13 research outputs found
Royal society of Canada COVID-19 report: Enhancing COVID-19 vaccine acceptance in Canada
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the moveable middle heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies. Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors) - each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership
Maternal transmission of SARSâCOVâ2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis
Improving test properties for neonatal cystic fibrosis screening in the Netherlands before the nationwide start by May 1st 2011
Adverse Events Following Q Fever Immunisation in Young Adults
The study is part of Frequency of Adverse Events Following Q Fever Immunisation in Young Adults project which collected Q fever vaccine (Q-VAXÂź) adverse events following immunisation (AEFI) data in veterinary and animal science students at Australian universities. Students were enrolled at the time of vaccination and were emailed a link to an online AEFI survey one week later. Of the 60% (499/827) that responded, 85% were female and the median age was 18 years. Local injection site reactions (ISRs) occurred in 98% (95%; CI 96â99%) of respondents. Systemic AEFI occurred in 60% (95%; CI 55â64%) of respondents within the seven days following immunisation. Medical attention was sought by 19/499 (3.8%) respondents, of whom one sought treatment at a hospital emergency department. This dataset is an excel file of data obtained from a survey of young adults following Q fever immunisation. The survey contained questions pertaining to local and systemic adverse events following immunisation; frequency, size and onset of local reactions, and the presence of systemic events within the seven days following vaccination. The data headings can be interpreted with the data dictionary provided within the excel file
Development of Quality Indicators to Evaluate the Appropriateness of Empiric Antimicrobial Use in Pediatric Patients
Background: Use of quality indicators is one strategy recommended to assess antimicrobial prescribing for pediatric inpatients.
Objective: To achieve consensus from infectious diseases clinicians on quality indicators that characterize appropriate empiric antimicrobial use for the management of infectious syndromes in pediatric inpatients.
Methods: This study was completed using the Delphi technique. The research team developed an initial list of quality indicators, informed by a literature search. A multidisciplinary group of health care providers with expertise in infectious diseases was invited to participate. The list was disseminated to this panel of experts using Opinio survey software. The experts were asked to rate the indicators on a 9-point Likert scale in relation to the following criterion: âThe importance of each item in determining appropriateness considering benefit or harm at the individual or population levelâ. Consensus was defined as at least 75% agreement and a median score of 7 or higher.
Results: Twelve of 31 invited experts completed at least 1 round of the survey, and 10 completed all rounds. Consensus was achieved on 28 of 31 proposed indicators after 3 rounds. Indicators with consensus were categorized under âempiric choiceâ (n = 12 indicators), âdoseâ (n = 5), âdurationâ (n = 2), âadministrationâ (n = 4), âdiagnosisâ (n = 2), and âdocumentationâ (n = 3). Six of the indicators for which consensus was achieved were rephrased by the experts.
Conclusions: Consensus was achieved on quality indicators to assess the appropriateness of empiric antimicrobial use in pediatric patients. Clinicians and researchers can use these consensus-based indicators to assess adherence to best practice.
RĂSUMĂ
Contexte : Lâutilisation dâindicateurs de qualitĂ© est lâune des stratĂ©gies recommandĂ©es pour Ă©valuer la prescription dâantimicrobiens aux patients pĂ©diatriques hospitalisĂ©s.
Objectif : Parvenir Ă un consensus, entre les cliniciens des maladies infectieuses, portant sur les indicateurs de qualitĂ© qui caractĂ©risent lâutilisation empirique appropriĂ©e des antimicrobiens pour la prise en charge des syndromes infectieux chez les patients pĂ©diatriques hospitalisĂ©s.
MĂ©thodes : Cette Ă©tude a Ă©tĂ© rĂ©alisĂ©e Ă lâaide de la technique Delphi. LâĂ©quipe de recherche a dressĂ© une liste initiale dâindicateurs de qualitĂ© Ă©clairĂ©e par une recherche documentaire. Un groupe multidisciplinaire de prestataires de soins de santĂ© ayant une expertise dans le domaine des maladies infectieuses a Ă©tĂ© invitĂ© Ă participer. La liste a Ă©tĂ© diffusĂ©e Ă ce panel dâexperts Ă lâaide du logiciel dâenquĂȘte Opinio. Les experts ont Ă©tĂ© invitĂ©s Ă noter les indicateurs sur une Ă©chelle de Likert de 9 points par rapport au critĂšre suivant : « Lâimportance de chaque Ă©lĂ©ment pour dĂ©terminer la pertinence compte tenu du bienfait ou du dommage Ă lâĂ©chelle individuelle ou de la population ». Le consensus Ă©tait dĂ©fini comme « Un accord dâau moins 75 % et un score mĂ©dian dâau moins 7 ».
