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Sample records for sustaining immunization coverage

  1. Immunization Coverage

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    ... 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 ...

  2. Immunization coverage among Hispanic ancestry, 2003 National Immunization Survey.

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    Darling, Natalie J; Barker, Lawrence E; Shefer, Abigail M; Chu, Susan Y

    2005-12-01

    The Hispanic population is increasing and heterogeneous (Hispanic refers to persons of Spanish, Hispanic, or Latino descent). The objective was to examine immunization rates among Hispanic ancestry for the 4:3:1:3:3 series (> or = 4 doses diphtheria, tetanus toxoids, and pertussis vaccine; > or = 3 doses poliovirus vaccine; > or = 1 doses measles-containing vaccine; > or = 3 doses Haemophilus influenzae type b vaccine; and > or = 3 doses hepatitis B vaccine). The National Immunization Survey measures immunization coverage among 19- to 35-month-old U.S. children. Coverage was compared from combined 2001-2003 data among Hispanics and non-Hispanic whites using t-tests, and among Hispanic ancestry using a chi-square test. Hispanics were categorized as Mexican, Mexican American, Central American, South American, Puerto Rican, Cuban, Spanish Caribbean (primarily Dominican Republic), other, and multiple ancestry. Children of Hispanic ancestry increased from 21% in 1999 to 25% in 2003. These Hispanic children were less well immunized than non-Hispanic whites (77.0%, +/-2.1% [95% confidence interval] compared to 82.5%, +/-1.1% (95% CI) > in 2003). Immunization coverage did not vary significantly among Hispanics of varying ancestries (p=0.26); however, there was substantial geographic variability. In some areas, immunization coverage among Hispanics was significantly higher than non-Hispanic whites. Hispanic children were less well immunized than non-Hispanic whites; however, coverage varied notably by geographic area. Although a chi-square test found no significant differences in coverage among Hispanic ancestries, the range of coverage, 79.2%, +/-5.1% for Cuban Americans to 72.1%, +/-2.4% for Mexican descent, may suggest a need for improved and more localized monitoring among Hispanic communities.

  3. Tetanus toxoid immunization coverage among mothers of below one ...

    African Journals Online (AJOL)

    Poverty and lack of health facilities also contributed to the low level of immunization coverage. For TT immunization to improve in the area studied, factors impeding immunization must be addressed. Keywords: tetanus, immunization, coverage. African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 233- ...

  4. Recommendation system for immunization coverage and monitoring.

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    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.

  5. A mid-term assessment of progress towards the immunization coverage goal of the Global Immunization Vision and Strategy (GIVS

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    Karimov Rouslan I

    2011-10-01

    Full Text Available Abstract Background The Global Immunization Vision and Strategy (GIVS (2006-2015 aims to reach and sustain high levels of vaccine coverage, provide immunization services to age groups beyond infancy and to those currently not reached, and to ensure that immunization activities are linked with other health interventions and contribute to the overall development of the health sector. Objective To examine mid-term progress (through 2010 of the immunization coverage goal of the GIVS for 194 countries or territories with special attention to data from 68 countries which account for more than 95% of all maternal and child deaths. Methods We present national immunization coverage estimates for the third dose of diphtheria and tetanus toxoid with pertussis (DTP3 vaccine and the first dose of measles containing vaccine (MCV during 2000, 2005 and 2010 and report the average annual relative percent change during 2000-2005 and 2005-2010. Data are taken from the WHO and UNICEF estimates of national immunization coverage, which refer to immunizations given during routine immunization services to children less than 12 months of age where immunization services are recorded. Results Globally DTP3 coverage increased from 74% during 2000 to 85% during 2010, and MCV coverage increased from 72% during 2000 to 85% during 2010. A total of 149 countries attained or were on track to achieve the 90% coverage goal for DTP3 (147 countries for MCV coverage. DTP3 coverage ≥ 90% was sustained between 2005 and 2010 by 99 countries (98 countries for MCV. Among 68 priority countries, 28 countries were identified as having made either insufficient or no progress towards reaching the GIVS goal of 90% coverage by 2015 for DTP3 or MCV. DTP3 and MCV coverage remained Conclusion Progress towards GIVS goals highlights improvements in routine immunization coverage, yet it is troubling to observe priority countries with little or no progress during the past five years. These results

  6. IMMUNIZATION COVERAGE IN ETAWAH: A BORDER DISTRICT OF UTTAR PRADESH

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    C M Singh

    2012-06-01

    Full Text Available Research question: What is the coverage of immunization among children of 12-23 months age group in rural Etawah (a border District of Uttar Pradesh? Objectives: 1. To assess the immunization coverage among 12-23 months age group children in rural Etawah. 2. To study the association of different socio-demographic factors with utilization of immunization services. Study Design: A community based cross sectional study. Setting: The present study was conducted in Saifai Block of District Etawah. Participants: Two hundred and ten children of 12-23 months were included in the study. Results: The percentage of completely immunized children was found to be 40%. The present study revealed that approximately 79.0% children were immunized against BCG, while the corresponding figure for measles vaccination was just 42.4%. Drop-out rate for complete immunization was 48.1%. Conclusion: Overall coverage of immunization services among children aged 12-23 months was lower than the national figures for rural Etawah. Literacy status of parents was significantly associated with the percentage of fully immunized children and the drop-out rate was also found to be higher among children of illiterate mothers. So there is need and scope of more focused Information, education and communication efforts towards parents regarding immunization services.

  7. IMMUNIZATION COVERAGE IN ETAWAH: A BORDER DISTRICT OF UTTAR PRADESH

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    C M Singh

    2012-07-01

    Full Text Available Research question: What is the coverage of immunization among children of 12-23 months age group in rural Etawah (a border District of Uttar Pradesh? Objectives: 1. To assess the immunization coverage among 12-23 months age group children in rural Etawah. 2. To study the association of different socio-demographic factors with utilization of immunization services. Study Design: A community based cross sectional study. Setting: The present study was conducted in Saifai Block of District Etawah. Participants: Two hundred and ten children of 12-23 months were included in the study. Results: The percentage of completely immunized children was found to be 40%. The present study revealed that approximately 79.0% children were immunized against BCG, while the corresponding figure for measles vaccination was just 42.4%. Drop-out rate for complete immunization was 48.1%. Conclusion: Overall coverage of immunization services among children aged 12-23 months was lower than the national figures for rural Etawah. Literacy status of parents was significantly associated with the percentage of fully immunized children and the drop-out rate was also found to be higher among children of illiterate mothers. So there is need and scope of more focused Information, education and communication efforts towards parents regarding immunization services.

  8. Evaluation of immunization coverage in the rural area of Pune, Maharashtra, using the 30 cluster sampling technique

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    Pankaj Kumar Gupta

    2013-01-01

    Full Text Available Background: Infectious diseases are a major cause of morbidity and mortality in children. One of the most cost-effective and easy methods for child survival is immunization. Despite all the efforts put in by governmental and nongovernmental institutes for 100% immunization coverage, there are still pockets of low-coverage areas. In India, immunization services are offered free in public health facilities, but, despite rapid increases, the immunization rate remains low in some areas. The Millennium Development Goals (MDG indicators also give importance to immunization. Objective: To assess the immunization coverage in the rural area of Pune. Materials and Methods: A cross-sectional study was conducted in the field practice area of the Rural Health Training Center (RHTC using the WHO′s 30 cluster sampling method for evaluation of immunization coverage. Results: A total of 1913 houses were surveyed. A total of 210 children aged 12-23 months were included in the study. It was found that 86.67% of the children were fully immunized against all the six vaccine-preventable diseases. The proportion of fully immunized children was marginally higher in males (87.61% than in females (85.57%, and the immunization card was available with 60.95% of the subjects. The most common cause for partial immunization was that the time of immunization was inconvenient (36%. Conclusion: Sustained efforts are required to achieve universal coverage of immunization in the rural area of Pune district.

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

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    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.

  10. Pertussis: herd immunity and vaccination coverage in St Lucia.

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    Cooper, E; Fitch, L

    1983-11-12

    In a single complete epidemic in St Lucia, an island too small to support constant clinical pertussis, the pertussis case rates in small communities (villages and small towns) with differing levels of vaccination coverage of young children were compared. The association between greater vaccination coverage and greater herd immunity was clear, despite the imperfect protection given to individuals. An analysis in terms of population dynamics is evidence against the theory that endemic subclinical pertussis maintains transmission in a highly vaccinated population. We suggest that with a homogeneous vaccination coverage of 80% of 2-year-old children pertussis might be eradicated from the island, and that this is a practicable experiment.

  11. Immunization Coverage in WHO Regions: A Review Article

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    Rahim Vakili

    2015-03-01

    Full Text Available   In 1974, the World Health Organization (WHO established the Expanded Program on Immunization (EPI to ensure that all children have access to routinely recommended vaccines. Since then, global coverage with the four core vaccines (Bacille calmette guérin vaccine [for protection against tuberculosis], Diphtheria-tetanus-pertussis vaccine [DTP], Polio vaccine, and Measles vaccine has increased from

  12. A Study Of Universal Immunization Coverage During Last Five Years In Resettlement Colonies Of Delhi

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    Salhotra V S

    1999-01-01

    Full Text Available Research Question: Is there any difference in immunization coverage in resettlement colonies of Delhi during past five years? Objectives: 1. To study the immunization coverage levels of children over a period of five years. 2. To observe changes in the coverage levels of different years, if any. Study design: Cross-sectional study. Setting: Khichripur, Kalyanpuri, Kalyanpuri, Trilokpuri and Himmatpuri- four resettlement colonies of trans-Yamuna area of Delhi. Participants: 1500 children belonging to five age-groups i.e. birth-1 yr., 1-2 yrs., 2-3 yrs, and 4-5 yrs. Methods: Verification of child’s immunization from immunization card and interview of mother if immunization car was not available. Study period: May1997 to March1998 Results: Immunization with individual vaccines and immunization status of the children peaked in 1995-96 but started falling thereafter due to fall in ICE activities.

  13. Comparative assessment of immunization coverage of migrant children between national immunization program vaccines and non-national immunization program vaccines in East China

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    Hu, Yu; Luo, Shuying; Tang, Xuewen; Lou, Linqiao; Chen, Yaping; Guo, Jing

    2015-01-01

    This study aimed to describe the disparities in immunization coverage between National Immunization Program (NIP) vaccines and non-NIP vaccines in Yiwu and to identify potential determinants. A face-to-face interview-based questionnaire survey among 423 migrant children born from 1 June 2010 to 31 May 2013 was conducted. Immunization coverage was estimated according to the vaccines scheduled at different age, the birth cohorts, and socio- demographic characteristics. Single-level logistic regression analysis was applied to identify the determinants of coverage of non-NIP vaccines. We found that NIP vaccines recorded higher immunization coverage compared with non-NIP vaccines (87.9100%– vs 0%-74.8%). Among the non-NIP vaccines, varicella vaccine (VarV) recorded the highest coverage of 85.4%, which was introduced in 1998; while 7-valent pneumococcal conjugate vaccine(PCV7) recorded the lowest coverage of 0% for primary series, which was introduced recently. Lower coverage rate of non-NIP vaccines was significantly associated with more siblings in household, shorter duration of living in the surveyed areas, lower family income, mother with a job, mother with poor awareness of vaccination, and mother with lower education level. We found the immunization coverage rate of non-NIP vaccines was significant lower than that of NIP vaccines. Expansion of NIP to include non-NIP vaccines can provide better protection against the vaccine preventable diseases through increased immunization coverage. PMID:25760670

  14. Comparative assessment of immunization coverage of migrant children between national immunization program vaccines and non-national immunization program vaccines in East China.

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    Hu, Yu; Luo, Shuying; Tang, Xuewen; Lou, Linqiao; Chen, Yaping; Guo, Jing

    2015-01-01

    This study aimed to describe the disparities in immunization coverage between National Immunization Program (NIP) vaccines and non-NIP vaccines in Yiwu and to identify potential determinants. A face-to-face interview-based questionnaire survey among 423 migrant children born from 1 June 2010 to 31 May 2013 was conducted. Immunization coverage was estimated according to the vaccines scheduled at different age, the birth cohorts, and socio- demographic characteristics. Single-level logistic regression analysis was applied to identify the determinants of coverage of non-NIP vaccines. We found that NIP vaccines recorded higher immunization coverage compared with non-NIP vaccines (87.9100%- vs 0%-74.8%). Among the non-NIP vaccines, varicella vaccine (VarV) recorded the highest coverage of 85.4%, which was introduced in 1998; while 7-valent pneumococcal conjugate vaccine(PCV7) recorded the lowest coverage of 0% for primary series, which was introduced recently. Lower coverage rate of non-NIP vaccines was significantly associated with more siblings in household, shorter duration of living in the surveyed areas, lower family income, mother with a job, mother with poor awareness of vaccination, and mother with lower education level. We found the immunization coverage rate of non-NIP vaccines was significant lower than that of NIP vaccines. Expansion of NIP to include non-NIP vaccines can provide better protection against the vaccine preventable diseases through increased immunization coverage.

  15. Further observations on comparison of immunization coverage by lot quality assurance sampling and 30 cluster sampling.

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

    1996-06-01

    Lot Quality Assurance Sampling (LQAS) and standard EPI methodology (30 cluster sampling) were used to evaluate immunization coverage in a Primary Health Center (PHC) where coverage levels were reported to be more than 85%. Of 27 sub-centers (lots) evaluated by LQAS, only 2 were accepted for child coverage, whereas none was accepted for tetanus toxoid (TT) coverage in mothers. LQAS data were combined to obtain an estimate of coverage in the entire population; 41% (95% CI 36-46) infants were immunized appropriately for their ages, while 42% (95% CI 37-47) of their mothers had received a second/ booster dose of TT. TT coverage in 149 contemporary mothers sampled in EPI survey was also 42% (95% CI 31-52). Although results by the two sampling methods were consistent with each other, a big gap was evident between reported coverage (in children as well as mothers) and survey results. LQAS was found to be operationally feasible, but it cost 40% more and required 2.5 times more time than the EPI survey. LQAS therefore, is not a good substitute for current EPI methodology to evaluate immunization coverage in a large administrative area. However, LQAS has potential as method to monitor health programs on a routine basis in small population sub-units, especially in areas with high and heterogeneously distributed immunization coverage.

  16. Comparison Of Irms Delhi Methodology With Who Methodology On Immunization Coverage

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    Singh Padam

    1996-01-01

    Full Text Available Research question: What are the merits of IRMS Model over WHO Model for Coverage Evaluation Survey? Which method is superior and appropriate for coverage evolution survey of immunization in our setting? Objective: To compare IRMS Delhi methodology with WHO methodology on Immunization Coverage. Study Design: Cross-Sectional Setting: Urban and Rural both. Participants: Mothers& Children Sample Size: 300 children between 1-2 years and 300 mothers in rural areas and 75 children and 75 mothers in urban areas. Study Variables: Rural, Urban, Cast-Group, Size of the stratum, Literacy, Sex and Cost effectiveness. Outcome Variables: Coverage level of immunization. Analysis: Routine Statistical Analysis. Results: IRMS developed methodology scores better rating over WHO methodology, especially when coverage evolution is attempted in medium size villages with existence of socio-economic seggregation-which remains the main characteristic of the Indian villages.

  17. Immunization coverage and its determinants among children 12-23 months of age in Aden, Yemen

    International Nuclear Information System (INIS)

    Huda O. Basaleem; Khaled A. Al-Sakkaf; Khadijah Shamsuddin

    2010-01-01

    To assess the immunization status of children aged 12-23 months and its determinants in Aden, Yemen. This cross-sectional survey was conducted between March and July 2007 during which time mothers of 680 children from 37 randomly selected clusters in Aden, were interviewed. Information on socio-demographic profiles and children's immunization status was obtained. Immunization coverage of all officially provided vaccines was assessed. Analysis of association between immunization coverage and the socio-demographic characteristics were tested using logistic regression analysis with the immunization status as the dependent variable. We found that 83.1% had complete, 10.4% had partial, and 6.5% were never immunized. The immunization card retention rate was 84.9%. The immunization coverage was 92.9% for Bacillus-Calmette-Guerin, 89.6% for Oral Polio Vaccine-3, 86.6% for Diphtheria, Pertusis and Tetanus-3 and Hepatitis-B vaccination, and 89.1% for measles. Multivariate analysis showed that children with an immunization card (odds ratio [OR]=14.71; 95% confidence interval [CI]: 8.50-25.44) were more likely to have complete immunization, while children with older aged mothers (OR=0.41; 95% CI: 0.22-0.77) were more likely to have complete immunization. Despite the high immunization coverage, 16.9% of children did not have complete immunization, and this rate was lower among children of older mothers, and those who retained their immunization cards. Raising awareness of immunization and increasing access to health services must be strengthened (Author).

  18. Can investments in health systems strategies lead to changes in immunization coverage?

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    Brenzel, Logan

    2014-04-01

    National immunization programs in developing countries have made major strides to immunize the world's children, increasing full coverage to 83% of children. However, the World Health Organization estimates that 22 million children less than five years of age are left unvaccinated, and coverage levels have been plateauing for nearly a decade. This paper describes the evidence on factors contributing to low vaccination uptake, and describes the connection between these factors and the documented strategies and interventions that can lead to changes in immunization outcomes. The author suggests that investments in these areas may contribute more effectively to immunization coverage and also have positive spill-over benefits for health systems. The paper concludes that while some good quality evidence exists of what works and may contribute to immunization outcomes, the quality of evidence needs to improve and major gaps need to be addressed.

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

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    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).

  20. Is a 'convenience' sample useful for estimating immunization coverage in a small population?

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    Weir, Jean E; Jones, Carrie

    2008-01-01

    Rapid survey methodologies are widely used for assessing immunization coverage in developing countries, approximating true stratified random sampling. Non-random ('convenience') sampling is not considered appropriate for estimating immunization coverage rates but has the advantages of low cost and expediency. We assessed the validity of a convenience sample of children presenting to a travelling clinic by comparing the coverage rate in the convenience sample to the true coverage established by surveying each child in three villages in rural Papua New Guinea. The rate of DTF immunization coverage as estimated by the convenience sample was within 10% of the true coverage when the proportion of children in the sample was two-thirds or when only children over the age of one year were counted, but differed by 11% when the sample included only 53% of the children and when all eligible children were included. The convenience sample may be sufficiently accurate for reporting purposes and is useful for identifying areas of low coverage.

  1. Improving immunization in Afghanistan: results from a cross-sectional community-based survey to assess routine immunization coverage

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    Raveesha R. Mugali

    2017-04-01

    Full Text Available Abstract Background Despite progress in recent years, Afghanistan is lagging behind in realizing the full potential of immunization. The country is still endemic for polio transmission and measles outbreaks continue to occur. In spite of significant reductions over the past decade, the mortality rate of children under 5 years of age continues to remain high at 91 per 1000 live births. Methods The study was a descriptive community-based cross sectional household survey. The survey aimed to estimate the levels of immunization coverage at national and province levels. Specific objectives are to: establish valid baseline information to monitor progress of the immunization program; identify reasons why children are not immunized; and make recommendations to enhance access and quality of immunization services in Afghanistan. The survey was carried out in all 34 provinces of the country, with a sample of 6125 mothers of children aged 12–23 months. Results Nationally, 51% of children participating in the survey received all doses of each antigen irrespective of the recommended date of immunization or recommended interval between doses. About 31% of children were found to be partially vaccinated. Reasons for partial vaccination included: place to vaccinate child too far (23%, not aware of the need of vaccination (17%, no faith in vaccination (16%, mother was too busy (15%, and fear of side effects (11%. Conclusion The innovative mechanism of contracting out delivery of primary health care services in Afghanistan, including immunization, to non-governmental organizations is showing some positive results in quickly increasing coverage of essential interventions, including routine immunization. Much ground still needs to be covered with proper planning and management of resources in order to improve the immunization coverage in Afghanistan and increase survival and health status of its children.

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

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    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.

  3. Seeking consensus on universal health coverage indicators in the sustainable development goals.

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    Reddock, Jennifer

    2017-01-01

    There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

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

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

    2014-01-01

    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 childr...

  5. Financial sustainability planning for immunization services in Cambodia.

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    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.

  6. Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

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    Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

    2014-04-25

    To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

  7. Factors associated with routine immunization coverage of children under one year old in Lao People's Democratic Republic.

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    Phoummalaysith, Bounfeng; Yamamoto, Eiko; Xeuatvongsa, Anonh; Louangpradith, Viengsakhone; Keohavong, Bounxou; Saw, Yu Mon; Hamajima, Nobuyuki

    2018-05-03

    Routine vaccination is administered free of charge to all children under one year old in Lao People's Democratic Republic (Lao PDR) and the national goal is to achieve at least 95% coverage with all vaccines included in the national immunization program by 2025. In this study, factors related to the immunization system and characteristics of provinces and districts in Lao PDR were examined to evaluate the association with routine immunization coverage. Coverage rates for Bacillus Calmette-Guerin (BCG), Diphtheria-Tetanus-Pertussis-Hepatitis B (DTP-HepB), DTP-HepB-Hib (Haemophilus influenzae type B), polio (OPV), and measles (MCV1) vaccines from 2002 to 2014 collected through regular reporting system, were used to identify the immunization coverage trends in Lao PDR. Correlation analysis was performed using immunization coverage, characteristics of provinces or districts (population, population density, and proportion of poor villages and high-risk villages), and factors related to immunization service (including the proportions of the following: villages served by health facility levels, vaccine session types, and presence of well-functioning cold chain equipment). To determine factors associated with low coverage, provinces were categorized based on 80% of DTP-HepB-Hib3 coverage (<80% = low group; ≥80% = high group). Coverages of BCG, DTP-HepB3, OPV3 and MCV1 increased gradually from 2007 to 2014 (82.2-88.3% in 2014). However, BCG coverage showed the least improvement from 2002 to 2014. The coverage of each vaccine correlated with the coverage of the other vaccines and DTP-HepB-Hib dropout rate in provinces as well as districts. The provinces with low immunization coverage were correlated with higher proportions of poor villages. Routine immunization coverage has been improving in the last 13 years, but the national goal is not yet reached in Lao PDR. The results of this study suggest that BCG coverage and poor villages should be targeted to improve

  8. 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.

  9. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    Science.gov (United States)

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  10. 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.

  11. 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.

  12. Missed opportunities in full immunization coverage: findings from low- and lower-middle-income countries

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    María Clara Restrepo-Méndez

    2016-05-01

    Full Text Available Background: An estimated 23 million infants are still not being benefitted from routine immunization services. We assessed how many children failed to be fully immunized even though they or their mothers were in contact with health services to receive other interventions. Design: Fourteen countries with Demographic and Health Surveys and Multiple Indicator Cluster Surveys carried out after 2000 and with coverage for DPT (Diphtheria-tetanus-pertussis vaccine below 70% were selected. We defined full immunization coverage (FIC as having received one dose of BCG (bacille Calmette-Guérin, one dose of measles, three doses of polio, and three doses of DPT vaccines. We tabulated FIC against: antenatal care (ANC, skilled birth attendance (SBA, postnatal care for the mother (PNC, vitamin A supplementation (VitA for the child, and sleeping under an insecticide-treated bed-net (ITN. Missed opportunities were defined as the percentage of children who failed to be fully immunized among those receiving one or more other interventions. Results: Children who received other health interventions were also more likely to be fully immunized. In nearly all countries, FIC was lowest among children born to mothers who failed to attend ANC, and highest when the mother had four or more ANC visits Côte d'Ivoire presented the largest difference in FIC: 54 percentage points (pp between having four or more ANC visits and lack of ANC. SBA was also related with higher FIC. For instance, the coverage in children without SBA was 36 pp lower than for those with SBA in Nigeria. The largest absolute difference on FIC in relation to PNC was observed for Ethiopia: 31 pp between those without and with PNC. FIC was also positively related with having received VitA. The largest absolute difference was observed in DR Congo: 41 pp. The differences in FIC among whether or not children slept under ITN were much smaller than for other interventions. Haiti presented the largest absolute

  13. Immunization coverage among children in Al-Taizyah district, Taiz Governorate, Yemen

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    Nabil Ahmed Al-Rabeei

    2014-12-01

    Full Text Available Introduction: At least 2 million people die every year from diseases preventable by vaccines recommended by the World Health Organization. Objective: To assess the routine immunization coverage among children aged 12-23 month and to determine the reasons for unvaccinated. Methods: We conducted a community-based survey in Al-Taizyah district, Taiz governorate, Yemen. Information about vaccination status and related barriers was collected for 420 children from 1st March to 31st March 2012. Results: 49.8% of the children had vaccination cards. About 69.5% of the children were fully vaccinated by cards and by history, 15.5% were partially vaccinated and 15% not vaccinated. As a regards to crude vaccination coverage, 82.9% of children were received BCG vaccine. OPV1 vaccine was 82.6%. Pentavalent1 was 82.6%. Measles 1 represented for 71.7% and vitamin A1 was 46.4%. 91% was valid doses for OPV1 and 93% for pentavalent1. Only 76% of measles1 dose was valid. The high scores14% of drop-out rate was recorded between BCG and Measles. The main reasons for partially vaccinated and unvaccinated of children were the lack of information 61.7%. Conclusion: There is low vaccination coverage among children aged 12-23 months. There is a need to raise the awareness of community about vaccination and EPI services in Al-Taizyah district.

  14. 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)

  15. 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

  16. Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates. National Immunization Survey. National Health Interview Survey/National Immunization Provider Record Check Study.

    Science.gov (United States)

    Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z

    2001-05-01

    The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.

  17. India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

    Science.gov (United States)

    Narayana, Muttur Ranganathan

    2016-12-01

    India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public

  18. Switch from oral to inactivated poliovirus vaccine in Yogyakarta Province, Indonesia: summary of coverage, immunity, and environmental surveillance.

    Science.gov (United States)

    Wahjuhono, Gendro; Revolusiana; Widhiastuti, Dyah; Sundoro, Julitasari; Mardani, Tri; Ratih, Woro Umi; Sutomo, Retno; Safitri, Ida; Sampurno, Ondri Dwi; Rana, Bardan; Roivainen, Merja; Kahn, Anna-Lea; Mach, Ondrej; Pallansch, Mark A; Sutter, Roland W

    2014-11-01

    Inactivated poliovirus vaccine (IPV) is rarely used in tropical developing countries. To generate additional scientific information, especially on the possible emergence of vaccine-derived polioviruses (VDPVs) in an IPV-only environment, we initiated an IPV introduction project in Yogyakarta, an Indonesian province. In this report, we present the coverage, immunity, and VDPV surveillance results. In Yogyakarta, we established environmental surveillance starting in 2004; and conducted routine immunization coverage and seroprevalence surveys before and after a September 2007 switch from oral poliovirus vaccine (OPV) to IPV, using standard coverage and serosurvey methods. Rates and types of polioviruses found in sewage samples were analyzed, and all poliovirus isolates after the switch were sequenced. Vaccination coverage (>95%) and immunity (approximately 100%) did not change substantially before and after the IPV switch. No VDPVs were detected. Before the switch, 58% of environmental samples contained Sabin poliovirus; starting 6 weeks after the switch, Sabin polioviruses were rarely isolated, and if they were, genetic sequencing suggested recent introductions. This project demonstrated that under almost ideal conditions (good hygiene, maintenance of universally high IPV coverage, and corresponding high immunity against polioviruses), no emergence and circulation of VDPV could be detected in a tropical developing country setting. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Engaging communities with a simple tool to help increase immunization coverage.

    Science.gov (United States)

    Jain, Manish; Taneja, Gunjan; Amin, Ruhul; Steinglass, Robert; Favin, Michael

    2015-03-01

    The level of vaccination coverage in a given community depends on both service factors and the degree to which the public understands and trusts the immunization process. This article describes an approach that aims to raise awareness and boost demand. Developed in India, the "My Village Is My Home" (MVMH) tool, known as Uma Imunizasaun (UI) in Timor-Leste, is a poster-sized material used by volunteers and health workers to record the births and vaccination dates of every infant in a community. Introduction of the tool in 5 districts of India (April 2012 to March 2013) and in 7 initial villages in Timor-Leste (beginning in January 2012) allowed community leaders, volunteers, and health workers to monitor the vaccination status of every young child and guided reminder and motivational visits. In 3 districts of India, we analyzed data on vaccination coverage and timeliness before and during use of the tool; in 2 other districts, analysis was based only on data for new births during use of the tool. In Timor-Leste, we compared UI data from the 3 villages with the most complete data with data for the same villages from the vaccination registers from the previous year. In both countries, we also obtained qualitative data about perceptions of the tool through interviews with health workers and community members. Assessments in both countries found evidence suggesting improved vaccination timeliness and coverage. In India, pilot communities had 80% or higher coverage of identified and eligible children for all vaccines. In comparison, overall coverage in the respective districts during the same time period was much lower, at 49% to 69%. In Timor-Leste, both the number of infants identified and immunized rose substantially with use of the tool compared with the previous year (236 vs. 155, respectively, identified as targets; 185 vs. 147, respectively, received Penta 3). Although data challenges limit firm conclusions, the experiences in both countries suggest that "My

  20. Adolescent Immunization Coverage and Implementation of New School Requirements in Michigan, 2010

    Science.gov (United States)

    DeVita, Stefanie F.; Vranesich, Patricia A.; Boulton, Matthew L.

    2014-01-01

    Objectives. We examined the effect of Michigan’s new school rules and vaccine coadministration on time to completion of all the school-required vaccine series, the individual adolescent vaccines newly required for sixth grade in 2010, and initiation of the human papillomavirus (HPV) vaccine series, which was recommended but not required for girls. Methods. Data were derived from the Michigan Care Improvement Registry, a statewide Immunization Information System. We assessed the immunization status of Michigan children enrolled in sixth grade in 2009 or 2010. We used univariable and multivariable Cox regression models to identify significant associations between each factor and school completeness. Results. Enrollment in sixth grade in 2010 and coadministration of adolescent vaccines at the first adolescent visit were significantly associated with completion of the vaccines required for Michigan’s sixth graders. Children enrolled in sixth grade in 2010 had higher coverage with the newly required adolescent vaccines by age 13 years than did sixth graders in 2009, but there was little difference in the rate of HPV vaccine initiation among girls. Conclusions. Education and outreach efforts, particularly regarding the importance and benefits of coadministration of all recommended vaccines in adolescents, should be directed toward health care providers, parents, and adolescents. PMID:24922144

  1. [Immunization coverage of children aged 0 to 5 years in Libreville (Gabon)].

    Science.gov (United States)

    Ategbo, Simon; Ngoungou, Edgard Brice; Koko, Jean; Vierin, Yolande; Zang Ndong, Carine Eyi; Moussavou Mouyama, André

    2010-01-01

    The strategies recently implemented in Gabon have been effective in improving immunization coverage. These include, in particular, the integration of the Expanded Programme on Immunization (EPI) in primary health care centers, the integration of immunization outside of EPI, immunization by peripheral health centers according to pre-set advanced strategies, and awareness and catch-up campaigns. This descriptive, cross-sectional survey was conducted from 1 October 2007 through 30 January 2008, throughout public- and private-sector health care centers in the town of Libreville. In the public sector, where health care is free, the study took place at the largest health facility in the country, the Hospital Center of Libreville (HCL), at Estuary Mélen Hospital (on the outskirts of Libreville), at Nkembo Hospital, which houses the EPI offices, and the 5 Maternal and Child Health centers (MCH) where vaccine monitoring is done. Monitoring in the private sector covered only the three largest clinics, where vaccine monitoring is done, all of which agreed to participate. After obtaining informed consent from the parents or guardian accompanying the child, a semi-structured interview according to a standardised questionnaire was conducted to collect socioeconomic and demographic data, including age, sex, recruitment site, place of residence, number of siblings, parental origin, ethnicity of head of household, type of family (couple or single parent), mother's age, level of education, employment and socio-economic status, as determined by the head of household's monthly income (in three categories: 1) low income, at or below the minimum wage, set at 80 000 FCFA (120 euros); 2) average income, from more than 80 000 FCFA to 300 000 FCFA (458 euros); and 3) high income over 300 000 FCFA. After the interview, the child's vaccination booklet was carefully examined to identify the types of antigen, number of doses administered, age at vaccination, and the regularity of the

  2. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

  3. Geo-spatial reporting for monitoring of household immunization coverage through mobile phones: Findings from a feasibility study.

    Science.gov (United States)

    Kazi, A M; Ali, M; K, Ayub; Kalimuddin, H; Zubair, K; Kazi, A N; A, Artani; Ali, S A

    2017-11-01

    The addition of Global Positioning System (GPS) to a mobile phone makes it a very powerful tool for surveillance and monitoring coverage of health programs. This technology enables transfer of data directly into computer applications and cross-references to Geographic Information Systems (GIS) maps, which enhances assessment of coverage and trends. Utilization of these systems in low and middle income countries is currently limited, particularly for immunization coverage assessments and polio vaccination campaigns. We piloted the use of this system and discussed its potential to improve the efficiency of field-based health providers and health managers for monitoring of the immunization program. Using "30×7" WHO sampling technique, a survey of children less than five years of age was conducted in random clusters of Karachi, Pakistan in three high risk towns where a polio case was detected in 2011. Center point of the cluster was calculated by the application on the mobile. Data and location coordinates were collected through a mobile phone. This data was linked with an automated mHealth based monitoring system for monitoring of Supplementary Immunization Activities (SIAs) in Karachi. After each SIA, a visual report was generated according to the coordinates collected from the survey. A total of 3535 participants consented to answer to a baseline survey. We found that the mobile phones incorporated with GIS maps can improve efficiency of health providers through real-time reporting and replacing paper based questionnaire for collection of data at household level. Visual maps generated from the data and geospatial analysis can also give a better assessment of the immunization coverage and polio vaccination campaigns. The study supports a model system in resource constrained settings that allows routine capture of individual level data through GPS enabled mobile phone providing actionable information and geospatial maps to local public health managers, policy makers

  4. Factors associated with complete immunization coverage in children aged 12–23 months in Ambo Woreda, Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Etana Belachew

    2012-07-01

    Full Text Available Abstract Background Vaccination is a proven tool in preventing and eradicating communicable diseases, but a considerable proportion of childhood morbidity and mortality in Ethiopia is due to vaccine preventable diseases. Immunization coverage in many parts of the country remains low despite the efforts to improve the services. In 2005, only 20% of the children were fully vaccinated and about 1 million children were unvaccinated in 2007. The objective of this study was to assess complete immunization coverage and its associated factors among children aged 12–23 months in Ambo woreda. Methods A cross-sectional community-based study was conducted in 8 rural and 2 urban kebeles during January- February, 2011. A modified WHO EPI cluster sampling method was used for sample selection. Data on 536 children aged 12–23 months from 536 representative households were collected using trained nurses. The data collectors assessed the vaccination status of the children based on vaccination cards or mother’s verbal reports using a pre-tested structured questionnaire through house-to-house visits. Bivariate and multivariate logistic regression analyses were used to assess factors associated with immunization coverage. Results About 96% of the mothers heard about vaccination and vaccine preventable diseases and 79.5% knew the benefit of immunization. About 36% of children aged 12–23 months were fully vaccinated by card plus recall, but only 27.7% were fully vaccinated by card alone and 23.7% children were unvaccinated. Using multivariate logistic regression models, factors significantly associated with complete immunization were antenatal care follow-up (adjusted odds ratio(AOR = 2.4, 95% CI: 1.2- 4.9, being born in the health facility (AOR = 2.1, 95% CI: 1.3-3.4, mothers’ knowledge about the age at which vaccination begins (AOR = 2.9, 95% CI: 1.9-4.6 and knowledge about the age at which vaccination completes (AOR = 4.3, 95% CI: 2

  5. Improving Immunization Coverage in a Rural School District in Pierce County, Washington

    Science.gov (United States)

    Peterson, Robin M.; Cook, Carolyn; Yerxa, Mary E.; Marshall, James H.; Pulos, Elizabeth; Rollosson, Matthew P.

    2012-01-01

    Washington State has some of the highest percentages of school immunization exemptions in the country. We compared school immunization records in a rural school district in Pierce County, Washington, to immunization records in the state immunization information system (IIS) and parent-held records. Correcting school immunization records resulted…

  6. 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...

  7. Scientific Coverage in Community-Based Tourism: Sustainable Tourism and Strategy for Social Development

    Directory of Open Access Journals (Sweden)

    José Álvarez-García

    2018-04-01

    Full Text Available In the last decades in developing countries, the tourism sector has been immersed in an intense process of strengthening the participation of local communities through the so-called community tourism initiatives, whose main objective is to improve the quality of life of the inhabitants of host communities, ensuring the subsistence of traditional culture. Its growing momentum as a means for sustainable tourism and a strategy for social development has generated a large amount of academic literature, and it is necessary to analyze its presence in the main multidisciplinary databases. Thus, the main purpose of our article is to show the current state of scientific production on community tourism through a bibliometric comparative study of the documents indexed in the WoS and Scopus databases, dealing with aspects such as their coverage, correlation between both bases, overlapping of documents and journals, growth, dispersion or concentration of articles, among others. For this purpose, and by means of an advanced search by terms, a representative set of 115 articles in WoS and 185 in Scopus were selected, with the time limit set in 2017. These form the ad-hoc basis of the analysis. In view of the results, it is concluded that, although WoS and Scopus databases differ in terms of scope, volume of data, and coverage policies, both information systems are complementary but not exclusive. Although the documents and the results of their analysis are in many aspects similar, Scopus has a better coverage in the specific area of community tourism due to collecting a greater number of articles, journals and signatures, and its articles receiving a greater number of citations.

  8. Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

    Science.gov (United States)

    Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

    2015-04-29

    The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

  9. Assessing the universal health coverage target in the Sustainable Development Goals from a human rights perspective.

    Science.gov (United States)

    Chapman, Audrey R

    2016-12-15

    The UN's Sustainable Development Goals (SDGs), adopted in September 2015, include a comprehensive health goal, "to ensure healthy lives and promote well-being at all ages." The health goal (SDG 3) has nine substantive targets and four additional targets which are identified as a means of implementation. One of these commitments, to achieve universal health coverage (UHC), has been acknowledged as central to the achievement of all of the other health targets. As defined in the SDGs, UHC includes financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. This article evaluates the extent to which the UHC target in the SDGs conforms with the requirements of the right to health enumerated in the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, and other international human rights instruments and interpreted by international human rights bodies. It does so as a means to identify strengths and weaknesses in the framing of the UHC target that are likely to affect its implementation. While UHC as defined in the SDGs overlaps with human rights standards, there are important human rights omissions that will likely weaken the implementation and reduce the potential benefits of the UHC target. The most important of these is the failure to confer priority to providing access to health services to poor and disadvantaged communities in the process of expanding health coverage and in determining which health services to provide. Unless the furthest behind are given priority and strategies adopted to secure their participation in the development of national health plans, the SDGs, like the MDGs, are likely to leave the most disadvantaged and vulnerable communities behind.

  10. Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

    Directory of Open Access Journals (Sweden)

    Fabian Ling Ngai Tung

    2016-01-01

    Full Text Available Objectives: to explore nurses' knowledge of universal health coverage (UHC for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN or registered nurses (RN was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs. Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

  11. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

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    de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

    2016-09-01

    With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

  12. Yellow fever vaccination coverage following massive emergency immunization campaigns in rural Uganda, May 2011: a community cluster survey

    Science.gov (United States)

    2013-01-01

    Background Following an outbreak of yellow fever in northern Uganda in December 2010, Ministry of Health conducted a massive emergency vaccination campaign in January 2011. The reported vaccination coverage in Pader District was 75.9%. Administrative coverage though timely, is affected by incorrect population estimates and over or under reporting of vaccination doses administered. This paper presents the validated yellow fever vaccination coverage following massive emergency immunization campaigns in Pader district. Methods A cross sectional cluster survey was carried out in May 2011 among communities in Pader district and 680 respondents were indentified using the modified World Health Organization (WHO) 40 × 17 cluster survey sampling methodology. Respondents were aged nine months and above. Interviewer administered questionnaires were used to collect data on demographic characteristics, vaccination status and reasons for none vaccination. Vaccination status was assessed using self reports and vaccination card evidence. Our main outcomes were measures of yellow fever vaccination coverage in each age-specific stratum, overall, and disaggregated by age and sex, adjusting for the clustered design and the size of the population in each stratum. Results Of the 680 survey respondents, 654 (96.1%, 95% CI 94.9 – 97.8) reported being vaccinated during the last campaign but only 353 (51.6%, 95% CI 47.2 – 56.1) had valid yellow fever vaccination cards. Of the 280 children below 5 years, 269 (96.1%, 95% CI 93.7 – 98.7) were vaccinated and nearly all males 299 (96.9%, 95% CI 94.3 – 99.5) were vaccinated. The main reasons for none vaccination were; having travelled out of Pader district during the campaign period (40.0%), lack of transport to immunization posts (28.0%) and, sickness at the time of vaccination (16.0%). Conclusions Our results show that actual yellow fever vaccination coverage was high and satisfactory in Pader district since it was above the

  13. Comparative Estimates of Crude and Effective Coverage of Measles Immunization in Low-Resource Settings: Findings from Salud Mesoamérica 2015.

    Science.gov (United States)

    Colson, K Ellicott; Zúñiga-Brenes, Paola; Ríos-Zertuche, Diego; Conde-Glez, Carlos J; Gagnier, Marielle C; Palmisano, Erin; Ranganathan, Dharani; Usmanova, Gulnoza; Salvatierra, Benito; Nazar, Austreberta; Tristao, Ignez; Sanchez Monin, Emmanuelle; Anderson, Brent W; Haakenstad, Annie; Murphy, Tasha; Lim, Stephen; Hernandez, Bernardo; Lozano, Rafael; Iriarte, Emma; Mokdad, Ali H

    2015-01-01

    Timely and accurate measurement of population protection against measles is critical for decision-making and prevention of outbreaks. However, little is known about how survey-based estimates of immunization (crude coverage) compare to the seroprevalence of antibodies (effective coverage), particularly in low-resource settings. In poor areas of Mexico and Nicaragua, we used household surveys to gather information on measles immunization from child health cards and caregiver recall. We also collected dried blood spots (DBS) from children aged 12 to 23 months to compare crude and effective coverage of measles immunization. We used survey-weighted logistic regression to identify individual, maternal, household, community, and health facility characteristics that predict gaps between crude coverage and effective coverage. We found that crude coverage was significantly higher than effective coverage (83% versus 68% in Mexico; 85% versus 50% in Nicaragua). A large proportion of children (19% in Mexico; 43% in Nicaragua) had health card documentation of measles immunization but lacked antibodies. These discrepancies varied from 0% to 100% across municipalities in each country. In multivariate analyses, card-positive children in Mexico were more likely to lack antibodies if they resided in urban areas or the jurisdiction of De Los Llanos. In contrast, card-positive children in Nicaragua were more likely to lack antibodies if they resided in rural areas or the North Atlantic region, had low weight-for-age, or attended health facilities with a greater number of refrigerators. Findings highlight that reliance on child health cards to measure population protection against measles is unwise. We call for the evaluation of immunization programs using serological methods, especially in poor areas where the cold chain is likely to be compromised. Identification of within-country variation in effective coverage of measles immunization will allow researchers and public health

  14. RAPID APPRAISAL OF ROUTINE IMMUNIZATION COVERAGE IN A NEWLY FORMED DISTRICT OF UTTAR PRADESH

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    S K Kaushal

    2011-12-01

    Full Text Available Background Immunization is a proven cost effective intervention to reduce the child mortality & morbidity. As per DLHS-3(2007-08 only 30.3% of children are fully immunized in Uttar Pradesh. A new district, Kanshi Ram Nagar was created on 15 April 2008 within Etah district. Objective To assess the primary immunization status & dropout rate. To find out reasons for immunization default. To study the difference, if any between high risk & low risk block. Material & methods A cross sectional, observational study was undertaken in two blocks (Patiyali and Amanpur of Kanshi Ram Nagar District by interviewing 210 respondent mothers in each block, by using ‘30’ cluster sampling technique with help of predesigned, pretested schedule. Result: The percentages of fully immunized children were 50% in Patiyali & 44.08% in Amanpur block. ANM & ASHA were observed as main informer to the community. Immunization status was poor in Muslims and in female children. The highest covered antigen found was BCG and lowest was DPT-3 in both the blocks. The overall dropout rate was 36.52% for Patiyali & 32.96 % for Amanpur block. The main reasons for dropout identified were, non-cooperation of health workers and community were not aware about the need of Immunization in both the blocks. However the differential findings in among the blocks were statistically not significant. Conclusion However lesser number of children were left untouched for immunization services but the percentage of incomplete immunization was found high due to poor cooperation of health worker and unawareness about need of immunization in community

  15. 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.

  16. Boosting innate immunity to sustainably control diseases in crops.

    Science.gov (United States)

    Nicaise, Valerie

    2017-10-01

    Viruses cause epidemics in all major crops, threatening global food security. The development of efficient and durable resistance able to withstand viral attacks represents a major challenge for agronomy, and relies greatly on the understanding of the molecular dialogue between viral pathogens and their hosts. Research over the last decades provided substantial advances in the field of plant-virus interactions. Remarkably, the advent of studies of plant innate immunity has recently offered new strategies exploitable in the field. This review summarizes the recent breakthroughs that define the mechanisms underlying antiviral innate immunity in plants, and emphasizes the importance of integrating that knowledge into crop improvement actions, particularly by exploiting the insights related to immune receptors. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Assessment of Child Immunization Coverage and Associated Factors with Full Vaccination among Children Aged 12–23 Months at Mizan Aman Town, Bench Maji Zone, Southwest Ethiopia

    Science.gov (United States)

    Geremew, Mesfin; Birhanu, Frehiwot

    2017-01-01

    Immunization remains one of the most important and cost-effective public health interventions to reduce child mortality and morbidity. Globally, it is estimated to avert between 2 and 3 million deaths each year. In Ethiopia, immunization coverage rates stagnated and remained very low for many years. Thus, this study was aimed to assess child immunization coverage and factors associated with full vaccination among children aged 12–23 months in Mizan Aman town. The study design was community-based cross-sectional survey. Data was collected by using pretested structured questionnaire. A total of 322 mothers/caretakers were interviewed. Based on vaccination card and mothers/caretakers' recall, 295 (91.6%) of the children took at least a single dose of vaccine. From total children, 27 (8.4%) were not immunized at all, 159 (49.4%) were partially immunized, and 136 (42.2%) were fully immunized. Mothers/caretakers educational level, fathers' educational level, place of delivery, maternal health care utilization, and mothers/caretakers knowledge about vaccine and vaccine-preventable disease showed significant association with full child immunization. The finding from this study revealed that child immunization coverage in the studied area was low. Thus the town health office and concerned stakeholders need to work more to improve performance of the expanded program on immunization in this area. PMID:29434643

  18. Strategies to increase immunization coverage of tetanus vaccine among women in Sub Saharan Africa: a systematic review.

