Use of standing orders programs to increase adult vaccination rates

March 24, 2000Adult immunization programs in nontraditional settings : quality standards and guidance for program evaluation prepared by Alicia S. Postema, Robert F. Breiman, National Vaccine Program Office, Office of the Director.Use of standing orders programs to increase adult vaccination rates prepared by Linda J. McKibben, Paul V. Stange, Division of Prevention Research and Analytic Methods, Epidemiology Program Office; Vishnu-Priya Sneller, Raymond A. Strikas, Epidemiology and Surveillance Division; Lance E. Rodewald, Immunization Services Division, National Immunization Program; in collaboration with Peter A. Briss, Division of Prevention Research and Analytic Methods, Epidemiology Program Office.Also available via the World Wide Web.Includes bibliographical references

National Climate Indicators System Report

The National Climate Assessment (NCA), a component of the U.S. Global Change Research Program (USGCRP), is designed to produce periodic scientific assessments of the vulnerability of important sectors in the U.S. to climate change and variability, and to report on response strategies for responding to and coping with change. An important feature of the NCA is to develop climate-relevant information for use by a wide variety of stakeholders in the public and private sectors and in the scientific community. The development of a national system of indicators is an essential feature of such information, and provides a foundation for assessing change on an ongoing basis

The 2009 Report to the Secretary: Rural Health and Human Services Issues

This is the 2009 Annual Report by the National Advisory Committee on Rural Health and Human Services (NACRHHS). This year’s report examines three key topics in health and human services and their effects in rural areas: workforce and community development, creating viable patient-centered medical homes, and serving at-risk children. All are pertinent and timely issues that the Committee chose during its February 2008 meeting. The chapters draw from published research and from information gathered during site visits to rural North Carolina and rural Minnesota

Report of the National Advisory Committee on Palliative Care / Chairman, Dr. Tony O'Brien

DOHC / 200

Zimbabwe National Cancer Registry: summary data, 1986-1989

A summary data of the national registry of cancer in Zimbabwe in the period 1986 to 1989.The Zimbabwe National Cancer Registry began operation in 1986. Between 1986-1989, a total of 8 276 cases were identified. Among men of African descent, oesophageal (11,2 pc) and liver cancer (11,0 pc) were most common. Cervical cancer was by far the most common among women of African descent (34,5 pc). Among both males and females of non-African descent, skin cancers (other than melanoma) accounted for one-third of cancers followed by prostate cancer (7,7 pc) in males and breast cancer (18,5 pc) in females. These findings arc comparable to earlier reports of the epidemiology of cancer in Zimbabwe

Photovoice and refugee research: The case for a ‘layers’ versus ‘labels’ approach to vulnerability

‘Vulnerability’ is a key concept used to understand the ethical implications of conducting refugee-focused research. This case study illustrates the need to follow Luna’s (2009) call for a shift from a ‘labels’ to a ‘layers’ approach to vulnerability by analysing how two university ethics committees responded to issues of informed consent in two similar refugee research projects using the PhotoVoice method. The following commentary argues that, when driven by a research governance regime, ethics review risks viewing refugees through a static label of vulnerability, negatively affecting research viability and data quality. In contrast, a layers approach opens space for understanding the potential for vulnerability amongst refugee research participants while supporting PhotoVoice’s goals of empowerment and facilitating agency. The case study highlights the need for national-level ethics statements that encourage a more flexible approach within research institutions

Healthy Start vitamins—a missed opportunity:findings of a multimethod study

OBJECTIVE: To evaluate and provide a real-life view of the operation of the Healthy Start vitamins scheme. SETTING: The study took place in primary care and community settings that served rural, urban and ethnically diverse populations, in two sentinel sites: London, and Yorkshire and the Humber. An online consultation and stakeholder workshops elicited views from across England. PARTICIPANTS: 669 health and social care practitioners including health visitors, midwives, public health practitioners, general practitioners, paediatricians and support staff participated in focus group discussions (n=49) and an online consultation (n=620). 56 participants representing health and social care practitioners, policymakers, service commissioners, and voluntary and independent sectors took part in stakeholder workshops. METHODS: Three-phase multimethod study comprising focus group discussions, an online consultation and stakeholder workshops. Qualitative data were analysed thematically and quantitative data from the online survey were analysed using descriptive statistics. RESULTS: Study participants were concerned about the low uptake of Healthy Start vitamin supplements and the consequences of this for health outcomes for women and young children. They experienced Healthy Start vitamin distribution as logistically complex, requiring the time, resources and creative thinking of a range of local and regional practitioners from senior strategists to administrative support workers. In the light of this, many participants argued that moving to universal provision of vitamin supplements would be more cost-effective than the current system. CONCLUSIONS: There is consistency of views of health practitioners that the current targeted system of providing free vitamin supplements for low-income childbearing women and young children via the Healthy Start programme is not fulfilling its potential to address vitamin deficiencies. There is wide professional and voluntary sector support for moving from the current targeted system to provision of free vitamin supplements for all pregnant and new mothers, and children up to their fifth birthday

