk children, identified by cluster analysis, major benefits were associated with the fitness and home nutrition programmes. Physical activity combined with involvement of the family in nutrition education is likely to be the most successful approach to modifying lifestyle in children, including those with higher levels of risk. 4. Undernutrition by too rigid restriction of fat intake must be avoided in young children who need calorie-dense foods. Undernutrition, in itself, may predispose to cardiovascular disease in later life. Programmes should aim to establish a prudent diet appropriate to the age of the child combined with physical activity. As regular activity and a healthy diet in adult life will reduce risks of cardiovascular disease it is likely that childhood education will establish lifestyle habits of potential long-term benefit.

  15. Enter B and W: two new meningococcal vaccine programmes launched

    OpenAIRE

    Ladhani, Shamez N; Ramsay, Mary; Borrow, Ray; Riordan, Andrew; Watson, John M; Pollard, Andrew J

    2016-01-01

    In 2015, the UK became the first country in the world to have a comprehensive routine meningococcal vaccine programme targeting all of the main capsular groups of N. meningitidis. 1 An infant vaccine programme against meningococcal capsular group B Neisseria meningitidis (MenB) was launched from 1st September with an aim to reduce endemic MenB disease in early childhood. On 1st August 2015, an adolescent programme against groups A, C, W and Y meningococci (MenACWY) was rolled out to halt a gr...

  16. Uptake of the human papillomavirus-vaccination within the free-of-charge childhood vaccination programme in Denmark.

    Science.gov (United States)

    Widgren, Katarina; Simonsen, Jacob; Valentiner-Branth, Palle; Mølbak, Kåre

    2011-12-06

    Persistent infection with human papillomavirus (HPV) is a prerequisite for cervical cancer, which causes 175 yearly deaths and substantial morbidity in Denmark. In January 2009, HPV-vaccination for 12 year-old girls was introduced into the free-of-charge childhood vaccination programme. Due to concerns about potential poor compliance we determined the uptake and identified determinants for vaccination after the first year of the programme. All vaccinations given within the vaccination programme are reported to a central register, which we linked to demographic information found in the Danish civil register. We calculated vaccination uptake and used Cox regression survival analysis to compare the uptake rates between demographic subgroups in the population, e.g. by number of siblings, age of mother (at the daughter's birth) and place of origin. The uptake among the 33,838 eligible girls was 80%, 75% and 62% respectively for the three HPV-doses. All subgroups had uptake above 68% for the first HPV-vaccination. Girls with mothers younger or older than the reference group of 25-34 years had a lower uptake rate (adjHR 0.94, 95% CI 0.91-0.97 and adjHR 0.91, 95% CI 0.88-0.94 respectively). Girls with 5 or more siblings had lower uptake rate than girls without siblings (adjHR 0.79, 95% CI 0.71-0.87). Girls born in other EU/EFTA-countries had lower uptake rate than Danish-born girls with Danish-born parents (adjHR 0.74, 95% CI 0.67-0.82). The introduction of routine HPV-vaccination in Denmark resulted in a relatively high uptake, indicating little reason for major concern about barriers towards the vaccination in Denmark. Population groups with reduced uptake were identified, but as they were small in number their effect on the overall vaccination coverage was marginal. Nonetheless, these groups should be targeted in future acceptance studies and vaccination awareness campaigns. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Methods used for immunization coverage assessment in Canada, a Canadian Immunization Research Network (CIRN) study.

    Science.gov (United States)

    Wilson, Sarah E; Quach, Susan; MacDonald, Shannon E; Naus, Monika; Deeks, Shelley L; Crowcroft, Natasha S; Mahmud, Salaheddin M; Tran, Dat; Kwong, Jeff; Tu, Karen; Gilbert, Nicolas L; Johnson, Caitlin; Desai, Shalini

    2017-08-03

    Accurate and complete immunization data are necessary to assess vaccine coverage, safety and effectiveness. Across Canada, different methods and data sources are used to assess vaccine coverage, but these have not been systematically described. Our primary objective was to examine and describe the methods used to determine immunization coverage in Canada. The secondary objective was to compare routine infant and childhood coverage estimates derived from the Canadian 2013 Childhood National Immunization Coverage Survey (cNICS) with estimates collected from provinces and territories (P/Ts). We collected information from key informants regarding their provincial, territorial or federal methods for assessing immunization coverage. We also collected P/T coverage estimates for select antigens and birth cohorts to determine absolute differences between these and estimates from cNICS. Twenty-six individuals across 16 public health organizations participated between April and August 2015. Coverage surveys are conducted regularly for toddlers in Quebec and in one health authority in British Columbia. Across P/Ts, different methodologies for measuring coverage are used (e.g., valid doses, grace periods). Most P/Ts, except Ontario, measure up-to-date (UTD) coverage and 4 P/Ts also assess on-time coverage. The degree of concordance between P/T and cNICS coverage estimates varied by jurisdiction, antigen and age group. In addition to differences in the data sources and processes used for coverage assessment, there are also differences between Canadian P/Ts in the methods used for calculating immunization coverage. Comparisons between P/T and cNICS estimates leave remaining questions about the proportion of children fully vaccinated in Canada.

  18. [Oral diseases in auto-immune polyendocrine syndrome type 1].

    Science.gov (United States)

    Proust-Lemoine, Emmanuelle; Guyot, Sylvie

    2017-09-01

    Auto-immune polyendocrine syndrome type 1 (APS1) also called Auto-immune Polyendocrinopathy Candidiasis Ectodermal Dystrophy (APECED) is a rare monogenic childhood-onset auto-immune disease. This autosomal recessive disorder is caused by mutations in the auto-immune regulator (AIRE) gene, and leads to autoimmunity targeting peripheral tissues. There is a wide variability in clinical phenotypes in patients with APSI, with auto-immune endocrine and non-endocrine disorders, and chronic mucocutaneous candidiasis. These patients suffer from oral diseases such as dental enamel hypoplasia and candidiasis. Both are frequently described, and in recent series, enamel hypoplasia and candidiasis are even the most frequent components of APS1 together with hypoparathyroidism. Both often occur during childhood (before 5 years old for canrdidiasis, and before 15 years old for enamel hypoplasia). Oral candidiasis is recurrent all life long, could become resistant to azole antifungal after years of treatment, and be carcinogenic, leading to severe oral squamous cell carcinoma. Oral components of APS1 should be diagnosed and rigorously treated. Dental enamel hypoplasia and/or recurrent oral candidiasis in association with auto-immune diseases in a young child should prompt APS1 diagnosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. The prevention of overweight and obesity in children and adolescents : a review of interventions and programmes

    NARCIS (Netherlands)

    Doak, C M; Visscher, T L S; Renders, C M; Seidell, J C

    Overweight and obesity are serious, large-scale, global, public health concerns requiring population-based childhood overweight and obesity prevention. The overall objective of this review is to identify aspects of successful childhood overweight prevention programmes. This objective will be met by

  20. 'Communicate to vaccinate' (COMMVAC. building evidence for improving communication about childhood vaccinations in low- and middle-income countries: protocol for a programme of research

    Directory of Open Access Journals (Sweden)

    Lewin Simon

    2011-12-01

    Full Text Available Abstract Background Effective provider-parent communication can improve childhood vaccination uptake and strengthen immunisation services in low- and middle-income countries (LMICs. Building capacity to improve communication strategies has been neglected. Rigorous research exists but is not readily found or applicable to LMICs, making it difficult for policy makers to use it to inform vaccination policies and practice. The aim of this project is to build research knowledge and capacity to use evidence-based strategies for improving communication about childhood vaccinations with parents and communities in LMICs. Methods and design This project is a mixed methods study with six sub-studies. In sub-study one, we will develop a systematic map of provider-parent communication interventions for childhood vaccinations by screening and extracting data from relevant literature. This map will inform sub-study two, in which we will develop a taxonomy of interventions to improve provider-parent communication around childhood vaccination. In sub-study three, the taxonomy will be populated with trial citations to create an evidence map, which will also identify how evidence is linked to communication barriers regarding vaccination. In the project's fourth sub-study, we will present the interventions map, taxonomy, and evidence map to international stakeholders to identify high-priority topics for systematic reviews of interventions to improve parent-provider communication for childhood vaccination. We will produce systematic reviews of the effects of high-priority interventions in the fifth sub-study. In the sixth and final sub-study of the project, evidence from the systematic reviews will be translated into accessible formats and messages for dissemination to LMICs. Discussion This project combines evidence mapping, conceptual and taxonomy development, priority setting, systematic reviews, and knowledge transfer. It will build and share concepts, terms

  1. Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants.

    Science.gov (United States)

    Larsen, Jeppe Madura; Brix, Susanne; Thysen, Anna Hammerich; Birch, Sune; Rasmussen, Morten Arendt; Bisgaard, Hans

    2014-04-01

    Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonization of neonatal airways with the pathogenic bacterial strains Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae is associated with increased risk of later childhood asthma. We hypothesized that children with asthma have an abnormal immune response to pathogenic bacteria in infancy. We aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years. The Copenhagen Prospective Studies on Asthma in Childhood birth cohort was followed prospectively, and asthma was diagnosed at age 7 years. The immune response to H influenzae, M catarrhalis, and S pneumoniae was analyzed in 292 infants using PBMCs isolated and stored since the age of 6 months. The immune response was assessed based on the pattern of cytokines produced and T-cell activation. The immune response to pathogenic bacteria was different in infants with asthma by 7 years of age (P = .0007). In particular, prospective asthmatic subjects had aberrant production of IL-5 (P = .008), IL-13 (P = .057), IL-17 (P = .001), and IL-10 (P = .028), whereas there were no differences in T-cell activation or peripheral T-cell composition. Children with asthma by school age exhibited an aberrant immune response to pathogenic bacteria in infancy. We propose that an abnormal immune response to pathogenic bacteria colonizing the airways in early life might lead to chronic airway inflammation and childhood asthma. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  2. Limited availability of childhood overweight and obesity treatment programmes in Danish paediatric departments

    DEFF Research Database (Denmark)

    Eg, M; Cortes, Dina; Johansen, A.

    2016-01-01

    Committee in 2015. RESULTS: About 32% of the 19 departments had multi-dis-cip-linary programmes resembling the guideline recommendations. Roughly 37% of the departments offered considerably less comprehensive programmes than proposed by the guidelines, and roughly 32% offered only a general basic...... of departments offered less comprehensive programmes. The final third offered no multidisciplinary treatment programme for the target group. The criteria for referral to the paediatric departments that offered obesity programmes were heterogeneous. FUNDING: Funding for this study was received from Region...

  3. Inequity in access to childhood immunization in Enugu urban ...

    African Journals Online (AJOL)

    Principal components analysis in STATA software was used to characterize socioeconomic inequity. Results: Immunization coverage was as follows: Diphtheria, pertussis, tetanus third dose(DPT3), 3, 65.3%; oral polio vaccine 3, 78.0%; hepatitis B3, 65.2%; and measles, 55.8%. The full immunization rates for children 1–5 ...

  4. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence

    Directory of Open Access Journals (Sweden)

    Suma Uday

    2017-10-01

    Full Text Available Background: Nutritional rickets is a growing global public health concern despite existing prevention programmes and health policies. We aimed to compare infant and childhood vitamin D supplementation policies, implementation strategies and practices across Europe and explore factors influencing adherence. Methods: European Society for Paediatric Endocrinology Bone and Growth Plate Working Group members and other specialists completed a questionnaire on country-specific vitamin D supplementation policy and child health care programmes, socioeconomic factors, policy implementation strategies and adherence. Factors influencing adherence were assessed using Kendall’s tau-b correlation coefficient. Results: Responses were received from 29 of 30 European countries (97%. Ninety-six per cent had national policies for infant vitamin D supplementation. Supplements are commenced on day 1–5 in 48% (14/29 of countries, day 6–21 in 48% (14/29; only the UK (1/29 starts supplements at 6 months. Duration of supplementation varied widely (6 months to lifelong in at-risk populations. Good (≥80% of infants, moderate (50–79% and low adherence (<50% to supplements was reported by 59% (17/29, 31% (9/29 and 10% (3/29 of countries, respectively. UK reported lowest adherence (5–20%. Factors significantly associated with good adherence were universal supplementation independent of feeding mode (P = 0.007, providing information at neonatal unit (NNU discharge (P = 0.02, financial family support (P = 0.005; monitoring adherence at surveillance visits (P = 0.001 and the total number of factors adopted (P < 0.001. Conclusions: Good adherence to supplementation is a multi-task operation that works best when parents are informed at birth, all babies are supplemented, and adherence monitoring is incorporated into child health surveillance visits. Implementation strategies matter for delivering efficient prevention policies.

  5. Personality disorder, temperament, and childhood adversity: findings from a cohort of prisoners in England and Wales

    OpenAIRE

    Roberts, Amanda D.L.; Yang, Min; Zhang, Tianqiang; Coid, Jeremy

    2008-01-01

    Adverse childhood experiences and childhood temperamental features are known to contribute to the development of personality disorder. The aim of this study was to examine associations between personality disorder, childhood temperament, adverse childhood experiences, and victimisation. The Prisoner Cohort Study was carried out as part of the dangerous and severe personality disorder (DSPD) service development programme commissioned by the Home Office. The study comprised 1396 male offenders ...

  6. Evaluation of a social marketing campaign to increase awareness of immunizations for urban low-income children.

    Science.gov (United States)

    Ngui, Emmanuel M; Hamilton, Chelsea; Nugent, Melodee; Simpson, Pippa; Willis, Earnestine

    2015-02-01

    To assess community awareness of childhood immunizations and intent to immunize children after a social marketing immunization campaign. We used 2 interviewer-assisted street-intercept surveys to evaluate awareness of childhood immunizations and intent to immunize low-income children. The "Take Control! Immunize" social marketing campaign was developed using a community-based participatory research approach and used billboards, flyers, and various "walking billboard" (eg, backpacks, pens) to deliver immunization messages in the community settings. Over 85% of community members recalled the "Take Control! Immunize" message. Almost half of those who saw the immunization message indicated that the message motivated them to act, including getting their children immunized or calling their physician to inquire about their children's immunizations status. All respondents indicated that immunizations were important for children and that they were likely or very likely to immunize their children. Respondents who reported that "Take Control!" messages motivated them to act in the first intercept survey were significantly more likely than those in the second intercept to report being likely or very likely to immunize their children. Culturally appropriate social marketing immunization messages in targeted urban settings can increase parental awareness and behavioral intention to immunize children.

  7. Missed Opportunities For Immunization In Children And Pregnant Women

    Directory of Open Access Journals (Sweden)

    Benjamin A I

    1990-01-01

    Full Text Available The role of immunization in reducing childhood mortality cannot be over-emphasised, yet many opportunities for immunization are missed when children and pregnant women visit a health facility. Reducing missed opportunities is the cheapest way to increase immunization coverage. The present study discusses the extent of the problem of missed opportunities for immunization in children and pregnant women and the factors contributing to the problem, in spatiality and community outreach clinics of Christian Medical College & Hospital, Ludhiana. Recommendations are made regarding ways and means of reducing missed opportunities.

  8. Sport activity and eating habits of people who were attending special obesity treatment programme.

    Science.gov (United States)

    Videmsek, Mateja; Stihec, Joze; Karpljuk, Damir; Starman, Anja

    2008-09-01

    The aims of the study were to analyse the sport activity and eating habits of obese people in their childhood and adulthood. The research was underpinned by a survey questionnaire containing 37 variables which was completed by 71 people attending the obesity programme. The frequencies and contingency tables were calculated, whereas statistical significance was established at a 5% significance level. The analysis of the results showed that more than one-half of the survey respondents joined the obesity programme primarily for reasons of health and well-being. Most obese people did not engage in any organised sport activity in their childhood, nor did most of their parents. The respondents practiced sport in their childhood to a greater extent if their parents were also physically active and if they guided and encouraged their children. No less than one-third of the respondents were overweight in their childhood, of whom two-thirds did not participate in any organised sport activity. The majority of the respondents (85.9%) are currently engaged in an organised sport activity in their adulthood, mainly due to their participation in the weight reduction programme; most of them practice sport twice a week. Their eating habits are encouraging; the share of skipped meals is considerably lower and practically negligible compared to that in childhood. It has to be emphasized that most of them are of opinion that obese people have difficulties finding expert information on obesity, nutrition and sport activities as well as weight management centers and institutions.

  9. Early intervention as a catalyst for effective early childhood ...

    African Journals Online (AJOL)

    ... of positive attitudes towards children with disabilities in a country like Ghana. ... As Ghana strides towards mainstreaming early childhood education in the quest ... an integrated, inclusive and effective early intervention programme becomes ...

  10. Good practices in early childhood education:

    DEFF Research Database (Denmark)

    Sanders, Lise; Gregoriadis, Athanasis; Zachopoulou, Evridiki

    Good practices in early childhood education er en undersøgelse fortaget efter Early Childhood Environmental Rating Scale - R (ECERS-R). I undersøgelsen deltog Akademikere, pædagoger og kommunalt personale fra de 6 partnerlande bestående af Grækenland, Portugal, Finland, Danmark, Rumænien og Cypern....... Undersøgelsen fokuserede på indsamling af Good practice inden for 5 specifikke kategorier af daglig praksis i børnehaver og børnehaveklasser. Plads og Inventar Personlige omsorgsrutiner Sprog - Tænkning Aktiviteter Interaktioner Struktur Projektet er støttet af Lifelong learning programme of the European Union...

  11. Increasing Programme Effectiveness through Parent Empowerment: The Getting Ready for School Project in Tajikistan

    Science.gov (United States)

    Whitsel, Christopher Michael; Lapham, Kate

    2014-01-01

    Within the development studies framework, empowerment involves increasing individual agency vis-à-vis the formal and informal opportunity structure. The Open Society Foundation's Early Childhood Programme developed the Getting Ready for School programme specifically for parents of preschool-age children to use at home in the year before school to…

  12. Children developing asthma by school-age display aberrant immune responses to pathogenic airway bacteria as infants

    DEFF Research Database (Denmark)

    Larsen, Jeppe Madura; Pedersen, Susanne Brix; Thysen, Anna Hammerich

    2014-01-01

    Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonisation of neonatal airways with the pathogenic bacterial strains H. influenzae, M. catarrhalis and S. pneumoniae is associated with increased risk of later childhood asthma. We hypothesized that c...... that children developing asthma have an abnormal immune response to pathogenic bacteria in infancy. We aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years.......Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonisation of neonatal airways with the pathogenic bacterial strains H. influenzae, M. catarrhalis and S. pneumoniae is associated with increased risk of later childhood asthma. We hypothesized...

  13. Efficacy of screening immune system function in at-risk newborns

    OpenAIRE

    Pavlovski, Christopher J

    2014-01-01

    This paper explores the introduction of a screening test to highlight impaired immune system status for newborn infants and its efficacy as a preventative clinical measure. Moreover, it is suggested that screening of the infantile immune system has the potential to highlight susceptibility to a range of infant and childhood diseases, bestowing an opportunity to introduce early intervention to reduce the incidence of these diseases. Development of the neonatal immune system is an important hea...

  14. Fully immunized child: coverage, timing and sequencing of routine immunization in an urban poor settlement in Nairobi, Kenya.

    Science.gov (United States)

    Mutua, Martin Kavao; Kimani-Murage, Elizabeth; Ngomi, Nicholas; Ravn, Henrik; Mwaniki, Peter; Echoka, Elizabeth

    2016-01-01

    More efforts have been put in place to increase full immunization coverage rates in the last decade. Little is known about the levels and consequences of delaying or vaccinating children in different schedules. Vaccine effectiveness depends on the timing of its administration, and it is not optimal if given early, delayed or not given as recommended. Evidence of non-specific effects of vaccines is well documented and could be linked to timing and sequencing of immunization. This paper documents the levels of coverage, timing and sequencing of routine childhood vaccines. The study was conducted between 2007 and 2014 in two informal urban settlements in Nairobi. A total of 3856 children, aged 12-23 months and having a vaccination card seen were included in analysis. Vaccination dates recorded from the cards seen were used to define full immunization coverage, timeliness and sequencing. Proportions, medians and Kaplan-Meier curves were used to assess and describe the levels of full immunization coverage, vaccination delays and sequencing. The findings indicate that 67 % of the children were fully immunized by 12 months of age. Missing measles and third doses of polio and pentavalent vaccine were the main reason for not being fully immunized. Delays were highest for third doses of polio and pentavalent and measles. About 22 % of fully immunized children had vaccines in an out-of-sequence manner with 18 % not receiving pentavalent together with polio vaccine as recommended. Results show higher levels of missed opportunities and low coverage of routine childhood vaccinations given at later ages. New strategies are needed to enable health care providers and parents/guardians to work together to increase the levels of completion of all required vaccinations. In particular, more focus is needed on vaccines given in multiple doses (polio, pentavalent and pneumococcal conjugate vaccines).

  15. Urban Early Childhood Teachers' Attitudes towards Inclusive Education

    Science.gov (United States)

    Hsieh, Wu-Ying; Hsieh, Chang-Ming

    2012-01-01

    This study investigated the relationship between urban early childhood teachers' attitudes towards inclusive education and personal characteristics, professional background, and programme context. Questionnaires were completed by teachers (n = 130) who taught preschool children in primarily low-income, urban neighbourhoods. Attitude ratings were…

  16. Evaluation of an early childhood parenting programme in rural Bangladesh.

    Science.gov (United States)

    Aboud, Frances E

    2007-03-01

    To promote physical and mental development of children, parenting education programmes in developing countries focus on specific practices such as age-appropriate responsive stimulation and feeding. A programme delivered to groups of poor mothers of children, aged less than three years, in rural Bangladesh was evaluated using an intervention-control post-test design. Mothers (n=170) who had attended a year of educational sessions and their children were compared with those (n=159) from neighbouring villages who did not have access to such a programme. After covariates were controlled, the parenting mothers obtained higher scores on a test of child-rearing knowledge and on the Home Observation for Measurement of the Environment (HOME) inventory of stimulation. The parenting mothers did not communicate differently with their children while doing a picture-talking task, and children did not show benefits in nutritional status or language comprehension. Parenting sessions offered by peer educators were informative and participatory, yet they need to include more practice, problem-solving, and peer-support if information is to be translated into behaviour.

  17. More evidence on the impact of India's conditional cash transfer program, Janani Suraksha Yojana: quasi-experimental evaluation of the effects on childhood immunization and other reproductive and child health outcomes.

    Directory of Open Access Journals (Sweden)

    Natalie Carvalho

    Full Text Available In 2005, India established a conditional cash transfer program called Janani Suraksha Yojana (JSY, to increase institutional delivery and encourage the use of reproductive and child health-related services.To assess the effect of maternal receipt of financial assistance from JSY on childhood immunizations, post-partum care, breastfeeding practices, and care-seeking behaviors.We use data from the latest district-level household survey (2007-2008 to conduct a propensity score matching analysis with logistic regression. We conduct the analyses at the national level as well as separately across groups of states classified as high-focus and non-high-focus. We carry out several sensitivity analyses including a subgroup analysis stratified by possession of an immunization card.Receipt of financial assistance from JSY led to an increase in immunization rates ranging from 3.1 (95%CI 2.2-4.0 percentage points for one dose of polio vaccine to 9.1 (95%CI 7.5-10.7 percentage points in the proportion of fully vaccinated children. Our findings also indicate JSY led to increased post-partum check-up rates and healthy early breastfeeding practices around the time of childbirth. No effect of JSY was found on exclusive breastfeeding practices and care-seeking behaviors. Effect sizes were consistently larger in states identified as being a key focus for the program. In an analysis stratified by possession of an immunization card, there was little to no effect of JSY among those with vaccination cards, while the effect size was much larger than the base case results for those missing vaccination cards, across nearly all immunization outcomes.Early results suggest the JSY program led to a significant increase in childhood immunization rates and some healthy reproductive health behaviors, but the structuring of financial incentives to pregnant women and health workers warrants further review. Causal interpretation of our results relies on the assumption that

  18. Impact of Childhood Malnutrition on Host Defense and Infection.

    Science.gov (United States)

    Ibrahim, Marwa K; Zambruni, Mara; Melby, Christopher L; Melby, Peter C

    2017-10-01

    The global impact of childhood malnutrition is staggering. The synergism between malnutrition and infection contributes substantially to childhood morbidity and mortality. Anthropometric indicators of malnutrition are associated with the increased risk and severity of infections caused by many pathogens, including viruses, bacteria, protozoa, and helminths. Since childhood malnutrition commonly involves the inadequate intake of protein and calories, with superimposed micronutrient deficiencies, the causal factors involved in impaired host defense are usually not defined. This review focuses on literature related to impaired host defense and the risk of infection in primary childhood malnutrition. Particular attention is given to longitudinal and prospective cohort human studies and studies of experimental animal models that address causal, mechanistic relationships between malnutrition and host defense. Protein and micronutrient deficiencies impact the hematopoietic and lymphoid organs and compromise both innate and adaptive immune functions. Malnutrition-related changes in intestinal microbiota contribute to growth faltering and dysregulated inflammation and immune function. Although substantial progress has been made in understanding the malnutrition-infection synergism, critical gaps in our understanding remain. We highlight the need for mechanistic studies that can lead to targeted interventions to improve host defense and reduce the morbidity and mortality of infectious diseases in this vulnerable population. Copyright © 2017 American Society for Microbiology.

  19. Health-seeking behaviour and community perceptions of childhood undernutrition and a community management of acute malnutrition (CMAM) programme in rural Bihar, India: a qualitative study.

    Science.gov (United States)

    Burtscher, Doris; Burza, Sakib

    2015-12-01

    Since 2009, Médecins Sans Frontières has implemented a community management of acute malnutrition (CMAM) programme in rural Biraul block, Bihar State, India that has admitted over 10 000 severely malnourished children but has struggled with poor coverage and default rates. With the aim of improving programme outcomes we undertook a qualitative study to understand community perceptions of childhood undernutrition, the CMAM programme and how these affected health-seeking behaviour. Semi-structured and narrative interviews were undertaken with families of severely malnourished children, non-undernourished children and traditional and allopathic health-care workers. Analysis of transcripts was by qualitative content analysis. Biraul, Bihar State, India, 2010. One hundred and fifty people were interviewed in individual or group discussions during fifty-eight interviews. Undernutrition was not viewed as a disease; instead, local disease concepts were identified that described the clinical spectrum of undernutrition. These concepts informed perception, so caregivers were unlikely to consult health workers if children were 'only skinny'. Hindu and Muslim priests and other traditional health practitioners were more regularly consulted and perceived as easier to access than allopathic health facilities. Senior family members and village elders had significant influence on the health-seeking behaviour of parents of severely malnourished children. The results reaffirm how health education and CMAM programmes should encompass local disease concepts, beliefs and motivations to improve awareness that undernutrition is a disease and one that can be treated. CMAM is well accepted by the community; however, programmes must do better to engage communities, including traditional healers, to enable development of a holistic approach within existing social structures.

  20. Evaluation of a Social Marketing Campaign to Increase Awareness of Immunizations for Urban Low-Income Children

    Science.gov (United States)

    Ngui, Emmanuel M.; Hamilton, Chelsea; Nugent, Melodee; Simpson, Pippa; Willis, Earnestine

    2015-01-01

    Objective To assess community awareness of childhood immunizations and intent to immunize children after a social marketing immunization campaign. Methods We used 2 interviewer-assisted street-intercept surveys to evaluate awareness of childhood immunizations and intent to immunize low-income children. The “Take Control! Immunize” social marketing campaign was developed using a community-based participatory research approach and used billboards, flyers, and various “walking billboard” (eg, backpacks, pens) to deliver immunization messages in the community settings. Results Over 85% of community members recalled the “Take Control! Immunize” message. Almost half of those who saw the immunization message indicated that the message motivated them to act, including getting their children immunized or calling their physician to inquire about their children's immunizations status. All respondents indicated that immunizations were important for children and that they were likely or very likely to immunize their children. Respondents who reported that “Take Control!” messages motivated them to act in the first intercept survey were significantly more likely than those in the second intercept to report being likely or very likely to immunize their children. Conclusion Culturally appropriate social marketing immunization messages in targeted urban settings can increase parental awareness and behavioral intention to immunize children. PMID:25845130

  1. Permanent Childhood Hearing Impairment: Aetiological Evaluation of Infants identified through the Irish Newborn Hearing Screening Programme

    LENUS (Irish Health Repository)

    Smith, A

    2017-11-01

    The Newborn Hearing Screening Programme (NHSP) was established in Cork University Maternity Hospital (CUMH) in April 2011. Between April 2011 and July 2014, 42 infants were identified with a Permanent Childhood Hearing Impairment (PCHI). Following this diagnosis, infants underwent a paediatric assessment according to recognised guidelines with the intention of identifying the underlying aetiology of the PCHI. The aim of this study was to assess the findings of this aetiological workup via retrospective chart review. PCHI data was obtained from the eSP database. This is a web based information system (eSP) used to track each baby through the screening and referral process A retrospective chart review of these patients was performed. Sixteen (38%) infants were diagnosed with a bilateral sensorineural hearing loss. Two infants had congenital CMV infection. A Connexin 26 gene mutation was detected in one infant. Two infants were diagnosed with Waardenburg syndrome, One with Pendred syndrome and one with Pfeiffer syndrome. Five babies underwent cochlear implantation. Through adherence to the recommended protocol a possible cause of PCHI may be determined. This study has identified areas of future improvement for this service in Ireland.

  2. Immunization dropout rate and data quality among children 12-23 months of age in Ghana.

    Science.gov (United States)

    Baguune, Benjamin; Ndago, Joyce Aputere; Adokiya, Martin Nyaaba

    2017-01-01

    Immunization against diseases is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, a proportion of children particularly in Africa are not fully immunized with the recommended vaccines. Thus, many children are still susceptible to the Expanded Program on Immunization (EPI) targeted diseases. The objective of this study was to determine the immunization dropout rate and data quality among children aged 12-23 months in Techiman Municipality, Ghana. A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. Before the main data collection, the tools were pre-tested in three different communities in the Municipality. The mothers/caregivers were interviewed, extracted information from the child immunization cards and observation employed to confirm the presence of Bacillus Calmette-Guerin (BCG) scar on each child. Routine immunization data was also extracted from immunization registers and annual reports in the Municipality. I mmunization coverage for each of the fifteen vaccines doses is above 90.0% while full childhood immunized status is 89.5%. Immunization dropout rate was 5.6% (using BCG and Measles as proxy vaccines). This is lower than the 10.0% cutoff point by World Health Organization. However, routine administrative data was characterized by some discrepancies (e.g. > 100.0% immunization coverage for each of the vaccines) and high dropout rate (BCG - Measles = 31.5%). Binary regression was performed to determine predictors of dropout rate. The following were statistically significant: married (OR = 0.31; 95% = CI 0.15-0.62; and p  = 0.001), Christianity (OR = 0.27; 95% CI = 0.13-0.91; and p  dropout. Childhood full immunized status (89.5%) and immunization coverages (>90%) are high while dropout rate is lower than the recommended cutoff point by WHO

  3. Universal Immunization Programme : In Sarojininagar Block Of Lucknow District

    Directory of Open Access Journals (Sweden)

    Nirupam S

    1991-01-01

    Full Text Available The immunization status of infants and pregnant mothers in the community development block of Sarojini Nagar, having a population 1.6 lacs, was assessed for the year 1985-86 (pre UIP year and again in 1987-88(post UIP year using 30 cluster random sampling technique as proposed by WHO to study the impact of U.I.P. A significant increase in vaccine and dose-wise coverage was observed, this being 35.7%, 25.2% and 15.5% for DPT I, II & III in pre U.I.P year as compared to 69.5%, 57.1% &44.8% respectively for the post U.I.P year. Similar differences have been observed for OPV, BCG &Measles. A significant decrease in drop out rates has been observed. The percentage of fully vaccinated children although much higher (17.2% as against 1.9% in pre U.I.P. year was still quite low in relation to the envisaged target. However, only 26.6% infants were un-immunized in 1987-88 as compared to 57.6% in 1985-86. T etvac coverage of pregnant mothers has shown a modest increase from 44.3% to 54.8%. Not many changes were observed in main reasons for non-immunization.

  4. Immune responses to mumps vaccine in adults who were vaccinated in childhood.

    Science.gov (United States)

    Hanna-Wakim, Rima; Yasukawa, Linda L; Sung, Phillip; Arvin, Ann M; Gans, Hayley A

    2008-06-15

    In a mumps outbreak in the United States, many infected individuals were adults who had received 2 doses of mumps vaccine. The persistence of cellular immunity to mumps vaccine has not been defined. This was an observational, nonrandomized cohort study evaluating cell-mediated and humoral immunity to mumps in 10 vaccinated and 10 naturally immune adults. Mumps-specific T cell activation and interferon (IFN)-gamma production were measured using lymphoproliferative and flow cytometry assays, and mumps immunoglobulin (Ig) G was measured using enzyme-linked immunosorbent assay. T cell immunity to mumps was high in both groups; 70% of vaccinated and 80% of naturally immune individuals had a positive (> or =3) stimulation index (SI) (P = 1.0). The mean percentages of mumps-specific CD4+ T cells that expressed CD69 and produced IFN-gamma were equivalent in the 2 groups: 0.06% and 0.12%, respectively (P = .11). The mean SIs in the groups were also equivalent, although IFN-gamma concentrations from cultures stimulated with mumps antigen were higher in naturally immune adults than in vaccinated adults (P < or = .01). All adults were positive for mumps IgG. T and B cell immunity to mumps was detected in adults at least 10 years after immunization. Except for IFN-gamma release, responses in vaccinated adults paralleled those observed in naturally immune individuals.

  5. Feasibility of implementing a cellphone-based reminder/recall strategy to improve childhood routine immunization in a low-resource setting: a descriptive report.

    Science.gov (United States)

    Brown, Victoria Bolanle; Oluwatosin, O Abimbola

    2017-12-04

    Reminder/recall systems are effective ways to improve immunization rates, but their feasibility in primary health care (PHC) settings in Nigeria has not been adequately evaluated. In this study we describe the acceptability and adaptability of immunization reminder/recall system in an urban setting in southwest Nigeria. This is a descriptive report of a cluster randomized controlled trial. Four local government areas (LGAs) were randomly assigned into a cellphone reminder/recall intervention group or a usual care control group. Within each LGA, PHC centers were purposively selected to participate in the study. In each PHC center, mothers and their infants aged 0-3 months were enrolled into the two groups during the infants' first immunization visit. Mothers (or other contact persons) in the intervention group received cellphone calls reminding them to take their child for scheduled immunizations. Follow-up of all the children lasted till the final scheduled immunization visit for each child. The intervention lasted for 13 months. A total of 595 mothers/infants pairs (295 in the intervention group and 300 in the control group) participated in the study. Almost all mothers (n = 590, 99.2%) had access to their own cellphone or had access to a cellphone belonging to a significant other. Ninety-eight percent (n = 584) of all mothers were willing to receive immunization reminder/recall phone calls. Eighty-seven percent (n = 2023) of all calls (n = 2324) for the reminder/recall intervention went through to the recipients and of these calls, 1948 (96.3%) were received. The mean cost of each call in US Dollars was about 5 cents. Immunization compliance rate (the receipt of required number of doses of routine vaccines at the appropriate age at recommended interval) was 79.2% among the children in intervention group and 46.4% in the control group (p recall interventions to improve routine childhood immunization are feasible in PHC settings in limited

  6. Talking with Concerned Parents about Immunization

    Science.gov (United States)

    Sturm, Lynne A.; Zimet, Gregory D.; Klausmeier, Thomas

    2010-01-01

    Clinical conversations between health professionals and parents can be frustrating for both parties when the topic is childhood immunization. Parents bring to the table personal models of decision making and experiences of risk that may differ from those of their health care providers. They may also feel confused by an explosion of information…

  7. Assessing Quality in Early Childhood Education and Care

    Science.gov (United States)

    Ishimine, Karin; Tayler, Collette

    2014-01-01

    Evaluating quality in early childhood education and care (ECEC) service internationally is increasingly important. Research to date indicates that it is "high-quality" programmes that boost and sustain children's achievement outcomes over time. There is also growing interest in the accountability of public funds used for ECEC…

  8. Perceptions of childhood immunization in a minority community: qualitative study.

    Science.gov (United States)

    Henderson, Lesley; Millett, Christopher; Thorogood, Nicki

    2008-05-01

    To assess reasons for low uptake of immunization amongst orthodox Jewish families. Qualitative interviews with 25 orthodox Jewish mothers and 10 local health care workers. The orthodox Jewish community in North East London. Identification of views on immunization in the orthodox Jewish community. In a community assumed to be relatively insulated from direct media influence, word of mouth is nevertheless a potent source of rumours about vaccination dangers. The origins of these may lie in media scares that contribute to anxieties about MMR. At the same time, close community cohesion leads to a sense of relative safety in relation to tuberculosis, with consequent low rates of BCG uptake. Thus low uptake of different immunizations arises from enhanced feelings of both safety and danger. Low uptake was not found to be due to the practical difficulties associated with large families, or to perceived insensitive cultural practices of health care providers. The views and practices of members of this community are not homogeneous and may change over time. It is important that assumptions concerning the role of religious beliefs do not act as an obstacle for providing clear messages concerning immunization, and community norms may be challenged by explicitly using its social networks to communicate more positive messages about immunization. The study provides a useful example of how social networks may reinforce or challenge misinformation about health and risk and the complex nature of decision making about children's health.

  9. Perception of Childhood Immunization among Mothers of Under ...

    African Journals Online (AJOL)

    global immunization rates were at 83%. Increased knowledge ... Chain and Logistics systems are aging and often ... of better cold chain and supply logistic systems and promoting ... clearance was obtained from the management of St. Charles ...

  10. Shaping of Adaptive Immunity and Celiac Disease Autoimmunity in a Population based Childhood Cohort : The Generation R Study : De vorming van specifieke afweer en coeliakie autoimmuniteit in een populatie gebaseerd kinder cohort : Het Generation R Onderzoek

    NARCIS (Netherlands)

    M.A.E. Jansen (Michelle)

    2017-01-01

    markdownabstractThe studies described in __Part I__ of this thesis illustrate the complex, and large age-dependent inter-individual variability of immune maturation during childhood from birth until 6 years of age. This variability is largely driven by non-heritable (environmental) factors, of which

  11. Evaluation of low immunization coverage among the Amish population in rural Ohio.

    Science.gov (United States)

    Kettunen, Christine; Nemecek, John; Wenger, Olivia

    2017-06-01

    The Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Review included childhood immunizations among the 10 great public health achievements in the United States in the 20th century. Despite this acknowledged success, childhood immunization rates continue to be much lower in select populations. Amish communities have persistently lower immunization rates. Recent outbreaks in Amish communities include a 2014 measles outbreak in Ohio, resulting in 368 cases reported. A recent outbreak of pertussis in an Amish community in Ohio resulted in the death of a 6-week-old Amish baby. A study was designed to determine the knowledge, beliefs, attitudes, and opinions of Amish parents relative to the immunization of Amish children. Data were collected through a questionnaire. Each potential participant was mailed a copy of a letter describing the proposed study. The questionnaire, a copy of the current immunization schedule, and a return stamped envelope were also included in the mailed packet. The study sample consisted of 84 Amish individuals who voluntarily filled out and returned questionnaires. The findings from the data analysis demonstrated that fear, especially concern over too many recommended immunizations and immunizations overwhelming the child's system, was the most frequent reported reasons for not having children immunized according to recommendations. Religious factors and access to care were not among reasons most reported. Designing an educational campaign for educating Amish parents on the risks and benefits of immunizations with focus on specific concerns may improve immunization rates. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Programmable Toys and Free Play in Early Childhood Classrooms

    Science.gov (United States)

    Newhouse, Christopher Paul; Cooper, Martin; Cordery, Zina

    2017-01-01

    This paper reports on a study that investigated the ways that young children interact with discrete programmable digital toys in a free play setting. One intention was to see whether this interaction would address some of the requirements of the Digital Technologies subject in the Australian Curriculum. The study was implemented in two phases in…

  13. Immunization Milestones: A More Comprehensive Picture of Age-Appropriate Vaccination

    Directory of Open Access Journals (Sweden)

    Steve G. Robison

    2010-01-01

    Full Text Available A challenge facing immunization registries is developing measures of childhood immunization coverage that contain more information for setting policy than present vaccine series up-to-date (UTD rates. This study combined milestone analysis with provider encounter data to determine when children either do not receive indicated immunizations during medical encounters or fail to visit providers. Milestone analysis measures immunization status at key times between birth and age 2, when recommended immunizations first become late. The immunization status of a large population of children in the Oregon ALERT immunization registry and in the Oregon Health Plan was tracked across milestone ages. Findings indicate that the majority of children went back and forth with regard to having complete age-appropriate immunizations over time. We also found that immunization UTD rates when used alone are biased towards relating non-UTD status to a lack of visits to providers, instead of to provider visits on which recommended immunizations are not given.

  14. Immunizing Infants (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-04-18

    Parents can protect the health of their children by making sure they’re up-to-date on all recommended vaccines. This podcast discusses the importance of childhood immunization.  Created: 4/18/2013 by MMWR.   Date Released: 4/18/2013.

  15. Nutrition, Health and Safety in Early Childhood Development ...

    African Journals Online (AJOL)

    This article investigates the nutrition, health and safety status in Early Childhood Development (ECD) programmes and its impact thereof on the quality of care and education in Harare primary schools as perceived by the school heads, ECD teachers and parents. The study is part of a larger study on assessing the quality of ...

  16. The Concordance of Parent and Child Immunization.

    Science.gov (United States)

    Robison, Steve G; Osborn, Andrew W

    2017-05-01

    A substantial body of work has related survey-based parental vaccine hesitancy to noncompliant childhood immunization. However little attention has been paid to the connection between parents' own immunization behavior and the immunizations their children receive. Using the Oregon ALERT Immunization Information System, we identified adult caregiver-child pairs for children between 9 months and 17 years of age. The likelihood of adult-child concordance of influenza immunization per influenza season from 2010-2011 through 2014-2015 was assessed. The utility of adult immunization as a predictor was also assessed for other, noninfluenza recommended immunizations for children and adolescents. A total of 450 687 matched adult caregiver-child pairs were included in the study. The children of immunizing adults were 2.77 times more likely to also be immunized for seasonal influenza across all seasons (95% confidence interval, 2.74-2.79), with similar results applying within each season. Adult immunization status was also significantly associated with the likelihood of children and adolescents getting other noninfluenza immunizations, such as the human papillomavirus vaccine (HPV). When adults improved their own behavior from nonimmunizing to immunizing across influenza seasons, their children if not immunized in the previous season were 5.44 times (95% confidence interval, 5.35-5.53) more likely to become immunized for influenza. Children's likelihood of following immunization recommendations is associated with the immunization behavior of their parents. Encouraging parental immunization is a potential tool for increasing children's immunization rates. Copyright © 2017 by the American Academy of Pediatrics.

  17. Rotavirus vaccination within the South African Expanded Programme on Immunisation.

    Science.gov (United States)

    Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

    2012-09-07

    Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Outcomes of a Community-Based Paediatric Weight Management Programme in an Irish Midlands Setting

    LENUS (Irish Health Repository)

    Bennett, AE

    2018-02-01

    Ongoing investigation is needed into feasible approaches which reduce excess weight in childhood. This study aimed to assess the effectiveness of an adapted version of the Scottish Childhood Overweight Treatment Trial (SCOTT) in an Irish primary care setting. Families were offered monthly dietitian-led sessions for six months. These sessions targeted dietary habits, family meals, screen time and exercise. Of the 95 children (mean age 7.6 years) referred, 90.5% (n86) were obese and 9.5% (n9) were overweight. Fifty-one (53.7%) families opted into the programme from referral, and 18 completed the programme (64.7% attrition). Statistically significant reductions in body mass index (BMI) were observed between sessions one and six (25.7±4.2kg\\/m2 and 25.3±4.8kg\\/m2, respectively, p<0.01). BMI z-score modestly decreased by 0.2 (p=0.01). Despite these reductions, issues with programme referral, attrition and long-term effectiveness were evident. Further investigation into strategies which reduce paediatric overweight is warranted.

  19. Enter B and W: two new meningococcal vaccine programmes launched.

    Science.gov (United States)

    Ladhani, Shamez N; Ramsay, Mary; Borrow, Ray; Riordan, Andrew; Watson, John M; Pollard, Andrew J

    2016-01-01

    In 2015, the UK became the first country in the world to have a comprehensive routine meningococcal vaccine programme targeting all of the main capsular groups of N. meningitidis. 1 An infant vaccine programme against meningococcal capsular group B Neisseria meningitidis (MenB) was launched from 1st September with an aim to reduce endemic MenB disease in early childhood. On 1st August 2015, an adolescent programme against groups A, C, W and Y meningococci (MenACWY) was rolled out to halt a growing outbreak of capsular group W disease (MenW) caused by a hypervirulent clone of N. meningitidis, in addition to maintaining control against MenC disease provided by the current adolescent programme. 2. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The mother-offspring dyad: microbial transmission, immune interactions and allergy development.

    Science.gov (United States)

    Jenmalm, M C

    2017-12-01

    The increasing prevalence of allergy in affluent countries may be caused by reduced intensity and diversity of microbial stimulation, resulting in abnormal postnatal immune maturation. Most studies investigating the underlying immunomodulatory mechanisms have focused on postnatal microbial exposure, for example demonstrating that the gut microbiota differs in composition and diversity during the first months of life in children who later do or do not develop allergic disease. However, it is also becoming increasingly evident that the maternal microbial environment during pregnancy is important in childhood immune programming, and the first microbial encounters may occur already in utero. During pregnancy, there is a close immunological interaction between the mother and her offspring, which provides important opportunities for the maternal microbial environment to influence the immune development of the child. In support of this theory, combined pre- and postnatal supplementations seem to be crucial for the preventive effect of probiotics on infant eczema. Here, the influence of microbial and immune interactions within the mother-offspring dyad on childhood allergy development will be discussed. In addition, how perinatal transmission of microbes and immunomodulatory factors from mother to offspring may shape appropriate immune maturation during infancy and beyond, potentially via epigenetic mechanisms, will be examined. Deeper understanding of these interactions between the maternal and offspring microbiome and immunity is needed to identify efficacious preventive measures to combat the allergy epidemic. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  1. Childhood Cataract: Magnitude, Management, Economics and Impact

    Directory of Open Access Journals (Sweden)

    BR Shamanna

    2004-01-01

    Full Text Available The prevalence of blindness among children in different regions varies from 0.2/1000 children to over 1.5/1000 children with a global figure estimated at 0.7/1000. This means that there are an estimated 1.4 million blind children worldwide.1 The proportion of blindness in children due to cataract varies considerably between regions from 10%-30% with a global average estimated at 14%, giving 190,000 children blind from cataract. 2 While the magnitude of childhood cataracts varies from place to place, it is a priority within all blindness control programmes for children. Children who are blind have to overcome a lifetime of emotional, social and economic difficulties which affect the child, the family and society.3 Loss of vision in children influences their education, employment and social life. The numbers blind with cataract do not reflect the years of disability and lost quality of life. Childhood blindness is second only to adult cataract as a cause of blind-person years. Approximately 70 million blind-person years are caused by childhood blindness of which about 10 million blind-person years (14% is due to childhood cataract. Timely recognition and intervention can eliminate blind-years due to childhood cataract, as the condition is treatable.

  2. Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease.

    Science.gov (United States)

    Kuhlman, Kate Ryan; Chiang, Jessica J; Horn, Sarah; Bower, Julienne E

    2017-09-01

    Childhood adversity has been repeatedly and robustly linked to physical and mental illness across the lifespan. Yet, the biological pathways through which this occurs remain unclear. Functioning of the inflammatory arm of the immune system and the hypothalamic-pituitary-adrenal (HPA)-axis are both hypothesized pathways through which childhood adversity leads to disease. This review provides a novel developmental framework for examining the role of adversity type and timing in inflammatory and HPA-axis functioning. In particular, we identify elements of childhood adversity that are salient to the developing organism: physical threat, disrupted caregiving, and unpredictable environmental conditions. We propose that existing, well-characterized animal models may be useful in differentiating the effects of these adversity elements and review both the animal and human literature that supports these ideas. To support these hypotheses, we also provide a detailed description of the development and structure of both the HPA-axis and the inflammatory arm of the immune system, as well as recent methodological advances in their measurement. Recommendations for future basic, developmental, translational, and clinical research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A case of immune thrombocytopenic purpura presenting with intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Sinan Akbayram

    2013-01-01

    Full Text Available Immune thrombocytopenic purpura is an acute, generally considered a self-limiting benign disorder with a 60%-80% change of spontaneous recovery occurring usually within a few months after onset. Intracranial hemorrhage is a rare but life-threatening complication of childhood immune thrombocytopenic purpura. We report a 4-year-old girl who admitted with headache, vomiting, bleeding from noise and bruises on the extremities. Her neurological examination was normal. Based on laboratory finding she was diagnosed immune thrombocytopenic purpura and intracranial hemorrhage. We suggest that cranial imaging should be perform in patients with immune thrombocytopenic purpura admitted with bleeding symptoms, vomiting and headache even if they had no abnormal neurological signs.