    Science.gov (United States)

    Vouking, Marius Zambou; Tadenfok, Carine Nouboudem; Ekani, Jean Marie Edengue

    2017-01-01

    World Health Organization (WHO) estimated in 2013 that 49,000 deaths all over the world were caused by neonatal tetanus. Only as recently as the year 2000, neonatal tetanus was a public health problem in 59 countries, but since then it has been eliminated in 36 of the countries concerned. The objective of this piece of work, therefore, was to investigate which strategies intended to increase demand for vaccination are effective in increasing anti-tetanus vaccination coverage of women in Sub Saharan Africa. We searched the following electronic databases from January 1989 to July 2016: Medline, EMBASE (Excerpta Medica Database), The Cochrane Library, Google Scholar, CINAHL (Cumulative Index to Nursing and Allied Health Literature), WHOLIS (World Health Organization Library Database), LILACS (Latin American and Caribbean Literature on Health Sciences) and contacted experts in the field. There were no restrictions to language or publication status. All study designs that could provide the information we sought were eligible, provided the studies were conducted in sub-Saharan Africa. Critical appraisal of all identified citations was done independently by two authors to establish the possible relevance of the articles for inclusion in the review. Our search strategy yielded 191 records and after assessment for eligibility, 6 papers met the criteria for inclusion. In Ivory Coast, after reorganization, health workers said they were satisfied with the work environment and the care provided in 91% and 96% of cases, respectively. In Kenya, the main factors contributing to having sufficiently immunized part of the population against tetanus are lower birth order, higher household wealth index, women's employment, making joint health-related decisions with a partner, and higher number of antenatal care visits. Particularly in Ethiopia, compared with other member countries, the size of the unimmunized population, reporting quality, fragileness of the health system, resource

  19. System-level determinants of immunization coverage disparities among health districts in Burkina Faso: a multiple case study.

    Science.gov (United States)

    Haddad, Slim; Bicaba, Abel; Feletto, Marta; Taminy, Elie; Kabore, Moussa; Ouédraogo, Boubacar; Contreras, Gisèle; Larocque, Renée; Fournier, Pierre

    2009-10-14

    Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso. A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team. The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks). The discourse on factors that determine the performance or

  20. Determinants of inequality in the up-to-date fully immunization coverage among children aged 24-35 months: Evidence from Zhejiang province, East China.

    Science.gov (United States)

    Hu, Yu; Wang, Ying; Chen, Yaping; Li, Qian

    2017-08-03

    This study aimed to determine the degree and determinants of inequality in up-to-date fully immunization (UTDFI) coverage among children of Zhejiang province, east China. We used data from the Zhejiang provincial vaccination coverage survey of 2014 and the health outcome was the UTDFI status among children aged 24-35 months. The household income per month was used as an index of socio-economic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in UTDFI coverage. The UTDFI coverage was 80.63% and the CI for UTDFI coverage was 0.12028 (95% CI: 0.10852-0.13175), indicating that immunization practice significantly favored children with relatively higher socio-economic status. The results of decomposition analysis suggested that 68.2% of the socio-economic inequality in UTDFI coverage should be explained by the mother's education level. Furthermore, factors such as birth order, ethnic group, maternal employment status, residence, immigration status, GDP per-capital and percentage of public health spending of the total health spending also could explain the disparity in UTDFI coverage. There exists inequality in UTDFI coverage among the socio-economic disadvantage children. Health interventions of narrowing the socio-economic inequality in UTDFI coverage will benefit from being supplemented with strategies aimed at poverty and illiteracy reduction.

  1. "Girl Power!": The Relationship between Women's Autonomy and Children's Immunization Coverage in Ethiopia.

    Science.gov (United States)

    Ebot, Jane O

    2015-09-18

    Although immunizations are efficient and cost effective methods of reducing child mortality, worldwide, approximately 2 million children die yearly of vaccine-preventable diseases. Researchers and health organizations have detailed information on the positive relationship between women's autonomy and children's health outcomes in developing countries. This study investigates the links between women's household autonomy and children's immunization status using data from a nationally representative sample of children aged 12-30 months (N = 2941) from the 2011 Ethiopia Demographic and Health Survey. The results showed that women's socioeconomic status and household autonomy were significantly associated with children's immunization status. Overall, the implications of this study align with those of the Millennium Development Goal #3: improvements in women's household autonomy are linked to more positive child health outcomes.

  2. Inequities in coverage of preventive child health interventions: the rural drinking water supply program and the universal immunization program in Rajasthan, India.

    Science.gov (United States)

    Mohan, Pavitra

    2005-02-01

    I assessed whether the Rural Drinking Water Supply Program (RDWSP) and the Universal Immunization Program (UIP) have achieved equitable coverage in Rajasthan, India, and explored program characteristics that affect equitable coverage of preventive health interventions. A total of 2460 children presenting at 12 primary health facilities in one district of Rajasthan were enrolled and classified into economic quartiles based on possession of assets. Immunization coverage and prime source of drinking water were compared across quartiles. A higher access to piped water by wealthier families (P< .001) was compensated by higher access to hand pumps by poorer families (P<.001), resulting in equal access to a safe source (P=.9). Immunization coverage was inequitable, favoring the wealthier children (P<.001). The RDWSP has achieved equitable coverage, while UIP coverage remains highly inequitable. Programs can make coverage more equitable by formulating explicit objectives to ensure physical access to all, promoting the intervention's demand by the poor, and enhancing the support and monitoring of frontline workers who deliver these interventions.

  3. Maiden immunization coverage survey in the republic of South Sudan: a cross-sectional study providing baselines for future performance measurement

    Science.gov (United States)

    Mbabazi, William; Lako, Anthony K; Ngemera, Daniel; Laku, Richard; Yehia, Mostafah; Nshakira, Nathan

    2013-01-01

    Introduction Since the comprehensive peace agreement was signed in 2005, institutionalization of immunization services in South Sudan remained a priority. Routine administrative reporting systems were established and showed that national coverage rates for DTP-3 rose from 20% in 2002 to 80% in 2011. This survey was conducted as part of an overall review of progress in implementation of the first EPI Multi-Year Plan for South Sudan 2007-2011. This report provides maiden community coverage estimates for immunization. Methods A cross sectional community survey was conducted between January and May 2012. Ten cluster surveys were conducted to generate state-specific coverage estimates. The WHO 30x7 cluster sampling method was employed. Data was collected using pre-tested, interviewer guided, structured questionnaires through house to house visits. Results The fully immunized children were 7.3%. Coverage for specific antigens were; BCG (28.3%), DTP-1(25.9%), DTP-3 (22.0%), Measles (16.8%). The drop-out rate between the first and third doses of DTP was 21.3%. Immunization coverage estimates based on card and history were higher, at 45.7% for DTP-3, 45.8% for MCV and 32.2% for full immunization. Majority of immunizations (80.8%) were received at health facilities compared to community service points (19.2%). The major reason for missed immunizations was inadequate information (41.1%). Conclusion The proportion of card-verified, fully vaccinated among children aged 12-23 months is very low at 7.3%. Future efforts to improve vaccination quality and coverage should prioritize training of vaccinators and program communication to levels equivalent or higher than investments in EPI cold chain systems since 2007. PMID:24876899

  4. Accurate and High-Coverage Immune Repertoire Sequencing Reveals Characteristics of Antibody Repertoire Diversification in Young Children with Malaria

    Science.gov (United States)

    Jiang, Ning

    Accurately measuring the immune repertoire sequence composition, diversity, and abundance is important in studying repertoire response in infections, vaccinations, and cancer immunology. Using molecular identifiers (MIDs) to tag mRNA molecules is an effective method in improving the accuracy of immune repertoire sequencing (IR-seq). However, it is still difficult to use IR-seq on small amount of clinical samples to achieve a high coverage of the repertoire diversities. This is especially challenging in studying infections and vaccinations where B cell subpopulations with fewer cells, such as memory B cells or plasmablasts, are often of great interest to study somatic mutation patterns and diversity changes. Here, we describe an approach of IR-seq based on the use of MIDs in combination with a clustering method that can reveal more than 80% of the antibody diversity in a sample and can be applied to as few as 1,000 B cells. We applied this to study the antibody repertoires of young children before and during an acute malaria infection. We discovered unexpectedly high levels of somatic hypermutation (SHM) in infants and revealed characteristics of antibody repertoire development in young children that would have a profound impact on immunization in children.

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

    Science.gov (United States)

    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 infants and their mothers. The LQAS results from the 27 subcentres were also combined to obtain an overall estimate of coverage for the entire population of the primary health centre, and these results were compared with the EPI cluster survey results. The LQAS survey did not identify any subcentre with a level of immunization among infants high enough to be classified as acceptable; only three subcentres were classified as having acceptable levels of tetanus toxoid (TT) coverage among women. The estimated overall coverage in the PHC population from the combined LQAS results showed that a quarter of the infants were immunized appropriately for their ages and that 46% of their mothers had been adequately immunized with TT. Although the age groups and the periods of time during which the children were immunized differed for the LQAS and EPI survey populations, the characteristics of the mothers were largely similar. About 57% (95% CI, 46-67) of them were found to be fully immunized with TT by 30-cluster sampling, compared with 46% (95% CI, 41-51) by stratified random sampling. The difference was not statistically significant. The field work to collect LQAS data took about three times longer, and cost 60% more than the EPI survey. The apparently homogeneous and low level of immunization coverage in the 27 subcentres makes this an impractical situation in which to apply LQAS, and the results obtained were therefore not particularly useful. However, if LQAS had been applied by local

  6. Does introducing an immunization package of services for migrant children improve the coverage, service quality and understanding? An evidence from an intervention study among 1548 migrant children in eastern China.

    Science.gov (United States)

    Hu, Yu; Luo, Shuying; Tang, Xuewen; Lou, Linqiao; Chen, Yaping; Guo, Jing; Zhang, Bing

    2015-07-15

    An EPI (Expanded Program on Immunization) intervention package was implemented from October 2011 to May 2014 among migrant children in Yiwu, east China. This study aimed to evaluate its impacts on vaccination coverage, maternal understanding of EPI and the local immunization service performance. A pre- and post-test design was used. The EPI intervention package included: (1) extending the EPI service time and increasing the frequency of vaccination service; (2) training program for vaccinators; (3) developing a screening tool to identify vaccination demands among migrant clinic attendants; (4) Social mobilization for immunization. Data were obtained from random sampling investigations, vaccination service statistics and qualitative interviews with vaccinators and mothers of migrant children. The analysis of quantitative data was based on a "before and after" evaluation and qualitative data were analyzed using content analysis. The immunization registration (records kept by immunization clinics) rate increased from 87.4 to 91.9% (P = 0.016) after implementation of the EPI intervention package and the EPI card holding (EPI card kept by caregivers) rate increased from 90.9 to 95.6% (P = 0.003). The coverage of fully immunized increased from 71.5 to 88.6% for migrant children aged 1-4 years (P < 0.001) and increased from 42.2 to 80.5% for migrant children aged 2-4 years (P < 0.001). The correct response rates on valid doses and management of adverse events among vaccinators were over 90% after training. The correct response rates on immunization among mothers of migrant children were 86.8-99.3% after interventions. Our study showed a substantial improvement in vaccination coverage among migrant children in Yiwu after implementation of the EPI intervention package. Further studies are needed to evaluate the cost-effectiveness of the interventions, to identify individual interventions that make the biggest contribution to coverage, and to examine the

  7. Sustainability-related media coverage and socioeconomic development: a regional and North–South perspective

    OpenAIRE

    Ralf Barkemeyer; Frank Figge; Diane Holt

    2013-01-01

    With this paper we discuss the differences between sustainability-related media agendas across different countries and regions. Utilising a sample of 115 leading national newspapers covering forty-one countries, we show that typically no homogeneous global trends exist with regard to sustainability-related media agendas. Instead, significant differences exist regarding the national-level prioritisations of sustainability-related issues in the countries under review. To some extent, these obse...

  8. Perceptions of the usefulness of external support to immunization coverage in Chad: an analysis of the GAVI-Alliance cash-based support.

    Science.gov (United States)

    Ferrinho, Paulo; Dramé, Mohammed; Tumusiime, Prosper

    2013-01-01

    Chad is one of the countries supported by the GAVI-Alliance that remains with unsatisfactory vaccination coverage. This paper tries to understand the main barriers to better coverage. These barriers were categorised as up or downstream against the health system building blocks as proposed by WHO and compared with barriers and activities identified by the country in its health system's strengthening grant proposal as approved by the GAVI Alliance in 2007. Data were collected using a modified Delphi system and by analysis of grant and annual report documents. Most of the activities anticipated under the GAVI health system's strengthening proposal are activities targeting downstream barriers (the neglect of upstream issues is of major importance in a decentralised state like Chad) and aligned with, not complementary to, immunization services strengthening activities. Further, both set of cash grants are blind to important recommendations such as the need to address barriers at the level of leadership and governance and at the level of the financing system and also about initiatives to promote community demand of vaccination services. IN CHAD SLOW VACCINATION PROGRESS IS AGGRAVATED BY SEVERAL CONTEXTUAL BARRIERS: the size of the country, the low population density, the nomadic nature of a significant part of its peoples, the recent civil war, associated with civil unrest and political instability and its geographical localization. In this situation it would be important to sustain downstream operations (the major focus of the ISS grant) while taking a long term view of the needs of the health system. The GAVI effectively supports downstream operations, but neglects the long term view.

  9. Legal Harvesting, Sustainable Sourcing and Cascaded Use of Wood for Bioenergy: Their Coverage through Existing Certification Frameworks for Sustainable Forest Management

    Directory of Open Access Journals (Sweden)

    Richard Sikkema

    2014-09-01

    Full Text Available The first objective of this paper was to provide an inventory of developments of certification schemes for sustainable biomass production, following recent EU legislation (both formalized and under development. One main pillar is the EU Timber Regulation for legal harvesting; a second one is the EU’s 2010 recommendations for sustainable woody biomass sourcing for energy; the third one is the EU Waste Directive. The second objective was to benchmark the coverage of this (draft legislation, when wood product certificates for sustainable forest management (SFM are used as proof of the related legislative requirements. We studied North America, as it is a major biomass supplier to the EU-28. Together with existing forest legislation in the US and Canada, SFM certificates are actively used to cover the EU’s (draft legislation. However, North American forests are only partially certified with fibers coming from certified forests; these are referred to as forest management (FM fibers. Other certified fibers should come from complementary risk assessments downstream in the supply chain (risk based fibers. Our benchmark concludes that: (a FM fiber certification by the Forest Stewardship Council (FSC and the Program for the Endorsement of Forest Certification (PEFC international standards show the highest level of coverage with EU’s (draft legislation; (b There is insufficient coverage for risk based fibers by FSC Controlled Wood (FSC-CW, PEFC Due Diligence (PEFC-DD, or SFI-fiber sourcing (SFI-FS. Other weaknesses identified for elaboration are: (c Alignment in definitions are needed, such as for primary forest, high carbon stock, and wood waste (cascading; (d Imperfect mass balance (fiber check downstream needs to be solved, as non-certified fiber flows are inadequately monitored; (e Add-on of a GHG calculation tool is needed, as GHG life cycle reporting is not covered by any of the SFM frameworks.

  10. Clustered lot quality assurance sampling: a tool to monitor immunization coverage rapidly during a national yellow fever and polio vaccination campaign in Cameroon, May 2009.

    Science.gov (United States)

    Pezzoli, L; Tchio, R; Dzossa, A D; Ndjomo, S; Takeu, A; Anya, B; Ticha, J; Ronveaux, O; Lewis, R F

    2012-01-01

    We used the clustered lot quality assurance sampling (clustered-LQAS) technique to identify districts with low immunization coverage and guide mop-up actions during the last 4 days of a combined oral polio vaccine (OPV) and yellow fever (YF) vaccination campaign conducted in Cameroon in May 2009. We monitored 17 pre-selected districts at risk for low coverage. We designed LQAS plans to reject districts with YF vaccination coverage LQAS proved to be useful in guiding the campaign vaccination strategy before the completion of the operations.

  11. Clay Nanoparticles Elicit Long-Term Immune Responses by Forming Biodegradable Depots for Sustained Antigen Stimulation.

    Science.gov (United States)

    Chen, Weiyu; Zuo, Huali; Li, Bei; Duan, Chengcheng; Rolfe, Barbara; Zhang, Bing; Mahony, Timothy J; Xu, Zhi Ping

    2018-05-01

    Nanomaterials have been widely tested as new generation vaccine adjuvants, but few evoke efficient immunoreactions. Clay nanoparticles, for example, layered double hydroxide (LDH) and hectorite (HEC) nanoparticles, have shown their potent adjuvanticity in generating effective and durable immune responses. However, the mechanism by which clay nanoadjuvants stimulate the immune system is not well understood. Here, it is demonstrated that LDH and HEC-antigen complexes form loose agglomerates in culture medium/serum. They also form nodules with loose structures in tissue after subcutaneous injection, where they act as a depot for up to 35 d. More importantly, clay nanoparticles actively and continuously recruit immune cells into the depot for up to one month, and stimulate stronger immune responses than FDA-approved adjuvants, Alum and QuilA. Sustained antigen release is also observed in clay nanoparticle depots, with 50-60% antigen released after 35 d. In contrast, Alum-antigen complexes show minimal antigen release from the depot. Importantly, LDH and HEC are more effective than QuilA and Alum in promoting memory T-cell proliferation. These findings suggest that both clay nanoadjuvants can serve as active vaccine platforms for sustained and potent immune responses. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Effectiveness of community service models for increasing routine immunization coverage at primary healthcare facilities in a rural district of Pakistan: a quasi-experimental study

    International Nuclear Information System (INIS)

    Ali, Z.; Pongpanich, S.; Kumar, R.

    2015-01-01

    Background: In Pakistan Routine Immunization coverage has been reported to be significantly low due to multiple factors that results in high number of deaths in children under 5. This study was conducted to assess the effectiveness of integrating Community Services to improve Routine immunization coverage in rural district of Pakistan. Methods: A quasi-experimental study with control and intervention arms was conducted in government Basic Health units catchment population of Panjgur by interviewing household head/Fathers. Total 234 household head including fathers were interviewed during this baseline survey. Community service model was used for to increase routine immunization coverage at catchment area of Basic Health unit (BHU) in intervention group while routine services were given in control BHU. Results: 230 parents completed the questionnaire during the end line after three months of intervention. There were no significant differences found between two groups at baseline but after the intervention, there was statistically significance difference (<0.05) between both groups knowledge and practices regarding routine immunization. Moreover, there was no statistically significant difference in control group reported (>0.05) after the intervention period. Overall immunization status after intervention where fully immunization status in intervention group after intervention was 88.8% as compared to control group after intervention was 13.6% for partial immunization status in intervention group after intervention was 11.1% as compared to control group after intervention was 81.1 for the Non-Immunization status in intervention group after intervention was 0% as compared to control group after intervention was 5.1%. Conclusions: Community Service Model has significantly improved the Knowledge and Practices among households/parents of children under 5 in the intervention arm. (author)

  13. Sustainable industrial estate by managing the building coverage ratio in Cibitung Industrial Town, Indonesia

    Science.gov (United States)

    Budiyanto, T. M. T.; Prajitno, I. S.; Hasibuan, H. S.

    2018-03-01

    The problem faced in the management of the industrial estate is the development of industrial buildings which are not in accordance with the existing environmental regulations, especially the building coverage ratio (BCR). This violation is due to the limitation of industrial land owned, and the tenant’s desire to maximize building area. This research conducted at Cibitung Industrial Town, Indonesia, to assess the compliance of industrial building in complying with environmental regulations, and efforts by industrial estate manager together with industrial communities to meet building regulations. The compliance is shown from the conformity of the tenant’s BCR to the building provisions contained in the regulation within the industrial estate; which is maximum 60% from land owned. And whether the rest of green open space (GOS) area can still be maintained at a minimum 10%. This study found tenant’s building density (BCR) at 24.55% population was 84.77%, and the rest of green open space at 21.56% population was only 2.49%. Excessive building development and expansion by the industrial communities, led to a continued reduction in green open space as a rainwater absorption area. It is resulting the rainfall runoff directly into the environmental drainage system, and causing flooding in the region.

  14. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

    Science.gov (United States)

    de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

    2015-04-04

    Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009-2013 National Immunization Survey-Teen.

    Science.gov (United States)

    Perkins, Rebecca B; Lin, Mengyun; Wallington, Sherrie F; Hanchate, Amresh D

    2016-06-02

    To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Using data from the National Immunization Survey-Teen from 2009-2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13-17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, and WA) did not have higher HPV vaccine series initiation or completion than those living in states without mandates for any year (2009-2013). Similar results were seen when comparing girls ages 13-14 to those ages 15-17, and after adjustment for known covariates of vaccination. States and jurisdictions with school-entry and education mandates do not currently have higher HPV vaccination coverage than states without such legislation. Liberal opt-out language in existing school entry mandates may weaken their impact. Policy-makers contemplating legislation to improve vaccination coverage should be aware of the limitations of existing mandates.

  16. Childhood immunization rates in rural Intibucá, Honduras: an analysis of a local database tool and community health center records for assessing and improving vaccine coverage.

    Science.gov (United States)

    He, Yuan; Zarychta, Alan; Ranz, Joseph B; Carroll, Mary; Singleton, Lori M; Wilson, Paria M; Schlaudecker, Elizabeth P

    2012-12-07

    Vaccines are highly effective at preventing infectious diseases in children, and prevention is especially important in resource-limited countries where treatment is difficult to access. In Honduras, the World Health Organization (WHO) reports very high immunization rates in children. To determine whether or not these estimates accurately depict the immunization coverage in non-urban regions of the country, we compared the WHO data to immunization rates obtained from a local database tool and community health center records in rural Intibucá, Honduras. We used data from two sources to comprehensively evaluate immunization rates in the area: 1) census data from a local database and 2) immunization data collected at health centers. We compared these rates using logistic regression, and we compared them to publicly available WHO-reported estimates using confidence interval inclusion. We found that mean immunization rates for each vaccine were high (range 84.4 to 98.8 percent), but rates recorded at the health centers were significantly higher than those reported from the census data (p ≤ 0.001). Combining the results from both databases, the mean rates of four out of five vaccines were less than WHO-reported rates (p 0.05), except for diphtheria/tetanus/pertussis vaccine (p=0.02) and oral polio vaccine (p Honduras were high across data sources, though most of the rates recorded in rural Honduras were less than WHO-reported rates. Despite geographical difficulties and barriers to access, the local database and Honduran community health workers have developed a thorough system for ensuring that children receive their immunizations on time. The successful integration of community health workers and a database within the Honduran decentralized health system may serve as a model for other immunization programs in resource-limited countries where health care is less accessible.

  17. Report on: "The 1st Workshop on National Immunization Programs and Vaccine Coverage in ASEAN Countries, April 30, 2015, Pattaya, Thailand".

    Science.gov (United States)

    Hattasingh, Weerawan; Pengsaa, Krisana; Thisyakorn, Usa

    2016-03-04

    The 1st Workshop on National Immunization Programs and Vaccine Coverage in Association of Southeast Asian Nations (ASEAN) Countries Group (WNIPVC-ASEAN) held a meeting on April 30, 2015, Pattaya, Thailand under the auspices of the Pediatric Infectious Diseases Society and the World Health Organization (WHO). Reports on the current status and initiatives of the national immunization program (NIP) in each ASEAN countries that attended were presented. These reports along with survey data collected from ministries of health in ASEAN countries NIPs demonstrate that good progress has been made toward the goal of the Global Vaccine Action Plan (GVAP). However, some ASEAN countries have fragile health care systems that still have insufficient vaccine coverage of some basic EPI antigens. Most ASEAN countries still do not have national coverage of some new and underused vaccines, and raising funds for the expansion of NIPs is challenging. Also, there is insufficient research into disease burden of vaccine preventable diseases and surveillance. Health care workers must advocate NIPs to government policy makers and other stakeholders as well as improve research and surveillance to achieve the goals of the GVAP. Copyright © 2016. Published by Elsevier Ltd.. All rights reserved.

  18. The effect of loss of immunity on noise-induced sustained oscillations in epidemics.

    Science.gov (United States)

    Chaffee, J; Kuske, R

    2011-11-01

    The effect of loss of immunity on sustained population oscillations about an endemic equilibrium is studied via a multiple scales analysis of a SIRS model. The analysis captures the key elements supporting the nearly regular oscillations of the infected and susceptible populations, namely, the interaction of the deterministic and stochastic dynamics together with the separation of time scales of the damping and the period of these oscillations. The derivation of a nonlinear stochastic amplitude equation describing the envelope of the oscillations yields two criteria providing explicit parameter ranges where they can be observed. These conditions are similar to those found for other applications in the context of coherence resonance, in which noise drives nearly regular oscillations in a system that is quiescent without noise. In this context the criteria indicate how loss of immunity and other factors can lead to a significant increase in the parameter range for prevalence of the sustained oscillations, without any external driving forces. Comparison of the power spectral densities of the full model and the approximation confirms that the multiple scales analysis captures nonlinear features of the oscillations.

  19. The Influence of Women's Empowerment on Child Immunization Coverage in Low, Lower-Middle, and Upper-Middle Income Countries: A Systematic Review of the Literature.

    Science.gov (United States)

    Thorpe, Sara; VanderEnde, Kristin; Peters, Courtney; Bardin, Lauren; Yount, Kathryn M

    2016-01-01

    An estimated 1.5 million children under five die annually from vaccine preventable diseases, and 17% of these deaths can be averted with vaccination. Predictors of immunization coverage, such as maternal schooling, are well documented; yet, preventable under-five mortality persists. To understand these patterns, researchers are exploring the mother-child relationship through an empowerment framework. This systematic review assesses evidence of the relationship between women's agency as a component of empowerment and vaccine completion among children child vaccination. Our initial search identified 406 articles and abstracts for screening; 12 studies met the inclusion and exclusion criteria. A majority (83%) of studies revealed at least one positive association of measures for women's agency with immunization coverage. These relationships varied by geographic location, and most studies focused on women's decision making rather than freedom of movement. No included study came from Latin America or the Middle East. Overall, women's agency, typically measured by decision-making, was positively associated with the odds of complete childhood immunizations. Yet, the concept of agency was inconsistently defined and operationalized. Future research should address these inconsistencies and focus on under-represented geographic regions including Latin America and the Middle East.

  20. Sustained and transient oscillations and chaos induced by delayed antiviral immune response in an immunosuppressive infection model.

    Science.gov (United States)

    Shu, Hongying; Wang, Lin; Watmough, James

    2014-01-01

    Sustained and transient oscillations are frequently observed in clinical data for immune responses in viral infections such as human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. To account for these oscillations, we incorporate the time lag needed for the expansion of immune cells into an immunosuppressive infection model. It is shown that the delayed antiviral immune response can induce sustained periodic oscillations, transient oscillations and even sustained aperiodic oscillations (chaos). Both local and global Hopf bifurcation theorems are applied to show the existence of periodic solutions, which are illustrated by bifurcation diagrams and numerical simulations. Two types of bistability are shown to be possible: (i) a stable equilibrium can coexist with another stable equilibrium, and (ii) a stable equilibrium can coexist with a stable periodic solution.

  1. Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009–2013 National Immunization Survey-Teen

    Science.gov (United States)

    Perkins, Rebecca B.; Lin, Mengyun; Wallington, Sherrie F.; Hanchate, Amresh D.

    2016-01-01

    ABSTRACT Objective: To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Methods: Using data from the National Immunization Survey-Teen from 2009–2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13–17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Results: Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, and WA) did not have higher HPV vaccine series initiation or completion than those living in states without mandates for any year (2009–2013). Similar results were seen when comparing girls ages 13–14 to those ages 15–17, and after adjustment for known covariates of vaccination. Conclusions: States and jurisdictions with school-entry and education mandates do not currently have higher HPV vaccination coverage than states without such legislation. Liberal opt-out language in existing school entry mandates may weaken their impact. Policy-makers contemplating legislation to improve vaccination coverage should be aware of the limitations of existing mandates. PMID:27152418

  2. Sustained Elevated Adenosine via ADORA2B Promotes Chronic Pain through Neuro-immune Interaction

    Directory of Open Access Journals (Sweden)

    Xia Hu

    2016-06-01

    Full Text Available The molecular mechanisms of chronic pain are poorly understood and effective mechanism-based treatments are lacking. Here, we report that mice lacking adenosine deaminase (ADA, an enzyme necessary for the breakdown of adenosine, displayed unexpected chronic mechanical and thermal hypersensitivity due to sustained elevated circulating adenosine. Extending from Ada−/− mice, we further discovered that prolonged elevated adenosine contributed to chronic pain behaviors in two additional independent animal models: sickle cell disease mice, a model of severe pain with limited treatment, and complete Freund’s adjuvant paw-injected mice, a well-accepted inflammatory model of chronic pain. Mechanistically, we revealed that activation of adenosine A2B receptors on myeloid cells caused nociceptor hyperexcitability and promoted chronic pain via soluble IL-6 receptor trans-signaling, and our findings determined that prolonged accumulated circulating adenosine contributes to chronic pain by promoting immune-neuronal interaction and revealed multiple therapeutic targets.

  3. Rapid and sustained CD4(+) T-cell-independent immunity from adenovirus-encoded vaccine antigens

    DEFF Research Database (Denmark)

    Holst, Peter J; Bartholdy, Christina; Buus, Anette Stryhn

    2007-01-01

    -linked lymphocytic choriomeningitis virus (LCMV)-derived epitopes was long-lived and protective. Notably, in contrast to full-length protein, the response elicited with the beta(2)-microglobulin-linked LCMV-derived epitope was CD4(+) T-cell independent. Furthermore, virus-specific CD8(+) T cells primed...... in the absence of CD4(+) T-cell help were sustained in the long term and able to expand and control a secondary challenge with LCMV. Our results demonstrate that modifications to the antigen used in adenovirus vaccines may be used to improve the induced T-cell response. Such a strategy for CD4(+) T-cell...... to that elicited with an adenovirus-encoded minimal epitope covalently linked to beta(2)-microglobulin. We demonstrate that the beta(2)-microglobulin-linked epitope induced an accelerated and augmented CD8(+) T-cell response. Furthermore, the immunity conferred by vaccination with beta(2)-microglobulin...

  4. 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. ...

  5. A Study to Find Out the Full Immunization Coverage of 12 to 23-month old Children and Areas of Under-Performance using LQAS Technique in a Rural Area of Tripura.

    Science.gov (United States)

    Datta, Anjan; Baidya, Subrata; Datta, Srabani; Mog, Chanda; Das, Shampa

    2017-02-01

    It is very important to analyze the factors which acts as obstacle in achieving 100% immunization among children. Lot Quality Assurance Sampling (LQAS) is one of the effective method to assess such barriers. To assess the full immunization coverage among 12 to 23-month old children of rural field practice area under Department of Community Medicine, Agartala Government Medical College and identify the factors for failure of full immunization. A community based cross-sectional study was conducted from November 2013 to October 2014 on children aged 12 to 23 months old of area under Mohanpur Community health centre. Using LQAS technique 330 samples were selected with multi-stage sampling, each sub-centre being one lot and two calculated to be the decision value. Data was collected using pre-designed pre-tested questionnaire during home visit and verifying immunization card and analysed by computer software SPSS version 21.0. The full immunization coverage among 12 to 23 months old children of Mohanpur area was found as 91.67%. Out of all the 22 sub-centres, 36.36% was found under performing as per pre-fixed criteria and the main reasons for failure of full immunization in those areas are unawareness of need of subsequent doses of vaccines and illness of the children. LQAS is an effective method to identify areas of under-performance even though overall full immunization coverage is high.

  6. Sustainability.

    Science.gov (United States)

    Chang, Chein-Chi; DiGiovanni, Kimberly; Mei, Ying; Wei, Li

    2016-10-01

    This review on Sustainability covers selected 2015 publications on the focus of Sustainability. It is divided into the following sections : • Sustainable water and wastewater utilities • Sustainable water resources management • Stormwater and green infrastructure • Sustainability in wastewater treatment • Life cycle assessment (LCA) applications • Sustainability and energy in wastewater industry, • Sustainability and asset management.

  7. The costs, effects and cost-effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: systematic review of the grey literature.

    Science.gov (United States)

    Batt, Katherine; Fox-Rushby, J A; Castillo-Riquelme, Marianela

    2004-09-01

    Evidence-based reviews of published literature can be subject to several biases. Grey literature, however, can be of poor quality and expensive to access. Effective search strategies also vary by topic and are rarely known in advance. This paper complements a systematic review of the published literature on the costs and effects of expanding immunization services in developing countries. The quality of data on the effectiveness and cost-effectiveness of strategies to increase immunization coverage is shown to be similar across literatures, but the quality of information on costing is much lower in the grey literature. After excluding poorer quality studies from this review we found the quantity of available evidence almost doubled, particularly for more complex health-system interventions and cost or cost-effectiveness analyses. Interventions in the grey literature are more up to date and cover a different geographical spread. Consequently the conclusions of the published and grey literatures differ, although the number of papers is still too low to account for differences across types of interventions. We recommend that in future researchers consider using non-English keywords in their searches.

  8. Variation in hepatitis B immunization coverage rates associated with provider practices after the temporary suspension of the birth dose

    Directory of Open Access Journals (Sweden)

    Mullooly John P

    2006-11-01

    Full Text Available Abstract Background In 1999, the American Academy of Pediatrics and U.S. Public Health Service recommended suspending the birth dose of hepatitis B vaccine due to concerns about potential mercury exposure. A previous report found that overall national hepatitis B vaccination coverage rates decreased in association with the suspension. It is unknown whether this underimmunization occurred uniformly or was associated with how providers changed their practices for the timing of hepatitis B vaccine doses. We evaluate the impact of the birth dose suspension on underimmunization for the hepatitis B vaccine series among 24-month-olds in five large provider groups and describe provider practices potentially associated with underimmunization following the suspension. Methods Retrospective cohort study of children enrolled in five large provider groups in the United States (A-E. Logistic regression was used to evaluate the association between the birth dose suspension and a child's probability of being underimmunized at 24 months for the hepatitis B vaccine series. Results Prior to July 1999, the percent of children who received a hepatitis B vaccination at birth varied widely (3% to 90% across the five provider groups. After the national recommendation to suspend the hepatitis B birth dose, the percent of children who received a hepatitis B vaccination at birth decreased in all provider groups, and this trend persisted after the policy was reversed. The most substantial decreases were observed in the two provider groups that shifted the first hepatitis B dose from birth to 5–6 months of age. Accounting for temporal trend, children in these two provider groups were significantly more likely to be underimmunized for the hepatitis B series at 24 months of age if they were in the birth dose suspension cohort compared with baseline (Group D OR 2.7, 95% CI 1.7 – 4.4; Group E OR 3.1, 95% CI 2.3 – 4.2. This represented 6% more children in Group D and 9

  9. Malaria in pregnant women in an area with sustained high coverage of insecticide-treated bed nets

    Directory of Open Access Journals (Sweden)

    Mshinda Hassan

    2008-07-01

    Full Text Available Abstract Background Since 2000, the World Health Organization has recommended a package of interventions to prevent malaria during pregnancy and its sequelae that includes the promotion of insecticide-treated bed nets (ITNs, intermittent preventive treatment in pregnancy (IPTp, and effective case management of malarial illness. It is recommended that pregnant women in malaria-endemic areas receive at least two doses of sulphadoxine-pyrimethamine in the second and third trimesters of pregnancy. This study assessed the prevalence of placental malaria at delivery in women during 1st or 2nd pregnancy, who did not receive intermittent preventive treatment for malaria (IPTp in a malaria-endemic area with high bed net coverage. Methods A hospital-based cross-sectional study was done in Ifakara, Tanzania, where bed net coverage is high. Primi- and secundigravid women, who presented to the labour ward and who reported not using IPTp were included in the study. Self-report data were collected by questionnaire; whereas neonatal birth weight and placenta parasitaemia were measured directly at the time of delivery. Results Overall, 413 pregnant women were enrolled of which 91% reported to have slept under a bed net at home the previous night, 43% reported history of fever and 62% were primigravid. Malaria parasites were detected in 8% of the placenta samples; the geometric mean (95%CI placental parasite density was 3,457 (1,060–11,271 parasites/μl in primigravid women and 2,178 (881–5,383 parasites/μl in secundigravid women. Fifteen percent of newborns weighed Conclusion The observed incidence of LBW and prevalence of placental parasitaemia at delivery suggests that malaria remains a problem in pregnancy in this area with high bed net coverage when eligible women do not receive IPTp. Delivery of IPTp should be emphasized at all levels of implementation to achieve maximum community coverage.

  10. Legal harvesting, sustainable sourcing and cascaded use of wood for bioenergy : Their coverage through existing certification frameworks for sustainable forest management

    NARCIS (Netherlands)

    Sikkema, Richard; Junginger, Martin; van Dam, Jinke; Stegeman, Gerben; Durrant, David; Faaij, Andre

    2014-01-01

    The first objective of this paper was to provide an inventory of developments of certification schemes for sustainable biomass production, following recent EU legislation (both formalized and under development). One main pillar is the EU Timber Regulation for legal harvesting; a second one is the

  11. Genetic analysis and characterization of wild poliovirus type 1 during sustained transmission in a population with >95% vaccine coverage, Israel 2013.

    Science.gov (United States)

    Shulman, Lester M; Martin, Javier; Sofer, Danit; Burns, Cara C; Manor, Yossi; Hindiyeh, Musa; Gavrilin, Eugene; Wilton, Thomas; Moran-Gilad, Jacob; Gamzo, Ronni; Mendelson, Ella; Grotto, Itamar

    2015-04-01

    Israel has >95% polio vaccine coverage with the last 9 birth cohorts immunized exclusively with inactivated polio vaccine (IPV). Using acute flaccid paralysis and routine, monthly countrywide environmental surveillance, no wild poliovirus circulation was detected between 1989 and February 2013, after which wild type 1 polioviruses South Asia genotype (WPV1-SOAS) have persistently circulated in southern Israel and intermittently in other areas without any paralytic cases as determined by intensified surveillance of environmental and human samples. We aimed to characterize antigenic and neurovirulence properties of WPV1-SOAS silently circulating in a highly vaccinated population. WPV1-SOAS capsid genes from environmental and stool surveillance isolates were sequenced, their neurovirulence was determined using transgenic mouse expressing the human poliovirus receptor (Tg21-PVR) mice, and their antigenicity was characterized by in vitro neutralization using human sera, epitope-specific monoclonal murine anti-oral poliovirus vaccine (OPV) antibodies, and sera from IPV-immunized rats and mice. WPV1 amino acid sequences in neutralizing epitopes varied from Sabin 1 and Mahoney, with little variation among WPV1 isolates. Neutralization by monoclonal antibodies against 3 of 4 OPV epitopes was lost. Three-fold lower geometric mean titers (Z = -4.018; P < .001, Wilcoxon signed-rank test) against WPV1 than against Mahoney in human serum correlated with 4- to 6-fold lower neutralization titers in serum from IPV-immunized rats and mice. WPV1-SOAS isolates were neurovirulent (50% intramuscular paralytic dose in Tg21-PVR mice: log10(7.0)). IPV-immunized mice were protected against WPV1-induced paralysis. Phenotypic and antigenic profile changes of WPV1-SOAS may have contributed to the intense silent transmission, whereas the reduced neurovirulence may have contributed to the absence of paralytic cases in the background of high population immunity. © The Author 2014. Published by

  12. Analysis of vaccination campaign effectiveness and population immunity to support and sustain polio elimination in Nigeria.

    Science.gov (United States)

    Upfill-Brown, Alexander M; Voorman, Arend; Chabot-Couture, Guillaume; Shuaib, Faisal; Lyons, Hil M

    2016-03-30

    The world is closer than ever to a polio-free Africa. In this end-stage, it is important to ensure high levels of population immunity to prevent polio outbreaks. Here, we introduce a new method of assessing vaccination campaign effectiveness and estimating immunity at the district-level. We demonstrate how this approach can be used to plan the vaccination campaigns prospectively to better manage population immunity in Northern Nigeria. Using Nigerian acute flaccid paralysis surveillance data from 2004-2014, we developed a Bayesian hierarchical model of campaign effectiveness and compared it to lot-quality assurance sampling data. We then used reconstructed sero-specific population immunity based on campaign history and compared district estimates of immunity to the occurrence of confirmed poliovirus cases. Estimated campaign effectiveness has improved across northern Nigeria since 2004, with Kano state experiencing an increase of 40 % (95 % CI, 26-54 %) in effectiveness from 2013 to 2014. Immunity to type 1 poliovirus has increased steadily. On the other hand, type 2 immunity was low and variable until the recent use of trivalent oral polio vaccine. We find that immunity estimates are related to the occurrence of both wild and vaccine-derived poliovirus cases and that campaign effectiveness correlates with direct measurements using lot-quality assurance sampling. Future campaign schedules highlight the trade-offs involved with using different vaccine types. The model in this study provides a novel method for assessing vaccination campaign performance and epidemiologically-relevant estimates of population immunity. Small-area estimates of campaign effectiveness can then be used to evaluate prospective campaign plans. This modeling approach could be applied to other countries as well as other vaccine preventable diseases.

  13. Avaliação da cobertura vacinal do esquema básico para o primeiro ano de vida Assessment of immunization coverage for the basic schedule in children

    Directory of Open Access Journals (Sweden)

    Alcides S. de Miranda

    1995-06-01

    Full Text Available Em 1991 avaliou-se a cobertura vacinal em crianças de 12 a 23 meses de idade no território de responsabilidade de um Posto de Atenção Primária à Saúde, na periferia da Zona Norte de Porto Alegre, RS, Brasil, cinco anos após sua implantação, com a finalidade de melhorar a qualidade das ações de saúde desenvolvidas no serviço. Foram investigadas todas as crianças através de um inquérito domiciliar, observando-se a carteira de vacinas e as informações da mãe. Em 1986, um inquérito inicial havia identificado uma cobertura vacinal inferior a 60% para cada uma das vacinas. A atual cobertura vacinal (doses comprovadas para três doses da vacina DPT (Difteria, Pertussis e Tétano, três doses da Sabin (antipoliomielite, uma dose da anti-sarampo (VAS e uma dose de BCG são, respectivamente 87, 89, 88 e 79%. Apesar das altas coberturas observadas por tipos de vacinas, quando se verificou para cada criança se o esquema básico do primeiro ano de vida estava completo (3 doses de DPT + 3 doses de Sabin + 1 dose de VAS + 1 dose de BCG, encontrou-se apenas 75% das crianças na citada situação. A cobertura vacinal é heterogênea dentro do território, sendo maior naquelas áreas caracterizadas por piores condições socioeconômicas, onde a equipe de saúde havia intensificado esforços. A comparação com o método administrativo de avaliação de cobertura, realizado mensalmente, mostrou a não-adequação desse, que subestimava a cobertura vacinal. Avaliou-se a situação vacinal das mães, para vacina antitetânica, e apenas 49% das crianças estavam protegidas contra o tétano neonatal. Os dados obtidos subsidiaram a imediata reestruturação das ações do programa, com vistas a atingir uma cobertura vacinal de 100%, e melhorar a qualidade das ações de saúde prestadas pela equipe.Immunization coverage was evaluated in all 12-23 month-old children living in the area were five years before a Primary Care Practice had been set up

  14. Activated T cells sustain myeloid-derived suppressor cell-mediated immune suppression

    Science.gov (United States)

    Damuzzo, Vera; Francescato, Samuela; Pozzuoli, Assunta; Berizzi, Antonio; Mocellin, Simone; Rossi, Carlo Riccardo; Bronte, Vincenzo; Mandruzzato, Susanna

    2016-01-01

    The expansion of myeloid derived suppressor cells (MDSCs), a suppressive population able to hamper the immune response against cancer, correlates with tumor progression and overall survival in several cancer types. We have previously shown that MDSCs can be induced in vitro from precursors present in the bone marrow and observed that these cells are able to actively proliferate in the presence of activated T cells, whose activation level is critical to drive the suppressive activity of MDSCs. Here we investigated at molecular level the mechanisms involved in the interplay between MDSCs and activated T cells. We found that activated T cells secrete IL-10 following interaction with MDSCs which, in turn, activates STAT3 phosphorylation on MDSCs then leading to B7-H1 expression. We also demonstrated that B7-H1+ MDSCs are responsible for immune suppression through a mechanism involving ARG-1 and IDO expression. Finally, we show that the expression of ligands B7-H1 and MHC class II both on in vitro-induced MDSCs and on MDSCs in the tumor microenvironment of cancer patients is paralleled by an increased expression of their respective receptors PD-1 and LAG-3 on T cells, two inhibitory molecules associated with T cell dysfunction. These findings highlight key molecules and interactions responsible for the extensive cross-talk between MDSCs and activated T cells that are at the basis of immune suppression. PMID:26700461

  15. A nonproliferating parvovirus vaccine vector elicits sustained, protective humoral immunity following a single intravenous or intranasal inoculation.

    Science.gov (United States)

    Palmer, Gene A; Brogdon, Jennifer L; Constant, Stephanie L; Tattersall, Peter

    2004-02-01

    An ideal vaccine delivery system would elicit persistent protection following a single administration, preferably by a noninvasive route, and be safe even in the face of immunosuppression, either inherited or acquired, of the recipient. We have exploited the unique life cycle of the autonomous parvoviruses to develop a nonproliferating vaccine platform that appears to both induce priming and continually boost a protective immune response following a single inoculation. A crippled parvovirus vector was constructed, based on a chimera between minute virus of mice (MVM) and LuIII, which expresses Borrelia burgdorferi outer surface protein A (OspA) instead of its coat protein. The vector was packaged into an MVM lymphotropic capsid and inoculated into naive C3H/HeNcr mice. Vaccination with a single vector dose, either intravenously or intranasally, elicited high-titer anti-OspA-specific antibody that provided protection from live spirochete challenge and was sustained over the lifetime of the animal. Both humoral and cell-mediated Th(1) immunity was induced, as shown by anti-OspA immunoglobulin G2a antibody and preferential gamma interferon production by OspA-specific CD4(+) T cells.

  16. Sustained Partial Sleep Deprivation: Effects on Immune Modulation and Growth Factors

    Science.gov (United States)

    Mullington, Janet M.