RĂ©sultats : Douze des 31 experts invitĂ©s ont terminĂ© au moins 1 cycle de lâenquĂȘte et 10 les ont tous terminĂ©s. Un consensus a Ă©tĂ© atteint pour 28 des 31 indicateurs proposĂ©s aprĂšs 3 cycles. Les indicateurs qui ont atteint le consensus ont Ă©tĂ© classĂ©s en « choix empirique » (n = 12 indicateurs), « dose » (n = 5), « durĂ©e » (n = 2), « administration » (n = 4), « diagnostic » (n = 2) et « documentation » (n = 3). Six indicateurs faisant consensus ont Ă©tĂ© reformulĂ©s par les experts.
Conclusions : Un consensus a Ă©tĂ© atteint pour les indicateurs de qualitĂ© visant Ă Ă©valuer lâutilisation empirique appropriĂ©e des antimicrobiens chez les patients pĂ©diatriques. Les cliniciens et les chercheurs peuvent utiliser ces indicateurs basĂ©s sur le consensus pour Ă©valuer le respect des meilleures pratiques
Authors' reply re: maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis
Frequency of adverse events following Q fever immunisation in young adults
Q fever is a zoonosis of concern in many countries. Vaccination is the most effective means of prevention, and since 1989, Australia has had a licensed Q fever vaccine, Q-VAX((R)). This vaccine was also used in the Netherlands in 2011 following the largest recorded Q fever outbreak globally. There is a paucity of available data regarding adverse events following immunisation (AEFI) for young adult females. Such data are important for informing future vaccination recommendations both within Australia and internationally. This study collected Q fever vaccine (Q-VAX((R))) AEFI data in veterinary and animal science students at Australian universities. Students were enrolled at the time of vaccination and were emailed a link to an online AEFI survey one week later. Of the 60% (499/827) that responded, 85% were female and the median age was 18 years. Local injection site reactions (ISRs) occurred in 98% (95%; CI 96-99%) of respondents, of which 30% (95% CI 24-32%) were severe. Systemic AEFI occurred in 60% (95%; CI 55-64%) of respondents within the seven days following immunisation. Medical attention was sought by 19/499 (3.8%) respondents, of whom one sought treatment at a hospital emergency department. Females were more likely than males to experience any local ISR (odds ratio [OR] 9.3; 95% CI 2.5-33.8; p < 0.001), ISRs of greater severity (OR 2.5; 95% CI 1.5-4.2; p < 0.001), and any systemic AEFI (OR 1.9; 95% CI 1.1-3.1; p = 0.016). These safety data suggest that a high frequency of adverse events following immunisation should be expected in young adults, particularly females. However, the consequences of Q fever disease are potentially far more debilitating
Challenges and opportunities of school-based HPV vaccination in Canada
Primary prevention of human papillomavirus (HPV) through vaccination is a high priority in Canadaâs cancer prevention efforts. All Canadian provinces and territories have introduced publicly funded, school-based vaccination programs against HPV, but vaccine uptake remains suboptimal in some jurisdictions. We conducted a descriptive qualitative study to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance using the socio-ecological model. In Quebec, interviews and focus groups were held in 2015â2016 with 70 key informants including immunization managers, school nurses, school principals, teachers and parents of Grade 4 students (9Â years of age). Our findings showed that HPV vaccine uptake was dependent on many interrelated factors at the individual and interpersonal level (e.g. knowledge and attitudes of the different players involved in the vaccination system), at the community level (e.g. social group values and norms, media coverage around the HPV vaccine), at the organizational level (e.g. allocated resources, information provision, consent process, immunization setting and environment) and at the policy level (e.g. changes in provincial HPV vaccine program). We are using the data collection and interpretation tools and approaches developed by our team and used in Quebec to expand our study to four other provinces (British Columbia, Alberta, Ontario and Nova Scotia). We are conducting environmental scans, semi-structured interviews and a survey to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance. Having an in-depth understanding of the determinants of HPV vaccination in school settings is critical in order to identify root causes of the suboptimal vaccine uptake and to develop tailored interventions to address these on both supply- and demand-side issues