Disparities in Influenza Vaccination Coverage Rates by Target Group in Five European Countries: Trends Over Seven Consecutive Seasons

BACKGROUND: The primary objective of this study was to measure influenza vaccination coverage rates in the general population, including children, and in high-risk groups of five European countries during the season 2007/2008. An additional aim was to analyze coverage trends over seven consecutive seasons and to gain an understanding of the primary drivers and barriers to immunization. METHODS: Community-based telephone and mail surveys have been conducted in the UK, Germany, Italy, France, and Spain, yearly, since 2001/2002. Approximately 2,000 individuals per country and season were interviewed who were considered to be representative of the adult population aged 14 years and older. Data on the vaccination status of children were obtained by proxy interviews. The questionnaire used was essentially the same for all seven seasons. Five target groups were identified for the study: (1) persons aged >/= 65 years; (2) elderly suffering from a chronic illness; (3) patients suffering from a chronic illness; (4) persons working in the health care sector; (5) children. RESULTS: In the season 2007/2008, vaccination coverage rates in the general population remained stable in Germany. Compared to the coverage rates of the previous season, increases of 3.7%, 2.0%, and 1.8% were observed for the UK, Spain, and France, respectively, while a decrease of -1.5% was observed for Italy. Across all five countries, vaccination rates in the predefined target groups decreased to some extent (elderly) or increased slightly (chronically ill and health care workers). Vaccination rates among children varied strongly between countries and ranged from 6.1% in UK to 19.3% in Germany. The most powerful motivation for getting vaccinated in all countries was advice from a family doctor (58.6%) and the perception of influenza as a serious illness (51.9%). The major reasons why individuals did not become vaccinated were (1) the feeling of not being likely to catch influenza (39.5%) and (2) never having considered the option of being vaccinated (35.8%). CONCLUSIONS: The change in general influenza vaccination coverage in the 2007/2008 season compared to the previous season was small, but decreases were seen in some target groups. The underlying motivations for and against vaccination did not substantially change. An effort to activate those driving forces that would encourage vaccination as well as dealing with barriers that tend to prevent it may help enhance coverage rates in Europe in the future

Detecting nutritional state and food source use in field-collected insects that synthesize honeydew oligosaccharides.

1. During the adult stage many arthropod species, including aphid predators and parasitoids, depend on nectar and honeydew as a source of carbohydrates. Despite the importance of sugar feeding for these organisms, we know little about their energy and nutrient provision under field conditions. 2. Here we assessed the nutritional state of adult parasitoids, hoverflies and lacewings in a Swiss winter wheat (WW) and a spring wheat (SW) field and studied the contribution of honeydew to the diet of these aphidophagous insects. The total sugar level and the glucose-fructose ratio were used as indicators for nutritional state and sugar feeding. 3. Over 76% of the collected individuals from each of the three insect groups in both fields had recently consumed carbohydrates. The average nutritional state was significantly higher in the SW field for Chrysoperla carnea and Aphidius spp. 4. Honeydew consumption by insects is commonly investigated by analyzing target insects for the presence of honeydew 'signature' sugars, such as melezitose and erlose. However, our laboratory studies show that adults of the three insect orders investigated synthesize these 'honeydew-specific' sugars after sucrose feeding. 5. As the erlose-melezitose ratio of sucrose-fed Aphidius spp. and the hoverfly Episyrphus balteatus differed clearly from the honeydew sugar profiles of wheat infesting aphids, this ratio could be used as an alternative indicator of honeydew feeding. However, this method could not be used for the lacewing C. carnea. 6. Our data show that 55% (WW) and 59% (SW) of field-collected Aphidius spp. which showed evidence of sugar feeding could be classified as having consumed honeydew within the 24–48 h before collection. Evidence of honeydew feeding by hoverflies, on the other hand, was found to be much more variable, ranging from 0% in the WW field to 44% in the SW field. 7. This study shows that the detection of honeydew consumption in field-collected insects based on honeydew oligosaccharides can be feasible even when insects synthesize these oligosaccharides themselves

Guidelines for the diagnosis and treatment of acute and subacute rhinosinusitis in children

The importance of rhinosinusitis finally reached pediatricians' attention a few years ago, and it has now been demonstrated that it is medically important and has a considerable socioeconomic impact in childhood. These guidelines, which have been prepared with and approved by many Italian Scientific Societies, are based on the most recent findings in the fields of clinical symptoms, imaging and microbiology tests for the diagnosis of acute rhinosinusitis, and efficacy evidence concerning antibiotic treatment and non-antibiotic adjuvant treatment. A Pubmed search using the key words "sinusitis", "rhinosinusitis", "child" and "antibiotic treatment", and the limits "human studies" and "English language", led to the selection of more than 2,700 articles published between 1966 and 2007. These guidelines are based on the 125 that were considered truly relevant and reflect the most widely shared positions concerning the diagnosis and treatment of acute, subacute and recurrent rhinosinusitis in children