    1999-01-01

    from this larger study: a 4.2 hour per night condition, and a 8.2 hour per night condition. During space flight, muscle mass and bone density are reduced, apparently due to loss of GH and IGF-I, associated with microgravity. Since >70% of growth hormone (GH) is secreted at night in normal adults, we hypothesized that the chronic sleep restriction to 4 hours per night would reduce GH levels as measured in the periphery. In this synergy project, in collaboration with the "Muscle Alterations and Atrophy Team ", we are measuring insulin-like growth factor-I (IGF-I) in peripheral circulation to test the prediction that it will be reduced by chronic sleep restriction. In addition to stress modulation of immune function, recent research suggests that sleep is also involved. While we all have the common experience of being sleepy when suffering from infection, and being susceptible to infection when not getting enough sleep, the mechanisms involved in this process are not understood and until recently have gone largely overlooked. We believe that the immune function changes seen in spaceflight may also be related to the cumulative effects of sleep loss. Moreover, in space flight, the possibility of compromised immune function or of the reactivation of latent viruses are serious potential hazards for the success of long term missions. Confined living conditions, reduced sleep, altered diet and stress are all factors that may compromise immune function, thereby increasing the risks of developing and transmitting disease. Medical complications, which would not pose serious problems on earth, may be disastrous if they emerged in space.

  17. Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009–2013 National Immunization Survey-Teen

    OpenAIRE

    Perkins, Rebecca B.; Lin, Mengyun; Wallington, Sherrie F.; Hanchate, Amresh D.

    2016-01-01

    Objective: To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula...

  18. 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

  19. 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

  20. Strengthening the partnership between routine immunization and the global polio eradication initiative to achieve eradication and assure sustainability.

    Science.gov (United States)

    Abdelwahab, Jalaa; Dietz, Vance; Eggers, Rudolf; Maher, Christopher; Olaniran, Marianne; Sandhu, Hardeep; Vandelaer, Jos

    2014-11-01

    Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the number of polio endemic countries has declined from 125 to 3 in 2013. Despite this remarkable achievement, ongoing circulation of wild poliovirus in polio-endemic countries and the increase in the number of circulating vaccine-derived poliovirus cases, especially those caused by type 2, is a cause for concern. The Polio Eradication and Endgame Strategic Plan 2013-2018 (PEESP) was developed and includes 4 objectives: detection and interruption of poliovirus transmission, containment and certification, legacy planning, and a renewed emphasis on strengthening routine immunization (RI) programs. This is critical for the phased withdrawal of oral poliovirus vaccine, beginning with the type 2 component, and the introduction of a single dose of inactivated polio vaccine into RI programs. This objective has inspired renewed consideration of how the GPEI and RI programs can mutually benefit one another, how the infrastructure from the GPEI can be used to strengthen RI, and how a strengthened RI can facilitate polio eradication. The PEESP is the first GPEI strategic plan that places strong and clear emphasis on the necessity of improving RI to achieve and sustain global polio eradication. 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.

  1. Percent Coverage

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Percent Coverage is a spreadsheet that keeps track of and compares the number of vessels that have departed with and without observers to the numbers of vessels...

  2. 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

  3. Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health.

    Science.gov (United States)

    Kamei, Tomoko; Takahashi, Keiko; Omori, Junko; Arimori, Naoko; Hishinuma, Michiko; Asahara, Kiyomi; Shimpuku, Yoko; Ohashi, Kumiko; Tashiro, Junko

    2017-01-30

    this study developed a people-centered care (PCC) partnership model for the aging society to address the challenges of social changes affecting people's health and the new role of advanced practice nurses to sustain universal health coverage. a people-centered care partnership model was developed on the basis of qualitative meta-synthesis of the literature and assessment of 14 related projects. The ongoing projects resulted in individual and social transformation by improving community health literacy and behaviors using people-centered care and enhancing partnership between healthcare providers and community members through advanced practice nurses. people-centered care starts when community members and healthcare providers foreground health and social issues among community members and families. This model tackles these issues, creating new values concerning health and forming a social system that improves quality of life and social support to sustain universal health care through the process of building partnership with communities. a PCC partnership model addresses the challenges of social changes affecting general health and the new role of advanced practice nurses in sustaining UHC. o estudo desenvolveu um modelo de parceria de cuidados centrados nas pessoas (CCP) para uma sociedade que está envelhecendo, com o fim de enfrentar os desafios das mudanças sociais que afetam a saúde das pessoas e o novo papel da prática avançada de enfermagem para sustentar a cobertura universal de saúde. um modelo de parceria de cuidados centrados nas pessoas foi desenvolvido com base na meta-síntese qualitativa da literatura e a avaliação de 14 projetos relacionados. Os projetos em curso resultaram na transformação individual e social, melhorando a alfabetização de saúde da comunidade e comportamentos que usam o cuidado centrado nas pessoas e aumentando a parceria entre os profissionais de saúde e membros da comunidade por meio da prática avançada de enfermagem

  4. EPIVAC International Conference on Financial Sustainability of Immunization Programs in sub-Saharan Africa, February 16-18, 2012, Ouidah, Benin.

    Science.gov (United States)

    Drach, Marcel; Le Gargasson, Jean-Bernard; Mathonnat, Jacky; Da Silva, Alfred; Kaddar, Miloud; Colombini, Anaïs

    2013-09-23

    The introduction of new vaccines with much higher prices than traditional vaccines results in increasing budgetary pressure on immunization programs in GAVI-eligible countries, increasing the need to ensure their financial sustainability. In this context, the third EPIVAC (Epidemiology and Vaccinology) technical conference was held from February 16 to 18, 2012 at the Regional Institute of Public Health in Ouidah, Benin. Managers of ministries of health and finance from 11 West African countries (GAVI eligible countries), as well as former EPIVAC students and European experts, shared their knowledge and best practices on immunization financing at district and country level. The conference concluded by stressing five major priorities for the financial sustainability of national immunization programs (NIPs) in GAVI-eligible countries. - Strengthen public financing by increasing resources and fiscal space, improving budget processes, increasing contribution of local governments and strengthen efficiency of budget spending. - Promote equitable community financing which was recognized as a significant and essential contribution to the continuity of EPI operations. - Widen private funding by exploring prospects offered by sponsorship through foundations dedicated to immunization and by corporate social responsibility programs. - Contain the potential crowding-out effect of GAVI co-financing and ensure that decisions on new vaccine introductions are evidence-based. - Seek out innovative financing mechanisms such as taxes on food products or a national solidarity fund. Copyright © 2013. Published by Elsevier Ltd.. All rights reserved.

  5. Functional coverages

    NARCIS (Netherlands)

    Donchyts, G.; Baart, F.; Jagers, H.R.A.; Van Dam, A.

    2011-01-01

    A new Application Programming Interface (API) is presented which simplifies working with geospatial coverages as well as many other data structures of a multi-dimensional nature. The main idea extends the Common Data Model (CDM) developed at the University Corporation for Atmospheric Research

  6. Long term protection after immunization with P. berghei sporozoites correlates with sustained IFNγ responses of hepatic CD8+ memory T cells.

    Science.gov (United States)

    Nganou-Makamdop, Krystelle; van Gemert, Geert-Jan; Arens, Theo; Hermsen, Cornelus C; Sauerwein, Robert W

    2012-01-01

    Protection against P. berghei malaria can successfully be induced in mice by immunization with both radiation attenuated sporozoites (RAS) arresting early during liver stage development, or sporozoites combined with chloroquine chemoprophylaxis (CPS), resulting in complete intra-hepatic parasite development before killing of blood-stages by chloroquine takes place. We assessed the longevity of protective cellular immune responses by RAS and CPS P. berghei immunization of C57BL/6j mice. Strong effector and memory (T(EM)) CD8+ T cell responses were induced predominantly in the liver of both RAS and CPS immunized mice while CD4+ T cells with memory phenotype remained at base line levels. Compared to unprotected naïve mice, we found high sporozoite-specific IFNγ ex vivo responses that associated with induced levels of in vivo CD8+ T(EM) cells in the liver but not spleen. Long term evaluation over a period of 9 months showed a decline of malaria-specific IFNγ responses in RAS and CPS mice that significantly correlated with loss of protection (r(2) = 0.60, pmemory CD8+ T cells could be boosted by re-exposure to wild-type sporozoites. Our data show that sustainable protection against malaria associates with distinct intra-hepatic immune responses characterized by strong IFNγ producing CD8+ memory T cells.

  7. Long term protection after immunization with P. berghei sporozoites correlates with sustained IFNγ responses of hepatic CD8+ memory T cells.

    Directory of Open Access Journals (Sweden)

    Krystelle Nganou-Makamdop

    Full Text Available Protection against P. berghei malaria can successfully be induced in mice by immunization with both radiation attenuated sporozoites (RAS arresting early during liver stage development, or sporozoites combined with chloroquine chemoprophylaxis (CPS, resulting in complete intra-hepatic parasite development before killing of blood-stages by chloroquine takes place. We assessed the longevity of protective cellular immune responses by RAS and CPS P. berghei immunization of C57BL/6j mice. Strong effector and memory (T(EM CD8+ T cell responses were induced predominantly in the liver of both RAS and CPS immunized mice while CD4+ T cells with memory phenotype remained at base line levels. Compared to unprotected naïve mice, we found high sporozoite-specific IFNγ ex vivo responses that associated with induced levels of in vivo CD8+ T(EM cells in the liver but not spleen. Long term evaluation over a period of 9 months showed a decline of malaria-specific IFNγ responses in RAS and CPS mice that significantly correlated with loss of protection (r(2 = 0.60, p<0.0001. The reducing IFNγ response by hepatic memory CD8+ T cells could be boosted by re-exposure to wild-type sporozoites. Our data show that sustainable protection against malaria associates with distinct intra-hepatic immune responses characterized by strong IFNγ producing CD8+ memory T cells.

  8. Sustained long-term immune responses after in situ gene therapy combined with radiotherapy and hormonal therapy in prostate cancer patients

    International Nuclear Information System (INIS)

    Fujita, Tetsuo; Teh, Bin S.; Timme, Terry L.; Mai, W.-Y.; Satoh, Takefumi; Kusaka, Nobuyuki; Naruishi, Koji; Fattah, Elmoataz Abdel; Aguilar-Cordova, Estuardo; Butler, E. Brian; Thompson, Timothy C.

    2006-01-01

    Purpose: To explore long-term immune responses after combined radio-gene-hormonal therapy. Methods and Materials: Thirty-three patients with prostate specific antigen 10 or higher or Gleason score of 7 or higher or clinical stage T2b to T3 were treated with gene therapy that consisted of 3 separate intraprostatic injections of AdHSV-tk on Days 0, 56, and 70. Each injection was followed by 2 weeks of valacyclovir. Intensity-modulated radiation therapy was delivered 2 days after the second AdHSV-tk injection for 7 weeks. Hormonal therapy was initiated on Day 0 and continued for 4 months or 2.3 years. Blood samples were taken before, during, and after treatment. Lymphocytes were analyzed by fluorescent antibody cell sorting (FACS). Results: Median follow-up was 26 months (range, 4-48 months). The mean percentages of DR + CD8 + T cells were increased at all timepoints up to 8 months. The mean percentages of DR + CD4 + T cells were increased later and sustained longer until 12 months. Long-term (2.3 years) use of hormonal therapy did not affect the percentage of any lymphocyte population. Conclusions: Sustained long-term (up to 8 to 12 months) systemic T-cell responses were noted after combined radio-gene-hormonal therapy for prostate cancer. Prolonged use of hormonal therapy does not suppress this response. These results suggest the potential for sustained activation of cell-mediated immune responses against cancer

  9. Challenges in Estimating Vaccine Coverage in Refugee and Displaced Populations: Results From Household Surveys in Jordan and Lebanon

    Science.gov (United States)

    Roberton, Timothy; Weiss, William; Doocy, Shannon

    2017-01-01

    Ensuring the sustained immunization of displaced persons is a key objective in humanitarian emergencies. Typically, humanitarian actors measure coverage of single vaccines following an immunization campaign; few measure routine coverage of all vaccines. We undertook household surveys of Syrian refugees in Jordan and Lebanon, outside of camps, using a mix of random and respondent-driven sampling, to measure coverage of all vaccinations included in the host country’s vaccine schedule. We analyzed the results with a critical eye to data limitations and implications for similar studies. Among households with a child aged 12–23 months, 55.1% of respondents in Jordan and 46.6% in Lebanon were able to produce the child’s EPI card. Only 24.5% of Syrian refugee children in Jordan and 12.5% in Lebanon were fully immunized through routine vaccination services (having received from non-campaign sources: measles, polio 1–3, and DPT 1–3 in Jordan and Lebanon, and BCG in Jordan). Respondents in Jordan (33.5%) and Lebanon (40.1%) reported difficulties obtaining child vaccinations. Our estimated immunization rates were lower than expected and raise serious concerns about gaps in vaccine coverage among Syrian refugees. Although our estimates likely under-represent true coverage, given the additional benefit of campaigns (not captured in our surveys), there is a clear need to increase awareness, accessibility, and uptake of immunization services. Current methods to measure vaccine coverage in refugee and displaced populations have limitations. To better understand health needs in such groups, we need research on: validity of recall methods, links between campaigns and routine immunization programs, and improved sampling of hard-to-reach populations. PMID:28805672

  10. HIV-1-negative female sex workers sustain high cervical IFNɛ, low immune activation, and low expression of HIV-1-required host genes.

    Science.gov (United States)

    Abdulhaqq, S A; Zorrilla, C; Kang, G; Yin, X; Tamayo, V; Seaton, K E; Joseph, J; Garced, S; Tomaras, G D; Linn, K A; Foulkes, A S; Azzoni, L; VerMilyea, M; Coutifaris, C; Kossenkov, A V; Showe, L; Kraiselburd, E N; Li, Q; Montaner, L J

    2016-07-01

    Sex workers practicing in high HIV endemic areas have been extensively targeted to test anti-HIV prophylactic strategies. We hypothesize that in women with high levels of genital exposure to semen changes in cervico-vaginal mucosal and/or systemic immune activation will contribute to a decreased susceptibility to HIV-1 infection. To address this question, we assessed sexual activity and immune activation status (in peripheral blood), as well as cellular infiltrates and gene expression in ectocervical mucosa biopsies in female sex workers (FSWs; n=50), as compared with control women (CG; n=32). FSWs had low-to-absent HIV-1-specific immune responses with significantly lower CD38 expression on circulating CD4(+) or CD8(+) T-cells (both: PHIV-1 integration and replication. A correlative relationship between semen exposure and elevated type-1 IFN expression in FSWs was also established. Overall, our data suggest that long-term condomless sex work can result in multiple changes within the cervico-vaginal compartment that would contribute to sustaining a lower susceptibility for HIV-1 infection in the absence of HIV-specific responses.

  11. Medicare Coverage Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD...

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

    Science.gov (United States)

    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

  13. 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

  14. Universal immunization in urban areas: Calcutta's success story.

    Science.gov (United States)

    Chaudhuri, E R

    1990-01-01

    The Central Government of Calcutta, India aimed to immunize 85% (85,262) of the city's 12 month old infants against polio, diphtheria, measles, tuberculosis, pertussis and tetanus. The Universal Immunization Program (UIP) achieved this target 3 months earlier than intended. In fact, at the end of December 1990, it achieved 110.6% for DPT3, 142.16% for OPV3, 151.96% for BCG, and 97% for measles. UIP was able to surpass its targets by emphasizing team work. Government, the private sector, UNICEF, and the voluntary sector made up the Apex Coordination Committee on Immunization headed up by the mayor. The committee drafted an action plan which included routine immunization sessions on a fixed day and intensive immunization drives. Further the involved organizations pooled together cold chain equipment. In addition, the District Family Welfare Bureau was the distribution center for vaccines, syringes, immunization cards, report formats, vaccine carriers, and ice packs. Health workers administered immunizations from about 300 centers generally on Wednesday, National Immunization Day. Intensive immunization drives focused on measles immunizations. UIP leaders encouraged all center to routinely record coverage and submit monthly progress reports to the District Family Welfare Bureau. The Calcutta Municipal Corporation coordinated promotion activities and social mobilization efforts. Promotion included radio and TV announcements, newspaper advertisements, cinema slides, billboards, and posters. The original UIP plan to use professional communicators to mobilize communities was ineffective, so nongovernmental organizations entered the slums to encourage people to encourage their neighbors to immunize their children. Further Islamic, Protestant, and Catholic leaders encouraged the faithful to immunize their children. A UNICEF officer noted that this success must be sustained, however.

  15. Women's Health Insurance Coverage

    Science.gov (United States)

    ... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

  16. Fully immunized child

    DEFF Research Database (Denmark)

    Mutua, Martin Kavao; Kimani-Murage, Elizabeth; Ngomi, Nicholas

    2016-01-01

    Background: 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 ...

  17. Vitamin A supplementation in Tanzania: the impact of a change in programmatic delivery strategy on coverage

    Directory of Open Access Journals (Sweden)

    Shekar Meera

    2006-11-01

    Full Text Available Abstract Background Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on Immunization (EPI+ approach to twice-yearly mass distribution campaigns on coverage of vitamin A supplementation in Tanzania Methods We investigated disparities in age, sex, socio-economic status, nutritional status and maternal education within vitamin A coverage in children between 1 and 2 years of age from two independent household level child health surveys conducted (1 during a continuous universal targeting scheme based on routine EPI contacts for children aged 9, 15 and 21 months (1999; and (2 three years later after the introduction of twice-yearly vitamin A supplementation campaigns for children aged 6 months to 5 years, a 6-monthly universal targeting scheme (2002. A representative cluster sample of approximately 2,400 rural households was obtained from Rufiji, Morogoro Rural, Kilombero and Ulanga districts. A modular questionnaire about the health of all children under the age of five was administered to consenting heads of households and caretakers of children. Information on the use of child health interventions including vitamin A was asked. Results Coverage of vitamin A supplementation among 1–2 year old children increased from 13% [95% CI 10–18%] in 1999 to 76% [95%CI 72–81%] in 2002. In 2002 knowledge of two or more child health danger signs was negatively associated with vitamin A supplementation coverage (80% versus 70% (p = 0.04. Nevertheless, we did not find any disparities in coverage of vitamin A by district, gender, socio-economic status and DPT vaccinations. Conclusion Change in programmatic delivery of vitamin A supplementation was associated with a major improvement in coverage in Tanzania that was been sustained by repeated campaigns for at least three years. There is a

  18. Long term protection after immunization with P. berghei sporozoites correlates with sustained IFNgamma responses of hepatic CD8+ memory T cells.

    NARCIS (Netherlands)

    Nganou Makamdop, C.K.; Gemert, G.J.A. van; Arens, T.; Hermsen, C.C.; Sauerwein, R.W.

    2012-01-01

    Protection against P. berghei malaria can successfully be induced in mice by immunization with both radiation attenuated sporozoites (RAS) arresting early during liver stage development, or sporozoites combined with chloroquine chemoprophylaxis (CPS), resulting in complete intra-hepatic parasite

  19. Moving forward on strengthening and sustaining National Immunization Technical Advisory Groups (NITAGs) globally: Recommendations from the 2nd global NITAG network meeting.

    Science.gov (United States)

    MacDonald, Noni E; Duclos, Philippe; Wichmann, Ole; Henaff, Louise; Harnden, Anthony; Alshammary, Aisha; Tijerino, Roberto Arroba; Hall, Madeline; Sacarlal, Jahit; Singh, Rupa Rajbhandari

    2017-12-15

    National Immunization Technical Advisory Groups (NITAGs) provide independent, evidence-informed advice to assist their governments in immunization policy formation. This is complex work and many NITAGs face challenges in fulfilling their roles. Inter-country NITAG collaboration opportunities have the potential to enhance NITAG function and grow the quality of recommendations. Hence the many requests for formation of a network linking NITAGs together so they can learn from each other. The first Global NITAG Network (GNN) meeting, held in 2016, led to a push to launch the GNN and grow the network. At the second GNN meeting, held June 28-29, 2017 in Berlin, the GNN was formally inaugurated. Participants discussed GNN governance, reflected on the April 2017 Strategic Advisory Group of Experts (SAGE) on Immunization conclusions concerning strengthening of NITAGs and also shared NITAG experiences in evaluation and inter-country collaborations and independence. They also discussed the role of Regional Technical Advisory Groups on Immunization (RTAGs) and regional networks. A number of issues were raised including NITAGs and communications, dissemination of recommendations and vaccine implementation as well as implications of off-label recommendations. Participants were alerted to immunization evidence assessment sites and value of sharing of resources. They also discussed potential GNN funding opportunities, developed an action plan for 2017-18 and selected a Steering Committee to help move the GNN forward. All participants agreed on the importance of the GNN and the value in attracting more countries to join the GNN. Copyright © 2017.

  20. Successful introduction of an underutilized elderly pneumococcal vaccine in a national immunization program by integrating the pre-existing public health infrastructure.

    Science.gov (United States)

    Yang, Tae Un; Kim, Eunsung; Park, Young-Joon; Kim, Dongwook; Kwon, Yoon Hyung; Shin, Jae Kyong; Park, Ok

    2016-03-18

    Although pneumococcal vaccines had been recommended for the elderly population in South Korea for a considerable period of time, the coverage has been well below the optimal level. To increase the vaccination rate with integrating the pre-existing public health infrastructure and governmental funding, the Korean government introduced an elderly pneumococcal vaccination into the national immunization program with a 23-valent pneumococcal polysaccharide vaccine in May 2013. The aim of this study was to assess the performance of the program in increasing the vaccine coverage rate and maintaining stable vaccine supply and safe vaccination during the 20 months of the program. We qualitatively and quantitatively analyzed the process of introducing and the outcomes of the program in terms of the systematic organization, efficiency, and stability at the national level. A staggered introduction during the first year utilizing the public sector, with a target coverage of 60%, was implemented based on the public demand for an elderly pneumococcal vaccination, vaccine supply capacity, vaccine delivery capacity, safety, and sustainability. During the 20-month program period, the pneumococcal vaccine coverage rate among the population aged ≥65 years increased from 5.0% to 57.3% without a noticeable vaccine shortage or safety issues. A web-based integrated immunization information system, which includes the immunization registry, vaccine supply chain management, and surveillance of adverse events following immunization, reduced programmatic errors and harmonized the overall performance of the program. Introduction of an elderly pneumococcal vaccination in the national immunization program based on strong government commitment, meticulous preparation, financial support, and the pre-existing public health infrastructure resulted in an efficient, stable, and sustainable increase in vaccination coverage. Copyright © 2016. Published by Elsevier Ltd.

  1. 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

  2. A two-dose heterologous prime-boost vaccine regimen eliciting sustained immune responses to Ebola Zaire could support a preventive strategy for future outbreaks.

    Science.gov (United States)

    Shukarev, Georgi; Callendret, Benoit; Luhn, Kerstin; Douoguih, Macaya

    2017-02-01

    The consequences of the 2013-16 Ebola Zaire virus disease epidemic in West Africa were grave. The economies, healthcare systems and communities of Guinea, Sierra Leone and Liberia were devastated by over 18 months of active Ebola virus transmission, followed by sporadic resurgences potentially related to sexual transmission by survivors with viral persistence in body fluids following recovery. The need to develop and implement strategies to prevent and mitigate future outbreaks is now beyond dispute. The potential for unpredictable outbreaks of indeterminate duration, and control challenges posed by the possibility of sporadic re-emergence, mean that implementation of an effective vaccination program for outbreak containment necessitates a vaccine providing durable immunity. Heterologous prime-boost vaccine regimens deliver the same or similar antigens through different vaccine types, the first to prime and the second to boost the immune system. Ad26.ZEBOV/MVA-BN-Filo is an investigational Ebola Zaire vaccine regimen that uses this heterologous prime-boost approach. Preliminary Phase 1 data suggest that Ad26.ZEBOV/MVA-BN-Filo confers durable immunity for at least 240 d and is well-tolerated with a good safety profile. This regimen may therefore be suitable for prophylactic use in a regional or targeted population vaccination strategy, and could potentially aid prevention and control of future Ebola outbreaks.

  3. The distribution over time of costs and social net benefits for pertussis immunization programs.

    Science.gov (United States)

    Girard, Dorota Zdanowska

    2010-03-01

    The cost of a six-dose pertussis immunization programs for children and adolescents is investigated in relation to estimators of the price of acellular vaccine, the value of a child's life, levels of vaccination rate and discount rates. We compare the cost of the program maintained over time at 90% with three alternative strategies, each involving a decrease in vaccination coverage. Data from England and Wales, 1966-2005, is used to formalize a delay in occurrence of pertussis cases as a result of a fall in coverage. We first apply the criterion of minimization of the total social cost of pertussis to identify the best cost saving immunization strategy. The results are also discussed in form of the discounted present value of the total social net benefits. We find that the discounted present value of the total social net benefit is maximized when a stable vaccination program at 90% is compared to a gradual decrease in vaccination coverage leading to the lowest vaccination rate. The benefits to society of providing sustained immunization strategy, vaccinating the highest proportion of children and adolescents, are systematically proved on the basis of the second optimisation criterion, independently of the level of estimators applied during economic evaluation for the cost variables.

  4. Controlling measles using supplemental immunization activities: a mathematical model to inform optimal policy.

    Science.gov (United States)

    Verguet, Stéphane; Johri, Mira; Morris, Shaun K; Gauvreau, Cindy L; Jha, Prabhat; Jit, Mark

    2015-03-03

    The Measles & Rubella Initiative, a broad consortium of global health agencies, has provided support to measles-burdened countries, focusing on sustaining high coverage of routine immunization of children and supplementing it with a second dose opportunity for measles vaccine through supplemental immunization activities (SIAs). We estimate optimal scheduling of SIAs in countries with the highest measles burden. We develop an age-stratified dynamic compartmental model of measles transmission. We explore the frequency of SIAs in order to achieve measles control in selected countries and two Indian states with high measles burden. Specifically, we compute the maximum allowable time period between two consecutive SIAs to achieve measles control. Our analysis indicates that a single SIA will not control measles transmission in any of the countries with high measles burden. However, regular SIAs at high coverage levels are a viable strategy to prevent measles outbreaks. The periodicity of SIAs differs between countries and even within a single country, and is determined by population demographics and existing routine immunization coverage. Our analysis can guide country policymakers deciding on the optimal scheduling of SIA campaigns and the best combination of routine and SIA vaccination to control measles. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Strengthening and sustainability of national immunization technical advisory groups (NITAGs) globally: Lessons and recommendations from the founding meeting of the global NITAG network.

    Science.gov (United States)

    Adjagba, Alex; MacDonald, Noni E; Ortega-Pérez, Inmaculada; Duclos, Philippe

    2017-05-25

    National Immunization Technical Advisory Groups (NITAGs) provide independent, evidence-informed advice to assist their governments in immunization policy formation. However, many NITAGs face challenges in fulfilling their roles. Hence the many requests for formation of a network linking NITAGs together so they can learn from each other. To address this request, the Health Policy and Institutional Development (HPID) Center (a WHO Collaborating Center at the Agence de Médecine Préventive - AMP), in collaboration with WHO, organized a meeting in Veyrier-du-Lac, France, on 11 and 12 May 2016, to establish a Global NITAG Network (GNN). The meeting focused on two areas: the requirements for (a) the establishment of a global NITAG collaborative network; and (b) the global assessment/evaluation of the performance of NITAGs. 35 participants from 26 countries reviewed the proposed GNN framework documents and NITAG performance evaluation. Participants recommended that a GNN should be established, agreed on its governance, function, scope and a proposed work plan as well as setting a framework for NITAG evaluation. Copyright © 2017.

  6. Massachusetts health reform: employer coverage from employees' perspective.

    Science.gov (United States)

    Long, Sharon K; Stockley, Karen

    2009-01-01

    The national health reform debate continues to draw on Massachusetts' 2006 reform initiative, with a focus on sustaining employer-sponsored insurance. This study provides an update on employers' responses under health reform in fall 2008, using data from surveys of working-age adults. Results show that concerns about employers' dropping coverage or scaling back benefits under health reform have not been realized. Access to employer coverage has increased, as has the scope and quality of their coverage as assessed by workers. However, premiums and out-of-pocket costs have become more of an issue for employees in small firms.

  7. Coverage Metrics for Model Checking

    Science.gov (United States)

    Penix, John; Visser, Willem; Norvig, Peter (Technical Monitor)

    2001-01-01

    When using model checking to verify programs in practice, it is not usually possible to achieve complete coverage of the system. In this position paper we describe ongoing research within the Automated Software Engineering group at NASA Ames on the use of test coverage metrics to measure partial coverage and provide heuristic guidance for program model checking. We are specifically interested in applying and developing coverage metrics for concurrent programs that might be used to support certification of next generation avionics software.

  8. 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

  9. Participação em dias nacionais de vacinação contra poliomielite: resultados de inquérito de cobertura vacinal em crianças nas 27 capitais brasileiras Participation in national polio immunization days: results of a vaccine coverage survey among children in 27 Brazilian cities

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Rocha Mello

    2010-06-01

    Immunization Days (NIDs are held twice a year to maintain the elimination of poliomyelitis and to provide routine immunization for children younger than five years of age. Few studies have examined factors associated with participation in National Immunization Days among Brazilian children, or the contribution of immunization days to the coverage of recommended vaccines. METHODS: We conducted a household cluster survey in 26 state capitals and the Federal District among children aged 19 to 35 months. Vaccination histories, including dates of vaccination, participation in the most recent NID or reasons for non-participation were obtained. Survey estimates were compared with official estimates based on doses administered. RESULTS: Among the 17,749 children surveyed, 16,213 (91% participated in the most recent NID. Children who received vaccination in the private sector had the lowest participation (84% in NIDs. In 13 capitals, official coverage estimates were higher than those from the survey. The main reasons given for non-participation the most recent NID included parent's decision not to participate, doctor's advice, child's illness, and factors associated with the organization of the NID. Overall, 15% of the children surveyed had received at least one immunization in addition to oral polio vaccine in the most recent NID, including yellow fever, hepatitis B, measles-mumps-rubella (MMR and combined diphtheria-tetanus-pertussis-Haemophilus influenzae type b vaccines. CONCLUSIONS: In Brazilian capitals, National Immunization Days continue to enjoy high levels of acceptance by the population and offer opportunities to complete recommended immunization schedules. Reasons for non-participation suggest the need for different communication strategies to reach parents who do not bring their children for vaccination on NIDs.

  10. The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries.

    Science.gov (United States)

    Howard, Natasha; Bell, Sadie; Walls, Helen; Blanchard, Laurence; Brenzel, Logan; Jit, Mark; Mounier-Jack, Sandra

    2018-02-22

    National Immunisation Technical Advisory Groups (NITAGs) provide independent guidance to health ministries to support evidence-based and nationally relevant immunisation decisions. We examined NITAGs' value, sustainability, and need for support in low and middle-income countries, drawing from a mixed-methods study including 130 global and national-level key informant interviews. NITAGs were particularly valued for providing independent and nationally owned evidence-based decision-making (EBDM), but needed to be integrated within national processes to effectively balance independence and influence. Participants agreed that most NITAGs, being relatively new, would need developmental and strengthening support for at least a decade. While national governments could support NITAG functioning, external support is likely needed for requisite capacity building. This might come from Gavi mechanisms and WHO, but would require alignment among stakeholders to be effective.

  11. Insurance premiums and insurance coverage of near-poor children.

    Science.gov (United States)

    Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

    States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

  12. 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

  13. Immunizations - diabetes

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000331.htm Immunizations - diabetes To use the sharing features on this page, please enable JavaScript. Immunizations (vaccines or vaccinations) help protect you from some ...

  14. Modelling the implications of moving towards universal coverage in Tanzania.

    Science.gov (United States)

    Borghi, Josephine; Mtei, Gemini; Ally, Mariam

    2012-03-01

    A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to

  15. 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.

  16. Attaining higher coverage: obstacles to overcome. English-speaking Caribbean and Suriname.

    Science.gov (United States)

    1984-12-01

    In 1983, 8 (42%) of the 19 English-speaking Caribbean countries (including Suriname) achieved at least 50% coverage with 3 doses of diphtheria-pertussis-tetanus (DPT) vaccine among children under 1 year of age and 6 countries (32%) had at least 50% coverage with 3 doses of trivalent oral polio vaccine (TOPV). In addition, 10 countries (53%) achieved over 75% DPT coverage and 11 (58%) achieved over 75% TOPV coverage. Despite this record of progress, several factors continue to impede further gains in immunization coverage. Of particular concern is the high dropout rate. As many as 25% of infants receive their 1st dose of DPT and TOPV but do not return to complete their course of immunization. There is also a need for each health center to estimate its annual target population for immunization every year through analysis of the total live births from the previous year in the health center's catchment area (minus infant mortality). Monthly target figures can thus be computed and coverage monitored. A further problem has been a reluctance on the part of some health workers to administer vaccines simultaneously. This does not reduce effectiveness or increase the risk of complications, and reduces the number of visits needed to complete the immunization schedule. An unresolved question is whether to immunize ill or malnourished children. Decisions on this matter should take into account the availability and accessibility of health care services, the ability to follow-up children who are not immunized, and the likelihood that children will return for subsequent immunizations. Finally, a number of immunizations performed by private practitioners and institutions are not reported. Both public and private health care providers should agree on a standardized reporting format to allow better estimation of coverage.

  17. Innate immunity in the pathogenesis of psoriasis.

    LENUS (Irish Health Repository)

    Sweeney, Cheryl M

    2011-12-01

    Psoriasis is a common, immune-mediated inflammatory skin disorder. T helper(h)1 and Th17 lymphocytes contribute to the pathogenesis of psoriasis through the release of inflammatory cytokines that promote further recruitment of immune cells, keratinocyte proliferation and sustained inflammation. The innate immune system is the first line of defence against infection and plays a crucial role in the initiation of the adaptive immune response. The presence of innate immune cells and their products in psoriatic skin plaques suggests a role for innate immunity in this disease. In addition, the innate immune system can direct the development of pathogenic Th cells in psoriasis. In this article, we will summarise the role of the innate immune system in psoriasis with particular emphasis on the role of cytokines, signalling pathways and cells of the innate immune system.

  18. Inquérito de cobertura vacinal: avaliação empírica da técnica de amostragem por conglomerados proposta pela Organização Mundial da Saúde Immunization coverage survey: empirical assessment of the cluster sampling method proposed by the World Health Organization

    Directory of Open Access Journals (Sweden)

    Rita Barradas Barata

    2005-03-01

    íplice viral (12,9% e para o esquema completo (11,2%. CONCLUSÃO: O método de inquérito de cobertura vacinal proposto pela Organização Mundial da Saúde é capaz de fornecer dados representativos da população, desde que os procedimentos metodológicos de seleção da amostra sejam rigorosamente seguidos no campo.OBJECTIVE: To assess sample representativeness and the precision of estimates of immunization coverage obtained with the 30 by 7 cluster sampling method proposed by the World Health Organization, by applying the method to determine immunization coverage in two municipalities (Diadema and São Caetano do Sul in the state of São Paulo, Brazil, in 2000. METHOD: The representativeness of the samples was determined by comparing the census sectors picked by lot for the surveyed sectors and for the nonsurveyed sectors in both municipalities, in terms of socioeconomic and demographic characteristics (age distribution of the population, schooling, proportion of households headed by a women, monthly income of household head, and sanitary conditions of the home (piped-in water, connected to the sewer system. The precision of the coverage estimates for the vaccines in the basic immunization schedule-BCG; diphtheria, pertussis, and tetanus (DPT; poliomyelitis; hepatitis B; measles; and measles, mumps, and rubella (MMR-was determined by calculating the design effect and the width of the confidence intervals. Precision was considered to be satisfactory if the design effect was below 2.0 and the confidence interval width was below 10%. RESULTS: In both municipalities the comparison between the surveyed and nonsurveyed sectors showed a similar distribution in terms of socioeconomic and demographic variables. Concerning the precision of the estimates, the design effect was below 2.0 for all the vaccines, both in São Caetano do Sul and Diadema. In Diadema, the confidence interval width was below 10% for all the vaccines, except for MMR (10.1%. In São Caetano do Sul, only 89% of

  19. The paradigm of efficiency and sustainability

    African Journals Online (AJOL)

    John Roche

    environmental sustainability are mutually exclusive terms. .... because so much is dependent on the agricultural policies of the E.U., the U.S.A. and Japan ..... people's fears because of their disproportionate coverage of events (Glassner, 1999).

  20. Full Immunization Status of Under-Five Children in an Urban ...

    African Journals Online (AJOL)

    Caregivers numbering 250 (96.5%) correctly stated at least one benefit of immunization. Overall, immunization coverage was low, despite accessible immunization services. Community members and household influencers should educate caregivers to ensure their children's full immunization and employers should grant ...

  1. Immune System

    Science.gov (United States)

    A properly functioning immune system is essential to good health. It defends the body against infectious agents and in some cases tumor cells. Individuals with immune deficiencies resulting from genetic defects, diseases (e.g., AIDS, leukemia), or drug therapies are more suscepti...

  2. Population Immunity against Serotype-2 Poliomyelitis Leading up to the Global Withdrawal of the Oral Poliovirus Vaccine: Spatio-temporal Modelling of Surveillance Data.

    Science.gov (United States)

    Pons-Salort, Margarita; Molodecky, Natalie A; O'Reilly, Kathleen M; Wadood, Mufti Zubair; Safdar, Rana M; Etsano, Andrew; Vaz, Rui Gama; Jafari, Hamid; Grassly, Nicholas C; Blake, Isobel M

    2016-10-01

    Global withdrawal of serotype-2 oral poliovirus vaccine (OPV2) took place in April 2016. This marked a milestone in global polio eradication and was a public health intervention of unprecedented scale, affecting 155 countries. Achieving high levels of serotype-2 population immunity before OPV2 withdrawal was critical to avoid subsequent outbreaks of serotype-2 vaccine-derived polioviruses (VDPV2s). In August 2015, we estimated vaccine-induced population immunity against serotype-2 poliomyelitis for 1 January 2004-30 June 2015 and produced forecasts for April 2016 by district in Nigeria and Pakistan. Population immunity was estimated from the vaccination histories of children poliomyelitis. District immunity estimates were spatio-temporally smoothed using a Bayesian hierarchical framework. Coverage estimates for immunisation activities were also obtained, allowing for heterogeneity within and among districts. Forward projections of immunity, based on these estimates and planned immunisation activities, were produced through to April 2016 using a cohort model. Estimated population immunity was negatively correlated with the probability of VDPV2 poliomyelitis being reported in a district. In Nigeria and Pakistan, declines in immunity during 2008-2009 and 2012-2013, respectively, were associated with outbreaks of VDPV2. Immunity has since improved in both countries as a result of increased use of trivalent OPV, and projections generally indicated sustained or improved immunity in April 2016, such that the majority of districts (99% [95% uncertainty interval 97%-100%] in Nigeria and 84% [95% uncertainty interval 77%-91%] in Pakistan) had >70% population immunity among children poliomyelitis was forecasted to improve in April 2016 compared to the first half of 2015 in Nigeria and Pakistan. These analyses informed the endorsement of OPV2 withdrawal in April 2016 by the WHO Strategic Advisory Group of Experts on Immunization.

  3. Immunity booster

    International Nuclear Information System (INIS)

    Stefanescu, Ioan; Titescu, Gheorghe; Tamaian, Radu; Haulica, Ion; Bild, Walther

    2002-01-01

    The immunity booster is, according to its patent description, microbiologically pure water with an D/(D+H) isotopic concentration of 100 ppm, with physical-chemical characteristics similar to those of distilled water. It is obtained by sterilization of a mixture of deuterium depleted water, with a 25 ppm isotopic concentration, with distilled water in a volume ratio of 4:6. Unlike natural immunity boosters (bacterial agents as Bacillus Chalmette-Guerin, Corynebacterium parvum; lipopolysaccharides; human immunoglobulin) or synthetical products (levamysol; isoprinosyne with immunostimulating action), which cause hypersensitivity and shocks, thrill, fever, sickness and the immunity complex disease, the water of 100 ppm D/(D + H) isotopic concentration is a toxicity free product. The testing for immune reaction of the immunity booster led to the following results: - an increase of cell action capacity in the first immunity shielding stage (macrophages), as evidenced by stimulation of a number of essential characterizing parameters, as well as of the phagocytosis capacity, bactericide capacity, and opsonic capacity of serum; - an increase of the number of leucocyte particularly of the granulocyte in peripheral blood, produced especially when medullar toxic agents like caryolysine are used; - it hinders the effect of lowering the number of erythrocytes in peripheral blood produced by experimentally induced chronic inflammation; - an increase of nonspecific immunity defence capacity against specific bacterial aggression of both Gram-positive bacteria (Streptococcus pneumoniae 558 ) and of the Gram-negative ones (Klebsiella pneumoniae 507 ); - an increase of immunity - stimulating activity (proinflamatory), like that of levamisole as evidenced by the test of stimulation of experimentally induced inflammation by means of carrageenan. The following advantages of the immunity booster are stressed: - it is toxicity free and side effect free; - can be orally administrated as

  4. Grassland Sustainability

    Science.gov (United States)

    Deborah U. Potter; Paulette L. Ford

    2004-01-01

    In this chapter we discuss grassland sustainability in the Southwest, grassland management for sustainability, national and local criteria and indicators of sustainable grassland ecosystems, and monitoring for sustainability at various scales. Ecological sustainability is defined as: [T]he maintenance or restoration of the composition, structure, and processes of...

  5. Assuring Access to Affordable Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  6. Innate immunity

    African Journals Online (AJOL)

    Ronnie Anderson is Director of the Medical Research Council Unit for Inflammation and Immunity. ... field have included macrophage, T cell, cytokine and cytokine activated killer cell interactions .... monocytes, mast cells, lymphocytes, eccrine.

  7. Immunity's fourth dimension: approaching the circadian-immune connection.

    Science.gov (United States)

    Arjona, Alvaro; Silver, Adam C; Walker, Wendy E; Fikrig, Erol

    2012-12-01

    The circadian system ensures the generation and maintenance of self-sustained ~24-h rhythms in physiology that are linked to internal and environmental changes. In mammals, daily variations in light intensity and other cues are integrated by a hypothalamic master clock that conveys circadian information to peripheral molecular clocks that orchestrate physiology. Multiple immune parameters also vary throughout the day and disruption of circadian homeostasis is associated with immune-related disease. Here, we discuss the molecular links between the circadian and immune systems and examine their outputs and disease implications. Understanding the mechanisms that underlie circadian-immune crosstalk may prove valuable for devising novel prophylactic and therapeutic interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. 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

  9. Sociocultural factors and the success of immunization in selected ...

    African Journals Online (AJOL)

    Globally, immunization has been considered as one of the effective methods of reducing child morbidity and mortality rate. In spite of the increasing immunization coverage worldwide, Kaduna state in Nigeria has remained one of the areas with high mortality rate as a result of vaccine preventable diseases. Research ...

  10. 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 ...

  11. The role of ethnicity and travel on Hepatitis A vaccination coverage and disease incidence in Arizona at the United States–Mexico Border

    Science.gov (United States)

    Ernst, Kacey C; Erhart, Laura M

    2014-01-01

    Background: Hepatitis A (HAV) incidence has decreased in the United States, yet regional disparities persist. The role of international travel has become increasingly important in HAV transmission. We compared the relative burden of HAV in border and non-border regions in Arizona and examined the role of travel in sustaining HAV transmission. Methods: HAV vaccination coverage was calculated by age and region, using Arizona State Immunization Information System data. Incidence, demographics, and risk factors of cases reported through Arizona’s infectious disease surveillance system between 2006 and 2011 were analyzed. Results: Hepatitis A incidence was higher in the border region of Arizona. Compared with the rest of Arizona, one-dose coverage in children <15 years was lower in the border region until 2008. Second dose coverage was lower in the border region, particularly among Spanish speakers. International travel among cases was generally high; however, in the border region cases were more likely to visit Mexico or South/Central America (94% vs. 80%, P value = 0.01) and be Hispanic (68% vs. 42%, P value = 0.0003). Conclusions: Rates of HAV continue to be higher in the Arizona border region; the risk appears particularly high among Hispanics with recent travel in the Americas. Border surveillance should be emphasized, along with vaccination of all travelers, to continue to decrease and control HAV. PMID:24603091

  12. Insurance Coverage for Rehabilitation Therapies and Association with Social Participation Outcomes among Low-Income Children.

    Science.gov (United States)

    Mirza, Mansha; Kim, Yoonsang

    2016-01-01

    (1) To profile children's health insurance coverage rates for specific rehabilitation therapies; (2) to determine whether coverage for rehabilitation therapies is associated with social participation outcomes after adjusting for child and household characteristics; (3) to assess whether rehabilitation insurance differentially affects social participation of children with and without disabilities. We conducted a cross-sectional analysis of secondary survey data on 756 children (ages 3-17) from 370 households living in low-income neighborhoods in a Midwestern U.S. city. Multivariate mixed effects logistic regression models were estimated. Significantly higher proportions of children with disabilities had coverage for physical therapy, occupational therapy, and speech and language pathology, yet gaps in coverage were noted. Multivariate analysis indicated that rehabilitation insurance coverage was significantly associated with social participation (OR = 1.67, 95% CI: 1.013-2.75). This trend was sustained in subgroup analysis. Findings support the need for comprehensive coverage of all essential services under children's health insurance programs.

  13. Sustainable Food & Sustainable Economics

    OpenAIRE

    Alvarez, Mavis Dora

    2012-01-01

    Cuba today is immersed in a very intense process of perfecting its agricultural production structures with the goal of making them more efficient and sustainable in their economic administration and in their social and environmental management. Agricultural cooperatives in Cuba have the responsibility of producing on 73% of the country's farmland. Their contributions are decisive to developing agricultural production and to ensuring more and better food for the population, in addition to redu...

  14. 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.

  15. Scalable Coverage Maintenance for Dense Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Jun Lu

    2007-06-01

    Full Text Available Owing to numerous potential applications, wireless sensor networks have been attracting significant research effort recently. The critical challenge that wireless sensor networks often face is to sustain long-term operation on limited battery energy. Coverage maintenance schemes can effectively prolong network lifetime by selecting and employing a subset of sensors in the network to provide sufficient sensing coverage over a target region. We envision future wireless sensor networks composed of a vast number of miniaturized sensors in exceedingly high density. Therefore, the key issue of coverage maintenance for future sensor networks is the scalability to sensor deployment density. In this paper, we propose a novel coverage maintenance scheme, scalable coverage maintenance (SCOM, which is scalable to sensor deployment density in terms of communication overhead (i.e., number of transmitted and received beacons and computational complexity (i.e., time and space complexity. In addition, SCOM achieves high energy efficiency and load balancing over different sensors. We have validated our claims through both analysis and simulations.

  16. Mediating Trust in Terrorism Coverage

    DEFF Research Database (Denmark)

    Mogensen, Kirsten

    crisis. While the framework is presented in the context of television coverage of a terror-related crisis situation, it can equally be used in connection with all other forms of mediated trust. Key words: National crisis, risk communication, crisis management, television coverage, mediated trust.......Mass mediated risk communication can contribute to perceptions of threats and fear of “others” and/or to perceptions of trust in fellow citizens and society to overcome problems. This paper outlines a cross-disciplinary holistic framework for research in mediated trust building during an acute...