  4. Preventing childhood obesity in Latin America: an agenda for regional research and strategic partnerships.

    Science.gov (United States)

    Caballero, B; Vorkoper, S; Anand, N; Rivera, J A

    2017-07-01

    The increasing prevalence of childhood obesity in Latin America poses a major public health challenge to the region. In response, many countries are implementing obesity prevention programmes aimed at modifying known risk factors. However, the limited scientific evidence inhibits the development and implementation of novel, effective interventions across the region. To address these gaps, the NIH Fogarty International Center convened a workshop of researchers, policymakers, programme implementers and public health advocates who are actively engaged in the region to prevent childhood obesity. Major aims of the meeting were to define the current status of childhood obesity, identify the scientific gaps in our understanding of the epidemic, point out the barriers and opportunities for research and outline a plan for capacity building in the region in the area of childhood obesity. This series of articles reflects the key outcome of the meeting and offers an analysis of the knowledge translation needed for evidence-based policy initiatives, a review of the research agenda and an evaluation of research capacity in the region. The goal of the papers is to inform the development of multidisciplinary and multisector research collaborations, which are essential to the implementation of successful childhood obesity prevention strategies in the region. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  5. Self-reported parenting style is associated with children's inflammation and immune activation.

    Science.gov (United States)

    Byrne, Michelle L; Badcock, Paul B; Simmons, Julian G; Whittle, Sarah; Pettitt, Adam; Olsson, Craig A; Mundy, Lisa K; Patton, George C; Allen, Nicholas B

    2017-04-01

    Family environments and parenting have been associated with inflammation and immune activation in children and adolescents; however, it remains unclear which specific aspects of parenting drive this association. In this study, we cross-sectionally examined the association between 5 discrete parenting styles and inflammation and immune activation in late childhood. Data were drawn from 102 families (55 with female children, mean age 9.50 years, SD = 0.34) participating in the Imaging Brain Development in the Childhood to Adolescence Transition Study. Children provided saliva samples from which inflammation (C-reactive protein) and immune competence/activation (secretory immunoglobulin A) were measured. Parents completed the Alabama Parenting Questionnaire, which measures 5 aspects of parenting style-positive parental involvement, positive disciplinary techniques, consistency in disciplinary techniques, corporal punishment, and monitoring and supervision. Results showed that higher scores on the poor parental monitoring scale were associated with higher levels of both inflammation and immune activation in children. This study highlights parental monitoring and supervision as a specific aspect of parenting behavior that may be important for children's physical and mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Simultaneous administration of vitamin A and DTP vaccine modulates the immune response in a murine cerebral malaria model

    DEFF Research Database (Denmark)

    Hein-Kristensen, L; Jørgensen, M J; Ravn, H

    2010-01-01

    The World Health Organisation recommends vitamin A supplementation (VAS) to children aged 6 months to 5 years in low-income countries, and for logistic reasons, this has been linked to routine childhood immunizations. Observational studies suggest that VAS given with diphtheria-tetanus-pertussis ......The World Health Organisation recommends vitamin A supplementation (VAS) to children aged 6 months to 5 years in low-income countries, and for logistic reasons, this has been linked to routine childhood immunizations. Observational studies suggest that VAS given with diphtheria...

  7. The Impact of Rotavirus Vaccination on Discounted Net Tax Revenue in Egypt A Government Perspective Analysis

    NARCIS (Netherlands)

    Connolly, Mark P.; Topachevskyi, Oleksandr; Standaert, Baudouin; Ortega, Omayra; Postma, Maarten

    2012-01-01

    Background: We evaluated national rotavirus (RV) immunization programme costs to estimate how resulting changes in morbidity and mortality will influence government fiscal accounts over time. The assumption was that increased childhood survival in vaccinated cohorts leads to increased numbers of

  8. Adverse childhood experience and asthma onset: a systematic review.

    Science.gov (United States)

    Exley, Daniel; Norman, Alyson; Hyland, Michael

    2015-06-01

    Adverse childhood experiences such as abuse and neglect are associated with subsequent immune dysregulation. Some studies show an association between adverse childhood experiences and asthma onset, although significant disparity in results exists in the published literature. We aimed to review available studies employing a prospective design that investigates associations between adverse childhood experience and asthma. A search protocol was developed and studies were drawn from four electronic journal databases. Studies were selected in accordance with pre-set inclusion criteria and relevant data were extracted. 12 studies, assessing data from a total of 31 524 individuals, were identified that investigate the impact of a range of adverse childhood experiences on the likelihood of developing asthma. Evidence suggests that chronic stress exposure and maternal distress in pregnancy operate synergistically with known triggers such as traffic-related air pollution to increase asthma risk. Chronic stress in early life is associated with an increased risk of asthma onset. There is evidence that adverse childhood experience increases the impact of traffic-related air pollution and inconsistent evidence that adverse childhood experience has an independent effect on asthma onset. Copyright ©ERS 2015.

  9. An exploratory qualitative assessment of factors influencing childhood vaccine providers' intention to recommend immunization in the Netherlands

    Directory of Open Access Journals (Sweden)

    Mollema Liesbeth

    2012-02-01

    Full Text Available Abstract Background Under the Dutch national immunization program (NIP, childhood vaccination is not mandatory, but its recommendation by childhood vaccine providers (CVP is important for maintaining high vaccination coverage. We therefore examined factors related to providers' intentions to recommend vaccinations to parents of young children. Methods We conducted four focus group discussions with nurses and physicians who provide vaccines to children 0-4 years old in diverse regions of the Netherlands. Three groups represented CVPs at child welfare centers (CWCs serving the general population, with the fourth representing anthroposophical CWCs. Elements of the Theory of Planned Behaviour (TPB were used to design the groups; thematic analysis was used to structure and analyze the dataset. Results Four main themes emerged, including 1 perceived responsibility: to promote vaccines and discuss pros and cons with parents (although this was usually not done if parents readily accepted the vaccination; 2 attitudes toward the NIP: mainly positive, but doubts as to NIP plans to vaccinate against diseases with a low perceived burden; 3 organizational factors: limited time and information can hamper discussions with parents; 4 relationship with parents: crucial and based mainly on communication to establish trust. Compared to CVPs at standard CWCs, the anthroposophical CWCs spent more time communicating and were more willing to adapt the NIP to individual cases. Conclusions Our qualitative assessment provides an overview of beliefs associated with providers' intention to recommend vaccinations. They were motivated to support the NIP, but their intentions to recommend vaccinations were affected by the perceived relevance of the vaccines, practical issues like limited time and by certain types of resistant parents. These results will inform future studies to test the magnitude and relative impact of these factors.

  10. Childhood measles contributes to post-bronchodilator airflow obstruction in middle-aged adults: A cohort study.

    Science.gov (United States)

    Perret, Jennifer L; Matheson, Melanie C; Gurrin, Lyle C; Johns, David P; Burgess, John A; Thompson, Bruce R; Lowe, Adrian J; Markos, James; Morrison, Stephen S; McDonald, Christine F; Wood-Baker, Richard; Svanes, Cecilie; Thomas, Paul S; Hopper, John L; Giles, Graham G; Abramson, Michael J; Walters, E Haydn; Dharmage, Shyamali C

    2018-03-20

    Chronic obstructive pulmonary disease (COPD) has potential origins in childhood but an association between childhood measles and post-bronchodilator (BD) airflow obstruction (AO) has not yet been shown. We investigated whether childhood measles contributed to post-BD AO through interactions with asthma and/or smoking in a non-immunized middle-aged population. The population-based Tasmanian Longitudinal Health Study (TAHS) cohort born in 1961 (n = 8583) underwent spirometry in 1968 before immunization was introduced. A history of childhood measles infection was obtained from school medical records. During the fifth decade follow-up (n = 5729 responses), a subgroup underwent further lung function measurements (n = 1389). Relevant main associations and interactions by asthma and/or smoking on post-BD forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC; continuous variable) and AO (FEV 1 /FVC childhood measles. Childhood measles augmented the combined adverse effect of current clinical asthma and smoking at least 10 pack-years on post-BD FEV 1 /FVC ratio in middle age (z-score: -0.70 (95% CI: -1.1 to -0.3) vs -1.36 (-1.6 to -1.1), three-way interaction: P = 0.009), especially for those with childhood-onset asthma. For never- and ever-smokers of childhood measles, paradoxically, the odds for post-BD AO was not significant in the presence of childhood measles (OR: 12.0 (95% CI: 3.4-42) vs 2.17 (0.9-5.3)). Childhood measles infection appears to compound the associations between smoking, current asthma and post-BD AO. Differences between asthma subgroups provide further insight into the complex aetiology of obstructive lung diseases for middle-aged adults. © 2018 Asian Pacific Society of Respirology.

  11. Professionalisation in Early Childhood Education: A Comparative View of Emerging Professional Profiles in Germany (Bremen) and Greece

    Science.gov (United States)

    Vrinioti, Kalliope

    2013-01-01

    In this article, a comparative approach is applied to two programmes of study for the education of early childhood pedagogues. One of the terms of our comparison is the University of Bremen's Bachelor of Arts degree in "subject related educational sciences," while the other is the programme offered by Aristotle University of…

  12. Use of bisphosphonate therapy for osteoporosis in childhood and adolescence.

    Science.gov (United States)

    Batch, J A; Couper, J J; Rodda, C; Cowell, C T; Zacharin, M

    2003-03-01

    Congenital and acquired forms of osteoporosis in childhood and adolescence can result in morbidity from fracture and pain in childhood, and place an individual at significant risk for problems in adult life. A range of therapies exist for the prevention and treatment of osteoporosis, including optimization of daily calcium intake, adequate vitamin D status, weight-bearing exercise, treatment with sex steroids where delayed puberty is a problem and, more recently, use of bisphosphonate therapy. Intravenous pamidronate therapy (a bisphosphonate) has been shown to reduce fractures and improve bone density in children with osteogenesis imperfecta, and might prove to be of benefit in other osteoporotic conditions in childhood. However, a number of issues regarding the optimal use of bisphosphonate therapy in children and adolescents remain to be resolved, including total annual dose and frequency and duration of administration. Bisphosphonate therapy should, therefore, be used only in the context of a well-run clinical programme with specialist knowledge in the management of osteopenic disorders in childhood.

  13. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2018.

    Science.gov (United States)

    Robinson, Candice L; Romero, José R; Kempe, Allison; Pellegrini, Cynthia; Szilagyi, Peter

    2018-02-09

    In October 2017, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2018. The 2018 child and adolescent immunization schedule summarizes ACIP recommendations, including several changes from the 2017 immunization schedules, in three figures and footnotes to the figures. These documents can be found on the CDC immunization schedule website (https://www.cdc.gov/vaccines/schedules/index.html). These immunization schedules are approved by ACIP (https://www.cdc.gov/vaccines/acip/index.html), the American Academy of Pediatrics (https://www.aap.org), the American Academy of Family Physicians (https://www.aafp.org), and the American College of Obstetricians and Gynecologists (https://www.acog.org). Health care providers are advised to use the figures and the footnotes together. The full ACIP recommendations for each vaccine, including contraindications and precautions, can be found at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. Providers should be aware that changes in recommendations for specific vaccines can occur between annual updates to the childhood/adolescent immunization schedules. If errors or omissions are discovered within the child and adolescent schedule, CDC posts revised versions on the CDC immunization schedule website.

  14. High breast milk IL-1β level is associated with reduced risk of childhood eczema

    DEFF Research Database (Denmark)

    Jepsen, A. A.; Chawes, B. L.; Carson, C. G.

    2016-01-01

    We recently demonstrated a dual effect of breastfeeding with increased risk of eczema and decreased risk of wheezing in early childhood by increasing breastfeeding length. We hypothesize that immune mediators in breast milk could explain such association either through a direct effect or as a sur...... or as a surrogate marker of maternal immune constitution....

  15. Population growth changes targets for immunization.

    Science.gov (United States)

    Tuljapurkar, S; John, A M

    1995-01-01

    The faster the rate of population growth in developing countries, the less likely it is that current protocols for immunization against measles, rubella, and mumps will eradicate these childhood diseases. Standard protocols (timing, percentage of children to be immunized) do not take into account the rapid rates of population growth in developing countries (3.0% per year on average in sub-Saharan Africa and 2.0% in the rest of Africa, in Latin America, and in Asia, excluding China). Most public health planning models in this area were created based on static infant populations. The World Health Organization advises vaccinating at least 85% of children aged 6 to 9 months, a 3-month immunization window during which maternal antibodies are low (so the vaccination takes) and herd immunity is high (the probability that a child will encounter the disease is low because most children have been immunized). In practice, the immunization window in developing countries is 1 year or more. More susceptible children are present than assumed by the models. A larger number of susceptible babies are added each year during rapid population growth. As the age range for immunization widens, a higher percentage of children must be vaccinated to eradicate disease (chart). The proportion of each birth cohort that must be immunized rises as the population growth rate increases. At zero population growth, 94% must be vaccinated; at population growth rates greater than 3%, 98% must be vaccinated.

  16. Age at BCG administration during routine immunization.

    African Journals Online (AJOL)

    Age at BCG administration during routine immunization. R.D. Wammanda , M.J. Gambo and I. Abdulkadir. Department of Paediatrics,. Ahmadu Bello University Teaching Hospital,. Zaria. Correspondence to: Dr.R.D. Wammanda. Email: wammanda@yahoo.com. Summary. In Nigeria, as part of the National Programme on ...

  17. Assessing Interventions: IAEA Technical Cooperation Enhances Nutrition Programmes

    International Nuclear Information System (INIS)

    Aning, Kwaku

    2014-01-01

    Malnutrition — in all its forms — is a significant development challenge, affecting childhood health, workplace productivity, and national health programmes in countries around the world. While the effects of undernutrition are well recognized, there is less recognition of the fact that the long term impact of obesity or inappropriate nutrition can also be very damaging to health and to national economies. Increasingly, countries around the world are taking action to implement nutritional or physical activity interventions designed to improve the future health of children, as well as the health of their populations in general. Such interventions may include the promotion of exclusive breastfeeding, school breakfast or lunch programmes, nutrition awareness campaigns, food fortification, and investment in sports activities and facilities. The IAEA, through its Technical Cooperation (TC) programme, is working with its Member States to help them to assess the efficiency and effectiveness of such intervention programmes, in order to ensure that government efforts are having the desired effect, and that resources are being well applied. For such assessments, reliable data are essential, and it is here that nuclear science and technology come into play

  18. Timeliness of Receipt of Early Childhood Vaccinations Among Children of Immigrants - Minnesota, 2016.

    Science.gov (United States)

    Leeds, Maureen; Muscoplat, Miriam Halstead

    2017-10-27

    Receiving recommended childhood vaccinations on schedule is the best way to prevent the occurrence and spread of vaccine-preventable diseases (1). Vaccination coverage among children aged 19-35 months in the United States exceeds 90% for most recommended vaccines in the early childhood series (2); however, previous studies have found that few children receive all recommended vaccine doses on time (3). The Minnesota Department of Health (MDH), using information from the Minnesota Immunization Information Connection (MIIC) and the MDH Office of Vital Records, examined early childhood immunization rates and found that children with at least one foreign-born parent were less likely to be up-to-date on recommended immunizations at ages 2, 6, 18, and 36 months than were children with two U.S.-born parents. Vaccination coverage at age 36 months varied by mother's region of origin, ranging from 77.5% among children born to mothers from Central and South America and the Caribbean to 44.2% among children born to mothers from Somalia. Low vaccination coverage in these communities puts susceptible children and adults at risk for outbreaks of vaccine-preventable diseases, as evidenced by the recent measles outbreak in Minnesota (4). Increased outreach to immigrant, migrant, and refugee populations and other populations with low up-to-date vaccination rates might improve timely vaccination in these communities.

  19. Childhood malnutrition and the intestinal microbiome.

    Science.gov (United States)

    Kane, Anne V; Dinh, Duy M; Ward, Honorine D

    2015-01-01

    Malnutrition contributes to almost half of all deaths in children under the age of 5 y, particularly those who live in resource-constrained areas. Those who survive frequently suffer from long-term sequelae including growth failure and neurodevelopmental impairment. Malnutrition is part of a vicious cycle of impaired immunity, recurrent infections, and worsening malnutrition. Recently, alterations in the gut microbiome have also been strongly implicated in childhood malnutrition. It has been suggested that malnutrition may delay the normal development of the gut microbiota in early childhood or force it toward an altered composition that lacks the required functions for healthy growth and/or increases the risk for intestinal inflammation. This review addresses our current understanding of the beneficial contributions of gut microbiota to human nutrition (and conversely the potential role of changes in that community to malnutrition), the process of acquiring an intestinal microbiome, potential influences of malnutrition on the developing microbiota, and the evidence directly linking alterations in the intestinal microbiome to childhood malnutrition. We review recent studies on the association between alterations in the intestinal microbiome and early childhood malnutrition and discuss them in the context of implications for intervention or prevention of the devastation caused by malnutrition.

  20. Editorial: Childhood Cancer in sub-Saharan Africa.

    Science.gov (United States)

    Parkin, Donald Maxwell; Stefan, Cristina

    2017-01-01

    Measurement of incidence rates of childhood cancer in Africa is difficult. The study 'Cancer of Childhood in sub Saharan Africa' [Stefan C, Bray F, Ferlay J, Parkin DM and Liu B (2017) Cancer of Childhood in sub-Saharan Africa ecancer 11 (755)] brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA. It is clear that, in many centres, lack of adequate diagnostic and treatment facilities, leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers-retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents). The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have-potentially-an excellent prognosis.

  1. Etiology of common childhood acute lymphoblastic leukemia: the adrenal hypothesis

    DEFF Research Database (Denmark)

    Schmiegelow, K.; Vestergaard, T.; Nielsen, S.M.

    2008-01-01

    The pattern of infections in the first years of life modulates our immune system, and a low incidence of infections has been linked to an increased risk of common childhood acute lymphoblastic leukemia (ALL). We here present a new interpretation of these observations--the adrenal hypothesis...

  2. Siblings Promote a Type 1/Type 17-oriented immune response in the airways of asymptomatic neonates.

    Science.gov (United States)

    Wolsk, H M; Chawes, B L; Følsgaard, N V; Rasmussen, M A; Brix, S; Bisgaard, H

    2016-06-01

    Siblings have been shown to reduce the risk of childhood asthma and allergy, but the mechanism driving this association is unknown. The objective was to study whether siblings affect the airway immune response in healthy neonates, which could represent an underlying immune modulatory pathway. We measured 20 immune mediators related to the Type 1, Type 2, Type 17, or regulatory immune pathways in the airway mucosa of 571 one-month-old asymptomatic neonates from the Copenhagen Prospective Studies on Asthma in Childhood2010 birth cohort (COPSAC2010 ). The association between airway mediator levels and presence of siblings was investigated using conventional statistics and principle component analysis (PCA). Neonates with siblings had an upregulated level of airway immune mediators, with predominance of Type 1- and Type 17-related mediators. This was supported by the PCA showing a highly significant difference between children with vs without siblings: P Siblings mediate a Type 1/Type 17-related immune-stimulatory effect in the airways of asymptomatic neonates, also after adjustment for pathogenic bacteria and viruses, indicating that siblings exert a transferable early immune modulatory effect. These findings may represent an in utero immune priming effect of the fetal immune system caused by previous pregnancies as the effect was attenuated with time since last childbirth, or it could relate to the presence of unidentified microbes, but further studies are needed to confirm our findings. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark

    DEFF Research Database (Denmark)

    Damkjaer, M B; Perslev, A; Clausen, F B

    2012-01-01

    A targeted routine antenatal anti-D prophylaxis programme was implemented in Denmark where anti-D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation. Materials and...

  4. Tetanus antibody levels among adolescent girls in developing countries

    NARCIS (Netherlands)

    Brabin, L.; Fazio-Tirrozzo, G.; Shahid, S.; Agbaje, O.; Maxwell, S.; Broadhead, R.; Briggs, N.; Brabin, B.

    2000-01-01

    Neonatal and maternal tetanus infections remain an important cause of death in many countries. Few studies have reported tetanus toxoid antibody levels of adolescent girls. As part of the Expanded Programme on Immunization most girls receive up to 3 injections in early childhood, and many

  5. Online supplementary mathematics tuition in a first-year childhood teacher education programme

    Directory of Open Access Journals (Sweden)

    Kathleen Fonseca

    2016-02-01

    Full Text Available This study reports on an intervention that was aimed at improving the content knowledge of first-year intermediate-phase education students at a South African university. The study gives some insight into preservice teachers’ perceptions of an online programme for the development of mathematics common content knowledge for teachers of mathematics in the intermediate grades. The effectiveness of the intervention programme was analysed according to Shapiro’s evaluation criteria for intervention research. The findings show that there has been a positive shift in preservice teachers’ common content knowledge but that there is much room for further development. The student teachers found the programme to be of great benefit with regard to the development of their mathematics knowledge as well as their confidence as future teachers of mathematics. The findings highlighted their disturbingly limited knowledge of mathematics content knowledge and pointed to the responsibility of teacher education departments at universities to implement sufficient maths content courses that will address the status quo of poor mathematics teaching in South African primary schools. The authors conclude that the students need to spend much more time on ‘catching up’ before they become teachers.

  6. Immune Evasion Strategies and Persistence of Helicobacter pylori.

    Science.gov (United States)

    Mejías-Luque, Raquel; Gerhard, Markus

    Helicobacter pylori infection is commonly acquired during childhood, can persist lifelong if not treated, and can cause different gastric pathologies, including chronic gastritis, peptic ulcer disease, and eventually gastric cancer. H. pylori has developed a number of strategies in order to cope with the hostile conditions found in the human stomach as well as successful mechanisms to evade the strong innate and adaptive immune responses elicited upon infection. Thus, by manipulating innate immune receptors and related signaling pathways, inducing tolerogenic dendritic cells and inhibiting effector T cell responses, H. pylori ensures low recognition by the host immune system as well as its persistence in the gastric epithelium. Bacterial virulence factors such as cytotoxin-associated gene A, vacuolating cytotoxin A, or gamma-glutamyltranspeptidase have been extensively studied in the context of bacterial immune escape and persistence. Further, the bacterium possesses other factors that contribute to immune evasion. In this chapter, we discuss in detail the main evasion and persistence strategies evolved by the bacterium as well as the specific bacterial virulence factors involved.

  7. Types of conflict, types of relationships and preferred conflict resolution strategies: Implications for constructive conflict resolution programmes

    OpenAIRE

    Petrović Danijela S.; Vučetić Milica

    2012-01-01

    Constructive conflict resolution programmes are based on the idea that children and youth do no have sufficient knowledge of the procedures and skills for conflict resolution, which is why the conflicts they take part in soon become destructive. Notwithstanding the indubitable practical significance of the constructive conflict resolution programmes, it can be objected that they are not sufficiently based on empirical findings about the characteristics of conflicts in childhood and adol...

  8. Food appearances in children's television programmes in Iceland.

    Science.gov (United States)

    Olafsdottir, Steingerdur; Berg, Christina

    2017-11-01

    Exposure to advertisements cannot fully explain the associations between young children's dietary intake and the time they spend in front of the television. It is therefore of importance to study television content other than advertisements in this aspect. The present study aimed to examine the nature and extent of verbal and visual appearances of foods and beverages in children's television programmes on Icelandic public service television. A total of 27 h of children's programmes (domestic and internationally produced) were watched. All verbal and visual appearances of foods and beverages were coded, as well as the context in which the foods/beverages were discussed or appeared. Children's programmes on Icelandic public service television. Two food groups were of special interest for their importance from a public health perspective: high-calorie and low-nutrient (HCLN) foods and fruits and vegetables (F&V). The χ 2 test and logistic regression were performed to analyse if the occurrence of the two groups was associated with the context where foods/beverages appeared. Of the 125 different programmes, a food or beverage appeared in 86 %. Of the total food appearances (n 599), HCLN foods accounted for 26 % and F&V for 23 %. HCLN foods were presented as desirable by appearing more frequently with child characters (Pfood and eating is presented in children's programmes, as young childhood is a critical period for founding healthy habits for later life.

  9. Integration of vitamin A supplementation with the expanded program on immunization does not affect seroconversion to oral poliovirus vaccine in infants.

    NARCIS (Netherlands)

    R.D. Semba; M. Muhilal; N.E. Mohgaddam (Nasrin); Z. Munasir; A. Akib; D. Permaesih; M.S. Muherdiyantiningsih; A.D.M.E. Osterhaus (Albert)

    1999-01-01

    textabstractChildhood immunization programs may provide infrastructure for delivering vitamin A supplements to infants in developing countries. The effect of giving vitamin A, an immune enhancer, on antibody responses to trivalent oral poliovirus vaccine (TOPV) is unknown. A

  10. Loss of population levels of immunity to malaria as a result of exposure-reducing interventions: consequences for interpretation of disease trends.

    Directory of Open Access Journals (Sweden)

    Azra C Ghani

    Full Text Available BACKGROUND: The persistence of malaria as an endemic infection and one of the major causes of childhood death in most parts of Africa has lead to a radical new call for a global effort towards eradication. With the deployment of a highly effective vaccine still some years away, there has been an increased focus on interventions which reduce exposure to infection in the individual and -by reducing onward transmission-at the population level. The development of appropriate monitoring of these interventions requires an understanding of the timescales of their effect. METHODS & FINDINGS: Using a mathematical model for malaria transmission which incorporates the acquisition and loss of both clinical and parasite immunity, we explore the impact of the trade-off between reduction in exposure and decreased development of immunity on the dynamics of disease following a transmission-reducing intervention such as insecticide-treated nets. Our model predicts that initially rapid reductions in clinical disease incidence will be observed as transmission is reduced in a highly immune population. However, these benefits in the first 5-10 years after the intervention may be offset by a greater burden of disease decades later as immunity at the population level is gradually lost. The negative impact of having fewer immune individuals in the population can be counterbalanced either by the implementation of highly-effective transmission-reducing interventions (such as the combined use of insecticide-treated nets and insecticide residual sprays for an indefinite period or the concurrent use of a pre-erythrocytic stage vaccine or prophylactic therapy in children to protect those at risk from disease as immunity is lost in the population. CONCLUSIONS: Effective interventions will result in rapid decreases in clinical disease across all transmission settings while population-level immunity is maintained but may subsequently result in increases in clinical disease many

  11. Maternal Immune-Mediated Conditions, Autism Spectrum Disorders, and Developmental Delay

    Science.gov (United States)

    Lyall, Kristen; Ashwood, Paul; Van de Water, Judy; Hertz-Picciotto, Irva

    2014-01-01

    The maternal immune system may play a role in offspring neurodevelopment. We examined whether maternal autoimmune disease, asthma, and allergy were associated with child autism spectrum disorder (ASD) and developmental delay without autism (DD) using 560 ASD cases, 391 typically developing controls, and 168 DD cases from the CHildhood Autism Risk…

  12. Minimizing pain during childhood vaccination injections: improving adherence to vaccination schedules

    Directory of Open Access Journals (Sweden)

    Eden LM

    2014-09-01

    Full Text Available Lacey M Eden, Janelle LB Macintosh, Karlen E Luthy, Renea L Beckstrand College of Nursing, Brigham Young University, Provo, UT, USA Abstract: Pain experienced in childhood can lead to long-term and psychologically detrimental effects. Unfortunately, the most common pain experienced in childhood is caused by vaccinations and may lead to non-adherence to the recommended vaccination schedule. As a result, it is the health care provider's responsibility to take measures to reduce vaccination pain; however, there are a plethora of pain relieving interventions during immunizations and it is unclear which interventions are most cost efficient, timely, and effective. Studies have been conducted to investigate the efficacy of different pain management interventions during vaccinations. This review evaluates various pain relieving interventions and provide health care providers age appropriate guidance on pain relieving interventions during vaccinations. Employment of these strategies may successfully reduce vaccination-associated pain in infants, children, and adolescents, and may improve compliance with the vaccination schedule. Keywords: immunization, intervention, effective, compliance

  13. A cluster randomised school-based lifestyle intervention programme for the prevention of childhood obesity and related early cardiovascular disease (JuvenTUM 3

    Directory of Open Access Journals (Sweden)

    Haller Bernhard

    2011-04-01

    Full Text Available Abstract Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease. The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear, as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function. In this study a comprehensive school-based randomized intervention programme will be investigated in 10-14-year old children addressing the influence of lifestyle intervention on inactivity, cardiometabolic risk factors and early signs of vascular disease. Methods/Design 15 secondary schools in Southern Germany are randomly assigned to intervention or control schools. Children in the fifth grade (10-11 years will be observed over four years. The study combines a school-based with a home-based approach, aiming at children, teachers and parents. The main components are weekly lifestyle-lessons for children, taught by regular classroom teachers to increase physical activity in- and outside of school, to improve eating patterns at school and at home, to reduce media consumption and to amplify well-being. In 4-6 annual meetings, teachers receive information about health-related topics with worksheets for children and supporting equipment, accounting for school-specific needs and strategies. Parents' trainings are provided on a regular basis. All examinations are performed at the beginning and at the end of every school year. Anthropometry includes measurements of BMI, waist and upper arm circumferences, skinfold thickness as well as peripheral blood pressure. Blood sampling includes lipid parameters, insulin, glucose, hsCRP, adiponectin, and IL-6 as well as testosteron and estrogen to determine maturation status. Vascular function is non-invasively assessed by measuring arterial stiffness in large

  14. Stress management for adult survivors of childhood sexual abuse: a holistic inquiry.

    Science.gov (United States)

    Wilson, Debra Rose

    2010-02-01

    Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.

  15. Immune phenotype in children with therapy-naïve remitted and relapsed Crohn’s disease

    Science.gov (United States)

    Cseh, Aron; Vasarhelyi, Barna; Molnar, Kriszta; Szalay, Balazs; Svec, Peter; Treszl, Andras; Dezsofi, Antal; Lakatos, Peter Laszlo; Arato, Andras; Tulassay, Tivadar; Veres, Gabor

    2010-01-01

    AIM: To characterize the prevalence of subpopulations of CD4+ cells along with that of major inhibitor or stimulator cell types in therapy-naïve childhood Crohn’s disease (CD) and to test whether abnormalities of immune phenotype are normalized with the improvement of clinical signs and symptoms of disease. METHODS: We enrolled 26 pediatric patients with CD. 14 therapy-naïve CD children; of those, 10 children remitted on conventional therapy and formed the remission group. We also tested another group of 12 children who relapsed with conventional therapy and were given infliximab; and 15 healthy children who served as controls. The prevalence of Th1 and Th2, naïve and memory, activated and regulatory T cells, along with the members of innate immunity such as natural killer (NK), NK-T, myeloid and plasmocytoid dendritic cells (DCs), monocytes and Toll-like receptor (TLR)-2 and TLR-4 expression were determined in peripheral blood samples. RESULTS: Children with therapy-naïve CD and those in relapse showed a decrease in Th1 cell prevalence. Simultaneously, an increased prevalence of memory and activated lymphocytes along with that of DCs and monocytes was observed. In addition, the ratio of myeloid /plasmocytoid DCs and the prevalence of TLR-2 or TLR-4 positive DCs and monocytes were also higher in therapy-naïve CD than in controls. The majority of alterations diminished in remitted CD irrespective of whether remission was obtained by conventional or biological therapy. CONCLUSION: The finding that immune phenotype is normalized in remission suggests a link between immune phenotype and disease activity in childhood CD. Our observations support the involvement of members of the adaptive and innate immune systems in childhood CD. PMID:21157977

  16. The role of early childhood education programmes in the promotion of child and adolescent mental health in low- and middle-income countries.

    Science.gov (United States)

    Baker-Henningham, Helen

    2014-04-01

    There is growing evidence that early childhood education (ECE) interventions can reduce the loss of developmental potential of disadvantaged children in low- and middle-income countries (LAMIC). Less attention has been paid to the potential of these programmes to prevent child mental health problems and promote child well-being. Peer-reviewed journal articles describing controlled evaluations of ECE interventions in LAMIC were reviewed to identify studies with child mental health outcomes. Studies with proximal outcomes for child mental health including caregiver practices and caregiver mental health were also reviewed. Of 63 studies identified, 21 (33.33%) included child mental health outcomes; 12 of 16 studies with short-term measures showed benefits; 6 studies included a longer-term follow-up and all found benefits; 25 studies included caregiver outcomes: consistent benefits were found for caregiver practices (21 studies) and 6 of 9 studies that measured caregiver mental health reported benefits. Gains to child mental health may be most likely when ECE interventions include three main elements: (i) activities to increase child skills including cognition, language, self-regulation and social-emotional competence; (ii) training caregivers in the skills required to provide a cognitively stimulating and emotionally supportive environment; and (iii) attention to the caregivers' mental health, motivation and self-efficacy. Recommendations for the design and implementation of programmes are provided. ECE interventions are an important component of mental health prevention and promotion in LAMIC, and promoting child and caregiver well-being is a fundamental aspect of interventions to improve child development.

  17. Mixed-Age Grouping in Early Childhood--Creating the Outdoor Learning Environment

    Science.gov (United States)

    Rouse, Elizabeth

    2015-01-01

    Children attending centre-based early childhood care and education programmes across Australia are most likely to be grouped according to age and development. While multi- or mixed-age grouping has been seen to have positive benefits on young children's learning and pro-social behaviours, this approach is not usually adopted in the organisation of…

  18. Innate and adaptive immune traits are differentially affected by genetic and environmental factors

    Science.gov (United States)

    Mangino, Massimo; Roederer, Mario; Beddall, Margaret H.; Nestle, Frank O.; Spector, Tim D.

    2017-01-01

    The diversity and activity of leukocytes is controlled by genetic and environmental influences to maintain balanced immune responses. However, the relative contribution of environmental compared with genetic factors that affect variations in immune traits is unknown. Here we analyse 23,394 immune phenotypes in 497 adult female twins. 76% of these traits show a predominantly heritable influence, whereas 24% are mostly influenced by environment. These data highlight the importance of shared childhood environmental influences such as diet, infections or microbes in shaping immune homeostasis for monocytes, B1 cells, γδ T cells and NKT cells, whereas dendritic cells, B2 cells, CD4+ T and CD8+ T cells are more influenced by genetics. Although leukocyte subsets are influenced by genetics and environment, adaptive immune traits are more affected by genetics, whereas innate immune traits are more affected by environment. PMID:28054551

  19. Parasitic worms and allergies in childhood: insights from population studies 2008-2013

    NARCIS (Netherlands)

    Amoah, Abena S.; Boakye, Daniel A.; van Ree, Ronald; Yazdanbakhsh, Maria

    2014-01-01

    The last few decades have seen a marked increase in the global prevalence of allergic diseases particularly among children. Among the factors attributed to this rise has been reduced exposure to pathogens during childhood leading to insufficient maturation of the regulatory arm of developing immune

  20. Childhood tuberculosis in the State of Qatar: the effect of a limited expatriate screening programme on the incidence of tuberculosis.

    Science.gov (United States)

    Al-Marri, M R

    2001-09-01

    To determine incidence rates and the effectiveness of the expatriate screening programme on paediatric tuberculosis (TB) in the State of Qatar. A state-wide, population-based, retrospective analysis of all cases of tuberculosis among children 0-14 years of age reported to the TB Unit of the Division of Public Health during 1983-1996. One hundred and forty-four children with tuberculous disease were identified, with a steadily declining incidence rate (rate of notification) from 11/100000 children (0-14 years) population in 1983 to 7/100000 in 1996. This decrease in the childhood TB case notification rate correlated with foreign-born children, older children and the implementation of expatriate screening in 1986. Diagnosis in 56% of children was made abroad or within 3 months of arrival from vacation and 30% within one year of arrival. Comparison of the three age groups (nationality, sex, type of TB, radiological findings and screening. However older children were more likely to be symptomatic (P Qatar has a high rate of paediatric tuberculosis. The policy of BCG vaccination at birth should be continued, and screening children at school entry and on return from vacation would be useful for further case identification.

  1. Community Screening for Preschool Child Inhibition to Offer the "Cool Little Kids" Anxiety Prevention Programme

    Science.gov (United States)

    Beatson, Ruth M.; Bayer, Jordana K.; Perry, Alexandra; Mathers, Megan; Hiscock, Harriet; Wake, Melissa; Beesley, Kate; Rapee, Ronald M.

    2014-01-01

    Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the…

  2. Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza Hospital, Zimbabwe, 2008.

    Science.gov (United States)

    Ngwende, Stella; Gombe, Notion T; Midzi, Stanley; Tshimanga, Mufuta; Shambira, Gerald; Chadambuka, Addmore

    2013-12-14

    Zimbabwe is one of the five countries worst affected by the HIV/AIDS pandemic with HIV infection contributing increasingly to childhood morbidity and mortality. Among the children born to HIV positive mothers participating in the PMTCT programme, 25% tested positive to HIV. We investigated factors associated with HIV infection among children born to mothers on the PMTCT programme. A 1:1 unmatched case-control study was conducted at Chitungwiza Hospital, Zimbabwe, 2008. A case was defined as a child who tested HIV positive, born to a mother who had been on PMTCT programme. A control was a HIV negative child born to a mother who had been on PMTCT programme. An interviewer-administered questionnaire was used to collect data on demographic characteristics, risk factors associated with HIV infection and immunization status. A total of 120 mothers were interviewed. Independent risk factors associated with HIV infection among children included maternal CD4 count of less than 200 during pregnancy [aOR = 7.1, 95% CI (2.6-17)], mixed feeding [aOR = 29, 95% CI (4.2-208)], being hospitalized since birth [aOR = 2.9, 95% CI (1.2-4.8)] whilst being exclusively breast fed for less than 6 months [aOR = 0.1 (95% CI 0.03-0.4)] was protective. HIV infection among children increased if the mother's CD4 count was ≤200 cells/μL and if the child was exposed to mixed feeding. Breastfeeding exclusively for less than six months was protective. We recommended exclusive breast feeding period for the first six months and stop breast feeding after 6 months if affordable, sustainable and safe.

  3. Systems biology of neutrophil differentiation and immune response

    DEFF Research Database (Denmark)

    Theilgaard-Mönch, Kim; Porse, Bo T; Borregaard, Niels

    2005-01-01

    Systems biology has emerged as a new scientific field, which aims at investigating biological processes at the genomic and proteomic levels. Recent studies have unravelled aspects of neutrophil differentiation and immune responses at the systems level using high-throughput technologies. These stu......Systems biology has emerged as a new scientific field, which aims at investigating biological processes at the genomic and proteomic levels. Recent studies have unravelled aspects of neutrophil differentiation and immune responses at the systems level using high-throughput technologies....... These studies have identified a plethora of novel effector proteins stored in the granules of neutrophils. In addition, these studies provide evidence that neutrophil differentiation and immune response are governed by a highly coordinated transcriptional programme that regulates cellular fate and function...

  4. Incomplete childhood immunization with new and old vaccines and associated factors: BRISA birth cohort, São Luís, Maranhão State, Northeast Brazil.

    Science.gov (United States)

    Silva, Francelena de Sousa; Barbosa, Yonna Costa; Batalha, Mônica Araújo; Ribeiro, Marizélia Rodrigues Costa; Simões, Vanda Maria Ferreira; Branco, Maria Dos Remédios Freitas Carvalho; Thomaz, Érika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; Araújo, Waleska Regina Machado; Silva, Antônio Augusto Moura da

    2018-03-12

    This study estimated the percentages of incomplete immunization with new vaccines and old vaccines and associated factors in children 13 to 35 months of age belonging to a birth cohort in São Luís, the capital of Maranhão State, Brazil. The sample was probabilistic, with 3,076 children born in 2010. Information on vaccination was obtained from the Child's Health Card. The new vaccines, namely those introduced in 2010, were meningococcal C and 10-valent pneumococcal, and the old vaccines, or those already on the childhood immunization schedule, were BCG, hepatitis B, human rotavirus, polio, tetravalent (diphtheria, tetanus, pertussis, Haemophilus influenzae b), yellow fever, and triple viral (measles, mumps, rubella). The study used hierarchical modeling and Poisson regression with robust variance. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. Incomplete immunization was higher with new vaccines (51.1%) than with old vaccines (33.2%). Children 25 to 35 months of age (PR = 1.27; 95%CI: 1.14-1.41) and those in economic classes D/E (PR = 1.20; 95%CI: 1.06-1.35) were only significantly associated with new vaccines; low maternal schooling (PR = 1.58; 95%CI: 1.21-2.06), unavailability of outpatient and/or hospital care for the child (PR = 1.20; 95%CI: 1.04-1.38), and unavailability of the vaccine in health services (PR: 1.28; 95%CI: 1.12-1.46) were only associated with old vaccines. Immunization strategies should consider the vulnerability of older preschool-age children and those belonging to classes D and E, especially when new vaccines are introduced, as well as children of mothers with low schooling. Strategies should also address problems with the availability of health services and vaccines.

  5. The Virome and Its Major Component, Anellovirus, a Convoluted System Molding Human Immune Defenses and Possibly Affecting the Development of Asthma and Respiratory Diseases in Childhood

    Directory of Open Access Journals (Sweden)

    Giulia Freer

    2018-04-01

    Full Text Available The microbiome, a thriving and complex microbial community colonizing the human body, has a broad impact on human health. Colonization is a continuous process that starts very early in life and occurs thanks to shrewd strategies microbes have evolved to tackle a convoluted array of anatomical, physiological, and functional barriers of the human body. Cumulative evidence shows that viruses are part of the microbiome. This part, called virome, has a dynamic composition that reflects what we eat, how and where we live, what we do, our genetic background, and other unpredictable variables. Thus, the virome plays a chief role in shaping innate and adaptive host immune defenses. Imbalance of normal microbial flora is thought to trigger or exacerbate many acute and chronic disorders. A compelling example can be found in the respiratory apparatus, where early-life viral infections are major determinants for the development of allergic diseases, like asthma, and other non-transmissible diseases. In this review, we focus on the virome and, particularly, on Anelloviridae, a recently discovered virus family. Anelloviruses are major components of the virome, present in most, if not all, human beings, where they are acquired early in life and replicate persistently without causing apparent disease. We will discuss how modulation of innate and adaptive immune systems by Anelloviruses can influence the development of respiratory diseases in childhood and provide evidence for the use of Anelloviruses as useful and practical molecular markers to monitor inflammatory processes and immune system competence.

  6. Impact of a Community-Based Programme for Motor Development on Gross Motor Skills and Cognitive Function in Preschool Children from Disadvantaged Settings

    Science.gov (United States)

    Draper, Catherine E.; Achmat, Masturah; Forbes, Jared; Lambert, Estelle V.

    2012-01-01

    The aims of the studies were to assess the impact of the Little Champs programme for motor development on (1) the gross motor skills, and (2) cognitive function of children in the programme. In study 1, 118 children from one Early Childhood Development Centre (ECDC) were tested using the Test of Gross Motor Development-2, and in study 2, 83…

  7. Aetiology of childhood acute leukaemias: Current status of knowledge

    International Nuclear Information System (INIS)

    Rossig, C.; Juergens, H.

    2008-01-01

    Acute leukaemia is a consequence of malignant transformation of a haematopoietic progenitor cell. Molecular studies have revealed a prenatal origin of many childhood leukaemias. According to current models, a pre-leukaemic stem cell clone is generated by a first mutation in utero which, in a minority of children, progresses to leukaemia after receiving further postnatal genetic hits. The nature of pre- and postnatal events involved in leukemogenesis in children is not well understood. Although genetic predisposition and specific environmental exposures may account for individual cases, the bulk of childhood leukaemia cannot be explained by any of these factors. The higher incidence of the most common leukaemia subtype in affluent societies, as well as the age peak between 2-5 y, suggest a contributory role of socioeconomic factors. An abnormal immune response during delayed exposure to common infections provides a plausible mechanism for malignant progression of pre-leukaemic clones in a subgroup of children. As highlighted in this review, a common cause for all types and subtypes of childhood leukaemia is highly unlikely. Deeper insights into the pathogenesis of childhood leukaemia will rely on large-scale and combined epidemiological and bio-molecular studies. (authors)

  8. School-based vaccination programmes: a systematic review of the evidence on organisation and delivery in high income countries

    Directory of Open Access Journals (Sweden)

    Sarah Perman

    2017-03-01

    Full Text Available Abstract Background Many countries have recently expanded their childhood immunisation programmes. Schools are an increasingly attractive setting for delivery of these new immunisations because of their ability to reach large numbers of children in a short period of time. However, there are organisational challenges to delivery of large-scale vaccination programmes in schools. Understanding the facilitators and barriers is important for improving the delivery of future school-based vaccination programmes. Methods We undertook a systematic review of evidence on school-based vaccination programmes in order to understand the influence of organisational factors on the delivery of programmes. Our eligibility criteria were studies that (1 focused on childhood or adolescent vaccination programmes delivered in schools; (2 considered organisational factors that influenced the preparation or delivery of programmes; (3 were conducted in a developed or high-income country; and (4 had been peer reviewed. We searched for articles published in English between 2000 and 2015 using MEDLINE and HMIC electronic databases. Additional studies were identified by searching the Cochrane Library and bibliographies. We extracted data from the studies, assessed quality and the risk of bias, and categorised findings using a thematic framework of eight organisational factors. Results We found that most of the recent published literature is from the United States and is concerned with the delivery of pandemic or seasonal flu vaccination programmes at a regional (state or local level. We found that the literature is largely descriptive and not informed by the use of theory. Despite this, we identified common factors that influence the implementation of programmes. These factors included programme leadership and governance, organisational models and institutional relationships, workforce capacity and roles particularly concerning the school nurse, communication with parents and

  9. Initial results from the newborn hearing screening programme in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, A

    2013-03-02

    INTRODUCTION: Hearing screening programmes aim to detect hearing loss in the neonate. The Health Service Executive (HSE) South was the first phase of a national roll-out of a neonatal hearing screening programme in Ireland, going live on 28 April 2011. RESULTS: Over 11,738 babies have been screened for permanent childhood hearing impairment (PCHI) during the first 12 months. The percentage of eligible babies offered hearing screening was 99.2 %. Only 0.2 % (n = 25) of those offered screening declined. 493 (4 %) were referred for immediate diagnostic audiological assessment. The average time between screen and diagnostic audiology appointment was 2 weeks. 15 (1.3\\/1,000) babies have been identified with a PCHI over the 12-month period. 946 (4 %) babies screened were admitted to the neonatal intensive care unit (NICU) for >48 h. The prevalance of PCHI is 7.3\\/1,000 in the NICU population compared to 0.6\\/1000 in the well baby population. 214 (1.8 % of total babies screened) had a clear response in the screening programmes, but were deemed to be at risk of an acquired childhood hearing impairment. These babies will be reassessed with a diagnostic audiology appointment at 8-9 months of age. To date, there is one case of acquired hearing impairment through this targeted follow-up screen. Of the 15 cases of PCHI identified, 8 (53 %) of these had one or more risk factors for hearing loss and 7 (37 %) were admitted to the NICU for >48 h. Four babies were referred for assessment at the National Cochlear Implant Centre.

  10. Systematic review of pediatric health outcomes associated with childhood adversity.

    Science.gov (United States)

    Oh, Debora Lee; Jerman, Petra; Silvério Marques, Sara; Koita, Kadiatou; Purewal Boparai, Sukhdip Kaur; Burke Harris, Nadine; Bucci, Monica

    2018-02-23

    Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers. After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion. Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children's response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better

  11. Host genome variations and risk of infections during induction treatment for childhood acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Lund, Bendik; Wesolowska-Andersen, Agata; Lausen, Birgitte

    2014-01-01

    Objectives: To investigate association of host genomic variation and risk of infections during treatment for childhood acute lymphoblastic leukaemia (ALL). Methods: We explored association of 34 000 singlenucleotide polymorphisms (SNPs) related primarily to pharmacogenomics and immune function...

  12. (More) Men in Early Childhood Education and Care

    DEFF Research Database (Denmark)

    Wohlgemuth, Ulla Gerner

    2016-01-01

    on their profession. Obviously, attracting men to a BA study programme within care and Early Childhood Education and Care (ECEC) is one thing, recruiting men afterwards to ECEC is quite another matter, especially when gender and ECEC hold so very strong gender associated expectations. The participants and especially......This article reports the results from five recently completed projects funded by the Danish Ministry for Children, Education and Gender Equality and based on an idea developed in cooperation with the Danish Union of Early Childhood and Youth Educators. The Danish government is obliged not only...... by European legislation but also by national resolutions and therefore is very interested in ways to break down the gender segregated labour market and the gender segregated choices of education. The five projects spread across Denmark in five different municipalities took place in day-care institutions...

  13. Trachoma: protective and pathogenic ocular immune responses to Chlamydia trachomatis.

    Directory of Open Access Journals (Sweden)

    Victor H Hu

    Full Text Available Trachoma, caused by Chlamydia trachomatis (Ct, is the leading infectious blinding disease worldwide. Chronic conjunctival inflammation develops in childhood and leads to eyelid scarring and blindness in adulthood. The immune response to Ct provides only partial protection against re-infection, which can be frequent. Moreover, the immune response is central to the development of scarring pathology, leading to loss of vision. Here we review the current literature on both protective and pathological immune responses in trachoma. The resolution of Ct infection in animal models is IFNγ-dependent, involving Th1 cells, but whether this is the case in human ocular infection still needs to be confirmed. An increasing number of studies indicate that innate immune responses arising from the epithelium and other innate immune cells, along with changes in matrix metalloproteinase activity, are important in the development of tissue damage and scarring. Current trachoma control measures, which are centred on repeated mass antibiotic treatment of populations, are logistically challenging and have the potential to drive antimicrobial resistance. A trachoma vaccine would offer significant advantages. However, limited understanding of the mechanisms of both protective immunity and immunopathology to Ct remain barriers to vaccine development.