Public health preparedness in Alberta: a systems-level study

BACKGROUND: Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. METHODS/DESIGN: We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. DISCUSSION: The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems

Brexit: human resourcing implications

Purpose: Three years on from the Brexit vote, while it remains a central topic for debate in the media, there has been limited discussion about the human resource (HR) implications. The purpose of this paper is to provide theoretical evaluation and informed discussion, distilled into four interconnected propositions, on how employee resourcing as a HR practice may be impacted following actual Brexit decisions. Design/methodology/approach: Drawing on the employee resourcing literature, the paper adopts a discursive approach which examines how the UK’s decision to exit the European Union will affect HR practice. The paper draws comparison with the global recession since 2008, a similarly unprecedented development in its discussion of employee resourcing practices and draws parallels which may help to inform the future of HR practices in the UK, because of Brexit. Findings: This paper offers a set of propositions; the flow of talent into the UK may become more restricted and reinvigorate the “war for talent” that followed the effects of the global financial crisis on the UK. To attract and retain workers in relatively lower-skilled roles, employers may be faced with a need to re-skill such roles and adopt more flexible working arrangements. Finally, to meet skilled employment requirements, removal of restrictions to recruit from within the European Economic Area may trigger increased global migration of skilled workers. Originality/value: This paper contributes to the discussions regarding the implications of Brexit for HR practice by offering propositions to shape future research agendas

The epidemiology of invasive pneumococcal disease in the Canadian North from 1999 to 2010

Introduction . The International Circumpolar Surveillance network is a population-based surveillance system that collects data on invasive pneumococcal disease (IPD) in Northern Canada. A 7-valent pneumococcal conjugate vaccine was first introduced in some regions of Northern Canada in 2002, followed by 10-valent (2009) and 13-valent (PCV-13) vaccines (2010). A 23-valent polysaccharide (PPV-23) vaccine was first introduced in 1988 for special populations and adults aged 65 years and older. To describe the epidemiology in the context of pneumococcal vaccination programs, we analysed surveillance data from Northern Canada from 1999 to 2010. Methods . A standardized case report form capturing demographic and clinical information was completed for all IPD cases in Northern Canada meeting the national case definition. Isolates were sent to a reference laboratory for confirmation, serotyping and antimicrobial resistance testing. Both laboratory and epidemiological data were sent to the Public Health Agency of Canada for analysis. Population denominators were obtained from Statistics Canada. Results . From 1999 to 2010, 433 IPD cases were reported (average 36 cases per year). Incidence was greatest among infants aged <2 years and among those aged 65 years and older, with an average annual incidence of 133 and 67 cases per 100,000 population, respectively. After a peak in incidence in 2008, rates among infants have declined. Incidence rates varied from 2 to 16 times greater, depending on the year, among Aboriginals compared to non-Aboriginals. Hospitalization was reported in 89% of all cases and the case fatality ratio was 6.0%. Clinical manifestations varied, with some patients reporting >1 manifestation. Pneumonia was the most common (70%), followed by bacteremia/septicaemia (30%) and meningitis (8%). Approximately, 42% of cases aged <2 years in 2009 and 2010 had serotypes covered by the PCV-13. In addition, the majority (89%) of serotypes isolated in cases aged 65 years and older were included in the PPV-23 vaccine. Conclusion . IPD continues to be a major cause of disease in Northern Canadian populations, with particularly high rates among infants and Aboriginals. Continued surveillance is needed to determine the impact of conjugate pneumococcal vaccine programs. Additional studies investigating factors that predispose infants and Aboriginal peoples would also be beneficial