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1.
《Vaccine》2018,36(52):8138-8147
ObjectiveTo determine uptake of influenza vaccination in children with special risk medical conditions (SRMC) and to explore associations with vaccination.DesignCross-sectional study.Setting/participantsParents of children with a SRMC attending either outpatient department clinics or being an inpatient at the Women’s and Children’s Hospital (WCH), Adelaide, Australia from September 2015 to February 2016 were recruited using convenience sampling.MethodsData were collected using a face-to-face survey. Influenza vaccination was verified with providers. Characteristics associated with uptake were explored using univariable and multivariable analyses.ResultsThere were 410 participants with complete data. Confirmed influenza vaccination at least once in the last two years was 50%, annual uptake was 32.8%. 63.9% of parents were aware of the vaccination recommendation and 57.9% had been recommended by a specialist or general practitioner (GP). Characteristics strongly associated with uptake included: receiving a recommendation from a specialist or GP and having a parent receive the influenza vaccine annually.ConclusionsDespite a long standing funded program, influenza vaccination uptake in children with SRMC is suboptimal. Parental vaccination behaviour, along with medical practitioner recommendation, particularly specialist recommendation, appear to be key influences in facilitating vaccination. Potential interventions could target the family rather than just the individual child. Understanding the barriers to recommendation from the perspective of general medical practitioners and specialists who treat these children is needed.  相似文献   

2.
《Vaccine》2020,38(17):3387-3396
BackgroundIn many countries, annual immunization with inactivated influenza vaccine (IIV) is recommended for children with medical risk conditions. Prior cost-effectiveness analyses found such immunization to be cost saving, but assumed effectiveness against non-severe influenza outcomes and a higher effectiveness against severe influenza outcomes than recent studies would suggest. However, recent vaccine studies do not indicate any reduction in community or outpatient disease episodes in IIV immunized individuals. We therefore evaluated cost-effectiveness of IIV immunization in children with medical risk conditions in the Netherlands, assuming that IIV reduces influenza-related hospitalization and death, but has no meaningful impact on non-severe health outcomes.MethodsA health economic decision tree model was developed to evaluate health effects and costs of annual IIV immunization versus no immunization. Model inputs were based on our study on influenza-related primary care visits and other literature. Immunization was considered cost effective if associated costs were less than €20,000 per quality-adjusted life year (QALY) gained. Probabilistic sensitivity analyses were performed to assess robustness of results, and one-way sensitivity analyses and scenario analyses were done to assess the influence of individual parameters.ResultsAnnual IIV prevents an average of 1.59 influenza-related hospitalizations and 0.02 deaths per 1,000 children with medical risk conditions. This results in an expected QALY gain of 0.43 at incremental costs of €21,564 per 1,000 children, corresponding to an incremental cost-effectiveness ratio (ICER) of €50,297/QALY compared to no immunization. Under base case assumptions, immunization had a 5% probability of being cost effective. Results were most influenced by vaccine efficacy against fatal influenza, QALY loss due to death, and mortality rate.ConclusionsIf IIV only reduces severe disease outcomes, as current evidence suggests, annual immunization of medical risk children is unlikely to be cost effective. Results should however be interpreted with caution as cost-effectiveness is largely dependent on incidence and QALY losses for fatal influenza, for which evidence is scarce.  相似文献   

3.
《Vaccine》2020,38(17):3397-3403
BackgroundThe effectiveness of inactivated influenza vaccine (IIV) immunization in preventing all cause respiratory illness (RI) in children with pre-existing medical conditions has not been fully established and varies from season to season. This study aims to quantify the overall impact of IIV immunization on primary care attended RI episodes in children with pre-existing medical conditions, using robust observational data spanning twelve influenza seasons.MethodsElectronic records of IIV eligible children aged 6 months to 18 years were extracted from primary care databases over the years 2004–2015. IIV eligibility criteria according to Dutch guidelines included (chronic) respiratory and cardiovascular disease and diabetes mellitus. For each year, information on IIV immunization status, primary care attended RI episodes (including influenza, acute respiratory tract infections and asthma exacerbations) and potential confounders were collected. Generalized estimating equations were used to model the association between IIV status and occurrence of at least one RI episode during the influenza epidemic period with “current year immunized” as reference group. Robustness of findings were assessed by performing various sensitivity analyzes in which (i) seasons with a mismatch between the dominant circulating influenza virus and vaccine strain were excluded, (ii) influenza periods were further restricted to weeks with at least 30% influenza virus positive specimens in sentinel surveillance (instead of 5%), (iii) propensity scores were used to adjust for confounding.ResultsIn total, 11,797 children (follow-up duration: 38,701 child-years) were eligible for IIV for ≥ one season with 29% immunized at least once. The adjusted odds for primary care attended RI episodes during the influenza epidemic period did not differ between current season immunized versus not immunized children (adjusted OR:1.01; 95%CI:0.90–1.13). The various sensitivity analysis showed comparable results.ConclusionsIIV immunization in children with pre-existing medical conditions does not reduce all cause RI episodes encountered in primary care during the influenza season.  相似文献   

4.
《Vaccine》2021,39(17):2331-2334
Data on influenza vaccination status among household contacts of asthmatic children are lacking. Our aim was to assess the influenza vaccination status of parents and caregivers of asthmatic children in the 2018–2019 season as well as to identify reasons for undervaccination. We performed a questionnaire-based survey in parents, caregivers and household contacts of 178 asthmatic children. Only the 50.6% of children were vaccinated, while in 79.8% of cases both parents were unvaccinated. More than 40% of them reported that they were unaware about the necessity of vaccination; approximately 30% stated that they were not properly advised, and the rest were concerned about influenza vaccine side effects and effectiveness. Factor analysis identified three groups: (a) influenza vaccine “believers” who were unaware that vaccination was necessary; (b) “deniers” who were less educated and with older children; (c) older and more educated vaccine “deniers”. To improve influenza vaccine coverage among household contacts of asthmatic children, appropriate counseling and targeted interventions should be planned.  相似文献   