  14. Immunization, urbanization and slums - a systematic review of factors and interventions.

    Science.gov (United States)

    Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

    2017-06-08

    In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context

  15. The role of immune mechanisms in Tourette syndrome.

    Science.gov (United States)

    Martino, Davide; Zis, Panagiotis; Buttiglione, Maura

    2015-08-18

    Tourette syndrome (TS) is a childhood-onset tic disorder associated with abnormal development of brain networks involved in the sensory and motor processing. An involvement of immune mechanisms in its pathophysiology has been proposed. Animal models based on active immunization with bacterial or viral mimics, direct injection of cytokines or patients' serum anti-neuronal antibodies, and transgenic approaches replicated stereotyped behaviors observed in human TS. A crucial role of microglia in the neural-immune crosstalk within TS and related disorders has been proposed by animal models and confirmed by recent post mortem studies. With analogy to autism, genetic and early life environmental factors could foster the involvement of immune mechanisms to the abnormal developmental trajectories postulated in TS, as well as lead to systemic immune dysregulation in this condition. Clinical studies demonstrate an association between TS and immune responses to pathogens like group A Streptococcus (GAS), although their role as risk-modifiers is still undefined. Overactivity of immune responses at a systemic level is suggested by clinical studies exploring cytokine and immunoglobulin levels, immune cell subpopulations, and gene expression profiling of peripheral lymphocytes. The involvement of autoantibodies, on the other hand, remains uncertain and warrants more work using live cell-based approaches. Overall, a body of evidence supports the hypothesis that disease mechanisms in TS, like other neurodevelopmental illnesses (e.g. autism), may involve dysfunctional neural-immune cross-talk, ultimately leading to altered maturation of brain pathways controlling different behavioral domains and, possibly, differences in organising immune and stress responses. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Survey of childhood blindness and visual impairment in Botswana

    Science.gov (United States)

    Nallasamy, Sudha; Anninger, William V; Quinn, Graham E; Kroener, Brian; Zetola, Nicola M; Nkomazana, Oathokwa

    2014-01-01

    Background/aims In terms of blind-person years, the worldwide burden of childhood blindness is second only to cataracts. In many developing countries, 30–72% of childhood blindness is avoidable. The authors conducted this study to determine the causes of childhood blindness and visual impairment (VI) in Botswana, a middle-income country with limited access to ophthalmic care. Methods This study was conducted over 4 weeks in eight cities and villages in Botswana. Children were recruited through a radio advertisement and local outreach programmes. Those ≤15 years of age with visual acuity Blindness Eye Examination Record for Children with Blindness and Low Vision was used to record data. Results The authors enrolled 241 children, 79 with unilateral and 162 with bilateral VI. Of unilateral cases, 89% were avoidable: 23% preventable (83% trauma-related) and 66% treatable (40% refractive error and 31% amblyopia). Of bilateral cases, 63% were avoidable: 5% preventable and 58% treatable (33% refractive error and 31% congenital cataracts). Conclusion Refractive error, which is easily correctable with glasses, is the most common cause of bilateral VI, with cataracts a close second. A nationwide intervention is currently being planned to reduce the burden of avoidable childhood VI in Botswana. PMID:21242581

  17. EPODE approach for childhood obesity prevention: methods, progress and international development.

    Science.gov (United States)

    Borys, J-M; Le Bodo, Y; Jebb, S A; Seidell, J C; Summerbell, C; Richard, D; De Henauw, S; Moreno, L A; Romon, M; Visscher, T L S; Raffin, S; Swinburn, B

    2012-04-01

    Childhood obesity is a complex issue and needs multi-stakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. 'Ensemble Prévenons l'Obésité Des Enfants' (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity. At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input--drawing on the evidence-base--together with evaluation of the programme. Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

  18. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Directory of Open Access Journals (Sweden)

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  19. Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations.

    Science.gov (United States)

    Chen, Edith; Shalowitz, Madeleine U; Story, Rachel E; Ehrlich, Katherine B; Levine, Cynthia S; Hayen, Robin; Leigh, Adam K K; Miller, Gregory E

    The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.

  20. Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial.

    Science.gov (United States)

    Kempe, Allison; Saville, Alison; Dickinson, L Miriam; Eisert, Sheri; Reynolds, Joni; Herrero, Diana; Beaty, Brenda; Albright, Karen; Dibert, Eva; Koehler, Vicky; Lockhart, Steven; Calonge, Ned

    2013-06-01

    We compared the effectiveness and cost-effectiveness of population-based recall (Pop-recall) versus practice-based recall (PCP-recall) at increasing immunizations among preschool children. This cluster-randomized trial involved children aged 19 to 35 months needing immunizations in 8 rural and 6 urban Colorado counties. In Pop-recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In PCP-recall counties, practices were invited to attend webinar training using CIIS and offered financial support for mailings. The percentage of up-to-date (UTD) and vaccine documentation were compared 6 months after recall. A mixed-effects model assessed the association between intervention and whether a child became UTD. Ten of 195 practices (5%) implemented recall in PCP-recall counties. Among children needing immunizations, 18.7% became UTD in Pop-recall versus 12.8% in PCP-recall counties (P immunization rates in preschool children.

  1. Quality Management in Slovenian Education Programmes

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    Milena Alič

    2015-05-01

    Full Text Available Product and service quality, effective process management, continuous improvement and innovation are some essential conditions for making a successful business. They are often emphasised by managers of successful organizations, by authors of professional and scientific papers and even by politicians and journalists. Quality management standards and models, such as ISO 9001 and EFQM model appeared in assistance to the needs of organisations to assure stable product and service quality, to improve it and to make the production process and its supporting processes effective. It has been 28 years since the standard ISO 9001 appeared. Now it is the most widely spread global standard implemented in more than 1.100.000 organizations worldwide. If quality management was proved to be an important approach to make organizations operate better and thus to contribute to well-being of the society, it would be expected that it is somehow included in our regular school programmes on all the levels. We expect that learning and living quality approaches in childhood and youth would be the least costly way to improve the culture of quality in the society and to implement it in our organizations as well. The paper gives some insight in the situation by searching for quality management related programmes and approaches in our primary, secondary and tertiary school programmes. The purpose of this paper is only to highlight the issue of teaching for quality in our regular education programmes – just to become aware of it and to find some improvement opportunities. There should be still some more detailed research on this topic to give strong suggestions.

  2. Fostering Effective Early Learning (FEEL) through a professional development programme for early childhood educators to improve professional practice and child outcomes in the year before formal schooling: study protocol for a cluster randomised controlled trial.

    Science.gov (United States)

    Melhuish, Edward; Howard, Steven J; Siraj, Iram; Neilsen-Hewett, Cathrine; Kingston, Denise; de Rosnay, Marc; Duursma, Elisabeth; Luu, Betty

    2016-12-19

    A substantial research base documents the benefits of attendance at high-quality early childhood education and care (ECEC) for positive behavioural and learning outcomes. Research has also found that the quality of many young children's experiences and opportunities in ECEC depends on the skills, dispositions and understandings of the early childhood adult educators. Increasingly, research has shown that the quality of children's interactions with educators and their peers, more than any other programme feature, influence what children learn and how they feel about learning. Hence, we sought to investigate the extent to which evidence-based professional development (PD) - focussed on promoting sustained shared thinking through quality interactions - could improve the quality of ECEC and, as a consequence, child outcomes. The Fostering Effective Early Learning (FEEL) study is a cluster randomised controlled trial for evaluating the benefits of a professional development (PD) programme for early childhood educators, compared with no extra PD. Ninety long-day care and preschool centres in New South Wales, Australia, will be selected to ensure representation across National Quality Standards (NQS) ratings, location, centre type and socioeconomic areas. Participating centres will be randomly allocated to one of two groups, stratified by centre type and NQS rating: (1) an intervention group (45 centres) receiving a PD intervention or (2) a control group (45 centres) that continues engaging in typical classroom practice. Randomisation to these groups will occur after the collection of baseline environmental quality ratings. Primary outcomes, at the child level, will be two measures of language development: verbal comprehension and expressive vocabulary. Secondary outcomes at the child level will be measures of early numeracy, social development and self-regulation. Secondary outcomes at the ECEC room level will be measures of environmental quality derived from full

  3. Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis.

    Science.gov (United States)

    Henderson, E J; Ells, L J; Rubin, G P; Hunter, D J

    2015-11-01

    This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  4. Food and beverage cues in children's television programmes: the influence of programme genre.

    Science.gov (United States)

    Scully, Paul; Reid, Orlaith; Macken, Alan; Healy, Mark; Saunders, Jean; Leddin, Des; Cullen, Walter; Dunne, Colum; O'Gorman, Clodagh S

    2016-03-01

    The link between childhood obesity and both television viewing and television advertising have previously been examined. We sought to investigate the frequency and type of food and beverage placements in children-specific television broadcasts and, in particular, differences between programme genres. Content of five weekdays of children-specific television broadcasting on both UK (BBC) and Irish (RTE) television channels was summarized. Food and beverage placements were coded based on type of product, product placement, product use and characters involved. A comparison was made between different programme genres: animated, cartoon, child-specific, film, quiz, tween and young persons' programming. A total of 1155 (BBC=450; RTE=705) cues were recorded giving a cue every 4·2 min, an average of 12·3 s/cue. The genre with most cues recorded was cartoon programming (30·8%). For the majority of genres, cues related to sweet snacks (range 1·8-23·3%) and sweets/candy (range 3·6-25·8%) featured highly. Fast-food (18·0%) and sugar-sweetened beverage (42·3%) cues were observed in a high proportion of tween programming. Celebratory/social motivation factors (range 10-40 %) were most common across all genres while there were low proportions of cues based on reward, punishment or health-related motivating factors. The study provides evidence for the prominence of energy-dense/nutrient-poor foods and beverages in children's programming. Of particular interest is the high prevalence of fast-food and sugar-sweetened beverage cues associated with tween programming. These results further emphasize the need for programme makers to provide a healthier image of foods and beverages in children's television.

  5. Immune-mediated animal models of Tourette syndrome

    Science.gov (United States)

    Hornig, Mady; Lipkin, W. Ian

    2014-01-01

    An autoimmune diathesis has been proposed in Tourette syndrome (TS) and related neuropsychiatric disorders such as obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism and anorexia nervosa. Environmental triggers including infection and xenobiotics are hypothesized to lead to the production of brain-directed autoantibodies in a subset of genetically susceptible individuals. Although much work has focused on Group A Streptococcus (GAS), the role of this common childhood infection remains controversial. Animal model studies based on immune and autoantibody findings in TS have demonstrated immunoglobulin (Ig) deposits and stereotypic movements and related behavioral disturbances reminiscent of TS following exposure to GAS and other activators of host anti-microbial responses, soluble immune mediators and anti-GAS or anti-neuronal antibodies. Demonstration of the ability to recreate these abnormalities through passive transfer of serum IgG from GAS-immunized mice into naïve mice and abrogation of this activity through depletion of IgG has provided compelling evidence in support of the autoimmune hypothesis. Immunologically-based animal models of TS are a potent tool for dissecting the pathogenesis of this serious neuropsychiatric syndrome. PMID:23313649

  6. Maternal autonomy and attitudes towards gender norms: associations with childhood immunization in Nigeria.

    Science.gov (United States)

    Singh, Kavita; Haney, Erica; Olorunsaiye, Comfort

    2013-07-01

    Globally 2.5 million children under-five die from vaccine preventable diseases, and in Nigeria only 23 % of children ages 12-23 months are fully immunized. The international community is promoting gender equality as a means to improve the health and well-being of women and their children. This paper looks at whether measures of gender equality, autonomy and individual attitudes towards gender norms, are associated with a child being fully immunized in Nigeria. Data from currently married women with a child 12-23 months from the 2008 Nigeria demographic and health survey were used to study the influence of autonomy and gender attitudes on whether or not a child is fully immunized. Multivariate logistic regression was used and several key socioeconomic variables were controlled for including wealth and education, which are considered key inputs into gender equality. Findings indicated that household decision-making and attitudes towards wife beating were significantly associated with a child being fully immunized after controlling for socioeconomic variables. Ethnicity, wealth and education were also significant factors. Programmatic and policy implications indicate the potential for the promotion of gender equality as a means to improve child health. Gender equality can be seen as a means to enable women to access life-saving services for their children.

  7. Thirty years of vaccination in Vietnam: Impact and cost-effectiveness of the national Expanded Programme on Immunization.

    Science.gov (United States)

    Jit, Mark; Dang, Thi Thanh Huyen; Friberg, Ingrid; Hoang, Van Minh; Pham Huy, Tuan Kiet; Walker, Neff; Nguyen, Van Cuong; Tran, Nhu Duong; Toda, Kohei; Hutubessy, Raymond; Fox, Kimberley; Nguyen, Tran Hien

    2015-05-07

    Countries like Vietnam transitioning to middle-income status increasingly bear the cost of both existing and new vaccines. However, the impact and cost-effectiveness of the Expanded Programme on Immunization (EPI) as a whole has never been assessed on a country level. Data on vaccine-preventable disease incidence and mortality from Vietnam's national surveillance was analysed to estimate the likely impact that vaccination in 1980-2010 may have had. Adjustment for under-reporting was made by examining trends in reported mumps incidence and in case-fatality risks for each disease. The same data were separately analysed using the Lives Saved Tool (LiST) to give an alternative estimate of impact. The financial cost of EPI in 1996-2010 was also estimated from the perspective of service provider. National surveillance data suggests that up to 5.7 million diseases cases and 26,000 deaths may have been prevented by EPI. Analysis using LiST suggests that even more deaths (370,000) may have been prevented by measles and pertussis vaccination alone. The cost-effectiveness of EPI is estimated to be around $1000-$27,000 per death prevented. Two separate approaches to assessing EPI impact in Vietnam give different quantitative results but a common conclusion: that EPI has made a substantial impact on mortality and represents good value for money. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Impact of community-based immunization services.

    Directory of Open Access Journals (Sweden)

    Sing K

    1986-07-01

    Full Text Available The knowledge, attitude and practice of mothers toward childhood immunization was surveyed in 2 neighborhoods in greater Bombay, India. The areas were a slum of 75,000 called Malavani, and a nearby area called Kharodi. Measles and triple (DPT or DPV vaccines were available at local health centers, 1.5 km away at the most; oral polio vaccines were given by field workers to the Malavani community to children in their homes, but only in the center for those in Kharodi. BCG tuberculosis vaccinations were available to all, but from a center 5 km away. Malavani mothers had significantly better knowledge of triple and measles vaccines, but knowledge about BCG was similar in the 2 groups. Slightly more women from Kharodi expressed negative attitudes toward immunization. Coverage of children, established from clinic records, was significantly better in the Malavani area: 91% vs. 58% for polio; 71% vs 61% for BCG (n.s.; 85% vs. 55% for triple vaccine; and 21% vs 1% for measles. Evidently, visitation by field teams with polio vaccinations affected mothers′ knowledge and practice for other immunizations available only at the center.

  9. Researching routine immunization-do we know what we don't know?

    Science.gov (United States)

    Clements, C John; Watkins, Margaret; de Quadros, Ciro; Biellik, Robin; Hadler, James; McFarland, Deborah; Steinglass, Robert; Luman, Elizabeth; Hennessey, Karen; Dietz, Vance

    2011-11-03

    The Expanded Programme on Immunization (EPI), launched in 1974, has developed and implemented a range of strategies and practices over the last three decades to ensure that children and adults receive the vaccines they need to help protect them against vaccine-preventable diseases. Many of these strategies have been implemented, resulting in immunization coverage exceeding 80% among children one year of age in many countries. Yet millions of infants remain under-immunized or unimmunized, particularly in poorer countries. In November 2009, a panel of external experts met at the United States Centers for Disease Control and Prevention (CDC) to review and identify areas of research required to strengthen routine service delivery in developing countries. Research opportunities were identified utilizing presentations emphasizing existing research, gaps in knowledge and key questions. Panel members prioritized the topics, as did other meeting participants. Several hundred research topics covering a wide range were identified by the panel members and participants. However there were relatively few topics for which there was a consensus that immediate investment in research is warranted. The panel identified 28 topics as priorities. 18 topics were identified as priorities by at least 50% of non-panel participants; of these, five were also identified as priorities by the panel. Research needs included identifying the best ways to increase coverage with existing vaccines and introduce new vaccines, integrate other services with immunizations, and finance immunization programmes. There is an enormous range of research that could be undertaken to support routine immunization. However, implementation of strategic plans, rather than additional research will have the greatest impact on raising immunization coverage and preventing disease, disability, and death from vaccine-preventable diseases. The panel emphasized the importance of tying operational research to programmatic

  10. Inherited and acquired immunodeficiencies underlying tuberculosis in childhood

    Science.gov (United States)

    Boisson-Dupuis, Stéphanie; Bustamante, Jacinta; El-Baghdadi, Jamila; Camcioglu, Yildiz; Parvaneh, Nima; Azbaoui, Safaa El; Agader, Aomar; Hassani, Amal; Hafidi, Naima El; Mrani, Nidal Alaoui; Jouhadi, Zineb; Ailal, Fatima; Najib, Jilali; Reisli, Ismail; Zamani, Adil; Yosunkaya, Sebnem; Gulle-Girit, Saniye; Yildiran, Alisan; Cipe, Funda Erol; Torun, Selda Hancerli; Metin, Ayse; Atikan, Basak Yildiz; Hatipoglu, Nevin; Aydogmus, Cigdem; Kilic, Sara Sebnem; Dogu, Figen; Karaca, Neslihan; Aksu, Guzide; Kutukculer, Necil; Keser-Emiroglu, Melike; Somer, Ayper; Tanir, Gonul; Aytekin, Caner; Adimi, Parisa; Mahdaviani, Seyed Alireza; Mamishi, Setareh; Bousfiha, Aziz; Sanal, Ozden; Mansouri, Davood; Casanova, Jean-Laurent; Abel, Laurent

    2015-01-01

    Summary Tuberculosis (TB), caused by Mycobacterium tuberculosis (M.tb) and a few related mycobacteria, is a devastating disease, killing more than a million individuals per year worldwide. However, its pathogenesis remains largely elusive, as only a small proportion of infected individuals develop clinical disease either during primary infection or during reactivation from latency or secondary infection. Subacute, hematogenous, and extrapulmonary disease tends to be more frequent in infants, children, and teenagers than in adults. Life-threatening primary TB of childhood can result from known acquired or inherited immunodeficiencies, although the vast majority of cases remain unexplained. We review here the conditions conferring a predisposition to childhood clinical diseases caused by mycobacteria, including not only M.tb but also weakly virulent mycobacteria, such as BCG vaccines and environmental mycobacteria. Infections with weakly virulent mycobacteria are much rarer than TB, but the inherited and acquired immunodeficiencies underlying these infections are much better known. Their study has also provided genetic and immunological insights into childhood TB, as illustrated by the discovery of single-gene inborn errors of IFN-γ immunity underlying severe cases of TB. Novel findings are expected from ongoing and future human genetic studies of childhood TB in countries that combine a high proportion of consanguineous marriages, a high incidence of TB, and an excellent clinical care, such as Iran, Morocco, and Turkey. PMID:25703555

  11. Immunization in India 1993-1999: wealth, gender, and regional inequalities revisited.

    Science.gov (United States)

    Gaudin, Sylvestre; Yazbeck, Abdo S

    2006-02-01

    Previously published evidence from the 1992-1993 Indian National Family and Health Survey (NFHS) on the state of childhood immunization showed the importance of analyzing immunization outcomes beyond national averages. Reported total system failure (no immunization for all) in some low performance areas suggested that improvements in immunization levels may come with a worsening of the distribution of immunization based on wealth. In this paper, using the second wave of the NFHS (1998-1999), we take a new snapshot of the situation and compare it to 1992-1993, focusing on heterogeneities between states, rural-urban differentials, gender differentials, and more specifically on wealth-related inequalities. To assess whether improvements in overall immunization rates (levels) were accompanied by distributional improvements, or conversely, whether inequalities were reduced at the expense of overall achievement, we use a recently developed methodology to calculate an inequality-adjusted achievement index that captures performance both in terms of efficiency (change in levels) and equity (distribution by wealth quintiles) for each of the 17 largest Indian states. Comparing 1992-1993 to 1998-1999 achievements using different degrees of "inequality aversion" provides no evidence that distributional improvements occur at the expense of overall performance.

  12. Budget impact analysis of vaccination against Haemophilus influenzae type b as a part of a Pentavalent vaccine in the childhood immunization schedule of Iran.

    Science.gov (United States)

    Teimouri, Fatemeh; Kebriaeezadeh, Abbas; Zahraei, Seyed Mohsen; Gheiratian, MohammadMahdi; Nikfar, Shekoufeh

    2017-01-14

    Health decision makers need to know the impact of the development of a new intervention on the public health and health care costs so that they can plan for economic and financial objectives. The aim of this study was to determine the budget impact of adding Haemophilus influenzae type b (Hib) as a part of a Pentavalent vaccine (Hib-HBV-DTP) to the national childhood immunization schedule of Iran. An excel-based model was developed to determine the costs of including the Pentavalent vaccine in the national immunization program (NIP), comparing the present schedule with the previous one (including separate DTP and hepatitis B vaccines). The total annual costs included the cost of vaccination (the vaccine and syringe) and the cost of Hib treatment. The health outcome was the estimated annual cases of the diseases. The net budget impact was the difference in the total annual cost between the two schedules. Uncertainty about the vaccine effectiveness, vaccination coverage, cost of the vaccine, and cost of the diseases were handled through scenario analysis. The total cost of vaccination during 5 years was $18,060,463 in the previous program and $67,774,786 in the present program. Inclusion of the Pentavalent vaccine would increase the vaccination cost about $49 million, but would save approximately $6 million in the healthcare costs due to reduction of disease cases and treatment costs. The introduction of the Pentavalent vaccine resulted in a net increase in the healthcare budget expenditure across all scenarios from $43.4 million to $50.7 million. The results of this study showed that the inclusion of the Pentavalent vaccine in the NIP of Iran had a significant impact on the health care budget and increased the financial burden on the government. Budget impact of including Pentavalent vaccine in the national immunization schedule of Iranᅟ.

  13. Childhood sarcoidosis: A rare but fascinating disorder

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    Gedalia Abraham

    2008-09-01

    Full Text Available Abstract Childhood sarcoidosis is a rare multisystemic granulomatous disorder of unknown etiology. In the pediatric series reported from the southeastern United States, sarcoidosis had a higher incidence among African Americans. Most reported childhood cases have occurred in patients aged 13–15 years. Macrophages bearing an increased expression of major histocompatibility class (MHC II molecules most likely initiate the inflammatory response of sarcoidosis by presenting an unidentified antigen to CD4+ Th (helper-inducer lymphocytes. A persistent, poorly degradable antigen driven cell-mediated immune response leads to a cytokine cascade, to granuloma formation, and eventually to fibrosis. Frequently observed immunologic features include depression of cutaneous delayed-type hypersensitivity and a heightened helper T cell type 1 (Th1 immune response at sites of disease. Circulating immune complexes, along with signs of B cell hyperactivity, may also be found. The clinical presentation can vary greatly depending upon the organs involved and age of the patient. Two distinct forms of sarcoidosis exist in children. Older children usually present with a multisystem disease similar to the adult manifestations, with frequent hilar lymphadenopathy and pulmonary infiltrations. Early-onset sarcoidosis is a unique form of the disease characterized by the triad of rash, uveitis, and arthritis in children presenting before four years of age. The diagnosis of sarcoidosis is confirmed by demonstrating a typical noncaseating granuloma on a biopsy specimen. Other granulmatous diseases should be reasonably excluded. The current therapy of choice for sarcoidosis in children with multisystem involvement is oral corticosteroids. Methotrexate given orally in low doses has been effective, safe and steroid sparing in some patients. Alternative immunosuppressive agents, such as azathioprine, cyclophosphamide, chlorambucil, and cyclosporine, have been tried in adult cases

  14. The Educationalising of Early Childhood in Aotearoa New Zealand: Tracking "Free Play" 1940s-2010

    Science.gov (United States)

    Stover, Sue

    2016-01-01

    Geographically isolated in the south-west Pacific but intellectually and culturally connected to Western Europe, Aotearoa New Zealand's early childhood education sector is a unique mix of influences. The imprint of progressive education is evident in a legacy of "free play" programmes, yet its national curriculum is built on the…

  15. Measles immune suppression: lessons from the macaque model.

    Directory of Open Access Journals (Sweden)

    Rory D de Vries

    Full Text Available Measles remains a significant childhood disease, and is associated with a transient immune suppression. Paradoxically, measles virus (MV infection also induces robust MV-specific immune responses. Current hypotheses for the mechanism underlying measles immune suppression focus on functional impairment of lymphocytes or antigen-presenting cells, caused by infection with or exposure to MV. We have generated stable recombinant MVs that express enhanced green fluorescent protein, and remain virulent in non-human primates. By performing a comprehensive study of virological, immunological, hematological and histopathological observations made in animals euthanized at different time points after MV infection, we developed a model explaining measles immune suppression which fits with the "measles paradox". Here we show that MV preferentially infects CD45RA(- memory T-lymphocytes and follicular B-lymphocytes, resulting in high infection levels in these populations. After the peak of viremia MV-infected lymphocytes were cleared within days, followed by immune activation and lymph node enlargement. During this period tuberculin-specific T-lymphocyte responses disappeared, whilst strong MV-specific T-lymphocyte responses emerged. Histopathological analysis of lymphoid tissues showed lymphocyte depletion in the B- and T-cell areas in the absence of apoptotic cells, paralleled by infiltration of T-lymphocytes into B-cell follicles and reappearance of proliferating cells. Our findings indicate an immune-mediated clearance of MV-infected CD45RA(- memory T-lymphocytes and follicular B-lymphocytes, which causes temporary immunological amnesia. The rapid oligoclonal expansion of MV-specific lymphocytes and bystander cells masks this depletion, explaining the short duration of measles lymphopenia yet long duration of immune suppression.

  16. Institutional factors that affect black South African students' perceptions of early childhood teacher education

    Directory of Open Access Journals (Sweden)

    M G Steyn

    2014-03-01

    Full Text Available Black students account for over 72% of enrolments in higher education, but only a small percentage of them choose Early Childhood Education (ECE as a field of study and complete the qualification. The purpose of this study was to examine, from the perspective of black ECE students, why so few of them enrol in this particular programme at a historically white university. Through a qualitative, case study approach the reasons for the low enrolment and completion rates were investigated. Participants mentioned that recruitment for this programme, particularly in rural areas should be improved. They also pointed out the higher prestige of other career options, the linguistic challenges they face, the cost of university education and early teacher education in particular, as well as access to transport and resources as barriers to recruitment and retention. Their recommendations for higher enrolment rates included the use of black students to recruit in rural and in township areas, increased funding for bursaries, and more culturally sensitive pedagogies in early childhood teacher education.

  17. [Impact of thymic function in age-related immune deterioration].

    Science.gov (United States)

    Ferrando-Martínez, Sara; de la Fuente, Mónica; Guerrero, Juan Miguel; Leal, Manuel; Muñoz-Fernández, M Ángeles

    2013-01-01

    Age-related biological deterioration also includes immune system deterioration and, in consequence, a rise in the incidence and prevalence of infections and cancers, as well as low responses to vaccination strategies. Out of all immune cell subsets, T-lymphocytes seem to be involved in most of the age-related defects. Since T-lymphocytes mature during their passage through the thymus, and the thymus shows an age-related process of atrophy, thymic regression has been proposed as the triggering event of this immune deterioration in elderly people. Historically, it has been accepted that the young thymus sets the T-lymphocyte repertoire during the childhood, whereupon atrophy begins until the elderly thymus is a non-functional evolutionary trace. However, a rising body of knowledge points toward the thymus functioning during adulthood. In the elderly, higher thymic function is associated with a younger immune system, while thymic function failure is associated with all-cause mortality. Therefore, any new strategy focused on the improvement of the elderly quality of life, especially those trying to influence the immune system, should take into account, together with peripheral homeostasis, thymus function as a key element in slowing down age-related decline. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  18. Childhood adversity profiles and adult psychopathology in a representative Northern Ireland study.

    Science.gov (United States)

    McLafferty, Margaret; Armour, Cherie; McKenna, Aine; O'Neill, Siobhan; Murphy, Sam; Bunting, Brendan

    2015-10-01

    Childhood adversities are key aetiological factors in the onset and persistence of psychopathology. The aims of this study were to identify childhood adversity profiles, and investigate the relationship between the adversity classes and psychopathology in Northern Ireland. The study utilized data from the Northern Ireland Study of Health and Stress, an epidemiological survey (N=1986), which used the CIDI to examine mental health disorders and associated risk factors. Latent Class Analysis revealed 3 distinct typologies; a low risk class (n=1709; 86%), a poly-adversity class (n=122; 6.1%), and an economic adversity class (n=155; 7.8%). Logistic Regression models revealed that individuals in the economic adversity class had a heightened risk of anxiety and substance disorders, with individuals in the poly-adversity class more likely to have a range of mental health problems and suicidality. The findings indicate the importance of considering the impact of co-occurring childhood adversities when planning treatment, prevention, and intervention programmes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Childhood Malnutrition and the Intestinal Microbiome Malnutrition and the microbiome

    OpenAIRE

    Kane, Anne V.; Dinh, Duy M.; Ward, Honorine D.

    2014-01-01

    Malnutrition contributes to almost half of all deaths in children under the age of 5 years, particularly those who live in resource-constrained areas. Those who survive frequently suffer from long-term sequelae including growth failure and neurodevelopmental impairment. Malnutrition is part of a vicious cycle of impaired immunity, recurrent infections and worsening malnutrition. Recently, alterations in the gut microbiome have also been strongly implicated in childhood malnutrition. It has be...

  20. DNA Methyltransferase 3B Gene Promoter and Interleukin-1 Receptor Antagonist Polymorphisms in Childhood Immune Thrombocytopenia

    Directory of Open Access Journals (Sweden)

    Margarita Pesmatzoglou

    2012-01-01

    Full Text Available Primary immune thrombocytopenia (ITP is one of the most common blood diseases as well as the commonest acquired bleeding disorder in childhood. Although the etiology of ITP is unclear, in the pathogenesis of the disease, both environmental and genetic factors including polymorphisms of TNF-a, IL-10, and IL-4 genes have been suggested to be involved. In this study, we investigated the rs2424913 single-nucleotide polymorphism (SNP (C46359T in DNA methyltransferase 3B (DNMT3B gene promoter and the VNTR polymorphism of IL-1 receptor antagonist (IL-1 Ra intron-2 in 32 children (17 boys with the diagnosis of ITP and 64 healthy individuals. No significant differences were found in the genotype distribution of DNMT3B polymorphism between the children with ITP and the control group, whereas the frequency of allele T appeared significantly increased in children with ITP (P = 0.03, OR = 2, 95% CI: 1.06–3.94. In case of IL-1 Ra polymorphism, children with ITP had a significantly higher frequency of genotype I/II, compared to control group (P = 0.043, OR = 2.60, 95% CI: 1.02–6.50. Moreover, genotype I/I as well as allele I was overrepresented in the control group, suggesting that allele I may have a decreased risk for development of ITP. Our findings suggest that rs2424913 DNMT3B SNP as well as IL-1 Ra VNTR polymorphism may contribute to the susceptibility to ITP.

  1. Early immune response patterns to pathogenic bacteria are associated to increased risk of lower respiratory infections in children

    DEFF Research Database (Denmark)

    Vissing, N. H.; Larsen, Jeppe Madura; Rasmussen, Mette Annelie

    2014-01-01

    Neonatal colonisation of the airways with respiratory pathogens is associated with increased risk of lower respiratory infections (LRI) in early childhood (1). Therefore, we hypothesized that children developing LRI have an abnormal immune response to pathogenic bacteria in infancy. We aimed...... to characterise the systemic immune response to pathogenic bacteria at the age of 6 months and study the association with incidence of LRI during the first 3 years of life....

  2. Family involvement in the treatment of childhood obesity

    DEFF Research Database (Denmark)

    Grønbæk, Helle Nergaard; Madsen, Svend Aage Lykke; Michaelsen, Kim F.

    2009-01-01

    INTRODUCTION: The objective of this study was to assess the impacts of a family-based childhood obesity treatment on anthropometry and predictors of dropout and successful weight loss. MATERIALS AND METHODS: The 18-month treatment consisted of a intensive period (IP) including physical exercise...... had limited education and in immigrant families. CONCLUSIONS: This treatment with a psychological approach is feasible and results in significant weight loss during the programme. Future research should focus on how to improve the results of families with limited education and immigrants with non...

  3. "Is That What We Do?" Using a Conversation-Analytic Approach to Highlight the Contribution of Dialogic Reading Strategies to Educator-Child Interactions during Storybook Reading in Two Early Childhood Settings

    Science.gov (United States)

    Cohrssen, Caroline; Niklas, Frank; Tayler, Collette

    2016-01-01

    In Australia, much emphasis in early childhood education is placed on the importance of supporting young children's literacy development, and book-reading occurs frequently during typical early-childhood education and care programmes. Reading a story to a child presents an opportunity for rich language-learning through reciprocal and extended…

  4. Effectiveness of a School-Based Early Intervention CBT Group Programme for Children with Anxiety Aged 5-7 Years

    Science.gov (United States)

    Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.

    2016-01-01

    Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…

  5. Lifestyle Knowledge and Preferences in Preschool Children: Evaluation of the "Get up and Grow" Healthy Lifestyle Education Programme

    Science.gov (United States)

    Wiseman, Nicola; Harris, Neil; Lee, Patricia

    2016-01-01

    Objective: Early childhood is considered a window of opportunity for lifestyle interventions, as this is a critical life-stage at which children accumulate knowledge and skills around behaviours such as eating and physical activity. This study examined how exposure to a settings-based healthy lifestyle programme influences knowledge and preference…

  6. Support for immunization registries among parents of vaccinated and unvaccinated school-aged children: a case control study

    Directory of Open Access Journals (Sweden)

    Pan William KY

    2006-09-01

    Full Text Available Abstract Background Immunizations have reduced childhood vaccine preventable disease incidence by 98–100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Despite substantial resources directed towards registry development in the U.S., only 48% of children were enrolled in a registry in 2004. Parental attitudes likely impact child participation. Consequently, the purpose of this study was to assess the attitudes of parents of vaccinated and unvaccinated school-aged children regarding: support for immunization registries; laws authorizing registries and mandating provider reporting; opt-in versus opt-out registry participation; and financial worth and responsibility of registry development and implementation. Methods A case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Children were recruited from 112 elementary schools in Colorado, Massachusetts, Missouri, and Washington. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Parental views were summarized and logistic regression models compared differences between parents of exempt and vaccinated children. Results Surveys were completed by 56.1% of respondents. Fewer than 10% of parents were aware of immunization registries in their communities. Among parents aware of registries, exempt children were more likely to be enrolled (65.0% than vaccinated children (26.5% (p value = 0.01. A substantial proportion of parents of exempt children support immunization

  7. Two case study evaluations of an arts-based social skills intervention for adolescents with childhood brain disorder.

    Science.gov (United States)

    Agnihotri, Sabrina; Gray, Julia; Colantonio, Angela; Polatajko, Helene; Cameron, Debra; Wiseman-Hakes, Catherine; Rumney, Peter; Keightley, Michelle

    2012-01-01

    Arts-based programmes have been shown to be useful for individuals with disturbances in cognitive and behavioural functioning. The current case studies examined the feasibility and effectiveness of a theatre skills training programme to facilitate social skills and participation for adolescents with childhood brain disorder. A case study approach was used with two adolescent participants. Focus groups were conducted immediately post-intervention, while a battery of quantitative measures were administered pre- and post-treatment, as well as 8 months post-treatment. Perceived and documented improvements in social skills and participation were observed from pre- to post-intervention and at follow-up. Results support the use of an arts-based intervention for youth with brain injuries to facilitate social skills and participation. Findings also highlight the need for more sensitive measures of these skills for youth with childhood brain disorder, who may have impaired awareness of their abilities and/or impairments in memory and language comprehension.

  8. Childhood tuberculosis and malnutrition.

    Science.gov (United States)

    Jaganath, Devan; Mupere, Ezekiel

    2012-12-15

    Despite the burden of both malnutrition and tuberculosis in children worldwide, there are few studies on the mechanisms that underlie this relationship. From available research, it appears that malnutrition is a predictor of tuberculosis disease and is associated with worse outcomes. This is supported through several lines of evidence, including the role of vitamin D receptor genotypes, malnutrition's effects on immune development, respiratory infections among malnourished children, and limited work specifically on pediatric tuberculosis and malnutrition. Nutritional supplementation has yet to suggest significant benefits on the course of tuberculosis in children. There is a critical need for research on childhood tuberculosis, specifically on how nutritional status affects the risk and progression of tuberculosis and whether nutritional supplementation improves clinical outcomes or prevents disease.

  9. Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of bangalore city using cluster sampling and lot quality assurance sampling techniques.

    Science.gov (United States)

    K, Punith; K, Lalitha; G, Suman; Bs, Pradeep; Kumar K, Jayanth

    2008-07-01

    Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Population-based cross-sectional study. Areas under Mathikere Urban Health Center. Children aged 12 months to 23 months. 220 in cluster sampling, 76 in lot quality assurance sampling. Percentages and Proportions, Chi square Test. (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

  10. Childhood trauma and resilience in psoriatic patients: A preliminary report.

    Science.gov (United States)

    Crosta, Maria Luigia; De Simone, Clara; Di Pietro, Salvatore; Acanfora, Mariateresa; Caldarola, Giacomo; Moccia, Lorenzo; Callea, Antonino; Panaccione, Isabella; Peris, Ketty; Rinaldi, Lucio; Janiri, Luigi; Di Nicola, Marco

    2018-03-01

    Psoriasis is a chronic inflammatory skin disease with a complex etiology, involving the immune system, genetic factors, and external/internal triggers, with psychosomatic aspects. The aim of the study was to investigate childhood trauma and resilience in a psoriatic sample compared with healthy controls. Correlations between childhood trauma, resilience, quality of life, clinical data and psoriatic features were also evaluated. Seventy-seven psoriatic patients and seventy-six homogeneous healthy controls were enrolled. We used the Psoriasis Area and Severity Index (PASI) to assess the severity of psoriasis and the Skindex-29 to measure health-related quality of life. The psychometric battery included the Childhood Trauma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-Risc) to assess trauma exposure and resilience, respectively. Psoriatic patients showed a significant prevalence of childhood trauma and a lower resilience level compared to healthy controls. Associations between traumatic experiences, low resilience and reduced quality of life in psoriatic subjects were also observed. A multidisciplinary approach is helpful to investigate clinical aspects, trigger factors and psychophysiological stress response in psoriatic subjects. Improving resilience with an early psychological intervention focused on self-motivation and strengthening of self-efficacy could facilitate the management of psoriasis. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Social influence in childhood obesity interventions: a systematic review.

    Science.gov (United States)

    Jalali, M S; Sharafi-Avarzaman, Z; Rahmandad, H; Ammerman, A S

    2016-09-01

    The objective of this study is to understand the pathways through which social influence at the family level moderates the impact of childhood obesity interventions. We conducted a systematic review of obesity interventions in which parents' behaviours are targeted to change children's obesity outcomes, because of the potential social and environmental influence of parents on the nutrition and physical activity behaviours of children. PubMed (1966-2013) and the Web of Science (1900-2013) were searched, and 32 studies satisfied our inclusion criteria. Results for existing mechanisms that moderate parents' influence on children's behaviour are discussed, and a causal pathway diagram is developed to map out social influence mechanisms that affect childhood obesity. We provide health professionals and researchers with recommendations for leveraging family-based social influence mechanisms to increase the efficacy of obesity intervention programmes. © 2016 World Obesity. © 2016 World Obesity.

  12. Gender based within-household inequality in childhood immunization in India: changes over time and across regions.

    Directory of Open Access Journals (Sweden)

    Ashish Singh

    Full Text Available Despite India's substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI.The present study used households with a pair of male-female siblings (aged 1-5 years from two rounds of National Family Health Survey (NFHS, 1992-93 and 2005-06. The overall inequality in the immunization status (after controlling for age and birth order of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992-93 and 2005-06. Household fixed-effects models for immunization status of children were also estimated.Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992-93 to 0.023 in 2005-06. However, as a percentage of total inequality, it increased marginally (15.5% to 16.5%. In absolute terms, GWHI decreased in all the regions except in the North-East. But, as a percentage of total inequality it increased in the North-Eastern, Western and Southern regions. The main conclusions are the following: GWHI contributes substantially to the overall inequality in immunization status of Indian children; and though the overall inequality in immunization status declined

  13. Gender based within-household inequality in childhood immunization in India: changes over time and across regions.

    Science.gov (United States)

    Singh, Ashish

    2012-01-01

    Despite India's substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI. The present study used households with a pair of male-female siblings (aged 1-5 years) from two rounds of National Family Health Survey (NFHS, 1992-93 and 2005-06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992-93 and 2005-06). Household fixed-effects models for immunization status of children were also estimated. Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992-93 to 0.023 in 2005-06. However, as a percentage of total inequality, it increased marginally (15.5% to 16.5%). In absolute terms, GWHI decreased in all the regions except in the North-East. But, as a percentage of total inequality it increased in the North-Eastern, Western and Southern regions. The main conclusions are the following: GWHI contributes substantially to the overall inequality in immunization status of Indian children; and though the overall inequality in immunization status declined in all the

  14. Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions

    Science.gov (United States)

    Singh, Ashish

    2012-01-01

    Background and Objectives Despite India's substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI. Data and Methods The present study used households with a pair of male-female siblings (aged 1–5 years) from two rounds of National Family Health Survey (NFHS, 1992–93 and 2005–06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992–93 and 2005–06). Household fixed-effects models for immunization status of children were also estimated. Results and Conclusions Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992–93 to 0.023 in 2005–06. However, as a percentage of total inequality, it increased marginally (15.5% to 16.5%). In absolute terms, GWHI decreased in all the regions except in the North-East. But, as a percentage of total inequality it increased in the North-Eastern, Western and Southern regions. The main conclusions are the following: GWHI contributes substantially to the overall inequality in immunization status of Indian children

  15. Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions

    OpenAIRE

    Singh, Ashish

    2012-01-01

    Background and Objectives Despite India's substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of ...

  16. Living on a farm, contact with farm animals and pets, and childhood acute lymphoblastic leukemia: pooled and meta-analyses from the Childhood Leukemia International Consortium.

    Science.gov (United States)

    Orsi, Laurent; Magnani, Corrado; Petridou, Eleni T; Dockerty, John D; Metayer, Catherine; Milne, Elizabeth; Bailey, Helen D; Dessypris, Nick; Kang, Alice Y; Wesseling, Catharina; Infante-Rivard, Claire; Wünsch-Filho, Victor; Mora, Ana M; Spector, Logan G; Clavel, Jacqueline

    2018-04-16

    The associations between childhood acute lymphoblastic leukemia (ALL) and several factors related to early stimulation of the immune system, that is, farm residence and regular contacts with farm animals (livestock, poultry) or pets in early childhood, were investigated using data from 13 case-control studies participating in the Childhood Leukemia International Consortium. The sample included 7847 ALL cases and 11,667 controls aged 1-14 years. In all studies, the data were obtained from case and control parents using standardized questionnaires. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Contact with livestock in the first year of life was inversely associated with ALL (OR = 0.65, 95% CI: 0.50, 0.85). Inverse associations were also observed for contact with dogs (OR = 0.92, 95% CI: 0.86, 0.99) and cats (OR = 0.87, 95% CI: 0.80, 0.94) in the first year of life. There was no evidence of a significant association with farm residence in the first year of life. The findings of these large pooled and meta-analyses add additional evidence to the hypothesis that regular contact with animals in early childhood is inversely associated with childhood ALL occurrence which is consistent with Greaves' delayed infection hypothesis. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  17. Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of Bangalore city using cluster sampling and lot quality assurance sampling techniques

    Directory of Open Access Journals (Sweden)

    Punith K

    2008-01-01

    Full Text Available Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1 Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2 Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

  18. WEALTH-BASED INEQUALITY IN CHILD IMMUNIZATION IN INDIA: A DECOMPOSITION APPROACH.

    Science.gov (United States)

    Debnath, Avijit; Bhattacharjee, Nairita

    2018-05-01

    SummaryDespite years of health and medical advancement, children still suffer from infectious diseases that are vaccine preventable. India reacted in 1978 by launching the Expanded Programme on Immunization in an attempt to reduce the incidence of vaccine-preventable diseases (VPDs). Although the nation has made remarkable progress over the years, there is significant variation in immunization coverage across different socioeconomic strata. This study attempted to identify the determinants of wealth-based inequality in child immunization using a new, modified method. The present study was based on 11,001 eligible ever-married women aged 15-49 and their children aged 12-23 months. Data were from the third District Level Household and Facility Survey (DLHS-3) of India, 2007-08. Using an approximation of Erreyger's decomposition technique, the study identified unequal access to antenatal care as the main factor associated with inequality in immunization coverage in India.

  19. Provider Preferences and Experiences With a Countywide Centralized Collaborative Reminder/Recall for Childhood Immunizations.

    Science.gov (United States)

    Saville, Alison W; Gurfinkel, Dennis; Sevick, Carter; Beaty, Brenda; Dickinson, L Miriam; Kempe, Allison

    2016-01-01

    To assess among providers in 7 Colorado counties where a collaborative centralized reminder/recall (CC-R/R) using the Colorado Immunization Information System (CIIS) was performed: 1) preferences about CC-R/R conducted by the public health department (PHD); 2) preferences for future CC-R/R for different vaccines with and without practice names; and 3) experiences with including their name on CC-R/R notices. A mailed survey was sent to all primary care sites where CC-R/R had been previously conducted. Respondents self-identified as the "the person in charge of immunization policy within the practice." Overall response rate was 69.9% (160 of 229). Twenty-one were removed because they did not provide immunizations to children. Among respondents, 65.0% were from family medicine and 26.3% from pediatric practices; 32.1% physicians or midlevel providers; 34.3% nurses or medical assistants; and 33.6% office managers. Taking into account all issues, 57.6% were "okay" with either the PHD or their practice conducting recall; 27.3% preferred the PHD; and 14.4% preferred their practice conduct R/R. Fifty-six percent of active CIIS practices (n = 95) included their practice's name on CC-R/R notices. Interest in future CC-R/R for different ages and vaccines was strongly related to whether reminders included the practice name: 77.8% for routine immunizations in 4- to 6-year-olds; 74.8% for immunizations for 0- to 3-year-olds; 73.3% for vaccines administered to adolescents; and 59.7% for influenza (P < .001). Most practices are accepting of the PHD centrally conducting R/R, but most prefer collaboration that includes their name. Given the success and support of this method, it should be more widely adopted. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. Modular and coordinated expression of immune system regulatory and signaling components in the developing and adult nervous system.

    Science.gov (United States)

    Monzón-Sandoval, Jimena; Castillo-Morales, Atahualpa; Crampton, Sean; McKelvey, Laura; Nolan, Aoife; O'Keeffe, Gerard; Gutierrez, Humberto

    2015-01-01

    During development, the nervous system (NS) is assembled and sculpted through a concerted series of neurodevelopmental events orchestrated by a complex genetic programme. While neural-specific gene expression plays a critical part in this process, in recent years, a number of immune-related signaling and regulatory components have also been shown to play key physiological roles in the developing and adult NS. While the involvement of individual immune-related signaling components in neural functions may reflect their ubiquitous character, it may also reflect a much wider, as yet undescribed, genetic network of immune-related molecules acting as an intrinsic component of the neural-specific regulatory machinery that ultimately shapes the NS. In order to gain insights into the scale and wider functional organization of immune-related genetic networks in the NS, we examined the large scale pattern of expression of these genes in the brain. Our results show a highly significant correlated expression and transcriptional clustering among immune-related genes in the developing and adult brain, and this correlation was the highest in the brain when compared to muscle, liver, kidney and endothelial cells. We experimentally tested the regulatory clustering of immune system (IS) genes by using microarray expression profiling in cultures of dissociated neurons stimulated with the pro-inflammatory cytokine TNF-alpha, and found a highly significant enrichment of immune system-related genes among the resulting differentially expressed genes. Our findings strongly suggest a coherent recruitment of entire immune-related genetic regulatory modules by the neural-specific genetic programme that shapes the NS.

  1. High agreement between the new Mongolian electronic immunization register and written immunization records: a health centre based audit

    Directory of Open Access Journals (Sweden)

    Jocelyn Chan

    2017-09-01

    Full Text Available Introduction: Monitoring of vaccination coverage is vital for the prevention and control of vaccine-preventable diseases. Electronic immunization registers have been increasingly adopted to assist with the monitoring of vaccine coverage; however, there is limited literature about the use of electronic registers in low- and middle-income countries such as Mongolia. We aimed to determine the accuracy and completeness of the newly introduced electronic immunization register for calculating vaccination coverage and determining vaccine effectiveness within two districts in Mongolia in comparison to written health provider records. Methods: We conducted a cross-sectional record review among children 2–23 months of age vaccinated at immunization clinics within the two districts. We linked data from written records with the electronic immunization register using the national identification number to determine the completeness and accuracy of the electronic register. Results: Both completeness (90.9%; 95% CI: 88.4–93.4 and accuracy (93.3%; 95% CI: 84.1–97.4 of the electronic immunization register were high when compared to written records. The increase in completeness over time indicated a delay in data entry. Conclusion: Through this audit, we have demonstrated concordance between a newly introduced electronic register and health provider records in a middle-income country setting. Based on this experience, we recommend that electronic registers be accompanied by routine quality assurance procedures for the monitoring of vaccination programmes in such settings.