  17. Monitoring intervention coverage in the context of universal health coverage.

    Directory of Open Access Journals (Sweden)

    Ties Boerma

    2014-09-01

    Full Text Available Monitoring universal health coverage (UHC focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the

  18. Immune System

    Science.gov (United States)

    ... of the Immune System Print en español El sistema inmunitario Whether you're stomping through the showers ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  19. Immunizing Adults

    Centers for Disease Control (CDC) Podcasts

    Vaccines aren’t just for kids; adults also need to get immunized. Overall, far too many people 19 years and older aren’t getting the vaccines they need and remain unprotected. In this podcast, Dr. Walter Williams discuss the importance of adults being fully vaccinated.

  20. The quality of immunization data from routine primary health care reports

    DEFF Research Database (Denmark)

    Onta, S R; Sabroe, S; Hansen, E H

    1998-01-01

    , and measles; the number was lower for poliomyelitis. The overall number of immunizations was higher in the DHO Reports than in the Immunization Registers, by 31% for BCG, 44% for DPT, 155% for polio, and 71% for measles. We conclude that the official report overestimates the immunization coverage...

  1. Vaccines (immunizations) - overview

    Science.gov (United States)

    Vaccinations; Immunizations; Immunize; Vaccine shots; Prevention - vaccine ... of the vaccine. VACCINE SCHEDULE The recommended vaccination (immunization) schedule is updated every 12 months by the ...

  2. Terrorism and nuclear damage coverage

    International Nuclear Information System (INIS)

    Horbach, N. L. J. T.; Brown, O. F.; Vanden Borre, T.

    2004-01-01

    This paper deals with nuclear terrorism and the manner in which nuclear operators can insure themselves against it, based on the international nuclear liability conventions. It concludes that terrorism is currently not covered under the treaty exoneration provisions on 'war-like events' based on an analysis of the concept on 'terrorism' and travaux preparatoires. Consequently, operators remain liable for nuclear damage resulting from terrorist acts, for which mandatory insurance is applicable. Since nuclear insurance industry looks at excluding such insurance coverage from their policies in the near future, this article aims to suggest alternative means for insurance, in order to ensure adequate compensation for innocent victims. The September 11, 2001 attacks at the World Trade Center in New York City and the Pentagon in Washington, DC resulted in the largest loss in the history of insurance, inevitably leading to concerns about nuclear damage coverage, should future such assaults target a nuclear power plant or other nuclear installation. Since the attacks, some insurers have signalled their intentions to exclude coverage for terrorism from their nuclear liability and property insurance policies. Other insurers are maintaining coverage for terrorism, but are establishing aggregate limits or sublimits and are increasing premiums. Additional changes by insurers are likely to occur. Highlighted by the September 11th events, and most recently by those in Madrid on 11 March 2004, are questions about how to define acts of terrorism and the extent to which such are covered under the international nuclear liability conventions and various domestic nuclear liability laws. Of particular concern to insurers is the possibility of coordinated simultaneous attacks on multiple nuclear facilities. This paper provides a survey of the issues, and recommendations for future clarifications and coverage options.(author)

  3. Human papillomavirus (HPV) vaccine coverage achievements in low and middle-income countries 2007-2016.

    Science.gov (United States)

    Gallagher, Katherine E; Howard, Natasha; Kabakama, Severin; Mounier-Jack, Sandra; Burchett, Helen E D; LaMontagne, D Scott; Watson-Jones, Deborah

    2017-12-01

    Since 2007, HPV vaccine has been available to low and middle income countries (LAMIC) for small-scale 'demonstration projects', or national programmes. We analysed coverage achieved in HPV vaccine demonstration projects and national programmes that had completed at least 6 months of implementation between January 2007-2016. A mapping exercise identified 45 LAMICs with HPV vaccine delivery experience. Estimates of coverage and factors influencing coverage were obtained from 56 key informant interviews, a systematic published literature search of 5 databases that identified 61 relevant full texts and 188 solicited unpublished documents, including coverage surveys. Coverage achievements were analysed descriptively against country or project/programme characteristics. Heterogeneity in data, funder requirements, and project/programme design precluded multivariate analysis. Estimates of uptake, schedule completion rates and/or final dose coverage were available from 41 of 45 LAMICs included in the study. Only 17 estimates from 13 countries were from coverage surveys, most were administrative data. Final dose coverage estimates were all over 50% with most between 70% and 90%, and showed no trend over time. The majority of delivery strategies included schools as a vaccination venue. In countries with school enrolment rates below 90%, inclusion of strategies to reach out-of-school girls contributed to obtaining high coverage compared to school-only strategies. There was no correlation between final dose coverage and estimated recurrent financial costs of delivery from cost analyses. Coverage achieved during joint delivery of HPV vaccine combined with another intervention was variable with little/no evaluation of the correlates of success. This is the most comprehensive descriptive analysis of HPV vaccine coverage in LAMICs to date. It is possible to deliver HPV vaccine with excellent coverage in LAMICs. Further good quality data are needed from health facility based

  4. Adult Immunization

    Directory of Open Access Journals (Sweden)

    Omer Coskun

    2008-04-01

    Full Text Available Despite the many advances in modern medicine, each year thousands of people in the world die from diseases that are easily prevented by safe and effective vaccines. Few measures in preventive medicine are of such proven value and as easy to implement as routine immunization against infectious diseases. Prevention of infection by immunization is a lifelong process. There are a number of vaccines that all adults (¡I18 years require. There are also other vaccines that need to be tailored to meet individual variations in risk resulting from occupation, foreign travel, underlying illness, lifestyle and age. In this study, we tried to review this important subject. [TAF Prev Med Bull 2008; 7(2.000: 159-166

  5. Sustainable Marketing

    NARCIS (Netherlands)

    Dam, van Y.K.

    2017-01-01

    In this article, three different conceptions of sustainable marketing are discussed and compared. These different conceptions are referred to as social, green, and critical sustainable marketing. Social sustainable marketing follows the logic of demand-driven marketing management and places the

  6. Immunizations for Preterm Babies

    Science.gov (United States)

    ... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Immunizations For Preterm Babies Safety & ...

  7. Weakened Immune Systems

    Science.gov (United States)

    ... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Weakened Immune Systems Safety & Prevention ...

  8. Immunizations: Active vs. Passive

    Science.gov (United States)

    ... Issues Health Issues Health Issues Conditions Injuries & Emergencies Vaccine Preventable Diseases ... Children > Safety & Prevention > Immunizations > Immunizations: Active vs. Passive Safety & ...

  9. Root coverage with bridge flap

    Directory of Open Access Journals (Sweden)

    Pushpendra Kumar Verma

    2013-01-01

    Full Text Available Gingival recession in anterior teeth is a common concern due to esthetic reasons or root sensitivity. Gingival recession, especially in multiple anterior teeth, is of huge concern due to esthetic reasons. Various mucogingival surgeries are available for root coverage. This case report presents a new bridge flap technique, which allows the dentist not only to cover the previously denuded root surfaces but also to increase the zone of attached gingiva at a single step. In this case, a coronally advanced flap along with vestibular deepening technique was used as root coverage procedure for the treatment of multiple recession-type defect. Here, vestibular deepening technique is used to increase the width of the attached gingiva. The predictability of this procedure results in an esthetically healthy periodontium, along with gain in keratinized tissue and good patient′s acceptance.

  10. -Net Approach to Sensor -Coverage

    Directory of Open Access Journals (Sweden)

    Fusco Giordano

    2010-01-01

    Full Text Available Wireless sensors rely on battery power, and in many applications it is difficult or prohibitive to replace them. Hence, in order to prolongate the system's lifetime, some sensors can be kept inactive while others perform all the tasks. In this paper, we study the -coverage problem of activating the minimum number of sensors to ensure that every point in the area is covered by at least sensors. This ensures higher fault tolerance, robustness, and improves many operations, among which position detection and intrusion detection. The -coverage problem is trivially NP-complete, and hence we can only provide approximation algorithms. In this paper, we present an algorithm based on an extension of the classical -net technique. This method gives an -approximation, where is the number of sensors in an optimal solution. We do not make any particular assumption on the shape of the areas covered by each sensor, besides that they must be closed, connected, and without holes.

  11. [Quantification of acetabular coverage in normal adult].

    Science.gov (United States)

    Lin, R M; Yang, C Y; Yu, C Y; Yang, C R; Chang, G L; Chou, Y L

    1991-03-01

    Quantification of acetabular coverage is important and can be expressed by superimposition of cartilage tracings on the maximum cross-sectional area of the femoral head. A practical Autolisp program on PC AutoCAD has been developed by us to quantify the acetabular coverage through numerical expression of the images of computed tomography. Thirty adults (60 hips) with normal center-edge angle and acetabular index in plain X ray were randomly selected for serial drops. These slices were prepared with a fixed coordination and in continuous sections of 5 mm in thickness. The contours of the cartilage of each section were digitized into a PC computer and processed by AutoCAD programs to quantify and characterize the acetabular coverage of normal and dysplastic adult hips. We found that a total coverage ratio of greater than 80%, an anterior coverage ratio of greater than 75% and a posterior coverage ratio of greater than 80% can be categorized in a normal group. Polar edge distance is a good indicator for the evaluation of preoperative and postoperative coverage conditions. For standardization and evaluation of acetabular coverage, the most suitable parameters are the total coverage ratio, anterior coverage ratio, posterior coverage ratio and polar edge distance. However, medial coverage and lateral coverage ratios are indispensable in cases of dysplastic hip because variations between them are so great that acetabuloplasty may be impossible. This program can also be used to classify precisely the type of dysplastic hip.

  12. ANALYSIS OF FACTORS CAUSE LOW INFANT IMMUNIZATION ACHIEVEMENTS IN TANJUNGSARI CLINICSANALYSIS OF FACTORS CAUSE LOW INFANT IMMUNIZATION ACHIEVEMENTS IN PUBLIC HEALTH DISTRIC

    Directory of Open Access Journals (Sweden)

    Juni Kurnia Santi

    2016-07-01

    Full Text Available Immunization is a promotif and preventive efforts in basic health services play an important role in the decline of infant mortality that occurs due to a disease that can be prevented by immunization (PD3I. Annual reports from public health Tanjungsari noted that the results of the coverage of immunization activities results of the baby has not yet reached the target UCI (Uneversal Child Immunization. An assumption of the reason for immunization low coverage was the way on how Public Heath Center implemented its management funtion : planning, actuacting (supervision, coordination, cold chain, work load, motivation, evaluating and the result of baby`s immunization program. The risset of study is observational study. tanjunsari Public Health Center district the unit of analysis of this study. The object of study was all immunization program documentation which constituted of planning, implementation, supervision check list, coordination check list, evaluation documents as well as the document of coverage results. The respondent were the personnel of immunization program. The results of study revealed baby`s immunization until four years old is 86% campak, 89% DPT1, 86% DPT3, 87% Polio4, 84% BCG dan 85% HB3. Conclusively, it can derived that was discovered that the coverage of baby`s immunization was far below the UCI (Universal Child Immunization standart in public health, implementatiton (supervision, coordination, clod chain, load work, motivation and evaluating immunization program has nor been performed well. The inhibiting factors are now knowledge the process Planning Of Action formulation, no supervision to immunization program dan insufficient motivation to personnel immunization program. Key words : planning, immunization program, Public Health

  13. Vaccination Coverage for Infants: Cross-Sectional Studies in Two Regions of Belgium

    Directory of Open Access Journals (Sweden)

    Emmanuelle Robert

    2014-01-01

    Full Text Available Methods and Objectives. To estimate infant vaccination coverage in the French-speaking region of Belgium (Wallonia and in the Brussels-Capital Region, two cross-sectional studies were performed in 2012. A face-to-face questionnaire was administered by trained investigators. The objective was to evaluate infant vaccination coverage retrospectively in 18- to 24-month-old children. These studies offered the opportunity to assess some factors influencing vaccine uptake in infants. Results and Discussion. Approximately 99% of the children had received the first dose of IPV-DTaP, 90% the fourth dose, 94% the MMR vaccine, 97% the first dose of pneumococcal vaccine, and 90% the third dose. In both regions, when fitting a logistic model, the most associated factor was attendance at maternal and child clinics (MCH. No association was observed between vaccination coverage and the mother’s level of education. For the last immunization session, where the mother was a Belgian native and when she worked more hours, child was better immunized, but only in Brussels. Conclusion. Coverage for the fourth dose of hexavalent vaccine (DTaP-IPV-HBV/Hib needs to be increased. Indeed, additional effort is needed to increase HIB and pertussis coverage rates because the herd immunity threshold for these two diseases has not been reached.

  14. Vaccination coverage and out-of-sequence vaccinations in rural Guinea-Bissau

    DEFF Research Database (Denmark)

    Hornshøj, Linda; Benn, Christine Stabell; Fernandes, Manuel

    2012-01-01

    OBJECTIVE: The WHO aims for 90% coverage of the Expanded Program on Immunization (EPI), which in Guinea-Bissau included BCG vaccine at birth, three doses of diphtheria-tetanus-pertussis vaccine (DTP) and oral polio vaccine (OPV) at 6, 10 and 14 weeks and measles vaccine (MV) at 9 months when...

  15. Immunization registries in the EMR Era

    Science.gov (United States)

    Stevens, Lindsay A.; Palma, Jonathan P.; Pandher, Kiran K.; Longhurst, Christopher A.

    2013-01-01

    Background: The CDC established a national objective to create population-based tracking of immunizations through regional and statewide registries nearly 2 decades ago, and these registries have increased coverage rates and reduced duplicate immunizations. With increased adoption of commercial electronic medical records (EMR), some institutions have used unidirectional links to send immunization data to designated registries. However, access to these registries within a vendor EMR has not been previously reported. Purpose: To develop a visually integrated interface between an EMR and a statewide immunization registry at a previously non-reporting hospital, and to assess subsequent changes in provider use and satisfaction. Methods: A group of healthcare providers were surveyed before and after implementation of the new interface. The surveys addressed access of the California Immunization Registry (CAIR), and satisfaction with the availability of immunization information. Information Technology (IT) teams developed a “smart-link” within the electronic patient chart that provides a single-click interface for visual integration of data within the CAIR database. Results: Use of the tool has increased in the months since its initiation, and over 20,000 new immunizations have been exported successfully to CAIR since the hospital began sharing data with the registry. Survey data suggest that providers find this tool improves workflow and overall satisfaction with availability of immunization data. (p=0.009). Conclusions: Visual integration of external registries into a vendor EMR system is feasible and improves provider satisfaction and registry reporting. PMID:23923096

  16. 29 CFR 95.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... § 95.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage...

  17. Assessing Measurement Error in Medicare Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey Using linked administrative data, to validate Medicare coverage estimates...

  18. 76 FR 7767 - Student Health Insurance Coverage

    Science.gov (United States)

    2011-02-11

    ... Student Health Insurance Coverage AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance [[Page 7768

  19. 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.

  20. 5 CFR 890.1106 - Coverage.

    Science.gov (United States)

    2010-01-01

    ... family member is an individual whose relationship to the enrollee meets the requirements of 5 U.S.C. 8901... EMPLOYEES HEALTH BENEFITS PROGRAM Temporary Continuation of Coverage § 890.1106 Coverage. (a) Type of enrollment. An individual who enrolls under this subpart may elect coverage for self alone or self and family...

  1. 40 CFR 51.356 - Vehicle coverage.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

  2. 29 CFR 801.3 - Coverage.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any...

  3. Evolution of Rape Myths and Sexual Assaults in Newspaper Coverage

    Directory of Open Access Journals (Sweden)

    Yan-Wen Tsai

    2016-07-01

    Full Text Available The article presents an analysis of the coverage of three newspapers of rape in the daily Press in Taiwan. The idea that rape is a sexual rather than an aggressive act encourages people not to take it seriously as a crime-an attitude frequently revealed in comments by defense attorneys and newspaper. The authors’ investigated that the female victim who did not know most of her attackers will be portrayed as helpless and not responsible for her victimization. The newspapers sustained and reinforced the myths that a woman who is having consensual sex cannot be raped, and if so, she is held culpable and perceived as “asking for it.” A content analysis of newspapers’ headlines and coverage between 2002 and 2013 showed that more than 50% endorsed a rape myth.

  4. Sustainable Disruptions

    DEFF Research Database (Denmark)

    Friis, Silje Alberthe Kamille; Kjær, Lykke Bloch

    2016-01-01

    Since 2012 the Sustainable Disruptions (SD) project at the Laboratory for Sustainability at Design School Kolding (DK) has developed and tested a set of design thinking tools, specifically targeting the barriers to economically, socially, and environmentally sustainable business development....... The tools have been applied in practice in collaboration with 11 small and medium sized companies (SMEs). The study investigates these approaches to further understand how design thinking can contribute to sustainable transition in a business context. The study and the findings are relevant to organizations...... invested in the issue of sustainable business development, in particular the leaders and employees of SMEs, but also to design education seeking new ways to consciously handle and teach the complexity inherent in sustainable transformation. Findings indicate that the SD design thinking approach contributes...

  5. Factors associated with vaccination coverage in children < 5 years in Angola

    Directory of Open Access Journals (Sweden)

    Manuel Falcão Saturnino de Oliveira

    2014-12-01

    Full Text Available OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0% and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups.

  6. Computational sustainability

    CERN Document Server

    Kersting, Kristian; Morik, Katharina

    2016-01-01

    The book at hand gives an overview of the state of the art research in Computational Sustainability as well as case studies of different application scenarios. This covers topics such as renewable energy supply, energy storage and e-mobility, efficiency in data centers and networks, sustainable food and water supply, sustainable health, industrial production and quality, etc. The book describes computational methods and possible application scenarios.

  7. 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.

  8. Sustainable Universities

    DEFF Research Database (Denmark)

    Grindsted, Thomas Skou

    2011-01-01

    Declarations on Sustainability in Higher Education (SHE) can be viewed as a piece of international regulation. Over the past 30 years research at universities has produced convincing data to warn about deterioration of the environment, resource scarcity and the need for sustainability. This in turn....... Declarations tend to have impact on three trends. Firstly, there is emerging international consensus on the university’s role and function in relation to sustainable development; secondly, the emergence of national legislation, and thirdly, an emerging international competition to be leader in sustainable...

  9. MF59- and Al(OH3-adjuvanted Staphylococcus aureus (4C-Staph vaccines induce sustained protective humoral and cellular immune responses, with a critical role for effector CD4 T cells at low antibody titers.

    Directory of Open Access Journals (Sweden)

    Elisabetta eMonaci

    2015-09-01

    Full Text Available Staphylococcus aureus (S. aureus is an important opportunistic pathogen that may cause invasive life-threatening infections like sepsis and pneumonia. Due to increasing antibiotic-resistance, the development of an effective vaccine against S. aureus is needed. Although a correlate of protection against staphylococcal diseases is not yet established, several findings suggest that both antibodies and CD4 T cells might contribute to optimal immunity. In this study, we show that adjuvanting a multivalent vaccine (4C-Staph with MF59, an oil-in-water emulsion licensed in human vaccines, further potentiated antigen-specific IgG titers and CD4 T cell responses compared to alum and conferred protection in the peritonitis model of S. aureus infection. Moreover, we showed that MF59- and alum-adjuvanted 4C-Staph vaccines induced persistent antigen-specific humoral and T cell responses, and protected mice from infection up to 4 months after immunization. Furthermore, 4C-Staph formulated with MF59 was used to investigate which immune compartment is involved in vaccine-induced protection. Using CD4 T cell-depleted mice or B cell deficient mice, we demonstrated that both T and B cell responses contributed to 4C-Staph vaccine-mediated protective immunity. However, the role of CD4 T cells seemed more evident in the presence of low antibody responses. This study provides preclinical data further supporting the use of the adjuvanted 4C-Staph vaccines against S. aureus diseases, and provides critical insights on the correlates of protective immunity necessary to combat this pathogen.

  10. Polio immunity and the impact of mass immunization campaigns in the Democratic Republic of the Congo.

    Science.gov (United States)

    Voorman, Arend; Hoff, Nicole A; Doshi, Reena H; Alfonso, Vivian; Mukadi, Patrick; Muyembe-Tamfum, Jean-Jacques; Wemakoy, Emile Okitolonda; Bwaka, Ado; Weldon, William; Gerber, Sue; Rimoin, Anne W

    2017-10-09

    In order to prevent outbreaks from wild and vaccine-derived poliovirus, maintenance of population immunity in non-endemic countries is critical. We estimated population seroprevalence using dried blood spots collected from 4893 children 6-59months olds in the 2013-2014 Demographic and Health Survey in the Democratic Republic of the Congo (DRC). Population immunity was 81%, 90%, and 70% for poliovirus types 1, 2, and 3, respectively. Among 6-59-month-old children, 78% reported at least one dose of polio in routine immunization, while only 15% had three doses documented on vaccination cards. All children in the study had been eligible for at least two trivalent oral polio vaccine campaigns at the time of enrollment; additional immunization campaigns seroconverted 5.0%, 14%, and 5.5% of non-immune children per-campaign for types 1, 2, and 3, respectively, averaged over relevant campaigns for each serotype. Overall polio immunity was high at the time of the study, though pockets of low immunity cannot be ruled out. The DRC still relies on supplementary immunization campaigns, and this report stresses the importance of the quality and coverage of those campaigns over their quantity, as well as the importance of routine immunization. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. 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.

  12. 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

  13. Immunization delivery in British Columbia

    Science.gov (United States)

    Omura, John; Buxton, Jane; Kaczorowski, Janusz; Catterson, Jason; Li, Jane; Derban, Andrea; Hasselback, Paul; Machin, Shelagh; Linekin, Michelle; Morgana, Tamsin; O’Briain, Barra; Scheifele, David; Dawar, Meena

    2014-01-01

    Abstract Objective To explore the experiences of family physicians and pediatricians delivering immunizations, including perceived barriers and supports. Design Qualitative study using focus groups. Setting Ten cities throughout British Columbia. Participants A total of 46 family physicians or general practitioners, 10 pediatricians, and 2 residents. Methods A semistructured dialogue guide was used by a trained facilitator to explore participants’ experiences and views related to immunization delivery in British Columbia. Verbatim transcriptions were independently coded by 2 researchers. Key themes were analyzed and identified in an iterative manner using interpretive description. Main findings Physicians highly valued vaccine delivery. Factors facilitating physician-delivered immunizations included strong beliefs in the value of vaccines and having adequate information. Identified barriers included the large time commitment and insufficient communication about program changes, new vaccines, and the adult immunization program in general. Some physicians reported good relationships with local public health, while others reported the opposite experience, and this varied by geographic location. Conclusion These findings suggest that physicians are supportive of delivering vaccines. However, there are opportunities to improve the sustainability of physician-delivered immunizations. While compensation schemes remain under the purview of the provincial governments, local public health authorities can address the information needs of physicians. PMID:24627403

  14. Sustainable Transition

    DEFF Research Database (Denmark)

    Hansen, Ole Erik; Søndergård, Bent

    2014-01-01

    of agendas/vision, technologies, actors and institutions in the emergent design of an urban mobility system based on an electric car sharing system. Why. Designing for sustainability is a fundamental challenge for future design practices; designers have to obtain an ability to contribute to sustainable...

  15. Sustainable transformation

    DEFF Research Database (Denmark)

    Andersen, Nicolai Bo

    This paper is about sustainable transformation with a particular focus on listed buildings. It is based on the notion that sustainability is not just a question of energy conditions, but also about the building being robust. Robust architecture means that the building can be maintained and rebuil...

  16. Sustainability Labeling

    NARCIS (Netherlands)

    Dam, van Y.K.

    2017-01-01

    Sustainability labeling originated from a need to protect the identity of alternative systems of food production and to increase market transparency. From the 1980s onwards sustainability labeling has changed into a policy instrument replacing direct government regulation of the food market, and a

  17. Vaccination coverage among children in kindergarten - United States, 2013-14 school year.

    Science.gov (United States)

    Seither, Ranee; Masalovich, Svetlana; Knighton, Cynthia L; Mellerson, Jenelle; Singleton, James A; Greby, Stacie M

    2014-10-17

    State and local vaccination requirements for school entry are implemented to maintain high vaccination coverage and protect schoolchildren from vaccine-preventable diseases. Each year, to assess state and national vaccination coverage and exemption levels among kindergartners, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013-14 school year. Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%. High exemption levels and suboptimal vaccination coverage leave children vulnerable to vaccine-preventable diseases. Although vaccination coverage among kindergartners for the majority of reporting states was at or near the 95% national Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine, low vaccination coverage and high exemption levels can cluster within communities. Immunization programs might have access to school vaccination coverage and exemption rates at a local level for counties, school districts, or schools that can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that vaccinations provide to their children.

  18. Afterschool Sustainability

    Directory of Open Access Journals (Sweden)

    Hilary D. Joyce

    2014-12-01

    Full Text Available Youth participation in quality extended learning opportunities (ELOs results in positive academic, physical, mental health, and social/emotional outcomes. Funding is essential to implementing and sustaining quality ELOs; however multiple funding barriers and challenges exist. Understanding the types of funds available for ELOs and the factors that influence sustainability is critical. Through surveys and telephone interviews of ELO providers, this descriptive study identified and examined ELO funding streams, the ways ELO providers use these funding streams, and the barriers and challenges to sustainability. ELO programs often relied on one major funding stream coupled with nutrition supports as well as in-kind resources. Barriers to sustainability included year-to-year funding, transportation costs, reducing community partnerships, and difficulty in diversifying funds. Recommendations to enhance ELO sustainability are offered, particularly in relation to overcoming the challenges to diversification of funding resources and establishing mutually supportive partnerships and collaboration.

  19. 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.

  20. Auditing the quality of immunization data in Tunisia

    Directory of Open Access Journals (Sweden)

    Mohamed Kouni Chahed

    2013-02-01

    Full Text Available Objective: To carry out a data quality audit for the consistency and quality of immunization monitoring in Kasserine governorate in Tunisia, where immunization coverage rates more than 100%, negative dropout and conflicting coverage rates had been reported. Methods: In a randomly selected sample of 12 primary health care facilities in 2 districts all files used to record immunization data were checked to verify the accuracy of the reported 3rd dose of diphtheriatetanus-pertussis vaccine during a calendar year. Results: The results found frequent overreporting or under-reporting of doses being administrated in all health facilities. The regional verification factor was estimated as 85% and quality index was 55%. Conclusions: Data quality audit provides a effective tool for self-assessment implementation and developing a critical analysis of the quality of routine immunization data at all levels of health service.

  1. Compulsory and recommended vaccination in Italy: evaluation of coverage and non-compliance between 1998-2002 in Northern Italy

    OpenAIRE

    Stampi, Serena; Ricci, Rita; Ruffilli, Isa; Zanetti, Franca

    2005-01-01

    Abstract Background Since vaccinations are an effective prevention tool for maintaining the health of society, the monitoring of immunization coverage allows us to identify areas where disease outbreaks are likely to occur, and possibly assist us in predicting future outbreaks. The aim of this study is the investigation of the coverage achieved for compulsory (diphtheria, tetanus, polio, hepatitis B,) and recommended (pertussis, Haemophilus influenzae, measles-mumps-rubella) vaccinations betw...

  2. Immune System Quiz

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Quiz: Immune System KidsHealth / For Kids / Quiz: Immune System Print How much do you know about your immune system? Find out by taking this quiz! About Us ...

  3. Immunization Schedules for Adults

    Science.gov (United States)

    ... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedule for Adults (19 Years of Age and ... diseases that can be prevented by vaccines . 2018 Immunization Schedule Recommended Vaccinations for Adults by Age and ...

  4. Immunizations and African Americans

    Science.gov (United States)

    ... Data > Minority Population Profiles > Black/African American > Immunizations Immunizations and African Americans African American adults are less ... 19 to 35 months had comparable rates of immunization. African American women are as likely to have ...

  5. 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 ...

  6. Sideline coverage of youth football.

    Science.gov (United States)

    Rizzone, Katie; Diamond, Alex; Gregory, Andrew

    2013-01-01

    Youth football is a popular sport in the United States and has been for some time. There are currently more than 3 million participants in youth football leagues according to USA Football. While the number of participants and overall injuries may be higher in other sports, football has a higher rate of injuries. Most youth sporting events do not have medical personnel on the sidelines in event of an injury or emergency. Therefore it is necessary for youth sports coaches to undergo basic medical training in order to effectively act in these situations. In addition, an argument could be made that appropriate medical personnel should be on the sideline for collision sports at all levels, from youth to professional. This article will discuss issues pertinent to sideline coverage of youth football, including coaching education, sideline personnel, emergency action plans, age and size divisions, tackle versus flag football, and injury prevention.

  7. Pilot projects and nation-wide immunization in India.

    Science.gov (United States)

    Haxton, D

    1984-01-01

    These studies identify possibilities for expanding immunization coverage in India and show that there have been positive experiences in going to scale with immunizationation at the district level. Reasons for success are discussed. The promotion of social awareness and participation through all available channels is of central importance. Continuing attention should be directed to vaccine supply and distribution systems, program management and manpower training, especially at the community level. There are many opportunities for extending involvement in immunization efforts and broad-spectrum programs beyond the confines of the health system, and for flexibility in program organization. Planning must incorporate political commitment as well as the provision of adequate financial resources. India launched the Expanded Program on Immunization (EPI) in 1978. 6 diseases are currently on the official schedule for progressive nation-wide immunization: tuberculosis, poliomyelitis, whooping cough, diptheria, tetanus and typhoid. The experiences of 3 efforts in Dewas, in Bidar, (2 rural areas), and in Delhi (an urban area) are covered. Immunization coverage before the intensive efforts did not exceed 30%. Major elements of program organization were: nonhealth sector political and administrative involvement from the state; multisectoral planning committees at different levels; household surveys to identify children to be immunized; training sessions for each category of workers; and strengthening the cold chain. Factors in operational design and implementation include: vaccination posts in the community; selection of acceptable vaccination days; reminders the day before vaccination; collection of children; immunization cards as a device for informing about next round; counteraction of side-effects; follow-up of drop-outs; monitoring for corrective action involving all participants; and formal evaluation by local medical colleges. Intensive immunization in the 3 pilot sites

  8. 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...

  9. Sustainable Cities

    DEFF Research Database (Denmark)

    Georg, Susse; Garza de Linde, Gabriela Lucía

    Judging from the number of communities and cities striving or claiming to be sustainable and how often eco-development is invoked as the means for urban regeneration, it appears that sustainable and eco-development have become “the leading paradigm within urban development” (Whitehead 2003....../assessment tool. The context for our study is urban regeneration in one Danish city, which had been suffering from industrial decline and which is currently investing in establishing a “sustainable city”. Based on this case study we explore how the insights and inspiration evoked in working with the tool...

  10. Sustainable development indicators for territories

    International Nuclear Information System (INIS)

    Moreau; Sylvain; Bottin, Anne; Bovar, Odile; Nirascou, Francoise; Albecker, Marie-Fleur; Bardou, Magali; Barret, Christophe; Berger, Emmanuel; Blanc, Christophe; Bovar, Odile; Briquel, Vincent; Chery, Jean-Pierre; Deshayes, Michel; Firdion, Laetitia; Fluxa, Christine; Girault, Maurice; Guerrero, David; Hassaine, Zahida; Hilal, Mohamed; Imbert, Frederic; Kerouanton, Marie-Helene; Lacroix, Steve; Magnier, Celine; Moreau, Jacques; Nirascou, Francoise; Pageaud, Dorothee; Schaeffer, Yves; Thienard, Helene; Vinet, Loic; Wemelbeke, Guillaume; Wichmann, Martine; Boitard, Corinne; Bird, Geoffrey

    2011-11-01

    For different themes (Sustainable consumption and production, Knowledge and social and economic development society, governance, climate change and energy management, sustainable transport and modality, conservation and sustainable management of biodiversity and natural resources, public health, risk prevention and management, social and territorial cohesion), this study proposes a set of axis, and several indicators for each axis. Indicators correspond to different geographical scale and are determined from different sources. These indicators are for example: production of aggregates, proportion of organic agriculture in usable agricultural area, evolution in quantity of household waste collected per inhabitant, employment rate, research spending in relation to GDP, coverage of population by local Agenda 21, and so on. Thus, each indicator is discussed, commented and analysed

  11. Microsensing networks for sustainable cities

    CERN Document Server

    Lambrechts, Johannes

    2016-01-01

    This book explores the microsensing technologies and systems now available to monitor the quality of air and water within the urban environment and examines their role in the creation of sustainable cities against the background of the challenges posed by rapid urbanization. The opening section addresses the theoretical and conceptual background of microsensing networks. The coverage includes detailed description of microsensors, supported by design-specific equations, and clear explanation of the ways in which devices that harvest energy from ambient sources can detect and quantify pollution. The practical application of such systems in addressing environmental impacts within cities and in sustainable urban planning is then discussed with the aid of case studies in developing countries. The book will be of interest to all who wish to understand the benefits of microsensing networks in promoting sustainable cities through better delivery of information on health hazards and improved provision of data to envir...

  12. Immunization Action Coalition

    Science.gov (United States)

    ... IAC | Contact | A-Z Index | Donate | Shop | SUBSCRIBE Immunization Action Coalition Favorites ACIP Recommendations Package Inserts Additional Immunization Resources Photos Adult Vaccination Screening Checklists Ask the ...

  13. National and state vaccination coverage among children aged 19-35 months--United States, 2010.

    Science.gov (United States)

    2011-09-02

    The National Immunization Survey (NIS) monitors vaccination coverage among children aged 19-35 months using a random-digit-dialed sample of telephone numbers of households to evaluate childhood immunization programs in the United States. This report describes the 2010 NIS coverage estimates for children born during January 2007-July 2009. Nationally, vaccination coverage increased in 2010 compared with 2009 for ≥ 1 dose of measles, mumps, and rubella vaccine (MMR), from 90.0% to 91.5%; ≥ 4 doses of pneumococcal conjugate vaccine (PCV), from 80.4% to 83.3%; the birth dose of hepatitis B vaccine (HepB), from 60.8% to 64.1%; ≥ 2 doses of hepatitis A vaccine (HepA), from 46.6% to 49.7%; rotavirus vaccine, from 43.9% to 59.2%; and the full series of Haemophilus influenzae type b (Hib) vaccine, from 54.8% to 66.8%. Coverage for poliovirus vaccine (93.3%), MMR (91.5%), ≥ 3 doses HepB (91.8%), and varicella vaccine (90.4%) continued to be at or above the national health objective targets of 90% for these vaccines.* The percentage of children who had not received any vaccinations remained low (poverty status still exist. Maintaining high vaccination coverage levels is important to reduce the burden of vaccine-preventable diseases and prevent a resurgence of these diseases in the United States, particularly in undervaccinated populations.

  14. Providing Universal Health Insurance Coverage in Nigeria.

    Science.gov (United States)

    Okebukola, Peter O; Brieger, William R

    2016-07-07

    Despite a stated goal of achieving universal coverage, the National Health Insurance Scheme of Nigeria had achieved only 4% coverage 12 years after it was launched. This study assessed the plans of the National Health Insurance Scheme to achieve universal health insurance coverage in Nigeria by 2015 and discusses the challenges facing the scheme in achieving insurance coverage. In-depth interviews from various levels of the health-care system in the country, including providers, were conducted. The results of the analysis suggest that challenges to extending coverage include the difficulty in convincing autonomous state governments to buy into the scheme and an inadequate health workforce that might not be able to meet increased demand. Recommendations for increasing the scheme's coverage include increasing decentralization and strengthening human resources for health in the service delivery systems. Strong political will is needed as a catalyst to achieving these goals. © The Author(s) 2016.

  15. Sustainable Transportation

    DEFF Research Database (Denmark)

    Hall, Ralph P.; Gudmundsson, Henrik; Marsden, Greg

    2014-01-01

    The transportation system is the backbone of economic and social progress and the means by which humans access goods and services and connect with one another. Yet, as the scale of transportation activities has grown worldwide, so too have the negative environmental, social, and economic impacts...... that relate to the construction and maintenance of transportation infrastructure and the operation or use of the different transportation modes. The concept of sustainable transportation emerged in response to these concerns as part of the broader notion of sustainable development. Given the transportation...... sector’s significant contribution to global challenges such as climate change, it is often said that sustainable development cannot be achieved without sustainable transportation....

  16. Agriculture: Sustainability

    Science.gov (United States)

    Sustainability creates and maintains the conditions under which humans and nature can exist in productive harmony, that permit fulfilling the food, feed, and fiber needs of our country and the social, economic and other requirements.

  17. Sustainable consumption

    DEFF Research Database (Denmark)

    Prothero, Andrea; Dobscha, Susan; Freund, Jim

    2011-01-01

    This essay explores sustainable consumption and considers possible roles for marketing and consumer researchers and public policy makers in addressing the many sustainability challenges that pervade our planet. Future research approaches to this interdisciplinary topic need to be comprehensive...... and systematic and will benefit from a variety of different perspectives. There are a number of opportunities for future research, and three areas are explored in detail. First, the essay considers the inconsistency between the attitudes and behaviors of consumers with respect to sustainability; next, the agenda...... is broadened to explore the role of individual citizens in society; and finally, a macro institutional approach to fostering sustainability is explored. Each of these areas is examined in detail and possible research avenues and public policy initiatives are considered within each of these separate...

  18. Sustainable Futures

    Science.gov (United States)

    Sustainable Futures is a voluntary program that encourages industry to use predictive models to screen new chemicals early in the development process and offers incentives to companies subject to TSCA section 5.

  19. Sustainability reporting

    NARCIS (Netherlands)

    Kolk, A.

    2005-01-01

    This article gives an overview of developments in sustainability (also sometimes labelled corporate social responsibility) reporting. The article will first briefly indicate how accountability on social and environmental issues started, already in the 1970s when social reports were published.

  20. Sustainable transformation

    DEFF Research Database (Denmark)

    Andersen, Nicolai Bo

    This paper is about sustainable transformation with a particular focus on listed buildings. It is based on the notion that sustainability is not just a question of energy conditions, but also about the building being robust. Robust architecture means that the building can be maintained and rebuilt......, that it can be adapted to changing functional needs, and that it has an architectural and cultural value. A specific proposal for a transformation that enhances the architectural qualities and building heritage values of an existing building forms the empirical material, which is discussed using different...... theoretical lenses. It is proposed that three parameters concerning the ꞌtransformabilityꞌ of the building can contribute to a more nuanced understanding of sustainable transformation: technical aspects, programmatic requirements and narrative value. It is proposed that the concept of ꞌsustainable...

  1. Sustainable Consumption

    DEFF Research Database (Denmark)

    Røpke, Inge

    2015-01-01

    The intention of this chapter is to explore the role of consumption and consumers in relation to sustainability transition processes and wider systemic transformations. In contrast to the individualistic focus in much research on sustainable consumption, the embeddedness of consumption activities...... in wider social, economic and technological frameworks is emphasised. In particular, the chapter is inspired by practice theory and transition theory. First, various trends in consumption are outlined to highlight some of the challenges for sustainability transitions. Then, it is discussed how consumption...... patterns are shaped over time and what should be considered in sustainability strategies. While discussions on consumption often take their point of departure in the perspective of the individual and then zoom to the wider context, the present approach is the opposite. The outline starts with the basic...

  2. Stabilizing Sustainability

    DEFF Research Database (Denmark)

    Reitan Andersen, Kirsti

    The publication of the Brundtland Report in 1987 put the topic of sustainable development on the political and corporate agenda. Defining sustainable development as “a development that meets the needs of the future without compromising the ability of future generations to meet their own needs......” (WCED, 1987, p. 43), the Report also put a positive spin on the issue of sustainability by upholding capitalist beliefs in the possibility of infinite growth in a world of finite resources. While growth has delivered benefits, however, it has done so unequally and unsustainably. This thesis focuses...... on the textile and fashion industry, one of the world’s most polluting industries and an industry to some degree notorious for leading the ‘race to the bottom’ in global labour standards. Despite being faced with increasing demands to practise sustainability, most textile and fashion companies continue to fail...

  3. Immune restoration in the context of HAART | Martin | Southern ...

    African Journals Online (AJOL)

    HAART induces a sustained effective suppression of HIV replication in most patients and leads to a preservation or restoration of immune function. The restoration of an impaired immune system is assessed by clinical parameters, immunological changes which can be measured in the laboratory and a marked reduction in ...

  4. Immune recovery among HIV-infected patients in northwestern ...

    African Journals Online (AJOL)

    Background: The use of antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) is associated with significant and sustained decrease in the viral RNA levels that allows the immune system to recover. The extent of this immune recovery depends on the baseline CD4 count. Evidence on the ...

  5. [Using the concept of universal health coverage to promote the health system reform in China].

    Science.gov (United States)

    Hu, S L

    2016-11-06

    The paper is systematically explained the definition, contents of universal health coverage (UHC). Universal health coverage calls for all people to have access to quality health services they need without facing undue financial burden. The relationship between five main attributes, i.e., quality, efficiency, equity, accountability and resilience, and their 15 action plans has been explained. The nature of UHC is belonged to the State and government. The core function is commitment with equality. The whole-of-system method is used to promoting the health system reform. In China, the universal health coverage has been reached to the preliminary achievements, which include universal coverage of social medical insurance, basic medical services, basic public health services, and the provision of essential medicines. China has completed millennium development goals (MDG) and is being stepped to the sustainable development goals (SDG).

  6. Seeking Sustainability

    OpenAIRE

    Clive L. Spash

    2014-01-01

    What does sustainability research do to help the environment? One might well wonder when observing the annual conference season with various academics and professors in sustainability science, ecological economics or environmental ethics driving to the airport to fly off to international meetings to discuss how bad things are getting, what should been done about it, and how time is running out for action. In fact, singling out a few academic groups is highly unfair because the link between pr...

  7. Rapid immune colloidal gold strip for cetacean meat restraining illegal trade and consumption: implications for conservation and public health.

    Science.gov (United States)

    Lo, Chieh; Chin, Li-Te; Chu, Chi-Shih; Wang, Yu-Ting; Chan, Kun-Wei; Yang, Wei-Cheng

    2013-01-01

    The consumption of cetacean meat is geographically common and often of undetermined sustainability. Besides, it can expose humans to contaminants and zoonotic pathogens. The illegality of possessing cetacean meat was likely under-reported in some countries due to lack of attention paid by the officials although DNA analysis of market products helped to show such practices. We developed two monoclonal antibodies against synthetic peptides of myoglobin (Mb) for constructing a rapid immune colloidal gold strip. Only cetacean Mb is capable of binding to both antibodies and presents positive signal while the Mb from other animals can bind only 1 of the antibodies and presents negative result. The strip for cetacean meat would be an applicable and cost-effective test for field inspectors and even the general public. It contributes to increase the reporting capacity and coverage of illegal cetacean meat possession, which has implications for global cetacean conservation and public health.

  8. Local Sustainability

    International Nuclear Information System (INIS)

    Carrizosa Umana, Julio

    1998-01-01

    The current polemic about the possibilities of sustainable development has led to a renovated interest for the topic of the sustainability of the communities and the local sustainability. In front of the global sustainability whose conditions have been exposed by systemic ecologists and for macro economists, the sustainability of specific places arises in the planet whose conditions are object of study of the ecology of landscapes, of the ecological economy, of the cultural anthropology, of the environmental sociology and naturally, of the integral environmentalism. In this discussion the Colombian case charges unusual interest to be one of the few countries of Latin America, where a very dense net of municipalities exists, each one with its urban helmet and with a position and some functions defined by the political constitution of the nation. This net of municipalities and of urban helmets it also constitutes net of alternative to the current macro-cephalic situation. As well as Bogota grew, in a hundred years, of less than a hundred thousand inhabitants to six million inhabitants, each one of these municipalities contains a potential of growth that depends on the characteristics of its ecological, social, economic and politic sustainability

  9. Sustainable markets for sustainable energy

    Energy Technology Data Exchange (ETDEWEB)

    Millan, J.; Smyser, C.

    1997-12-01

    The author discusses how the Inter-American Development Bank (IDB) is involved in sustainable energy development. It presently has 50 loans and grants for non conventional renewable energy projects and ten grants for efficiency programs for $600 and $17 million respectively, representing 100 MW of power. The IDB is concerned with how to create a sustainable market for sustainable energy projects. The IDB is trying to work with government, private sector, NGOs, trading allies, credit sources, and regulators to find proper roles for such projects. He discusses how the IDB is working to expand its vision and objectives in renewable energy projects in Central and South America.

  10. Immune cells in term and preterm labor

    Science.gov (United States)

    Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia

    2014-01-01

    Labor resembles an inflammatory response that includes secretion of cytokines/chemokines by resident and infiltrating immune cells into reproductive tissues and the maternal/fetal interface. Untimely activation of these inflammatory pathways leads to preterm labor, which can result in preterm birth. Preterm birth is a major determinant of neonatal mortality and morbidity; therefore, the elucidation of the process of labor at a cellular and molecular level is essential for understanding the pathophysiology of preterm labor. Here, we summarize the role of innate and adaptive immune cells in the physiological or pathological activation of labor. We review published literature regarding the role of innate and adaptive immune cells in the cervix, myometrium, fetal membranes, decidua and the fetus in late pregnancy and labor at term and preterm. Accumulating evidence suggests that innate immune cells (neutrophils, macrophages and mast cells) mediate the process of labor by releasing pro-inflammatory factors such as cytokines, chemokines and matrix metalloproteinases. Adaptive immune cells (T-cell subsets and B cells) participate in the maintenance of fetomaternal tolerance during pregnancy, and an alteration in their function or abundance may lead to labor at term or preterm. Also, immune cells that bridge the innate and adaptive immune systems (natural killer T (NKT) cells and dendritic cells (DCs)) seem to participate in the pathophysiology of preterm labor. In conclusion, a balance between innate and adaptive immune cells is required in order to sustain pregnancy; an alteration of this balance will lead to labor at term or preterm. PMID:24954221

  11. Coverage of vitamin A supplementation and deworming during Malezi Bora in Kenya.

    Science.gov (United States)

    Clohossey, Paloma C; Katcher, Heather I; Mogonchi, Geoffrey O; Nyagoha, Nancy; Isidro, Marissa C; Kikechi, Evelyn; Okoth, Edgar E V; Blankenship, Jessica L

    2014-09-01

    Twice-yearly child health weeks are an effective way of reaching children with essential child survival services in developing countries. In Kenya, child health weeks, or Malezi Bora, were restructured in 2007 from an outreach-based delivery structure to a health facility-based delivery structure to reduce delivery costs and increase sustainability of the events. Administrative data from 2007 to 2011 have demonstrated a decrease in coverage of Malezi Bora services to targeted children. A post-event coverage (PEC) survey was conducted after the May 2012 Malezi Bora to validate coverage of vitamin A supplementation (VAS) and deworming and to inform program strategy. Nine hundred caregivers with children aged 6-59months were interviewed using a randomized, 30×30 cluster design. For each cluster, one facility-based health worker and one community-based health worker were also interviewed. Coverage of VAS was 31.0% among children aged 6-59months and coverage of deworming was 19.6% among children aged 12-59months. Coverage of VAS was significantly higher for children aged 6-11months (45.7%, n=116) than for children aged 12-59months (28.8%, n=772) (pneeds to be reviewed and reformed to meet WHO guidelines of 80% coverage with VAS. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  12. An Evaluation of Voluntary Varicella Vaccination Coverage in Zhejiang Province, East China.

