The role of schools in the spread of mumps among unvaccinated children: a retrospective cohort study

Contains fulltext : 98461.pdf (publisher's version ) (Open Access)BACKGROUND: In the Netherlands, epidemics of vaccine preventable diseases are largely confined to an orthodox protestant minority with religious objections to vaccination. The clustering of unvaccinated children in orthodox protestant schools can foster the spread of epidemics. School closure has nevertheless not been practiced up until now. A mumps epidemic in 2007-2008 gave us an opportunity to study the role of schools in the spread of a vaccine preventable disease in a village with low vaccination coverage. METHODS: A retrospective cohort study was conducted among the students in four elementary schools and their siblings. The following information was collected for each child: having had the mumps or not and when, school, age, MMR vaccination status, household size, presence of high school students in the household, religious denomination, and home village. The spread of mumps among unvaccinated children was compared for the four schools in a Kaplan-Meier analysis using a log-rank test. Cox proportional hazard analyses were performed to test for the influence of other factors. To correct for confounding, a univariate Cox regression model with only school included as a determinant was compared to a multivariate regression model containing all possible confounders. RESULTS: Out of 650 households with children at the schools, 54% completed a questionnaire, which provided information on 1191 children. For the unvaccinated children (N = 769), the Kaplan-Meier curves showed significant differences among the schools in their cumulative attack rates. After correction for confounding, the Cox regression analysis showed the hazard of mumps to be higher in one orthodox protestant school compared to the other (hazard ratio 1.43, p < 0.001). Household size independently influenced the hazard of mumps (hazard ratio 1.44, p < 0.005) with children in larger households running a greater risk. CONCLUSION: If and when unvaccinated children got mumps was determined by the particular school the children and their siblings attended, and by the household size. This finding suggests that school closure can influence the spread of an epidemic among orthodox protestant populations, provided that social distancing is adhered to as well. Further research on the effects of school closure on the final attack rate is nevertheless recommended

Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation

OBJECTIVE: It is not well known whether physical activity (PA) is useful in the management of patients complaining of constipation. The aim of this study was to test the influence of regular PA on colonic transit time and defecation in middle-aged inactive patients suffering from chronic idiopathic constipation. MATERIAL AND METHODS: Forty-three subjects (> 45 years) were randomly divided into group A (n = 18, 16 F, 2 M) and group B (n = 25, 20 F, 5 M). Group A subjects maintained their normal lifestyle during 12 weeks, followed by a 12-week PA programme. Group B performed a 12-week PA programme after randomization. PA comprised 30 min of brisk walking and a daily 11-min home-based programme. Both groups received dietary advice. Colonic transit time was measured using a radiographic multiple marker single film technique. RESULTS: Despite dietary advice, mean fibre and fluid intake did not change. In group B a significant reduction in 3 out of 4 of the Rome I criteria for constipation was observed, i.e. percentage of incomplete defecations, percentage of defecations requiring straining and percentage of hard stools (p < 0.05). As a consequence, the number of fulfilled Rome criteria for constipation decreased (2.7 to 1.7; p < 0.05). Furthermore, the rectosigmoid and total colonic transit time decreased (17.5 to 9.6 h and 79.2 to 58.4 h, respectively; p < 0.05). After PA the number of fulfilled Rome criteria also decreased in group A (2.6 to 1.7; p < 0.05). CONCLUSIONS: In middle-aged inactive subjects with symptoms of chronic constipation, it is advisable to promote regular physical activity since it improves both the defecation pattern and rectosigmoid or total colonic transit tim

Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation

Objective. It is not well known whether physical activity (PA) is useful in the management of patients complaining of constipation. The aim of this study was to test the influence of regular PA on colonic transit time and defecation in middle-aged inactive patients suffering from chronic idiopathic constipation. Material and methods. Forty-three subjects (>45 years) were randomly divided into group A (n=18, 16 F, 2 M) and group B (n=25, 20 F, 5 M). Group A subjects maintained their normal lifestyle during 12 weeks, followed by a 12-week PA programme. Group B performed a 12-week PA programme after randomization. PA comprised 30 min of brisk walking and a daily 11-min home-based programme. Both groups received dietary advice. Colonic transit time was measured using a radiographic multiple marker single film technique. Results. Despite dietary advice, mean fibre and fluid intake did not change. In group B a significant reduction in 3 out of 4 of the Rome I criteria for constipation was observed, i.e. percentage of incomplete defecations, percentage of defecations requiring straining and percentage of hard stools (

Kollektiv stöttning i samtal mellan inlärare av svenska som främmandespråk

Syftet med studien är att undersöka förekomster av kollektiv stöttning i samtal mellan inlärare som studerar svenska som främmandespråk. Undersökningsmaterialet består av inspelningar av två grupper som löser en didaktisk uppgift. Deltagarna studerar samtliga svenska som främmandespråk i Frankrike och har alla franska som förstaspråk. Grupperna har dock olika lång erfarenhet av svenskstudier. Uppsatsens frågeställningar är följande: Förekommer kollektiv stöttning vid lösningarna av uppgifterna och hur kan man i så fall beskriva den? På vilket sätt utnyttjas kommunikativa strategier och språkliga funktioner och vilken betydelse får de för den kollektiva stöttningen? Vilken relation finns mellan den kollektiva stöttningen och uppgiftens instruktioner? Vilka likheter och skillnader finns mellan de två undersökningsgrupperna och vilken betydelse får resultatet för lärarprofessionen? Materialet undersöks genom en analys av samtalen där sekventiering, närhetspar och turtagning fungerar som den ram inom vilken stöttning antas vara verksam. Inom denna ram undersöks stöttande processerna med hjälp av ett antal språkteoretiska begrepp som relateras till en sociokulturell syn på lärande. Centrala är kommunikativa strategier och språkliga funktioner vilka ses som viktiga för att interaktionella och potentiellt stöttande processer skall möjliggöras. Resultatet visar att kollektiv stöttning förekommer i samtalen genom att deltagarna utnyttjar varandra som språkliga resurser. Stöttningen är starkt knuten till två för grupperna gemensamma projekt – ett målspråkligt och ett interaktionellt. Inom dessa tar sig stöttningen för grupperna olika uttryck. I gruppen med kortare erfarenhet av svenska sker den ofta öppet med hjälp av kodväxling medan den i gruppen med längre erfarenhet ofta sker genom att deltagarna tar efter varandra. Ur ett didaktiskt perspektiv visar undersökningen bland annat på instruktionernas betydelse för vilka kollektiva stöttningsprocesser aktualiseras.Interdisciplinärt arbete, SSA133, 15 hp Ämne: Svenska som andraspråk Termin: Vt 2014 Handledare: Ann-Christine Randah