  2. Silencing the alarms: innate immune antagonism by rotavirus NSP1 and VP3

    Science.gov (United States)

    Morelli, Marco; Ogden, Kristen M.; Patton, John T.

    2016-01-01

    The innate immune response involves a broad array of pathogen sensors that stimulate the production of interferons (IFN) to induce an antiviral state. Rotavirus, a significant cause of childhood gastroenteritis and a member of the Reoviridae family of segmented, double-stranded RNA viruses, encodes at least two direct antagonists of host innate immunity: NSP1 and VP3. NSP1, a putative E3 ubiquitin ligase, mediates the degradation of cellular factors involved in both IFN induction and downstream signaling. VP3, the viral capping enzyme, utilizes a 2H-phosphodiesterase domain to prevent activation of the cellular oligoadenylate synthase (OAS)-RNase L pathway. Computational, molecular, and biochemical studies have provided key insights into the structural and mechanistic basis of innate immune antagonism by NSP1 and VP3 of group A rotaviruses (RVA). Future studies with non-RVA isolates will be essential to understand how other RV species evade host innate immune responses. PMID:25724417

  3. 25-Hydroxyvitamin D and Peripheral Immune Mediators

    DEFF Research Database (Denmark)

    Thorsen, Steffen; Pipper, Christian; Skogstrand, Kristin

    2017-01-01

    Background: We aimed to examine if 25-hydroxyvitamin D (25(OH)D) was related to the peripheral immunological and inflammatory signature both at birth, and in newly diagnosed patients with childhood type 1 diabetes (T1D) and their healthy controls; (2) Methods: The birth cohort consisted of 470...... patients and 500 healthy controls. Dried blood samples were collected from the neonates in the period 1981–1999. The newly diagnosed cohort consisted of 460 patients and 453 siblings. Serum samples were collected in the period 1997–2005. A variety of peripheral immune mediators were measured and compared...... to total 25(OH)D levels (25(OH)D2 + 25(OH)D3). For each immune mediator, the relative change (RC) in the mean level was modeled by robust log-normal regression and correction for multiple testing was performed; (3) Results: Two associations were identified; there was a negative association between 25(OH...

  4. Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants

    DEFF Research Database (Denmark)

    Larsen, Jeppe Madura; Pedersen, Susanne Brix; Thysen, Anna Hammerich

    2014-01-01

    childhood asthma. We hypothesized that children with asthma have an abnormal immune response to pathogenic bacteria in infancy. ObjectiveWe aimed to assess the bacterial immune response in asymptomatic infants and the association with later development of asthma by age 7 years. MethodsThe Copenhagen...... was assessed based on the pattern of cytokines produced and T-cell activation. ResultsThe immune response to pathogenic bacteria was different in infants with asthma by 7 years of age (P = .0007). In particular, prospective asthmatic subjects had aberrant production of IL-5 (P = .008), IL-13 (P = .057), IL-17...... (P = .001), and IL-10 (P = .028), whereas there were no differences in T-cell activation or peripheral T-cell composition. ConclusionsChildren with asthma by school age exhibited an aberrant immune response to pathogenic bacteria in infancy. We propose that an abnormal immune response to pathogenic...

  5. Autoimmune hepatitis in childhood: the role of genetic and immune factors.

    Science.gov (United States)

    Ferri Liu, Priscila Menezes; de Miranda, Débora Marques; Fagundes, Eleonora Druve Tavares; Ferreira, Alexandre Rodrigues; Simões e Silva, Ana Cristina

    2013-07-28

    Autoimmune hepatitis (AIH) is a rare chronic inflammatory disease of the liver, which affects a group of patients who lost their immunological tolerance to antigens of the liver. It is clinically characterized by hypergammaglobulinemia, elevated liver enzymes, presence of autoantibodies and histological changes. Although being rare in children, it represents a serious cause of chronic hepatic disease that can lead to cirrhosis and hepatic failure. Clinical findings, exclusion of more common liver disorders and the detection of antibodies antinuclear antibodies, smooth muscle antibodies and anti-LKM1 are usually enough for diagnosis on clinical practice. The pathogenic mechanisms that lead to AIH remain obscure, but some research findings suggest the participation of immunologic and genetic factors. It is not yet knew the triggering factor or factors that stimulate inflammatory response. Several mechanisms proposed partially explain the immunologic findings of AIH. The knowledge of immune factors evolved might result in better markers of prognosis and response to treatment. In this review, we aim to evaluate the findings of research about genetic and immune markers and their perspectives of application in clinical practice especially in pediatric population.

  6. Seasonality and comparative dynamics of six childhood infections in pre-vaccination Copenhagen

    DEFF Research Database (Denmark)

    Metcalf, C. Jessica E.; Bjørnstad, Ottar N.; Grenfell, Bryan T.

    2009-01-01

    Seasonal variation in infection transmission is a key determinant of epidemic dynamics of acute infections. For measles, the best-understood strongly immunizing directly transmitted childhood infection, the perception is that term-time forcing is the main driver of seasonality in developed...... of seasonality and basic reproductive rate of infections that should result from term-time forcing are also not upheld. We conclude that where yearly trajectories of susceptible numbers are perturbed, e.g. via waning of immunity, seasonality is unlikely to be entirely driven by term-time forcing. For the three...... bacterial infections, pertussis, scarlet fever and diphtheria, there is additionally a strong increase in transmission during the late summer before the end of school vacations....

  7. Susceptibility to Childhood Pneumonia: A Genome-Wide Analysis.

    Science.gov (United States)

    Hayden, Lystra P; Cho, Michael H; McDonald, Merry-Lynn N; Crapo, James D; Beaty, Terri H; Silverman, Edwin K; Hersh, Craig P

    2017-01-01

    Previous studies have indicated that in adult smokers, a history of childhood pneumonia is associated with reduced lung function and chronic obstructive pulmonary disease. There have been few previous investigations using genome-wide association studies to investigate genetic predisposition to pneumonia. This study aims to identify the genetic variants associated with the development of pneumonia during childhood and over the course of the lifetime. Study subjects included current and former smokers with and without chronic obstructive pulmonary disease participating in the COPDGene Study. Pneumonia was defined by subject self-report, with childhood pneumonia categorized as having the first episode at pneumonia (843 cases, 9,091 control subjects) and lifetime pneumonia (3,766 cases, 5,659 control subjects) were performed separately in non-Hispanic whites and African Americans. Non-Hispanic white and African American populations were combined in the meta-analysis. Top genetic variants from childhood pneumonia were assessed in network analysis. No single-nucleotide polymorphisms reached genome-wide significance, although we identified potential regions of interest. In the childhood pneumonia analysis, this included variants in NGR1 (P = 6.3 × 10 -8 ), PAK6 (P = 3.3 × 10 -7 ), and near MATN1 (P = 2.8 × 10 -7 ). In the lifetime pneumonia analysis, this included variants in LOC339862 (P = 8.7 × 10 -7 ), RAPGEF2 (P = 8.4 × 10 -7 ), PHACTR1 (P = 6.1 × 10 -7 ), near PRR27 (P = 4.3 × 10 -7 ), and near MCPH1 (P = 2.7 × 10 -7 ). Network analysis of the genes associated with childhood pneumonia included top networks related to development, blood vessel morphogenesis, muscle contraction, WNT signaling, DNA damage, apoptosis, inflammation, and immune response (P ≤ 0.05). We have identified genes potentially associated with the risk of pneumonia. Further research will be required to confirm these

  8. Neonatal Bacterial Colonization Predispose to Lower Respiratory Infections in Early Childhood

    DEFF Research Database (Denmark)

    Vissing, Nadja Hawwa

    2014-01-01

    , and high sensitivity to respiratory, infectious and skin related illness. In particular, sensitivity on LRI was 96%. There was no evidence of bias from concurrent asthmatic disease or socioeconomic status. In conclusion, the study confirmed that COPSAC data is a valid source for investigating childhood......Lower respiratory infections (LRI) in childhood are common and account for considerable morbidity and health care utilization. The frequency of LRI varies significantly between otherwise healthy children, but extrinsic and intrinsic triggers of such variation are poorly understood. Traditionally...... neonatal airway colonization and risk of the LRI in a validated study cohort, and whether a possible association could be reflected in the early immune response to airway pathogens. In study I we aimed to ascertain the quality of information on child’s health, including asthma, allergy, eczema, respiratory...

  9. Using Human Factors Techniques to Design Text Message Reminders for Childhood Immunization

    Science.gov (United States)

    Ahlers-Schmidt, Carolyn R.; Hart, Traci; Chesser, Amy; Williams, Katherine S.; Yaghmai, Beryl; Shah-Haque, Sapna; Wittler, Robert R.

    2012-01-01

    This study engaged parents to develop concise, informative, and comprehensible text messages for an immunization reminder system using Human Factors techniques. Fifty parents completed a structured interview including demographics, technology questions, willingness to receive texts from their child's doctor, and health literacy. Each participant…

  10. The Impact of Rotavirus Vaccination on Discounted Net Tax Revenue in Egypt: A Government Perspective Analysis

    OpenAIRE

    Mark P. Connolly; Oleksandr Topachevskyi; Baudouin Standaert; Omayra Ortega; Maarten Postma

    2012-01-01

    Background:Background: We evaluated national rotavirus (RV) immunization programme costs to estimate how resulting changes in morbidity and mortality will influence government fiscal accounts over time. The assumption was that increased childhood survival in vaccinated cohorts leads to increased numbers of children consuming government resource, and an increased number of future tax payers. Abstract: Objective:Objective: Our objective was to evaluate the difference in lifetime discounted net ...

  11. Farm-to-School Programmes in the USA: An Examination of State-Level Enacted, Pending and Vetoed or Dead Bills

    Science.gov (United States)

    Thompson, Olivia M.; Ghelardini, Lauren; Keene, Kristin L.; Stewart, Kendra B.

    2014-01-01

    Objectives: We sought to determine the prevalence and distribution of state-level legislation regulating farm-to-school programmes throughout the United States of America (USA). The research is timely given national goals put forth by the Let's Move Campaign and the Healthy, Hunger-Free Kids Act to reduce childhood obesity prevalence and…

  12. Seroepidemiology of diphtheria, tetanus, poliomyelitis and pertussis : evaluation of the national immunisation programme in the Netherlands

    NARCIS (Netherlands)

    Melker, de H.

    1999-01-01

    In view of the evaluation of the National Immunisation Programme in the Netherlands the main objectives were to obtain insight into the immunity to diphtheria, tetanus and poliomyelitis, into the occurrence of pertussis and to improve serodiagnosis of pertussis.

    In a

  13. Follow-up of permanent hearing impairment in childhood.

    Science.gov (United States)

    Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

    2016-02-01

    Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  14. Childhood injuries in Ilesa, South-Western Nigeria: causes, pattern, and outcome.

    Science.gov (United States)

    Adegoke, S A; Ademola, A S; Dedeke, I O F; Oyelami, O A

    2010-01-01

    In Sub-Saharan Africa, infections and undernutrition are the leading causes of childhood death; however injuries are now contributing significantly to childhood morbidity and mortality. To determine the aetiology, morbidity and mortality associated with injuries in children in South-Western Nigeria. This was an observational cross-sectional study of consecutive childhood injury attendances and admissions into the hospital's Children Emergency Room (CHER) over a one-year period. Socio-demographic data as well as the data on the cause, site, and possible risks of injury; parts of the body affected and eventual outcome of the patients were documented. Injury accounted for 382 (10.6%) of the 3,604 attendances, 142 (11.9%) of 1193 admissions and 11 (20.4%) of 54 deaths in CHER. Their ages ranged from six weeks to 15 years, with a mean (SD) of 6.7 (3.9) years, and a male:female ratio of 1.6:1. Road traffic accidents, 130 (34.0%), were the most common cause, followed by falls 119 (31.2%), cuts 44 (11.5%), bits 26 (6.8%), and burns 24 (6.3%). Injuries occurred mostly at home 154 (40.1%), on the road 142 (37.4%), and at school 59 (15.2%). Lack of supervision and/or poor anticipation of potential dangers were the leading risks associated with childhood injuries. Injuries contribute significantly to childhood deaths in South-Western Nigeria. A well-orchestrated public enlightenment programme to improve home, school, and road supervision of children as well as concerted efforts to make these places safer could help ameliorate the situation.

  15. Th2-like chemokine levels are increased in allergic children and influenced by maternal immunity during pregnancy.

    Science.gov (United States)

    Abelius, Martina S; Lempinen, Esma; Lindblad, Karin; Ernerudh, Jan; Berg, Göran; Matthiesen, Leif; Nilsson, Lennart J; Jenmalm, Maria C

    2014-06-01

    The influence of the intra-uterine environment on the immunity and allergy development in the offspring is unclear. We aimed to investigate (i) whether the pregnancy magnifies the Th2 immunity in allergic and non-allergic women, (ii) whether the maternal chemokine levels during pregnancy influenced the offspring's chemokine levels during childhood and (iii) the relationship between circulating Th1/Th2-associated chemokines and allergy in mothers and children. The Th1-associated chemokines CXCL9, CXCL10, CXCL11, and the Th2-associated chemokines CCL17, CCL18 and CCL22 were quantified by Luminex and ELISA in 20 women with and 36 women without allergic symptoms at gestational week (gw) 10-12, 15-16, 25, 35, 39 and 2 and 12 months post-partum and in their children at birth, 6, 12, 24 months and 6 years of age. Total IgE levels were measured using ImmunoCAP Technology. The levels of the Th2-like chemokines were not magnified by pregnancy. Instead decreased levels were shown during pregnancy (irrespectively of maternal allergy status) as compared to post-partum. In the whole group, the Th1-like chemokine levels were higher at gw 39 than during the first and second trimester and post-partum. Maternal CXCL11, CCL18 and CCL22 levels during and after pregnancy correlated with the corresponding chemokines in the offspring during childhood. Increased CCL22 and decreased CXCL10 levels in the children were associated with sensitisation and increased CCL17 levels with allergic symptoms during childhood. Maternal chemokine levels were not associated with maternal allergic disease. Allergic symptoms and sensitisation were associated with decreased Th1- and increased Th2-associated chemokine levels during childhood, indicating a Th2 shift in the allergic children, possibly influenced by the maternal immunity during pregnancy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Introduction of Sequential Inactivated Polio Vaccine–Oral Polio Vaccine Schedule for Routine Infant Immunization in Brazil’s National Immunization Program

    Science.gov (United States)

    Domingues, Carla Magda Allan S.; de Fátima Pereira, Sirlene; Marreiros, Ana Carolina Cunha; Menezes, Nair; Flannery, Brendan

    2015-01-01

    In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. PMID:25316829

  17. Health consequences of the US Deferred Action for Childhood Arrivals (DACA immigration programme: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Atheendar S Venkataramani, DrMD

    2017-04-01

    Full Text Available Summary: Background: The effects of changes in immigration policy on health outcomes among undocumented immigrants are not well known. We aimed to examine the physical and mental health effects of the Deferred Action for Childhood Arrivals (DACA programme, a 2012 US immigration policy that provided renewable work permits and freedom from deportation for a large number of undocumented immigrants. Methods: We did a retrospective, quasi-experimental study using nationally representative, repeated cross-sectional data from the US National Health Interview Survey (NHIS for the period January, 2008, to December, 2015. We included non-citizen, Hispanic adults aged 19–50 years in our analyses. We used a difference-in-differences strategy to compare changes in health outcomes among individuals who met key DACA eligibility criteria (based on age at immigration and at the time of policy implementation before and after programme implementation versus changes in outcomes for individuals who did not meet these criteria. We additionally restricted the sample to individuals who had lived in the USA for at least 5 years and had completed high school or its equivalent, in order to hold fixed two other DACA eligibility criteria. Our primary outcomes were self-reported overall health (measured on a 5 point Likert scale and psychological distress (Kessler 6 [K6] scale, the latter was administered to a random subset of NHIS respondents. Findings: Our final sample contained 14 973 respondents for the self-reported health outcome and 5035 respondents for the K6 outcome. Of these individuals, 3972 in the self-reported health analysis and 1138 in the K6 analysis met the DACA eligibility criteria. Compared with people ineligible for DACA, the introduction of DACA was associated with no significant change among DACA-eligible individuals in terms of self-reported overall health (b=0·056, 95% CI −0·024 to 0·14, p=0·17 or the likelihood of reporting poor or fair

  18. Genetic variation in the extended major histocompatibility complex and susceptibility to childhood acute lymphoblastic leukemia: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Kevin Y Urayama

    2013-12-01

    Full Text Available The enduring suspicion that infections and immunologic response may play a role in the etiology of childhood leukemia, particularly acute lymphoblastic leukemia (ALL, is now supported, albeit still indirectly, by numerous epidemiological studies. The cumulative evidence includes, for example, descriptive observations of a peculiar peak incidence at age 2-5 years for ALL in economically developed countries, clustering of cases in situations of population mixing associated with unusual patterns of personal contacts, associations with various proxy measures for immune modulatory exposures early in life, and genetic susceptibility conferred by variation in genes involved in the immune system. In this review, our focus is the extended major histocompatibility complex (xMHC, an approximately 7.6 megabase region that is well-known for its high density of expressed genes, extensive polymorphisms exhibiting complex linkage disequilibrium patterns, and its disproportionately large number of immune-related genes, including human leukocyte antigen (HLA. First discovered through the role they play in transplant rejection, the classical HLA class I (HLA-A, -B, and -C and class II (HLA-DR, HLA-DQ, and HLA-DP molecules reside at the epicenter of the immune response pathways and are now the targets of many disease susceptibility studies, including those for childhood leukemia. The genes encoding the HLA molecules are only a minority of the over 250 expressed genes in the xMHC, and a growing number of studies are beginning to evaluate other loci through targeted investigations or utilizing a mapping approach with a comprehensive screen of the entire region. Here, we review the current epidemiologic evidence available to date regarding genetic variation contained within this highly unique region of the genome and its relationship with childhood ALL risk.

  19. Autoimmune liver disease and therapy in childhood

    Directory of Open Access Journals (Sweden)

    Matjaž Homan

    2013-10-01

    Full Text Available Autoimmune hepatitis is a chronic immune-mediated disease of the liver. In childhood, autoimmune liver disorders include autoimmune hepatitis type I and II, autoimmune sclerosing cholangitis, Coombs-positive giant cell hepatitis, and de novo autoimmune hepatitis after liver transplantation. Autoimmune liver disease has a more aggressive course in children, especially autoimmune hepatitis type II. Standard therapy is a combination of corticosteroids and azathioprine. Around 80 % of children with autoimmune liver disease show a rapid response to combination therapy. The non-responders are treated with more potent drugs, otherwise autoimmune disease progresses to cirrhosis of the liver and the child needs liver transplantation as rescue therapy.

  20. Immune globulins are effective in severe pediatric Guillain-Barré syndrome.

    Science.gov (United States)

    Shahar, E; Shorer, Z; Roifman, C M; Levi, Y; Brand, N; Ravid, S; Murphy, E G

    1997-01-01

    The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guillain-Barré syndrome. They presented with mild to moderate flaccid weakness of extremities, with cranial nerve involvement (20) and sensory impairment (22). All children rapidly deteriorated in 2-16 days (mean 6) to become bedridden, and 2 children also developed respiratory failure requiring artificial ventilation (Disability Grading Scale 4-5). Immune globulins were then administered at a total dose of 2 gm/kg, on 2 consecutive days, without adverse effects requiring discontinuation of therapy. Marked and rapid improvement was noted in 25 children, who improved by 1 to 2 Disability Grade Scales ventilator. Eighteen children recovered by 2 weeks. The rest recuperated in a period of four months, including a child who was artificially ventilated for 4 weeks. The uniform rapid improvement and recovery associated with immune globulins contrasts with the slow recovery course in severe natural cases. We conclude that immune globulins are effective and safe in severe childhood-onset Guillain-Barré syndrome and therefore may serve as the initial treatment of choice.

  1. High-Quality Interactions with Infants: Relationships with Early-Childhood Practitioners' Interpretations and Qualification Levels in Play and Routine Contexts

    Science.gov (United States)

    Degotardi, Sheila

    2010-01-01

    This study investigated factors related to the quality of early-childhood practitioners' interactions with infants in play and routine contexts. Participants were 24 practitioners working with 9-20-month-old infants in long day-care infant programmes. Video-recordings of their interactions with a nominated infant during play and in routine…

  2. Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England.

    OpenAIRE

    Paterson, P; Chantler, T; Larson, HJ

    2017-01-01

    In 2013, the annual influenza immunisation programme in England was extended to children to reduce the burden of influenza, but uptake was sub-optimal at 53.2%. To explore the reasons some parents decided not to vaccinate their child against influenza as part of the pilot programme offered in schools. Cross-sectional qualitative study conducted between February and July 2015. 913 parents whose children were not vaccinated against influenza in the school pilots in West Yorkshire and Greater Ma...

  3. Does Breastfeeding Protect Against Childhood Obesity? Moving Beyond Observational Evidence.

    Science.gov (United States)

    Woo, Jessica G; Martin, Lisa J

    2015-06-01

    Human milk is the optimal feeding choice for infants, as it dynamically provides the nutrients, immunity support, and other bioactive factors needed for infants at specific stages during development. Observational studies and several meta-analyses have suggested that breastfeeding is protective against development of obesity in childhood and beyond. However, these findings are not without significant controversy. This review includes an overview of observational findings to date, then focuses on three specific pathways that connect human milk and infant physiology: maternal obesity, microbiome development in the infant, and the development of taste preference and diet quality. Each of these pathways involves complex interactions between mother and infant, includes both biologic and non-biologic factors, and may have both direct and indirect effects on obesity risk in the offspring. This type of integrated approach to examining breastfeeding and childhood obesity is necessary to advance research in this area beyond observational findings.

  4. Susceptibility to Lower Respiratory Infections in Childhood is Associated with Perturbation of the Cytokine Response to Pathogenic Airway Bacteria.

    Science.gov (United States)

    Vissing, Nadja Hawwa; Larsen, Jeppe Madura; Rasmussen, Morten Arendt; Chawes, Bo Lund Krogsgaard; Thysen, Anna Hammerich; Bønnelykke, Klaus; Brix, Susanne; Bisgaard, Hans

    2016-05-01

    Neonatal colonization of the airways with respiratory pathogens is associated with increased risk of lower respiratory infections (LRI) in early childhood. Therefore, we hypothesized that children developing LRI have an aberrant immune response to pathogenic bacteria in infancy. The objective was to characterize in vitro the early life systemic immune response to pathogenic bacteria and study the possible association with incidence of LRI during the first 3 years of life. The Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) is a clinical birth cohort study of 411 children born of mothers with asthma. LRI incidence was prospectively captured from 6-monthly planned visits and visits at acute respiratory episodes. The in vitro systemic immune response to Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae was characterized by the production of TNF-α, IFN-γ, IL-2, IL-5, IL-10, IL-13 and IL-17 in peripheral blood mononuclear cells isolated at age 6 months from 291 infants. Data were analyzed by Poisson regression against incidence of LRI in infancy. A multivariable model including all cytokine responses from the 3 different bacterial stimulations significantly identified children at risk of LRI (P = 0.006). The immune response pattern associated with LRI was characterized by perturbed production of several cytokines rather than production of one specific cytokine, and was independent of concurrent asthma. TNF-α and IL-5 were key drivers but did not explain the entire variation in LRI susceptibility. Children at risk of future LRI present a perturbed systemic immune response upon exposure to common airway pathogens in early life.

  5. INFLAMMATION AND NEURONAL PLASTICITY: A LINK BETWEEN CHILDHOOD TRAUMA AND DEPRESSION PATHOGENESIS

    Directory of Open Access Journals (Sweden)

    Annamaria eCattaneo

    2015-03-01

    Full Text Available During the past two decades, there has been increasing interest in understanding and characterizing the role of inflammation in major depressive disorder. Several evidences linked inflammation to major depression, including the presence of elevated levels of pro-inflammatory cytokines, together with other mediators of inflammation both in the blood and in the brain of depressed patients.However, whether depression itself acts in an immunomodulatory fashion or whether other factors related to depression result in these immunological effects remains an open question. Regardless, major depression is often the result of the exposure to stressful events early in life, which may also act through the modulation of inflammatory responses. Indeed, subjects with a history of childhood trauma show high levels of pro-inflammatory cytokines and an increased risk to develop psychopathologies later in life. Moreover, depressed patients with a history of childhood trauma are also less responsive to antidepressant therapies, suggesting that increased inflammation or altered activation of the immune system may also be relevant for the response to antidepressant therapies. This review will provide an overview on the potential role of the inflammatory/immune system and stress related biomarkers to aid diagnosis, predict treatment response, enhance treatment matching, and prevent the onset or relapse of major depression. We will also discuss the role of early life adverse events in increasing the vulnerability to depression development by acting on the inflammatory and stress-related system. Finally, we will discuss the putative biological mechanisms underlying the transmission, from one generation to the next, of the stress signatures and thus, of the increased vulnerability for psychopathologies induced by childhood trauma events.

  6. Impact of childhood chronic illnesses on siblings: a literature review.

    Science.gov (United States)

    O' Brien, Irene; Duffy, Anita; Nicholl, Honor

    Childhood illness can have a significant impact on families, particularly on the ill child's siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: 'siblings', 'chronic illness', 'disability', 'cancer', 'sibling relations', 'sibling adjustment', 'coping', 'family-centred care', 'sibling interventions', 'camps', 'autism', 'Down's syndrome'. Seventeen research studies in total were reviewed. This review focuses on three sibling groups related to children suffering from autism, cancer and Down's syndrome, and are discussed under the following headings: sibling adjustment; family functioning and sibling's coping resources; and intervention programmes. The literature revealed that siblings of children with Down's syndrome were well adjusted to living with their brother or sister. However, there was conflicting information on the adjustment of siblings of children with cancer and autism. An awareness of the harmful effect that living with childhood illness and disability can have on some siblings is essential to enable healthcare professionals to provide supportive interventions to protect siblings' physical and emotional wellbeing.

  7. Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India.

    OpenAIRE

    Singh, J.; Jain, D. C.; Sharma, R. S.; Verghese, T.

    1996-01-01

    The immunization coverage of infants, children and women residing in a primary health centre (PHC) area in Rajasthan was evaluated both by lot quality assurance sampling (LQAS) and by the 30-cluster sampling method recommended by WHO's Expanded Programme on Immunization (EPI). The LQAS survey was used to classify 27 mutually exclusive subunits of the population, defined as residents in health subcentre areas, on the basis of acceptable or unacceptable levels of immunization coverage among inf...

  8. Differences by sex in IgG levels following infant and childhood vaccinations : An individual participant data meta-analysis of vaccination studies

    NARCIS (Netherlands)

    Boef, Anna G. C.; van der Klis, Fiona R M; Berbers, Guy A M; Buisman, Anne-Marie; Sanders, Elisabeth A.M.; Kemmeren, Jeanet M.; van der Ende, Arie; de Melker, Hester E.; Rots, Nynke Y; Knol, Mirjam J.

    2018-01-01

    Background If immune responses to vaccination differ between males and females, sex-specific vaccination schedules may be indicated. We systematically reanalysed childhood vaccination studies conducted in The Netherlands for sex-differences in IgG-responses. To assess the impact of potential

  9. Differences by sex in IgG levels following infant and childhood vaccinations: An individual participant data meta-analysis of vaccination studies

    NARCIS (Netherlands)

    Boef, Anna G. C.; van der Klis, Fiona R. M.; Berbers, Guy A. M.; Buisman, Anne-Marie; Sanders, Elisabeth A. M.; Kemmeren, Jeanet M.; van der Ende, Arie; de Melker, Hester E.; Rots, Nynke Y.; Knol, Mirjam J.

    2018-01-01

    Background: If immune responses to vaccination differ between males and females, sex-specific vaccination schedules may be indicated. We systematically reanalysed childhood vaccination studies conducted in The Netherlands for sex-differences in IgG-responses. To assess the impact of potential

  10. Can probiotics enhance vaccine-specific immunity in children and adults?

    Science.gov (United States)

    Kwak, J Y; Lamousé-Smith, E S N

    2017-10-13

    The growing use of probiotics by the general public has heightened the interest in understanding the role of probiotics in promoting health and preventing disease. General practitioners and specialists often receive inquiries from their patients regarding probiotic products and their use to ward off systemic infection or intestinal maladies. Enhanced immune function is among the touted health benefits conferred by probiotics but has not yet been fully established. Results from recent clinical trials in adults suggest a potential role for probiotics in enhancing vaccine-specific immunity. Although almost all vaccinations are given during infancy and childhood, the numbers of and results from studies using probiotics in pediatric subjects are limited. This review evaluates recent clinical trials of probiotics used to enhance vaccine-specific immune responses in adults and infants. We highlight meaningful results and the implications of these findings for designing translational and clinical studies that will evaluate the potential clinical role for probiotics. We conclude that the touted health claims of probiotics for use in children to augment immunity warrant further investigation. In order to achieve this goal, a consensus should be reached on common study designs that apply similar treatment timelines, compare well-characterised probiotic strains and monitor effective responses against different classes of vaccines.

  11. Childhood leukaemia risks: from unexplained findings near nuclear installations to recommendations for future research

    International Nuclear Information System (INIS)

    Laurier, D; Jacob, S; Grosche, B; Dehos, A; Hornhardt, S; Ziegelberger, G

    2014-01-01

    Recent findings related to childhood leukaemia incidence near nuclear installations have raised questions which can be answered neither by current knowledge on radiation risk nor by other established risk factors. In 2012, a workshop was organised on this topic with two objectives: (a) review of results and discussion of methodological limitations of studies near nuclear installations; (b) identification of directions for future research into the causes and pathogenesis of childhood leukaemia. The workshop gathered 42 participants from different disciplines, extending widely outside of the radiation protection field. Regarding the proximity of nuclear installations, the need for continuous surveillance of childhood leukaemia incidence was highlighted, including a better characterisation of the local population. The creation of collaborative working groups was recommended for consistency in methodologies and the possibility of combining data for future analyses. Regarding the causes of childhood leukaemia, major fields of research were discussed (environmental risk factors, genetics, infections, immunity, stem cells, experimental research). The need for multidisciplinary collaboration in developing research activities was underlined, including the prevalence of potential predisposition markers and investigating further the infectious aetiology hypothesis. Animal studies and genetic/epigenetic approaches appear of great interest. Routes for future research were pointed out. (review)

  12. Assessment of Routine Immunization Coverage in Nyala Locality, Reasons behind Incomplete Immunization in South Darfur State, Sudan.

    Science.gov (United States)

    Ismail, Ismail Tibin Adam; El-Tayeb, Elsadeg Mahgoob; Omer, Mohammed Diaaeldin F A; Eltahir, Yassir Mohammed; El-Sayed, El-Tayeb Ahmed; Deribe, Kebede

    2014-02-25

    Little is known about the coverage of routine immunization service in South Darfur state, Sudan. Therefore, this study was conducted to determine the vaccination rate and barriers for vaccination. A cross-sectional community-based study was undertaken in Nyala locality, south Darfur, Sudan, including urban, rural and Internal Displaced Peoples (IDPs) population in proportional representation. Survey data were collected by a questionnaire which was applied face to face to parents of 213 children 12-23 months. The collected data was then analyzed with SPSS software package. Results showed that vaccination coverage as revealed by showed vaccination card alone was 63.4% while it was increased to 82.2% when both history and cards were used. Some (5.6%) of children were completely non-vaccinated. The factors contributing to the low vaccination coverage were found to be knowledge problems of mothers (51%), access problems (15%) and attitude problems (34%). Children whose mother attended antenatal care and those from urban areas were more likely to complete their immunization schedule. In conclusion, the vaccination coverage in the studied area was low compared to the national coverage. Efforts to increase vaccination converge and completion of the scheduled plan should focus on addressing concerns of caregivers particularly side effects and strengthening the Expanded Programmer on Immunization services in rural areas.

  13. T helper cell 2 immune skewing in pregnancy/early life

    DEFF Research Database (Denmark)

    McFadden, J P; Thyssen, J P; Basketter, D A

    2015-01-01

    During the last 50 years there has been a significant increase in Western societies of atopic disease and associated allergy. The balance between functional subpopulations of T helper cells (Th) determines the quality of the immune response provoked by antigen. One such subpopulation - Th2 cells...... that in Westernized societies reduced exposure during early childhood to pathogenic microorganisms favours the development of atopic allergy. Pregnancy is normally associated with Th2 skewing, which persists for some months in the neonate before Th1/Th2 realignment occurs. In this review, we consider...... the immunophysiology of Th2 immune skewing during pregnancy. In particular, we explore the possibility that altered and increased patterns of exposure to certain chemicals have served to accentuate this normal Th2 skewing and therefore further promote the persistence of a Th2 bias in neonates. Furthermore, we propose...

  14. Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status.

    Science.gov (United States)

    Aris, I M; Bernard, J Y; Chen, L-W; Tint, M T; Pang, W W; Soh, S E; Saw, S-M; Shek, L P-C; Godfrey, K M; Gluckman, P D; Chong, Y-S; Yap, F; Kramer, M S; Lee, Y S

    2018-01-01

    Many studies have identified early-life risk factors for subsequent childhood overweight/obesity, but few have evaluated how they combine to influence risk of childhood overweight/obesity. We examined associations, individually and in combination, of potentially modifiable risk factors in the first 1000 days after conception with childhood adiposity and risk of overweight/obesity in an Asian cohort. Six risk factors were examined: maternal pre-pregnancy overweight/obesity (body mass index (BMI) ⩾25 kg m -2 ), paternal overweight/obesity at 24 months post delivery, maternal excessive gestational weight gain, raised maternal fasting glucose during pregnancy (⩾5.1 mmol l -1 ), breastfeeding duration childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

  15. Childhood Cancer Incidence in India Betweem 2012 and 2014: Report of a Population-based Cancer Registry.

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    Das, Suman; Paul, Dilip Kumar; Anshu, Kumar; Bhakta, Subhajit

    2017-12-15

    To provide an overview of childhood cancer incidence in India between 2012-2014. Secondary data analysis on age-adjusted rates of cancer incidence for children (0-14 years) were collected from the report of the National Cancer Registry Programme in the year 2016. Age-adjusted rates of childhood cancer incidence ranged from 18.5 per million in the state of Nagaland to 235.3 per million in Delhi for boys. The rates were 11.4 per million in East Khasi Hill district and 152.3 per million in Delhi for girls. Leukemia was the most predominant cancer for both boys and girls. Lymphoma was the second most common cancer in boys, and brain tumors in girls. Childhood cancer incidence is increasing in India compared to population-based cancer registry survey of 2009-2011. Cancers are mostly affecting 0-4 years age group, and there is a rising trend of Non-Hodgkin's lymphoma.

  16. Role of the immune system in regeneration and its dynamic interplay with adult stem cells.

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    Abnave, Prasad; Ghigo, Eric

    2018-04-09

    The immune system plays an indispensable role in the process of tissue regeneration following damage as well as during homeostasis. Inflammation and immune cell recruitment are signs of early onset injury. At the wound site, immune cells not only help to clear debris but also secrete numerous signalling molecules that induce appropriate cell proliferation and differentiation programmes essential for successful regeneration. However, the immune system does not always perform a complementary role in regeneration and several reports have suggested that increased inflammation can inhibit the regeneration process. Successful regeneration requires a balanced immune cell response, with the recruitment of accurately polarised immune cells in an appropriate quantity. The regulatory interactions of the immune system with regeneration are not unidirectional. Stem cells, as key players in regeneration, can also modulate the immune system in several ways to facilitate regeneration. In this review, we will focus on recent research demonstrating the key role of immune system in the regeneration process as well as the immunomodulatory effects of stem cells. Finally, we propose that research investigating the interplay between the immune system and stem cells within highly regenerating animals can benefit the identification of the key interactions and molecules required for successful regeneration. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Newcomers in paediatric GI pathology: childhood enteropathies including very early onset monogenic IBD.

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    Ensari, Arzu; Kelsen, Judith; Russo, Pierre

    2018-01-01

    Childhood enteropathies are a group of diseases causing severe chronic (>2-3 weeks) diarrhoea often starting in the first week of life with the potential for fatal complications for the affected infant. Early identification and accurate classification of childhood enteropathies are, therefore, crucial for making treatment decisions to prevent life-threatening complications. Childhood enteropathies are classified into four groups based on the underlying pathology: (i) conditions related to defective digestion, absorption and transport of nutrients and electrolytes; (ii) disorders related to enterocyte differentiation and polarization; (iii) defects of enteroendocrine cell differentiation; and (iv) disorders associated with defective modulation of intestinal immune response. While the intestinal mucosa is usually normal in enteropathies related to congenital transport or enzyme deficiencies, the intestinal biopsy in other disorders may reveal a wide range of abnormalities varying from normal villous architecture to villous atrophy and/or inflammation, or features specific to the underlying disorder including epithelial abnormalities, lipid vacuolization in the enterocytes, absence of plasma cells, lymphangiectasia, microorganisms, and mucosal eosinophilic or histiocytic infiltration. This review intends to provide an update on small intestinal biopsy findings in childhood enteropathies, the "newcomers", including very early onset monogenic inflammatory bowel disease (IBD), in particular, for the practicing pathologist.

  18. Childhood Obesity

    OpenAIRE

    Trandafir, Laura Mihaela; Ioniuc, Ileana; Miron, Ingrith

    2017-01-01

    Childhood obesity has important consequences for health and wellbeing both during childhood and also in later adult life. The rising prevalence of childhood obesity poses a major public health challenge in both developed and developing countries by increasing the burden of chronic non-communicable diseases. Despite the urgent need for effective preventative strategies, there remains disagreement over its definition due to a lack of evidence on the optimal cut-offs linking childhood BMI to dis...

  19. [Environmental pollutants as adjuvant factors of immune system derived diseases].

    Science.gov (United States)

    Lehmann, Irina

    2017-06-01

    The main task of the immune system is to protect the body against invading pathogens. To be able to do so, immune cells must be able to recognize and combat exogenous challenges and at the same time tolerate body-borne structures. A complex regulatory network controls the sensitive balance between defense and tolerance. Perturbation of this network ultimately leads to the development of chronic inflammation, such as allergies, autoimmune reactions, and infections, because the immune system is no longer able to efficiently eliminate invading pathogens. Environmental pollutants can cause such perturbations by affecting the function of immune cells in such a way that they would react hypersensitively against allergens and the body's own structures, respectively, or that they would be no longer able to adequately combat pathogens. This indirect effect is also known as adjuvant effect. For pesticides, heavy metals, wood preservatives, or volatile organic compounds such adjuvant effects are well known. Examples of the mechanism by which environmental toxins contribute to chronic inflammatory diseases are manifold and will be discussed along asthma and allergies.While the immune system of healthy adults is typically well able to distinguish between foreign and endogenous substances even under adverse environmental conditions, that of children would react much more sensible upon comparable environmental challenges. To prevent priming for diseases by environmental cues during that highly sensitive period of early childhood children are to be particularly protected.

  20. Gender inequalities in immunization of children in a rural population of Barabanki, Uttar Pradesh

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    Ravindra Ahuja

    2014-12-01

    Full Text Available Background: There is evidence of inequalities in immunization in India, despite the fact that childhood immunization has been an important part of maternal and child health services since the 1940s [1]. Objective: To evaluate the gender inequality in the missed opportunity for immunization in pre-school children in the rural population of Barabanki, Uttar Pradesh, India.  Methods: This was a cross-sectional study conducted in the rural areas of Barabanki district among the children of 1- 2 years of age. The information was collected on pre-designed questionnaire. A total of 15 villages were covered. A door to door survey was conducted in all the villages. There was 6% non-response due unavailability of mother/father of children.  A total of 447 children were included in the study. Results: Out of the total children, 50.6% (226/447 were males and 49.4% (221/447 were females. Overall, 49.7% were fully immunized and 20.4% partially immunized.  However, 5.8% were having contraindication for immunization.  The percentage of fully immunized children was higher among males (54.4% compared with females (44.8%.  However, the percentage of partially immunized was found to be higher among females (21.3% than males (19.5%.  The percentage of contraindication was similar among both male and female children. Conclusion: Missed opportunity for immunization can be brought down by creating awareness periodically once in 2 or 3 months for immunization among health personnel.

  1. Gender inequalities in immunization of children in a rural population of Barabanki, Uttar Pradesh

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    Ravindra Ahuja

    2014-12-01

    Full Text Available Background: There is evidence of inequalities in immunization in India, despite the fact that childhood immunization has been an important part of maternal and child health services since the 1940s [1]. Objective: To evaluate the gender inequality in the missed opportunity for immunization in pre-school children in the rural population of Barabanki, Uttar Pradesh, India.  Methods: This was a cross-sectional study conducted in the rural areas of Barabanki district among the children of 1- 2 years of age. The information was collected on pre-designed questionnaire. A total of 15 villages were covered. A door to door survey was conducted in all the villages. There was 6% non-response due unavailability of mother/father of children.  A total of 447 children were included in the study. Results: Out of the total children, 50.6% (226/447 were males and 49.4% (221/447 were females. Overall, 49.7% were fully immunized and 20.4% partially immunized.  However, 5.8% were having contraindication for immunization.  The percentage of fully immunized children was higher among males (54.4% compared with females (44.8%.  However, the percentage of partially immunized was found to be higher among females (21.3% than males (19.5%.  The percentage of contraindication was similar among both male and female children. Conclusion: Missed opportunity for immunization can be brought down by creating awareness periodically once in 2 or 3 months for immunization among health personnel.

  2. Health consequences of the US Deferred Action for Childhood Arrivals (DACA) immigration programme: a quasi-experimental study.

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    Venkataramani, Atheendar S; Shah, Sachin J; O'Brien, Rourke; Kawachi, Ichiro; Tsai, Alexander C

    2017-04-01

    The effects of changes in immigration policy on health outcomes among undocumented immigrants are not well known. We aimed to examine the physical and mental health effects of the Deferred Action for Childhood Arrivals (DACA) programme, a 2012 US immigration policy that provided renewable work permits and freedom from deportation for a large number of undocumented immigrants. We did a retrospective, quasi-experimental study using nationally representative, repeated cross-sectional data from the US National Health Interview Survey (NHIS) for the period January, 2008, to December, 2015. We included non-citizen, Hispanic adults aged 19-50 years in our analyses. We used a difference-in-differences strategy to compare changes in health outcomes among individuals who met key DACA eligibility criteria (based on age at immigration and at the time of policy implementation) before and after programme implementation versus changes in outcomes for individuals who did not meet these criteria. We additionally restricted the sample to individuals who had lived in the USA for at least 5 years and had completed high school or its equivalent, in order to hold fixed two other DACA eligibility criteria. Our primary outcomes were self-reported overall health (measured on a 5 point Likert scale) and psychological distress (Kessler 6 [K6] scale), the latter was administered to a random subset of NHIS respondents. Our final sample contained 14 973 respondents for the self-reported health outcome and 5035 respondents for the K6 outcome. Of these individuals, 3972 in the self-reported health analysis and 1138 in the K6 analysis met the DACA eligibility criteria. Compared with people ineligible for DACA, the introduction of DACA was associated with no significant change among DACA-eligible individuals in terms of self-reported overall health (b=0·056, 95% CI -0·024 to 0·14, p=0·17) or the likelihood of reporting poor or fair health (adjusted odds ratio [aOR] 0·98, 95% CI 0·66-1·44

  3. What's in a country average? Wealth, gender, and regional inequalities in immunization in India.

    Science.gov (United States)

    Pande, Rohini P; Yazbeck, Abdo S

    2003-12-01

    Recent attention to Millennium Development Goals by the international development community has led to the formation of targets to measure country-level achievements, including achievements on health status indicators such as childhood immunization. Using the example of immunization in India, this paper demonstrates the importance of disaggregating national averages for a better understanding of social disparities in health. Specifically, the paper uses data from the India National Family Health Survey 1992-93 to analyze socioeconomic, gender, urban-rural and regional inequalities in immunization in India for each of the 17 largest states. Results show that, on average, southern states have better immunization levels and lower immunization inequalities than many northern states. Wealth and regional inequalities are correlated with overall levels of immunization in a non-linear fashion. Gender inequalities persist in most states, including in the south, and seem unrelated to overall immunization or the levels of other inequalities measured here. This suggests that the gender differentials reflect deep-seated societal factors rather than health system issues per se. The disaggregated information and analysis used in this paper allows for setting more meaningful targets than country averages. Additionally, it helps policy makers and planners to understand programmatic constraints and needs by identifying disparities between sub-groups of the population, including strong and weak performers at the state and regional levels.

  4. Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development.

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    Stafford, Mai; Gale, Catharine R; Mishra, Gita; Richards, Marcus; Black, Stephanie; Kuh, Diana L

    2015-01-01

    Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention. Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64. Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered. Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation's mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age.

  5. Childhood Environment and Mental Wellbeing at Age 60-64 Years: Prospective Evidence from the MRC National Survey of Health and Development.

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    Mai Stafford

    Full Text Available Mental wellbeing, conceptualised as positive affect, life satisfaction and realisation of needs that contribute to psychological growth, captures more than the absence of mental ill health. Several nations now aim to monitor and improve mental wellbeing. Whilst many studies document associations between adverse childhood experiences and mental disorders in adulthood, possible links between childhood experiences and adult mental wellbeing have so far received less attention.Using data from 1976 men and women in the MRC National Survey for Health and Development, we investigated prospective associations between childhood socioeconomic and psychosocial environments and the Warwick Edinburgh Mental Wellbeing Scale, designed to capture both hedonic and eudaimonic facets of wellbeing, at age 60-64.Whilst there was no evidence that childhood socioeconomic circumstances were related to later wellbeing independently of other childhood experiences, elements of childrearing and parenting, parental health and adjustment, and childhood illness were related. More advantaged socioeconomic position was associated with greater wellbeing but this did not explain the links between these childhood exposures and adult wellbeing, suggesting alternative explanatory pathways should be considered.Childhood illness and family psychosocial environment are associated with mental wellbeing in early older age, with effects sizes that are larger or comparable to socioeconomic circumstances in adulthood. Initiatives to improve the nation's mental wellbeing that include programmes targeted to supporting families and children may additionally have benefits that continue into older age.

  6. Diet Quality throughout Early Life in Relation to Allergic Sensitization and Atopic Diseases in Childhood

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    Anh N. Nguyen

    2017-08-01

    Full Text Available Early-life nutrition is an important modifiable determinant in the development of a child’s immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands. Diet was assessed during pregnancy, infancy, and childhood using validated food-frequency questionnaires. We calculated food-based diet quality scores (0–10 or 0–15, reflecting adherence to dietary guidelines. At age 10 years, allergic sensitization was assessed with skin prick tests. Information on physician-diagnosed inhalant and food allergies, eczema, and asthma was obtained with questionnaires. We observed no associations between diet quality during pregnancy and allergic sensitization (odds ratio (OR = 1.05 per point in the diet score, 95% confidence interval (CI: 0.99, 1.13, allergies (0.96, 95% CI: 0.88, 1.04, eczema (0.99, 95% CI: 0.93, 1.06, or asthma (0.93, 95% CI: 0.85, 1.03 in childhood. Also, diet quality in infancy or childhood were not associated with atopic outcomes in childhood. Our findings do not support our hypothesis that a healthy dietary pattern in early life is associated with a lower risk of allergic sensitization or atopic diseases in childhood.

  7. INDIAN CHILDHOOD AND OTHER CHILDHOODS

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    Alceu Zoia

    2010-12-01

    Full Text Available This article aims to show how children of the Indian community Terena, from North Mato Grosso, live, how they are educated, and what are the conceptions of childhood among the members of this community. Taking childhood in various contexts, we seek to analyze how this education process has been carried out.

  8. State of equity: childhood immunization in the World Health Organization African Region.

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    Casey, Rebecca Mary; Hampton, Lee McCalla; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron Stuart

    2017-01-01

    In 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category. We compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children's Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015. DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%. Disparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting

  9. Long-Term Immunogenicity of Hepatitis A Virus Vaccine in Alaska 17 Years After Initial Childhood Series

    Science.gov (United States)

    Raczniak, Gregory A.; Bulkow, Lisa R.; Bruce, Michael G.; Zanis, Carolyn L.; Baum, Richard L.; Snowball, Mary M.; Byrd, Kathy K.; Sharapov, Umid M.; Hennessy, Thomas W.; McMahon, Brian J.

    2013-01-01

    The Centers for Disease Control and Prevention recommends hepatitis A virus (HAV) vaccination for all children at age 1 year and for high-risk adults. The vaccine is highly effective; however, protection duration is unknown. We report HAV antibody concentrations 17 years after childhood immunization, demonstrating that protective antibody levels remain and have stabilized over the past 7 years. PMID:23204169

  10. Maternal Filarial Infection Influences the Development of Regulatory T Cells in Children from Infancy to Early Childhood.