    Science.gov (United States)

    Hu, Yu; Chen, Yaping; Zhang, Bing; Li, Qian

    2016-06-03

    In 2014 a 2-doses varicella vaccine (VarV) schedule was recommended by the Zhejiang Provincial Center for Disease Control and Prevention. We aimed to assess the coverage of the 1st dose of VarV (VarV₁) and the 2nd dose of VarV (VarV₂) among children aged 2-6 years through the Zhejiang Provincial Immunization Information System (ZJIIS) and to explore the determinants associated with the VarV coverage. Children aged 2-6 years (born from 1 January 2009 to 31 December 2013) registered in ZJIIS were enrolled. Anonymized individual records of target children were extracted from the ZJIIS database on 1 January 2016, including their VarV and (measles-containing vaccine) MCV vaccination information. The VarV₁ and VarV₂ coverage rates were evaluated for each birth cohorts. The coverage of VarV also was estimated among strata defined by cities, gender and immigration status. We also evaluated the difference in coverage between VarV and MCV. A total of 3,028,222 children aged 2-6 years were enrolled. The coverage of VarV₁ ranged from 84.8% to 87.9% in the 2009-2013 birth cohorts, while the coverage of VarV₂ increased from 31.8% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Higher coverage rates for both VarV₁ and VarV₂ were observed among resident children in relevant birth cohorts. The coverage rates of VarV₁ and VarV₂ were lower than those for the 1st and 2nd dose of MCV, which were above 95%. The proportion of children who were vaccinated with VarV₁ at the recommended age increased from 34.6% for the 2009 birth cohort to 75.2% for the 2013 birth cohort, while the proportion of children who were vaccinated with VarV₂ at the recommended age increased from 19.7% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Our study showed a rapid increasing VarV₂ coverage of children, indicating a growing acceptance of the 2-doses VarV schedule among children's caregivers and physicians after the new recommendation released. We

  13. Coverage-based constraints for IMRT optimization

    Science.gov (United States)

    Mescher, H.; Ulrich, S.; Bangert, M.

    2017-09-01

    Radiation therapy treatment planning requires an incorporation of uncertainties in order to guarantee an adequate irradiation of the tumor volumes. In current clinical practice, uncertainties are accounted for implicitly with an expansion of the target volume according to generic margin recipes. Alternatively, it is possible to account for uncertainties by explicit minimization of objectives that describe worst-case treatment scenarios, the expectation value of the treatment or the coverage probability of the target volumes during treatment planning. In this note we show that approaches relying on objectives to induce a specific coverage of the clinical target volumes are inevitably sensitive to variation of the relative weighting of the objectives. To address this issue, we introduce coverage-based constraints for intensity-modulated radiation therapy (IMRT) treatment planning. Our implementation follows the concept of coverage-optimized planning that considers explicit error scenarios to calculate and optimize patient-specific probabilities q(\\hat{d}, \\hat{v}) of covering a specific target volume fraction \\hat{v} with a certain dose \\hat{d} . Using a constraint-based reformulation of coverage-based objectives we eliminate the trade-off between coverage and competing objectives during treatment planning. In-depth convergence tests including 324 treatment plan optimizations demonstrate the reliability of coverage-based constraints for varying levels of probability, dose and volume. General clinical applicability of coverage-based constraints is demonstrated for two cases. A sensitivity analysis regarding penalty variations within this planing study based on IMRT treatment planning using (1) coverage-based constraints, (2) coverage-based objectives, (3) probabilistic optimization, (4) robust optimization and (5) conventional margins illustrates the potential benefit of coverage-based constraints that do not require tedious adjustment of target volume objectives.

  14. 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, ” ...

  15. CDMA coverage under mobile heterogeneous network load

    NARCIS (Netherlands)

    Saban, D.; van den Berg, Hans Leo; Boucherie, Richardus J.; Endrayanto, A.I.

    2002-01-01

    We analytically investigate coverage (determined by the uplink) under non-homogeneous and moving traffic load of third generation UMTS mobile networks. In particular, for different call assignment policies, we investigate cell breathing and the movement of the coverage gap occurring between cells

  16. 5 CFR 531.402 - Employee coverage.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Employee coverage. 531.402 Section 531... GENERAL SCHEDULE Within-Grade Increases § 531.402 Employee coverage. (a) Except as provided in paragraph (b) of this section, this subpart applies to employees who— (1) Are classified and paid under the...

  17. 22 CFR 226.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Insurance coverage. 226.31 Section 226.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Property Standards § 226.31 Insurance coverage. Recipients...

  18. 14 CFR 1260.131 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided for property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  19. 2 CFR 215.31 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  20. 36 CFR 1210.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ....31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with NHPRC funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  1. Coverage matters: insurance and health care

    National Research Council Canada - National Science Library

    Board on Health Care Services Staff; Institute of Medicine Staff; Institute of Medicine; National Academy of Sciences

    2001-01-01

    ...? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters...

  2. Legislating health care coverage for the unemployed.

    Science.gov (United States)

    Palley, H A; Feldman, G; Gallner, I; Tysor, M

    1985-01-01

    Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations.

  3. The Assessment of Effectiveness of Immunization in the Control of ...

    African Journals Online (AJOL)

    This strong partnership resulted in the increase of routine immunization coverage of Diptheria-Pertussis-Tetanus 3 from 37.5% in December 2005 to 72% by end of December 2006. There was a decline in the transmission of wild polio virus type 1. Only 22% of the 1129 polio cases confirmed in 2006 occurred during the ...

  4. Pertussis vaccinations in Dutch children: memory immune responses

    NARCIS (Netherlands)

    Hendrikx, L.H.

    2011-01-01

    Despite high pertussis vaccination coverage, pertussis is reemerging in the Netherlands since 1996. In attempt to improve protection against whooping cough, two major changes in the national immunization program have been made; the introduction of a preschool booster vaccination in children 4 years

  5. A proposal to measure absolute environmental sustainability in lifecycle assessment

    DEFF Research Database (Denmark)

    Bjørn, Anders; Margni, Manuele; Roy, Pierre-Olivier

    2016-01-01

    sustainable are therefore increasingly important. Such absolute indicators exist, but suffer from shortcomings such as incomplete coverage of environmental issues, varying data quality and varying or insufficient spatial resolution. The purpose of this article is to demonstrate that life cycle assessment (LCA...... in supporting decisions aimed at simultaneously reducing environmental impacts efficiently and maintaining or achieving environmental sustainability. We have demonstrated that LCA indicators can be modified from being relative to being absolute indicators of environmental sustainability. Further research should...

  6. Immune markers and correlates of protection for vaccine induced immune responses

    DEFF Research Database (Denmark)

    Thakur, Aneesh; Pedersen, Lasse Eggers; Jungersen, Gregers

    2012-01-01

    of an appropriate humoral response currently remain the best validated correlates of protective immunity after vaccination. Despite advancements in the field of immunology over the past few decades currently there are, however, no sufficiently validated immune correlates of vaccine induced protection against......-specific production of interferon-gamma (IFN-γ) has been promoted as a quantitative marker of protective cell-mediated immune responses over the past couple of decades. More recently, however, evidence from several infections has pointed towards the quality of the immune response, measured through increased levels...... of antigen-specific polyfunctional T cells capable of producing a triad of relevant cytokines, as a better correlate of sustained protective immunity against this type of infections. Also the possibilities to measure antigen-specific cytotoxic T cells (CTL) during infection or in response to vaccination...

  7. Roundtabling Sustainability

    DEFF Research Database (Denmark)

    Ponte, Stefano

    2014-01-01

    councils’ and ‘sustainability roundtables’ and have been designed around a set of institutional features seeking to establish legitimacy, fend off possible criticism, and ‘sell’ certifications to potential users. The concept of ‘roundtabling’ emphasizes the fitting a variety of commodity...... and procedures to meet ‘good practice’ in standard setting and management. This is opening space for competing initiatives that are less democratic, quicker, and more aligned with industry interests to establish substantial presence in the market for sustainability certifications. These tend to more easily...

  8. Primary Immunization Status In Rural Block Of Kanpur District

    Directory of Open Access Journals (Sweden)

    S K Kaushal

    2009-06-01

    Full Text Available Research question: What is the status of primary immunization of children in the age group of 12-23 month Objective: To assess the status of Primary immunization in age group of 12 to 23 month Children, To compare the primary immunization in intensive and twilight villages, To study the influence of socialfactors affecting immunization & Tofind out reasons for immunization default Study design: cross sectional study Setting and participants: rural block of.Kanpur District and mothers ofchildren in age group of 12-23 months. Study period: July to December 2005 Sample size: 280 mothers of study group children. Study variable: Immunization status, socialfactors, vaccine, reasons for immunization default Results : 32.85% of children were fully immunized. Highest (92.85% covered antigen were found as OPV-1 and lowest (41.78% covered antigen as DPT-3.Literacy and joint family had positive impact on immunization status. The main reasons were observed for immunization default as ignorance (about need/place/person/time and distance factor. Conclusion : Quantity1 wise coverage was quite satisfactory. High dropout rate due to ignorance and distance factors should be taken into

  9. [Immunization against varicella and zoster].

    Science.gov (United States)

    Floret, Daniel

    2007-06-01

    Two vaccines against varicella-zoster virus are available in France. These live attenuated vaccines are derived from the Oka strain used in Japan since 1974. They are indicated for healthy subjects from 12 months of age, at a dose of one injection until 12 years of age, and two injections 4-8 weeks apart for older children and adults. Seroconversion occurs in 95% of cases and the antibodies persist beyond 5 years. Clinical efficacy is about 85% against all forms of varicella and nearly 100% against severe forms. Post-exposure vaccination within 3 days may also prevent the disease. A universal immunization program against varicella was implemented in the USA in 1995. Now, with vaccine coverage at about 80%, the incidence of the disease has been reduced by 85%, with the largest decrease in 1- to 4-year-olds. Tolerability is generally good, with only mild reactions at the injection site and moderate fever The length of protection is not yet known. A two-dose schedule seems advisable to avoid breakthrough varicella, which occurs in 4% of vaccinees each year. Insufficient coverage is expected to lead to later disease onset, with more severe cases in adolescents and adults. Universal immunization could also increase the incidence of zoster. These problems indeed seem to be emerging in the United States. France has adopted restrictive guidelines on VZV vaccination, but they are expected to be revised when the combined MMR-V vaccine becomes available. Zoster vaccine, prepared with the same strain but at a higher concentration, has moderate efficacy on zoster and on post-zoster neuralgia in patients over 70. This vaccine is not yet recommended in France, because the length of protection is not known and there is a potential risk of delaying the occurrence of zoster and, thus, of increasing the risk of post zoster neuralgia.

  10. Sustainable finance

    NARCIS (Netherlands)

    Boersma-de Jong, Margreet F.

    2012-01-01

    Presentation for Springschool of Strategy, University of Groningen, 10 October 2012. The role of CSR is to stimulate ethical behaviour, and as a result, mutual trust in society. Advantage of CSR for the company and the evolution of CSR. From CSR to Sustainable Finance: how does CSR influence

  11. Sustainable Procurement

    DEFF Research Database (Denmark)

    Telles, Pedro; Ølykke, Grith Skovgaard

    2017-01-01

    and within it how sustainable requirements have increased the level of compliance required, particularly regulatory compliance. Compliance was already present in previous EU public procurement frameworks, but its extent on Directive 2014/24/EU leads the authors to consider the current legal framework...

  12. Exergy sustainability.

    Energy Technology Data Exchange (ETDEWEB)

    Robinett, Rush D. III (.; ); Wilson, David Gerald; Reed, Alfred W.

    2006-05-01

    Exergy is the elixir of life. Exergy is that portion of energy available to do work. Elixir is defined as a substance held capable of prolonging life indefinitely, which implies sustainability of life. In terms of mathematics and engineering, exergy sustainability is defined as the continuous compensation of irreversible entropy production in an open system with an impedance and capacity-matched persistent exergy source. Irreversible and nonequilibrium thermodynamic concepts are combined with self-organizing systems theories as well as nonlinear control and stability analyses to explain this definition. In particular, this paper provides a missing link in the analysis of self-organizing systems: a tie between irreversible thermodynamics and Hamiltonian systems. As a result of this work, the concept of ''on the edge of chaos'' is formulated as a set of necessary and sufficient conditions for stability and performance of sustainable systems. This interplay between exergy rate and irreversible entropy production rate can be described as Yin and Yang control: the dialectic synthesis of opposing power flows. In addition, exergy is shown to be a fundamental driver and necessary input for sustainable systems, since exergy input in the form of power is a single point of failure for self-organizing, adaptable systems.

  13. Sustainable Buildings

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Elle, Morten

    The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems...

  14. Sustainable Entrepreneurship

    DEFF Research Database (Denmark)

    Schaltegger, Stefan; Beckmann, Markus; Hockerts, Kai

    2018-01-01

    . We also explore the transformation path of the case company, which starts with simple use and then moves to the feedback to core business pattern. By drawing on insights from lead user theory in innovation management and sustainable entrepreneurship, we ground the new concept in extant literature...

  15. Sustainable machining

    CERN Document Server

    2017-01-01

    This book provides an overview on current sustainable machining. Its chapters cover the concept in economic, social and environmental dimensions. It provides the reader with proper ways to handle several pollutants produced during the machining process. The book is useful on both undergraduate and postgraduate levels and it is of interest to all those working with manufacturing and machining technology.

  16. Sustainable processing

    DEFF Research Database (Denmark)

    Kristensen, Niels Heine

    2004-01-01

    Kristensen_NH and_Beck A: Sustainable processing. In Otto Schmid, Alexander Beck and Ursula Kretzschmar (Editors) (2004): Underlying Principles in Organic and "Low-Input Food" Processing - Literature Survey. Research Institute of Organic Agriculture FiBL, CH-5070 Frick, Switzerland. ISBN 3-906081-58-3...

  17. Architecture Sustainability

    NARCIS (Netherlands)

    Avgeriou, Paris; Stal, Michael; Hilliard, Rich

    2013-01-01

    Software architecture is the foundation of software system development, encompassing a system's architects' and stakeholders' strategic decisions. A special issue of IEEE Software is intended to raise awareness of architecture sustainability issues and increase interest and work in the area. The

  18. Sustainable development

    International Nuclear Information System (INIS)

    Boiteux, M.

    2004-01-01

    Marcel Boiteux evokes the results of the work on the sustainable development by the Academie des Sciences Morales et Politiques. This is a vast political programme with the goal of allowing all humanity to live well in growing unity while protecting the environment and favouring economic growth. (author)

  19. Sustainable Development

    African Journals Online (AJOL)

    Tsegai Berhane Ghebretekle

    Ethiopia is selected as a case study in light of its pace in economic growth ... Interrogating the Economy-First Paradigm in 'Sustainable Development' … 65 .... agreement, since such effective global cooperation on climate change ultimately ..... and foster innovation; reduce inequality within and among countries; make cities.

  20. Sustainable Soesterkwartier

    NARCIS (Netherlands)

    Abrahams, H.; Goosen, H.; Jong, de F.; Sickmann, J.; Prins, D.

    2010-01-01

    The municipality of Amersfoort wants to construct an endurable and sustainable eco-town in the Soesterkwartier neighbourhood, by taking future climate change into account. The impact of climate change at the location of the proposed eco-town was studied by a literature review.

  1. Sustainable Sizing.

    Science.gov (United States)

    Robinette, Kathleen M; Veitch, Daisy

    2016-08-01

    To provide a review of sustainable sizing practices that reduce waste, increase sales, and simultaneously produce safer, better fitting, accommodating products. Sustainable sizing involves a set of methods good for both the environment (sustainable environment) and business (sustainable business). Sustainable sizing methods reduce (1) materials used, (2) the number of sizes or adjustments, and (3) the amount of product unsold or marked down for sale. This reduces waste and cost. The methods can also increase sales by fitting more people in the target market and produce happier, loyal customers with better fitting products. This is a mini-review of methods that result in more sustainable sizing practices. It also reviews and contrasts current statistical and modeling practices that lead to poor fit and sizing. Fit-mapping and the use of cases are two excellent methods suited for creating sustainable sizing, when real people (vs. virtual people) are used. These methods are described and reviewed. Evidence presented supports the view that virtual fitting with simulated people and products is not yet effective. Fit-mapping and cases with real people and actual products result in good design and products that are fit for person, fit for purpose, with good accommodation and comfortable, optimized sizing. While virtual models have been shown to be ineffective for predicting or representing fit, there is an opportunity to improve them by adding fit-mapping data to the models. This will require saving fit data, product data, anthropometry, and demographics in a standardized manner. For this success to extend to the wider design community, the development of a standardized method of data collection for fit-mapping with a globally shared fit-map database is needed. It will enable the world community to build knowledge of fit and accommodation and generate effective virtual fitting for the future. A standardized method of data collection that tests products' fit methodically

  2. Network television news coverage of environmental risks

    International Nuclear Information System (INIS)

    Greenberg, M.R.; Sandman, P.M.; Sachsman, D.V.; Salomone, K.L.

    1989-01-01

    Despite the criticisms that surround television coverage of environmental risk, there have been relatively few attempts to measure what and whom television shows. Most research has focused analysis on a few weeks of coverage of major stories like the gas leak at Bhopal, the Three Mile Island nuclear accident, or the Mount St. Helen's eruption. To advance the research into television coverage of environmental risk, an analysis has been made of all environmental risk coverage by the network nightly news broadcasts for a period of more than two years. Researchers have analyzed all environmental risk coverage-564 stories in 26 months-presented on ABC, CBS, and NBC's evening news broadcasts from January 1984 through February 1986. The quantitative information from the 564 stories was balanced by a more qualitative analysis of the television coverage of two case studies-the dioxin contamination in Times Beach, Missouri, and the suspected methyl isocyanate emissions from the Union Carbide plant in Institute, West Virginia. Both qualitative and quantitative data contributed to the analysis of the role played by experts and environmental advocacy sources in coverage of environmental risk and to the suggestions for increasing that role

  3. Insurance Coverage Policies for Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Andrew Hresko

    2012-10-01

    Full Text Available Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related and pharmacogenetic (PGx tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  4. Assessment of coverage levels of single dose measles vaccine

    International Nuclear Information System (INIS)

    Tariq, P.

    2003-01-01

    Objective: To study the consequences of low coverage levels of a single dose of measles vaccine. Results: mean age observed in measles cases was 2 years and 8 months with a range from 3 months to 8 years. Maximum number of cases reported were <1 year of age (n=22,32%). Fifty percent of cases were seen among vaccinated children. Seventy-five percent (n=51) had history of contact with a measles case. Pneumonia was the commonest complication followed by acute gastroenteritis, encephalitis, febrile convulsions, oral ulcers, oral thrush, eye changes of vitamin-A deficiency and pulmonary tuberculosis (T.B.) in descending order of frequency. Fifty four cases were successfully treated for complications of measles and discharged. Nine cases left against medical advice. Five patients died all of them had encephalitis either alone (n=1) or in combination with pneumonia and acute gastroenteritis (n=4). Conclusion: There is a dire need to increase the immunization coverage to reduce the rate of vaccine failure and achieve effective control of measles.(author)

  5. 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.

  6. Skin innate immune system

    Directory of Open Access Journals (Sweden)

    Berna Aksoy

    2013-06-01

    Full Text Available All multicellular organisms protect themselves from external universe and microorganisms by innate immune sytem that is constitutively present. Skin innate immune system has several different components composed of epithelial barriers, humoral factors and cellular part. In this review information about skin innate immune system and its components are presented to the reader. Innate immunity, which wasn’t adequately interested in previously, is proven to provide a powerfull early protection system, control many infections before the acquired immunity starts and directs acquired immunity to develop optimally

  7. [Medical coverage of a road bicycle race].

    Science.gov (United States)

    Reifferscheid, Florian; Stuhr, Markus; Harding, Ulf; Schüler, Christine; Thoms, Jürgen; Püschel, Klaus; Kappus, Stefan

    2010-07-01

    Major sport events require adequate expertise and experience concerning medical coverage and support. Medical and ambulance services need to cover both participants and spectators. Likewise, residents at the venue need to be provided for. Concepts have to include the possibility of major incidents related to the event. Using the example of the Hamburg Cyclassics, a road bicycle race and major event for professional and amateur cyclists, this article describes the medical coverage, number of patients, types of injuries and emergencies. Objectives regarding the planning of future events and essential medical coverage are consequently discussed. (c) Georg Thieme Verlag Stuttgart-New York.

  8. 42 CFR 440.330 - Benchmark health benefits coverage.

    Science.gov (United States)

    2010-10-01

    ...) Federal Employees Health Benefit Plan Equivalent Coverage (FEHBP—Equivalent Health Insurance Coverage). A... coverage. Health benefits coverage that is offered and generally available to State employees in the State... 42 Public Health 4 2010-10-01 2010-10-01 false Benchmark health benefits coverage. 440.330 Section...

  9. Progress toward universal health coverage in ASEAN.

    Science.gov (United States)

    Van Minh, Hoang; Pocock, Nicola Suyin; Chaiyakunapruk, Nathorn; Chhorvann, Chhea; Duc, Ha Anh; Hanvoravongchai, Piya; Lim, Jeremy; Lucero-Prisno, Don Eliseo; Ng, Nawi; Phaholyothin, Natalie; Phonvisay, Alay; Soe, Kyaw Min; Sychareun, Vanphanom

    2014-01-01

    The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and 'snowball' further data. We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1) financial constraints, including low levels of overall and government spending on health; 2) supply side constraints, including inadequate numbers and densities of health workers; and 3) the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should be explicitly considered to mitigate

  10. Progress toward universal health coverage in ASEAN

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: The Association of Southeast Asian Nations (ASEAN is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design: Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and ‘snowball’ further data. Results: We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1 financial constraints, including low levels of overall and government spending on health; 2 supply side constraints, including inadequate numbers and densities of health workers; and 3 the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should

  11. 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.

  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. Summary of DOD Acquisition Program Audit Coverage

    National Research Council Canada - National Science Library

    2001-01-01

    This report will provide the DoD audit community with information to support their planning efforts and provide management with information on the extent of audit coverage of DoD acquisition programs...

  14. NOAA Weather Radio - County Coverage by State

    Science.gov (United States)

    Non-Zero All Hazards Logo Emergency Alert Description Event Codes Fact Sheet FAQ Organization Search Coverage Listings NWR Station Search Maps SAME SAME Coding Using SAME SAME Non-Zero Codes DOCUMENTS NWR

  15. Media Coverage of Nuclear Energy after Fukushima

    International Nuclear Information System (INIS)

    Oltra, C.; Roman, P.; Prades, A.

    2013-01-01

    This report presents the main findings of a content analysis of printed media coverage of nuclear energy in Spain before and after the Fukushima accident. Our main objective is to understand the changes in the presentation of nuclear fission and nuclear fusion as a result of the accident in Japan. We specifically analyze the volume of coverage and thematic content in the media coverage for nuclear fusion from a sample of Spanish print articles in more than 20 newspapers from 2008 to 2012. We also analyze the media coverage of nuclear energy (fission) in three main Spanish newspapers one year before and one year after the accident. The results illustrate how the media contributed to the presentation of nuclear power in the months before and after the accident. This could have implications for the public understanding of nuclear power. (Author)

  16. Media Coverage of Nuclear Energy after Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Oltra, C.; Roman, P.; Prades, A.

    2013-07-01

    This report presents the main findings of a content analysis of printed media coverage of nuclear energy in Spain before and after the Fukushima accident. Our main objective is to understand the changes in the presentation of nuclear fission and nuclear fusion as a result of the accident in Japan. We specifically analyze the volume of coverage and thematic content in the media coverage for nuclear fusion from a sample of Spanish print articles in more than 20 newspapers from 2008 to 2012. We also analyze the media coverage of nuclear energy (fission) in three main Spanish newspapers one year before and one year after the accident. The results illustrate how the media contributed to the presentation of nuclear power in the months before and after the accident. This could have implications for the public understanding of nuclear power. (Author)

  17. 22 CFR 518.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 518.31 Insurance coverage. Recipients shall, at a minimum, provide the...

  18. 7 CFR 3019.31 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... Standards § 3019.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance...

  19. 34 CFR 74.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... by the recipient. Federally-owned property need not be insured unless required by the terms and... Property Standards § 74.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent...

  20. 49 CFR 19.31 - Insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 19.31 Insurance coverage. Recipients shall, at a minimum, provide the...

  1. 10 CFR 600.131 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... provided to property owned by the recipient. Federally-owned property need not be insured unless required... Nonprofit Organizations Post-Award Requirements § 600.131 Insurance coverage. Recipients shall, at a minimum...

  2. 20 CFR 435.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... funds as provided to property owned by the recipient. Federally-owned property need not be insured... ORGANIZATIONS Post-Award Requirements Property Standards § 435.31 Insurance coverage. Recipients must, at a...

  3. 28 CFR 70.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... with Federal funds as provided to property owned by the recipient. Federally-owned property need not be...-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 70.31 Insurance coverage. Recipients...

  4. Coverage for SCS Pre-1941 Aerial Photography

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This shapefile was generated by the U.S. Bureau of Land Management (BLM) at the New Mexico State Office to show the coverage for the Pre-1941 aerial photography...

  5. Immune System (For Parents)

    Science.gov (United States)

    ... of the Immune System Print en español El sistema inmunitario The immune system, which is made up ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for ...

  6. 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.

  7. Immunity's ancient arms

    OpenAIRE

    Litman, Gary W.; Cannon, John P.

    2009-01-01

    Diverse receptors on two types of cell mediate adaptive immunity in jawed vertebrates. In the lamprey, a jawless vertebrate, immunity is likewise compartmentalized but the molecular mechanics are very different.

  8. [Immune system and tumors].

    Science.gov (United States)

    Terme, Magali; Tanchot, Corinne

    2017-02-01

    Despite having been much debated, it is now well established that the immune system plays an essential role in the fight against cancer. In this article, we will highlight the implication of the immune system in the control of tumor growth and describe the major components of the immune system involved in the antitumoral immune response. The immune system, while exerting pressure on tumor cells, also will play a pro-tumoral role by sculpting the immunogenicity of tumors cells as they develop. Finally, we will illustrate the numerous mechanisms of immune suppression that take place within the tumoral microenvironment which allow tumor cells to escape control from the immune system. The increasingly precise knowledge of the brakes to an effective antitumor immune response allows the development of immunotherapy strategies more and more innovating and promising of hope. Copyright © 2016. Published by Elsevier Masson SAS.

  9. Immune System and Disorders

    Science.gov (United States)

    Your immune system is a complex network of cells, tissues, and organs that work together to defend against germs. It ... t, to find and destroy them. If your immune system cannot do its job, the results can be ...

  10. Aging changes in immunity

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/004008.htm Aging changes in immunity To use the sharing features ... cells and antibodies that destroy these harmful substances. AGING CHANGES AND THEIR EFFECTS ON THE IMMUNE SYSTEM ...

  11. Immunizations for adult women.

    Science.gov (United States)

    Faubion, Stephanie S; Larkin, Lisa C

    2016-12-01

    Immunizations protect individual persons and contribute to public health by reducing morbidity and mortality associated with common infectious diseases. In this Practice Pearl, we review guidelines for adult immunizations and recent and potential changes in vaccines.

  12. Length and coverage of inhibitory decision rules

    KAUST Repository

    Alsolami, Fawaz

    2012-01-01

    Authors present algorithms for optimization of inhibitory rules relative to the length and coverage. Inhibitory rules have a relation "attribute ≠ value" on the right-hand side. The considered algorithms are based on extensions of dynamic programming. Paper contains also comparison of length and coverage of inhibitory rules constructed by a greedy algorithm and by the dynamic programming algorithm. © 2012 Springer-Verlag.

  13. Mumps vaccine effectiveness in highly immunized populations.

    Science.gov (United States)

    Domínguez, Angela; Torner, Núria; Castilla, Jesús; Batalla, Joan; Godoy, Pere; Guevara, Marcela; Carnicer, Dolors; Caylà, Joan; Rius, Cristina; Jansà, Josep Maria

    2010-04-30

    The aim of the study was to investigate effectiveness of mumps MMR component in communities with high MMR coverage. Outbreak-related cases of mumps born between 1995 and 2005 notified to Navarre and Catalonia public health services during the period 2005-2007 were studied. Vaccine effectiveness (VE) and their 95%CI were calculated using the screening method. Of 47 confirmed, 85.1% immunized with at least one dose (1MMR) and 44.9% with two (2MMR). Estimated VE was 85.4% (95%CI: 67.3-93.4) for 1MMR and 88.5% (95%CI: 78.1-93.9) for 2MMR. High 2MMR coverage, improved confirmation techniques and further VE studies with all confirmed cases are needed to prevent further outbreaks. (c) 2010 Elsevier Ltd. All rights reserved.

  14. Immune system simulation online

    DEFF Research Database (Denmark)

    Rapin, Nicolas; Lund, Ole; Castiglione, Filippo

    2011-01-01

    MOTIVATION: The recognition of antigenic peptides is a major event of an immune response. In current mesoscopic-scale simulators of the immune system, this crucial step has been modeled in a very approximated way. RESULTS: We have equipped an agent-based model of the immune system with immuno...

  15. The Immune System Game

    Science.gov (United States)

    Work, Kirsten A.; Gibbs, Melissa A.; Friedman, Erich J.

    2015-01-01

    We describe a card game that helps introductory biology students understand the basics of the immune response to pathogens. Students simulate the steps of the immune response with cards that represent the pathogens and the cells and molecules mobilized by the immune system. In the process, they learn the similarities and differences between the…

  16. Plant innate immunity

    Indian Academy of Sciences (India)

    Plants are invaded by an array of pathogens of which only a few succeed in causing disease. The attack by others is countered by a sophisticated immune system possessed by the plants. The plant immune system is broadly divided into two, viz. microbial-associated molecular-patterns-triggered immunity (MTI) and ...

  17. Cooperative Cloud Service Aware Mobile Internet Coverage Connectivity Guarantee Protocol Based on Sensor Opportunistic Coverage Mechanism

    Directory of Open Access Journals (Sweden)

    Qin Qin

    2015-01-01

    Full Text Available In order to improve the Internet coverage ratio and provide connectivity guarantee, based on sensor opportunistic coverage mechanism and cooperative cloud service, we proposed the coverage connectivity guarantee protocol for mobile Internet. In this scheme, based on the opportunistic covering rules, the network coverage algorithm of high reliability and real-time security was achieved by using the opportunity of sensor nodes and the Internet mobile node. Then, the cloud service business support platform is created based on the Internet application service management capabilities and wireless sensor network communication service capabilities, which is the architecture of the cloud support layer. The cooperative cloud service aware model was proposed. Finally, we proposed the mobile Internet coverage connectivity guarantee protocol. The results of experiments demonstrate that the proposed algorithm has excellent performance, in terms of the security of the Internet and the stability, as well as coverage connectivity ability.

  18. From the parents' perspective: a user-satisfaction survey of immunization services in Guatemala.

    Science.gov (United States)

    Barrera, Lissette; Trumbo, Silas Pierson; Bravo-Alcántara, Pamela; Velandia-González, Martha; Danovaro-Holliday, M Carolina

    2014-03-06

    Immunization coverage levels in Guatemala have increased over the last two decades, but national targets of ≥95% have yet to be reached. To determine factors related to undervaccination, Guatemala's National Immunization Program conducted a user-satisfaction survey of parents and guardians of children aged 0-5 years. Variables evaluated included parental immunization attitudes, preferences, and practices; the impact of immunization campaigns and marketing strategies; and factors inhibiting immunization. Based on administrative coverage levels and socio-demographic indicators in Guatemala's 22 geographical departments, five were designated as low-coverage and five as high-coverage areas. Overall, 1194 parents and guardians of children aged 0-5 years were interviewed in these 10 departments. We compared indicators between low- and high-coverage areas and identified risk factors associated with undervaccination. Of the 1593 children studied, 29 (1.8%) were determined to be unvaccinated, 458 (28.8%) undervaccinated, and 1106 (69.4%) fully vaccinated. In low-coverage areas, children of less educated (no education: RR=1.49, p=0.01; primary or less: 1.39, p=0.009), older (aged>39 years: RR=1.31, p=0.05), and single (RR=1.32, p=0.03) parents were more likely to have incomplete vaccination schedules. Similarly, factors associated with undervaccination in high-coverage areas included the caregiver's lack of education (none: RR=1.72, p=0.0007; primary or less: RR=1.30, p=0.05) and single marital status (RR=1.36, p=0.03), as well as the child's birth order (second: RR=1.68, p=0.003). Although users generally approved of immunization services, problems in service quality were identified. According to participants, topics such as the risk of adverse events (47.4%) and next vaccination appointments (32.3%) were inconsistently communicated to parents. Additionally, 179 (15.0%) participants reported the inability to vaccinate their child on at least one occasion. Compared to high-coverage

  19. 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.

  20. Indonesia's road to universal health coverage: a political journey.

    Science.gov (United States)

    Pisani, Elizabeth; Olivier Kok, Maarten; Nugroho, Kharisma

    2017-03-01

    In 2013 Indonesia, the world's fourth most populous country, declared that it would provide affordable health care for all its citizens within seven years. This crystallised an ambition first enshrined in law over five decades earlier, but never previously realised. This paper explores Indonesia's journey towards universal health coverage (UHC) from independence to the launch of a comprehensive health insurance scheme in January 2014. We find that Indonesia's path has been determined largely by domestic political concerns – different groups obtained access to healthcare as their socio-political importance grew. A major inflection point occurred following the Asian financial crisis of 1997. To stave off social unrest, the government provided health coverage for the poor for the first time, creating a path dependency that influenced later policy choices. The end of this programme coincided with decentralisation, leading to experimentation with several different models of health provision at the local level. When direct elections for local leaders were introduced in 2005, popular health schemes led to success at the polls. UHC became an electoral asset, moving up the political agenda. It also became contested, with national policy-makers appropriating health insurance programmes that were first developed locally, and taking credit for them. The Indonesian experience underlines the value of policy experimentation, and of a close understanding of the contextual and political factors that drive successful UHC models at the local level. Specific drivers of success and failure should be taken into account when scaling UHC to the national level. In the Indonesian example, UHC became possible when the interests of politically and economically influential groups were either satisfied or neutralised. While technical considerations took a back seat to political priorities in developing the structures for health coverage nationally, they will have to be addressed going forward

  1. The impact of declining vaccination coverage on measles control: a case study of Abia state Nigeria.

    Science.gov (United States)

    Umeh, Chukwuemeka Anthony; Ahaneku, Hycienth Peterson

    2013-01-01

    Efforts at immunizing children against measles was intensified in Nigeria with nation-wide measles vaccination campaigns in 2005-2006, 2008 and 2011 targeting children between 9 and 59 months. However, there were measles outbreaks in 2010 and 2011 in Abia state Nigeria. This study seeks to find out if there is any association between measles immunization coverage and measles outbreak. This is a descriptive analysis of the 2007 to 2011 Abia state measles case-based surveillance data supplied to Abia state World Health Organization office and Abia State Ministry of Health by the disease surveillance and notification officers. As the proportion of cases with febrile rash who were immunized decreased from 81% in 2007 to 42% in 2011, the laboratory confirmed cases of measles increased from two in 2007 to 53 in 2011.Of the laboratory confirmed cases of measles, five (7%) occurred in children Abia state bearing in mind that measles immunization coverage in urban and rural areas was not markedly different.

  2. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority.

    Science.gov (United States)

    Patel, Vikram

    2016-07-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, acceptability and cost-effectiveness of the delivery of these interventions through a collaborative care model in low resource settings. While there are a number of barriers to scaling up this evidence, for eg, the finances needed to train and deploy community based workers and the lack of agency for people with schizophrenia, the experiences of some upper middle income countries show that sustained political commitment, allocation of transitional financial resources to develop community services, a commitment to an integrated approach with a strong role for community based institutions and providers, and a progressive realization of coverage are the key ingredients for scale up of services for schizophrenia. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  3. 45 CFR 148.124 - Certification and disclosure of coverage.

    Science.gov (United States)

    2010-10-01

    ... method of counting creditable coverage, and the requesting entity may identify specific information that... a payroll deduction for health coverage, a health insurance identification card, a certificate of...

  4. Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in Dschang, West Region, Cameroon: a cross-sectional survey during a polio outbreak.

    Science.gov (United States)

    Russo, Gianluca; Miglietta, Alessandro; Pezzotti, Patrizio; Biguioh, Rodrigue Mabvouna; Bouting Mayaka, Georges; Sobze, Martin Sanou; Stefanelli, Paola; Vullo, Vincenzo; Rezza, Giovanni

    2015-07-10

    Inadequate immunization coverage with increased risk of vaccine preventable diseases outbreaks remains a problem in Africa. Moreover, different factors contribute to incomplete vaccination status. This study was performed in Dschang (West Region, Cameroon), during the polio outbreak occurred in October 2013, in order to estimate the immunization coverage among children aged 12-23 months, to identify determinants for incomplete vaccination status and to assess the risk of poliovirus spread in the study population. A cross-sectional household survey was conducted in November-December 2013, using the WHO two-stage sampling design. An interviewer-administered questionnaire was used to obtain information from consenting parents of children aged 12-23 months. Vaccination coverage was assessed by vaccination card and parents' recall. Chi-square test and multilevel logistic regression model were used to identify the determinants of incomplete immunization status. Statistical significance was set at p children were enrolled. Complete immunization coverage was 85.9% and 84.5%, according to card plus parents' recall and card only, respectively. All children had received at least one routine vaccination, the OPV-3 (Oral Polio Vaccine) coverage was >90%, and 73.4% children completed the recommended vaccinations before 1-year of age. In the final multilevel logistic regression model, factors significantly associated with incomplete immunization status were: retention of immunization card (AOR: 7.89; 95% CI: 1.08-57.37), lower mothers' utilization of antenatal care (ANC) services (AOR:1.25; 95% CI: 1.07-63.75), being the ≥ 3(rd) born child in the family (AOR: 425.4; 95% CI: 9.6-18,808), younger mothers' age (AOR: 49.55; 95% CI: 1.59-1544), parents' negative attitude towards immunization (AOR: 20.2; 95% CI: 1.46-278.9), and poorer parents' exposure to information on vaccination (AOR: 28.07; 95 % CI: 2.26-348.1). Longer distance from the vaccination centers was marginally

  5. Oral candidosis in relation to oral immunity.

    Science.gov (United States)

    Feller, L; Khammissa, R A G; Chandran, R; Altini, M; Lemmer, J

    2014-09-01

    Symptomatic oral infection with Candida albicans is characterized by invasion of the oral epithelium by virulent hyphae that cause tissue damage releasing the inflammatory mediators that initiate and sustain local inflammation. Candida albicans triggers pattern-recognition receptors of keratinocytes, macrophages, monocytes and dendritic cells, stimulating the production of IL-1β, IL-6 and IL-23. These cytokines induce the differentiation of Th17 cells and the generation of IL-17- and/or IL-22-mediated antifungal protective immuno-inflammatory responses in infected mucosa. Some immune cells including NKT cells, γδ T cells and lymphoid cells that are innate to the oral mucosa have the capacity to produce large quantities of IL-17 in response to C. albicans, sufficient to mediate effective protective immunity against C. albicans. On the other hand, molecular structures of commensal C. albicans blastoconidia, although detected by pattern-recognition receptors, are avirulent, do not invade the oral epithelium, do not elicit inflammatory responses in a healthy host, but induce regulatory immune responses that maintain tissue tolerance to the commensal fungi. The type, specificity and sensitivity of the protective immune response towards C. albicans is determined by the outcome of the integrated interactions between the intracellular signalling pathways of specific combinations of activated pattern-recognition receptors (TLR2, TLR4, Dectin-1 and Dectin-2). IL-17-mediated protective immune response is essential for oral mucosal immunity to C. albicans infection. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Hepatitis B vaccination coverage rates among adults in rural China: are economic barriers relevant?

    Science.gov (United States)

    Zhu, Dawei; Wang, Jian; Wangen, Knut Reidar

    2014-11-20

    Hepatitis B virus (HBV) infections cause major health problems in China. The Expanded Program of Immunization has succeeded in reducing infection rates among infants and children, but HBV vaccination coverage rates among adults remain low. The objective was to investigate how individual adult HBV vaccination decisions are influenced by economic factors, socioeconomic status, and demographic characteristics, and to assess how potential vaccination policies could affect HBV vaccination coverage rates among adults. We interviewed 22,618 adults, aged 15-59 years, from 7948 households, in 45 villages from 7 provinces. A questionnaire was used to collect information. The actual vaccine status was modeled using a polychotomous logistic regression with three outcomes; unvaccinated, partial vaccination, and complete vaccination. A subsample of unvaccinated adults gave responses to a hypothetical vaccination policy that offered HBV vaccination free of charge and various amounts of money to compensate for direct and indirect vaccination-related costs. The polychotomous logistic regression results suggest that vaccination user fees, time needed to get a vaccination, and vaccination-related travel costs were negatively associated with HBV vaccination coverage rates. Higher income was associated with higher coverage rates, and coverage rates decrease with age, with no significant difference between the genders. In the subsample that responded to the hypothetical policy, 55-72% (depending on the amount of money offered as compensation) stated they would accept a vaccination if it was offered free of charge. Our polychotomous logistic regression results suggest that higher HBV vaccination coverage rates among adults are obtainable and that user fees, time needed to get a vaccination, and travel costs have acted as economic barriers to vaccination. This is supported by the responses to the hypothetical policy, which suggest that adult coverage rates could surge if HBV vaccine is

  7. Building sustainability

    CSIR Research Space (South Africa)

    Mass Media

    2007-11-01

    Full Text Available particu- lar social environment also being awarded. If a building can be used by the community after hours, it should be awarded extra points.” School sports facilities or meeting halls in corporate buildings, are some example. Multi-purpose use..., architect and senior researcher for the CSIR’s Built Environment Unit, the integra- tion of sustainability in building design cannot begin soon enough before it is too late. He says: “Unfortunately nothing is in place in South Africa. For a start...

  8. Cytokine regulation of immune tolerance

    OpenAIRE

    Wu, Jie; Xie, Aini; Chen, Wenhao

    2014-01-01

    The immune system provides defenses against invading pathogens while maintaining immune tolerance to self-antigens. This immune homeostasis is harmonized by the direct interactions between immune cells and the cytokine environment in which immune cells develop and function. Herein, we discuss three non-redundant paradigms by which cytokines maintain or break immune tolerance. We firstly describe how anti-inflammatory cytokines exert direct inhibitory effects on immune cells to enforce immune ...

  9. Kidney and innate immunity.

    Science.gov (United States)

    Wang, Ying-Hui; Zhang, Yu-Gen

    2017-03-01

    Innate immune system is an important modulator of the inflammatory response during infection and tissue injury/repair. The kidney as a vital organ with high energy demand plays a key role in regulating the disease related metabolic process. Increasing research interest has focused on the immune pathogenesis of many kidney diseases. However, innate immune cells such as dendritic cells, macrophages, NK cells and a few innate lymphocytes, as well as the complement system are essential for renal immune homeostasis and ensure a coordinated balance between tissue injury and regeneration. The innate immune response provides the first line of host defense initiated by several classes of pattern recognition receptors (PRRs), such as membrane-bound Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs), together with inflammasomes responsible for early innate immune response. Although the innate immune system is well studied, the research on the detailed relationship between innate immunity and kidney is still very limited. In this review, we will focus on the innate immune sensing system in renal immune homeostasis, as well as the corresponding pathogenesis of many kidney diseases. The pivotal roles of innate immunity in renal injury and regeneration with special emphasis on kidney disease related immunoregulatory mechanism are also discussed. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  10. Alternative Immune Systems

    Directory of Open Access Journals (Sweden)

    Luis Fernando Cadavid Gutierrez

    2011-09-01

    Full Text Available The immune system in animals is a complex network of molecules, cells and tissues that coordinately maintain the physiological and genetic integrity of the organism. Traditionally, two classes of immunity have been considered, the innate immunity and the adaptive immunity. The former is ancestral, with limited variability and low discrimination. The latter is highly variable, specific and limited to jawed vertebrates. Adaptive immunity is based on antigen receptors that rearrange somatically to generate a nearly unlimited diversity of molecules. Likely, this mechanism of somatic recombination arose as a consequence of a horizontal transfer of transposons and transposases from bacterial genomes in the ancestor of jawed vertebrates. The recent discovery in jawless vertebrates and invertebrates of alternative adaptive immune mechanisms, suggests during evolution different animal groups have found alternative solutions to the problem of immune recognition.

  11. Organization of an optimal adaptive immune system

    Science.gov (United States)

    Walczak, Aleksandra; Mayer, Andreas; Balasubramanian, Vijay; Mora, Thierry

    The repertoire of lymphocyte receptors in the adaptive immune system protects organisms from a diverse set of pathogens. A well-adapted repertoire should be tuned to the pathogenic environment to reduce the cost of infections. I will discuss a general framework for predicting the optimal repertoire that minimizes the cost of infections contracted from a given distribution of pathogens. The theory predicts that the immune system will have more receptors for rare antigens than expected from the frequency of encounters and individuals exposed to the same infections will have sparse repertoires that are largely different, but nevertheless exploit cross-reactivity to provide the same coverage of antigens. I will show that the optimal repertoires can be reached by dynamics that describes the competitive binding of antigens by receptors, and selective amplification of stimulated receptors.

  12. Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services

    Directory of Open Access Journals (Sweden)

    Wenjing Tao

    2013-04-01

    Full Text Available Background and objective: The Expanded Programme on Immunization was introduced by the World Health Organization (WHO in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF. Design: Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS conducted in 71 low- and middle-income countries during 1986–2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates. Results: From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates. Conclusions: The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.

  13. Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services.

    Science.gov (United States)

    Tao, Wenjing; Petzold, Max; Forsberg, Birger C

    2013-04-30

    The Expanded Programme on Immunization was introduced by the World Health Organization (WHO) in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF). Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS) conducted in 71 low- and middle-income countries during 1986-2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates. From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates. The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.

