Niedergelassene Ärzte als Multiplikatoren der Influenzaimpfung bei älteren Menschen, chronisch Kranken und medizinischem Personal

Die Bundeszentrale für gesundheitliche Aufklärung (BZgA) und das Robert Koch-Institut (RKI) haben im Oktober 2006 mit Maßnahmen zur Steigerung der Durchimpfungsrate bei Risikogruppen begonnen. Zur Ansprache von Älteren und chronisch Kranken wurden niedergelassene Ärzte (Internisten, Allgemeinmediziner, Pädiater) als Multiplikatoren gewählt: Den Ärzten wurden zielgruppenspezifische Aufklärungsmaterialien zugesandt, und sie wurden in einem Anschreiben dazu aufgefordert, die Influenzaimpfung insbesondere bei Patienten der Risikogruppen durchzuführen. Ziel der vorliegenden Studie war die Erhebung des Impfstatus der niedergelassenen Ärzte und ihrer Mitarbeiter, die Befragung der niedergelassenen Ärzte zu Einstellungen zur Influenzaerkrankung und -impfung bei Patienten der Risikogruppen und die Erhebung des Anteils der Niedergelassenen, der Patienten der Risikogruppen zur Durchführung der Influenzaimpfung motiviert. Die Befragung wurde mittels Telefoninterviews (Computer Assisted Telephone Interview, CATI) durchgeführt. Befragt wurden 700 Ärzte, davon 432 Allgemeinmediziner, 178 Internisten und 90 Pädiater. Die Influenzaimpfquote der befragten Niedergelassenen liegt bei 73% in der Saison 2006/7. Das Hauptmotiv für die Impfung ist der eigene Schutz vor einer Erkrankung. 93% der Niedergelassenen bewerten eine Influenzaerkrankung für ältere Menschen, 94% für chronisch Kranke und 59% für medizinisches Personal als gefährlich. Die Influenzaimpfung wird von den befragten Ärzten als sehr effektiv zur Krankheitsvorbeugung bei allen drei Gruppen eingeschätzt (von 93% für Ältere, von 94% für chronisch Kranke und von 83% für medizinisches Personal). Die Hälfte (50%) aller befragten Niedergelassenen empfiehlt allen drei Patientengruppen eine Influenzaimpfung. Trotz einer hohen Sensibilität für die Gefährlichkeit einer Influenzaerkrankung und einer positiven Bewertung der Influenzaimpfung zur Krankheitsvorbeugung ist der Anteil der befragten Niedergelassenen, der die Impfung allen drei Patientengruppen empfiehlt, mit 50% zu niedrig. Die Optimierung des Empfehlungsverhaltens niedergelassener Ärzte bezüglich der Influenzaimpfung wird ein Ansatzpunkt der Maßnahmen von BZgA und RKI in den Folgenjahren sein.The Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung – BZgA) and the Robert Koch Institute (RKI) started a national vaccination campaign against influenza in October 2006. Main target groups are people aged 60 and above, patients with chronic conditions, and health care workers (HCWs). The recommendation of the physician is very important for a patient’s decision to be vaccinated against influenza. Therefore, measures to increase the vaccination rate of the elderly and patients with chronic conditions were aimed at physicians as key communicators. This survey was designed to assess influenza vaccination status of physicians (general practitioners, internists, pediatricians) and their employees. Furthermore, influenza-related attitudes of the physicians and the percentage of physicians who recommend the vaccination to target groups were determined. A telephone-based survey (computer-assisted telephone interview - CATI) was conducted. A total of 700 physicians participated (432 general practitioners, 178 internists and 90 pediatricians). Physicians reported an influenza vaccination rate of 73% during the 2006/2007 influenza season. Most physicians were vaccinated to protect themselves. A total of 93% of the respondents consider influenza as dangerous for elderly patients, 94% for patients with chronic conditions, and 59% for HCWs. Vaccination is seen as very effective to prevent an influenza infection by the physicians (of 93% for the elderly, of 94% for the chronically ill, and of 83% for HCWs). Half of the physicians recommend influenza vaccination to the elderly, the chronically ill as well as to HCWs. Though physicians are well aware of the potential danger of an influenza infection for these target groups, the percentage of physicians (50%) who recommend vaccination is too low. Future optimization measures of the influenza campaign of BZgA and RKI will focus more closely on physicians’ recommendations to patients of target groups

Determination of chlorinated solvents in industrial water and wastewater by DAI–GC–ECD

A very simple and quick analytical method, based on direct aqueous injection, for determination of halogenated solvents in refinery water and wastewater, is described. There is a need to determine halogenated solvents in refinery water streams, because they may originate from several processes. There is also a need to develop methods enabling VOX to be determined in samples containing oil fractions. The method described enables simultaneous determination of 26 compounds with low detection limits (sub-μg L−1) and excellent precision, especially for highly halogenated solvents. The matrix effects of four types of sample were evaluated—the method seemed to be relatively insensitive to variations in matrix composition. Deuterated 1,2-dichloroethane was used as internal standard and surrogate compound in quantitative analysis; application of isotopically labelled compounds is rarely reported when non-mass spectrometric detectors are used for analysis. Analysis of real samples showed that the most frequently detected compounds were dichloromethane and 1,2-dichloroethane

Lanthanide-based time-resolved luminescence immunoassays

The sensitive and specific detection of analytes such as proteins in biological samples is critical for a variety of applications, for example disease diagnosis. In immunoassays a signal in response to the concentration of analyte present is generated by use of antibodies labeled with radioisotopes, luminophores, or enzymes. All immunoassays suffer to some extent from the problem of the background signal observed in the absence of analyte, which limits the sensitivity and dynamic range that can be achieved. This is especially the case for homogeneous immunoassays and surface measurements on tissue sections and membranes, which typically have a high background because of sample autofluorescence. One way of minimizing background in immunoassays involves the use of lanthanide chelate labels. Luminescent lanthanide complexes have exceedingly long-lived luminescence in comparison with conventional fluorophores, enabling the short-lived background interferences to be removed via time-gated acquisition and delivering greater assay sensitivity and a broader dynamic range. This review highlights the potential of using lanthanide luminescence to design sensitive and specific immunoassays. Techniques for labeling biomolecules with lanthanide chelate tags are discussed, with aspects of chelate design. Microtitre plate-based heterogeneous and homogeneous assays are reviewed and compared in terms of sensitivity, dynamic range, and convenience. The great potential of surface-based time-resolved imaging techniques for biomolecules on gels, membranes, and tissue sections using lanthanide tracers in proteomics applications is also emphasized

Receptivity to Protective Garments among the Elderly

Hip fractures among elders resulting from falls are a growing concern as the proportion of elders increases and health care costs mount. A recent innovation is the development of an undergarment worn to protect against hip injuries. This study attempted to determine whether a community population of elders would be receptive to wearing such a garment and the characteristics of those who would and would not be receptive. It was assumed that receptivity can be predicted by variables that have been shown to relate to risks of falling. Predictor characteristics represent three domains: demographic/predisposition, health/mobility, and social support. A logistic regression procedure was employed to determine the probability and odds of receptivity among elders given a profile of specific characteristics. Results were interpreted with reference to past research on risks of falling.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66692/2/10.1177_089826439700900305.pd