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    Madhusmita Bal

    2016-11-01

    Full Text Available Children born from filarial infected mothers are comparatively more susceptible to filarial infection than the children born to uninfected mothers. But the mechanism of such increased susceptibility to infection in early childhood is not exactly known. Several studies have shown the association of active filarial infection with T cell hypo-responsiveness which is mediated by regulatory T cells (Tregs. Since the Tregs develop in the thymus from CD4+ CD25hi thymocytes at an early stage of the human fetus, it can be hypothesized that the maternal infection during pregnancy affects the development of Tregs in children at birth as well as early childhood. Hence the present study was designed to test the hypothesis by selecting a cohort of pregnant mothers and children born to them subsequently in a filarial endemic area of Odisha, India.A total number of 49 pregnant mothers and children born to them subsequently have been followed up (mean duration 4.4 years in an area where the microfilariae (Mf rate has come down to <1% after institution of 10 rounds of annual mass drug administration (MDA. The infection status of mother, cord and children were assessed through detection of microfilariae (Mf and circulating filarial antigen (CFA. Expression of Tregs cells were measured by flow cytometry. The levels of IL-10 were evaluated by using commercially available ELISA kit. A significantly high level of IL-10 and Tregs have been observed in children born to infected mother compared to children of uninfected mother at the time of birth as well as during early childhood. Moreover a positive correlation between Tregs and IL-10 has been observed among the children born to infected mother.From these observations we predict that early priming of the fetal immune system by filarial antigens modulate the development of Tregs, which ultimately scale up the production of IL-10 in neonates and creates a milieu for high rate of acquisition of infection in children born

  11. Research capacity for childhood obesity prevention in Latin America: an area for growth.

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    Parra, Diana C; Vorkoper, Susan; Kohl, Harold W; Caballero, Benjamin; Batis, Carolina; Jauregui, Alejandra; Mason, Jessica; Pratt, Michael

    2017-07-01

    The rise of childhood obesity in Latin America calls for research capacity to understand, monitor and implement strategies, policies and programmes to address it. The objective of the study was to assess current research capacity in Latin America related to childhood obesity, nutrition and physical activity. We conducted a search of peer-reviewed articles on childhood obesity in Latin America with at least one Latin American author from 2010 to May 2015. We coded 484 published articles for author affiliation, study subjects' nationality, research topic and study design and extracted a series of networks per research topic, study design and collaborating country for each of the countries. Obesity is the most frequently explored topic. Nutrition and obesity are somewhat better developed compared with physical activity and sedentary behaviour. There are numerous observational and cross-sectional studies, indicating either a lack of capacity required for more complex research or the extent of the problem and associated factors is still unknown. The low number of intervention studies and the near absence of policy articles suggest a void in research capacity. For childhood obesity, there is a clear need to build research capacity that documents the current state of the problem and design evidence-based prevention and intervention efforts. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

  12. Cough during infancy and subsequent childhood asthma.

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    Oren, E; Rothers, J; Stern, D A; Morgan, W J; Halonen, M; Wright, A L

    2015-09-01

    Wheezing in infancy has been associated with subsequent asthma, but whether cough similarly influences asthma risk has been little studied. We sought to determine whether prolonged cough and cough without cold in the first year of life are associated with childhood asthma. Participants in the Infant Immune Study, a non-selected birth cohort, were surveyed 7 times in the first 9 months of life regarding the presence of wheeze and cough. Cough for more than 28 days was defined as prolonged. Parents were asked at 1 year if the child ever coughed without a cold. Asthma was defined as parental report of physician diagnosis of asthma, with symptoms or medication use between 2 and 9 years. Logistic regression was used to assess adjusted odds for asthma associated with cough characteristics. A total of 24% (97) of children experienced prolonged cough and 23% (95) cough without cold in the first 9 months, respectively. Prolonged cough was associated with increased risk of asthma relative to brief cough (OR 3.57, CI: 1.88, 6.76), with the risk being particularly high among children of asthmatic mothers. Cough without cold (OR 3.13, 95% CI: 1.76, 5.57) was also independently associated with risk of childhood asthma. Both relations persisted after adjustment for wheeze and total IgE at age 1. Prolonged cough in infancy and cough without cold are associated with childhood asthma, independent of infant wheeze. These findings suggest that characteristics of cough in infancy are early markers of asthma susceptibility, particularly among children with maternal asthma. © 2015 John Wiley & Sons Ltd.

  13. Determinants of immunization inequality among urban poor children: evidence from Nairobi's informal settlements.

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    Egondi, Thaddaeus; Oyolola, Maharouf; Mutua, Martin Kavao; Elung'ata, Patricia

    2015-02-27

    Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008-9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. The study aims to determine the degree and determinants of immunization inequality among the urban poor of Nairobi. We used data from the Nairobi Cross-Sectional Slum Survey of 2012 and the health outcome was full immunization status among children aged 12-23 months. The wealth index was used as a measure of social economic position for inequality analysis. The potential determinants considered included sex of the child and mother's education, their occupation, age at birth of the child, and marital status. The concentration index (CI) was used to quantify the degree of inequality and decomposition approach to assess determinants of inequality in immunization. The CI for not fully immunized was -0.08 indicating that immunization inequality is mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother's level of education. There exists immunization inequality among urban poor children in Nairobi and efforts to reduce this inequality should aim at targeting mothers with low level of education during immunization campaigns.

  14. Beneficial effects of a woman-focused development programme on child survival: evidence from rural Bangladesh.

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    Bhuiya, Abbas; Chowdhury, Mushtaque

    2002-11-01

    This paper reports results from a prospective study of the impact of a woman-focused development programme on child survival in Matlab, a rural area of Bangladesh. The programme was targeted to households owning less than 50 decimals of land and members selling more than 100 days of labour for living in a year. Programme components included formation of women's groups for saving and credit, training on skill development, functional literacy including legal and social awareness, and technical and marketing support to projects undertaken with the loan money from the organization. A total of 13,549 children born alive during 1988-97 in the study area were included in the study. Hazards of mortality during pre- and post-intervention periods were compared among the programme participants and non-participants controlling the effects of other relevant variables. There has been a substantial reduction in mortality during the post-intervention period; however, the reduction was much greater for infants whose mothers participated in the development programme compared to infants of non-participant mothers from similar socioeconomic background. In a relative sense, there has been a 52% reduction of the pre-intervention level hazard of death of children during infancy of participant mothers compared to 31% reduction for the infants of non-participant mothers from similar socioeconomic background. There had also been a substantial reduction in hazard of death during childhood (1-4 year age group), however, the reduction was statistically similar for all groups of children irrespective of their mothers' participation in the development programmes.

  15. The Healthy Lifestyles Programme (HeLP)--an overview of and recommendations arising from the conceptualisation and development of an innovative approach to promoting healthy lifestyles for children and their families.

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    Lloyd, Jenny; Wyatt, Katrina

    2015-01-20

    Despite the rise in childhood obesity, there remains a paucity of evidence for effective interventions that engage children and parents sufficiently to make and sustain lifestyle behaviour change. The Healthy Lifestyles Programme (HeLP) is a school-located obesity prevention programme, which has been developed with teachers, families and healthcare professionals. The underpinning assumption in the development of HeLP was to take a relational approach to changing behaviour, building relationships with the schools, children and their families to create supportive environments for healthy lifestyle choices. Thus, HeLP was conceptualised as a complex intervention within a complex system and developed as a dynamic, evolving set of processes to support and motivate children towards healthy behaviours. The delivery methods used are highly interactive and encourage identification with and ownership of the healthy lifestyle messages so that the children are motivated to take them home to their parents and effect change within the family. We have good evidence that HeLP engages schools and children such that they want to participate in the Programme. Results from an exploratory trial showed that the Programme is feasible and acceptable and has the potential to change behaviours and affect weight status. This paper presents an overview of and recommendations arising from the conceptualization; development and evaluation of the Healthy Lifestyles Programme as part of a special issue focusing on novel approaches to the global problem of childhood obesity.

  16. A rare case of recurrent pyogenic liver abscess since childhood: A case of Papillon-Lefèvre syndrome

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    Somak K Das

    2013-01-01

    Full Text Available Recurrent pyogenic liver abscess since childhood is an uncommon finding in clinical medicine. Papillon-Lefèvre syndrome (PLS is a rare disease characterized by skin lesions caused by palmar-plantar hyperkeratosis, and severe periodontal destruction involving both the primary and permanent dentitions. Till date, more than 200 cases have been reported worldwide. In addition to the skin and oral findings, patients may have immune suppression and an increased susceptibility to bacteria, associated with recurrent pyogenic infections of the skin. Pyogenic liver abscess is an uncommon presentation of this rare syndrome. We present a case of PLS presenting as recurrent pyogenic liver abscess since childhood.

  17. Patient reminder and recall interventions to improve immunization rates.

    Science.gov (United States)

    Jacobson Vann, Julie C; Jacobson, Robert M; Coyne-Beasley, Tamera; Asafu-Adjei, Josephine K; Szilagyi, Peter G

    2018-01-18

    immunizations for childhood (RR 1.22, 95% CI 1.15 to 1.29; risk difference of 8%; 23 studies; 31,099 participants) and adolescent vaccinations (RR 1.29, 95% CI 1.17 to 1.42; risk difference of 7%; 10 studies; 30,868 participants). Reminders probably improve receipt of vaccinations for childhood influenza (RR 1.51, 95% CI 1.14 to 1.99; risk difference of 22%; five studies; 9265 participants) and adult influenza (RR 1.29, 95% CI 1.17 to 1.43; risk difference of 9%; 15 studies; 59,328 participants) based on moderate certainty evidence. They may improve receipt of vaccinations for adult pneumococcus, tetanus, hepatitis B, and other non-influenza vaccinations based on low certainty evidence although the confidence interval includes no effect of these interventions (RR 2.08, 95% CI 0.91 to 4.78; four studies; 8065 participants). Patient reminder and recall systems, in primary care settings, are likely to be effective at improving the proportion of the target population who receive immunizations.

  18. CHILDHOODS AND INTERPRETATIONS: RESEARCH ON ATTITUDES TOWARDS CONTEMPORARY DISCOURSES ON CHILDHOOD

    Directory of Open Access Journals (Sweden)

    Czető, Krisztina

    2018-01-01

    Full Text Available This study deals with the theoretical interpretations of childhoods in the twenty-first century, and presents the results of an exploratory research on students’ attitudes towards contemporary childhood discourses conducted in Hungarian secondary schools. In a narrative literature review, the developmental and the new social paradigms of childhood are discussed. In the quantitative part of the research, the participants’ (N=806 attitudes were measures by a four-dimension questionnaire. The results of the exploratory research show that there are three dominant themes in childhood discourses highly accepted by the research participants: childhood as a development, the motif of initiation and the social and cultural relativity of childhoods.

  19. From reaching every district to reaching every community: analysis and response to the challenge of equity in immunization in Cambodia

    Science.gov (United States)

    Chan Soeung, Sann; Grundy, John; Duncan, Richard; Thor, Rasoka; Bilous, Julian B

    2013-01-01

    Background An international review of the Cambodian Expanded Programme on Immunization (EPI) in 2010 and other data show that despite immunization coverage increases and vaccine preventable diseases incidence reductions, inequities in access to immunization services exist. Utilizing immunization and health systems literature, analysis of global health databases and the EPI review findings, this paper examines the characteristics of immunization access and outcome inequities, and describes proposed longer-term strategic and operational responses to these problems. Findings The national programme has evolved from earlier central and provincial level planning to strengthening routine immunization coverage through the District level ‘Reaching Every District Strategy’. However, despite remarkable improvements, the review found over 20% of children surveyed were not fully immunized, primarily from communities where inequities of both access and impact persist. These inequities relate mainly to socio-economic exposures including wealth and education level, population mobility and ethnicity. To address these problems, a shift in strategic and operational response is proposed that will include (a) a re-focus of planning on facility level to detect disadvantaged communities, (b) establishment of monitoring systems to provide detailed information on community access and utilization, (c) development of communication strategies and health networks that enable providers to adjust service delivery according to the needs of vulnerable populations, and (d) securing financial, management and political commitment for ‘reaching every community’. Conclusions For Cambodia to achieve its immunization equity objectives and disease reduction goals, a shift of emphasis to health centre and community is needed. This approach will maximize the benefits of new vaccine introduction in the coming ‘Decade of Vaccines’, plus potentially extend the reach of other life-saving maternal

  20. Population segmentation: an approach to reducing childhood obesity inequalities.

    Science.gov (United States)

    Mahmood, Hashum; Lowe, Susan

    2017-05-01

    The aims of this study are threefold: (1) to investigate the relationship between socio-economic status (inequality) and childhood obesity prevalence within Birmingham local authority, (2) to identify any change in childhood obesity prevalence between deprivation quintiles and (3) to analyse individualised Birmingham National Child Measurement Programme (NCMP) data using a population segmentation tool to better inform obesity prevention strategies. Data from the NCMP for Birmingham (2010/2011 and 2014/2015) were analysed using the deprivation scores from the Income Domain Affecting Children Index (IDACI 2010). The percentage of children with excess weight was calculated for each local deprivation quintile. Population segmentation was carried out using the Experian's Mosaic Public Sector 6 (MPS6) segmentation tool. Childhood obesity levels have remained static at the national and Birmingham level. For Year 6 pupils, obesity levels have increased in the most deprived deprivation quintiles for boys and girls. The most affluent quintile shows a decreasing trend of obesity prevalence for boys and girls in both year groups. For the middle quintiles, the results show fluctuating trends. This research highlighted the link in Birmingham between obesity and socio-economic factors with the gap increasing between deprivation quintiles. Obesity is a complex problem that cannot simply be addressed through targeting most deprived populations, rather through a range of effective interventions tailored for the various population segments that reside within communities. Using population segmentation enables a more nuanced understanding of the potential barriers and levers within populations on their readiness for change. The segmentation of childhood obesity data will allow utilisation of social marketing methodology that will facilitate identification of suitable methods for interventions and motivate individuals to sustain behavioural change. Sequentially, it will also inform

  1. Childhood Cancer Statistics

    Science.gov (United States)

    ... Watchdog Ratings Feedback Contact Select Page Childhood Cancer Statistics Home > Cancer Resources > Childhood Cancer Statistics Childhood Cancer Statistics – Graphs and Infographics Number of Diagnoses Incidence Rates ...

  2. Childhood victimization and inflammation in young adulthood: A genetically sensitive cohort study.

    Science.gov (United States)

    Baldwin, Jessie R; Arseneault, Louise; Caspi, Avshalom; Fisher, Helen L; Moffitt, Terrie E; Odgers, Candice L; Pariante, Carmine; Ambler, Antony; Dove, Rosamund; Kepa, Agnieszka; Matthews, Timothy; Menard, Anne; Sugden, Karen; Williams, Benjamin; Danese, Andrea

    2018-01-01

    Childhood victimization is an important risk factor for later immune-related disorders. Previous evidence has demonstrated that childhood victimization is associated with elevated levels of inflammation biomarkers measured decades after exposure. However, it is unclear whether this association is (1) already detectable in young people, (2) different in males and females, and (3) confounded by genetic liability to inflammation. Here we sought to address these questions. Participants were 2232 children followed from birth to age 18years as part of the Environmental Risk (E-Risk) Longitudinal Twin Study. Childhood victimization was measured prospectively from birth to age 12years. Inflammation was measured through C-reactive protein (CRP) levels in dried blood spots at age 18years. Latent genetic liability for high inflammation levels was assessed through a twin-based method. Greater exposure to childhood victimization was associated with higher CRP levels at age 18 (serum-equivalent means were 0.65 in non-victimized Study members, 0.74 in those exposed to one victimization type, and 0.81 in those exposed to poly-victimization; p=0.018). However, this association was driven by a significant association in females (serum-equivalent means were 0.75 in non-victimized females, 0.87 in those exposed to one type of victimization, and 1.19 in those exposed to poly-victimization; p=0.010), while no significant association was observed in males (p=0.19). Victimized females showed elevated CRP levels independent of latent genetic influence, as well as childhood socioeconomic status, and waist-hip ratio and body temperature at the time of CRP assessment. Childhood victimization is associated with elevated CRP levels in young women, independent of latent genetic influences and other key risk factors. These results strengthen causal inference about the effects of childhood victimization on inflammation levels in females by accounting for potential genetic confounding. Copyright

  3. VALUE OF UNIVERSAL CHILDHOOD VARICELLA VACCINATION IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Jerneja Ahčan

    2002-11-01

    Full Text Available Background. In 1974 effective and safe vaccine against varicella was developed. Vaccination is recomended for universal childhood immunisation in some of west European countries and in the United States. The aim of the study was to perform economic analysis of universal childhood vaccination against varicella in Slovenia.Methods. We examined hypothetical birth cohort of 5800 persons followed from birth to their 30th birthday and calculated the cost-benefit ratio for varicella vaccination program. We assumed that one dose of vaccine would be given to 15-monthold children along with measles, mumps and rubella vaccination. It was also assumed that 95% of children would be vaccinated, that vaccine efficacy would be 90%, that vaccine induced immunity would be lifelong and that the program would have no effect on either the incidence rate or severity of herpes zoster. For both disease and vaccine we measured the direct medical cost and indirect cost.Results. Indirect cost represented major part compared to medical cost. The benefit to cost ratio was 0.89.Conclusions. Considering major assumptions in this analysis, there is no financial benefits from vaccinating all children against varicella in our country.

  4. Management of immunization solid wastes in Kano State, Nigeria

    International Nuclear Information System (INIS)

    Oke, I.A.

    2008-01-01

    Inadequate management of waste generated from injection activities can have a negative impact on the community and environment. In this paper, a report on immunization wastes management in Kano State (Nigeria) is presented. Eight local governments were selected randomly and surveyed by the author. Solid wastes generated during the Expanded Programme on Immunization were characterised using two different methods: one by weighing the waste and the other by estimating the volume. Empirical data was obtained on immunization waste generation, segregation, storage, collection, transportation, and disposal; and waste management practices were assessed. The study revealed that immunization offices were accommodated in either in local government buildings, primary health centres or community health care centres. All of the stations demonstrated a high priority for segregation of the infectious wastes. It can be deduced from the data obtained that infectious waste ranged from 67.6% to 76.7% with an average of 70.1% by weight, and 36.0% to 46.1% with an average of 40.1% by volume. Non-infectious waste generated ranged from 23.3% to 32.5% with an average of 29.9% by weight and 53.9% to 64.0% with an average of 59.9% by volume. Out of non-infectious waste (NIFW) and infectious waste (IFW), 66.3% and 62.4% by weight were combustible and 33.7% and 37.6% were non-combustible respectively. An assessment of the treatment revealed that open pit burning and burial and small scale incineration were the common methods of disposal for immunization waste, and some immunization centres employed the services of the state or local government owned solid waste disposal board for final collection and disposal of their immunization waste at government approved sites

  5. The Healthy Lifestyles Programme (HeLP — An Overview of and Recommendations Arising from the Conceptualisation and Development of an Innovative Approach to Promoting Healthy Lifestyles for Children and Their Families

    Directory of Open Access Journals (Sweden)

    Jenny Lloyd

    2015-01-01

    Full Text Available Despite the rise in childhood obesity, there remains a paucity of evidence for effective interventions that engage children and parents sufficiently to make and sustain lifestyle behaviour change. The Healthy Lifestyles Programme (HeLP is a school-located obesity prevention programme, which has been developed with teachers, families and healthcare professionals. The underpinning assumption in the development of HeLP was to take a relational approach to changing behaviour, building relationships with the schools, children and their families to create supportive environments for healthy lifestyle choices. Thus, HeLP was conceptualised as a complex intervention within a complex system and developed as a dynamic, evolving set of processes to support and motivate children towards healthy behaviours. The delivery methods used are highly interactive and encourage identification with and ownership of the healthy lifestyle messages so that the children are motivated to take them home to their parents and effect change within the family. We have good evidence that HeLP engages schools and children such that they want to participate in the Programme. Results from an exploratory trial showed that the Programme is feasible and acceptable and has the potential to change behaviours and affect weight status. This paper presents an overview of and recommendations arising from the conceptualization; development and evaluation of the Healthy Lifestyles Programme as part of a special issue focusing on novel approaches to the global problem of childhood obesity.

  6. Gates, GAVI, the glorious global funds and more: all you ever wanted to know.

    Science.gov (United States)

    Nossal, Gustav J V

    2003-02-01

    Global immunization programmes have achieved some remarkable successes. In 1977, Frank Fenner's Commission declared smallpox to have been eradicated by an 11-year-long intensive campaign. The Expanded Programme on Immunization encompassed six important childhood vaccines and reached over three-quarters of the world's children. Polio eradication has gone remarkably well, with only 10 out of 200 countries reporting residual cases. But amidst all the good news, there is also bad news. Coverage is variable; infrastructure is crumbling; and newer vaccines are not being incorporated in many country programmes. The Bill and Melinda Gates Foundation has introduced a new dynamic here. From their initial gift of $100 million in December 1998, their commitment to date is US$1.5 billion - and rising. At the centre is a Global Children's Vaccine Fund which permitted the launch, in January 2000, of the Global Alliance for Vaccines and Immunization. This is targeted to the 74 poorest countries of the world and is designed to improve vaccination infrastructure, to purchase newer vaccines and to support research and development. Even before we know how successful this programme will be, it has had its imitators. The Global Fund to Fight AIDS, TB and Malaria borrowed many concepts from GAVI. The Global Alliance for Improved Nutrition announced in May 2002 does so as well, and is heavily supported by Gates. Highly effective parasite control programmes antedate all this but will be much strengthened. However, we still face a sizeable budgetary gap both for research and for bringing the best advances to all people who need them.

  7. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; Meije, Carin; Myin-Germeys, Inez; van Os, Jim; Wiersma, Durk

    2015-01-01

    Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of

  8. Childhood trauma and childhood urbanicity in relation to psychotic disorder

    NARCIS (Netherlands)

    Frissen, Aleida; Lieverse, Ritsaert; Drukker, Marjan; van Winkel, Ruud; Delespaul, Philippe; Cahn, W

    2015-01-01

    BACKGROUND: Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect

  9. Missed Immunization Opportunities Among Children Under 5 Years Of Age Dwelling In Karachi City.

    Science.gov (United States)

    Khaliq, Asif; Sayed, Sayeeda Amber; Hussaini, Syed Abdullah; Azam, Kiran; Qamar, Mehak

    2017-01-01

    Immunization is the safest and effective measure for preventing and eradicating various communicable diseases. A glaring immunization gap exists between developing and industrialized countries towards immunization, because the developing countries including Pakistan are still striving to provide basic immunization to their children. The purpose of this study was to access the prevalence and factors of missing immunization among under 5-year children of Karachi.. A cross sectional study was conducted from June 2015 to October 2015 among different outpatient clinics of Karachi. Parents who had child less than 5 year of age were approached by non-probability purposive sampling. Data was analysed by using Statistical Package of Social Sciences. There were around 59.09% (n=156) and 64.43% (n=165) parents who have correctly responded regarding the number of essential immunization visit during the first and second year of their child life respectively. About 28.12% (n=108) parents responded that they do not know about the name and number of missed doses of vaccines. 31.78% (n=122) parents responded that their children have missed either one or more than one doses of routine immunization vaccines. Of which 34.42% (n=42) children have missed more than one vaccine. Lack of knowledge regarding immunization schedule 28.68% (n=34), concern about vaccine side effects 21.31%, (n=26), child sickness 17.21% (n=21), and lack of trust about government 10.65%, (n=13) were the major barriers identified by parents for missed immunization opportunities. Parents have inadequate knowledge regarding routine immunization visits, immunization schedule and vaccine doses. The practices of parents for routine childhood immunization are also poor. Parents refuse to immunize their child because of lack of immunization visit knowledge and also because of their doubts regarding vaccine potency and side effects. A proper system of immunization promotion, advocacy and reminder systems with proper

  10. Introduction of sequential inactivated polio vaccine-oral polio vaccine schedule for routine infant immunization in Brazil's National Immunization Program.

    Science.gov (United States)

    Domingues, Carla Magda Allan S; de Fátima Pereira, Sirlene; Cunha Marreiros, Ana Carolina; Menezes, Nair; Flannery, Brendan

    2014-11-01

    In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  11. Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jessica L. Watterson

    2015-01-01

    Full Text Available Mobile health (mHealth technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients’, caretakers’, or health workers’ behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC, postnatal care (PNC, and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%, n=8 and most were conducted in African countries (80%, n=8. All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

  12. Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature.

    Science.gov (United States)

    Watterson, Jessica L; Walsh, Julia; Madeka, Isheeta

    2015-01-01

    Mobile health (mHealth) technologies have been implemented in many low- and middle-income countries to address challenges in maternal and child health. Many of these technologies attempt to influence patients', caretakers', or health workers' behavior. The purpose of this study was to conduct a systematic review of the literature to determine what evidence exists for the effectiveness of mHealth tools to increase the coverage and use of antenatal care (ANC), postnatal care (PNC), and childhood immunizations through behavior change in low- and middle-income countries. The full text of 53 articles was reviewed and 10 articles were identified that met all inclusion criteria. The majority of studies used text or voice message reminders to influence patient behavior change (80%, n = 8) and most were conducted in African countries (80%, n = 8). All studies showed at least some evidence of effectiveness at changing behavior to improve antenatal care attendance, postnatal care attendance, or childhood immunization rates. However, many of the studies were observational and further rigorous evaluation of mHealth programs is needed in a broader variety of settings.

  13. Understanding the main barriers to immunization in Colombia to better tailor communication strategies.

    Science.gov (United States)

    García L, Diego Alejandro; Velandia-González, Martha; Trumbo, Silas Pierson; Pedreira, M Cristina; Bravo-Alcántara, Pamela; Danovaro-Holliday, M Carolina

    2014-06-30

    The Expanded Program on Immunization (EPI) in Colombia has made great advances since its inception in 1979; however, by 2010 vaccination coverage rates had been declining. In 2010, the EPI commissioned a nationwide study on practices on immunization, attitudes and knowledge, perceived service quality, and barriers to childhood immunization in order to tailor EPI communication strategies. Colombia's 32 geographical departments were divided into 10 regions. Interviewers from an independent polling company administered a survey to 4802 parents and guardians of children aged communication preferences, and parental attitudes on vaccination. Although all respondents indicated that vaccines have health benefits, and 4738 (98.7%) possessed vaccination cards for their children, attitudes and knowledge were not always favorable to immunization. Six groups of immunization barriers were identified: 1) factors related to caregivers (24.4%), 2) vaccinators (19.7%), 3) health centers (18.0%), 4) the health system (13.4%), 5) concerns about adverse events (13.1%), and 6) cultural and religious beliefs (11.4%); groups 1, 5 and 6 together represented almost half (48.9%) of users, indicating problems related to the demand for vaccines as the primary barriers to immunization. Differences in demographics, communication preferences, and reported service quality were found among participants in the six groups and among participants in the 10 regions. Additionally, differences between how participants reported receiving information on vaccination and how they believed such information should be communicated were observed. Better understanding immunization barriers and the users of the EPI can help tailor communication strategies to increase demand for immunization services. Results of the study have been used by Colombia's EPI to inform the design of new communication strategies.

  14. Childhood Obesity Facts

    Science.gov (United States)

    ... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Facts Recommend on Facebook Tweet Share Compartir On ... Children (WIC) Program, 2000-2014 Prevalence of Childhood Obesity in the United States Childhood obesity is a ...

  15. Logistics management in Universal Immunisation Programme.

    Science.gov (United States)

    Bachani, D; Bansal, R D

    1990-01-01

    The review of the National Immunization Programme of India in 1989 focused attention to the issue of storage and distribution of vaccines. Cold-chain equipment such as walk-in-coolers (WICs), deep freezers, ice-lined refrigerators (ILRs), and vaccine carriers proliferated after the introduction of the universal immunization program (UIP) but the available units fell short of the official targets in 1988, especially ILRs (7500 proposed and 2876 available) and vaccine carriers (250,000 proposed and 35,500 available). Some states had over 6 months of supplies of vaccines whose management posed problems of losing potency: oral polio virus (OPV) potency was acceptable in 63% of stock in 1988. Syringes, needles, stoves, pressure-cooker sterilizers, dial thermometers, and refrigerator repair kits were in short supply especially at the primary health care (PHC) level. Only 1/3 of subcenters had sterilizers and 58% had vaccines carriers. Logistics management on the state level required provision of vaccines based on previous use and eligible population with even distribution throughout the year. On the district level WICs were needed for every district with 1.5 million inhabitants. Recording of vaccine requirement, utilization, and storage would aid target allocations and avoid wastage. On the institutional and PHC level an ILR and a transporting vehicle was needed. The number of women and children eligible for immunization had to be calculated based on real population figures. Cold-chain capacity of 30,000-40,000 vials was required for a district as well as about 500 reusable syringes and needles a year along with vaccination cards exceeding the number of women and children by 10% for recordkeeping at the PHC center.

  16. Programme

    OpenAIRE

    Hobday, E, fl. 1905, artist

    2003-01-01

    A photograph of an illustrated programme listing dances. The illustration shows a snake charmer playing to a snake while another man watches. Buildings and trees can be seen behind a wall in the distance. In the lower right-hand corner of the programme is the signature 'E. Hobday'. The programme is almost certainly related to the Punjab Ball, Lahore. It is placed next to the Punjab Ball Menu in the album and the Menu is also illustrated by 'E. Hobday'.

  17. Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana.

    Science.gov (United States)

    Renner, Lorna Awo; McGill, Deborah

    2016-09-01

    Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings. To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control. This exploratory qualitative study was conducted based on an interpretative epistemology using a social constructionist approach. Purposive sampling of parents attending the Paediatric Oncology Unit, Korle Bu Teaching Hospital in Accra, Ghana was undertaken. Twelve semi-structured moderate interviews and two small focus group discussions with a total of seven participants were undertaken. Data analysis was through thematic content analysis. Five major themes emerged. Knowledge and perceptions revealed a total lack of appropriate knowledge prior to diagnosis. Health-seeking behaviour was determined by interplay of individual and environmental factors. Orthodox medical treatment was largely perceived favourably. The impact of cancer on parents and children included psychological, physical and socioeconomic effects. Financial, spiritual and psychosocial support helped in coping. Parents recommended public education and health financing to address the major barriers. Broad social determinants and experiences influence parental decision making for children with cancer. This implies Health Promotion strategies with multi-sectorial involvement will be required for effective implementation of the National Strategy for Cancer Control. Funded by authors.

  18. A Gossip or a Good Yack? Reconceptualizing Parent Support in New Zealand Early Childhood Centre Based Programmes

    Science.gov (United States)

    Duncan, Judith; Bowden, Chris; Smith, Anne B.

    2006-01-01

    Parental support has been an increasingly essential part of New Zealand early childhood (EC) education services over the last 20 years. This support has taken many shapes and forms over this time period, and has depended on the differing philosophies of the EC education services. What this support "looks like" and how it is delivered is…

  19. Crispv programme

    International Nuclear Information System (INIS)

    Marinkovicj, N.

    CRISPV (Criticality and Spectrum code) is a multigroup neutron spectrum code for homogeneous reactor cores and is actually a somewhat modified version of the original CRISP programme. It is a combination of DATAPREP-II and BIGG-II programmes. It is assumed that the reactor cell is a cylindrical fuel rod in the light or heavy water moderator. DATEPREP-II CODE forms the multigroup data for homogeneous reactor and prepares the input parameters for the BIGG-II code. It has its own nuclear data library on a separate tape in binary mode. BIGG-II code is a multigroup neutron spectrum and criticality code for a homogenized medium. It has as well its own separate data library. In the CRISPV programme the overlay structure enables automatic handling of data calculated in the DATAPREP-II programme and needed in the BIGG-II core. Both programmes are written in FORTRAN for CDC 3600. Using the programme is very efficient and simple

  20. “Management of Overweight during Childhood: A Focus Group Study on Health Professionals’ Experiences in General Practice,”

    DEFF Research Database (Denmark)

    Larsen, Lone Marie; Ledderer, Loni; Jarbol, Dorte E

    2015-01-01

    Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised...... controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health...... to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised...

  1. Maternal sensitivity and mental health: does an early childhood intervention programme have an impact?

    Science.gov (United States)

    Brahm, Paulina; Cortázar, Alejandra; Fillol, María Paz; Mingo, María Verónica; Vielma, Constanza; Aránguiz, María Consuelo

    2016-06-01

    Maternal sensitivity (MS) and mental health influence mother-child attachment and the child's mental health. Early interventions may promote resilience and facilitate healthy development of the children through an impact on mothers' outcomes such as their sensitivity and mental health. Play with Our Children (POC) is an early intervention programme aiming to promote a positive mother-child interaction for children who attend three family health centres of deprived areas of Santiago de Chile. To estimate the effect of the programme POC on MS and mental health. A quasi-experimental design with propensity score matching estimations was employed. MS was measured with the Q-Sort of Maternal Sensitivity, and maternal mental health was assessed with the Patient Health Questionnaire and the Parenting Stress Index. Mean-difference comparison and difference-in-difference method were used as statistical strategies. The sample included 102 children from 2 to 23 months of age, 54 of them participated in the intervention and 48 children were the comparison group. Estimates showed that participation in POC was positively associated with less stress in mothers of children younger than 12 months (P early intervention POC may influence mother's mental health and indirectly impact children's well-being during critical stages of their development by strengthening their mother's sensitivity towards them. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. National programme: Finland

    International Nuclear Information System (INIS)

    Forsten, J.

    1986-01-01

    Finland's programmes in the field of reactor pressure components are presented in this paper. The following information on each of these programmes is given: the brief description of the programme; the programme's schedule and duration; the name of the project manager

  3. Neuroblastoma arginase activity creates an immunosuppressive microenvironment that impairs autologous and engineered immunity

    Science.gov (United States)

    Mussai, Francis; Egan, Sharon; Hunter, Stuart; Webber, Hannah; Fisher, Jonathan; Wheat, Rachel; McConville, Carmel; Sbirkov, Yordan; Wheeler, Kate; Bendle, Gavin; Petrie, Kevin; Anderson, John; Chesler, Louis; De Santo, Carmela

    2015-01-01

    Neuroblastoma is the most common extra cranial solid tumour of childhood, and survival remains poor for patients with advanced disease. Novel immune therapies are currently in development, but clinical outcomes have not matched preclinical results. Here, we describe key mechanisms in which neuroblastoma inhibits the immune response. We show that murine and human neuroblastoma tumour cells suppress T cell proliferation, through increased arginase activity. Arginase II is the predominant isoform expressed and creates an arginine deplete local and systemic microenvironment. Neuroblastoma arginase activity results in inhibition of myeloid cell activation and suppression of bone marrow CD34+ progenitor proliferation. Finally we demonstrate that the arginase activity of neuroblastoma impairs NY-ESO-1 specific TCR and GD2-specific CAR engineered T cell proliferation and cytotoxicity. High arginase II expression correlates with poor survival for neuroblastoma patients. The results support the hypothesis that neuroblastoma creates an arginase-dependent immunosuppressive microenvironment in both the tumour and blood that leads to impaired immune surveillance and sub-optimal efficacy of immunotherapeutic approaches. PMID:26054597

  4. Using the Intervention Mapping Protocol to develop an online video intervention for parents to prevent childhood obesity: Movie Models.

    Science.gov (United States)

    De Lepeleere, Sara; Verloigne, Maïté; Brown, Helen Elizabeth; Cardon, Greet; De Bourdeaudhuij, Ilse

    2016-08-08

    The increasing prevalence of childhood overweight/obesity caused by an unhealthy diet, insufficient physical activity (PA) and high levels of sedentary behaviour (SB) is a prominent public health concern. Parenting practices may contribute to healthy behaviour change in children, but well-researched examples are limited. The aim of this study is to describe the systematic development of an intervention for parents to prevent childhood overweight/obesity through the improvement of parenting practices. The six steps of the Intervention Mapping Protocol (IMP), a theory- and evidence-based tool to develop health-related interventions, were used as a framework to develop the 'Movie Models' programme. In Step 1, a needs assessment was performed to better understand the health problem of overweight/obesity in children and its association with diet, PA and SB. In Step 2, the programme goal (increasing the adoption of effective parenting practices) was sub-divided into performance objectives. Change objectives, which specify explicit actions required to accomplish the performance objectives, were also identified. Step 3 included the selection of theoretical methods (e.g. 'modelling' and 'images'), which were then translated into the practical strategy of online parenting videos. Step 4 comprised the development of a final intervention framework, and Step 5 included the planning of programme adoption and implementation. The final phase, Step 6, included the development of an effect- and process-evaluation plan. The IMP was used to structure the development of 'Movie Models', an intervention targeting specific parenting practices related to children's healthy diet, PA, SB, and parental self-efficacy. A clear framework for process analyses is offered, which aims to increase the potential effectiveness of an intervention and can be useful for those developing health promotion programmes. © The Author(s) 2016.

  5. Functional variant in the autophagy-related 5 gene promotor is associated with childhood asthma.

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    Lisa J Martin

    Full Text Available Autophagy is a cellular process directed at eliminating or recycling cellular proteins. Recently, the autophagy pathway has been implicated in immune dysfunction, the pathogenesis of inflammatory disorders, and response to viral infection. Associations between two genes in the autophagy pathway, ATG5 and ATG7, with childhood asthma were investigated.Using genetic and experimental approaches, we examined the association of 13 HapMap-derived tagging SNPs in ATG5 and ATG7 with childhood asthma in 312 asthmatic and 246 non-allergic control children. We confirmed our findings by using independent cohorts and imputation analysis. Finally, we evaluated the functional relevance of a disease associated SNP.We demonstrated that ATG5 single nucleotide polymorphisms rs12201458 and rs510432 were associated with asthma (p = 0.00085 and 0.0025, respectively. In three independent cohorts, additional variants in ATG5 in the same LD block were associated with asthma (p<0.05. We found that rs510432 was functionally relevant and conferred significantly increased promotor activity. Furthermore, Atg5 expression was increased in nasal epithelium of acute asthmatics compared to stable asthmatics and non-asthmatic controls.Genetic variants in ATG5, including a functional promotor variant, are associated with childhood asthma. These results provide novel evidence for a role for ATG5 in childhood asthma.

  6. Certification of poliomyelitis eradication in Singapore and the challenges ahead.

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    Lee, Hwee Ching; Tay, Joanne; Kwok, Cynthia Y H; Wee, Moi Kim; Ang, Li Wei; Kita, Yuske; Cutter, Jeffery L; Chan, Kwai Peng; Chew, Suok Kai; Goh, Kee Tai

    2012-11-01

    This study reviewed the epidemiological trends of poliomyelitis from 1946 to 2010, and the impact of the national immunisation programme in raising the population herd immunity against poliovirus. We also traced the efforts Singapore has made to achieve certification of poliomyelitis eradication by the World Health Organisation. Epidemiological data on all reported cases of poliomyelitis were obtained from the Communicable Diseases Division of the Ministry of Health as well as historical records. Coverage of the childhood immunisation programme against poliomyelitis was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against poliovirus, 6 serological surveys were conducted in 1962, 1978, 1982 to 1984, 1989, 1993 and from 2008 to 2010. Singapore was among the fi rst countries in the world to introduce live oral poliovirus vaccine (OPV) on a mass scale in 1958. With the comprehensive coverage of the national childhood immunisation programme, the incidence of paralytic poliomyelitis declined from 74 cases in 1963 to 5 cases from 1971 to 1973. The immunisation coverage for infants, preschool and primary school children has been maintained at 92% to 97% over the past decade. No indigenous poliomyelitis case had been reported since 1978 and all cases reported subsequently were imported. Singapore was certified poliomyelitis free along with the rest of the Western Pacific Region in 2000 after fulfilling all criteria for poliomyelitis eradication, including the establishment of a robust acute flaccid paralysis surveillance system. However, post-certification challenges remain, with the risk of wild poliovirus importation. Furthermore, it is timely to consider the replacement of OPV with the inactivated poliovirus vaccine in Singapore's national immunisation programme given the risk of vaccine-associated paralytic poliomyelitis and circulating vaccine-derived polioviruses.

  7. High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada.

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    Barker, Brittany; Kerr, Thomas; Dong, Huiru; Wood, Evan; DeBeck, Kora

    2017-03-01

    While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51-2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young

  8. An Evaluation of Twenty Years of EU Framework Programme-funded Immune-mediated Inflammatory Translational Research in Non-human Primates

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    Krista Geraldine Haanstra

    2016-11-01

    Full Text Available Ageing western societies are facing an increasing prevalence of chronic inflammatory and degenerative diseases for which often no effective treatments exist, resulting in increasing health care expenditure. Despite high investments in drug development, the number of promising new drug candidates decreases. We propose that preclinical research in non-human primate can help to bridge the gap between drug discovery and drug prescription.Translational research covers various stages of drug development of which pre-clinical efficacy tests in valid animal models is usually the last stage. Pre-clinical research in non-human primates may be essential in the evaluation of new drugs or therapies when a relevant rodent model is not available. Non-human primate models for life-threatening or severely debilitating diseases in humans are available at the Biomedical Primate Research Centre (BPRC. These have been instrumental in translational research for several decades.In order to stimulate European health research and innovation from bench to bedside, the European Commission (EC has invested heavily in access to non-human primate research for more than 20 years. BPRC has hosted European users in a series of transnational access programs covering a wide range of research areas with the common theme being immune-mediated inflammatory disorders. We present an overview of the results and give an account of the studies performed as part of European Union Framework Programme (EU FP-funded translational non-human primate research performed at the BPRC. The data illustrate value of translational non-human primate research for the development of new therapies and emphasize the importance of EU FP funding

  9. Reasons for non-vaccination: Parental vaccine hesitancy and the childhood influenza vaccination school pilot programme in England.

    Science.gov (United States)

    Paterson, Pauline; Chantler, Tracey; Larson, Heidi J

    2017-08-14

    In 2013, the annual influenza immunisation programme in England was extended to children to reduce the burden of influenza, but uptake was sub-optimal at 53.2%. To explore the reasons some parents decided not to vaccinate their child against influenza as part of the pilot programme offered in schools. Cross-sectional qualitative study conducted between February and July 2015. 913 parents whose children were not vaccinated against influenza in the school pilots in West Yorkshire and Greater Manchester, England, were asked to comment on their reasons for non-vaccination and invited to take part in a semi-structured interview. 138 parents returned response forms, of which 38 were eligible and interested in participating and 25 were interviewed. Interview transcripts were coded by theme in NVivo. A third of parents who returned response forms had either vaccinated their child elsewhere, intended to have them vaccinated, or had not vaccinated them due to medical reasons (valid or perceived). Most interviewees were not convinced of the need to vaccinate their child against influenza. Parents expressed concerns about influenza vaccine effectiveness and vaccine side effects. Several parents interviewed declined the vaccine for faith reasons due to the presence of porcine gelatine in the vaccine. To significantly decrease the burden of influenza in England, influenza vaccination coverage in children needs to be >60%. Hence, it is important to understand the reasons why parents are not vaccinating their children, and to tailor the communication and immunisation programme accordingly. Our finding that a third of parents, who did not consent to their child being vaccinated as part of the school programme, had actually vaccinated their child elsewhere, intended to have their child vaccinated, or had not vaccinated them due to medical reasons, illustrates the importance of including additional questions or data sources when investigating under-vaccination. Copyright © 2017 The

  10. Antibody and immune memory persistence post infant hepatitis B vaccination

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    Hudu SA

    2013-09-01

    Full Text Available Shuaibu A Hudu,1,2 Yasmin A Malik,3 Mohd Taib Niazlin,1 Nabil S Harmal,1,4 Ariza Adnan,5 Ahmed S Alshrari,1 Zamberi Sekawi1 1Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia; 2Department of Pathology and Medical Microbiology, College of Health Sciences, Usmanu Danfodiyo University Sokoto, Sokoto State, Nigeria; 3Department of Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia; 4Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen; 5Cluster of Laboratory Medical Sciences, Faculty of Medicine Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia Objectives: This study aimed to evaluate the level of hepatitis B immunity among undergraduate students 23 years after commencement of the nationwide hepatitis B childhood immunization program in Malaysia. Methods: A total of 402 serum samples obtained from volunteer undergraduate students were screened for the presence of hepatitis B surface antibodies using qualitative ELISA. Results: Results showed that 62.7% of volunteers had protective anti-hepatitis B surface antigens (≥10 IU/L, of whom 67.9% received three doses of the vaccine. The estimated post-vaccination immunity was found to be at least 20 years, indicating persistent immunity against hepatitis B and a significant association (P < 0.05 with duration of vaccination. Anamnestic response 1 month post-hepatitis B booster was 94.0% and highly significant (P < 0.01. Isolated anti-hepatitis B core antigen (anti-HBc prevalence was found to be 5.0%, all having had a positive anamnestic response. Conclusion: Immunity after primary vaccination with hepatitis B recombinant vaccine persists for at least 20 years post-vaccination, with significant association with the number of vaccinations. Furthermore, the presence of anamnestic response to

  11. Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

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    Melissa B Gilkey

    Full Text Available To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents.We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR, varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status.A substantial minority of parents reported a history of vaccine refusal (15% or delay (27%. Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63 as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86. Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68, varicella (OR = 1.54, 95% CI, 1.42-1.66, and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42.Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

  12. Assessing the Evidence for Maternal Pertussis Immunization: A Report From the Bill & Melinda Gates Foundation Symposium on Pertussis Infant Disease Burden in Low- and Lower-Middle-Income Countries.

    Science.gov (United States)

    Sobanjo-Ter Meulen, Ajoke; Duclos, Philippe; McIntyre, Peter; Lewis, Kristen D C; Van Damme, Pierre; O'Brien, Katherine L; Klugman, Keith P

    2016-12-01

    Implementation of effective interventions has halved maternal and child mortality over the past 2 decades, but less progress has been made in reducing neonatal mortality. Almost 45% of under-5 global mortality now occurs in infants <1 month of age, with approximately 86% of neonatal deaths occurring in low- and lower-middle-income countries (LMICs). As an estimated 23% of neonatal deaths globally are due to infectious causes, maternal immunization (MI) is one intervention that may reduce mortality in the first few months of life, when direct protection often relies on passively transmitted maternal antibodies. Despite all countries including pertussis-containing vaccines in their routine childhood immunization schedules, supported through the Expanded Programme on Immunization, pertussis continues to circulate globally. Although based on limited robust epidemiologic data, current estimates derived from modeling implicate pertussis in 1% of under-5 mortality, with infants too young to be vaccinated at highest risk of death. Pertussis MI programs have proven effective in reducing infant pertussis mortality in high-income countries using tetanus-diphtheria-acellular pertussis (Tdap) vaccines in their maternal and infant programs; however, these vaccines are cost-prohibitive for routine use in LMICs. The reach of antenatal care programs to deliver maternal pertussis vaccines, particularly with respect to infants at greatest risk of pertussis, needs to be further evaluated. Recognizing that decisions on the potential impact of pertussis MI in LMICs need, as a first step, robust contemporary mortality data for early infant pertussis, a symposium of global key experts was held. The symposium reviewed current evidence and identified knowledge gaps with respect to the infant pertussis disease burden in LMICs, and discussed proposed strategies to assess the potential impact of pertussis MI. © The Author 2016. Published by Oxford University Press for the Infectious Diseases

  13. A structured blood conservation programme reduces transfusions and costs in cardiac surgery.

    Science.gov (United States)

    Ternström, Lisa; Hyllner, Monica; Backlund, Erika; Schersten, Henrik; Jeppsson, Anders

    2014-11-01

    Transfusions of blood products can be lifesaving, but they are also associated with considerable risks and adverse effects, including immune response and infections. In cardiac surgery, transfusions have also been associated with increased mortality. We prospectively studied the effects of a structured programme to reduce transfusions and transfusion-associated costs in cardiac surgery. The programme included: (i) education of all staff about the risks and benefits of blood transfusions; (ii) revised guidelines for transfusions; and (iii) a transfusion log where indication for transfusion, status of the patient and prescribing physician were registered. Transfusion prevalence, complications and costs for blood products were registered for all acute and elective cardiac operations during a 12-month period before (n = 1128) and after (n = 1034) the programme was started. The two time periods were compared. In addition, the prevalence of transfusions was registered for 2 more years after the programme was initiated. The first year after the programme was initiated the proportion of patients transfused with red blood cell concentrate decreased by 21.8% (from 58.2 to 45.5%, P platelets by 21.0% (from 20.5 to 16.2%, P = 0.010). Reoperations for bleeding (5.8 vs 5.0%), early complication rate and 30-day mortality (2.5 vs 2.6%) were not significantly different before and after the start date. Based on the 2009 institutional prices for red blood cell concentrate (102 €/unit), plasma (35 €/unit) and platelets (290 €/unit), the savings on blood products were €161,623 during the first 12 months after the programme was launched. The proportion of patients transfused with any blood product was 60.9% before the programme was started and 48.3, 54.0 and 50.7% 1-3 years after its start (all P conservation programme reduces transfusions and costs for blood products in cardiac surgery, without any signs of compromised medical safety. The effects of introducing such a programme

  14. Factors Affecting the Immunity to Respiratory Syncytial Virus: From Epigenetics to Microbiome

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    Wendy Fonseca

    2018-02-01

    Full Text Available Respiratory syncytial virus (RSV is a common pathogen that infects virtually all children by 2 years of age and is the leading cause of hospitalization of infants worldwide. While most children experience mild symptoms, some children progress to severe lower respiratory tract infection. Those children with severe disease have a much higher risk of developing childhood wheezing later in life. Many risk factors are known to result in exacerbated disease, including premature birth and early age of RSV infection, when the immune system is relatively immature. The development of the immune system before and after birth may be altered by several extrinsic and intrinsic factors that could lead to severe disease predisposition in children who do not exhibit any currently known risk factors. Recently, the role of the microbiome and the resulting metabolite profile has been an area of intense study in the development of lung disease, including viral infection and asthma. This review explores both known risk factors that can lead to severe RSV-induced disease as well as emerging topics in the development of immunity to RSV and the long-term consequences of severe infection.