  14. Risk factors for low vaccination coverage among Roma children in disadvantaged settlements in Belgrade, Serbia.

    Science.gov (United States)

    Stojanovski, Kristefer; McWeeney, Gerry; Emiroglu, Nedret; Ostlin, Piroska; Koller, Theadora; Licari, Lucianne; Kaluski, Dorit Nitzan

    2012-08-10

    Full vaccination coverage for children under 59 months of age in Serbia is over 90%. This study assesses vaccination coverage and examines its association with birth registration among Roma children who resided in disadvantaged settlements in Belgrade, Serbia. The First Roma Health and Nutrition Survey in Belgrade settlements, 2009, was conducted among households of 468 Roma children between the ages of 6-59 months. The 2005 WHO Immunization Coverage Cluster Survey sampling methodology was employed. Vaccinations were recorded using children's vaccination cards and through verification steps carried out in the Primary Health Care Centers. For those who had health records the information on vaccination was recorded. About 88% of children had vaccination cards. The mean rate of age appropriate full immunization was 16% for OPV and DTP and 14.3% for MMR. Multivariate analyses indicated that children whose births were registered with the civil authorities were more likely to have their vaccination cards [OR=6.1, CI (2.5, 15.0)] and to have their full, age appropriate, series vaccinations for DTP, OPV, MMR and HepB [OR=3.8, CI (1.5, 10.0), OR=3.2, CI (1.5, 6.6), OR=4.8, CI (1.1, 21.0), OR=5.4, CI (1.4, 21.6), respectively]. The immunization coverage among Roma children in settlements is far below the WHO/UNICEF MDG4 target in achieving prevention and control of vaccine preventable diseases. It demonstrates the need to include "invisible" populations into the health systems in continuous, integrated, comprehensive, accessible and sensitive modes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. 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.

  16. Progress in Vaccine-Preventable and Respiratory Infectious Diseases-First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006-2015.

    Science.gov (United States)

    Schuchat, Anne; Anderson, Larry J; Rodewald, Lance E; Cox, Nancy J; Hajjeh, Rana; Pallansch, Mark A; Messonnier, Nancy E; Jernigan, Daniel B; Wharton, Melinda

    2018-07-01

    The need for closer linkages between scientific and programmatic areas focused on addressing vaccine-preventable and acute respiratory infections led to establishment of the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention. During its first 10 years (2006-2015), NCIRD worked with partners to improve preparedness and response to pandemic influenza and other emergent respiratory infections, provide an evidence base for addition of 7 newly recommended vaccines, and modernize vaccine distribution. Clinical tools were developed for improved conversations with parents, which helped sustain childhood immunization as a social norm. Coverage increased for vaccines to protect adolescents against pertussis, meningococcal meningitis, and human papillomavirus-associated cancers. NCIRD programs supported outbreak response for new respiratory pathogens and oversaw response of the Centers for Disease Control and Prevention to the 2009 influenza A(H1N1) pandemic. Other national public health institutes might also find closer linkages between epidemiology, laboratory, and immunization programs useful.

  17. Vaccination coverage and timeliness in three South African areas: a prospective study

    Directory of Open Access Journals (Sweden)

    Sanders David

    2011-05-01

    Full Text Available Abstract Background Timely vaccination is important to induce adequate protective immunity. We measured vaccination timeliness and vaccination coverage in three geographical areas in South Africa. Methods This study used vaccination information from a community-based cluster-randomized trial promoting exclusive breastfeeding in three South African sites (Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal between 2006 and 2008. Five interview visits were carried out between birth and up to 2 years of age (median follow-up time 18 months, and 1137 children were included in the analysis. We used Kaplan-Meier time-to-event analysis to describe vaccination coverage and timeliness in line with the Expanded Program on Immunization for the first eight vaccines. This included Bacillus Calmette-Guérin (BCG, four oral polio vaccines and 3 doses of the pentavalent vaccine which protects against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B. Results The proportion receiving all these eight recommended vaccines were 94% in Paarl (95% confidence interval [CI] 91-96, 62% in Rietvlei (95%CI 54-68 and 88% in Umlazi (95%CI 84-91. Slightly fewer children received all vaccines within the recommended time periods. The situation was worst for the last pentavalent- and oral polio vaccines. The hazard ratio for incomplete vaccination was 7.2 (95%CI 4.7-11 for Rietvlei compared to Paarl. Conclusions There were large differences between the different South African sites in terms of vaccination coverage and timeliness, with the poorer areas of Rietvlei performing worse than the better-off areas in Paarl. The vaccination coverage was lower for the vaccines given at an older age. There is a need for continued efforts to improve vaccination coverage and timeliness, in particular in rural areas. Trial registration number ClinicalTrials.gov: NCT00397150

  18. Sustainability Tensions in Supply Chains: A Case Study of Paradoxes and Their Management

    OpenAIRE

    Carolin Brix-Asala; Anne-Kristin Geisbüsch; Philipp Christopher Sauer; Patrick Schöpflin; Axel Zehendner

    2018-01-01

    The comprehensive coverage of sustainability issues in a supply chain incurs goal conflicts—i.e., sustainability tensions—and is often limited by market characteristics, such as the availability of sustainable materials and services. While the mainstream business is prioritizing economic goals, a number of entrepreneurs are trying to move forward to more sustainable business practices for their own company and their supply chain. Fairphone represents such a case in the electronics industry, w...

  19. Interdependences between sustainable development and sustainable economy

    OpenAIRE

    Emilia Mioara CÂMPEANU; Carmen Valentina RĂDULESCU

    2014-01-01

    Sustainable development and sustainable economy are mostly used concepts. Understanding clearly their meaning allows their use in an appropriate context and, therefore, their boundaries in terms of theoretical and practical approaches on which occasion it can be given their interdependencies. The paper aim is to analyze the interdependences between sustainable development and sustainable economy.

  20. 76 FR 12117 - Call for Comments on the Draft Report of the Adult Immunization Working Group to the National...

    Science.gov (United States)

    2011-03-04

    ... matters related to program responsibilities. The Assistant Secretary for Health (ASH) has been designated... adult immunization coverage levels.'' The Adult Immunization Working Group (AIWG) of NVAC has developed a draft report and recommendations for the consideration of the NVAC. Individuals and organizations...

  1. Conceptualising the lack of health insurance coverage.

    Science.gov (United States)

    Davis, J B

    2000-01-01

    This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

  2. Resolution, coverage, and geometry beyond traditional limits

    Energy Technology Data Exchange (ETDEWEB)

    Ronen, Shuki; Ferber, Ralf

    1998-12-31

    The presentation relates to the optimization of the image of seismic data and improved resolution and coverage of acquired data. Non traditional processing methods such as inversion to zero offset (IZO) are used. To realize the potential of saving acquisition cost by reducing in-fill and to plan resolution improvement by processing, geometry QC methods such as DMO Dip Coverage Spectrum (DDCS) and Bull`s Eyes Analysis are used. The DDCS is a 2-D spectrum whose entries consist of the DMO (Dip Move Out) coverage for a particular reflector specified by it`s true time dip and reflector normal strike. The Bull`s Eyes Analysis relies on real time processing of synthetic data generated with the real geometry. 4 refs., 6 figs.

  3. Innovations that reach the patient : Early health technology assessment and improving the chances of coverage and implementation

    NARCIS (Netherlands)

    Van Harten, W. H.; Retèl, V. P.

    2016-01-01

    With growing concerns for the sustainability of the financial burden that health care-and especially cancer services-poses on the national budgets, the role of health economic analyses in coverage decisions is likely to grow. One of the strategies for the biomedical research field-also in oncology

  4. Virtual Sustainability

    Directory of Open Access Journals (Sweden)

    William Sims Bainbridge

    2010-09-01

    Full Text Available In four ways, massively multiplayer online role-playing games may serve as tools for advancing sustainability goals, and as laboratories for developing alternatives to current social arrangements that have implications for the natural environment. First, by moving conspicuous consumption and other usually costly status competitions into virtual environments, these virtual worlds might reduce the need for physical resources. Second, they provide training that could prepare individuals to be teleworkers, and develop or demonstrate methods for using information technology to replace much transportation technology, notably in commuting. Third, virtual worlds and online games build international cooperation, even blending national cultures, thereby inching us toward not only the world consciousness needed for international agreements about the environment, but also toward non-spatial government that cuts across archaic nationalisms. Finally, realizing the potential social benefits of this new technology may urge us to reconsider a number of traditional societal institutions.

  5. Sustainability; Sustentabilidade

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    This chapter analyses the production chain of ethanol, considering the impacts on the quality of the air, water supplies, soil occupation and biodiversity, and the efforts for the soil preservation. It is pointed out the activities of the production cycle and use of bio ethanol due to great uncertainties as far the environmental impacts is concerning and that will deserve more attention in future evaluations. At same time, the chapter highlights another activities where the present acknowledge is sufficient to assure the control and/or prediction of consequences of the desired intervention on the environment media to accommodate the sugar and ethanol production expansion. The consideration is not conservative but to promote the sustainable development.

  6. Aspects of coverage in medical DNA sequencing

    Directory of Open Access Journals (Sweden)

    Wilson Richard K

    2008-05-01

    Full Text Available Abstract Background DNA sequencing is now emerging as an important component in biomedical studies of diseases like cancer. Short-read, highly parallel sequencing instruments are expected to be used heavily for such projects, but many design specifications have yet to be conclusively established. Perhaps the most fundamental of these is the redundancy required to detect sequence variations, which bears directly upon genomic coverage and the consequent resolving power for discerning somatic mutations. Results We address the medical sequencing coverage problem via an extension of the standard mathematical theory of haploid coverage. The expected diploid multi-fold coverage, as well as its generalization for aneuploidy are derived and these expressions can be readily evaluated for any project. The resulting theory is used as a scaling law to calibrate performance to that of standard BAC sequencing at 8× to 10× redundancy, i.e. for expected coverages that exceed 99% of the unique sequence. A differential strategy is formalized for tumor/normal studies wherein tumor samples are sequenced more deeply than normal ones. In particular, both tumor alleles should be detected at least twice, while both normal alleles are detected at least once. Our theory predicts these requirements can be met for tumor and normal redundancies of approximately 26× and 21×, respectively. We explain why these values do not differ by a factor of 2, as might intuitively be expected. Future technology developments should prompt even deeper sequencing of tumors, but the 21× value for normal samples is essentially a constant. Conclusion Given the assumptions of standard coverage theory, our model gives pragmatic estimates for required redundancy. The differential strategy should be an efficient means of identifying potential somatic mutations for further study.

  7. 29 CFR 2.13 - Audiovisual coverage prohibited.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audiovisual coverage prohibited. 2.13 Section 2.13 Labor Office of the Secretary of Labor GENERAL REGULATIONS Audiovisual Coverage of Administrative Hearings § 2.13 Audiovisual coverage prohibited. The Department shall not permit audiovisual coverage of the...

  8. 28 CFR 55.6 - Coverage under section 203(c).

    Science.gov (United States)

    2010-07-01

    ... THE VOTING RIGHTS ACT REGARDING LANGUAGE MINORITY GROUPS Nature of Coverage § 55.6 Coverage under section 203(c). (a) Coverage formula. There are four ways in which a political subdivision can become subject to section 203(c). 2 2 The criteria for coverage are contained in section 203(b). (1) Political...

  9. Sustainability Science Needs Sustainable Data!

    Science.gov (United States)

    Downs, R. R.; Chen, R. S.

    2013-12-01

    Sustainability science (SS) is an 'emerging field of research dealing with the interactions between natural and social systems, and with how those interactions affect the challenge of sustainability: meeting the needs of present and future generations while substantially reducing poverty and conserving the planet's life support systems' (Kates, 2011; Clark, 2007). Bettencourt & Kaur (2011) identified more than 20,000 scientific papers published on SS topics since the 1980s with more than 35,000 distinct authors. They estimated that the field is currently growing exponentially, with the number of authors doubling approximately every 8 years. These scholars are undoubtedly using and generating a vast quantity and variety of data and information for both SS research and applications. Unfortunately we know little about what data the SS community is actually using, and whether or not the data that SS scholars generate are being preserved for future use. Moreover, since much SS research is conducted by cross-disciplinary, multi-institutional teams, often scattered around the world, there could well be increased risks of data loss, reduced data quality, inadequate documentation, and poor long-term access and usability. Capabilities and processes therefore need to be established today to support continual, reliable, and efficient preservation of and access to SS data in the future, especially so that they can be reused in conjunction with future data and for new studies not conceived in the original data collection activities. Today's long-term data stewardship challenges include establishing sustainable data governance to facilitate continuing management, selecting data to ensure that limited resources are focused on high priority SS data holdings, securing sufficient rights to allow unforeseen uses, and preparing data to enable use by future communities whose specific research and information needs are not yet known. Adopting sustainable models for archival

  10. Microstrip Antenna Design for Femtocell Coverage Optimization

    Directory of Open Access Journals (Sweden)

    Afaz Uddin Ahmed

    2014-01-01

    Full Text Available A mircostrip antenna is designed for multielement antenna coverage optimization in femtocell network. Interference is the foremost concern for the cellular operator in vast commercial deployments of femtocell. Many techniques in physical, data link and network-layer are analysed and developed to settle down the interference issues. A multielement technique with self-configuration features is analyzed here for coverage optimization of femtocell. It also focuses on the execution of microstrip antenna for multielement configuration. The antenna is designed for LTE Band 7 by using standard FR4 dielectric substrate. The performance of the proposed antenna in the femtocell application is discussed along with results.

  11. Contraceptive Coverage and the Affordable Care Act.

    Science.gov (United States)

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Origins of adaptive immunity.

    Science.gov (United States)

    Liongue, Clifford; John, Liza B; Ward, Alister

    2011-01-01

    Adaptive immunity, involving distinctive antibody- and cell-mediated responses to specific antigens based on "memory" of previous exposure, is a hallmark of higher vertebrates. It has been argued that adaptive immunity arose rapidly, as articulated in the "big bang theory" surrounding its origins, which stresses the importance of coincident whole-genome duplications. Through a close examination of the key molecules and molecular processes underpinning adaptive immunity, this review suggests a less-extreme model, in which adaptive immunity emerged as part of longer evolutionary journey. Clearly, whole-genome duplications provided additional raw genetic materials that were vital to the emergence of adaptive immunity, but a variety of other genetic events were also required to generate some of the key molecules, whereas others were preexisting and simply co-opted into adaptive immunity.

  13. Immunization campaigns and political agendas: retrospective from Ecuador and El Salvador.

    Science.gov (United States)

    Gloyd, Stephen; Suarez Torres, Jose; Mercer, Mary Anne

    2003-01-01

    Since the mid-1980s international donors have promoted vertical, campaign-based strategies to help improve immunization coverage in poor countries. National immunization days (NIDs) are currently in vogue and are prominent in the worldwide polio eradication efforts. In spite of their widespread use, campaigns that include NIDs have not been well evaluated for their effects on coverage, reduction in vaccine-preventable diseases, or effects on the health system. An assessment of the results of two such campaigns implemented in Ecuador and El Salvador shows limited impact on short-term coverage and questionable effects on long-term coverage and disease incidence. Although NIDs may have substantial short-term political benefits, the vertical approach can undermine provision of routine services by ministries of health and may be counterproductive in the long-term.

  14. Immunization for Women

    Science.gov (United States)

    ... ACOG Update on Zika Virus Pregnancy Attention pregnant women! Pregnant women, their unborn babies, and newborns have a higher ... a new MMWR Influenza Vaccination Coverage Among Pregnant Women - United States, 2016-17 Influenza Season September 26, ...

  15. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  16. Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

    Science.gov (United States)

    Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

    2017-07-01

    To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  17. 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

  18. 24 CFR 51.302 - Coverage.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Coverage. 51.302 Section 51.302 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... significantly prolongs the physical or economic life of existing facilities or which, in the case of Accident...

  19. 5 CFR 880.304 - FEGLI coverage.

    Science.gov (United States)

    2010-01-01

    ... under § 880.205, FEGLI premiums and benefits will be computed using the date of death established under...) RETIREMENT AND INSURANCE BENEFITS DURING PERIODS OF UNEXPLAINED ABSENCE Continuation of Benefits § 880.304 FEGLI coverage. (a) FEGLI premiums will not be collected during periods when an annuitant is a missing...

  20. 44 CFR 17.610 - Coverage.

    Science.gov (United States)

    2010-10-01

    ... SECURITY GENERAL GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) § 17.610 Coverage. (a) This... covered by this subpart, except where specifically modified by this subpart. In the event of any conflict... are deemed to control with respect to the implementation of drug-free workplace requirements...

  1. 77 FR 16453 - Student Health Insurance Coverage

    Science.gov (United States)

    2012-03-21

    ... eliminating annual and lifetime dollar limits would result in dramatic premium hikes for student plans and.... Industry and university commenters noted that student health insurance coverage benefits typically... duplication of benefits and makes student plans more affordable. Industry commenters noted that student health...

  2. Coverage of space by random sets

    Indian Academy of Sciences (India)

    Consider the non-negative integer line. For each integer point we toss a coin. If the toss at location i is a. Heads we place an interval (of random length) there and move to location i + 1,. Tails we move to location i + 1. Coverage of space by random sets – p. 2/29 ...

  3. 5 CFR 610.402 - Coverage.

    Science.gov (United States)

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS HOURS OF DUTY Flexible and Compressed Work Schedules § 610.402 Coverage. The regulations contained in this subpart apply only to flexible work schedules and compressed work schedules established under subchapter 11 of chapter 61 of...

  4. 14 CFR 205.5 - Minimum coverage.

    Science.gov (United States)

    2010-01-01

    ... 18,000 pounds maximum payload capacity, carriers need only maintain coverage of $2,000,000 per... than 30 seats or 7,500 pounds maximum cargo payload capacity, and a maximum authorized takeoff weight... not be contingent upon the financial condition, solvency, or freedom from bankruptcy of the carrier...

  5. 5 CFR 734.401 - Coverage.

    Science.gov (United States)

    2010-01-01

    ...) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES Employees in Certain Agencies and Positions § 734.401 Coverage. (a... Criminal Investigation of the Internal Revenue Service. (11) The Office of Investigative Programs of the... Firearms; (13) The Criminal Division of the Department of Justice; (14) The Central Imagery Office; (15...

  6. Danish Media coverage of 22/7

    DEFF Research Database (Denmark)

    Hervik, Peter; Boisen, Sophie

    2013-01-01

    ’s Danish connections through an analysis of the first 100 days of Danish media coverage. We scrutinised 188 articles in the largest daily newspapers to find out how Danish actors related to ABB’s ideas. The key argument is that the discourses and opinions reflect pre-existing opinions and entrenched...

  7. Binning metagenomic contigs by coverage and composition

    NARCIS (Netherlands)

    Alneberg, J.; Bjarnason, B.S.; Bruijn, de I.; Schirmer, M.; Quick, J.; Ijaz, U.Z.; Lahti, L.M.; Loman, N.J.; Andersson, A.F.; Quince, C.

    2014-01-01

    Shotgun sequencing enables the reconstruction of genomes from complex microbial communities, but because assembly does not reconstruct entire genomes, it is necessary to bin genome fragments. Here we present CONCOCT, a new algorithm that combines sequence composition and coverage across multiple

  8. Synthetic sustained gene delivery systems.

    Science.gov (United States)

    Agarwal, Ankit; Mallapragada, Surya K

    2008-01-01

    Gene therapy today is hampered by the need of a safe and efficient gene delivery system that can provide a sustained therapeutic effect without cytotoxicity or unwanted immune responses. Bolus gene delivery in solution results in the loss of delivered factors via lymphatic system and may cause undesired effects by the escape of bioactive molecules to distant sites. Controlled gene delivery systems, acting as localized depot of genes, provide an extended sustained release of genes, giving prolonged maintenance of the therapeutic level of encoded proteins. They also limit the DNA degradation in the nuclease rich extra-cellular environment. While attempts have been made to adapt existing controlled drug delivery technologies, more novel approaches are being investigated for controlled gene delivery. DNA encapsulated in nano/micro spheres of polymers have been administered systemically/orally to be taken up by the targeted tissues and provide sustained release once internalized. Alternatively, DNA entrapped in hydrogels or scaffolds have been injected/implanted in tissues/cavities as platforms for gene delivery. The present review examines these different modalities for sustained delivery of viral and non-viral gene-delivery vectors. Design parameters and release mechanisms of different systems made with synthetic or natural polymers are presented along with their prospective applications and opportunities for continuous development.

  9. Health Newscasts for Increasing Influenza Vaccination Coverage: An Inductive Reasoning Game Approach

    Science.gov (United States)

    Breban, Romulus

    2011-01-01

    Both pandemic and seasonal influenza are receiving more attention from mass media than ever before. Topics such as epidemic severity and vaccination are changing the way in which we perceive the utility of disease prevention. Voluntary influenza vaccination has been recently modeled using inductive reasoning games. It has thus been found that severe epidemics may occur because individuals do not vaccinate and, instead, attempt to benefit from the immunity of their peers. Such epidemics could be prevented by voluntary vaccination if incentives were offered. However, a key assumption has been that individuals make vaccination decisions based on whether there was an epidemic each influenza season; no other epidemiological information is available to them. In this work, we relax this assumption and investigate the consequences of making more informed vaccination decisions while no incentives are offered. We obtain three major results. First, individuals will not cooperate enough to constantly prevent influenza epidemics through voluntary vaccination no matter how much they learned about influenza epidemiology. Second, broadcasting epidemiological information richer than whether an epidemic occurred may stabilize the vaccination coverage and suppress severe influenza epidemics. Third, the stable vaccination coverage follows the trend of the perceived benefit of vaccination. However, increasing the amount of epidemiological information released to the public may either increase or decrease the perceived benefit of vaccination. We discuss three scenarios where individuals know, in addition to whether there was an epidemic, (i) the incidence, (ii) the vaccination coverage and (iii) both the incidence and the vaccination coverage, every influenza season. We show that broadcasting both the incidence and the vaccination coverage could yield either better or worse vaccination coverage than broadcasting each piece of information on its own. PMID:22205944

  10. Health newscasts for increasing influenza vaccination coverage: an inductive reasoning game approach.

    Science.gov (United States)

    Breban, Romulus

    2011-01-01

    Both pandemic and seasonal influenza are receiving more attention from mass media than ever before. Topics such as epidemic severity and vaccination are changing the way in which we perceive the utility of disease prevention. Voluntary influenza vaccination has been recently modeled using inductive reasoning games. It has thus been found that severe epidemics may occur because individuals do not vaccinate and, instead, attempt to benefit from the immunity of their peers. Such epidemics could be prevented by voluntary vaccination if incentives were offered. However, a key assumption has been that individuals make vaccination decisions based on whether there was an epidemic each influenza season; no other epidemiological information is available to them. In this work, we relax this assumption and investigate the consequences of making more informed vaccination decisions while no incentives are offered. We obtain three major results. First, individuals will not cooperate enough to constantly prevent influenza epidemics through voluntary vaccination no matter how much they learned about influenza epidemiology. Second, broadcasting epidemiological information richer than whether an epidemic occurred may stabilize the vaccination coverage and suppress severe influenza epidemics. Third, the stable vaccination coverage follows the trend of the perceived benefit of vaccination. However, increasing the amount of epidemiological information released to the public may either increase or decrease the perceived benefit of vaccination. We discuss three scenarios where individuals know, in addition to whether there was an epidemic, (i) the incidence, (ii) the vaccination coverage and (iii) both the incidence and the vaccination coverage, every influenza season. We show that broadcasting both the incidence and the vaccination coverage could yield either better or worse vaccination coverage than broadcasting each piece of information on its own.

  11. Proton Therapy Coverage for Prostate Cancer Treatment

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Mahajan, Chaitali; Indelicato, Daniel; Fryer, Amber; Falchook, Aaron; Horne, David C.; Chellini, Angela; McKenzie, Craig C.; Lawlor, Paula C.; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the impact of prostate motion on dose coverage in proton therapy. Methods and Materials: A total of 120 prostate positions were analyzed on 10 treatment plans for 10 prostate patients treated using our low-risk proton therapy prostate protocol (University of Florida Proton Therapy Institute 001). Computed tomography and magnetic resonance imaging T 2 -weighted turbo spin-echo scans were registered for all cases. The planning target volume included the prostate with a 5-mm axial and 8-mm superoinferior expansion. The prostate was repositioned using 5- and 10-mm one-dimensional vectors and 10-mm multidimensional vectors (Points A-D). The beam was realigned for the 5- and 10-mm displacements. The prescription dose was 78 Gy equivalent (GE). Results: The mean percentage of rectum receiving 70 Gy (V 70 ) was 7.9%, the bladder V 70 was 14.0%, and the femoral head/neck V 50 was 0.1%, and the mean pelvic dose was 4.6 GE. The percentage of prostate receiving 78 Gy (V 78 ) with the 5-mm movements changed by -0.2% (range, 0.006-0.5%, p > 0.7). However, the prostate V 78 after a 10-mm displacement changed significantly (p 78 coverage had a large and significant reduction of 17.4% (range, 13.5-17.4%, p 78 coverage of the clinical target volume. The minimal prostate dose was reduced 33% (25.8 GE), on average, for Points A-D. The prostate minimal dose improved from 69.3 GE to 78.2 GE (p < 0.001) with realignment for 10-mm movements. Conclusion: The good dose coverage and low normal doses achieved for the initial plan was maintained with movements of ≤5 mm. Beam realignment improved coverage for 10-mm displacements

  12. 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

  13. Reinfection immunity in schistosomiasis

    International Nuclear Information System (INIS)

    Kamiya, Haruo

    1987-01-01

    Schistosomiasis is one of the most important parasitic diseases in the world, especially in endemic areas of developing countries. This situation has prompted parasitologist to attempt intensive researches on immune mechanisms, especially those of reinfection immunity associated with eliminating challenge infection. The current knowledge of reinfection immunity against Schistosoma spp. infection was therefore reviewed briefly and discussed with special reference to our data on protective immune responses induced by radiation-attenuated cercarial infection. A recently developed technique of compressed organ autoradiography (COA) has contributed to assessing parasite attrition in immune animals following challenge infection. Our study using COA has demonstrated that major attrition of schistosomula from challenge infection occurs in the skin of CBA/Ca mice vaccinated with 20 Krad gamma radiation-attenuated cercariae of S. mansoni, while in both lungs and liver of similarly vaccinated guinea pig model. Furthermore, gamma-irradiation to cercariae affected their migration potential and surface-antigen profiles. The immunizing stimuli of gamma radiation-attenuated cercariae profoundly affected the expression of responsiveness in vaccinated animals. The change in antigenic profiles and migration potential of those vaccinating population was discussed in relation to the kinetics of reinfection immunity induced in vaccinated amimal models. These works might provide a base line data to develop a practical vaccine for schistosomiasis using defined antigens. It must be emphasized that these vaccines could serve as a practical prophylactic measure for schistosomiasis in the endemic areas, even if the vaccines fail to induce sterilizing immunity. (author). 141 refs

  14. Ethics of Immunization

    NARCIS (Netherlands)

    Verweij, M.F.; Quah, S.R.; Cockerham, W.C.

    2017-01-01

    Collective immunization can be highly effective in protecting societies against infectious diseases, but policy decisions about both the character and the content of immunization policies require ethical justification. This article offers an overview of ethical aspects that should be taken into

  15. Immunity and skin cancer

    International Nuclear Information System (INIS)

    Smith, E.B.; Brysk, M.M.

    1981-01-01

    Observations in humans and animal studies support the theory that immunologic surveillance plays an important role in limiting the development of skin malignancies. These immune responses undergo progressive diminution with age. In addition, other factors, such as bereavement, poor nutrition, and acute and chronic exposure to ultraviolet light, can further diminish immune mechanisms

  16. Immunizations. Position Statement. Revised

    Science.gov (United States)

    Bobo, Nichole; Garrett, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy; Burrows-Mezu, Alicia L.

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood. Promotion of immunizations by the registered professional school nurse (hereinafter referred to as school nurse) is central to the public health focus of school nursing practice…

  17. Neural circuitry and immunity

    Science.gov (United States)

    Pavlov, Valentin A.; Tracey, Kevin J.

    2015-01-01

    Research during the last decade has significantly advanced our understanding of the molecular mechanisms at the interface between the nervous system and the immune system. Insight into bidirectional neuroimmune communication has characterized the nervous system as an important partner of the immune system in the regulation of inflammation. Neuronal pathways, including the vagus nerve-based inflammatory reflex are physiological regulators of immune function and inflammation. In parallel, neuronal function is altered in conditions characterized by immune dysregulation and inflammation. Here, we review these regulatory mechanisms and describe the neural circuitry modulating immunity. Understanding these mechanisms reveals possibilities to use targeted neuromodulation as a therapeutic approach for inflammatory and autoimmune disorders. These findings and current clinical exploration of neuromodulation in the treatment of inflammatory diseases defines the emerging field of Bioelectronic Medicine. PMID:26512000

  18. Methods for estimating population coverage of mass distribution programmes: a review of practices in relation to trachoma control.

    Science.gov (United States)

    Cromwell, Elizabeth A; Ngondi, Jeremiah; McFarland, Deborah; King, Jonathan D; Emerson, Paul M

    2012-10-01

    In the context of trachoma control, population coverage with mass drug administration (MDA) using antibiotics is measured using routine data. Due to the limitations of administrative records as well as the potential for bias from incomplete or incorrect records, a literature review of coverage survey methods applied in neglected tropical disease control programmes and immunisation outreach was conducted to inform the design of coverage surveys for trachoma control. Several methods were identified, including the '30 × 7' survey method for the Expanded Programme on Immunization (EPI 30×7), other cluster random sampling (CRS) methods, lot quality assurance sampling (LQAS), purposive sampling and routine data. When compared against one another, the EPI and other CRS methods produced similar population coverage estimates, whilst LQAS, purposive sampling and use of administrative data did not generate estimates consistent with CRS. In conclusion, CRS methods present a consistent approach for MDA coverage surveys despite different methods of household selection. They merit use until standard guidelines are available. CRS methods should be used to verify population coverage derived from LQAS, purposive sampling methods and administrative reports. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  19. Sustainable NREL - Site Sustainability Plan FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-01-01

    NREL's Site Sustainability Plan FY 2015 reports on sustainability plans for the lab for the year 2015 based on Executive Order Goals and provides the status on planned actions cited in the FY 2014 report.

  20. The immortality of humoral immunity.

    Science.gov (United States)

    Elgueta, Raul; de Vries, Victor C; Noelle, Randolph J

    2010-07-01

    Decades of high-titered antibody are sustained due to the persistence of memory B cells and long-lived plasma cells (PCs). The differentiation of each of these subsets is antigen- and T-cell driven and is dependent on signals acquired and integrated during the germinal center response. Inherent in the primary immune response must be the delivery of signals to B cells to create these populations, which have virtual immortality. Differences in biology and chemotactic behavior disperse memory B cells and long-lived PCs to a spectrum of anatomic sites. Each subset must rely on survival factors that can support their longevity. This review focuses on the generation of each of these subsets, their survival, and renewal, which must occur to sustain serological memory. In this context, we discuss the role of antigen, bystander inflammation, and cellular niches. The contribution of BAFF (B-cell activating factor belonging to the tumor necrosis factor family) and APRIL (a proliferation-inducing ligand) to the persistence of memory B cells and PCs are also detailed. Insights that have been provided over the past few years in the regulation of long-lived B-cell responses will have profound impact on vaccine development, the treatment of pre-sensitized patients for organ transplantation, and therapeutic interventions in both antibody- and T-cell-mediated autoimmunity.

  1. Effects of coverage gap reform on adherence to diabetes medications.

    Science.gov (United States)

    Zeng, Feng; Patel, Bimal V; Brunetti, Louis

    2013-04-01

    To investigate the impact of Part D coverage gap reform on diabetes medication adherence. Retrospective data analysis based on pharmacy claims data from a national pharmacy benefit manager. We used a difference-in-difference-indifference method to evaluate the impact of coverage gap reform on adherence to diabetes medications. Two cohorts (2010 and 2011) were constructed to represent the last year before Affordable Care Act (ACA) reform and the first year after reform, respectively. Each patient had 2 observations: 1 before and 1 after entering the coverage gap. Patients in each cohort were divided into groups based on type of gap coverage: no coverage, partial coverage (generics only), and full coverage. Following ACA reform, patients with no gap coverage and patients with partial gap coverage experienced substantial drops in copayments in the coverage gap in 2011. Their adherence to diabetes medications in the gap, measured by percentage of days covered, improved correspondingly (2.99 percentage points, 95% confidence interval [CI] 0.49-5.48, P = .019 for patients with no coverage; 6.46 percentage points, 95% CI 3.34-9.58, P gap in 2011. However, their adherence did not increase (-0.13 percentage point, P = .8011). In the first year of ACA coverage gap reform, copayments in the gap decreased substantially for all patients. Patients with no coverage and patients with partial coverage in the gap had better adherence in the gap in 2011.

  2. Financial incentives and coverage of child health interventions: a systematic review and meta-analysis.

    Science.gov (United States)

    Bassani, Diego G; Arora, Paul; Wazny, Kerri; Gaffey, Michelle F; Lenters, Lindsey; Bhutta, Zulfiqar A

    2013-01-01

    Financial incentives are widely used strategies to alleviate poverty, foster development, and improve health. Cash transfer programs, microcredit, user fee removal policies and voucher schemes that provide direct or indirect monetary incentives to households have been used for decades in Latin America, Sub-Saharan Africa, and more recently in Southeast Asia. Until now, no systematic review of the impact of financial incentives on coverage and uptake of health interventions targeting children under 5 years of age has been conducted. The objective of this review is to provide estimates on the effect of six types of financial incentive programs: (i) Unconditional cash transfers (CT), (ii) Conditional cash transfers (CCT), (iii) Microcredit (MC), (iv) Conditional Microcredit (CMC), (v) Voucher schemes (VS) and (vi) User fee removal (UFR) on the uptake and coverage of health interventions targeting children under the age of five years. We conducted systematic searches of a series of databases until September 1st, 2012, to identify relevant studies reporting on the impact of financial incentives on coverage of health interventions and behaviors targeting children under 5 years of age. The quality of the studies was assessed using the CHERG criteria. Meta-analyses were undertaken to estimate the effect when multiple studies meeting our inclusion criteria were available. Our searches resulted in 1671 titles identified 25 studies reporting on the impact of financial incentive programs on 5 groups of coverage indicators: breastfeeding practices (breastfeeding incidence, proportion of children receiving colostrum and early initiation of breastfeeding, exclusive breastfeeding for six months and duration of breastfeeding); vaccination (coverage of full immunization, partial immunization and specific antigens); health care use (seeking healthcare when child was ill, visits to health facilities for preventive reasons, visits to health facilities for any reason, visits for health

  3. The Microbiome and Sustainable Healthcare

    Science.gov (United States)

    Dietert, Rodney R.; Dietert, Janice M.

    2015-01-01

    Increasing prevalences, morbidity, premature mortality and medical needs associated with non-communicable diseases and conditions (NCDs) have reached epidemic proportions and placed a major drain on healthcare systems and global economies. Added to this are the challenges presented by overuse of antibiotics and increased antibiotic resistance. Solutions are needed that can address the challenges of NCDs and increasing antibiotic resistance, maximize preventative measures, and balance healthcare needs with available services and economic realities. Microbiome management including microbiota seeding, feeding, and rebiosis appears likely to be a core component of a path toward sustainable healthcare. Recent findings indicate that: (1) humans are mostly microbial (in terms of numbers of cells and genes); (2) immune dysfunction and misregulated inflammation are pivotal in the majority of NCDs; (3) microbiome status affects early immune education and risk of NCDs, and (4) microbiome status affects the risk of certain infections. Management of the microbiome to reduce later-life health risk and/or to treat emerging NCDs, to spare antibiotic use and to reduce the risk of recurrent infections may provide a more effective healthcare strategy across the life course particularly when a personalized medicine approach is considered. This review will examine the potential for microbiome management to contribute to sustainable healthcare. PMID:27417751

  4. Evaluation of a poliomyelitis immunization campaign in Madras city.

    Science.gov (United States)

    Balraj, V; John, T J

    1986-01-01

    An annual pulse immunization campaign with oral polio vaccine (OPV) was evaluated to determine vaccine coverage, relative success of publicity methods and reasons for lack of response. The campaign was directed at 3-36 month olds in Madras city, India, in January-March 1985. The evaluation method was the "30-cluster" sample survey technique, designed by WHO, where surveys were done in 30 districts of the city on 10 children in each age group. The survey was conducted in April 1985 by 5 trained and supervised interviewers. This campaign increased the vaccine coverage to 94%, 88% and 72% for first, second and third doses of OPV. Coverage was higher in older children. Percent coverage decreased slightly over 1-3 doses, and from there rapidly up to 6-7 doses. The campaign accounted for 27% of all the OPV the study children had received. 47% of parents heard about the vaccination through word of mouth, either from health workers, volunteers or "balwadi ayahs," women day-care workers. 17% learned through television or radio. 3% cited mobile loudspeakers, handbills, posters or slides in cinemas. Many parents did not avail themselves of the vaccine because they believed that 3 doses are sufficient. Actually the WHO recommends 4 doses; the Indian Academy of Pediatrics recommends 5 doses; while criteria from research on Indian children would suggest that 5-7 doses are required to raise strong immunity.

  5. Universal varicella vaccine immunization in Japan.

    Science.gov (United States)

    Yoshikawa, Tetsushi; Kawamura, Yoshiki; Ohashi, Masahiro

    2016-04-07

    In 1974, Japanese scientists developed a live attenuated varicella vaccine based on the Oka strain. The efficacy of the vaccine for the prevention of varicella has been primarily demonstrated in studies conducted in the United States following the adoption of universal immunization using the Oka strain varicella vaccine in 1996. Although the vaccine was developed by Japanese scientists, until recently, the vaccine has been administered on a voluntary basis in Japan resulting in a vaccine coverage rate of approximately 40%. Therefore, Japan initiated universal immunization using the Oka strain varicella vaccine in November 2014. Given the transition from voluntary to universal immunization in Japan, it will also be important to monitor the epidemiology of varicella and herpes zoster. The efficacy and safety of co-administration of the varicella vaccine and measles, mumps, and rubella vaccine have been demonstrated in many countries; however, there was no data from Japan. In order to adopt the practice of universal immunization using the Oka strain varicella vaccine in Japan, data demonstrating the efficacy and safety of co-administration of varicella vaccine and measles and rubella (MR) vaccine were required. Additionally, we needed to elucidate the appropriate time interval between the first and second administrations of the vaccine. It is also important to differentiate between wild type and Oka vaccine type strains in herpes zoster patient with past history of varicella vaccine. Thus, there are many factors to consider regarding the adoption of universal immunization in Japan to control varicella zoster virus (VZV) infections. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Strategies for sustainability and equity of prepayment health ...

    African Journals Online (AJOL)

    Background: Despite the long existence of community health insurance schemes (CHI) in Uganda, their numbers and coverage levels have remained small with limited accessibility by the poor. Objectives: To examine issues of equity and sustainability in CHI schemes, which are prerequisites to health sector financing.

  7. Universal health coverage in Rwanda: dream or reality.

    Science.gov (United States)

    Nyandekwe, Médard; Nzayirambaho, Manassé; Baptiste Kakoma, Jean

    2014-01-01

    Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors. The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing. Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.

  8. 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.

  9. Sustainability : Politics and governance

    NARCIS (Netherlands)

    Heinrichs, Harald; Biermann, Frank

    2016-01-01

    he article gives an overview of global sustainability policy and politics. It is shown how international policy making on sustainable development has progressed from environmental policy toward recent approaches of Earth system governance. Key challenges of international sustainability politics are

  10. Sustainability in Transport Planning

    DEFF Research Database (Denmark)

    Gudmundsson, Henrik; Greve, Carsten

    Contribution to session J: Joint University Sustainability Initiatives. This session will provide an inspiring overview of interdisciplinary research and teaching activities on sustainability bridging DTU, KU, and CBS, and introduce the joint collaboration Copenhagen Sustainability Initiative (COSI...

  11. Sustainable Supply Chain Design in Social Businesses

    DEFF Research Database (Denmark)

    Tate, Wendy L.; Bals, Lydia

    2018-01-01

    A significant conceptual and practical challenge for companies is how to integrate triple bottom line (TBL) sustainability into their global supply chains. In supply chain research, the classic economic perspective—the business of business is to be profitable—still dominates, followed by coverage......, how to connect these insights into supply chain design for TBL sustainability has not been studied. Therefore, the purpose of this research was to move the theory of supply chain forward into the sustainable supply chain management (SSCM) research agenda. Toward that purpose, the paper analyzes...... of the environmental dimension; the social dimension is underrepresented. Stakeholders, however, are calling for a TBL perspective that simultaneously includes environmental, social, and economic gains. While there have been recent theoretical advances on how to characterize supply chains in terms of their structure...

  12. SPECIALIZATION AND SUSTAINABLE DEVELOPMENT OF AGRICULTURAL HOLDINGS

    Directory of Open Access Journals (Sweden)

    Zofia Kołoszko-Chomentowska

    2016-03-01

    Full Text Available In the present article, an attempt was made to assess the sustainability of agricultural holdings with diff erent directions of production. Agricultural holdings in the Podlaskie voivodeship registered in the FADN system in 2011–2012 were investigated. Assessment accounted for agroecological indicators (share of permanent grasslands, share of cereals in crops, soil coverage with vegetation, stock density and economic indicators (profi tableness of land and labor. Analysis was conducted according to a classifi cation into agricultural holding types: fi eldcrops, dairy cattle, and granivores. Fieldcrop and granivore holdings achieved more favourable environmental sustainability indicators. Holdings specializing in dairy cattle breeding posed a threat to the natural environment, mainly due to their excessive stock density. Economic sustainability assessment showed that granivore holdings were assessed most favorably. In these holdings, holding income per full-time worker was 37% greater than in fi eldcrop holdings and 57% greater than in dairy cattle holdings.

  13. Textiles and clothing sustainability sustainable technologies

    CERN Document Server

    2017-01-01

    This is the first book to deal with the innovative technologies in the field of textiles and clothing sustainability. It details a number of sustainable and innovative technologies and highlights their implications in the clothing sector. There are currently various measures to achieve sustainability in the textiles and the clothing industry, including innovations in the manufacturing stage, which is the crux of this book.

  14. Sustainable diets within sustainable food systems.

    Science.gov (United States)

    Meybeck, Alexandre; Gitz, Vincent

    2017-02-01

    Sustainable diets and sustainable food systems are increasingly explored by diverse scientific disciplines. They are also recognised by the international community and called upon to orient action towards the eradication of hunger and malnutrition and the fulfilment of sustainable development goals. The aim of the present paper is to briefly consider some of the links between these two notions in order to facilitate the operationalisation of the concept of sustainable diet. The concept of sustainable diet was defined in 2010 combining two totally different perspectives: a nutrition perspective, focused on individuals, and a global sustainability perspective, in all its dimensions: environmental, economic and social. The nutrition perspective can be easily related to health outcomes. The global sustainability perspective is more difficult to analyse directly. We propose that it be measured as the contribution of a diet to the sustainability of food systems. Such an approach, covering the three dimensions of sustainability, enables identification of interactions and interrelations between food systems and diets. It provides opportunities to find levers of change towards sustainability. Diets are both the results and the drivers of food systems. The drivers of change for those variously involved, consumers and private individuals, are different, and can be triggered by different dimensions (heath, environment, social and cultural). Combining different dimensions and reasons for change can help facilitate the transition to sustainable diets, recognising the food system's specificities. The adoption of sustainable diets can be facilitated and enabled by food systems, and by appropriate policies and incentives.

  15. Vaccination Coverage Among Children Aged 2 Years - U.S. Affiliated Pacific Islands, April-October, 2016.

    Science.gov (United States)

    Tippins, Ashley; Murthy, Neil; Meghani, Mehreen; Solsman, Amy; Apaisam, Carter; Basilius, Merlyn; Eckert, Maribeth; Judicpa, Peter; Masunu, Yolanda; Pistotnik, Kelsey; Pedro, Daisy; Sasamoto, Jeremy; Underwood, J Michael

    2018-05-25

    Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, † USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau). § Differences in vaccination coverage between main and outer islands ¶ were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ≥3 doses of inactivated poliovirus vaccine (IPV); ≥1 dose of measles, mumps, and rubella vaccine (MMR); ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; ≥3 doses of hepatitis B (HepB) vaccine; and ≥4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ≥3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines †† was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions

  16. An Evaluation of Voluntary Varicella Vaccination Coverage in Zhejiang Province, East China

    Directory of Open Access Journals (Sweden)

    Yu Hu

    2016-06-01

    Full Text Available Background: In 2014 a 2-doses varicella vaccine (VarV schedule was recommended by the Zhejiang Provincial Center for Disease Control and Prevention. We aimed to assess the coverage of the 1st dose of VarV (VarV1 and the 2nd dose of VarV (VarV2 among children aged 2–6 years through the Zhejiang Provincial Immunization Information System (ZJIIS and to explore the determinants associated with the VarV coverage. Methods: Children aged 2–6 years (born from 1 January 2009 to 31 December 2013 registered in ZJIIS were enrolled. Anonymized individual records of target children were extracted from the ZJIIS database on 1 January 2016, including their VarV and (measles-containing vaccine MCV vaccination information. The VarV1 and VarV2 coverage rates were evaluated for each birth cohorts. The coverage of VarV also was estimated among strata defined by cities, gender and immigration status. We also evaluated the difference in coverage between VarV and MCV. Results: A total of 3,028,222 children aged 2–6 years were enrolled. The coverage of VarV1 ranged from 84.8% to 87.9% in the 2009–2013 birth cohorts, while the coverage of VarV2 increased from 31.8% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Higher coverage rates for both VarV1 and VarV2 were observed among resident children in relevant birth cohorts. The coverage rates of VarV1 and VarV2 were lower than those for the 1st and 2nd dose of MCV, which were above 95%. The proportion of children who were vaccinated with VarV1 at the recommended age increased from 34.6% for the 2009 birth cohort to 75.2% for the 2013 birth cohort, while the proportion of children who were vaccinated with VarV2 at the recommended age increased from 19.7% for the 2009 birth cohort to 48.7% for the 2011 birth cohort. Conclusions: Our study showed a rapid increasing VarV2 coverage of children, indicating a growing acceptance of the 2-doses VarV schedule among children’s caregivers and physicians after

  17. A long way to go - Estimates of combined water, sanitation and hygiene coverage for 25 sub-Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Rachel Roche

    Full Text Available Water, sanitation and hygiene (WASH are essential for a healthy and dignified life. International targets to reduce inadequate WASH coverage were set under the Millennium Development Goals (MDGs, 1990-2015 and now the Sustainable Development Goals (SDGs, 2016-2030. The MDGs called for halving the proportion of the population without access to adequate water and sanitation, whereas the SDGs call for universal access, require the progressive reduction of inequalities, and include hygiene in addition to water and sanitation. Estimating access to complete WASH coverage provides a baseline for monitoring during the SDG period. Sub-Saharan Africa (SSA has among the lowest rates of WASH coverage globally.The most recent available Demographic Household Survey (DHS or Multiple Indicator Cluster Survey (MICS data for 25 countries in SSA were analysed to estimate national and regional coverage for combined water and sanitation (a combined MDG indicator for 'improved' access and combined water with collection time within 30 minutes plus sanitation and hygiene (a combined SDG indicator for 'basic' access. Coverage rates were estimated separately for urban and rural populations and for wealth quintiles. Frequency ratios and percentage point differences for urban and rural coverage were calculated to give both relative and absolute measures of urban-rural inequality. Wealth inequalities were assessed by visual examination of coverage across wealth quintiles in urban and rural populations and by calculating concentration indices as standard measures of relative wealth related inequality that give an indication of how unevenly a health indicator is distributed across the wealth distribution.Combined MDG coverage in SSA was 20%, and combined basic SDG coverage was 4%; an estimated 921 million people lacked basic SDG coverage. Relative measures of inequality were higher for combined basic SDG coverage than combined MDG coverage, but absolute inequality was lower

  18. A long way to go - Estimates of combined water, sanitation and hygiene coverage for 25 sub-Saharan African countries.