  15. [Vaccination against hepatitis B. Impact of vaccination programmes after 20 years of use in Spain. Is it time for a change?].

    Science.gov (United States)

    Arístegui Fernández, Javier; Díez-Domingo, Javier; Marés Bermúdez, Josep; Martinón Torres, Federico

    2015-02-01

    The highest incidence rate of hepatitis B (HB) in Spain is detected in adults between 20 and 54 years old, whereas the incidence in children under 1 year old is almost nil. The low prevalence of HB in children under 1 year is mainly due to the success of gestational screening strategies for the detection of HBsAg(+) in pregnant women, and vaccination campaigns during childhood. Currently, in Spain, the last dose of the HB included in the national childhood immunization program is administered at 6 months of age, although some studies show that delaying the age of the administration of the last dose of HB vaccine and increasing the time between doses, may improve immune memory by offering greater protection against this virus in the adulthood. In this article, the impact of HB vaccination in Spain is reviewed, and other potential vaccination strategies in our environment are discussed, such as extending the interval between doses, and administering the last dose in the second year of life, adapting the valid strategy in Spain to the current epidemiological context in order to reduce the prevalence of HB in adulthood. Copyright © 2015. Published by Elsevier España.

  16. Childhood Emergencies

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    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  17. Characteristics of mobile phone access and usage in rural and urban Guatemala: assessing feasibility of text message reminders to increase childhood immunizations.

    Science.gov (United States)

    Domek, Gretchen J; Contreras-Roldan, Ingrid L; Asturias, Edwin J; Bronsert, Michael; Bolaños Ventura, Guillermo Antonio; O'Leary, Sean T; Kempe, Allison; Bull, Sheana

    2018-01-01

    Despite efforts to promote vaccination in low- and middle-income countries (LMICs), over 20 million infants remain under-immunized and at risk for unnecessary morbidity and mortality. Mobile health technologies, such as Short Message Service (SMS) texts, have tremendous and untapped potential for disease management. Patient reminder systems are an important mechanism for improving childhood vaccination coverage and can be easily adapted to SMS platforms. However, current research lacks an understanding of the barriers and facilitators to mHealth program design, implementation, and scale in LMICs. We analyzed survey data collected March-November 2016 at the enrollment visit from a randomized controlled trial conducted at public health clinics in urban and rural Guatemala. Participants included eligible infants 6 weeks to 6 months of age receiving the first dose of the primary immunization series. At least one parent needed to own a mobile phone and be capable of deciphering SMS. Chi-square or Fisher's exact and Student's t-test were used to assess significance levels in demographic differences to describe factors that contribute to the feasibility of using an SMS-based vaccination reminder system. Of 1,088 families approached for enrollment, 871 were eligible and 720 (82.7%) participated with equal numbers of urban and rural children enrolled; 54 parents did not own a mobile phone with SMS capability and three parents could not use SMS. There was no significant difference between urban and rural maternal mobile phone ownership (94.4% vs. 93.3%, P=0.53), but more urban fathers owned mobile phones (72.8% vs. 47.1%, Pphones (93.9% vs. 61.1%, Pphones present in the home (Pphone access, usage, and preferences for voice and text communication across rural and urban populations of an LMIC that can be used to inform future mHealth interventions. Our findings suggest that offering a combination of more traditional communication methods with newer, modern technologies may be

  18. Hepatitis A immunity and region-of-origin in a Swiss prison.

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    Getaz, Laurent; Casillas, Alejandra; Motamed, Sandrine; Gaspoz, Jean-Michel; Chappuis, Francois; Wolff, Hans

    2016-06-13

    Purpose - The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population. Design/methodology/approach - The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland's largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician. Findings - In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026). Originality/value - In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient's area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.

  19. Childhood Determinants of Adult Psychiatric Disorder

    Science.gov (United States)

    Fryers, Tom; Brugha, Traolach

    2013-01-01

    The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then

  20. Childhood determinants of adult psychiatric disorder.

    Science.gov (United States)

    Fryers, Tom; Brugha, Traolach

    2013-01-01

    The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then

  1. Assessing the efficacy of the healthy eating and lifestyle programme (HELP compared with enhanced standard care of the obese adolescent in the community: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Christie Deborah

    2011-11-01

    Full Text Available Abstract Background The childhood obesity epidemic is one of the foremost UK health priorities. Childhood obesity tracks into adult life and places individuals at considerable risk for diabetes, cardiovascular disease, liver disease and other morbidities. There is widespread need for paediatric lifestyle programmes as change may be easier to accomplish in childhood than later in life. Study Design/Method The study will evaluate the management of adolescent obesity by conducting a Medical Research Council complex intervention phase III efficacy randomised clinical trial of the Healthy Eating Lifestyle Programme within primary care. The study tests a community delivered multi-component intervention designed for adolescents developed from best practice as identified by National Institute for Health and Clinical Excellence. The hospital based pilot reduced body mass index and improved health-related quality of life. Subjects will be individually randomised to receiving either the Healthy Eating Lifestyle Programme (12 fortnightly family sessions or enhanced standard care. Baseline and follow up assessments will be undertaken blind to allocation status. A health economic evaluation is also being conducted. 200 obese young people (13-17 years, body mass index > 98th centile for age and sex will be recruited from primary care within the greater London area. The primary hypothesis is that a motivational and solution-focused family-based weight management programme delivered over 6 months is more efficacious in reducing body mass index in obese adolescents identified in the community than enhanced standard care. The primary outcome will be body mass index at the end of the intervention, adjusted for baseline body mass index, age and sex. The secondary hypothesis is that the Healthy Eating Lifestyle Programme is more efficacious in improving quality of life and psychological function and reducing waist circumference and cardiovascular risk factors in

  2. Recent Coverage of Early Childhood Education Approaches in Open Access Early Childhood Journals

    Science.gov (United States)

    Keskin, Burhanettin

    2016-01-01

    A content analysis of the coverage of the major approaches to early childhood education in the early childhood research journals, published between 2010 and 2014, that are early childhood research oriented and have free online access were investigated. Among 21 journals in early childhood education, two journals were selected for the content…

  3. Clinical aspects of obesity in childhood and adolescence.

    Science.gov (United States)

    Kiess, W; Galler, A; Reich, A; Müller, G; Kapellen, T; Deutscher, J; Raile, K; Kratzsch, J

    2001-02-01

    The level of fatness of a child at which morbidity acutely and/or later in life increases is determined on an acturial basis. Direct measurements of body fat content, e.g. hydrodensitometry, bioimpedance, or DEXA, are useful tools in scientific studies. However, body mass index (BMI) is easy to calculate and is generally accepted now to be used to define obesity in children and adolescents clinically. An increased risk of death from cardiovascular disease in adults has been found in subjects whose BMI had been greater than the 75th percentile as adolescents. Childhood obesity seems to substantially increase the risk of subsequent morbidity whether or not obesity persists into adulthood. The genetic basis of childhood obesity has been elucidated to some extent through the discovery of leptin, the ob gene product, and the increasing knowledge on the role of neuropeptides such as POMC, neuropeptide Y (NPY) and the melanocyte concentrating hormone receptors (for example, MC4R). Environmental/exogenous factors largely contribute to the development of a high degree of body fatness early in life. Twin studies suggest that approximately 50% of the tendency toward obesity is inherited. There are numerous disorders including a number of endocrine disorders (Cushing's syndrome, hypothyroidism, etc.) and genetic syndromes (Prader-Labhard-Willi syndrome, Bardet Biedl syndrome, etc.) that can present with obesity. A simple diagnostic algorithm allows for the differentiation between primary or secondary obesity. Among the most common sequelae of primary childhood obesity are hypertension, dyslipidemia, back pain and psychosocial problems. Therapeutic strategies include psychological and family therapy, lifestyle/behaviour modification and nutrition education. The role of regular exercise and exercise programmes is emphasized. Surgical procedures and drugs used in adult obesity are still not generally recommended in children and adolescents with obesity. As obesity is the most

  4. Childhood Stress

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Childhood Stress KidsHealth / For Parents / Childhood Stress What's in this ... and feel stress to some degree. Sources of Stress Stress is a function of the demands placed ...

  5. Dental complications of rickets in early childhood: case report on 2 young girls.

    Science.gov (United States)

    Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

    2014-04-01

    Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

  6. Traumatic experiences in childhood and psychopathy: a study on a sample of violent offenders from Italy

    Directory of Open Access Journals (Sweden)

    Giuseppe Craparo

    2013-12-01

    Full Text Available Background: The link between early traumatic experiences of abuse/neglect and criminal behaviour has been widely demonstrated. Less is known, however, about the relationship between these experiences and the development of psychopathic personality. Objective: This study investigated childhood relational trauma in a group of violent offenders from Italy. We hypothesised a higher level of early relational trauma associated with higher scores on psychopathy. Method: Twenty-two offenders convicted for violent crimes aged 22–60 (M=38, SD=11 participated in this study. Participants were selected by the Italian justice system for an experimental research programme aiming at the evaluation of psychopathic personality traits among violent offenders. Within the group, 14 participants (64% had committed murder, 4 (18% had committed rape, and 4 (18% were convicted child sex offenders. The Traumatic Experience Checklist was used to assess childhood relational trauma; the Hare Psychopathy Checklist—Revised (PCL-R was used to assess psychopathy. Results: There was a high prevalence of childhood experiences of neglect and abuse among the offenders. Higher levels of childhood relational trauma were found among participants who obtained high scores on the PCL-R. There was also a significant negative association between age of first relational trauma and psychopathy scores. Conclusions: Findings of this study suggest that an early exposure to relational trauma in childhood can play a relevant role in the development of more severe psychopathic traits.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  7. [Impact of childhood sexual abuse on the sexual and affective relationships of adult women].

    Science.gov (United States)

    López, Sílvia; Faro, Concepció; Lopetegui, Lourdes; Pujol-Ribera, Enriqueta; Monteagudo, Mònica; Cobo, Jesús; Fernández, María Isabel

    To analyse perceived sexual satisfaction, sexual dysfunction, satisfaction with affective relationships and confidence and communication in existing relationships, related to a past history of childhood sexual abuse (CSA) and type suffered, among women treated as part of the Catalonian Sexual and Reproductive Health Care Programme (PASSIR). Multicentric, descriptive, cross-sectional study. A total of 1,013 women over the age of 18 years, who underwent psychological therapy at any of the 24 PASSIR centres, were enrolled. A structured, anonymised, self-administered Sex History Questionnaire adapted from Wyatt (1985) & Dubé et al. (2005), and the Female Sexual Function Index (Rosen, 2000), were used. Statistical analysis was descriptive, bivariate and multivariate. Women who suffered childhood sexual abuse had a significantly higher prevalence of sexual dysfunction, with lower perceived sexual satisfaction. CSA with penetration or attempted penetration was associated with greater arousal difficulties and greater rejection. Women who experienced CSA were less confident and experienced greater communication difficulties with their partner. It is necessary to identify potential childhood sexual abuse among women who seek therapy due to relationship problems. It is also necessary to continue research into protective factors and therapeutic interventions to alleviate the consequences of CSA in adult life. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Pregnancy exposures and risk of childhood asthma admission in a population birth cohort.

    Science.gov (United States)

    Algert, Charles S; Bowen, Jennifer R; Lain, Samantha L; Allen, Hugh D; Vivian-Taylor, Josephine M; Roberts, Christine L

    2011-12-01

    There is increasing interest in the potential for in utero exposures to affect the risk of asthma. We used population data to explore the associations between perinatal conditions and the risk of hospital admission with asthma between the 2nd and 5th birthday. The study population was 240,511 singleton infants born during 2001-2003. Birth records and longitudinally linked hospital admissions were used to identify asthma admissions and to model potential risk factors. A total of 7245 children (3.0%) had one or more childhood admissions with asthma. In utero infectious exposures associated with childhood asthma were maternal antenatal admission with a urinary tract infection (UTI) [adjusted odds ratio (aOR) = 1.49, 95% confidence interval (1.23-1.79)] and pre-term pre-labor rupture of membranes (PROM) [aOR = 1.23 (1.04-1.45)]. There was no evidence that gestational age at time of first antenatal UTI admission (UTI and PROM carry an increased risk of childhood asthma admission, this suggests that the immune system response generally is the relevant factor rather than a specific organism. The season-associated risk is consistent with early pregnancy exposures such as the winter flu season or low vitamin D. © 2011 John Wiley & Sons A/S.

  9. Sociocultural dimensions of HIV/AIDS among Middle Eastern immigrants in the US: bridging culture with HIV/AIDS programmes.

    Science.gov (United States)

    Ehsanzadeh-Cheemeh, Parvaneh; Sadeque, Abul; Grimes, Richard M; Essien, E James

    2009-09-01

    The population of Middle Eastern immigrants in the US has been increasing dramatically over the past 30 years, growing from 200,000 in 1970 to 1.5 million in 2000. These immigrants and their descendants constitute an important new population of interest for public health and other social programmes. With this addition to the cultural diversity of American society, it is important for healthcare programmes to be responsive to the unique cultural needs of those of Middle Eastern origin and to include them in healthcare curricula. This need is particularly imperative for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) intervention programmes, where the reduction of risky behaviours is essential to controlling the epidemic. When Middle Easterners emigrate to the US they must adjust to the American culture, which leads to preservation of some aspects of their culture and adjustment of behaviors to match American customs. This article aims to present sociocultural factors of HIV risk behaviours that are specific to Middle Eastern culture. The article also provides recommendations for HIV/AIDS-culturally appropriate intervention programmes.

  10. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity.

    Science.gov (United States)

    Schmidt, M D; Magnussen, C G; Rees, E; Dwyer, T; Venn, A J

    2016-07-01

    The objective of this study was to examine whether childhood cardiorespiratory fitness attenuates or modifies the long-term cardiometabolic risks associated with childhood obesity. The study consisted of a 20-year follow-up of 1792 adults who participated in the 1985 Australian Schools Health and Fitness Survey when they were 7-15 years of age. Baseline measures included a 1.6-km run to assess cardiorespiratory fitness and waist circumference to assess abdominal adiposity. At follow-up, participants attended study clinics where indicators of Metabolic Syndrome (MetS) (waist circumference, blood pressure, fasting blood glucose and lipids) were measured and cardiorespiratory fitness was reassessed using a submaximal graded exercise test. Both high waist circumference and low cardiorespiratory fitness in childhood were significant independent predictors of MetS in early adulthood. The mutually adjusted relative risk of adult MetS was 3.00 (95% confidence interval: 1.85-4.89) for children in the highest (vs lowest) third of waist circumference and 0.64 (95% confidence interval: 0.43-0.96) for children with high (vs low) cardiorespiratory fitness. No significant interaction between waist circumference and fitness was observed, with higher levels of childhood fitness associated with lower risks of adult MetS among those with either low or high childhood waist circumference values. Participants who had both high waist circumference and low cardiorespiratory fitness in childhood were 8.5 times more likely to have MetS in adulthood than those who had low waist circumference and high cardiorespiratory fitness in childhood. Regardless of childhood obesity status, participants with low childhood fitness who increased their relative fitness by adulthood had a substantially lower prevalence of MetS than those who remained low fit. Childhood waist circumference and cardiorespiratory fitness are both strongly associated with cardiometabolic health in later life. Higher levels of

  11. Investing in the foundation of sustainable development: pathways to scale up for early childhood development

    Science.gov (United States)

    Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

    2018-01-01

    Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. PMID:27717610

  12. The need for theory evaluation in global citizenship programmes: The case of the GCSA programme.

    Science.gov (United States)

    Goodier, Sarah; Field, Carren; Goodman, Suki

    2018-02-01

    Many education programmes lack a documented programme theory. This is a problem for programme planners and evaluators as the ability to measure programme success is grounded in the plausibility of the programme's underlying causal logic. Where the programme theory has not been documented, conducting a theory evaluation offers a foundational evaluation step as it gives an indication of whether the theory behind a programme is sound. This paper presents a case of a theory evaluation of a Global Citizenship programme at a top-ranking university in South Africa, subsequently called the GCSA Programme. This evaluation highlights the need for documented programme theory in global citizenship-type programmes for future programme development. An articulated programme theory produced for the GCSA Programme, analysed against the available social science literature, indicated it is comparable to other such programmes in terms of its overarching framework. What the research found is that most other global citizenship programmes do not have an articulated programme theory. These programmes also do not explicitly link their specific activities to their intended outcomes, making demonstrating impact impossible. In conclusion, we argue that taking a theory-based approach can strengthen and enable outcome evaluations in global citizenship programmes. Copyright © 2017. Published by Elsevier Ltd.

  13. Distorted food pyramid in kids programmes: a content analysis of television advertising watched in Switzerland.

    Science.gov (United States)

    Keller, Simone K; Schulz, Peter J

    2011-06-01

    In the light of increasing childhood obesity, the role of food advertisements relayed on television (TV) is of high interest. There is evidence of food commercials having an impact on children's food preferences, choices, consumption and obesity. We describe the product categories advertised during kids programmes, the type of food promoted and the characteristics of food commercials targeting children. A content analysis of the commercials aired during the kids programmes of six Swiss, one German and one Italian stations was conducted. The commercials were collected over a 6-month period in 2006. Overall, 1365 h of kids programme were recorded and 11 613 advertisements were found: 3061 commercials (26.4%) for food, 2696 (23.3%) promoting toys, followed by those of media, cleaning products and cosmetics. Regarding the broadcast food advertisements, 55% were for fast food restaurants or candies. The results of the content analysis suggest that food advertising contributes to the obesity problem: every fourth advertisement is for food, half of them for products high in sugar and fat and hardly any for fruit or vegetables. Long-term exposure to this distortion of the pyramid of recommended food should be considered in the discussion of legal restrictions for food advertising targeting children.

  14. Polio Eradication Initiative contribution in strengthening immunization and integrated disease surveillance data management in WHO African region, 2014.

    Science.gov (United States)

    Poy, Alain; Minkoulou, Etienne; Shaba, Keith; Yahaya, Ali; Gaturuku, Peter; Dadja, Landoh; Okeibunor, Joseph; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The PEI Programme in the WHO African region invested in recruitment of qualified staff in data management, developing data management system and standards operating systems since the revamp of the Polio Eradication Initiative in 1997 to cater for data management support needs in the Region. This support went beyond polio and was expanded to routine immunization and integrated surveillance of priority diseases. But the impact of the polio data management support to other programmes such as routine immunization and disease surveillance has not yet been fully documented. This is what this article seeks to demonstrate. We reviewed how Polio data management area of work evolved progressively along with the expansion of the data management team capacity and the evolution of the data management systems from initiation of the AFP case-based to routine immunization, other case based disease surveillance and Supplementary immunization activities. IDSR has improved the data availability with support from IST Polio funded data managers who were collecting them from countries. The data management system developed by the polio team was used by countries to record information related to not only polio SIAs but also for other interventions. From the time when routine immunization data started to be part of polio data management team responsibility, the number of reports received went from around 4000 the first year (2005) to >30,000 the second year and to >47,000 in 2014. Polio data management has helped to improve the overall VPD, IDSR and routine data management as well as emergency response in the Region. As we approach the polio end game, the African Region would benefit in using the already set infrastructure for other public health initiative in the Region. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Secular trends in new childhood epidemics: insights from evolutionary medicine.

    Science.gov (United States)

    Brüne, Martin; Hochberg, Ze'ev

    2013-10-21

    In the last few decades, pediatric medicine has observed a dramatic increase in the prevalence of hitherto rare illnesses, among which obesity, diabetes, allergies and other autoimmune diseases stand out. In addition, secular trends towards earlier onset of puberty and sexual activity contribute to the psychological problems of youth and adolescents. All this has occurred in spite of the improved health care provision for children, yet traditional concepts of medicine have failed to explain these new "epidemics". A recent conference and science school of the European Society of Paediatric Endocrinology (ESPE) in Acre, Israel, has taken up this challenge. Experts across disciplines including medicine, anthropology and developmental psychology discussed potential causes of childhood ill-health from an evolutionary point-of-view. Seen from an evolutionary vantage point, the "epidemics" of childhood obesity, diabetes and psychological dysfunction appear, in part, to be related to a mismatch between ancestral adaptations and novel environmental contingencies. These include changing exposures to pathogens, which impact on the function of the immune system, as well as changing patterns of parenting, which influence the timing of puberty and the risk for developing psychopathology.

  16. Programme documentation to control programme for Solar-tracker; Programdokumentation til styringsprogram til Solar-tracker

    Energy Technology Data Exchange (ETDEWEB)

    Rudbeck, C.

    1995-07-01

    The report contains the programme documentation partly for a programme to control of a tracking system and partly a programme, which uses this programme to make measurements of transmittance for covering layer. Both the transmittance measurement programme and the programme is built in Borland Pascal v7.0, and is compiled in Real mode for the use on a processor of the 80X86-family. The source code for the programme for transmittance measurements and the programmes (the positioning routines) are described in Appendix B. (EHS)

  17. Does an exercise programme integrating the Nintendo Wii-Fit Balance Board improve balance in ambulatory children with cerebral palsy?

    OpenAIRE

    Cooper, T.; Williams, Jonathan M.

    2017-01-01

    Background: Cerebral palsy is a common childhood movement disorder with balance impairment a common complaint. Active video games such as the Nintendo Wii-Fit have been found to be a valuable therapeutic tool, enjoyed by a variety of populations including children with CP, but a synthesis of the research investigating its specific use for balance in children with CP has yet to be conducted.\\ud \\ud Objectives: To determine the effectiveness of a Nintendo Wii-Fit Balance board programme in impr...

  18. Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

    Science.gov (United States)

    Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

    2016-10-01

    While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

  19. Increasing socioeconomic inequality in childhood undernutrition in urban India: trends between 1992-93, 1998-99 and 2005-06.

    Science.gov (United States)

    Kumar, Abhishek; Kumari, Divya; Singh, Aditya

    2015-10-01

    This article examines the trends and pattern in socioeconomic inequality in stunting, underweight and wasting among children aged inequality in childhood undernutrition in urban India has increased over the study period. The salient findings of this study call for separate programmes targeting the children of lower socioeconomic groups in urban population of India. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  20. Effect of intakes of n-3 long chain polyunsaturated fatty acids during pregnancy and early childhood оn development, morbidity and immunity of in infants in fist year of life: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2014-03-01

    Full Text Available Background: at present, there are considered the efficient mechanisms existed by which diets high in n-3 LC PUFAs during pregnancy and early childhood may modulate the development of innative immune disorders and promote the adequate formation of immune system both on general and local levels. Early availability of n-3 LC PUFA could contribute to the normal growth and development, decrease risk factors of diseases or pathological disorders in infants. Goals: to assess the relationship between n-3 LC PUFAs intakes during pregnancy and postnatally and development, morbidity and immunity of infants in first year of life. A retrospective study was conducted using interview method of 300 women, whose children reached the age of one year. Elaborated questionnaires were filled in by pediatricians throughout their daily working hours while attending the patients. Was conducted assessment of frequency of common diseases and disorders like respiratory diseases, functional intestinal disorders and atopic diseases. Were investigated immunity of infants assessing the content of IgA, IgG and IgM by immunological methods and detected DHA, EPA (n-3 LC PUFAs and AA (n-6 LC PUFAs by gas chromatographic analysis in blood serum of children. The outcomes of the study were analysed and processed using statistical methods. Retrospective clinical findings indicate on higher incidence of acute respiratory tract and atopic diseases as well as functional disorders of the gastrointestinal tract in infants whose mothers did not use seafood in their diets during the pregnancy and in the lactating period. The research of immunity of children showed no difference in concentration of IgG and IgM in blood serum (p >> 0,05 but significant difference for IgA concentrations in plasma. In infants of n-3 LC PUFAs group IgA concentration was higher compared to opposite group. The fatty acid composition of the blood serum showed changes in the content of the main representatives of n-3

  1. Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC).

    Science.gov (United States)

    Marcotte, Erin L; Thomopoulos, Thomas P; Infante-Rivard, Claire; Clavel, Jacqueline; Petridou, Eleni Th; Schüz, Joachim; Ezzat, Sameera; Dockerty, John D; Metayer, Catherine; Magnani, Corrado; Scheurer, Michael E; Mueller, Beth A; Mora, Ana M; Wesseling, Catharina; Skalkidou, Alkistis; Rashed, Wafaa M; Francis, Stephen S; Ajrouche, Roula; Erdmann, Friederike; Orsi, Laurent; Spector, Logan G

    2016-04-01

    childhood ALL after prelabour caesarean delivery. If this association is causal, maladaptive immune activation due to an absence of stress response before birth in children born by prelabour caesarean delivery could be considered as a potential mechanism. National Cancer Institute. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Systemic Comorbidity in Children with Cataracts in Nigeria: Advocacy for Rubella Immunization

    Directory of Open Access Journals (Sweden)

    Roseline Duke

    2015-01-01

    Full Text Available Background. Congenital and developmental cataracts are leading causes of childhood blindness and severe visual impairment. They may be associated with systemic diseases including congenital heart diseases which are among the major causes of morbidity and mortality in childhood. The pattern of systemic comorbidities seen in children diagnosed with cataract in Calabar, Nigeria, was studied. Methods. A retrospective review was conducted on the children who had cataract surgery between 2011 and 2012. Diagnosis of the systemic condition was documented. Results. A total of 66 children were recruited for the study. Cardiac disease was seen in 26 children (39.9%, followed by delayed milestone in 16 (24.2%, intellectual disability in 14 (21.2%, deafness in 11 (16.7%, epilepsy in 4 (6.1%, and physical handicap in 3 (4.5% of them. Clinically confirmed Congenital Rubella Syndrome was seen in 30 (45% of the children. The pattern of CHD seen was as follows: patent ductus arteriosus in 16 (24.2% followed by ventricular-septal defect in 5 (7.6%, atrial-septal defect in 3 (4.5%, and pulmonary stenosis in 2 (3%. Conclusion. Systemic comorbidities, especially cardiac anomalies, are common among children with cataract in Nigeria. Congenital Rubella Syndrome may be a prominent cause of childhood cataract in our environment. Routine immunization of school girls against rubella is advocated as a measure to mitigate this trend.

  3. Coverage And Efficacy Of Measles Immunization In Rural Areas Of Aligarh

    Directory of Open Access Journals (Sweden)

    Z Khan

    1997-12-01

    Full Text Available Research Problem: How effective isthemeasles immu­nization programme in rural areas? Objectives: i To determine the vaccine coverage in eligible children. ii To estimate the seropositivity in immunized children iii To assess the decline in maternal antibody levels in 0 - 9 months old children. iv To study the socio - cultural variables in the study area. Study Design: Cross sectional study. Setting: Registered villages under Rural Health Train­ing Centre (RHTC, Jawan Block, Aligarh. Participants: Children in 0 - 5 yearrs age group, from 2104 house holds by systematic random sampling. Sample size: 456 children in 0 - 5 years age group. Study Variables: Age, sex, immunization status, measles antibody, type of family, overcrowding, literacy status of parents, occupation of parents. Statistical Analysis: By proportions. Result: 0-5 years age group made up 13.7% of the population. Most of the families belonged to lowe socio-economic groups. Measles immunization coveage was 64.5% with sero conversion in 96.5% children while failure rate of ya&tyne was 3.5%. Maternal mealses antibody level showed linear decline with age from 100% at 0 - 3 months to 1 8.4% at 6 - 9 months

  4. Childhood obesity in low- and middle-income countries.

    Science.gov (United States)

    Poskitt, E M E

    2014-11-01

    Overweight and obesity in childhood is an increasing problem for the less affluent countries of the world. The prevalence of overweight/obesity varies, not only between countries but across countries, depending on the environments in which children live. Changes in physical activity and diet are having adverse effects on children's nutrition. Greater affluence and urbanisation with more technology such as television in homes are associated with overweight. Affluence also brings the ability to purchase commercial, prepared 'fast-food' items, leading too often to disadvantageous effects on children's diets. The solutions to this rising tide of overweight/obesity seem to lie with broad-based programmes initiated at central government level or at more local community level but which are designed to reach across and throughout societies to enable families and communities to modify the unhealthy lifestyle which too often accompanies increasing affluence and development.

  5. Skin Immunization Obviates Alcohol-Related Immune Dysfunction

    Directory of Open Access Journals (Sweden)

    Rhonda M. Brand

    2015-11-01

    Full Text Available Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD and liver-sparing Meadows-Cook (MC diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM, directly to liver (hydrodynamic, or cutaneously (biolistic, ID. We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg, and myeloid-derived suppressor cell (MDSC populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH, antigen-specific cytotoxic T lymphocyte (CTL, and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.

  6. Childhood versus adulthood-onset autoinflammatory disorders: myths and truths intertwined

    Directory of Open Access Journals (Sweden)

    L. Cantarini

    2013-06-01

    Full Text Available Autoinflammatory disorders are characterized by spontaneous episodes of systemic inflammation deriving from inherited defects of the innate immune system. Childhood is usually the lifetime involved in most inherited autoinflammatory disorders, but a moderate number of patients may experience disease onset during adulthood. Herein we report our experience in the clinical and genetic approach to the diagnosis of autoinflammatory disorders in regard of the first 500 pediatric and adult patients evaluated during the period 2007-2012 in our Center, due to histories of periodically-recurring inflammatory attacks, giving emphasis to the differences observed according to patients’age and to the most relevant data differentiating child and adult-onset autoinflammatory disorders in the medical literature.

  7. The broader economic impact of vaccination: reviewing and appraising the strength of evidence.

    Science.gov (United States)

    Jit, Mark; Hutubessy, Raymond; Png, May Ee; Sundaram, Neisha; Audimulam, Jananie; Salim, Safiyah; Yoong, Joanne

    2015-09-03

    Microeconomic evaluations of public health programmes such as immunisation typically only consider direct health benefits and medical cost savings. Broader economic benefits around childhood development, household behaviour, and macro-economic indicators are increasingly important, but the evidence linking immunization to such benefits is unclear. A conceptual framework of pathways between immunisation and its proposed broader economic benefits was developed through expert consultation. Relevant articles were obtained from previous reviews, snowballing, and expert consultation. Articles were associated with one of the pathways and quality assessed using modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. We found 20 studies directly relevant to one or more pathways. Evidence of moderate quality from experimental and observational studies was found for benefits due to immunisation in improved childhood physical development, educational outcomes, and equity in distribution of health gains. Only modelling evidence or evidence outside the immunization field supports extrapolating these benefits to household economic behaviour and macro-economic indicators. Innovative use of experimental and observational study designs is needed to fill evidence gaps around key pathways between immunisation and many of its proposed economic benefits.

  8. Childhood obesity case statement.

    Science.gov (United States)

    Esposito, Paul W; Caskey, Paul; Heaton, Lisa E; Otsuka, Norman

    2013-04-01

    The goal of this publication is to raise awareness of the impact of childhood obesity on the musculoskeletal health of children and its potential long-term implications. Relevant articles dealing with musculoskeletal disorders either caused by or worsened by childhood obesity were reviewed through a Pub Med search. Efforts to recognize and combat the childhood obesity epidemic were also identified through Internet search engines. This case statement was then reviewed by the members of the pediatric specialty group of the US Bone and Joint Initiative, which represents an extensive number of organizations dealing with musculoskeletal health. Multiple musculoskeletal disorders are clearly caused by or worsened by childhood obesity. The review of the literature clearly demonstrates the increased frequency and severity of many childhood musculoskeletal disorders. Concerns about the long-term implications of these childhood onset disorders such as pain and degenerative changes into adulthood are clearly recognized by all the member organizations of the US Bone and Joint Initiative. It is imperative to recognize the long-term implications of musculoskeletal disorders caused by or worsened by childhood obesity. It is also important to recognize that the ability to exercise comfortably is a key factor to developing a healthy lifestyle and maintaining a healthy body weight. Efforts to develop reasonable and acceptable programs to increase physical activity by all facets of society should be supported. Further research into the long-term implications of childhood musculoskeletal disorders related to childhood obesity is necessary. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Maternal immunity enhances systemic recall immune responses upon oral immunization of piglets with F4 fimbriae.

    Science.gov (United States)

    Nguyen, Ut V; Melkebeek, Vesna; Devriendt, Bert; Goetstouwers, Tiphanie; Van Poucke, Mario; Peelman, Luc; Goddeeris, Bruno M; Cox, Eric

    2015-06-23

    F4 enterotoxigenic Escherichia coli (ETEC) cause diarrhoea and mortality in piglets leading to severe economic losses. Oral immunization of piglets with F4 fimbriae induces a protective intestinal immune response evidenced by an F4-specific serum and intestinal IgA response. However, successful oral immunization of pigs with F4 fimbriae in the presence of maternal immunity has not been demonstrated yet. In the present study we aimed to evaluate the effect of maternal immunity on the induction of a systemic immune response upon oral immunization of piglets. Whereas F4-specific IgG and IgA could be induced by oral immunization of pigs without maternal antibodies and by intramuscular immunization of pigs with maternal antibodies, no such response was seen in the orally immunized animals with maternal antibodies. Since maternal antibodies can mask an antibody response, we also looked by ELIspot assays for circulating F4-specific antibody secreting cells (ASCs). Enumerating the F4-specific ASCs within the circulating peripheral blood mononuclear cells, and the number of F4-specific IgA ASCs within the circulating IgA(+) B-cells revealed an F4-specific immune response in the orally immunized animals with maternal antibodies. Interestingly, results suggest a more robust IgA booster response by oral immunization of pigs with than without maternal antibodies. These results demonstrate that oral immunization of piglets with F4-specific maternal antibodies is feasible and that these maternal antibodies seem to enhance the secondary systemic immune response. Furthermore, our ELIspot assay on enriched IgA(+) B-cells could be used as a screening procedure to optimize mucosal immunization protocols in pigs with maternal immunity.

  10. Effects of a Hybrid Education Programme for Korean Mothers of Children with Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Je-Bog Yoo

    2017-12-01

    Full Text Available Atopic dermatitis (AD, a common childhood skin disorder, can limit a child’s learning and physical activities. South Korean mothers, as primary caregivers, experience anxiety and helplessness when caring for their ill children. The aim of this study was to develop a hybrid AD education programme (consisting of a face-to-face session followed by 8 online sessions and evaluate its effects on anxiety, caregiving efficacy and caregiving behaviour among mothers of children with AD. Twenty mothers of patients with AD treated in a South Korean hospital received one on-site session and 8 weekly online modules. After the intervention, mothers’ mean±standard deviation anxiety reduced (from 50.3 ± 14.2 to 31.7 ± 6.3 points, t = 5.75, p <0.001. Their caregiving efficacy and caregiving behaviour improved significantly, from 18.3 ± 3.5 to 29.4 ± 3.2 points (t = –9.64, p< 0.001 and from 47.7 ± 7.7 to 78.8 ± 4.9 points (t = –14.4, p <0.001, respectively. The effects of the hybrid education programme for this population were significant. Healthcare providers should consider examining the programme nationwide, including in rural areas, while investigating its long-term effects.

  11. U.S. Immunization program adult immunization activities and resources

    Science.gov (United States)

    Woods, LaDora O.; Bridges, Carolyn B.; Graitcer, Samuel B.; Lamont, Brock

    2016-01-01

    ABSTRACT Adults are recommended to receive vaccines based on their age, medical conditions, prior vaccinations, occupation and lifestyle. However, adult immunization coverage is low in the United States and lags substantially below Healthy People 2020 goals. To assess activities and resources designated for adult immunization programs by state and local health department immunization programs in the United States, we analyzed 2012 and 2013 data from the Centers for Disease Control and Prevention's (CDC) Program Annual Reports and Progress Assessments (PAPA) survey of CDC-funded immunization programs. Fifty-six of 64 funded US immunization programs' responses were included in the analysis. Eighty-two percent of (n = 46) programs reported having a designated adult immunization coordinator in 2012 and 73% (n = 41) in 2013. Of the 46 coordinators reported in 2012, 30% (n = 14) spent more than 50% of their time on adult immunization activities, and only 24% (n = 10) of the 41 adult coordinators in 2013 spent more than 50% of their time on adult immunization activities. In 2012, 23% (n = 13) of the 56 programs had a separate immunization coalition for adults and 68% (n = 38) included adult issues in their overall immunization program coalition. In 2013, 25% (n = 14) had a separate adult immunization coalition while 57% (n = 32) incorporated adult immunizations into their overall immunization program coalition. The results indicate substantial variation across the US in public health infrastructure to support adult immunizations. Continued assessment of adult immunization resources and activities will be important in improving adult immunization coverage levels though program support. With many programs having limited resources dedicated to improving adult immunization rates in the in US, efforts by the health departments to collaborate with providers and other partners in their jurisdictions to increase awareness, increase the use of proven strategies to improve

  12. A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities : the parenting early intervention pathfinder (PEIP)

    OpenAIRE

    Lindsay, Geoff; Strand, Steve; Davis, Hilton

    2011-01-01

    Abstract Background There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling...

  13. Herd immunity to Newcastle disease virus in broiler flocks in Israel.

    Science.gov (United States)

    Wiseman, Anat; Berman, Elyakum M

    2017-08-01

    Due to the ongoing need to protect poultry from virulent Newcastle disease virus, all commercial poultry flocks in Israel are vaccinated according to a defined programme using a combination of live and inactivated vaccines. The vaccination protocol for broilers during the years of the study comprised a live vaccine administered by spray on the day of hatching, inactivated vaccine by subcutaneous injection at 10-12 days of age, and another live vaccine given by aerosol at 17-21 days of age. A cross-sectional study was designed in order to examine the influence of herd immunity on the risk of Newcastle disease outbreak in broiler flocks. The study was based on the extensive field data kept in the Poultry Health Laboratories database. The results of serology tests employing haemagglutination inhibition for Newcastle disease virus were analysed and crossed with the list of flocks that had been diagnosed with ND in the years 2007-2014. At the peak of induced immunization (fifth week of growth), 87.5% of the tested flocks had achieved herd immunity (≥85% of birds in the flock with an HI titre ≥4). Based on a logistic regression model, the odds ratio for ND in flocks without herd immunity was 3.7 (95% CI 1.8-7.3, P-value < 0.001). The higher the percentage of birds with low HI titres the higher the risk of ND outbreak. Under field conditions, herd immunity is an important indicator for the risk of ND outbreak.

  14. Parent opinions about use of text messaging for immunization reminders.

    Science.gov (United States)

    Ahlers-Schmidt, Carolyn Rose; Chesser, Amy K; Paschal, Angelia M; Hart, Traci A; Williams, Katherine S; Yaghmai, Beryl; Shah-Haque, Sapna

    2012-06-06

    Adherence to childhood immunization schedules is a function of various factors. Given the increased use of technology as a strategy to increase immunization coverage, it is important to investigate how parents perceive different forms of communication, including traditional means and text-message reminders. To examine current forms of communication about immunization information, parents' satisfaction levels with these communication modes, perceived barriers and benefits to using text messaging, and the ideal content of text messages for immunization reminders. Structured interviews were developed and approved by two Institutional Review Boards. A convenience sample of 50 parents was recruited from two local pediatric clinics. The study included a demographics questionnaire, the shortened form of the Test of Functional Health Literacy for Adults (S-TOFHLA), questions regarding benefits and barriers of text communication from immunization providers, and preferred content for immunization reminders. Content analyses were performed on responses to barriers, benefits, and preferred content (all Cohen's kappas > 0.70). Respondents were mostly female (45/50, 90%), white non-Hispanic (31/50, 62%), between 20-41 years (mean = 29, SD 5), with one or two children (range 1-9). Nearly all (48/50, 96%) had an S-TOFHLA score in the "adequate" range. All parents (50/50, 100%) engaged in face-to-face contact with their child's physician at appointments, 74% (37/50) had contact via telephone, and none of the parents (0/50, 0%) used email or text messages. Most parents were satisfied with the face-to-face (48/50, 96%) and telephone (28/50, 75%) communication. Forty-nine of the 50 participants (98%) were interested in receiving immunization reminders by text message, and all parents (50/50, 100%) were willing to receive general appointment reminders by text message. Parents made 200 comments regarding text-message reminders. Benefits accounted for 63.5% of comments (127/200). The

  15. The Effects of Sleep Extension on Sleep, Performance, Immunity and Physical Stress in Rugby Players.

    Science.gov (United States)

    Swinbourne, Richard; Miller, Joanna; Smart, Daniel; Dulson, Deborah K; Gill, Nicholas

    2018-05-10

    (1) Background: The purpose of the present study was to examine the efficacy of sleep extension in professional rugby players. The aims were to: (i) characterise sleep quantity in elite rugby players and determine changes in immune function and stress hormone secretion during a pre-season training programme; (ii) evaluate the efficacy of a sleep extension intervention in improving sleep, markers of physical stress, immune function and performance. (2) Methods: Twenty five highly trained athletes from a professional rugby team (age (mean ± SD) 25 ± 2.7 years; height 1.87 ± 0.07 m; weight 105 ± 12.1 kg) participated in a six week pre-post control-trial intervention study. Variables of sleep, immune function, sympathetic nervous activity, physiological stress and reaction times were measured. (3) Results: Sleep extension resulted in a moderate improvement in sleep quality scores ([mean; ± 90% confidence limits] −24.8%; ± 54.1%) and small to moderate increases in total sleep time (6.3%; ± 6.3%) and time in bed (7.3%; ± 3.6%). In addition, a small decrease in cortisol (−18.7%; ± 26.4%) and mean reaction times (−4.3%; ± 3.1%) was observed following the intervention, compared to the control. (4) Conclusions: Professional rugby players are at risk of poor sleep during pre-season training, with concomitant rises in physical stress. Implementing a sleep extension programme among professional athletes is recommended to improve sleep, with beneficial changes in stress hormone expression and reaction time performance.

  16. The Effects of Sleep Extension on Sleep, Performance, Immunity and Physical Stress in Rugby Players

    Directory of Open Access Journals (Sweden)

    Richard Swinbourne

    2018-05-01

    Full Text Available (1 Background: The purpose of the present study was to examine the efficacy of sleep extension in professional rugby players. The aims were to: (i characterise sleep quantity in elite rugby players and determine changes in immune function and stress hormone secretion during a pre-season training programme; (ii evaluate the efficacy of a sleep extension intervention in improving sleep, markers of physical stress, immune function and performance. (2 Methods: Twenty five highly trained athletes from a professional rugby team (age (mean ± SD 25 ± 2.7 years; height 1.87 ± 0.07 m; weight 105 ± 12.1 kg participated in a six week pre-post control-trial intervention study. Variables of sleep, immune function, sympathetic nervous activity, physiological stress and reaction times were measured. (3 Results: Sleep extension resulted in a moderate improvement in sleep quality scores ([mean; ± 90% confidence limits] −24.8%; ± 54.1% and small to moderate increases in total sleep time (6.3%; ± 6.3% and time in bed (7.3%; ± 3.6%. In addition, a small decrease in cortisol (−18.7%; ± 26.4% and mean reaction times (−4.3%; ± 3.1% was observed following the intervention, compared to the control. (4 Conclusions: Professional rugby players are at risk of poor sleep during pre-season training, with concomitant rises in physical stress. Implementing a sleep extension programme among professional athletes is recommended to improve sleep, with beneficial changes in stress hormone expression and reaction time performance.

  17. Childhood predictors of adult adiposity: findings from a longitudinal study.

    Science.gov (United States)

    McLeod, Geraldine Fh; Fergusson, David M; Horwood, L John; Boden, Joseph M; Carter, Frances A

    2018-03-23

    The increasing prevalence of overweight and obesity has become a key challenge for New Zealand. The purpose of the present study was to examine childhood risk factors for adult adiposity in a longitudinal birth cohort. Data were gathered from the Christchurch Health and Development Study (CHDS), a birth cohort of 1,265 children born in Christchurch in 1977. Associations were examined between socio-demographic background, perinatal factors, infant and child characteristics, family functioning/child maltreatment and adiposity at ages 30 and 35 years. Adiposity was assessed using body mass index scores. At ages 30 and 35, approximately one-third of cohort members were overweight and one-fifth were obese. Generalised estimating equation models showed that statistically significant (p<.05) predictors of later adiposity and overweight/obesity were: male gender, being born into a single-parent family, having parents with larger body size, higher early infant growth, limited or no breastfeeding, lower levels of cognitive ability and exposure to severe sexual abuse. Overweight and obesity was associated with social and family background, biological endowment, cognitive ability and childhood adversity factors. These findings may assist in the development of structured adiposity intervention programmes in conjunction with established community organisations specialising in child and family health.

  18. Immunization Information System and Informatics to Promote Immunizations: Perspective From Minnesota Immunization Information Connection.

    Science.gov (United States)

    Muscoplat, Miriam Halstead; Rajamani, Sripriya

    2017-01-01

    The vision for management of immunization information is availability of real-time consolidated data and services for all ages, to clinical, public health, and other stakeholders. This is being executed through Immunization Information Systems (IISs), which are population-based and confidential computerized systems present in most US states and territories. Immunization Information Systems offer many functionalities, such as immunization assessment reports, client follow-up, reminder/recall feature, vaccine management tools, state-supplied vaccine ordering, comprehensive immunization history, clinical decision support/vaccine forecasting and recommendations, data processing, and data exchange. This perspective article will present various informatics tools in an IIS, in the context of the Minnesota Immunization Information Connection.

  19. The Study of Supporting Learning Sufficiency Economy Philosophy of Students Majoring in Early Childhood Education by Backyard Gardening Activity

    Directory of Open Access Journals (Sweden)

    Vannisa Hakoon

    2017-06-01

    Full Text Available This research was aimed to make students majoring in early childhood education learn about the Sufficiency Economy Philosophy by integrating learning process through practicing planting vegetables and herbs, harvesting, processing products and selling the products at the CEECE farm. This case study include 104 students in total, 2 males students and 102 females students majoring in early childhood education in the second semester of academic year 2016, Mahasarakham university. The researcher integrated the learning with subjects in early childhood education field such as Story and literature for young Children, Thai languages and literacy for young children, Independent study in early childhood education and Early childhood education quality assurance. The research instruments were 1 CEECE Farm area for practicing growing vegetables and herbs and 2 Self Reflection from the students. Data collection was conducted through three phases including 1 preparation 2 process and 3 data collection. The researcher analyzed the content by describing and drawing conclusions from students opinions about the learning. This research revealed: 1. Factors affecting success or barriers to learning include students, location, materials, budget, academic advisors and other factors such as climate and workloads of students. 2. Students majoring in early childhood education learn the Sufficiency Economy Philosophy through practicing at the CEECE farm. Students learn Sufficiency Economy Philosophy and knowledge as follows ; 2.1 Moderation: Students learn to use the resources sufficiently. Students realize the value and use resources in order to maximize savings ; location, materials and budget. 2.2 Reasonableness: Students learn to apply the principles of reason and critical thinking to planning decisions and resolving issues arising from the implementation based on information that they have gathered and relies on the concept, “if students are consumers, will they

  20. Childhood attachment, childhood sexual abuse, and onset of masturbation among adult sexual offenders.

    Science.gov (United States)

    Smallbone, Stephen W; McCabe, Billee-Anne

    2003-01-01

    Written autobiographies of 48 incarcerated adult male sexual offenders (22 rapists, 13 intrafamilial child molesters, and 13 extrafamilial child molesters) were used to generate retrospective self-report measures of their childhood maternal and paternal attachment, childhood sexual abuse experiences, and onset of masturbation. Contrary to expectation, the offenders as a combined group more often reported secure than they did insecure childhood maternal and paternal attachment. There were no differences between the three offender subgroups with respect to maternal attachment; however the rapists and the intrafamilial child molesters were more likely to report insecure paternal attachment than were the extrafamilial child molesters. There were no differences between these offender subgroups in the frequency with which childhood sexual abuse was reported. However, offenders with insecure paternal attachment were more likely to report having been sexually abused than were those with secure paternal attachment. Sexually abused offenders in turn reported earlier onset of masturbation than did those who were not sexually abused. These results are consistent with contemporary attachment models linking insecure childhood attachment to childhood sexual abuse, and with traditional conditioning models linking childhood sexual abuse, early masturbation, and sexual offending.