    Science.gov (United States)

    Roche, Rachel; Bain, Robert; Cumming, Oliver

    2017-01-01

    Water, sanitation and hygiene (WASH) are essential for a healthy and dignified life. International targets to reduce inadequate WASH coverage were set under the Millennium Development Goals (MDGs, 1990-2015) and now the Sustainable Development Goals (SDGs, 2016-2030). The MDGs called for halving the proportion of the population without access to adequate water and sanitation, whereas the SDGs call for universal access, require the progressive reduction of inequalities, and include hygiene in addition to water and sanitation. Estimating access to complete WASH coverage provides a baseline for monitoring during the SDG period. Sub-Saharan Africa (SSA) has among the lowest rates of WASH coverage globally. The most recent available Demographic Household Survey (DHS) or Multiple Indicator Cluster Survey (MICS) data for 25 countries in SSA were analysed to estimate national and regional coverage for combined water and sanitation (a combined MDG indicator for 'improved' access) and combined water with collection time within 30 minutes plus sanitation and hygiene (a combined SDG indicator for 'basic' access). Coverage rates were estimated separately for urban and rural populations and for wealth quintiles. Frequency ratios and percentage point differences for urban and rural coverage were calculated to give both relative and absolute measures of urban-rural inequality. Wealth inequalities were assessed by visual examination of coverage across wealth quintiles in urban and rural populations and by calculating concentration indices as standard measures of relative wealth related inequality that give an indication of how unevenly a health indicator is distributed across the wealth distribution. Combined MDG coverage in SSA was 20%, and combined basic SDG coverage was 4%; an estimated 921 million people lacked basic SDG coverage. Relative measures of inequality were higher for combined basic SDG coverage than combined MDG coverage, but absolute inequality was lower. Rural

  19. Environmental conditions in health care facilities in low- and middle-income countries: Coverage and inequalities.

    Science.gov (United States)

    Cronk, Ryan; Bartram, Jamie

    2018-04-01

    Safe environmental conditions and the availability of standard precaution items are important to prevent and treat infection in health care facilities (HCFs) and to achieve Sustainable Development Goal (SDG) targets for health and water, sanitation, and hygiene. Baseline coverage estimates for HCFs have yet to be formed for the SDGs; and there is little evidence describing inequalities in coverage. To address this, we produced the first coverage estimates of environmental conditions and standard precaution items in HCFs in low- and middle-income countries (LMICs); and explored factors associated with low coverage. Data from monitoring reports and peer-reviewed literature were systematically compiled; and information on conditions, service levels, and inequalities tabulated. We used logistic regression to identify factors associated with low coverage. Data for 21 indicators of environmental conditions and standard precaution items were compiled from 78 LMICs which were representative of 129,557 HCFs. 50% of HCFs lack piped water, 33% lack improved sanitation, 39% lack handwashing soap, 39% lack adequate infectious waste disposal, 73% lack sterilization equipment, and 59% lack reliable energy services. Using nationally representative data from six countries, 2% of HCFs provide all four of water, sanitation, hygiene, and waste management services. Statistically significant inequalities in coverage exist between HCFs by: urban-rural setting, managing authority, facility type, and sub-national administrative unit. We identified important, previously undocumented inequalities and environmental health challenges faced by HCFs in LMICs. The information and analyses provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources. Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.

  20. [Options for flap coverage in pressure sores].

    Science.gov (United States)

    Nae, S; Antohi, N; Stîngu, C; Stan, V; Parasca, S

    2010-01-01

    Despite improvements in reconstructive techniques for pressure sores, recurrences are still seen frequently, and success rate remains variable. During 2003 - 2007, at the Emergency Hospital for Plastic Surgery and Burns in Bucharest, 27 patients underwent surgical repair of 45 pressure sores located at sacral (22 ulcers), ischial (12 ulcers) and trochanteric (11 ulcers) regions. The mean patient age was 57, 1 years (range 26 to 82 years). Mean postoperative follow-up was 6 months (range 2 months - 2 years). There were 18 complications for the 45 sores (40%). At 6 months postoperatively, recurrence was noted in 12 ulcers (27%). Details regarding indications, contraindications, advantages and disadvantages for different coverage options are outlined. The authors advocate the importance of surgical coverage in reducing morbidity, mortality and treatment costs.

  1. Tackling the Sustainability Dilemma: A Holistic Approach to Preparing Students for the Professional Organization

    Science.gov (United States)

    Mabry, Sibylle

    2011-01-01

    Increased knowledge of business sustainability as the basis of a holistic approach to value creation has inspired many managers to integrate ecological and social stewardship into their strategic business innovation plans. However, the coverage of sustainability issues in business courses remains small at many universities. This article…

  2. On Modelling an Immune System

    OpenAIRE

    Monroy, Raúl; Saab, Rosa; Godínez, Fernando

    2004-01-01

    Immune systems of live forms have been an abundant source of inspiration to contemporary computer scientists. Problem solving strategies, stemming from known immune system phenomena, have been successfully applied to challenging problems of modern computing. However, research in artificial immune systems has overlooked establishing a coherent model of known immune system behaviour. This paper aims reports on an preliminary computer model of an immune system, where each immune system component...

  3. Success Story of Mission Indradhanush: A Road to Achieve Universal Immunization

    OpenAIRE

    Bashar MA

    2016-01-01

    In order to improve the improve the immunization coverage of children under 2 years of age and to provide universal immunization to children from migratory population, Government of India launched mission Indradhanush in December 2014 as a special drive to vaccinate all unvaccinated and partially vaccinated children and pregnant women by 2020. A total of 201 high focus districts where more than 50% of the total unvaccinated or partially vaccinated children live were identified for covering un...

  4. Rebuilding immunity with Remune.

    Science.gov (United States)

    Whitfield, L

    1998-01-01

    Remune, an immune response therapy composed of inactivated HIV, is designed to enhance the immune system's ability to recognize and kill HIV proteins. Developed by Dr. Jonas Salk, researchers hope Remune's actions can alter the course of HIV infection and slow disease progression. Remune has gained Food and Drug Administration (FDA) approval to enter the critical Phase III trial stage. Two clinical trials are tracking Remune's immunogenicity (ability to provoke an immune response), its immunogenicity relative to dose level, and its effect on viral load. An ongoing trial, approved in February of 1996, enrolled 2,500 patients at 74 sites. The manufacturer, Immune Response Corporation (IRC), announced earlier this year that treatment with Remune induces an immune response to HIV that cross-reacts with different strains of the virus. This immune response is crucial for developing an effective worldwide treatment. Remune decreases levels of tumor necrosis factor alpha (TNF-a). IRC recently began a Phase I clinical trial in Great Britain that combines Remune with a protease inhibitor, two antiviral nucleoside analogues, and Interleukin-2. The trial is designed to determine the role that the drug may play in restoring immune response.

  5. Worker Sorting, Taxes and Health Insurance Coverage

    OpenAIRE

    Kevin Lang; Hong Kang

    2007-01-01

    We develop a model in which firms hire heterogeneous workers but must offer all workers insurance benefits under similar terms. In equilibrium, some firms offer free health insurance, some require an employee premium payment and some do not offer insurance. Making the employee contribution pre-tax lowers the cost to workers of a given employee premium and encourages more firms to charge. This increases the offer rate, lowers the take-up rate, increases (decreases) coverage among high (low) de...

  6. 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.

  7. National Network for Immunization Information

    Science.gov (United States)

    ... American College of Obstetricians and Gynecologists . © Copyright National Network for Immunization Information. The information contained in the National Network for Immunization Information Web site should not be ...

  8. Comparative analysis of the effectiveness of three immunization strategies in controlling disease outbreaks in realistic social networks.

    Directory of Open Access Journals (Sweden)

    Zhijing Xu

    Full Text Available The high incidence of emerging infectious diseases has highlighted the importance of effective immunization strategies, especially the stochastic algorithms based on local available network information. Present stochastic strategies are mainly evaluated based on classical network models, such as scale-free networks and small-world networks, and thus are insufficient. Three frequently referred stochastic immunization strategies-acquaintance immunization, community-bridge immunization, and ring vaccination-were analyzed in this work. The optimal immunization ratios for acquaintance immunization and community-bridge immunization strategies were investigated, and the effectiveness of these three strategies in controlling the spreading of epidemics were analyzed based on realistic social contact networks. The results show all the strategies have decreased the coverage of the epidemics compared to baseline scenario (no control measures. However the effectiveness of acquaintance immunization and community-bridge immunization are very limited, with acquaintance immunization slightly outperforming community-bridge immunization. Ring vaccination significantly outperforms acquaintance immunization and community-bridge immunization, and the sensitivity analysis shows it could be applied to controlling the epidemics with a wide infectivity spectrum. The effectiveness of several classical stochastic immunization strategies was evaluated based on realistic contact networks for the first time in this study. These results could have important significance for epidemic control research and practice.

  9. Comparative analysis of the effectiveness of three immunization strategies in controlling disease outbreaks in realistic social networks.

    Science.gov (United States)

    Xu, Zhijing; Zu, Zhenghu; Zheng, Tao; Zhang, Wendou; Xu, Qing; Liu, Jinjie

    2014-01-01

    The high incidence of emerging infectious diseases has highlighted the importance of effective immunization strategies, especially the stochastic algorithms based on local available network information. Present stochastic strategies are mainly evaluated based on classical network models, such as scale-free networks and small-world networks, and thus are insufficient. Three frequently referred stochastic immunization strategies-acquaintance immunization, community-bridge immunization, and ring vaccination-were analyzed in this work. The optimal immunization ratios for acquaintance immunization and community-bridge immunization strategies were investigated, and the effectiveness of these three strategies in controlling the spreading of epidemics were analyzed based on realistic social contact networks. The results show all the strategies have decreased the coverage of the epidemics compared to baseline scenario (no control measures). However the effectiveness of acquaintance immunization and community-bridge immunization are very limited, with acquaintance immunization slightly outperforming community-bridge immunization. Ring vaccination significantly outperforms acquaintance immunization and community-bridge immunization, and the sensitivity analysis shows it could be applied to controlling the epidemics with a wide infectivity spectrum. The effectiveness of several classical stochastic immunization strategies was evaluated based on realistic contact networks for the first time in this study. These results could have important significance for epidemic control research and practice.

  10. Assessing Requirements Quality through Requirements Coverage

    Science.gov (United States)

    Rajan, Ajitha; Heimdahl, Mats; Woodham, Kurt

    2008-01-01

    In model-based development, the development effort is centered around a formal description of the proposed software system the model. This model is derived from some high-level requirements describing the expected behavior of the software. For validation and verification purposes, this model can then be subjected to various types of analysis, for example, completeness and consistency analysis [6], model checking [3], theorem proving [1], and test-case generation [4, 7]. This development paradigm is making rapid inroads in certain industries, e.g., automotive, avionics, space applications, and medical technology. This shift towards model-based development naturally leads to changes in the verification and validation (V&V) process. The model validation problem determining that the model accurately captures the customer's high-level requirements has received little attention and the sufficiency of the validation activities has been largely determined through ad-hoc methods. Since the model serves as the central artifact, its correctness with respect to the users needs is absolutely crucial. In our investigation, we attempt to answer the following two questions with respect to validation (1) Are the requirements sufficiently defined for the system? and (2) How well does the model implement the behaviors specified by the requirements? The second question can be addressed using formal verification. Nevertheless, the size and complexity of many industrial systems make formal verification infeasible even if we have a formal model and formalized requirements. Thus, presently, there is no objective way of answering these two questions. To this end, we propose an approach based on testing that, when given a set of formal requirements, explores the relationship between requirements-based structural test-adequacy coverage and model-based structural test-adequacy coverage. The proposed technique uses requirements coverage metrics defined in [9] on formal high-level software

  11. Immunity: Insect Immune Memory Goes Viral.

    Science.gov (United States)

    Ligoxygakis, Petros

    2017-11-20

    Adaptive memory in insect immunity has been controversial. In this issue, Andino and co-workers propose that acquisition of viral sequences in the host genome gives rise to anti-sense, anti-viral piRNAs. Such sequences can be regarded as both a genomic archive of past infections and as an armour of potential heritable memory. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. An analysis of the policy coverage and examination of ...

    African Journals Online (AJOL)

    ... topics in subjects such as Life Sciences, Physical Sciences, Life Orientation, ... The aim of the research reported here was to investigate the coverage and ... In analysing the coverage and examination of environmental-impact topics, ...

  13. Assessment of Effective Coverage of Voluntary Counseling and ...

    African Journals Online (AJOL)

    Assessment of Effective Coverage of Voluntary Counseling and Testing ... The objective of this study was to assess effective coverage level for Voluntary Counseling and testing services in major health facilities ... AJOL African Journals Online.

  14. Determinants of vaccination coverage among pastoralists in north ...

    African Journals Online (AJOL)

    Determinants of vaccination coverage among pastoralists in north eastern Kenya. ... Attitudes, and Practices (KAPs) on vaccination coverage among settled and ... We used a structured instrument to survey pastoralist mothers with children ...

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

    Science.gov (United States)

    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.

  16. Population immunity to measles virus and the effect of HIV-1 infection after a mass measles vaccination campaign in Lusaka, Zambia: a cross-sectional survey.

    Science.gov (United States)

    Lowther, Sara A; Curriero, Frank C; Kalish, Brian T; Shields, Timothy M; Monze, Mwaka; Moss, William J

    2009-03-21

    Measles control efforts are hindered by challenges in sustaining high vaccination coverage, waning immunity in HIV-1-infected children, and clustering of susceptible individuals. Our aim was to assess population immunity to measles virus after a mass vaccination campaign in a region with high HIV prevalence. 3 years after a measles supplemental immunisation activity (SIA), we undertook a cross-sectional survey in Lusaka, Zambia. Households were randomly selected from a satellite image. Children aged 9 months to 5 years from selected households were eligible for enrolment. A questionnaire was administered to the children's caregivers to obtain information about measles vaccination history and history of measles. Oral fluid samples were obtained from children and tested for antibodies to measles virus and HIV-1 by EIA. 1015 children from 668 residences provided adequate specimens. 853 (84%) children had a history of measles vaccination according to either caregiver report or immunisation card. 679 children (67%) had antibodies to measles virus, and 64 (6%) children had antibodies to HIV-1. Children with antibodies to HIV-1 were as likely to have no history of measles vaccination as those without antibodies to HIV-1 (odds ratio [OR] 1.17, 95% CI 0.57-2.41). Children without measles antibodies were more likely to have never received measles vaccine than those with antibodies (adjusted OR 2.50, 1.69-3.71). In vaccinated children, 33 (61%) of 54 children with antibodies to HIV-1 also had antibodies to measles virus, compared with 568 (71%) of 796 children without antibodies to HIV-1 (p=0.1). 3 years after an SIA, population immunity to measles was insufficient to interrupt measles virus transmission. The use of oral fluid and satellite images for sampling are potential methods to assess population immunity and the timing of SIAs.

  17. HIV and Immunizations

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV and Immunizations Last Reviewed: February 6, 2018 Key ...

  18. Immunity to parasitic infection

    National Research Council Canada - National Science Library

    Lamb, Tracey J

    2012-01-01

    .... Often endemic in developing countries many parasitic diseases are neglected in terms of research funding and much remains to be understood about parasites and the interactions they have with the immune system...

  19. Exercise and immunity

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007165.htm Exercise and immunity To use the sharing features on ... take a daily walk or follow a simple exercise routine a few times a week. Exercise helps ...

  20. Adults Need Immunizations, Too!

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Andrew Kroger from CDC’s National Center for Immunization and Respiratory Diseases discusses simple, safe, and effective ways adults can help protect themselves, their family, and their community from serious and deadly diseases.

  1. [Exosomes and Immune Cells].

    Science.gov (United States)

    Seo, Naohiro

    2017-05-01

    In addition to the cytokines and cytotoxic granules, exosomes have been known as the intercellular communicator and cytotoxic missile of immune cells for the past decade. It has been well known that mature dendritic cell(DC)-derived exosomes participate in the T cell and natural killer(NK)cell activation, while immature DCs secrete tolerogenic exosomes for regulatory T(Treg)cell generation. Treg cell-derived EVs act as a suppressor against pathogenic type-1 T helper(Th1)cell responses. CD8+ T cells produce tumoricidal exosomes for preventing tumor invasion and metastasis transiently after T cell receptor(TCR)-mediated stimulation. Thus, immune cells produce functional exosomes in the activation state- and/or differentiation stage-dependent manner. In this review, the role of immune cell-derived exosomes will be introduced, focusing mainly on immune reaction against tumor.

  2. Immune responses to metastases

    International Nuclear Information System (INIS)

    Herberman, R.B.; Wiltrout, R.H.; Gorelik, E.

    1987-01-01

    The authors present the changes in the immune system in tumor-bearing hosts that may influence the development of progression of metastases. Included are mononuclear cell infiltration of metastases; alterations in natural resistance mediated by natural killer cells and macrophages; development of specific immunity mediated by T-lymphocytes or antibodies; modulation of tumor-associated antigen expression; and the down-regulation of the immune response to the tumor by several suppressor mechanisms; the augmentation of the immune response and its potential for therapeutic application; includes the prophylaxis of metastases formation by NK cells; the therapy of metastases by augmentation NK-, macrophage-, or T-lymphocyte-mediated responses by biological response modifiers; and the transfer of anticancer activity by cytoxic T-lymphocytes or immunoconjugates of monoclonal antibodies with specificity for tumors

  3. Immunity of international organizations

    CERN Document Server

    Schrijver, Nico

    2015-01-01

    Immunity rules are part and parcel of the law of international organizations. It has long been accepted that international organizations and their staff need to enjoy immunity from the jurisdiction of national courts. However, it is the application of these rules in practice that increasingly causes controversy. Claims against international organizations are brought before national courts by those who allegedly suffer from their activities. These can be both natural and legal persons such as companies. National courts, in particular lower courts, have often been less willing to recognize the immunity of the organization concerned than the organization s founding fathers. Likewise, public opinion and legal writings frequently criticize international organizations for invoking their immunity and for the lack of adequate means of redress for claimants. It is against this background that an international conference was organized at Leiden University in June 2013. A number of highly qualified academics and practit...

  4. Vaccines and immunization

    African Journals Online (AJOL)

    Prof Ezechukwu

    vaccines for malaria and HIV infection. Despite the ... decades, effective vaccines against the major causes of ... challenge antibodies, specific helper and effector T lymphocytes ... materials to produced immunity to a disease. It was originally ...

  5. Zinc Signals and Immunity.

    Science.gov (United States)

    Maywald, Martina; Wessels, Inga; Rink, Lothar

    2017-10-24

    Zinc homeostasis is crucial for an adequate function of the immune system. Zinc deficiency as well as zinc excess result in severe disturbances in immune cell numbers and activities, which can result in increased susceptibility to infections and development of especially inflammatory diseases. This review focuses on the role of zinc in regulating intracellular signaling pathways in innate as well as adaptive immune cells. Main underlying molecular mechanisms and targets affected by altered zinc homeostasis, including kinases, caspases, phosphatases, and phosphodiesterases, will be highlighted in this article. In addition, the interplay of zinc homeostasis and the redox metabolism in affecting intracellular signaling will be emphasized. Key signaling pathways will be described in detail for the different cell types of the immune system. In this, effects of fast zinc flux, taking place within a few seconds to minutes will be distinguish from slower types of zinc signals, also designated as "zinc waves", and late homeostatic zinc signals regarding prolonged changes in intracellular zinc.

  6. Mobile-robot navigation with complete coverage of unstructured environments

    OpenAIRE

    García Armada, Elena; González de Santos, Pablo

    2004-01-01

    There are some mobile-robot applications that require the complete coverage of an unstructured environment. Examples are humanitarian de-mining and floor-cleaning tasks. A complete-coverage algorithm is then used, a path-planning technique that allows the robot to pass over all points in the environment, avoiding unknown obstacles. Different coverage algorithms exist, but they fail working in unstructured environments. This paper details a complete-coverage algorithm for unstructured environm...

  7. Immunization in pregnancy.

    Science.gov (United States)

    Gruslin, Andrée; Steben, Marc; Halperin, Scott; Money, Deborah M; Yudin, Mark H

    2009-11-01

    To review the evidence and provide recommendations on immunization in pregnancy. Outcomes evaluated include effectiveness of immunization, risks and benefits for mother and fetus. The Medline and Cochrane databases were searched for articles published up to June 2008 on the topic of immunization in pregnancy. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. Implementation of the recommendations in this guideline should result in more appropriate immunization of pregnant and breastfeeding women, decreased risk of contraindicated immunization, and better disease prevention. The quality of evidence reported in this document has been assessed using the evaluation of evidence criteria in the Report of the Canadian Task Force on Preventive Health Care (Table 1). (1) All women of childbearing age should be evaluated for the possibility of pregnancy before immunization. (III-A). (2) Health care providers should obtain a relevant immunization history from all women accessing prenatal care. (III-A). (3) In general, live and/or live-attenuated virus vaccines should not be administered during pregnancy, as there is a, largely theoretical, risk to the fetus. (II-3B). (4) Women who have inadvertently received immunization with live or live-attenuated vaccines during pregnancy should not be counselled to terminate the pregnancy because of a teratogenic risk. (II-2A). (5) Non-pregnant women immunized with a live or live-attenuated vaccine should be counselled to delay pregnancy for at least four weeks. (III-B). (6) Inactivated viral vaccines, bacterial vaccines, and toxoids can be used safely in pregnancy. (II-1A). (7) Women who are breastfeeding can still be immunized (passive-active immunization, live or killed

  8. Immunization alters body odor.

    Science.gov (United States)

    Kimball, Bruce A; Opiekun, Maryanne; Yamazaki, Kunio; Beauchamp, Gary K

    2014-04-10

    Infections have been shown to alter body odor. Because immune activation accompanies both infection and immunization, we tested the hypothesis that classical immunization might similarly result in the alteration of body odors detectable by trained biosensor mice. Using a Y-maze, we trained biosensor mice to distinguish between urine odors from rabies-vaccinated (RV) and unvaccinated control mice. RV-trained mice generalized this training to mice immunized with the equine West Nile virus (WNV) vaccine compared with urine of corresponding controls. These results suggest that there are similarities between body odors of mice immunized with these two vaccines. This conclusion was reinforced when mice could not be trained to directly discriminate between urine odors of RV- versus WNV-treated mice. Next, we trained biosensor mice to discriminate the urine odors of mice treated with lipopolysaccharide (LPS; a general elicitor of innate immunological responses) from the urine of control mice. These LPS-trained biosensors could distinguish between the odors of LPS-treated mouse urine and RV-treated mouse urine. Finally, biosensor mice trained to distinguish between the odors of RV-treated mouse urine and control mouse urine did not generalize this training to discriminate between the odors of LPS-treated mouse urine and control mouse urine. From these experiments, we conclude that: (1) immunization alters urine odor in similar ways for RV and WNV immunizations; and (2) immune activation with LPS also alters urine odor but in ways different from those of RV and WNV. Published by Elsevier Inc.

  9. Adults Need Immunizations, Too!

    Centers for Disease Control (CDC) Podcasts

    2012-03-19

    In this podcast, Dr. Andrew Kroger from CDC’s National Center for Immunization and Respiratory Diseases discusses simple, safe, and effective ways adults can help protect themselves, their family, and their community from serious and deadly diseases.  Created: 3/19/2012 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 3/19/2012.

  10. Immune dysfunction in cirrhosis

    Science.gov (United States)

    Sipeki, Nora; Antal-Szalmas, Peter; Lakatos, Peter L; Papp, Maria

    2014-01-01

    Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, is a major component of cirrhosis, and plays a pivotal role in the pathogenesis of both the acute and chronic worsening of liver function. During the evolution of the disease, acute decompensation events associated with organ failure(s), so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and also development of disease specific complications, comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and increased occurrence of systemic bacterial infections have substantial impacts on both clinical situations. Acute and chronic exposure to bacteria and/or their products, however, can result in variable clinical consequences. The immune status of patients is not constant during the illness; consequently, alterations of the balance between pro- and anti-inflammatory processes result in very different dynamic courses. In this review we give a detailed overview of acquired immune dysfunction and its consequences for cirrhosis. We demonstrate the substantial influence of inherited innate immune dysfunction on acute and chronic inflammatory processes in cirrhosis caused by the pre-existing acquired immune dysfunction with limited compensatory mechanisms. Moreover, we highlight the current facts and future perspectives of how the assessment of immune dysfunction can assist clinicians in everyday practical decision-making when establishing treatment and care strategies for the patients with end-stage liver disease. Early and efficient recognition of inappropriate performance of the immune system is essential for overcoming complications, delaying progression and reducing mortality. PMID:24627592

  11. Immunity to Fish Rhabdoviruses

    OpenAIRE

    Purcell, Maureen K.; Laing, Kerry J.; Winton, James R.

    2012-01-01

    Members of the family Rhabdoviridae are single-stranded RNA viruses and globally important pathogens of wild and cultured fish and thus relatively well studied in their respective hosts or other model systems. Here, we review the protective immune mechanisms that fish mount in response to rhabdovirus infections. Teleost fish possess the principal components of innate and adaptive immunity found in other vertebrates. Neutralizing antibodies are critical for long-term protection from fish rhabd...

  12. Transdermal influenza immunization with vaccine-coated microneedle arrays.

    Directory of Open Access Journals (Sweden)

    Dimitrios G Koutsonanos

    Full Text Available Influenza is a contagious disease caused by a pathogenic virus, with outbreaks all over the world and thousands of hospitalizations and deaths every year. Due to virus antigenic drift and short-lived immune responses, annual vaccination is required. However, vaccine coverage is incomplete, and improvement in immunization is needed. The objective of this study is to investigate a novel method for transdermal delivery using metal microneedle arrays (MN coated with inactivated influenza virus to determine whether this route is a simpler and safer approach than the conventional immunization, capable to induce robust immune responses and confer protection against lethal virus challenge.Inactivated A/Aichi/2/68 (H3N2 influenza virus was coated on metal microneedle arrays and applied to mice as a vaccine in the caudal dorsal skin area. Substantial antibody titers with hemagglutination inhibition activity were detected in sera collected two and four weeks after a single vaccine dose. Challenge studies in mice with 5 x LD(50 of mouse adapted Aichi virus demonstrated complete protection. Microneedle vaccination induced a broad spectrum of immune responses including CD4+ and CD8+ responses in the spleen and draining lymph node, a high frequency of antigen-secreting cells in the lung and induction of virus-specific memory B-cells. In addition, the use of MN showed a dose-sparing effect and a strong Th2 bias when compared to an intramuscular (IM reference immunization.The present results show that delivery of inactivated influenza virus through the skin using metal microneedle arrays induced strong humoral and cellular immune responses capable of conferring protection against virus challenge as efficiently as intramuscular immunization, which is the standard vaccination route. In view of the convenience of delivery and the potential for self-administration, vaccine-coated metal microneedles may provide a novel and highly effective immunization method.

  13. Assessing sustainable remediation frameworks using sustainability principles.

    Science.gov (United States)

    Ridsdale, D Reanne; Noble, Bram F

    2016-12-15

    The remediation industry has grown exponentially in recent decades. International organizations of practitioners and remediation experts have developed several frameworks for integrating sustainability into remediation projects; however, there has been limited attention to how sustainability is approached and operationalized in sustainable remediation frameworks and practices - or whether sustainability plays any meaningful role at all in sustainable remediation. This paper examines how sustainability is represented in remediation frameworks and the guidance provided for practical application. Seven broad sustainability principles and review criteria are proposed and applied to a sample of six international remediation frameworks. Not all review criteria were equally satisfied and none of the frameworks fully met all criteria; however, the best performing frameworks were those identified as sustainability remediation frameworks. Intra-generational equity was addressed by all frameworks. Integrating social, economic and biophysical components beyond triple-bottom-line indicators was explicitly addressed only by the sustainable remediation frameworks. No frameworks provided principle- or rule-based guidance for dealing with trade-offs in sustainability decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Technology and sustainability

    NARCIS (Netherlands)

    Kroeze, C.; Boersema, J.J.; Tellegen, E.; Cremers, A.

    2011-01-01

    In ten essays, this book addresses a broad range of issues related to the interplay of sustainability and technology. How do population growth and technology relate to sustainable development? Can globalization be reconciled with sustainable development? Is sustainability a subjective or an

  15. Sustainable consumption and marketing

    NARCIS (Netherlands)

    Dam, van Y.K.

    2016-01-01

    Sustainable development in global food markets is hindered by the discrepancy between positive consumer attitudes towards sustainable development or sustainability and the lack of corresponding sustainable consumption by a majority of consumers. Apparently for many (light user) consumers the

  16. 42 CFR 457.410 - Health benefits coverage options.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... State Plan Requirements: Coverage and Benefits § 457.410 Health benefits coverage options. (a) Types of...

  17. 7 CFR 457.172 - Coverage Enhancement Option.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Coverage Enhancement Option. 457.172 Section 457.172..., DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.172 Coverage Enhancement Option. The Coverage Enhancement Option for the 2009 and succeeding crop years are as follows: FCIC policies: United...

  18. 20 CFR 701.401 - Coverage under state compensation programs.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Coverage under state compensation programs...; DEFINITIONS AND USE OF TERMS Coverage Under State Compensation Programs § 701.401 Coverage under state compensation programs. (a) Exclusions from the definition of “employee” under § 701.301(a)(12), and the...

  19. 20 CFR 404.1065 - Self-employment coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Self-employment coverage. 404.1065 Section... INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Self-Employment § 404.1065 Self-employment coverage. For an individual to have self-employment coverage under social security, the...

  20. 42 CFR 435.350 - Coverage for certain aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain aliens. 435.350 Section 435... ISLANDS, AND AMERICAN SAMOA Optional Coverage of the Medically Needy § 435.350 Coverage for certain aliens... treatment of an emergency medical condition, as defined in § 440.255(c) of this chapter, to those aliens...

  1. 42 CFR 436.128 - Coverage for certain qualified aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain qualified aliens. 436.128... Mandatory Coverage of the Categorically Needy § 436.128 Coverage for certain qualified aliens. The agency... § 440.255(c) of this chapter to those aliens described in § 436.406(c) of this subpart. [55 FR 36820...

  2. 7 CFR 1737.31 - Area Coverage Survey (ACS).

    Science.gov (United States)

    2010-01-01

    ... an ACS are provided in RUS Telecommunications Engineering and Construction Manual section 205. (e... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage... the borrower's records contain sufficient information as to subscriber development to enable cost...

  3. 29 CFR 2.12 - Audiovisual coverage permitted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audiovisual coverage permitted. 2.12 Section 2.12 Labor Office of the Secretary of Labor GENERAL REGULATIONS Audiovisual Coverage of Administrative Hearings § 2.12 Audiovisual coverage permitted. The following are the types of hearings where the Department...

  4. Immune mediated liver failure.

    Science.gov (United States)

    Wang, Xiaojing; Ning, Qin

    2014-01-01

    Liver failure is a clinical syndrome of various etiologies, manifesting as jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result in subsequent multiorgan failure. Clinically, liver failure is classified into four categories: acute, subacute, acute-on-chronic and chronic liver failure. Massive hepatocyte death is considered to be the core event in the development of liver failure, which occurs when the extent of hepatocyte death is beyond the liver regenerative capacity. Direct damage and immune-mediated liver injury are two major factors involved in this process. Increasing evidence has suggested the essential role of immune-mediated liver injury in the pathogenesis of liver failure. Here, we review the evolved concepts concerning the mechanisms of immune-mediated liver injury in liver failure from human and animal studies. Both innate and adaptive immunity, especially the interaction of various immune cells and molecules as well as death receptor signaling system are discussed. In addition, we highlight the concept of "immune coagulation", which has been shown to be related to the disease progression and liver injury exacerbation in HBV related acute-on-chronic liver failure.

  5. Mammalian Gut Immunity

    Science.gov (United States)

    Chassaing, Benoit; Kumar, Manish; Baker, Mark T.; Singh, Vishal; Vijay-Kumar, Matam

    2016-01-01

    The mammalian intestinal tract is the largest immune organ in the body and comprises cells from non-hemopoietic (epithelia, Paneth cells, goblet cells) and hemopoietic (macrophages, dendritic cells, T-cells) origin, and is also a dwelling for trillions of microbes collectively known as the microbiota. The homeostasis of this large microbial biomass is prerequisite to maintain host health by maximizing beneficial symbiotic relationships and minimizing the risks of living in such close proximity. Both microbiota and host immune system communicate with each other to mutually maintain homeostasis in what could be called a “love–hate relationship.” Further, the host innate and adaptive immune arms of the immune system cooperate and compensate each other to maintain the equilibrium of a highly complex gut ecosystem in a stable and stringent fashion. Any imbalance due to innate or adaptive immune deficiency or aberrant immune response may lead to dysbiosis and low-grade to robust gut inflammation, finally resulting in metabolic diseases. PMID:25163502

  6. Temporal trend of green space coverage in China and its relationship with urbanization over the last two decades

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Juanjuan, E-mail: jjzhao@iue.ac.cn [Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021 (China); Xiamen Key Lab of Urban Metabolism, 1799 Jimei Road, Xiamen 361021 (China); Chen, Shengbin, E-mail: chainpin@yahoo.com.cn [Nanjing Institute of Environmental Sciences, Ministry of Environmental Protection, 8 Jiangwangmiao Street, Nanjing 210042 (China); Jiang, Bo, E-mail: jbshuibao415@126.com [State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, P.O. Box 2871, Beijing 100085 (China); Ren, Yin, E-mail: yren@iue.ac.cn [Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021 (China); Xiamen Key Lab of Urban Metabolism, 1799 Jimei Road, Xiamen 361021 (China); Wang, Hua, E-mail: wanghuaphd@gmail.com [Institute of Forestry and Pomology, Beijing Academy of Agriculture and Forestry Sciences, Ruiwangfen Jia 12 Xiangshan, Beijing 100093 (China); Vause, Jonathan, E-mail: jonathanvause@hotmail.com [Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021 (China); Xiamen Key Lab of Urban Metabolism, 1799 Jimei Road, Xiamen 361021 (China); Yu, Haidong, E-mail: hoste@163.com [Xiamen Huaxia Vocational College, Wenjiaoqu Jimei District, Xiamen 361024 (China)

    2013-01-01

    Irrespective of which side is taken in the densification-sprawl debate, insights into the relationship between urban green space coverage and urbanization have been recognized as essential for guiding sustainable urban development. However, knowledge of the relationships between socio-economic variables of urbanization and long-term green space change is still limited. In this paper, using simple regression, hierarchical partitioning and multi-regression, the temporal trend in green space coverage and its relationship with urbanization were investigated using data from 286 cities between 1989 and 2009, covering all provinces in mainland China with the exception of Tibet. We found that: [1] average green space coverage of cities investigated increased steadily from 17.0% in 1989 to 37.3% in 2009; [2] cities with higher recent green space coverage also had relatively higher green space coverage historically; [3] cities in the same region exhibited similar long-term trends in green space coverage; [4] eight of the nine variables characterizing urbanization showed a significant positive linear relationship with green space coverage, with 'per capita GDP' having the highest independent contribution (24.2%); [5] among the climatic and geographic factors investigated, only mean elevation showed a significant effect; and [6] using the seven largest contributing individual factors, a linear model to predict variance in green space coverage was constructed. Here, we demonstrated that green space coverage in built-up areas tended to reflect the effects of urbanization rather than those of climatic or geographic factors. Quantification of the urbanization effects and the characteristics of green space development in China may provide a valuable reference for research into the processes of urban sprawl and its relationship with green space change. -- Highlights: Black-Right-Pointing-Pointer The green space coverage in Chinese cities increased steadily from 1991 to

  7. Temporal trend of green space coverage in China and its relationship with urbanization over the last two decades

    International Nuclear Information System (INIS)

    Zhao, Juanjuan; Chen, Shengbin; Jiang, Bo; Ren, Yin; Wang, Hua; Vause, Jonathan; Yu, Haidong

    2013-01-01

    Irrespective of which side is taken in the densification-sprawl debate, insights into the relationship between urban green space coverage and urbanization have been recognized as essential for guiding sustainable urban development. However, knowledge of the relationships between socio-economic variables of urbanization and long-term green space change is still limited. In this paper, using simple regression, hierarchical partitioning and multi-regression, the temporal trend in green space coverage and its relationship with urbanization were investigated using data from 286 cities between 1989 and 2009, covering all provinces in mainland China with the exception of Tibet. We found that: [1] average green space coverage of cities investigated increased steadily from 17.0% in 1989 to 37.3% in 2009; [2] cities with higher recent green space coverage also had relatively higher green space coverage historically; [3] cities in the same region exhibited similar long-term trends in green space coverage; [4] eight of the nine variables characterizing urbanization showed a significant positive linear relationship with green space coverage, with ‘per capita GDP’ having the highest independent contribution (24.2%); [5] among the climatic and geographic factors investigated, only mean elevation showed a significant effect; and [6] using the seven largest contributing individual factors, a linear model to predict variance in green space coverage was constructed. Here, we demonstrated that green space coverage in built-up areas tended to reflect the effects of urbanization rather than those of climatic or geographic factors. Quantification of the urbanization effects and the characteristics of green space development in China may provide a valuable reference for research into the processes of urban sprawl and its relationship with green space change. -- Highlights: ► The green space coverage in Chinese cities increased steadily from 1991 to 2009. ► Cities in the same

  8. Tumor inherent interferons: Impact on immune reactivity and immunotherapy.

    Science.gov (United States)

    Brockwell, Natasha K; Parker, Belinda S

    2018-04-19

    Immunotherapy has revolutionized cancer treatment, with sustained responses to immune checkpoint inhibitors reported in a number of malignancies. Such therapeutics are now being trialed in aggressive or advanced cancers that are heavily reliant on untargeted therapies, such as triple negative breast cancer. However, responses have been underwhelming to date and are very difficult to predict, leading to an inability to accurately weigh up the benefit-to-risk ratio for their implementation. The tumor immune microenvironment has been closely linked to immunotherapeutic response, with superior responses observed in patients with T cell-inflamed or 'hot' tumors. One class of cytokines, the type I interferons, are a major dictator of tumor immune infiltration and activation. Tumor cell inherent interferon signaling dramatically influences the immune microenvironment and the expression of immune checkpoint proteins, hence regulators and targets of this pathway are candidate biomarkers of immunotherapeutic response. In support of a link between IFN signaling and immunotherapeutic response, the combination of type I interferon inducers with checkpoint immunotherapy has recently been demonstrated critical for a sustained anti-tumor response in aggressive breast cancer models. Here we review evidence that links type I interferons with a hot tumor immune microenvironment, response to checkpoint inhibitors and reduced risk of metastasis that supports their use as biomarkers and therapeutics in oncology. Copyright © 2018. Published by Elsevier Ltd.

  9. Implementation of pertussis immunization in health-care personnel.

    Science.gov (United States)

    Walther, Kathi; Burckhardt, Marie-Anne; Erb, Thomas; Heininger, Ulrich

    2015-04-21

    Infection with Bordetella pertussis is most severe in young infants who frequently acquire it from adults. Pertussis immunization in adults 25-29 years of age and all adults in close contact with infants vaccination campaign. Between April 2012 and March 2013 we provided information about the campaign to our staff through several channels and offered appointments for counseling and immunization. After checking indications and contraindications of responding health-care personnel (HCP), informed consent for tetanus-diphtheria-acellular pertussis component (Tdap) immunization was obtained. Specific adverse events (AE) were self-assessed by standardized diaries for 7 days. Statistical analyses were performed using a t-test and Mann-Whitney U-tests SPSS (V21). Of 852 HCP eligible for pertussis immunization, 427 (51%) responded. Of these, 72 (17%) had already received Tdap now, 38 (9%) were scheduled for vaccination and 12 (3%) declined. Diaries were returned by 272 (89%) of 304 vaccinees; 56 HCP reported ≥1 local AE, most frequently local swelling (8%), redness (2%), redness and swelling (7%), and fever (5=2%); no serious AE occurred. Comprehensive efforts were needed to achieve pertussis immunization coverage of ≥49% among all HCP in our institution. Good tolerability of the vaccine and continuous and individual information to HCP about the rationale and benefits of pertussis immunization contributed to this partial success, but increased efforts are needed to mobilize non-responding HCP. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Externality or sustainability economics?

    International Nuclear Information System (INIS)

    Bergh, Jeroen C.J.M. van den

    2010-01-01

    In an effort to develop 'sustainability economics' Baumgaertner and Quaas (2010) neglect the central concept of environmental economics-'environmental externality'. This note proposes a possible connection between the concepts of environmental externality and sustainability. In addition, attention is asked for other aspects of 'sustainability economics', namely the distinction weak/strong sustainability, spatial sustainability and sustainable trade, distinctive sustainability policy, and the ideas of early 'sustainability economists'. I argue that both sustainability and externalities reflect a systems perspective and propose that effective sustainability solutions require that more attention is given to system feedbacks, notably other-regarding preferences and social interactions, and energy and environmental rebound. The case of climate change and policy is used to illustrate particular statements. As a conclusion, a list of 20 insights and suggestions for research is offered. (author)

  11. FastStats: Immunization

    Science.gov (United States)

    ... Women’s Health State and Territorial Data Reproductive Health Contraceptive Use Infertility Reproductive Health Notice Regarding FastStats Mobile ... 69 [PDF – 9.8 MB] Vaccination coverage among adolescents 13-17 years of age Health, United States, ...

  12. Engineering Sustainability: A Technical Approach to Sustainability

    OpenAIRE

    Rosen, Marc A.

    2012-01-01

    Sustainability is a critically important goal for human activity and development. Sustainability in the area of engineering is of great importance to any plans for overall sustainability given 1) the pervasiveness of engineering activities in societies, 2) their importance in economic development and living standards, and 3) the significant impacts that engineering processes and systems have had, and continue to have, on the environment. Many factors that need to be considered and appropriate...

  13. Analysis on the Change of Grassland Coverage in the Source Region of Three Rivers during 2000-2012

    International Nuclear Information System (INIS)

    Luo, Chengfeng; Wang, Jiao; Liu, Meilin; Liu, Zhengjun

    2014-01-01

    The Source Region of Three Rivers (SRTR) has very important ecological functions which form an ecological security barrier for China's Qinghai-Tibet plateau. As the biggest nationally occuring nature reserve region in China, the ecological environment here is very fragile. In SRTR the grassland coverage is an effective detector to reflect the ecological environment condition, because it records the changing process of climatic and environmental sensitively. In recent years SRTR has been suffering pressures from both nature and social pressures. With MODIS data the study monitored the grassland coverage continuously in SRTR from 2000 to 2012. The density-model was adapted to estimate grassland coverage degree firstly. Then the degree of change and the change intensity, change type were used to judge the grassland coverage change trend comprehensively. For grassland coverage there was natural change annual or within the year, and the degree of change was used to judge if there was change or not. The grassland has another important characteristic, annual fluctuation, and it can be differed from sustained changes with change type. For grassland coverage, such continuous change, like improvement or degradation, and to what extent, has more guidance sense on specific production practice. On the base of change type and degree of change, change intensity was used to identify the change trend of the grassland coverage. The analysis results from our study show that steady state and fluctuation are two main change trends for the vegetation coverage in SRTR from 2000 to 2012. The conclusion of this paper can provide references in response to environment change research and in the regional ecological environmental protection project in SRTR

  14. Impact of Adverse Events Following Immunization in Viet Nam in 2013 on chronic hepatitis B infection.

    Science.gov (United States)

    Li, Xi; Wiesen, Eric; Diorditsa, Sergey; Toda, Kohei; Duong, Thi Hong; Nguyen, Lien Huong; Nguyen, Van Cuong; Nguyen, Tran Hien

    2016-02-03

    Adverse Events Following Immunization in Viet Nam in 2013 led to substantial reductions in hepatitis B vaccination coverage (both the birth dose and the three-dose series). In order to estimate the impact of the reduction in vaccination coverage on hepatitis B transmission and future mortality, a widely-used mathematical model was applied to the data from Viet Nam. Using the model, we estimated the number of chronic infections and deaths that are expected to occur in the birth cohort in 2013 and the number of excessive infections and deaths attributable to the drop in immunization coverage in 2013. An excess of 90,137 chronic infections and 17,456 future deaths were estimated to occur in the 2013 birth cohort due to the drop in vaccination coverage. This analysis highlights the importance of maintaining high vaccination coverage and swiftly responding to reported Adverse Events Following Immunization in order to regain consumer confidence in the hepatitis B vaccine. Copyright © 2015 World Health Organization; licensee Elsevier. Published by Elsevier Ltd.. All rights reserved.