  1. Short-term and long-term antibody response by mice after immunization against Neisseria meningitidis B or diphtheria toxoid

    Directory of Open Access Journals (Sweden)

    G.P. Silva

    2013-02-01

    Full Text Available Serogroup B Neisseria meningitidis (MenB is a major cause of invasive disease in early childhood worldwide. The only MenB vaccine available in Brazil was produced in Cuba and has shown unsatisfactory efficacy when used to immunize millions of children in Brazil. In the present study, we compared the specific functional antibody responses evoked by the Cuban MenB vaccine with a standard vaccine against diphtheria (DTP: diphtheria, tetanus, pertussis after primary immunization and boosting of mice. The peak of bactericidal and opsonic antibody titers to MenB and of neutralizing antibodies to diphtheria toxoid (DT was reached after triple immunization with the MenB vaccine or DTP vaccine, respectively. However, 4 months after immunization, protective DT antibody levels were present in all DTP-vaccinated mice but in only 20% of the mice immunized against MenB. After 6 months of primary immunization, about 70% of animals still had protective neutralizing DT antibodies, but none had significant bactericidal antibodies to MenB. The booster doses of DTP or MenB vaccines produced a significant antibody recall response, suggesting that both vaccines were able to generate and maintain memory B cells during the period studied (6 months post-triple immunization. Therefore, due to the short duration of serological memory induced by the MenB vaccine (VA-MENGOC-BC® vaccine, its use should be restricted to outbreaks of meningococcal disease.

  2. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    Science.gov (United States)

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

  3. Varicella-zoster virus immunity in dermatological patients on systemic immunosuppressant treatment.

    LENUS (Irish Health Repository)

    Hackett, C B

    2012-02-01

    BACKGROUND: Primary varicella infection is caused by varicella-zoster virus (VZV). It is a common childhood infection, which is usually benign but can occasionally cause morbidity and mortality. In immunosuppressed adults, atypical presentation and disseminated disease can occur with significant morbidity and mortality. A VZV vaccine is available. OBJECTIVES: This study was designed to measure the prevalence of immunity to VZV and to determine the predictive value of a self-reported history of varicella infection in a population of dermatological patients receiving systemic immunosuppressant therapy. We sought to assess the need for routine serological testing for varicella-zoster immunity in this cohort. METHODS: Serological testing for VZV immunity was done on 228 patients receiving systemic immunosuppressive treatment for a dermatological condition. Information regarding a history of previous primary VZV infection was obtained from each patient. RESULTS: Two hundred and twenty-eight patients had VZV serology performed. The mean age of the patients was 49.6 years. The prevalence of VZV seropositivity in this cohort was 98.7%. One hundred and two patients (44.7%) reported having a definite history of primary VZV. The sensitivity of a self-reported history of VZV infection was 45.3% with a specificity of 100%. The positive and negative predictive values of a self-reported history of VZV for serologically confirmed immunity were 100% and 2.3%, respectively. CONCLUSIONS: The prevalence of VZV IgG antibodies in our cohort of Irish dermatology patients receiving immunosuppressive therapy is 98.7%. A recalled history of varicella infection is a good predictor of serological immunity. This study has shown that there are VZV-susceptible individuals within our cohort. These patients did not have a clear history of previous infection. We recommend serological testing of patients without a clear history of infection prior to the commencement of immunosuppressive therapy and

  4. Adverse childhood experiences and behavioral problems in middle childhood.

    Science.gov (United States)

    Hunt, Tenah K A; Slack, Kristen S; Berger, Lawrence M

    2017-05-01

    Children who have been exposed to maltreatment and other adverse childhood experiences (ACEs) are at increased risk for various negative adult health outcomes, including cancer, liver disease, substance abuse, and depression. However, the proximal associations between ACEs and behavioral outcomes during the middle childhood years have been understudied. In addition, many of the ACE studies contain methodological limitations such as reliance on retrospective reports and limited generalizability to populations of lower socioeconomic advantage. The current study uses data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort, to prospectively assess the adverse experiences and subsequent behavior problems of over 3000 children. Eight ACE categories to which a child was exposed by age 5 were investigated: childhood abuse (emotional and physical), neglect (emotional and physical), and parental domestic violence, anxiety or depression, substance abuse, or incarceration. Results from bivariate analyses indicated that Black children and children with mothers of low education were particularly likely to have been exposed to multiple ACE categories. Regression analyses showed that exposure to ACEs is strongly associated with externalizing and internalizing behaviors and likelihood of ADHD diagnosis in middle childhood. Variation in these associations by racial/ethnic, gender, and maternal education subgroups are examined. This study provides evidence that children as young as 9 begin to show behavioral problems after exposure to early childhood adversities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Rubella serology by solid-phase radioimmunoassay: its potential for screening programmes

    International Nuclear Information System (INIS)

    Sugishita, C.; O'Shea, S.; Best, J.M.; Banatvala, J.E.

    1978-01-01

    Sera from 269 adult females who had experienced naturally acquired or vaccine-induced infection by rubella virus, including immune persons challenged intranasally with rubella vaccine (RA27/3) as well as sera from 100 patients attending antenatal clinics, were tested for rubella antibodies by the conventional haemagglutination inhibition tests (HAI), as well as a newly developed solid-phase radioimmunoassay (RIA) for rubella immunoglobulin G(IgG) antibodies. Following both naturally acquired and vaccine-induced infection, titres by RIA were approximately ten-fold higher than by HAI. The RIA test was particularly useful in assessing the true immune status of those with apparently low levels of HAI antibody and has the added advantage that pretreatment of sera to remove inhibitors of haemagglutination and red cell agglutinins is unnecessary. The RIA test has potential for the large-scale screening programmes which need to be carried out if the Department of Health and Social Security recommendation, that women attending antenatal and family planning clinics be screened for rubella antibodies, is to be effectively met. (author)

  6. Childhood Brain Tumors

    Science.gov (United States)

    Brain tumors are abnormal growths inside the skull. They are among the most common types of childhood ... still be serious. Malignant tumors are cancerous. Childhood brain and spinal cord tumors can cause headaches and ...

  7. Investing in the foundation of sustainable development: pathways to scale up for early childhood development.

    Science.gov (United States)

    Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

    2017-01-07

    Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study

    Science.gov (United States)

    2014-01-01

    Background Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany. Methods A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. Results In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. Conclusions Our results demonstrate that vaccinating children 2–17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany. PMID:24450996

  9. Confidence and authority through new knowledge: An evaluation of the national educational programme in paediatric oncology nursing in Sweden.

    Science.gov (United States)

    Pergert, Pernilla; Af Sandeberg, Margareta; Andersson, Nina; Márky, Ildikó; Enskär, Karin

    2016-03-01

    There is a lack of nurse specialists in many paediatric hospitals in Sweden. This lack of competence is devastating for childhood cancer care because it is a highly specialised area that demands specialist knowledge. Continuing education of nurses is important to develop nursing practice and also to retain them. The aim of this study was to evaluate a Swedish national educational programme in paediatric oncology nursing. The nurses who participated came from all of the six paediatric oncology centres as well as from general paediatric wards. At the time of the evaluation, three groups of registered nurses (n=66) had completed this 2year, part-time educational programme. A study specific questionnaire, including closed and open-ended questions was sent to the 66 nurses and 54 questionnaires were returned. Answers were analysed using descriptive statistics and qualitative content analysis. The results show that almost all the nurses (93%) stayed in paediatric care after the programme. Furthermore, 31% had a position in management or as a consultant nurse after the programme. The vast majority of the nurses (98%) stated that the programme had made them more secure in their work. The nurses were equipped, through education, for paediatric oncology care which included: knowledge generating new knowledge; confidence and authority; national networks and resources. They felt increased confidence in their roles as paediatric oncology nurses as well as authority in their encounters with families and in discussions with co-workers. New networks and resources were appreciated and used in their daily work in paediatric oncology. The programme was of importance to the career of the individual nurse and also to the quality of care given to families in paediatric oncology. The national educational programme for nurses in Paediatric Oncology Care meets the needs of the highly specialised care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Single event upset susceptibilities of latchup immune CMOS process programmable gate arrays

    Science.gov (United States)

    Koga, R.; Crain, W. R.; Crawford, K. B.; Hansel, S. J.; Lau, D. D.; Tsubota, T. K.

    Single event upsets (SEU) and latchup susceptibilities of complementary metal oxide semiconductor programmable gate arrays (CMOS PPGA's) were measured at the Lawrence Berkeley Laboratory 88-in. cyclotron facility with Xe (603 MeV), Cu (290 MeV), and Ar (180 MeV) ion beams. The PPGA devices tested were those which may be used in space. Most of the SEU measurements were taken with a newly constructed tester called the Bus Access Storage and Comparison System (BASACS) operating via a Macintosh II computer. When BASACS finds that an output does not match a prerecorded pattern, the state of all outputs, position in the test cycle, and other necessary information is transmitted and stored in the Macintosh. The upset rate was kept between 1 and 3 per second. After a sufficient number of errors are stored, the test is stopped and the total fluence of particles and total errors are recorded. The device power supply current was closely monitored to check for occurrence of latchup. Results of the tests are presented, indicating that some of the PPGA's are good candidates for selected space applications.

  11. Low-grade disease activity in early life precedes childhood asthma and allergy.

    Science.gov (United States)

    Chawes, Bo Lund Krogsgaard

    2016-08-01

    Asthma and allergies are today the most common chronic diseases in children and the leading causes of school absences, chronic medication usage, emergency department visits and hospitalizations, which affect all members of the family and represent a significant societal and scientific challenge. These highly prevalent disorders are thought to originate from immune distortion in early childhood, but the etiology and heterogeneity of the disease mechanisms are not understood, which hampers preventive initiatives and makes treatment inadequate. The objective of this thesis is to investigate the presence of an early life disease activity prior to clinical symptoms to understand the anteceding pathophysiological steps towards childhood asthma and allergy. The thesis is built on seven studies from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) birth cohort examining biomarkers of disease activity in 411 asymptomatic neonates in cord blood (I-II), urine (III), exhaled breath (IV-V) and infant lung function (VI-VII) in relation to the subsequent development of asthma and allergy during the first seven years of life. In papers I-II, we studied cord blood chemokines and 25(OH)-vitamin D, which represent a proxy of the inborn immature immune system, the intrauterine milieu, and the maternal immune health during pregnancy. High levels of the Th2-related chemokine CCL22 and high CCL22/CXCL11 ratio were positively correlated with total IgE level during preschool age (II). This suggests an inborn Th2 skewing of the immune system in healthy newborns subsequently developing elevated total IgE antibodies, which is considered to increase the risk of asthma and allergies later in life. Additionally, deficient cord blood 25(OH)-vitamin D levels were associated with a 2.7-fold increased risk of recurrent wheeze at age 0-7 years (I). Together, these findings support the concept that early life immune programming in the pre-symptomatic era plays an essential role

  12. Imbalanced immune homeostasis in immune thrombocytopenia.

    Science.gov (United States)

    Yazdanbakhsh, Karina

    2016-04-01

    Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder resulting from low platelet counts caused by inadequate production as well as increased destruction by autoimmune mechanisms. As with other autoimmune disorders, chronic ITP is characterized by perturbations of immune homeostasis with hyperactivated effector cells as well as defective regulatory arm of the adaptive immune system, which will be reviewed here. Interestingly, some ITP treatments are associated with restoring the regulatory imbalance, although it remains unclear whether the immune system is redirected to a state of tolerance once treatment is discontinued. Understanding the mechanisms that result in breakdown of immune homeostasis in ITP will help to identify novel pathways for restoring tolerance and inhibiting effector cell responses. This information can then be translated into developing therapies for averting autoimmunity not only in ITP but also many autoimmune disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Immunizing Children

    Directory of Open Access Journals (Sweden)

    Geraldine Jody Macdonald

    2014-11-01

    Full Text Available This article addresses the complex contexts within which Canadian health professionals engage in immunizing children and focuses on the Canadian practice guidelines and current scientific evidence that direct Canadian health professional competencies. The article begins by presenting two current global vaccine initiatives and links these to immunization in Canada. A selected literature review identifies current best immunization practices. With the purpose of promoting quality improvement, three key Canadian immunization competencies for health professional are highlighted: communication with parents, including those who are experiencing vaccine hesitancy; administration of immunizing agents; and documentation of immunizations. Health professionals are encouraged to reflect on immunization competencies and ensure evidence-based practices underpin vaccine delivery in their primary care settings.

  14. A Reduced National Incidence of Anogenital Warts in Young Danish Men and Women after Introduction of a National Quadrivalent Human Papillomavirus Vaccination Programme for Young Women – An Ecological Study

    DEFF Research Database (Denmark)

    Sandø, Niels; Kofoed, Kristian; Zachariae, Claus

    2013-01-01

    In January 2009 the human papillomavirus (HPV) vaccine was included in the Danish childhood vaccination programme for girls aged 12 years. A catch-up programme for girls up to 16 years of age was started a couple of months earlier. Based on national register data, anogenital wart (AGW) incidences...... between January 2001 and December 2011 were estimated. We used χ2 analysis to identify significant trends in proportions of patients diagnosed with AGW in the period before and after inclusion of the HPV vaccine in the program. The development of chlamydia infections was included in this study as a proxy...

  15. Challenging 'girls only' publicly funded human papillomavirus vaccination programmes.

    Science.gov (United States)

    Law, Victoria G; Gustafson, Diana L

    2017-01-01

    This analysis examines the 'girls only' policy for publicly funded human papillomavirus (HPV) vaccination programmes. Current funding policy in most Canadian provinces covers 'girls only' with the goal of reducing mortality and morbidity rates of HPV-related cervical cancer. Recent studies indicate increasing rates of other HPV-related cancers among cisgender men and women. The HPV vaccine is proving effective against some of these cancers. Statistics on HPV vaccine uptake among individuals with different gender expressions are scarce. Critics argue that a 'girls only' HPV vaccine policy is inequitable. We add to this critique by reflecting on the gender binary embedded in such policies and produced through epidemiological studies that attend differentially to females, reinforcing exclusionary practices that leave out those who form their gender identities across the spectrum. We then draw on deontological (duties-based) and utilitarian (utility-based) frameworks to show that these gendered policies are also unethical. These challenges to the assumptions underlying 'girls only' immunization programmes have implications for nurses and the healthcare system. If we are to advance equitable and ethical health outcomes, we entreat nurses as a collective to mobilize the public to lobby federal, provincial and territorial governments to fund more inclusive HPV vaccination policies. © 2016 John Wiley & Sons Ltd.

  16. Types of conflict, types of relationships and preferred conflict resolution strategies: Implications for constructive conflict resolution programmes

    Directory of Open Access Journals (Sweden)

    Petrović Danijela S.

    2012-01-01

    Full Text Available Constructive conflict resolution programmes are based on the idea that children and youth do no have sufficient knowledge of the procedures and skills for conflict resolution, which is why the conflicts they take part in soon become destructive. Notwithstanding the indubitable practical significance of the constructive conflict resolution programmes, it can be objected that they are not sufficiently based on empirical findings about the characteristics of conflicts in childhood and adolescence. Hence, this paper explores different types of conflict with peers and friends with the aim of determining the preferred conflict resolution strategies and using the obtained results to consider the implications for the improvement of constructive conflict resolution programmes. The research was conducted on the sample of 286 adolescents. The method of hypothetical conflict situations was used for studying the preferred conflict resolution strategies. The key results, which should be taken into account when developing constructive conflict resolution programmes, indicate that the preference for a conflict resolution strategy varies depending on conflict type (problem solving is mostly used in conflicts occurring due to opinion differences and disrespect of agreement, unlike the conflicts arising due to provocations, stubbornness and dishonesty and relationship types (in conflicts with friends, adolescents prefer problem solving, while in peer conflicts they more frequently opt for competition. [Projekat Ministarstva nauke Republike Srbije, br. 179018: Identifikacija, merenje i razvoj kognitivnih i emocionalnih kompetencija važnih društvu orijentisanom na evropske integracije

  17. BCG vaccination at birth and early childhood hospitalisation

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Sørup, Signe; Aaby, Peter

    2017-01-01

    vaccination at birth would reduce early childhood hospitalisation in Denmark, a high-income setting. METHODS: Pregnant women planning to give birth at three Danish hospitals were invited to participate. After parental consent, newborn children were allocated to BCG or no intervention within 7 days of age......BACKGROUND: The BCG vaccine is administered to protect against tuberculosis, but studies suggest there may also be non-specific beneficial effects upon the infant immune system, reducing early non-targeted infections and atopic diseases. The present randomised trial tested the hypothesis that BCG......-protocol analyses. RESULTS: 4184 pregnant women were randomised and their 4262 children allocated to BCG or no intervention. There was no difference in risk of hospitalisation up to 15 months of age; 2129 children randomised to BCG experienced 1047 hospitalisations with a mean of 0.49 hospitalisation per child...

  18. The long reach of childhood. Childhood experiences influence close relationships and loneliness across life

    NARCIS (Netherlands)

    Merz, E.M.; Jak, S.

    2013-01-01

    This paper intends to gain insight into the role of childhood relationships and experiences within the parental home for the formation and meaning of later family relationships and loneliness. Particularly, childhood attachment to mother and father and stressful childhood experiences were studied in

  19. The long reach of childhood: childhood experiences influence close relationships and loneliness across life

    NARCIS (Netherlands)

    Merz, E.-M.; Jak, S.

    2013-01-01

    This paper intends to gain insight into the role of childhood relationships and experiences within the parental home for the formation and meaning of later family relationships and loneliness. Particularly, childhood attachment to mother and father and stressful childhood experiences were studied in

  20. Integration of HIV Care into Community Management of Acute Childhood Malnutrition Permits Good Outcomes: Retrospective Analysis of Three Years of a Programme in Lusaka.

    Science.gov (United States)

    Amadi, Beatrice; Imikendu, Mercy; Sakala, Milika; Banda, Rosemary; Kelly, Paul

    2016-01-01

    While HIV has had a major impact on health care in southern Africa, there are few data on its impact on acute malnutrition in children in the community. We report an analysis of outcomes in a large programme of community management of acute malnutrition in the south of Lusaka. Over 3 years, 68,707 assessments for undernutrition were conducted house-to-house, and children with severe acute malnutrition (SAM) or moderate acute malnutrition (MAM) were enrolled into either Outpatient Therapeutic Programme (OTP) or Supplementary Feeding Programme (SFP) respectively. Case records were analysed using tabulation and unconditional logistic regression. 1,859 children (889 boys, 970 girls; median age 16 months) with MAM (n = 664) or SAM (n = 1,195) were identified. Of 1,796 children whose parents consented to testing, 185 (10.3%) were HIV positive. Altogether 1,163 (62.6%) were discharged as recovered from acute malnutrition. Case fatality while in the programme was 4.2% in children with SAM and 0.5% in those with MAM (RR of SAM 10.9; 95%CI 3.4,34.8; Pmalnutrition programme, incorporating HIV care, can achieve low mortality even in a population heavily affected by HIV.

  1. [Therapeutic education in pediatric dentistry: analysis of obstacles and levers to the development of programmes in France in 2016].

    Science.gov (United States)

    Marquillier, Thomas; Trentesaux, Thomas; Gagnayre, Rémi

    2017-01-01

    Over recent years, therapeutic patient education has become part of dental medicine. Management of early childhood caries, known to be a very common chronic disease, has evolved to include an educational dimension. The objective of this study was to identify the levers and barriers to the development of formalized therapeutic education programmes and alternatives. A comprehensive exploratory qualitative study was conducted between November 2015 and June 2016 on a targeted sample of 15 people aware of the problem of TPE in dentistry. The study showed that TPE training in dentistry is underdeveloped, despite its numerous benefits: change of the healthcare professional's approach, implementation of structured educational programmes, development of research, etc. There are many obstacles to the development of TPE programmes: insufficient resources, rigid legislation or lack of knowledge of TPE practices. The dental profession is an obstacle itself because of its lack of understanding and variable degrees of integration the medical community. There are multiple levers, but the main ones are changing attitudes of the profession and the provision of resources to develop TPE. Although alternatives to TPE programmes exist (accompanying measures, short educational strategies, connected health), they cannot replace TPE. More educational strategies must be developed in the field of dentistry. However, the framework of TPE must be adapted to the profession to ensure good uptake.

  2. Migration and child immunization in Nigeria: individual- and community-level contexts

    Directory of Open Access Journals (Sweden)

    Antai Diddy

    2010-03-01

    Full Text Available Abstract Background Vaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria. This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups. Methods The proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed using a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics. Variance partition coefficients and Wald statistic i.e. the ratio of the estimate to its standard error were used to express measures of variation. Results Individual- and community contexts are strongly associated with the likelihood of receiving full immunization among migrant groups. The likelihood of full immunization was higher for children of rural non-migrant mothers compared to children of rural-urban migrant mothers. Findings provide support for the traditional migration perspectives, and show that individual-level characteristics, such as, migrant disruption (migration itself, selectivity (demographic and socio-economic characteristics, and adaptation (health care utilization, as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery are important in explaining the differentials in full immunization among the children. Conclusion Migration is an important

  3. Stages of Childhood Hodgkin Lymphoma

    Science.gov (United States)

    ... Version Key Points Childhood Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. There are two types of childhood Hodgkin lymphoma. Epstein-Barr virus infection increases the risk of childhood Hodgkin ...

  4. The difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment

    Directory of Open Access Journals (Sweden)

    Fitri Anissa Syaimima bt. Syaiful Azim

    2018-01-01

    Full Text Available Every child will go through several stages in his or her life. They are different from each other as they are in the process of development of cognition, physics, emotion, and personality. For many children, a visit to the dentist can raise their anxiety. This anxiousness will lead to stress that influences the cardiovascular function in the body. The purpose of this research was to determine the difference in pediatric blood pressure between middle childhood and late childhood prior to dental treatment. This research was a clinical trial, pure experimental study. The sample consisted of 30 children within the range of 4-12 years old where they were divided into two groups of age; middle childhood (4-7 years old and late childhood (8-12 years old. The blood pressures were measured before any dental treatment began and the values were recorded. The data were then analyzed using the One-Sample T-Test analysis. The results of blood pressure in middle childhood and late childhood were compared to the average mean values for each age group. It showed that there was a significant difference in the systolic pressure, which was found higher in the middle childhood group compared to the late childhood. From the result can be concluded that there was a difference in the pediatric blood pressure between middle childhood and late childhood prior to dental treatment.

  5. Fusion technology programme

    International Nuclear Information System (INIS)

    Finken, D.

    1984-04-01

    KfK participates to the Fusion Technology Programme of the European Community. Most of the work in progress addresses the Next European Torus (NET) and the long term technology aspects as defined in the 82/86 programme. A minor part serves to preparation of future contributions and to design studies on fusion concepts in a wider perspective. The Fusion Technology Programme of Euratom covers mainly aspects of nuclear engineering. Plasma engineering, heating, refueling and vacuum technology are at present part of the Physics Programme. In view of NET, integration of the different areas of work will be mandatory. KfK is therefore prepared to address technical aspects beyond the actual scope of the physics experiments. The technology tasks are reported project wise under title and code of the Euratom programme. Most of the projects described here are shared with other European fusion laboratories as indicated in the table annexed to this report. (orig./GG)

  6. Impact of pharmacists providing immunizations on adolescent influenza immunization.

    Science.gov (United States)

    Robison, Steve G

    2016-01-01

    To determine if the Oregon law change in 2011 to allow pharmacists to immunize adolescents 11 to 17 years of age increased influenza immunizations or changed existing immunization venues. With the use of Oregon's ALERT Immunization Information System (IIS), 2 measures of impact were developed. First, the change in adolescent age 11-17 influenza immunizations before (2007-2010) and after (2011-2014) the pharmacy law change was evaluated against a reference cohort (aged 7-10) not affected by the law. Community pharmacies were also compared with other types of influenza immunization sites within one of the study influenza seasons (2013-2014). From 2007 to 2014, adolescent influenza immunizations at community pharmacies increased from 36 to 6372 per year. After the 2011 pharmacy law change, adolescents aged 11 to 17 were more likely to receive an influenza immunization compared with the reference population (odds ratio, 1.21; 95% CI, 1.19-1.22). Analysis of the 2013-2014 influenza season suggests that community pharmacies immunized a different population of adolescents than other providers. The 2011 change in Oregon law allowed pharmacists to increase the total of influenza immunizations given to adolescents. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  7. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D. [VTT Energy, Jyvaeskylae (Finland)

    1996-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  8. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D [VTT Energy, Jyvaeskylae (Finland)

    1997-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  9. Breastfeeding, Childhood Asthma, and Allergic Disease.

    Science.gov (United States)

    Oddy, Wendy H

    2017-01-01

    The worldwide prevalence of childhood asthma has been increasing considerably, and the protection afforded by breastfeeding in its development has been the subject of controversy for more than 80 years. Previous systematic reviews have generally found a protective effect of breastfeeding on allergic outcomes, although many studies have methodological limitations. Although breastfeeding is protective against lower respiratory tract infection during infancy, such protection has not been demonstrated for asthma in all studies. Breastfeeding has health benefits for the mother and child. Exclusive breastfeeding for the first 6 months of an infant's life, with continued breastfeeding for up to 2 years or longer, is recognized as the "gold" standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote a healthy development. There is increasing concern that the practice of delaying complementary foods until 6 months may exacerbate the risk of allergic disease. Breast milk contains immunological components that protect against infections and allergic disease in infancy. The composition of human breast milk is complex, containing factors that interact with the infant immune system and intestinal milieu including allergens, cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines. Transforming growth factor β is a cytokine in human milk involved in maintaining intestinal homeostasis, inflammation regulation, and oral tolerance development. Modern day society, with increased standards of hygiene, has changed the gut flora of Western infants, potentially impacting the risk of developing immune-mediated diseases including allergic disease and asthma. Microbial diversity is intrinsic to healthy immune maturation and function. Compared to breastfed infants, formula-fed infants had lower bacterial diversity and an altered intestinal microbiota in the first few weeks of life associated with

  10. Crude childhood vaccination coverage in West Africa: Trends and predictors of completeness [version 1; referees: 1 approved, 3 approved with reservations

    Directory of Open Access Journals (Sweden)

    Jacob S. Kazungu

    2017-02-01

    Full Text Available Background: Africa has the lowest childhood vaccination coverage worldwide. If the full benefits of childhood vaccination programmes are to be enjoyed in sub-Saharan Africa, all countries need to improve on vaccine delivery to achieve and sustain high coverage. In this paper, we review trends in vaccination coverage, dropouts between vaccine doses and explored the country-specific predictors of complete vaccination in West Africa. Methods: We utilized datasets from the Demographic and Health Surveys Program, available for Benin, Burkina Faso, The Gambia, Ghana, Guinea, Cote d’Ivoire, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone and Togo, to obtain coverage for Bacillus Calmette-Guerin, polio, measles, and diphtheria, pertussis and tetanus (DPT vaccines in children aged 12 – 23 months. We also calculated the DPT1-to-DPT3 and DPT1-to-measles dropouts, and proportions of the fully immunised child (FIC. Factors predictive of FIC were explored using Chi-squared tests and multivariable logistic regression. Results: Overall, there was a trend of increasing vaccination coverage. The proportion of FIC varied significantly by country (range 24.1-81.4%, mean 49%. DPT1-to-DPT3 dropout was high (range 5.1% -33.9%, mean 16.3%. Similarly, DPT1-measles dropout exceeded 10% in all but four countries. Although no single risk factor was consistently associated with FIC across these countries, maternal education, delivery in a health facility, possessing a vaccine card and a recent post delivery visit to a health facility were the key predictors of complete vaccination. Conclusions: The low numbers of fully immunised children and high dropout between vaccine doses highlights weaknesses and the need to strengthen the healthcare and routine immunization delivery systems in this region. Country-specific correlates of complete vaccination should be explored further to identify interventions required to increase vaccination coverage. Despite the promise

  11. Asthma phenotypes in childhood.

    Science.gov (United States)

    Reddy, Monica B; Covar, Ronina A

    2016-04-01

    This review describes the literature over the past 18 months that evaluated childhood asthma phenotypes, highlighting the key aspects of these studies, and comparing these studies to previous ones in this area. Recent studies on asthma phenotypes have identified new phenotypes on the basis of statistical analyses (using cluster analysis and latent class analysis methodology) and have evaluated the outcomes and associated risk factors of previously established early childhood asthma phenotypes that are based on asthma onset and patterns of wheezing illness. There have also been investigations focusing on immunologic, physiologic, and genetic correlates of various phenotypes, as well as identification of subphenotypes of severe childhood asthma. Childhood asthma remains a heterogeneous condition, and investigations into these various presentations, risk factors, and outcomes are important since they can offer therapeutic and prognostic relevance. Further investigation into the immunopathology and genetic basis underlying childhood phenotypes is important so therapy can be tailored accordingly.

  12. Vascular-Rheological Properties of Blood in Hemorrhagic Vasculitis Occurring in Childhood and Adulthood

    Directory of Open Access Journals (Sweden)

    V.V. Gerasymenko

    2016-11-01

    Full Text Available Background. As a result of the immune-inflammatory necrotic changes in the walls of arterioles and capillaries in patients with hemorrhagic vasculitis (HV Henoch — Schönlein endothelial dysfunction of vessels occurs, contributing to violations of blood rheological properties and microcirculation. These processes depend on the age of patients, and in cases of onset of the disease in childhood and adulthood are unknown. Objective: to study vascular and rheological properties of blood serum in HV and to compare the indices with different age of the debut of the pathological process in the groups of patients. Material and methods. The study included 174 patients with HV (83 % men and 17 % women. In 92 patients, the disease made its debut in childhood (on average in 12 years old, and in 82 — in the adult (on average in 25 years old. I, II and III degree of activity of pathological process are set at a ratio of 1 : 2 : 2. Indicators of vascular endothelial function were investigated by immune-enzyme analysis and the adsorption-rheological pro­perties of blood were assessed by computer tensiometry. Results. HV is accompanied by severe disorders of the blood vascular and rheological properties which are involved in the pathogenesis of lesions of skin (endothelin-1, surface tension, joints (only surface activity, kidney (prostacyclin, cyclic guanosine monophosphate and heart (endothelin-1, viscoelastic modulus. At that the integrated indicators of vascular endothelial function, viscoelastic, surface-active and relaxation characteristics of serum depend on the age of the patients in the beginning of the disease, the degree of activity of the pathological process, the clinical form of the disease course, necrotic-ulcerative and polymorphic variants of cutaneous vasculitis, and HV, transforming from juvenile, occurs with lower blood levels of endothelin-1, but with a higher concentration of thromboxane A2, cyclic guanosine monophosphate and

  13. Induction of antitumor immunity through xenoplacental immunization

    Directory of Open Access Journals (Sweden)

    Agadjanyan Michael G

    2006-05-01

    Full Text Available Abstract Historically cancer vaccines have yielded suboptimal clinical results. We have developed a novel strategy for eliciting antitumor immunity based upon homology between neoplastic tissue and the developing placenta. Placenta formation shares several key processes with neoplasia, namely: angiogenesis, activation of matrix metalloproteases, and active suppression of immune function. Immune responses against xenoantigens are well known to break self-tolerance. Utilizing xenogeneic placental protein extracts as a vaccine, we have successfully induced anti-tumor immunity against B16 melanoma in C57/BL6 mice, whereas control xenogeneic extracts and B16 tumor extracts where ineffective, or actually promoted tumor growth, respectively. Furthermore, dendritic cells were able to prime tumor immunity when pulsed with the placental xenoantigens. While vaccination-induced tumor regression was abolished in mice depleted of CD4 T cells, both CD4 and CD8 cells were needed to adoptively transfer immunity to naïve mice. Supporting the role of CD8 cells in controlling tumor growth are findings that only freshly isolated CD8 cells from immunized mice were capable of inducing tumor cell caspases-3 activation ex vivo. These data suggest feasibility of using xenogeneic placental preparations as a multivalent vaccine potently targeting not just tumor antigens, but processes that are essential for tumor maintenance of malignant potential.

  14. Integrated Circuit Immunity

    Science.gov (United States)

    Sketoe, J. G.; Clark, Anthony

    2000-01-01

    This paper presents a DOD E3 program overview on integrated circuit immunity. The topics include: 1) EMI Immunity Testing; 2) Threshold Definition; 3) Bias Tee Function; 4) Bias Tee Calibration Set-Up; 5) EDM Test Figure; 6) EMI Immunity Levels; 7) NAND vs. and Gate Immunity; 8) TTL vs. LS Immunity Levels; 9) TP vs. OC Immunity Levels; 10) 7805 Volt Reg Immunity; and 11) Seventies Chip Set. This paper is presented in viewgraph form.

  15. Oral immune therapy: targeting the systemic immune system via the gut immune system for the treatment of inflammatory bowel disease.

    Science.gov (United States)

    Ilan, Yaron

    2016-01-01

    Inflammatory bowel diseases (IBD) are associated with an altered systemic immune response leading to inflammation-mediated damage to the gut and other organs. Oral immune therapy is a method of systemic immune modulation via alteration of the gut immune system. It uses the inherit ability of the innate system of the gut to redirect the systemic innate and adaptive immune responses. Oral immune therapy is an attractive clinical approach to treat autoimmune and inflammatory disorders. It can induce immune modulation without immune suppression, has minimal toxicity and is easily administered. Targeting the systemic immune system via the gut immune system can serve as an attractive novel therapeutic method for IBD. This review summarizes the current data and discusses several examples of oral immune therapeutic methods for using the gut immune system to generate signals to reset systemic immunity as a treatment for IBD.

  16. Childhood vitiligo: Treatment paradigms

    Directory of Open Access Journals (Sweden)

    Amrinder Jit Kanwar

    2012-01-01

    Full Text Available Childhood vitiligo differs from the adults by showing a higher incidence in females, segmental vitiligo being more common and less frequent association with other systemic autoimmune and endocrine disorders.Childhood vitiligo is often associated with a marked psychosocial and long lasting effect on the self-esteem of the affected children and their parents, hence an adequate treatment is very essential. Treatment of vitiligo is indeed a tough challenge for the dermatologists′ more so in the background of childhood vitiligo. Although multiple therapeutic modalities are available in the therapeutic armamentarium, not all can be used in children. This brief report updates regarding various therapies available in the treatment of childhood vitiligo.

  17. Bolsa Família (Family Grant Programme: an analysis of Brazilian income transfer programme

    Directory of Open Access Journals (Sweden)

    Luciana Mourão

    2012-06-01

    Full Text Available Income transfer programmes are common in various countries and play an important role in combating poverty. This article presents a review of the results of the Bolsa Família (Family Grant Programme, implemented in Brazil by the government of Lula da Silva in 2004. Over the last seven years many evaluations of the programme have been conducted, allowing an overview of its results and its strong and weak points to be mapped. Five central aspects relating to the programme are discussed in article five: (1 programme access, (2 hunger fighting results, (3 programme financial impacts, (4 conditioning factors of education and health, (5 supplementary programs and social mobility. The results of scientific research were presented for each of these aspects, and any of these believed to be convergent or divergent were discussed. As a general result it was concluded that the programme has generated significant results for the country, but there are still some issues that need to be reviewed, such as conditioning factors and the integrated management of the programme.

  18. The Winfrith DSN programme

    Energy Technology Data Exchange (ETDEWEB)

    Francescon, S [General Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1963-05-15

    The programme, which is written in the Fortran language, solves the Carlson discrete S{sub n} approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  19. The Winfrith DSN programme

    International Nuclear Information System (INIS)

    Francescon, S.

    1963-05-01

    The programme, which is written in the Fortran language, solves the Carlson discrete S n approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  20. UNESCO's Ethics Education Programme.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2008-01-01

    Unesco initiated the Ethics Education Programme in 2004 at the request of member states to reinforce and increase the capacities in the area of ethics teaching. The programme is focused on providing detailed information about existing teaching programmes. It also develops and promotes teaching

  1. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management.

    Science.gov (United States)

    Baruteau, Alban-Elouen; Pass, Robert H; Thambo, Jean-Benoit; Behaghel, Albin; Le Pennec, Solène; Perdreau, Elodie; Combes, Nicolas; Liberman, Leonardo; McLeod, Christopher J

    2016-09-01

    Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe permanent cardiac pacing in almost all patients, including those with structural heart abnormalities. Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current understanding of the pathogenetic mechanisms, clinical course, and optimal management of congenital and childhood AV block. • Prevalence of congenital heart block of 1 per 15,000 to 20,000 live births. AV block is defined as congenital if diagnosed in utero, at birth, or within the first month of life, whereas childhood AV block is diagnosed between the first month and the 18th year of life. As a result of several different etiologies, congenital and childhood atrioventricular block may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease. Cardiac pacing is indicated in symptomatic patients and has several prophylactic indications in asymptomatic patients to prevent sudden death. • Autoimmune, congenital AV block is associated with a high neonatal mortality rate and development of dilated cardiomyopathy in 5 to 30 % cases. What is New: • Several genes including SCN5A have been implicated in autosomal dominant forms of familial progressive cardiac conduction disorders. • Leadless pacemaker technology and gene therapy for

  2. Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adults with schizophrenia and bipolar diagnoses.

    Science.gov (United States)

    Aas, Monica; Dieset, Ingrid; Hope, Sigrun; Hoseth, Eva; Mørch, Ragni; Reponen, Elina; Steen, Nils Eiel; Laskemoen, Jannicke Fjæra; Ueland, Thor; Aukrust, Pål; Agartz, Ingrid; Andreassen, Ole A; Melle, Ingrid

    2017-10-01

    Several studies have described an association between childhood maltreatment and inflammatory markers in the psychotic disorders (schizophrenia [SZ] and bipolar disorder [BD]). Previous studies have been relatively small (childhood abuse severity and clinical diagnosis on inflammatory markers were investigated in a large sample (n=483) of patients with a disorder on the psychosis spectrum and in healthy controls (HCs). Plasma levels of inflammatory markers (high-sensitivity C-reactive protein [hs-CRP], soluble tumor necrosis factor receptor type 1 [TNFR-R1], glycoprotein 130 [gp130]) were analyzed, and BMI and data on childhood trauma events, on the basis of the Childhood Trauma Questionnaire (CTQ), were obtained from all participants. Patients had increased levels of hs-CRP (Pchildhood maltreatment experiences (Pchildhood abuse (up to three types of abuse: sexual abuse, physical abuse, and emotional abuse) was associated with elevated BMI (f=8.46, Pchildhood abuse were found for elevated hs-CRP (f=4.76, P<0.001, Cohen's d=0.4). Differences among the groups disappeared when BMI was added to the model. Trauma-altered immune activation via elevated hs-CRP in patients with SZ and BD may be mediated by higher BMI; however, the direction of this association needs further clarification. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Childhood Overweight and Obesity

    Science.gov (United States)

    ... and Nutrition Healthy Food Choices Childhood Overweight and Obesity: Helping Your Child Achieve a Healthy Weight Childhood Overweight and Obesity: Helping Your Child Achieve a Healthy Weight Share ...

  4. Hepatitis B serologic survey and review of immunization records of children, adolescents and adults in Fiji, 2008-2009.

    Science.gov (United States)

    Tsukakoshi, Tatsuhiko; Samuela, Josaia; Rafai, Eric V; Rabuatoka, Uraia; Honda, Sumihisa; Kamiya, Yasuhiko; Buerano, Corazon C; Morita, Kouichi

    2015-03-03

    In Fiji, hepatitis B (HB) vaccine was introduced into childhood immunization program in 1989 and has been administered as a pentavalent since 2006. This study aimed to: (i) survey and examine the extent to which HB infection continue to occur in children, adolescents and adults in Fiji, and (ii) determine HB coverage rates and timeliness of vaccine administration to children. Serum samples of children, adolescents and adults (aged 6 months to Fiji's HB vaccine control program is achieving its objectives.

  5. Recommendation system for immunization coverage and monitoring.

    Science.gov (United States)

    Bhatti, Uzair Aslam; Huang, Mengxing; Wang, Hao; Zhang, Yu; Mehmood, Anum; Di, Wu

    2018-01-02

    Immunization averts an expected 2 to 3 million deaths every year from diphtheria, tetanus, pertussis (whooping cough), and measles; however, an additional 1.5 million deaths could be avoided if vaccination coverage was improved worldwide. 1 1 Data source for immunization records of 1.5 M: http://www.who.int/mediacentre/factsheets/fs378/en/ New vaccination technologies provide earlier diagnoses, personalized treatments and a wide range of other benefits for both patients and health care professionals. Childhood diseases that were commonplace less than a generation ago have become rare because of vaccines. However, 100% vaccination coverage is still the target to avoid further mortality. Governments have launched special campaigns to create an awareness of vaccination. In this paper, we have focused on data mining algorithms for big data using a collaborative approach for vaccination datasets to resolve problems with planning vaccinations in children, stocking vaccines, and tracking and monitoring non-vaccinated children appropriately. Geographical mapping of vaccination records helps to tackle red zone areas, where vaccination rates are poor, while green zone areas, where vaccination rates are good, can be monitored to enable health care staff to plan the administration of vaccines. Our recommendation algorithm assists in these processes by using deep data mining and by accessing records of other hospitals to highlight locations with lower rates of vaccination. The overall performance of the model is good. The model has been implemented in hospitals to control vaccination across the coverage area.

  6. Epicutaneous immunization with type II collagen inhibits both onset and progression of chronic collagen-induced arthritis.

    Directory of Open Access Journals (Sweden)

    Jessica Strid

    Full Text Available Epicutaneous immunization is a potential non-invasive technique for antigen-specific immune-modulation. Topical application of protein antigens to barrier-disrupted skin induces potent antigen-specific immunity with a strong Th2-bias. In this study, we investigate whether the autoimmune inflammatory response of chronic collagen-induced arthritis (CCIA in DBA/1-TCR-beta Tg mice can be modified by epicutaneous immunization. We show that epicutaneous immunization with type II collagen (CII inhibited development and progression of CCIA and, importantly, also ameliorated ongoing disease as indicated by clinical scores of disease severity, paw swelling and joints histology. Treated mice show reduced CII-driven T cell proliferation and IFN-gamma production, as well as significantly lower levels of CII-specific IgG2a serum antibodies. In contrast, CII-driven IL-4 production and IgE antibody levels were increased consistent with skewing of the CII response from Th1 to Th2 in treated mice. IL-4 production in treated mice was inversely correlated with disease severity. Moreover, T cells from treated mice inhibited proliferation and IFN-gamma production by T cells from CCIA mice, suggesting induction of regulatory T cells that actively inhibit effector responses in arthritic mice. The levels of CD4(+CD25(+ T cells were however not increased following epicutaneous CII treatment. Together, these results suggest that epicutaneous immunization may be used as an immune-modulating procedure to actively re-programme pathogenic Th1 responses, and could have potential as a novel specific and simple treatment for chronic autoimmune inflammatory diseases such as rheumatoid arthritis.

  7. The INTEGRAL Core Observing Programme

    DEFF Research Database (Denmark)

    Winkler, C.; Gehrels, N.; Lund, Niels

    1999-01-01

    The Core Programme of the INTEGRAL mission is defined as the portion of the scientific programme covering the guaranteed time observations for the INTEGRAL Science Working Team. This paper describes the current status of the Core Programme preparations and summarizes the key elements...... of the observing programme....

  8. Associations of social environment, socioeconomic position and social mobility with immune response in young adults: the Jerusalem Perinatal Family Follow-Up Study.

    Science.gov (United States)

    Lawrence, Gabriella M; Friedlander, Yehiel; Calderon-Margalit, Ronit; Enquobahrie, Daniel A; Huang, Jonathan Yinhao; Tracy, Russell P; Manor, Orly; Siscovick, David S; Hochner, Hagit

    2017-12-21

    Immune response to cytomegalovirus (CMV) impacts adult chronic disease. This study investigates associations of childhood and adulthood social environment, socioeconomic position (SEP) and social mobility with CMV response in young adults. Historical prospective study design. Subcohort of all 17 003 births to residents of Jerusalem between 1974 and 1976. Participants included 1319 young adults born in Jerusalem with extensive archival and follow-up data, including childhood and adulthood SEP-related factors and anti-CMV IgG titre levels and seroprevalence measured at age 32. Principal component analysis was used to transform correlated social environment and SEP-related variables at two time points (childhood and adulthood) into two major scores reflecting household (eg, number of siblings/children, religiosity) and socioeconomic (eg, occupation, education) components. Based on these components, social mobility variables were created. Linear and Poisson regression models were used to investigate associations of components and mobility with anti-CMV IgG titre level and seroprevalence, adjusted for confounders. Lower levels of household and socioeconomic components in either childhood or adulthood were associated with higher anti-CMV IgG titre level and seropositivity at age 32. Compared with individuals with stable favourable components, anti-CMV IgG titre level and risk for seropositivity were higher in stable unfavourable household and socioeconomic components (household: β=3.23, P<0.001; relative risk (RR)=1.21, P<0.001; socioeconomic: β=2.20, P=0.001; RR=1.14, P=0.01), downward household mobility (β=4.32, P<0.001; RR=1.26, P<0.001) and upward socioeconomic mobility (β=1.37, P=0.04; RR=1.19, P<0.001). Among seropositive individuals, associations between household components and mobility with anti-CMV IgG titre level were maintained and associations between socioeconomic components and mobility with anti-CMV IgG titre level were attenuated. Our study

  9. Adaptation in the innate immune system and heterologous innate immunity.

    Science.gov (United States)

    Martin, Stefan F

    2014-11-01

    The innate immune system recognizes deviation from homeostasis caused by infectious or non-infectious assaults. The threshold for its activation seems to be established by a calibration process that includes sensing of microbial molecular patterns from commensal bacteria and of endogenous signals. It is becoming increasingly clear that adaptive features, a hallmark of the adaptive immune system, can also be identified in the innate immune system. Such adaptations can result in the manifestation of a primed state of immune and tissue cells with a decreased activation threshold. This keeps the system poised to react quickly. Moreover, the fact that the innate immune system recognizes a wide variety of danger signals via pattern recognition receptors that often activate the same signaling pathways allows for heterologous innate immune stimulation. This implies that, for example, the innate immune response to an infection can be modified by co-infections or other innate stimuli. This "design feature" of the innate immune system has many implications for our understanding of individual susceptibility to diseases or responsiveness to therapies and vaccinations. In this article, adaptive features of the innate immune system as well as heterologous innate immunity and their implications are discussed.

  10. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

    Science.gov (United States)

    Bosch-Capblanch, Xavier; Marceau, Claudine

    2014-12-01

    To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which

  11. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

    Science.gov (United States)

    Bosch–Capblanch, Xavier; Marceau, Claudine

    2014-01-01

    Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

  12. Parents as the start of the solution: a social marketing approach to understanding triggers and barriers to entering a childhood weight management service.

    Science.gov (United States)

    Gillespie, J; Midmore, C; Hoeflich, J; Ness, C; Ballard, P; Stewart, L

    2015-01-01

    Childhood obesity is a sensitive subject and barriers exist with respect to accessing weight management programmes. Social marketing insight gathering provides an opportunity to understand behaviours and address these challenges. This project gained insight into the views of parents/carers on triggers and barriers to entering a childhood weight management service. Participants were identified from the public using marketing recruitment. Four focus groups were conducted with parents of school aged children (n = 27) by an experienced interviewer. Twenty two mothers, three fathers and two grandmothers participated, with half describing their child as overweight. Groups discussed health behaviours; attitudes to health messages and weight issues; and motivations, benefits and barriers with respect to accessing weight management services. Discussions were taped and transcribed. Themes were identified using framework analysis of content matrix data analysis. Participants were aware of healthy lifestyle messages, although the ability to implement these was variable. Triggers to seeking help included bullying, health concerns and inability to participate in school activities. Barriers included feeling a lack of control, desire to avoid conflict and no proven case that weight was a problem. Parents wished to be given information regarding their child's weight by a trusted person. The Internet and word of mouth were identified as methods of recruitment into a weight management service, with a focus on fitness, fun and friendliness and being free-of-charge. Insight gathering can be used to establish parental/carer opinion regarding engaging in childhood weight management services. A fun, friendly programme that is free of charge appealed to parents. Local community involvement around normalising child weight issues may boost referrals into child healthy weight interventions. © 2014 The British Dietetic Association Ltd.

  13. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  14. Addressing health inequalities in the delivery of the human papillomavirus vaccination programme: examining the role of the school nurse.

    Directory of Open Access Journals (Sweden)

    Tammy Boyce

    in childhood and adolescent vaccination programmes.

  15. Dynamic re-immunization of off-treatment childhood cancer survivors: An implementation feasibility study.

    Directory of Open Access Journals (Sweden)

    Jennifer H Han

    Full Text Available There are no universally approved re-vaccination guidelines for non-transplant pediatric cancer survivors. We hypothesized that by utilizing a response-based re-vaccination schedule, we could tailor vaccine schedules in off-treatment cancer survivors. Pre-vaccination antibody levels were obtained in 7 patients at an average of 20 days after the end of treatment date. In those without protective antibody levels, we administered vaccines 3 months after completion of treatment. Revaccinating patients 3 months after the end of treatment date resulted in protective antibody levels for most vaccines. We showed, on a preliminary basis, that vaccinating non-transplanted pediatric cancer survivors can be dynamically implemented in children with recovering immune function.

  16. Microbiota and immunity: from preclinical data to clinical practice

    Directory of Open Access Journals (Sweden)

    Eleonora Giannetti

    2015-10-01

    Full Text Available The intestinal microbiota is composed of 1013-1014 microorganisms, with at least 100 times as many genes as our genome, the microbiome. Its composition is specific for each individual, changes among individuals and also shows an intra-individual variability during life. Although the gastrointestinal microbial communities of adults are often believed to be stable, there is evidence that, even though at lower rates than in childhood, they change with time, and effects of this variability on health have not been determined yet. The interaction between microbiota and environment is close and widely demonstrated. Gut flora composition is deeply influenced by a number of factors, including diet, age, medications, illness, stress and lifestyle. Intestinal microflora has protective, metabolic and trophic functions. Commensal microbiota can deeply influence the development of the gut mucosal immune system, modulating the maturation of the gut-associated lymphoid tissue and preventing exogenous pathogen intrusion, by stimulation of the immune system and by direct interaction with pathogenic bacteria. The increasing amount of preclinical studies regarding the interaction between intestinal microbiota and immune system and the multiple observations of altered microbiota in human diseases have paved the way for a number of clinical trials aimed at verifying the potential benefits deriving from the manipulation of the microbial ensemble. Several probiotic bacteria have been assessed for their potential applicability in human diseases, albeit with different levels of success. In conclusion, the gut microbiota codevelops with the immune system beginning at birth. The development of the microbiota and its interactions with the cellular populations of the bowel provide a substantial contribution to shaping the structure and dynamic operations of the innate and adaptive immune systems. Manipulation of the microbiota, particularly through the administration of

  17. Pneumonia's second wind? A case study of the global health network for childhood pneumonia.

    Science.gov (United States)

    Berlan, David

    2016-04-01

    Advocacy, policy, research and intervention efforts against childhood pneumonia have lagged behind other health issues, including malaria, measles and tuberculosis. Accelerating progress on the issue began in 2008, following decades of efforts by individuals and organizations to address the leading cause of childhood mortality and establish a global health network. This article traces the history of this network's formation and evolution to identify lessons for other global health issues. Through document review and interviews with current, former and potential network members, this case study identifies five distinct eras of activity against childhood pneumonia: a period of isolation (post WWII to 1984), the duration of WHO's Acute Respiratory Infections (ARI) Programme (1984-1995), Integrated Management of Childhood illness's (IMCI) early years (1995-2003), a brief period of network re-emergence (2003-2008) and recent accelerating progress (2008 on). Analysis of these eras reveals the critical importance of building a shared identity in order to form an effective network and take advantage of emerging opportunities. During the ARI era, an initial network formed around a relatively narrow shared identity focused on community-level care. The shift to IMCI led to the partial dissolution of this network, stalled progress on addressing pneumonia in communities and missed opportunities. Frustrated with lack of progress on the issue, actors began forming a network and shared identity that included a broad spectrum of those whose interests overlap with pneumonia. As the network coalesced and expanded, its members coordinated and collaborated on conducting and sharing research on severity and tractability, crafting comprehensive strategies and conducting advocacy. These network activities exerted indirect influence leading to increased attention, funding, policies and some implementation. Published by Oxford University Press in association with The London School of

  18. Parent "cocoon" immunization to prevent pertussis-related hospitalization in infants: the case of Piemonte in Italy.

    Science.gov (United States)

    Meregaglia, Michela; Ferrara, Lorenza; Melegaro, Alessia; Demicheli, Vittorio

    2013-02-06

    Pertussis incidence in Piemonte (Italy) is now at the lowest level ever reached (0.85 per 100,000 in 2010) but the disease is still endemic in infants (54 per 100,000 in 2005-2010). Parental "cocoon" immunization has been proposed in some countries (i.e. United States, France) as a measure to protect newborns from serious pertussis outcomes. We assessed the number needed to vaccinate (NNV) to prevent hospital admissions in infants (€100,000. The "cocoon" programme leads to net costs from a National Health Service (NHS) perspective (ROI<1). In contexts of low incidence and without reliable data on a high parent-attributable infant risk, the parental "cocoon" programme is poorly efficient and very resource intensive in preventing pertussis in infants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Experience of childhood abuse and later number of remaining teeth in older Japanese: a life-course study from Japan Gerontological Evaluation Study project.

    Science.gov (United States)

    Matsuyama, Yusuke; Fujiwara, Takeo; Aida, Jun; Watt, Richard G; Kondo, Naoki; Yamamoto, Tatsuo; Kondo, Katsunori; Osaka, Ken

    2016-12-01

    From a life-course perspective, adverse childhood experiences (ACEs) such as childhood abuse are known risk factors for adult diseases and death throughout life. ACEs could also cause poor dental health in later life because they could induce poor dental health in childhood, initiate unhealthy behaviors, and lower immune and physiological functions. However, it is not known whether ACEs have a longitudinal adverse effect on dental health in older age. This study aimed to investigate the association between experience of childhood abuse until the age of 18 and current number of remaining teeth among a sample of older Japanese adults. A retrospective cohort study was conducted using the data from the Japan Gerontological Evaluation Study (JAGES), a large-scale, self-reported survey in 2013 including 27 525 community-dwelling Japanese aged ≥65 years (response rate=71.1%). The outcome, current number of remaining teeth was used categorically: ≥20, 10-19, 5-9, 1-4, and no teeth. Childhood abuse was defined as having any experience of physical abuse, psychological abuse, and psychological neglect up until the age of 18 years. Ordered logistic regression models were applied. Of the 25 189 respondents who indicated their number of remaining teeth (mean age: 73.9; male: 46.5%), 14.8% had experience of childhood abuse. Distributions of ≥20, 10-19, 5-9, 1-4, and no teeth were as follows: 46.6%, 22.0%, 11.4%, 8.2%, and 11.8% among respondents with childhood abuse, while 52.3%, 21.3%, 10.3%, 6.6%, and 9.5% among respondents without childhood abuse. Childhood abuse was significantly associated with fewer remaining teeth after adjusting for covariates including socioeconomic status (odds ratio=1.14; 95% confidence interval: 1.06, 1.22). Childhood abuse could have a longitudinal adverse effect on later dental health in older age. This study emphasizes the importance of early life experiences on dental health throughout later life. © 2016 John Wiley & Sons A/S. Published by

  20. T cell immunity

    OpenAIRE

    Emel Bülbül Başkan

    2013-01-01

    Since birth, our immune system is constantly bombarded with self-antigens and foreign pathogens. To stay healthy, complex immune strategies have evolved in our immune system to maintain self-tolerance and to defend against foreign pathogens. Effector T cells are the key players in steering the immune responses to execute immune functions. While effector T cells were initially identified to be immune promoting, recent studies unraveled negative regulatory functions of effector T cells...

  1. Human Milk Oligosaccharides and Associations With Immune-Mediated Disease and Infection in Childhood: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Alice M. Doherty

    2018-04-01

    Full Text Available Complex sugars found in breastmilk, human milk oligosaccharides (HMOs, may assist in early-life immune programming and prevention against infectious diseases. This study aimed to systematically review the associations between maternal levels of HMOs and development of immune-mediated or infectious diseases in the offspring. PubMed and EMBASE databases were searched (last search on 22 February 2018 according to a predetermined search strategy. Original studies published in English examining the effect of HMOs on immune-mediated and infectious disease were eligible for inclusion. Of 847 identified records, 10 articles from 6 original studies were included, with study quality ranging from low to high. Of three studies to examine allergic disease outcomes, one reported a protective effect against cow’s milk allergy (CMA by 18 months of age associated with lower lacto-N-fucopentaose (LNFP III concentrations (OR: 6.7, 95% CI 2.0–22. Another study found higher relative abundance of fucosyloligosaccharides was associated with reduced diarrhea incidence by 2 years, due to (i stable toxin-E. coli infection (p = 0.04 and (ii “all causes” (p = 0.042. Higher LNFP-II concentrations were associated with (i reduced cases of gastroenteritis and respiratory tract infections at 6 weeks (p = 0.004, p = 0.010 and 12 weeks (p = 0.038, p = 0.038 and (ii reduced HIV transmission (OR: 0.45; 95% CI: 0.21–0.97 and mortality risk among HIV-exposed, uninfected infants (HR: 0.33; 95% CI: 0.14–0.74 by 24 months. Due to heterogeneity of the outcomes reported, pooling of results was not possible. There was limited evidence that low concentrations of LNFP-III are associated with CMA and that higher fucosyloligosaccharide levels protect infants against infectious disease. Further research is needed.

  2. Human Milk Oligosaccharides and Associations With Immune-Mediated Disease and Infection in Childhood: A Systematic Review.

    Science.gov (United States)

    Doherty, Alice M; Lodge, Caroline J; Dharmage, Shyamali C; Dai, Xin; Bode, Lars; Lowe, Adrian J

    2018-01-01

    Complex sugars found in breastmilk, human milk oligosaccharides (HMOs), may assist in early-life immune programming and prevention against infectious diseases. This study aimed to systematically review the associations between maternal levels of HMOs and development of immune-mediated or infectious diseases in the offspring. PubMed and EMBASE databases were searched (last search on 22 February 2018) according to a predetermined search strategy. Original studies published in English examining the effect of HMOs on immune-mediated and infectious disease were eligible for inclusion. Of 847 identified records, 10 articles from 6 original studies were included, with study quality ranging from low to high. Of three studies to examine allergic disease outcomes, one reported a protective effect against cow's milk allergy (CMA) by 18 months of age associated with lower lacto- N -fucopentaose (LNFP) III concentrations (OR: 6.7, 95% CI 2.0-22). Another study found higher relative abundance of fucosyloligosaccharides was associated with reduced diarrhea incidence by 2 years, due to (i) stable toxin- E. coli infection ( p  = 0.04) and (ii) "all causes" ( p  = 0.042). Higher LNFP-II concentrations were associated with (i) reduced cases of gastroenteritis and respiratory tract infections at 6 weeks ( p  = 0.004, p  = 0.010) and 12 weeks ( p  = 0.038, p  = 0.038) and (ii) reduced HIV transmission (OR: 0.45; 95% CI: 0.21-0.97) and mortality risk among HIV-exposed, uninfected infants (HR: 0.33; 95% CI: 0.14-0.74) by 24 months. Due to heterogeneity of the outcomes reported, pooling of results was not possible. There was limited evidence that low concentrations of LNFP-III are associated with CMA and that higher fucosyloligosaccharide levels protect infants against infectious disease. Further research is needed.

  3. The Wind Energy programme - SFOE Research Programme 2000 - 2003; Programm Wind. Konzept BFE-Forschungsprogramm 'Wind' 2000 - 2003

    Energy Technology Data Exchange (ETDEWEB)

    Horbaty, R.

    2001-07-01

    This document, issued by the Swiss Federal Office of Energy (SFOE) describes the concept behind the Swiss wind energy programme. The first part of the report discusses the origins and development of the wind energy programme in Switzerland, discussing the importance of wind energy and policy matters associated with its promotion. The experience gained during the previous research programmes is reviewed. The degree to which targets were reached, promotional activities, the central government's own wind energy activities and the results of a programme evaluation are discussed. Lists of projects that have been realised and activities that have been carried out are presented and positive and negative influences on development are noted. A second part is dedicated to the goals of the wind energy programme in terms of target figures for the year 2010 and the strategies chosen to reach these goals, including pilot and demonstration projects (P and D) and promotional activities. Details of the P and D programme including lists of wind-power projects to be supported, the priorities that have been set and information and further education that is to be provided, are given. New activities in the wind power area such as the development of new type of wind turbine especially suited to alpine conditions are discussed. The role of the Swiss Association for Wind Energy 'Suisse Eole' as a network-partner in the wind energy programme is discussed. An appendix provides details of wind energy projects in Switzerland, market partners and customers. The results of a survey made of wind energy activities at Swiss institutes of higher education are presented.

  4. Rapid growth and childhood obesity are strongly associated with lysoPC(14:0).

    Science.gov (United States)

    Rzehak, Peter; Hellmuth, Christian; Uhl, Olaf; Kirchberg, Franca F; Peissner, Wolfgang; Harder, Ulrike; Grote, Veit; Weber, Martina; Xhonneux, Annick; Langhendries, Jean-Paul; Ferre, Natalia; Closa-Monasterolo, Ricardo; Verduci, Elvira; Riva, Enrica; Socha, Piotr; Gruszfeld, Dariusz; Koletzko, Berthold

    2014-01-01

    Despite the growing interest in the early-origins-of-later-disease hypothesis, little is known about the metabolic underpinnings linking infant weight gain and childhood obesity. To discover biomarkers reflective of weight change in the first 6 months and overweight/obesity at age 6 years via a targeted metabolomics approach. This analysis comprised 726 infants from a European multicenter randomized trial (Childhood Obesity Programme, CHOP) for whom plasma blood samples at age 6 months and anthropometric data up to the age of 6 years were available. 'Rapid growth' was defined as a positive difference in weight within the first 6 months of life standardized to WHO growth standards. Weight change was regressed on each of 168 metabolites (acylcarnitines, lysophosphatidylcholines, sphingomyelins, and amino acids). Metabolites significant after Bonferroni's correction were tested as predictors of later overweight/obesity. Among the overall 19 significant metabolites, 4 were associated with rapid growth and 15 were associated with a less-than-ideal weight change. After adjusting for feeding group, only the lysophosphatidylcholine LPCaC14:0 remained significantly associated with rapid weight gain (β = 0.18). Only LPCaC14:0 at age 6 months was predictive of overweight/obesity at age 6 years (OR 1.33; 95% CI 1.04-1.69). LPCa14:0 is strongly related to rapid growth in infancy and childhood overweight/obesity. This suggests that LPCaC14:0 levels may represent a metabolically programmed effect of infant weight gain on the later obesity risk. However, these results require confirmation by independent cohorts. © 2014 S. Karger AG, Basel.

  5. Measuring polio immunity to plan immunization activities.

    Science.gov (United States)

    Voorman, Arend; Lyons, Hil M

    2016-11-21

    The Global Polio Eradication Initiative is closer than ever to achieving a polio-free world. Immunization activities must still be carried out in non-endemic countries to maintain population immunity at levels which will stop poliovirus from spreading if it is re-introduced from still-infected areas. In areas where there is no active transmission of poliovirus, programs must rely on surrogate indicators of population immunity to determine the appropriate immunization activities, typically caregiver-reported vaccination history obtained from non-polio acute flaccid paralysis patients identified through polio surveillance. We used regression models to examine the relationship between polio vaccination campaigns and caregiver-reported polio vaccination history. We find that in many countries, vaccination campaigns have a surprisingly weak impact on these commonly used indicators. We conclude that alternative criteria and data, such as routine immunization indicators from vaccination records or household surveys, should be considered for planning polio vaccination campaigns, and that validation of such surrogate indicators is necessary if they are to be used as the basis for program planning and risk assessment. We recommend that the GPEI and similar organizations consider or continue devoting additional resources to rigorously study population immunity and campaign effectiveness in at-risk countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Paternal occupational contact level and childhood leukaemia in rural Scotland: a case-control study.

    Science.gov (United States)

    Kinlen, L J; Bramald, S

    2001-04-06

    In a national Scottish study of 809 cases of leukaemia and non-Hodgkins lymphoma diagnosed in 1950-89 among children aged 0-4 years who were born in Scotland, together with 2363 matched population controls, we investigated one aspect of the infective hypothesis. This concerns whether in rural areas (where the prevalence of susceptible individuals is likely to be higher) the risk is greater among the young children of men whose work involves contacts with many different people, particularly children, as noted in certain childhood infections. A positive trend was found in rural areas across 3 levels of increasing paternal occupational contact (as recorded at birth) by each of 2 previously defined classifications; no such effect was found in urban areas. The rural trend was more marked in that part of the study period with greater population mixing, but the difference from the period with less mixing was not itself significant, leaving open whether these rural findings reflect the extreme isolation of much of rural Scotland, or the effects in such areas of a degree of population mixing. In marked contrast, among the 850 cases and 2492 controls aged 5-14, those in rural areas in the higher population mixing period showed a significantly decreasing trend with increasing paternal occupational contact level. This would be consistent with immunity produced either by earlier infection at ages 0-4 years, or directly by low doses of the infective agent that were largely immunizing at these older ages. The findings overall provide further support for infection underlying childhood leukaemia and for the role of adults. Copyright 2001 Cancer Research Campaign http://www.bjcancer.com.

  7. Resource needs of an occupational health service to accommodate a hepatitis B vaccination programme.

    Science.gov (United States)

    Jachuck, S J; Jones, C; Nicholls, A; Bartlett, M

    1990-01-01

    The administrative, organizational and clinical commitment of an occupational health department to implement the DHSS recommendation for a hepatitis B vaccination programme for the health care workers in a District General Hospital was reviewed to evaluate the resource implications needed to accommodate the additional workload. The deficiencies observed in the existing DHSS guidance in implementing the plan are described. It is suggested that the Department of Health, while making future recommendations for vaccination, should be more precise in identifying those at risk, in describing the desired titre to be achieved after vaccination, and in describing the follow-up plan for those who accept the vaccination, those who refuse and those who do not seroconvert. The recommendation should describe the commitment of the Health Authorities and must include recommendations for appropriate and adequate resources to support such a programme. Vaccination for 1000 employees at risk required 4000 additional consultations necessitating 16 additional hours of occupational health commitment per week. Eighteen months after initiating the vaccination programme, 677 employees had accepted the vaccine. After receiving 3 vaccines 508 (75 per cent) recipients had protective seroconversion (anti-Hbs greater than 100 I.U.) and a further 61 (9 per cent) converted after the 4th injection, thereby offering protective immunity to 84 per cent of the recipients. During the period 84 (12.4 per cent) were lost to follow-up. Recommendations have been made to accommodate the additional commitment through the vaccination programme to standardize our care and prevent disruption of the existing service.

  8. A qualitative evaluation to explore the suitability, feasibility and acceptability of using a 'celebration card' intervention in primary care to improve the uptake of childhood vaccinations.

    Science.gov (United States)

    Lwembe, Saumu; Green, Stuart A; Tanna, Nuttan; Connor, Jane; Valler, Colin; Barnes, Ruth

    2016-07-30

    Childhood vaccination remains a primary mechanism for reducing the burden of infectious disease. In the United Kingdom, as in many countries, a sustained effort is required to ensure that vaccination targets are met to afford protection to the whole population from vaccine preventable disease. The Celebrate and Protect programme is a collaborative partnership developed to improve the uptake of childhood vaccination across a number of boroughs within London through the use of a celebration card to encourage attendance for vaccination and enhance relationships between general practices and the parents/carers of children. This study was undertaken to assess the suitability, feasibility and acceptability of the Celebrate and Protect programme across nine boroughs in London. Data were collected either from telephone interviews (n = 24) or from focus groups (n = 31). A total of 55 key informants were included in the study, representing strategic, commissioning or policy leads, healthcare professionals and primary care teams delivering vaccinations and parents/carers of children under five. The analysis of data identified that whilst parents/carers saw the celebration card positively this raised the issue of 'vaccine hesitancy' and the lack of information that parents/carers have to make informed decisions about vaccination. Similarly, healthcare professionals viewed the programme positively and felt that it was deliverable within existing resources although they raised wider questions about on-going sustainability and about quantitative data collection. In relation to the collaboration between primary care and a pharmaceutical company in developing the Celebrate and Protect programme, it was generally felt that, provided appropriate governance is in place, it was a pragmatic approach in which the benefits outweighed any perceived disadvantages. The Celebrate and Protect programme was seen as an innovative collaborative programme to engage with parents and carers

  9. Discovering the Culture of Childhood

    Science.gov (United States)

    Plank, Emily

    2016-01-01

    We often filter our interactions with children through the lens of adulthood. View the culture of childhood through a whole new lens. Identify age-based bias and expand your outlook on and understanding of early childhood as a culture. Examine various elements of childhood culture: language, the power of believing, artistic expressions, and social…

  10. Exploration of predictors, moderators and mediators of change in parent skills training programmes for externalising behaviour problems in children – who benefits most and how do they work?

    OpenAIRE

    Jones, Holly

    2014-01-01

    Background: A key driver for early years strategies is the reduction of oppositional and defiant behaviour in childhood to prevent a negative life course of poor educational attainment and criminality. Despite a robust evidence base, manualised parent skills training programmes (PT) for externalising behaviour problems are only effective for approximately two-thirds of families. A limited number of variables that account for variance in outcome have been discovered. Finding fur...

  11. Childhood Obesity Causes & Consequences

    Science.gov (United States)

    ... and Local Programs Related Topics Diabetes Nutrition Childhood Obesity Causes & Consequences Recommend on Facebook Tweet Share Compartir ... determine how a community is designed. Consequences of Obesity More Immediate Health Risks Obesity during childhood can ...

  12. African indigenous care-giving practices: Stimulating early childhood development and education in Kenya

    Directory of Open Access Journals (Sweden)

    Pamela Wadende

    2016-12-01

    Full Text Available The indigenous communities in Africa, specifically Kenya, which is the focus of this article, had their own well-developed motivational systems that positively enhanced teaching and learning programmes in the community. These motivational systems were manifested in behaviours that were presented as sequential cultural tasks that demanded active engagement from children at every stage of development. The philosophical tenets of African indigenous education underscored education as preparation for life. This was a culturally based education that addressed the physical, emotional, mental and social aspects of a child’s successful development. It offered the child an opportunity to participate in practical, productive and responsible livelihood activities. This article suggests that a concert of research into these indigenous motivational care-giving practices and community participation in the activities of early childhood education may offer important insights into transitioning children from life in the home environment to that of the school and its accompanying academic tasks. When these motivational care-giving practices are incorporated in the process of transitioning children to formal schooling, then their chances of success in these new educational programmes could be enhanced.

  13. Immunizations challenge healthcare personnel and affects immunization rates.

    Science.gov (United States)

    Strohfus, Pamela K; Kim, Susan C; Palma, Sara; Duke, Russell A; Remington, Richard; Roberts, Caleb

    2017-02-01

    This study measured 1. medical office immunization rates and 2. health care personnel competency in managing vaccine practices before and after evidence-based immunization education was provided. This descriptive study compared 32 family medicine and pediatric offices and 178 medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians in knowledge-based testing pre-education, post-education, and 12-months post-education. Immunization rates were assessed before and 18-months post-education. Immunization rates increased 10.3% - 18months post-education; knowledge increased 7.8% - 12months post-education. Family medicine offices, licensed practical nurses, and medical assistants showed significant knowledge deficits before and 12-months post-education. All demographic groups scored less in storage/handling 12-months post-education. This study is one of the first studies to identify competency challenges in effective immunization delivery among medical assistants, licensed practical nurses, and family medicine offices. Formal and continuous education in immunization administration and storage/handling is recommended among these select groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Ghana's nuclear programme

    International Nuclear Information System (INIS)

    Ahafia, Albert K.

    1988-01-01

    The Paper gives the purpose of Ghana's Nuclear Programme and describes some specific research activities and peaceful applications of atomic energy in agriculture, medicine and industry. A discussion of some of the problem facing the programme concludes the Paper. (author)

  15. Immunization

    Science.gov (United States)

    ... a lot worse. Some are even life-threatening. Immunization shots, or vaccinations, are essential. They protect against ... B, polio, tetanus, diphtheria, and pertussis (whooping cough). Immunizations are important for adults as well as children. ...

  16. Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome.

    Science.gov (United States)

    Buckley, Maria M; O'Mahony, Siobhain M; O'Malley, Dervla

    2014-07-21

    Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome (IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked with periods of stress, both psychosocial and infection-related. Indeed, a high level of comorbidity exists between IBS and stress-related mood disorders such as anxiety and depression. Moreover, studies have observed alterations in autonomic output and neuro-endocrine signalling in IBS patients. Accumulating evidence indicates that a maladaptive stress response, probably mediated by the stress hormone, corticotropin-releasing factor contributes to the initiation, persistence and severity of symptom flares. Other risk factors for developing IBS include a positive family history, childhood trauma, dietary factors and prior gastrointestinal infection. An emerging role has been attributed to the importance of immune factors in the pathophysiology of IBS with evidence of altered cytokine profiles and increased levels of mucosal immune cells. These factors have also been shown to have direct effects on neural signalling. This review discusses how pathological changes in neural, immune and endocrine pathways, and communication between these systems, contribute to symptom flares in IBS.

  17. BACH transcription factors in innate and adaptive immunity.

    Science.gov (United States)

    Igarashi, Kazuhiko; Kurosaki, Tomohiro; Roychoudhuri, Rahul

    2017-07-01

    BTB and CNC homology (BACH) proteins are transcriptional repressors of the basic region leucine zipper (bZIP) transcription factor family. Recent studies indicate widespread roles of BACH proteins in controlling the development and function of the innate and adaptive immune systems, including the differentiation of effector and memory cells of the B and T cell lineages, CD4 + regulatory T cells and macrophages. Here, we emphasize similarities at a molecular level in the cell-type-specific activities of BACH factors, proposing that competitive interactions of BACH proteins with transcriptional activators of the bZIP family form a common mechanistic theme underlying their diverse actions. The findings contribute to a general understanding of how transcriptional repressors shape lineage commitment and cell-type-specific functions through repression of alternative lineage programmes.

  18. Personalizing the Approach to Childhood Asthma

    Science.gov (United States)

    ... to Childhood Asthma Share | Personalizing the approach to childhood asthma Published Online: March 24, 2104 Clinicians treating asthmatic ... classifying 1,041 asthmatics who participated in the Childhood Asthma Management Program (CAMP) clinical trial that assessed long- ...

  19. Immunity by equilibrium.

    Science.gov (United States)

    Eberl, Gérard

    2016-08-01

    The classical model of immunity posits that the immune system reacts to pathogens and injury and restores homeostasis. Indeed, a century of research has uncovered the means and mechanisms by which the immune system recognizes danger and regulates its own activity. However, this classical model does not fully explain complex phenomena, such as tolerance, allergy, the increased prevalence of inflammatory pathologies in industrialized nations and immunity to multiple infections. In this Essay, I propose a model of immunity that is based on equilibrium, in which the healthy immune system is always active and in a state of dynamic equilibrium between antagonistic types of response. This equilibrium is regulated both by the internal milieu and by the microbial environment. As a result, alteration of the internal milieu or microbial environment leads to immune disequilibrium, which determines tolerance, protective immunity and inflammatory pathology.

  20. Parenting self-efficacy, parenting stress and child behaviour before and after a parenting programme.

    Science.gov (United States)

    Bloomfield, Linda; Kendall, Sally

    2012-10-01

    To explore whether changes in parenting self-efficacy after attending a parenting programme are related to changes in parenting stress and child behaviour. Adverse parenting is a risk factor in the development of a range of health and behavioural problems in childhood and is predictive of poor adult outcomes. Strategies for supporting parents are recognised as an effective way to improve the health, well-being and development of children. Parenting is influenced by many factors including the behaviour and characteristics of the child, the health and psychological well-being of the parent and the contextual influences of stress and support. Parenting difficulties are a major source of stress for parents, and parenting self-efficacy has been shown to be an important buffer against parenting stress. In all, 63 parents who had a child under the age of 10 years took part in the research. Of those, 58 returned completed measures of parenting self-efficacy, parenting stress and child behaviour at the start of a parenting programme and 37 at three-month follow-up. Improvements in parenting self-efficacy and parenting stress were found at follow-up, but there was less evidence for improvements in child behaviour. The findings clearly suggest a relationship between parenting self-efficacy and parenting stress; parents who are feeling less efficacious experience higher levels of stress, whereas greater parenting self-efficacy is related to less stress. This study adds to the evidence that parent outcomes may be a more reliable measure of programme effectiveness than child outcomes at least in the short term.

  1. Cross-immunity among allogeneic tumors of rats immunized with solid tumors

    International Nuclear Information System (INIS)

    Ogasawara, Masamichi

    1979-01-01

    Several experiments were done for the study of cross-immunity among allogeneic rat tumors by immunization using gamma-irradiated or non-irradiated solid tumors. Each group of rats which were immunized with gamma-irradiation solid tumor inocula from ascites tumor cell line of tetra-ploid Hirosaki sarcoma, Usubuchi sarcoma or AH 130, showed an apparent resistance against the intraperitoneal challenge with Hirosaki sarcoma. A similar resistance was demonstrated in the case of the challenge with Usubuchi sarcoma into rats immunized with non-irradiated methylcholanthrene (MCA)-induced tumors. In using solid MCA tumors as immunogen and Hirosaki sarcoma as challenge tumor, it was also demonstrated in 2 out of 3 groups immunized with non-irradiated tumors. In the experiment of trying to induce cross-immunity between 2 MCA tumors by immunization with irradiated solid tumor only, the inhibitory effect on the growth was observed in the early stage in the treated groups as compared with the control one. From the above results, it may be considered that the immunization with irradiated solid tumors fromas cites cell lines and non-irradiated solid MCA tumors induced strong cross-immunity in general, but that the immunization with only irradiated solid MCA tumors induced weak cross-immunity commonly. (author)

  2. Childhood Obesity: Common Misconceptions

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Childhood Obesity: Common Misconceptions Page Content Article Body Everyone, it ... for less than 1% of the cases of childhood obesity. Yes, hypothyroidism (a deficit in thyroid secretion) and ...

  3. Childhood antecedents of adolescent personality disorders.

    Science.gov (United States)

    Bernstein, D P; Cohen, P; Skodol, A; Bezirganian, S; Brook, J S

    1996-07-01

    The purpose of this study was to investigate the childhood antecedents of personality disorders that are diagnosed in adolescence. A randomly selected community sample of 641 youths was assessed initially in childhood and followed longitudinally over 10 years. Childhood behavior ratings were based on maternal report; diagnoses of adolescent personality disorders were based on data obtained from both maternal and youth informants. Four composite measures of childhood behavior problems were used: conduct problems, depressive symptoms, anxiety/fear, and immaturity. Adolescent personality disorders were considered present only if the disorders persisted over a 2-year period. For all analyses, personality disorders were grouped into the three clusters (A, B, and C) of DSM-III-R. Logistic regression analyses indicated that all four of the putative childhood antecedents were associated with greater odds of an adolescent personality disorder 10 years later. Childhood conduct problems remained an independent predictor of personality disorders in all three clusters, even when other childhood problems were included in the same regression model. Additionally, depressive symptoms emerged as an independent predictor of cluster A personality disorders in boys, while immaturity was an independent predictor of cluster B personality disorders in girls. No moderating effects of age at time of childhood assessment were found. These results support the view that personality disorders can be traced to childhood emotional and behavioral disturbances and suggest that these problems have both general and specific relationships to adolescent personality functioning.

  4. FUSION technology programme 2003-2006

    International Nuclear Information System (INIS)

    Karttunen, S.; Rantamaeki, K.

    2007-01-01

    This report summarises the results of the FUSION technology programme during the period between 2003-2006. FUSION is a continuation of the previous FFusion and FFusion2 technology programmes that took place from 1993 to 2002. The FUSION technology programme was fully integrated into the European Fusion Programme in the sixth Framework Programme (Euratom), through the bilateral Contract of Association between Euratom and Tekes and the multilateral European Fusion Development Agreement (EFDA). The Association Euratom-Tekes was established in 1995. At the moment, there are 26 Euratom Fusion associations working together as an European Research Area. There are four research areas in the FUSION technology programme: (1) fusion physics and plasma engineering, (2) vessel/in-vessel materials, joints and components, (3) in-vessel remote handling systems, and (4) system studies. The FUSION team consists of research groups from the Technical Research Centre of Finland (VTT), the Helsinki, Tampere and Lappeenranta Universities of Technology and the University of Helsinki. The co-ordinating unit is VTT. A key element of the FUSION programme is the close collaboration between VTT, the universities and the industry, which has resulted in dynamic and sufficiently large research teams to tackle challenging research and development projects. The distribution of work between research institutes and industry has also been clear. Industrial activities related to the FUSION programme are co-ordinated through the 'Big Science' Project by Finpro and Prizztech. The total expenditure of the FUSION technology programme for 2003-2006 amounted to euro 14,9 million in research work at VTT and the universities with an additional euro 3,5 million for projects by the Finnish companies including the industry co-ordination. The funding of the FUSION programme and related industrial projects was mainly provided by Tekes (37%), Euratom (38%) and the participating institutes and industry (24%). The

  5. Microbial-immune cross-talk and regulation of the immune system.

    Science.gov (United States)

    Cahenzli, Julia; Balmer, Maria L; McCoy, Kathy D

    2013-01-01

    We are all born germ-free. Following birth we enter into a lifelong relationship with microbes residing on our body's surfaces. The lower intestine is home to the highest microbial density in our body, which is also the highest microbial density known on Earth (up to 10(12) /g of luminal contents). With our indigenous microbial cells outnumbering our human cells by an order of magnitude our body is more microbial than human. Numerous immune adaptations confine these microbes within the mucosa, enabling most of us to live in peaceful homeostasis with our intestinal symbionts. Intestinal epithelial cells not only form a physical barrier between the bacteria-laden lumen and the rest of the body but also function as multi-tasking immune cells that sense the prevailing microbial (apical) and immune (basolateral) milieus, instruct the underlying immune cells, and adapt functionally. In the constant effort to ensure intestinal homeostasis, the immune system becomes educated to respond appropriately and in turn immune status can shape the microbial consortia. Here we review how the dynamic immune-microbial dialogue underlies maturation and regulation of the immune system and discuss recent findings on the impact of diet on both microbial ecology and immune function. © 2012 The Authors. Immunology © 2012 Blackwell Publishing Ltd.

  6. Clarifying Parent-Child Reciprocities during Early Childhood: The Early Childhood Coercion Model

    Science.gov (United States)

    Scaramella, Laura V.; Leve, Leslie D.

    2004-01-01

    Consistent with existing theory, the quality of parent-child interactions during early childhood affects children's social relationships and behavioral adjustment during middle childhood and adolescence. Harsh parenting and a propensity toward emotional overarousal interact very early in life to affect risk for later conduct problems. Less…

  7. Overmathematisation in game theory : pitting the Nash Equilibrium Refinement Programme against the Epistemic Programme

    NARCIS (Netherlands)

    de Bruin, Boudewijn

    The paper argues that the Nash Equilibrium Refinement Programme was less successful than its competitor, the Epistemic Programme (Interactive Epistemology). The prime criterion of success is the extent to which the programmes were able to reach the key objective guiding non-cooperative game theory

  8. Extrapyramidal disorders in childhood

    International Nuclear Information System (INIS)

    Angelini, L.; Nardocci, N.; Balottin, U.; Lanzi, G.

    1987-01-01

    Movement disorders have become significantly interesting as a subject in the Neurosciences. The majority of the data, however, relate to the more specific problems of extrapyramidal disorders in adults. As a disease in childhood it still remains poorly systemized. This book is a collection of certain studies with reference to the most recent advances regarding the morphofunctional organization of the basal ganglia in relation to development. Moreover, the book attempts to systemize the extrapyramidal diseases typical of childhood or at the onset in childhood, focusing on diagnostic and therapeutic criteria. refs.; figs.; tabs

  9. Our Immune System

    Science.gov (United States)

    Our Immune System A story for children with primary immunodeficiency diseases Written by Sara LeBien IMMUNE DEFICIENCY FOUNDATION A note ... who are immune deficient to better understand their immune system. What is a “ B-cell, ” a “ T-cell, ” ...

  10. The comprehensive ‘Communicate to Vaccinate’ taxonomy of communication interventions for childhood vaccination in routine and campaign contexts

    Directory of Open Access Journals (Sweden)

    Jessica Kaufman

    2017-05-01

    Full Text Available Abstract Background Communication can be used to generate demand for vaccination or address vaccine hesitancy, and is crucial to successful childhood vaccination programmes. Research efforts have primarily focused on communication for routine vaccination. However, vaccination campaigns, particularly in low- or middle-income countries (LMICs, also use communication in diverse ways. Without a comprehensive framework integrating communication interventions from routine and campaign contexts, it is not possible to conceptualise the full range of possible vaccination communication interventions. Therefore, vaccine programme managers may be unaware of potential communication options and researchers may not focus on building evidence for interventions used in practice. In this paper, we broaden the scope of our existing taxonomy of communication interventions for routine vaccination to include communication used in campaigns, and integrate these into a comprehensive taxonomy of vaccination communication interventions. Methods Building on our taxonomy of communication for routine vaccination, we identified communication interventions used in vaccination campaigns through a targeted literature search; observation of vaccination activities in Cameroon, Mozambique and Nigeria; and stakeholder consultations. We added these interventions to descriptions of routine vaccination communication and categorised the interventions according to their intended purposes, building from an earlier taxonomy of communication related to routine vaccination. Results The comprehensive taxonomy groups communication used in campaigns and routine childhood vaccination into seven purpose categories: ‘Inform or Educate’; ‘Remind or Recall’; ‘Enhance Community Ownership’; ‘Teach Skills’; ‘Provide Support’; ‘Facilitate Decision Making’ and ‘Enable Communication’. Consultations with LMIC stakeholders and experts informed the taxonomy’s definitions and

  11. Pneumonia’s second wind? A case study of the global health network for childhood pneumonia

    Science.gov (United States)

    Berlan, David

    2016-01-01

    Advocacy, policy, research and intervention efforts against childhood pneumonia have lagged behind other health issues, including malaria, measles and tuberculosis. Accelerating progress on the issue began in 2008, following decades of efforts by individuals and organizations to address the leading cause of childhood mortality and establish a global health network. This article traces the history of this network’s formation and evolution to identify lessons for other global health issues. Through document review and interviews with current, former and potential network members, this case study identifies five distinct eras of activity against childhood pneumonia: a period of isolation (post WWII to 1984), the duration of WHO’s Acute Respiratory Infections (ARI) Programme (1984–1995), Integrated Management of Childhood illness’s (IMCI) early years (1995–2003), a brief period of network re-emergence (2003–2008) and recent accelerating progress (2008 on). Analysis of these eras reveals the critical importance of building a shared identity in order to form an effective network and take advantage of emerging opportunities. During the ARI era, an initial network formed around a relatively narrow shared identity focused on community-level care. The shift to IMCI led to the partial dissolution of this network, stalled progress on addressing pneumonia in communities and missed opportunities. Frustrated with lack of progress on the issue, actors began forming a network and shared identity that included a broad spectrum of those whose interests overlap with pneumonia. As the network coalesced and expanded, its members coordinated and collaborated on conducting and sharing research on severity and tractability, crafting comprehensive strategies and conducting advocacy. These network activities exerted indirect influence leading to increased attention, funding, policies and some implementation. PMID:26438780

  12. Parental Approach to the Prevention and Management of Fever and Pain Following Childhood Immunizations: A Survey Study.

    Science.gov (United States)

    Saleh, Ezzeldin; Swamy, Geeta K; Moody, M Anthony; Walter, Emmanuel B

    2017-05-01

    Antipyretic analgesics are commonly used to prevent and treat adverse events following immunizations. Current practice discourages routine use due to possible blunting of vaccine immune responses. We surveyed 150 parents/caregivers of recently vaccinated 6- and 15-month-old children to determine the prevalence of and beliefs regarding antipyretic analgesics use around vaccinations. 11% used them prophylactically, before vaccination. Use in the first 48 hours after vaccination was 64%, primarily to prevent and/or treat fever and pain. Acetaminophen was administered 2.6 times more frequently than ibuprofen. Ibuprofen was used more in the 15-month compared with the 6-month-old children (28% vs 7.4%, respectively, P = .001). The majority of caregivers disagreed with their use for fever (53%) or pain (59%). Antipyretic analgesic use, including prophylaxis, around vaccinations was common in our study population. Effective interventions are needed to target parents/caregivers to eliminate unnecessary antipyretic analgesic use around vaccination time and foster nonmedication alternatives.

  13. Immunization Coverage

    Science.gov (United States)

    ... room/fact-sheets/detail/immunization-coverage","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... Plan Global Health Observatory (GHO) data - Immunization More information on vaccines and immunization News 1 in 10 ...

  14. Changing Epidemiological Characteristics of Hepatitis A in Zhejiang Province, China: Increased Susceptibility in Adults.

    Directory of Open Access Journals (Sweden)

    Zhifang Wang

    Full Text Available Hepatitis A is a common acute hepatitis caused by hepatitis A virus (HAV. Annually, it affects 1.4 million people worldwide. Between 1991 and 1994, HAV infections were highly endemic in Zhejiang Province (China, with 78,720 reported HAV infections per year. Hepatitis A vaccine came on the market in 1995 and was implemented for voluntary immunization. Since 2008, hepatitis A vaccine has been integrated into the national childhood routine immunization program.To understand the current epidemiological profile of hepatitis A in Zhejiang Province since hepatitis A vaccine has been available for nearly two decades.This study used the 2005-2014 National Notifiable Diseases Reporting System data to evaluate the incidence rate of notified hepatitis A cases in Zhejiang Province.The overall trend of incidence rate of notified hepatitis A cases significantly decreased from 2005 to 2014 (P< 0.001. During the study period, the reported incidence rate in individuals aged ≤19 years declined to the historically lowest record in 2014. Compared with individuals aged ≤19 years, those aged ≥20 years showed the highest incidence rate (P< 0.001. Majority of HAV infected cases were Laborers, accounting for approximately 70% of reported cases.Childhood immunization strategy with hepatitis A vaccine seemed to be effective in decreasing notified hepatitis A incidence rate in individuals aged ≤19 years. Those aged ≥20 years were observed to be the most susceptible population. The vast majority of hepatitis A cases were notified among Laborers. Therefore, we strongly suggest that future preventive and control measures should focus more on adults, particularly Laborers, in addition to the current childhood hepatitis A vaccination programme.

  15. Serum levels of innate immunity cytokines are elevated in dogs with metaphyseal osteopathy (hypertrophic osteodytrophy) during active disease and remission.

    Science.gov (United States)

    Safra, Noa; Hitchens, Peta L; Maverakis, Emanual; Mitra, Anupam; Korff, Courtney; Johnson, Eric; Kol, Amir; Bannasch, Michael J; Pedersen, Niels C; Bannasch, Danika L

    2016-10-15

    Metaphyseal osteopathy (MO) (hypertrophic osteodystrophy) is a developmental disorder of unexplained etiology affecting dogs during rapid growth. Affected dogs experience relapsing episodes of lytic/sclerotic metaphyseal lesions and systemic inflammation. MO is rare in the general dog population; however, some breeds (Weimaraner, Great Dane and Irish Setter) have a much higher incidence, supporting a hereditary etiology. Autoinflammatory childhood disorders of parallel presentation such as chronic recurrent multifocal osteomyelitis (CRMO), and deficiency of interleukin-1 receptor antagonist (DIRA), involve impaired innate immunity pathways and aberrant cytokine production. Given the similarities between these diseases, we hypothesize that MO is an autoinflammatory disease mediated by cytokines involved in innate immunity. To characterize immune dysregulation in MO dogs we measured serum levels of inflammatory markers in 26 MO and 102 control dogs. MO dogs had significantly higher levels (pg/ml) of serum Interleukin-1beta (IL-1β), IL-18, IL-6, Granulocyte-macrophage colony stimulating factor (GM-CSF), C-X-C motif chemokine 10 (CXCL10), tumor necrosis factor (TNF), and IL-10. Notably, recovered MO dogs were not different from dogs during active MO disease, providing a suggestive mechanism for disease predisposition. This is the first documentation of elevated immune markers in MO dogs, uncovering an immune profile similar to comparable autoinflammatory disorders in children. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. FFUSION research programme 1993-1998. Final report of the Finnish fusion research programme

    Energy Technology Data Exchange (ETDEWEB)

    Karttunen, S.; Heikkinen, J.; Korhonen, R. [VTT Energy, Espoo (Finland)] [and others

    1998-12-31

    This report summarizes the results of the Fusion Energy Research Programme, FFUSION, during the period 1993-1998. After the planning phase the programme started in 1994, and later in March 1995 the FFUSION Programme was integrated into the EU Fusion Programme and the Association Euratom-Tekes was established. Research areas in the FFUSION Programme are (1) fusion physics and plasma engineering, (2) fusion reactor materials and (3) remote handling systems. In all research areas industry is involved. Recently, a project on environmental aspects of fusion and other future energy systems started as a part of the socio-economic research (SERF) in the Euratom Fusion Programme. A crucial component of the FFUSION programme is the close collaboration between VTT Research Institutes, universities and Finnish industry. This collaboration has guaranteed dynamic and versatile research teams, which are large enough to tackle challenging research and development projects. Regarding industrial fusion R and D activities, the major step was the membership of Imatran Voima Oy in the EFET Consortium (European Fusion Engineering and Technology), which further strengthened the position of industry in the engineering design activities of ITER. The number of FFUSION research projects was 66. In addition, there were 32 industrial R and D projects. The total cost of the FFUSION Programme in 1993-1998 amounted to FIM 54 million in research at VTT and universities and an additional FIM 21 million for R and D in Finnish industry. The main part of the funding was provided by Tekes, 36%. Since 1995, yearly Euratom funding has exceeded 25%. The FFUSION research teams have played an active role in the European Programme, receiving excellent recognition from the European partners. Theoretical and computational fusion physics has been at a high scientific level and the group collaborates with the leading experimental laboratories in Europe. Fusion technology is focused on reactor materials, joining

  17. FFUSION research programme 1993-1998. Final report of the Finnish fusion research programme

    International Nuclear Information System (INIS)

    Karttunen, S.; Heikkinen, J.; Korhonen, R.

    1998-01-01

    This report summarizes the results of the Fusion Energy Research Programme, FFUSION, during the period 1993-1998. After the planning phase the programme started in 1994, and later in March 1995 the FFUSION Programme was integrated into the EU Fusion Programme and the Association Euratom-Tekes was established. Research areas in the FFUSION Programme are (1) fusion physics and plasma engineering, (2) fusion reactor materials and (3) remote handling systems. In all research areas industry is involved. Recently, a project on environmental aspects of fusion and other future energy systems started as a part of the socio-economic research (SERF) in the Euratom Fusion Programme. A crucial component of the FFUSION programme is the close collaboration between VTT Research Institutes, universities and Finnish industry. This collaboration has guaranteed dynamic and versatile research teams, which are large enough to tackle challenging research and development projects. Regarding industrial fusion R and D activities, the major step was the membership of Imatran Voima Oy in the EFET Consortium (European Fusion Engineering and Technology), which further strengthened the position of industry in the engineering design activities of ITER. The number of FFUSION research projects was 66. In addition, there were 32 industrial R and D projects. The total cost of the FFUSION Programme in 1993-1998 amounted to FIM 54 million in research at VTT and universities and an additional FIM 21 million for R and D in Finnish industry. The main part of the funding was provided by Tekes, 36%. Since 1995, yearly Euratom funding has exceeded 25%. The FFUSION research teams have played an active role in the European Programme, receiving excellent recognition from the European partners. Theoretical and computational fusion physics has been at a high scientific level and the group collaborates with the leading experimental laboratories in Europe. Fusion technology is focused on reactor materials, joining

  18. An intronic polymorphism of IRF4 gene influences gene transcription in vitro and shows a risk association with childhood acute lymphoblastic leukemia in males.

    Science.gov (United States)

    Do, Thuy N; Ucisik-Akkaya, Esma; Davis, Charronne F; Morrison, Brittany A; Dorak, M Tevfik

    2010-02-01

    The interferon regulatory factor (IRF) family of DNA-binding proteins regulates expression of interferon-inducible genes with roles in the immune response and carcinogenesis. IRF4 is involved in the differentiation of B and T cells and is overexpressed in B-cell malignancies as a result of c-REL (NF-kappaB) hyperactivation. IRF4 polymorphisms are associated with susceptibility to chronic lymphoid leukemia (CLL) and non-Hodgkin lymphoma (NHL). We examined 13 IRF4 SNPs in 114 cases of childhood acute lymphoblastic leukemia (ALL) and 388 newborn controls from Wales (U.K.) using TaqMan assays. IRF4 intron 4 SNP rs12203592 showed a male-specific risk association (OR=4.4, 95% CI=1.5 to 12.6, P=0.007). Functional consequences of the C>T substitution at this SNP were assessed by cell-based reporter assays using three different cell lines. We found a repressive effect of the rs12203592 wildtype allele C on IRF4 promoter activity (Pcell line tested. Thus, homozygosity for the rs12203592 variant allele would result in increased IRF4 expression. This increase would be compounded by high levels of NF-kappaB activity in males due to the absence of estrogen. IRF4 differs from other IRFs in its anti-interferon activity which interferes with immune surveillance. We propose that a detailed study of IRF4 can provide information on the mechanism of the sex effect and the role of immune surveillance in childhood ALL development. Copyright 2009 Elsevier B.V. All rights reserved.

  19. Teaching in English-medium programmes

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.; Cozart, Stacey Marie

    in such a way that they take into account their students’ diverse cultural and linguistic backgrounds and use them as a strength in the classroom; and they should be able to engage all students in joint learning activities so that both the Danish and the international students benefit from the programme......This contribution describes and discusses the module Teaching in English-medium programmes, an elective module offered as part of the teacher training programme for assistant professors (“adjunktpædagogikum”) at Aarhus University. In order to complete the whole programme, assistant professors must...... have at least one such elective module (http://upnet.au.dk/adjunktkursus/). Aarhus University offers the teacher training programme in Danish and in English for international faculty. Teaching in English-medium programmes is part of the Danish track, but taught through English. Building...

  20. Postgraduate programme in tissue banking

    International Nuclear Information System (INIS)

    Yongyudh Vajaradul

    1999-01-01

    In 1992 in the Project Formulation Meeting of IAEA, the masters degree programme was proposed by Dr. Youngyudh Vajaradul, Thailand to upgrade the personnel of tissue bank and the person who had been working and involving in tissue banking. After The Bangkok Biomaterial Center proposed the degree programme and presented to Mahidol University, this programme was accepted by Ministry of University Affairs in 1998 and the masters degree programme under the name of 'Masters of Science in Biomaterial for Implantation' will be started in April 1999. IAEA will support the fellowship candidates from the region to study in masters degree programme. The programme includes 6 months of course work in Bangkok that is 12 credits and 24 is for the dissertation work which would be done in any country. The time of validity is 5 years