  15. The Expanded Program on Immunization in the Americas: a review.

    Science.gov (United States)

    1985-01-01

    The basis for the Pan America Health Organization/World Health Organization Expanded Program on Immunization (EPI) is provided by a resolution (WHA27.57) adopted by the World Health Assembly in May 1974. The program's longterm objectives include: to reduce morbidity and mortality from diphtheria, whooping cough, tetanus, measles, tuberculosis, and poliomyelitis by providing immunization services directed against those disease for every child in the world by 1990; to promote countries' self-reliance in the delivery of immunization services within the context of comprehensive health services; and to promote regional self-reliance in matters of vaccine production and quality control. The EPI, which requires a longterm commitment to continued immunization activities, is an essential element of PAHO/WHO's strategy to achieve health for all by the year 2000. Immunization coverage has been included among the indicators which will be used to monitor the success of that strategy at regional and global levels. As of April 1985, available country reports showed that immunization coverage in the Americas had improved considerably since the EPI was launched in 1977. In 1978, for example, only a very small proportion of the children under 1 year of age (less than 10%) outside the US and Canada lived in countr ies where 50% immunization coverage with the EPI vaccines had been attained for this age group. By 1984, over 55% of these children were living in countries where at least 50% infant coverage with DPT and measles vaccines had been attained, and over 80% were living in countries where at least 50% infant coverage with polio vaccine had been attained. Immunization coverage generally improved between 1980-84, especially in the 12 smaller countries of the subregion with populations of less than 130,000. In the period since EPI training activities were initiated in early 1979 through the end of 1984, it is estimated that at least 15,000 health workers attended EPI workshops

  16. 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

  17. Diphtheria in Lao PDR: Insufficient Coverage or Ineffective Vaccine?

    Science.gov (United States)

    Nanthavong, Naphavanh; Black, Antony P; Nouanthong, Phonethipsavanh; Souvannaso, Chanthasone; Vilivong, Keooudomphone; Muller, Claude P; Goossens, Sylvie; Quet, Fabrice; Buisson, Yves

    2015-01-01

    During late 2012 and early 2013 several outbreaks of diphtheria were notified in the North of the Lao People's Democratic Republic. The aim of this study was to determine whether the re-emergence of this vaccine-preventable disease was due to insufficient vaccination coverage or reduction of vaccine effectiveness within the affected regions. A serosurvey was conducted in the Huaphan Province on a cluster sampling of 132 children aged 12-59 months. Serum samples, socio-demographic data, nutritional status and vaccination history were collected when available. Anti-diphtheria and anti-tetanus IgG antibody levels were measured by ELISA. Overall, 63.6% of participants had detectable diphtheria antibodies and 71.2% tetanus antibodies. Factors independently associated with non-vaccination against diphtheria were the distance from the health centre (OR: 6.35 [95% CI: 1.4-28.8], p = 0.01), the Lao Theung ethnicity (OR: 12.2 [95% CI:1,74-85, 4], p = 0.01) and the lack of advice on vaccination given at birth (OR: 9.8 [95% CI: 1.5-63.8], (p = 0.01) while the level of maternal edu-cation was a protective factor (OR: 0.08 [95% CI: 0.008-0.81], p = 0.03). Most respondents claimed financial difficulties as the main reason for non-vaccination. Out of 55 children whose vaccination certificates stated that they were given all 3 doses of diphtheria-containing vaccine, 83.6% had diphtheria antibodies and 92.7% had tetanus antibodies. Furthermore, despite a high prevalence of stunted and underweight children (53% and 25.8%, respectively), the low levels of anti-diphtheria antibodies were not correlated to the nutritional status. Our data highlight a significant deficit in both the vaccination coverage and diphtheria vaccine effectiveness within the Huaphan Province. Technical deficiencies in the methods of storage and distribution of vaccines as well as unreliability of vaccination cards are discussed. Several hypotheses are advanced to explain such a decline in immunity against

  18. The natural history of varicella zoster virus infection in Norway: Further insights on exogenous boosting and progressive immunity to herpes zoster.

    Directory of Open Access Journals (Sweden)

    Luigi Marangi

    Full Text Available We use age-structured models for VZV transmission and reactivation to reconstruct the natural history of VZV in Norway based on available pre-vaccination serological data, contact matrices, and herpes zoster incidence data. Depending on the hypotheses on contact and transmission patterns, the basic reproduction number of varicella in Norway ranges between 3.7 and 5.0, implying a vaccine coverage between 73 and 80% to effectively interrupt transmission with a 100% vaccine efficacy against infection. The varicella force of infection peaks during early childhood (3-5 yrs and shows a prolonged phase of higher risk during the childbearing period, though quantitative variations can occur depending on contact patterns. By expressing the magnitude of exogenous boosting as a proportion of the force of infection, it is shown that reactivation is well described by a progressive immunity mechanism sustained by a large, though possibly below 100%, degree of exogenous boosting, in agreement with findings from other Nordic countries, implying large reproduction numbers of boosting. Moreover, magnitudes of exogenous boosting below 40% are robustly disconfirmed by data. These results bring further insight on the magnitude of immunity boosting and its relationship with reactivation.

  19. Immunization status of children upto 3 years in rural block, Muzaffarnagar

    Directory of Open Access Journals (Sweden)

    Rama Shankar

    2015-12-01

    Full Text Available Background: The year 2012-2013 was declared as ‘Year of intensification of Routine Immunization (IRI in India. As per CES, DLHS and AHS, Full Immunization for the children of age group of 12-23 months of Uttar Pradesh is 30.2 (DLHS 2007, 40.9 (CES 2009 and 45.3 (AHS 2010-2011. Studies have been done to assess the primary immunization status i.e. BCG, OPV3, DTP3 and Measles. Data on the Booster doses and the additional vaccine is insufficient. Objectives: To assess the status of full Immunization, Complete Immunization and the status of Immunization with regard to different vaccine and reasons for partial and No Immunization. Design & Methodology: A community based cross sectional study was done (Aug to December 31th 2014 in the field practice area of rural health and training centre (RHTC of Muzaffarnagar Medical College, Muzaffarnagar. 50% of the villages i.e. 3 villages (Bilaspur, Shernagar and Dhandhera selected by simple random sampling technique and the age group selected were up to three years of age. The data was analyzed using MS excel sheet and the software used was software Epi-info version 7.1.3. Results and Conclusion: The Full Immunization in the age group of children between 12-23 months was 65% with antigen coverage maximum for BCG (93% and lowest for Measles (68%. Reason for partial and unimmunized children were majority due to non-availability of vaccine at the centre followed by fear of AEFI. Complete Immunization in the age group between 24-36 months was 46% with MCV 2 coverage being the lowest (34%. Full Immunization in the age group of 24-36 months is significantly more than 12-23 months age group. Tendency is to have less and less immunization as the age of the child grows (P<0.05.

  20. Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

    Science.gov (United States)

    Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H

    2008-02-22

    While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue

  1. Sustainability in Business

    DEFF Research Database (Denmark)

    Tollin, Karin; Vej, Jesper

    2012-01-01

    How do companies integrate sustainability into their strategy and practices, and what factors explain their approach? In this paper a typology of sustainability strategies is presented as well as a conceptual framework relating sustainability at the company level to the functional level of market...... managers' mindsets, a framework addressing sustainability from four organisational learning schools was designed and followed......How do companies integrate sustainability into their strategy and practices, and what factors explain their approach? In this paper a typology of sustainability strategies is presented as well as a conceptual framework relating sustainability at the company level to the functional level...... of marketing. The central contribution of the typology is a strategic and managerial view on sustainability. Furthermore, the typology shows that sustainability in business is enacted from different areas of competences and fields in the literature (e.g. supply chain management, corporate branding, value...

  2. Armenian media coverage of science topics

    Science.gov (United States)

    Mkhitaryan, Marie

    2016-12-01

    The article discusses features and issues of Armenian media coverage on scientific topics and provides recommendations on how to promote scientific topics in media. The media is more interested in social or public reaction rather than in scientific information itself. Medical science has a large share of the global media coverage. It is followed by articles about environment, space, technology, physics and other areas. Armenian media mainly tends to focus on a scientific topic if at first sight it contains something revolutionary. Media primarily reviews whether that scientific study can affect the Armenian economy and only then decides to refer to it. Unfortunately, nowadays the perception of science is a little distorted in media. We can often see headlines of news where is mentioned that the scientist has made "an invention". Nowadays it is hard to see the border between a scientist and an inventor. In fact, the technological term "invention" attracts the media by making illusionary sensation and ensuring large audience. The report also addresses the "Gitamard" ("A science-man") special project started in 2016 in Mediamax that tells about scientists and their motivations.

  3. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter

    2005-03-01

    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  4. Experiences and Lessons From Polio Eradication Applied to Immunization in 10 Focus Countries of the Polio Endgame Strategic Plan.

    Science.gov (United States)

    van den Ent, Maya M V X; Mallya, Apoorva; Sandhu, Hardeep; Anya, Blanche-Philomene; Yusuf, Nasir; Ntakibirora, Marcelline; Hasman, Andreas; Fahmy, Kamal; Agbor, John; Corkum, Melissa; Sumaili, Kyandindi; Siddique, Anisur Rahman; Bammeke, Jane; Braka, Fiona; Andriamihantanirina, Rija; Ziao, Antoine-Marie C; Djumo, Clement; Yapi, Moise Desire; Sosler, Stephen; Eggers, Rudolf

    2017-07-01

    Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  5. Experiences and Lessons From Polio Eradication Applied to Immunization in 10 Focus Countries of the Polio Endgame Strategic Plan

    Science.gov (United States)

    Mallya, Apoorva; Sandhu, Hardeep; Anya, Blanche-Philomene; Yusuf, Nasir; Ntakibirora, Marcelline; Hasman, Andreas; Fahmy, Kamal; Agbor, John; Corkum, Melissa; Sumaili, Kyandindi; Siddique, Anisur Rahman; Bammeke, Jane; Braka, Fiona; Andriamihantanirina, Rija; Ziao, Antoine-Marie C.; Djumo, Clement; Yapi, Moise Desire; Sosler, Stephen; Eggers, Rudolf

    2017-01-01

    Abstract Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries. PMID:28838187

  6. Filoviral Immune Evasion Mechanisms

    Directory of Open Access Journals (Sweden)

    Christopher F. Basler

    2011-09-01

    Full Text Available The Filoviridae family of viruses, which includes the genera Ebolavirus (EBOV and Marburgvirus (MARV, causes severe and often times lethal hemorrhagic fever in humans. Filoviral infections are associated with ineffective innate antiviral responses as a result of virally encoded immune antagonists, which render the host incapable of mounting effective innate or adaptive immune responses. The Type I interferon (IFN response is critical for establishing an antiviral state in the host cell and subsequent activation of the adaptive immune responses. Several filoviral encoded components target Type I IFN responses, and this innate immune suppression is important for viral replication and pathogenesis. For example, EBOV VP35 inhibits the phosphorylation of IRF-3/7 by the TBK-1/IKKε kinases in addition to sequestering viral RNA from detection by RIG-I like receptors. MARV VP40 inhibits STAT1/2 phosphorylation by inhibiting the JAK family kinases. EBOV VP24 inhibits nuclear translocation of activated STAT1 by karyopherin-α. The examples also represent distinct mechanisms utilized by filoviral proteins in order to counter immune responses, which results in limited IFN-α/β production and downstream signaling.

  7. Immune memory in invertebrates.

    Science.gov (United States)

    Milutinović, Barbara; Kurtz, Joachim

    2016-08-01

    Evidence for innate immune memory (or 'priming') in invertebrates has been accumulating over the last years. We here provide an in-depth review of the current state of evidence for immune memory in invertebrates, and in particular take a phylogenetic viewpoint. Invertebrates are a very heterogeneous group of animals and accordingly, evidence for the phenomenon of immune memory as well as the hypothesized molecular underpinnings differ largely for the diverse invertebrate taxa. The majority of research currently focuses on Arthropods, while evidence from many other groups of invertebrates is fragmentary or even lacking. We here concentrate on immune memory that is induced by pathogenic challenges, but also extent our view to a non-pathogenic context, i.e. allograft rejection, which can also show forms of memory and can inform us about general principles of specific self-nonself recognition. We discuss definitions of immune memory and a number of relevant aspects such as the type of antigens used, the route of exposure, and the kinetics of reactions following priming. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Immunity to fish rhabdoviruses

    Science.gov (United States)

    Purcell, Maureen K.; Laing, Kerry J.; Winton, James R.

    2012-01-01

    Members of the family Rhabdoviridae are single-stranded RNA viruses and globally important pathogens of wild and cultured fish and thus relatively well studied in their respective hosts or other model systems. Here, we review the protective immune mechanisms that fish mount in response to rhabdovirus infections. Teleost fish possess the principal components of innate and adaptive immunity found in other vertebrates. Neutralizing antibodies are critical for long-term protection from fish rhabdoviruses, but several studies also indicate a role for cell-mediated immunity. Survival of acute rhabdoviral infection is also dependent on innate immunity, particularly the interferon (IFN) system that is rapidly induced in response to infection. Paradoxically, rhabdoviruses are sensitive to the effects of IFN but virulent rhabdoviruses can continue to replicate owing to the abilities of the matrix (M) protein to mediate host-cell shutoff and the non-virion (NV) protein to subvert programmed cell death and suppress functional IFN. While many basic features of the fish immune response to rhabdovirus infections are becoming better understood, much less is known about how factors in the environment affect the ecology of rhabdovirus infections in natural populations of aquatic animals.

  9. Immunity to fish rhabdoviruses.

    Science.gov (United States)

    Purcell, Maureen K; Laing, Kerry J; Winton, James R

    2012-01-01

    Members of the family Rhabdoviridae are single-stranded RNA viruses and globally important pathogens of wild and cultured fish and thus relatively well studied in their respective hosts or other model systems. Here, we review the protective immune mechanisms that fish mount in response to rhabdovirus infections. Teleost fish possess the principal components of innate and adaptive immunity found in other vertebrates. Neutralizing antibodies are critical for long-term protection from fish rhabdoviruses, but several studies also indicate a role for cell-mediated immunity. Survival of acute rhabdoviral infection is also dependent on innate immunity, particularly the interferon (IFN) system that is rapidly induced in response to infection. Paradoxically, rhabdoviruses are sensitive to the effects of IFN but virulent rhabdoviruses can continue to replicate owing to the abilities of the matrix (M) protein to mediate host-cell shutoff and the non‑virion (NV) protein to subvert programmed cell death and suppress functional IFN. While many basic features of the fish immune response to rhabdovirus infections are becoming better understood, much less is known about how factors in the environment affect the ecology of rhabdovirus infections in natural populations of aquatic animals.

  10. Immunity to Fish Rhabdoviruses

    Directory of Open Access Journals (Sweden)

    Maureen K. Purcell

    2012-01-01

    Full Text Available Members of the family Rhabdoviridae are single-stranded RNA viruses and globally important pathogens of wild and cultured fish and thus relatively well studied in their respective hosts or other model systems. Here, we review the protective immune mechanisms that fish mount in response to rhabdovirus infections. Teleost fish possess the principal components of innate and adaptive immunity found in other vertebrates. Neutralizing antibodies are critical for long-term protection from fish rhabdoviruses, but several studies also indicate a role for cell-mediated immunity. Survival of acute rhabdoviral infection is also dependent on innate immunity, particularly the interferon (IFN system that is rapidly induced in response to infection. Paradoxically, rhabdoviruses are sensitive to the effects of IFN but virulent rhabdoviruses can continue to replicate owing to the abilities of the matrix (M protein to mediate host-cell shutoff and the non‑virion (NV protein to subvert programmed cell death and suppress functional IFN. While many basic features of the fish immune response to rhabdovirus infections are becoming better understood, much less is known about how factors in the environment affect the ecology of rhabdovirus infections in natural populations of aquatic animals.

  11. 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

  12. Sustainable Table | Welcome to Sustainable Table

    Science.gov (United States)

    Sustainable Seafood Industrial Agriculture Industrial Livestock Production Antibiotics Hormones rBGH Animal , safeguarding animal welfare and supporting local communities. Questions to Ask Asking questions is the best way Livestock Husbandry Sustainable Crop Production Innovative Agriculture New Farmers Organic Agriculture Local

  13. Education for sustainable development

    DEFF Research Database (Denmark)

    Breiting, Søren

    2009-01-01

     An introduction to the idea of sustainable development (SD) and education for sustainable development (ESD) with reference to the international Decade for Education for Sustainable Development . The chapter includes a focus on conflicting interests between present and future generations related ...... to the use of natural resources and other matters, and how that kind of issues can be dealt with in education as ESD....... An introduction to the idea of sustainable development (SD) and education for sustainable development (ESD) with reference to the international Decade for Education for Sustainable Development . The chapter includes a focus on conflicting interests between present and future generations related...

  14. Extending Coverage and Lifetime of K-coverage Wireless Sensor Networks Using Improved Harmony Search

    Directory of Open Access Journals (Sweden)

    Shohreh Ebrahimnezhad

    2011-07-01

    Full Text Available K-coverage wireless sensor networks try to provide facilities such that each hotspot region is covered by at least k sensors. Because, the fundamental evaluation metrics of such networks are coverage and lifetime, proposing an approach that extends both of them simultaneously has a lot of interests. In this article, it is supposed that two kinds of nodes are available: static and mobile. The proposed method, at first, tries to balance energy among sensor nodes using Improved Harmony Search (IHS algorithm in a k-coverage and connected wireless sensor network in order to achieve a sensor node deployment. Also, this method proposes a suitable place for a gateway node (Sink that collects data from all sensors. Second, in order to prolong the network lifetime, some of the high energy-consuming mobile nodes are moved to the closest positions of low energy-consuming ones and vice versa after a while. This leads increasing the lifetime of network while connectivity and k-coverage are preserved. Through computer simulations, experimental results verified that the proposed IHS-based algorithm found better solution compared to some related methods.

  15. Smart Sustainable Islands VS Smart Sustainable Cities

    Science.gov (United States)

    Pantazis, D. N.; Moussas, V. C.; Murgante, B.; Daverona, A. C.; Stratakis, P.; Vlissidis, N.; Kavadias, A.; Economou, D.; Santimpantakis, K.; Karathanasis, B.; Kyriakopoulou, V.; Gadolou, E.

    2017-09-01

    This paper has several aims: a) the presentation of a critical analysis of the terms "smart sustainable cities" and "smart sustainable islands" b) the presentation of a number of principles towards to the development methodological framework of concepts and actions, in a form of a manual and actions guide, for the smartification and sustainability of islands. This kind of master plan is divided in thematic sectors (key factors) which concern the insular municipalities c) the creation of an island's smartification and sustainability index d) the first steps towards the creation of a portal for the presentation of our smartification actions manual, together with relative resources, smart applications examples, and, in the near future the first results of our index application in a number of Greek islands and e) the presentation of some proposals of possible actions towards their sustainable development and smartification for the municipalities - islands of Paros and Antiparos in Greece, as case studies.

  16. 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

  17. Effect of the conditional cash transfer program Oportunidades on vaccination coverage in older Mexican people

    Science.gov (United States)

    2013-01-01

    Background Immunization is one of the most effective ways of preventing illness, disability and death from infectious diseases for older people. However, worldwide immunization rates are still low, particularly for the most vulnerable groups within the elderly population. The objective of this study was to estimate the effect of the Oportunidades -an incentive-based poverty alleviation program- on vaccination coverage for poor and rural older people in Mexico. Methods Cross-sectional study, based on 2007 Oportunidades Evaluation Survey, conducted in low-income households from 741 rural communities (localities with <2,500 inhabitants) of 13 Mexican states. Vaccination coverage was defined according to three individual vaccines: tetanus, influenza and pneumococcal, and for complete vaccination schedule. Propensity score matching and linear probability model were used in order to estimate the Oportunidades effect. Results 12,146 older people were interviewed, and 7% presented cognitive impairment. Among remaining, 4,628 were matched. Low coverage rates were observed for the vaccines analyzed. For Oportunidades and non-Oportunidades populations were 46% and 41% for influenza, 52% and 45% for pneumococcal disease, and 79% and 71% for tetanus, respectively. Oportunidades effect was significant in increasing the proportion of older people vaccinated: for complete schedule 5.5% (CI95% 2.8-8.3), for influenza 6.9% (CI95% 3.8-9.6), for pneumococcal 7.2% (CI95% 4.3-10.2), and for tetanus 6.6% (CI95% 4.1-9.2). Conclusions The results of this study extend the evidence on the effect that conditional transfer programs exert on health indicators. In particular, Oportunidades increased vaccination rates in the population of older people. There is a need to continue raising vaccination rates, however, particularly for the most vulnerable older people. PMID:23835202

  18. Quercetin, Inflammation and Immunity

    Directory of Open Access Journals (Sweden)

    Yao Li

    2016-03-01

    Full Text Available In vitro and some animal models have shown that quercetin, a polyphenol derived from plants, has a wide range of biological actions including anti-carcinogenic, anti-inflammatory and antiviral activities; as well as attenuating lipid peroxidation, platelet aggregation and capillary permeability. This review focuses on the physicochemical properties, dietary sources, absorption, bioavailability and metabolism of quercetin, especially main effects of quercetin on inflammation and immune function. According to the results obtained both in vitro and in vivo, good perspectives have been opened for quercetin. Nevertheless, further studies are needed to better characterize the mechanisms of action underlying the beneficial effects of quercetin on inflammation and immunity.

  19. Pentraxins and immunity

    Directory of Open Access Journals (Sweden)

    Priya Nagar

    2014-01-01

    Full Text Available Pentraxin-3 (PTX3 is a multifactorial protein involved in immunity and inflammation, which is rapidly produced and released by several cell types in response to inflammatory signals. It may be suggested that PTX3 is related to periodontal tissue inflammation. Its salivary concentrations may have a diagnostic potential. Pentraxin-3 (PTX3 is an ancient family of multifactorial proteins involved in immunity and inflammation. They are rapidly produced and released by various types of cells when there are indications of inflammation. PTX3 is related to inflammation in the periodontal tissue and it can be suggested that salivary concentrations may be used for diagnosing the same.

  20. Mucosal immunity to poliovirus.

    Science.gov (United States)

    Ogra, Pearay L; Okayasu, Hiromasa; Czerkinsky, Cecil; Sutter, Roland W

    2011-10-01

    The Global Polio Eradication Initiative (GPEI) currently based on use of oral poliovirus vaccine (OPV) has identified suboptimal immunogenicity of this vaccine as a major impediment to eradication, with a failure to induce protection against paralytic poliomyelitis in certain population segments in some parts of the world. The Mucosal Immunity and Poliovirus Vaccines: Impact on Wild Poliovirus Infection, Transmission and Vaccine Failure conference was organized to obtain a better understanding of the current status of global control of poliomyelitis and identify approaches to improve the immune responsiveness and effectiveness of the orally administered poliovirus vaccines in order to accelerate the global eradication of paralytic poliomyelitis.

  1. Training and natural immunity

    DEFF Research Database (Denmark)

    Pedersen, Bente Klarlund; Helge, Jørn Wulff; Richter, Erik

    2000-01-01

    these subjects were used to eliminate day-to-day variation in the immunological tests. Independently of diet, training increased the percentage of CD3-CD16+ CD56+ natural killer (NK) cells from [mean (SEM)] 14 (1) % to 20 (3) % (P = 0.05), whereas the NK-cell activity, either unstimulated or stimulated...... influence natural immunity, and suggest that ingestion of a fat-rich diet during training is detrimental to the immune system compared to the effect of a carbohydrate-rich diet....

  2. Vaccines and Immunization Practice.

    Science.gov (United States)

    Hogue, Michael D; Meador, Anna E

    2016-03-01

    Vaccines are among most cost-effective public health strategies. Despite effective vaccines for many bacterial and viral illnesses, tens of thousands of adults and hundreds of children die each year in the United States from vaccine-preventable diseases. Underutilization of vaccines requires rethinking the approach to incorporating vaccines into practice. Arguably, immunizations could be a part all health care encounters. Shared responsibility is paramount if deaths are to be reduced. This article reviews the available vaccines in the US market, as well as practice recommendations of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Conceptualising sustainability assessment

    International Nuclear Information System (INIS)

    Pope, Jenny; Annandale, David; Morrison-Saunders, Angus

    2004-01-01

    Sustainability assessment is being increasingly viewed as an important tool to aid in the shift towards sustainability. However, this is a new and evolving concept and there remain very few examples of effective sustainability assessment processes implemented anywhere in the world. Sustainability assessment is often described as a process by which the implications of an initiative on sustainability are evaluated, where the initiative can be a proposed or existing policy, plan, programme, project, piece of legislation, or a current practice or activity. However, this generic definition covers a broad range of different processes, many of which have been described in the literature as 'sustainability assessment'. This article seeks to provide some clarification by reflecting on the different approaches described in the literature as being forms of sustainability assessment, and evaluating them in terms of their potential contributions to sustainability. Many of these are actually examples of 'integrated assessment', derived from environmental impact assessment (EIA) and strategic environmental assessment (SEA), but which have been extended to incorporate social and economic considerations as well as environmental ones, reflecting a 'triple bottom line' (TBL) approach to sustainability. These integrated assessment processes typically either seek to minimise 'unsustainability', or to achieve TBL objectives. Both aims may, or may not, result in sustainable practice. We present an alternative conception of sustainability assessment, with the more ambitious aim of seeking to determine whether or not an initiative is actually sustainable. We term such processes 'assessment for sustainability'. 'Assessment for sustainability' firstly requires that the concept of sustainability be well-defined. The article compares TBL approaches and principles-based approaches to developing such sustainability criteria, concluding that the latter are more appropriate, since they avoid many

  4. Alternatives to conventional vaccines--mediators of innate immunity.

    Science.gov (United States)

    Eisen, D P; Liley, H G; Minchinton, R M

    2004-01-01

    Vaccines have been described as "weapons of mass protection". The eradication of many diseases is testament to their utility and effectiveness. Nevertheless, many vaccine preventable diseases remain prevalent because of political and economic barriers. Additionally, the effects of immaturity and old age, therapies that incapacitate the adaptive immune system and the multitude of strategies evolved by pathogens to evade immediate or sustained recognition by the mammalian immune system are barriers to the effectiveness of existing vaccines or development of new vaccines. In the front line of defence against the pervasiness of infection are the elements of the innate immune system. Innate immunity is under studied and poorly appreciated. However, in the first days after entry of a pathogen into the body, our entire protective response is dependant upon the various elements of our innate immune repertoire. In spite of its place as our initial defence against infection, attention is only now turning to strategies which enhance or supplement innate immunity. This review examines the need for and potential of innate immune therapies.

  5. Effect of stone coverage on soil erosion

    Science.gov (United States)

    Jomaa, S.; Barry, D. A.; Heng, B. P.; Brovelli, A.; Sander, G. C.; Parlange, J.

    2010-12-01

    Soil surface coverage has a significant impact on water infiltration, runoff and soil erosion yields. In particular, surface stones protect the soils from raindrop detachment, they retard the overland flow therefore decreasing its sediment transport capacity, and they prevent surface sealing. Several physical and environmental factors control to what extent stones on the soil surface modify the erosion rates and the related hydrological response. Among the most important factors are the moisture content of the topsoil, stone size, emplacement, coverage density and soil texture. Owing to the different inter-related processes, there is ambiguity concerning the quantitative effect of stones, and process-based understanding is limited. Experiments were performed (i) to quantify how stone features affect sediment yields, (ii) to understand the local effect of isolated surface stones, that is, the changes of the soil particle size distribution in the vicinity of a stone and (iii) to determine how stones attenuate the development of surface sealing and in turn how this affects the local infiltration rate. A series of experiments using the EPFL 6-m × 2-m erosion flume were conducted at different rainfall intensities (28 and 74 mm h-1) and stone coverage (20 and 40%). The total sediment concentration, the concentration of the individual size classes and the flow discharge were measured. In order to analyze the measurements, the Hairsine and Rose (HR) erosion model was adapted to account for the shielding effect of the stone cover. This was done by suitably adjusting the parameters based on the area not covered by stones. It was found that the modified HR model predictions agreed well with the measured sediment concentrations especially for the long time behavior. Changes in the bulk density of the topsoil due to raindrop-induced compaction with and without stone protection revealed that the stones protect the upper soil surface against the structural seals resulting in

  6. 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

  7. Handbook of sustainable engineering

    CERN Document Server

    Lee, Kun-Mo

    2013-01-01

    "The efficient utilization of energy, sustainable use of natural resources, and large-scale adoption of sustainable technologies is the key to a sustainable future. The Handbook of Sustainable Engineering provides tools that will help us achieve these goals". Nobel Prize Winner Dr. R.K. Pauchauri, Chairman, UN Intergovernmental Panel on Climate Change As global society confronts the challenges of diminishing resources, ecological degradation, and climate change, engineers play a crucial role designing and building technologies and products that fulfil our needs for utility and sustainability. The Handbook of Sustainable Engineering equips readers with the context and the best practices derived from both academic research and practical examples of successful implementations of sustainable technical solutions. The handbook’s content revolves around the two themes, new ways of thinking and new business models, including sustainable production, products, service systems and consumption while addressing key asse...

  8. Sustainable Water Infrastructure

    Science.gov (United States)

    Resources for state and local environmental and public health officials, and water, infrastructure and utility professionals to learn about sustainable water infrastructure, sustainable water and energy practices, and their role.

  9. Sustainable development. First part

    International Nuclear Information System (INIS)

    Colombo, U.; Lanzavecchia, G.; Berrini, M; Zambrini, M.; Bologna, G.; Carraro, C.; Hinterberger, F.; Mastino, G.; Federico, A.; Gaudioso, D.; Luise, A.; Mauro, F.; Padovani, L.; Federico, A.

    1998-01-01

    This paper summarizes a collective effort and represents the second edition of: Environment, energy, economy: a sustainable future. In this work are reported various interventions on sustainable development problem [it

  10. Sustainable Public Bids

    Directory of Open Access Journals (Sweden)

    Gil César Costa de Paula

    2016-06-01

    Full Text Available In this article we will discuss the issue of sustainability in public procurement, given that the government in Brazil is constituted as a great promoter of economic development and needs to adapt its acquisitions worldwide sustainability agenda.

  11. Neighbourhood facilities for sustainability

    CSIR Research Space (South Africa)

    Gibberd, Jeremy T

    2013-01-01

    Full Text Available . In this paper these are referred to as ‘Neighbourhood Facilities for Sustainability’. Neighbourhood Facilities for Sustainability (NFS) are initiatives undertaken by individuals and communities to build local sustainable systems which not only improve...

  12. FORUM: Is Ecotourism Sustainable?

    Science.gov (United States)

    Wall

    1997-07-01

    / It is legitimate to ask whether and in what form tourism might contribute to sustainable development. This is not the same as sustainable tourism which, as a single-sector approach to development, may overlook important linkages with other sectors. If tourism is to contribute to sustainable development, then it must be economically viable, ecologically sensitive and culturally appropriate. Ecotourism is often advocated as being a sustainable form of tourism but imprecision in terminology clouds basic issues and there are strong economic, ecological, and cultural reasons for believing that, even in its purest forms, ecotourism is likely to present substantial challenges to destination areas, particularly if it competes for scarce resources and displaces existing uses and users. Sustainable tourism and ecotourism are not synonyms, many forms of ecotourism may not be sustainable, and if ecotourism is to contribute to sustainable development, then careful planning and management will be required.KEY WORDS: Ecotourism; Sustainable development; Development; Tourism

  13. Exergy energy, environment and sustainable development

    CERN Document Server

    Dincer, Ibrahim; Rosen, Marc A

    2007-01-01

    This book deals with exergy and its applications to various energy systems and applications as a potential tool for design, analysis and optimization, and its role in minimizing and/or eliminating environmental impacts and providing sustainable development. In this regard, several key topics ranging from the basics of the thermodynamic concepts to advanced exergy analysis techniques in a wide range of applications are covered as outlined in the contents. - Comprehensive coverage of exergy and its applications - Connects exergy with three essential areas in terms of energy, environment and sustainable development - Presents the most up-to-date information in the area with recent developments - Provides a number of illustrative examples, practical applications, and case studies - Easy to follow style, starting from the basics to the advanced systems.

  14. Immune System and Kidney Transplantation.

    Science.gov (United States)

    Shrestha, Badri Man

    2017-01-01

    The immune system recognises a transplanted kidney as foreign body and mounts immune response through cellular and humoral mechanisms leading to acute or chronic rejection, which ultimately results in graft loss. Over the last five decades, there have been significant advances in the understanding of the immune responses to transplanted organs in both experimental and clinical transplant settings. Modulation of the immune response by using immunosuppressive agents has led to successful outcomes after kidney transplantation. The paper provides an overview of the general organisation and function of human immune system, immune response to kidney transplantation, and the current practice of immunosuppressive therapy in kidney transplantation in the United Kingdom.

  15. Civil liability and nuclear coverage: synthesis report

    International Nuclear Information System (INIS)

    1995-01-01

    The report has been written considering the advanced work which has been done by the Expert Committee, sponsored by the International Atomic Energy Agency (IAEA), Vienna, having the purpose to examine the modifications issued in course of Vienna Convention as well as the Paris convention and the complementary Brussels Convention, in view to adapt the legislation to the actual context and to answer the populations expectations. The work has been organized in three majors chapters: the first one in concerned to the damage definition, proposition to the to reach the environment, the prevention and charges. the research and military installations are also considered. The second chapter has been dedicated to the civil responsibility, its limits, financing modes, the national and international legal competence besides the litigation charges due to the nuclear accidents born on the occasion. In the third chapter the insurance considering the damage nature, the capacity to assure liability coverage and the damage management are harmonized

  16. Neuroendocrine-immune interaction

    NARCIS (Netherlands)

    Kemenade, van Lidy; Cohen, Nicholas; Chadzinska, Magdalena

    2017-01-01

    It has now become accepted that the immune system and neuroendocrine system form an integrated part of our physiology. Immunological defense mechanisms act in concert with physiological processes like growth and reproduction, energy intake and metabolism, as well as neuronal development. Not only

  17. Amyloid and immune homeostasis.

    Science.gov (United States)

    Wang, Ying-Hui; Zhang, Yu-Gen

    2018-03-01

    Extracellular amyloid deposition defines a range of amyloidosis and amyloid-related disease. Addition to primary and secondary amyloidosis, amyloid-related disease can be observed in different tissue/organ that sharing the common pathogenesis based on the formation of amyloid deposition. Currently, both Alzheimer's disease and type 2 diabetes can be diagnosed with certainly only based on the autopsy results, by which amyloidosis of the associative tissue/organ is observed. Intriguingly, since it demonstrated that amyloid deposits trigger inflammatory reaction through the activation of cascaded immune response, wherein several lines of evidence implies a protective role of amyloid in preventing autoimmunity. Furthermore, attempts for preventing amyloid formation and/or removing amyloid deposits from the brain have caused meningoencephalitis and consequent deaths among the subjects. Hence, it is important to note that amyloid positively participates in maintaining immune homeostasis and contributes to irreversible inflammatory response. In this review, we will focus on the interactive relationship between amyloid and the immune system, discussing the potential functional roles of amyloid in immune tolerance and homeostasis. Copyright © 2017 Elsevier GmbH. All rights reserved.

  18. Lymphoma: Immune Evasion Strategies

    International Nuclear Information System (INIS)

    Upadhyay, Ranjan; Hammerich, Linda; Peng, Paul; Brown, Brian; Merad, Miriam; Brody, Joshua D.

    2015-01-01

    While the cellular origin of lymphoma is often characterized by chromosomal translocations and other genetic aberrations, its growth and development into a malignant neoplasm is highly dependent upon its ability to escape natural host defenses. Neoplastic cells interact with a variety of non-malignant cells in the tumor milieu to create an immunosuppressive microenvironment. The resulting functional impairment and dysregulation of tumor-associated immune cells not only allows for passive growth of the malignancy but may even provide active growth signals upon which the tumor subsequently becomes dependent. In the past decade, the success of immune checkpoint blockade and adoptive cell transfer for relapsed or refractory lymphomas has validated immunotherapy as a possible treatment cornerstone. Here, we review the mechanisms by which lymphomas have been found to evade and even reprogram the immune system, including alterations in surface molecules, recruitment of immunosuppressive subpopulations, and secretion of anti-inflammatory factors. A fundamental understanding of the immune evasion strategies utilized by lymphomas may lead to better prognostic markers and guide the development of targeted interventions that are both safer and more effective than current standards of care

  19. Lymphoma: Immune Evasion Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Ranjan; Hammerich, Linda; Peng, Paul [Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Brown, Brian [Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Merad, Miriam [Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Brody, Joshua D., E-mail: joshua.brody@mssm.edu [Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States)

    2015-04-30

    While the cellular origin of lymphoma is often characterized by chromosomal translocations and other genetic aberrations, its growth and development into a malignant neoplasm is highly dependent upon its ability to escape natural host defenses. Neoplastic cells interact with a variety of non-malignant cells in the tumor milieu to create an immunosuppressive microenvironment. The resulting functional impairment and dysregulation of tumor-associated immune cells not only allows for passive growth of the malignancy but may even provide active growth signals upon which the tumor subsequently becomes dependent. In the past decade, the success of immune checkpoint blockade and adoptive cell transfer for relapsed or refractory lymphomas has validated immunotherapy as a possible treatment cornerstone. Here, we review the mechanisms by which lymphomas have been found to evade and even reprogram the immune system, including alterations in surface molecules, recruitment of immunosuppressive subpopulations, and secretion of anti-inflammatory factors. A fundamental understanding of the immune evasion strategies utilized by lymphomas may lead to better prognostic markers and guide the development of targeted interventions that are both safer and more effective than current standards of care.

  20. Tick Innate Immunity.

    Czech Academy of Sciences Publication Activity Database

    Kopáček, Petr; Hajdušek, Ondřej; Burešová, Veronika; Daffre, S.

    2010-01-01

    Roč. 708, - (2010), 137-162 ISSN 0065-2598 R&D Projects: GA ČR GAP506/10/2136; GA MŠk(CZ) LC06009 Institutional research plan: CEZ:AV0Z60220518 Keywords : tick * pathogen transmission * innate immunity Subject RIV: EC - Immunology Impact factor: 1.379, year: 2010

  1. Sustainability Statement and Policy

    Science.gov (United States)

    Journal of Education for Sustainable Development, 2009

    2009-01-01

    This article presents nine resources that focus on environmental education and sustainability. These include: (1) "Sustainability Statement and Policy," Dalhousie University, Nova Scotia, Canada, 2009, which is available at http://office.sustainability.dal.ca/Governance; (2) "Climate Literacy: The Essential Principles of Climate…

  2. The sustainable development

    International Nuclear Information System (INIS)

    2004-01-01

    In the framework of the sustainable development week (june 2003), Actu Environnement published a complete document on the sustainable development to inform the public, recall the main steps of this notion (Rio conference and the following conferences) and the possible employments. It presents also the main organizations acting in the sustainable development domain. (A.L.B.)

  3. Toward sustainable logistics

    NARCIS (Netherlands)

    Soysal, Mehmet; Bloemhof-Ruwaard, Jacqueline M.

    2017-01-01

    The fast evolution of sustainability leads to the development of a new fast-growing concept called sustainable logistics management. This research addresses recent business trends and challenges in logistics and their implications for sustainable logistics management. Additionally, we discuss policy

  4. ORNL Annual Sustainability Report

    Energy Technology Data Exchange (ETDEWEB)

    Lapsa, Melissa Voss [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nichols, Teresa A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-02-01

    As described in this report, we have made substantial progress across the 25 roadmaps of the Sustainable Campus Initiative. The report also outlines our plans to continue integrating sustainable practices into the planning, execution, and evaluation of all ORNL activities. We appreciate your interest in our journey to sustainability, and we welcome your comments, questions, and suggestions.

  5. Toward sustainable logistics

    NARCIS (Netherlands)

    Soysal, Mehmet; Bloemhof-Ruwaard, Jacqueline M.

    2018-01-01

    The fast evolution of sustainability leads to the development of a new fast-growing concept called sustainable logistics management. This research addresses recent business trends and challenges in logistics and their implications for sustainable logistics management. Additionally, we discuss policy

  6. Sustainable Learning Organizations

    Science.gov (United States)

    Velazquez, Luis E.; Esquer, Javier; Munguia, Nora E.; Moure-Eraso, Rafael

    2011-01-01

    Purpose: The purpose of this paper is to debate how companies may better become a sustainable learning organization by offering the most used and insightful concepts of sustainability. Design/methodology/approach: Through literature review, learning organization and sustainability perspectives are explored and compared. Findings: Learning…

  7. Sustainability Annual Report 2013

    OpenAIRE

    2013-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  8. Sustainability Annual Report 2014

    OpenAIRE

    2014-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  9. Sustainability Annual Report 2017

    OpenAIRE

    2017-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  10. Sustainability Annual Report 2011

    OpenAIRE

    2011-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  11. Sustainability Annual Report 2012

    OpenAIRE

    2012-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  12. Sustainability Annual Report 2015

    OpenAIRE

    2015-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  13. Sustainability Annual Report 2016

    OpenAIRE

    2016-01-01

    Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

  14. 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.

  15. Seasonal influenza vaccine coverage among high-risk populations in Thailand, 2010-2012.

    Science.gov (United States)

    Owusu, Jocelynn T; Prapasiri, Prabda; Ditsungnoen, Darunee; Leetongin, Grit; Yoocharoen, Pornsak; Rattanayot, Jarowee; Olsen, Sonja J; Muangchana, Charung

    2015-01-29

    The Advisory Committee on Immunization Practice of Thailand prioritizes seasonal influenza vaccinations for populations who are at highest risk for serious complications (pregnant women, children 6 months-2 years, persons ≥65 years, persons with chronic diseases, obese persons), and healthcare personnel and poultry cullers. The Thailand government purchases seasonal influenza vaccine for these groups. We assessed vaccination coverage among high-risk groups in Thailand from 2010 to 2012. National records on persons who received publicly purchased vaccines from 2010 to 2012 were analyzed by high-risk category. Denominator data from multiple sources were compared to calculate coverage. Vaccine coverage was defined as the proportion of individuals in each category who received the vaccine. Vaccine wastage was defined as the proportion of publicly purchased vaccines that were not used. From 2010 to 2012, 8.18 million influenza vaccines were publicly purchased (range, 2.37-3.29 million doses/year), and vaccine purchases increased 39% over these years. Vaccine wastage was 9.5%. Approximately 5.7 million (77%) vaccine doses were administered to persons ≥65 years and persons with chronic diseases, 1.4 million (19%) to healthcare personnel/poultry cullers, 82,570 (1.1%) to children 6 months-2 years, 78,885 (1.1%) to obese persons, 26,481 (0.4%) to mentally disabled persons, and 17,787 (0.2%) to pregnant women. Between 2010 and 2012, coverage increased among persons with chronic diseases (8.6% versus 14%; pThailand. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Vaccination coverage and reasons for non-vaccination in a district of Istanbul

    Directory of Open Access Journals (Sweden)

    Bakırcı Nadi

    2006-05-01

    Full Text Available Abstract Background In order to control and eliminate the vaccine preventable diseases it is important to know the vaccination coverage and reasons for non-vaccination. The primary objective of this study was to determine the complete vaccination rate; the reasons for non-vaccination and the predictors that influence vaccination of children. The other objective was to determine coverage of measles vaccination of the Measles Immunization Days (MID 2005 for children aged 9 month to 6 years in a region of Umraniye, Istanbul, Turkey. Methods A '30 × 7' cluster sampling design was used as the sampling method. Thirty streets were selected at random from study area. Survey data were collected by a questionnaire which was applied face to face to parents of 221 children. A Chi-square test and logistic regression was used for the statistical analyses. Content analysis method was used to evaluate the open-ended questions. Results The complete vaccination rate for study population was 84.5% and 3.2% of all children were totally non-vaccinated. The siblings of non-vaccinated children were also non-vaccinated. Reasons for non-vaccination were as follows: being in the village and couldn't reach to health care services; having no knowledge about vaccination; the father of child didn't allow vaccination; intercurrent illness of child during vaccination time; missed opportunities like not to shave off a vial for only one child. In logistic regression analysis, paternal and maternal levels of education and immigration time of both parents to Istanbul were found to influence whether children were completely vaccinated or non-vaccinated. Measles vaccination coverage during MID was 79.3%. Conclusion Efforts to increase vaccination coverage should take reasons for non-vaccination into account.

  17. Feasibility of using global system for mobile communication (GSM)-based tracking for vaccinators to improve oral poliomyelitis vaccine campaign coverage in rural Pakistan.

    Science.gov (United States)

    Chandir, Subhash; Dharma, Vijay Kumar; Siddiqi, Danya Arif; Khan, Aamir Javed

    2017-09-05

    Despite multiple rounds of immunization campaigns, it has not been possible to achieve optimum immunization coverage for poliovirus in Pakistan. Supplementary activities to improve coverage of immunization, such as door-to-door campaigns are constrained by several factors including inaccurate hand-drawn maps and a lack of means to objectively monitor field teams in real time, resulting in suboptimal vaccine coverage during campaigns. Global System for Mobile Communications (GSM) - based tracking of mobile subscriber identity modules (SIMs) of vaccinators provides a low-cost solution to identify missed areas and ensure effective immunization coverage. We conducted a pilot study to investigate the feasibility of using GSM technology to track vaccinators through observing indicators including acceptability, ease of implementation, costs and scalability as well as the likelihood of ownership by District Health Officials. The real-time location of the field teams was displayed on a GSM tracking web dashboard accessible by supervisors and managers for effective monitoring of workforce attendance including 'time in-time out', and discerning if all target areas - specifically remote and high-risk locations - had been reached. Direct access to this information by supervisors eliminated the possibility of data fudging and inaccurate reporting by workers regarding their mobility. The tracking cost per vaccinator was USD 0.26/month. Our study shows that GSM-based tracking is potentially a cost-efficient approach, results in better monitoring and accountability, is scalable and provides the potential for improved geographic coverage of health services. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Target Coverage in Wireless Sensor Networks with Probabilistic Sensors

    Science.gov (United States)

    Shan, Anxing; Xu, Xianghua; Cheng, Zongmao

    2016-01-01

    Sensing coverage is a fundamental problem in wireless sensor networks (WSNs), which has attracted considerable attention. Conventional research on this topic focuses on the 0/1 coverage model, which is only a coarse approximation to the practical sensing model. In this paper, we study the target coverage problem, where the objective is to find the least number of sensor nodes in randomly-deployed WSNs based on the probabilistic sensing model. We analyze the joint detection probability of target with multiple sensors. Based on the theoretical analysis of the detection probability, we formulate the minimum ϵ-detection coverage problem. We prove that the minimum ϵ-detection coverage problem is NP-hard and present an approximation algorithm called the Probabilistic Sensor Coverage Algorithm (PSCA) with provable approximation ratios. To evaluate our design, we analyze the performance of PSCA theoretically and also perform extensive simulations to demonstrate the effectiveness of our proposed algorithm. PMID:27618902

  19. 2005 Tour de Sol: The Sustainable Energy and Transportation Festival and Competition

    Energy Technology Data Exchange (ETDEWEB)

    Nancy Hazard

    2005-05-07

    This report gives a summary of the 2005Tour de Sol: The Sustainable Energy and Transportation Festival and Competition. It lists our objectives, what we did, and an analysis of how we met our objectives. An 80-page report with a list of verified print, radio and TV media coverage, and copies of selected news clips and web media coverage is available at the NESEA office for review.

  20. Adult vaccination coverage levels among users of complementary/alternative medicine – results from the 2002 National Health Interview Survey (NHIS

    Directory of Open Access Journals (Sweden)

    Bardenheier Barbara H

    2008-02-01

    Full Text Available Abstract Background While many Complementary/Alternative Medicine (CAM practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Methods Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever, and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Results Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value Conclusion Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in