5.
《Vaccine》2015,33(41):5458-5463
BackgroundStroke may be triggered by respiratory infections, including influenza. Influenza vaccination could therefore reduce risk of stroke. Previous studies of this association have shown conflicting results. We aimed to investigate whether influenza vaccination was associated with reduced risk of stroke.MethodsWe used a self-controlled case series design. The General Practice Research Database (GPRD) was used to extract records of patients aged 18 years or over recorded with stroke (fatal or non-fatal) from September 2001 to May 2009. Statistical modelling with conditional Poisson regression was employed to compute incidence rate ratios (IRR). The incidence rate of stroke in fixed time periods after influenza vaccination was compared with the incidence rate during a baseline period.ResultsThere were 17,853 eligible individuals who received one or more influenza vaccinations and experienced a stroke during the observation period. The incidence of stroke was significantly reduced in the first 59 days following influenza vaccination compared with the baseline period. We found reductions of 55% (IRR 0.45; 95% CI 0.36–0.57) in the first 1–3 days after vaccination, 36% (0.64; 0.53–0.76) at 4–7 days, 30% (0.70; 0.61–0.79) at 8–14 days, 24% (0.76; 0.70–0.84) at 15–28 days and 17% (0.83; 0.77–0.89) at 29–59 days after vaccination. Early vaccination between 1 September and 15 November showed a greater reduction in IRR compared to later vaccination given after mid-November.ConclusionsInfluenza vaccination is associated with a reduction in incidence of stroke. This study supports previous studies which have shown a beneficial association of influenza vaccination for stroke prevention.  相似文献   

6.
Health-related quality of life denotes the patients’ perception of well-being and function in physical, emotional, mental, social, and everyday life areas. In medicine, it is frequently used as an outcome criterion to evaluate the quality and effect of different therapies. It is also frequently used in epidemiological studies, as well as health economic research. Approaches to assess the quality of life include patients’ self-report versus report by other persons, multidimensional versus unidimensional assessment of well-being and function, as well as the use of generic versus disease-specific methods. In the past 20 years, a multitude of instruments to assess health-related quality of life has been developed, mostly for adults, complying with psychometric standards concerning the reliability, validity, and sensitivity of the scales. The current paper describes challenges to the assessment of the quality of life in children and adolescents, introduces widely used generic measures, and focuses on the application of these measures in the research context by using examples from a German prospective study in pediatric rehabilitation and an international project to develop a set of quality of life instruments for children with chronic conditions. The quality of life area has developed to be a major innovation also in public health. In terms of including the perspective of children and adolescents, efforts directed at assessments have increased recently, but much needs to be done to include these measures in epidemiological and clinical studies.  相似文献   

7.
Influenza vaccination is recommended for children with chronic medical conditions yet is infrequently performed. The reasons for low influenza vaccination rates in this group have not been well studied. We assessed and compared parents of children with chronic medical conditions regarding their beliefs and attitudes about influenza vaccination in 2003 and 2004. Parents of 2- to 13-year-old children with chronic medical conditions from health centers in low-income urban neighborhoods completed a 19-question survey, mailed following the 2002–2003 and 2003–2004 influenza seasons. Parent-reported influenza vaccination rate declined from 2003 (44%) to 2004 (25%). The most important factors related to influenza vaccination status were perceived doctor's recommendation (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 3.7–9.7), parents' belief that the child should be vaccinated (OR = 5.4, 95%CI = 3.3–8.8), relatives' belief that the child should be vaccinated (OR = 1.7, 95%CI = 1.1–2.7), easy access to the doctor's office for a flu shot (OR = 2.4, 95%CI = 1.4–4.2), and receipt of a reminder from the doctor's office (OR = 1.7, 95%CI = 1.1–2.6). In 2004 compared with 2003, fewer parents reported getting a reminder, and fewer believed that their child's doctor recommended flu vaccine. Doctors' recommendation that children with chronic medical conditions should receive an annual influenza vaccine and vaccine availability are important factors that resulted in a higher likelihood of influenza vaccination. Our findings that fewer parents reported receiving reminders and that fewer children were vaccinated in 2004 suggest that sustained improvements in vaccination rates may require continual changes in the format and delivery method of vaccination reminders from physicians.  相似文献   

8.
《Vaccine》2018,36(52):8047-8053
BackgroundAnnual influenza vaccination has been recommended for persons with high-risk conditions since the 1960s. However, few estimates of influenza vaccine effectiveness (VE) for persons with high-risk conditions are available.MethodsData from the U.S. Influenza Vaccine Effectiveness Network from 2012 to 2016 were analyzed to compare VE of standard-dose inactivated vaccines against medically-attended influenza among patients aged ≥6 months with and without high-risk medical conditions. Patients with acute respiratory illness were tested for influenza by RT-PCR. Presence of high-risk conditions and vaccination status were obtained from medical records. VE by influenza virus type/subtype and age group was calculated for patients with and without high-risk conditions using the test-negative design. Interaction terms were used to test for differences in VE by high-risk conditions.ResultsOverall, 9643 (38%) of 25,369 patients enrolled during four influenza seasons had high-risk conditions; 2213 (23%) tested positive for influenza infection. For all ages, VE against any influenza was lower among patients with high-risk conditions (41%, 95% CI: 35–47%) than those without (48%, 95% CI: 43–52%; P-for-interaction = 0.02). For children aged <18 years, VE against any influenza was 51% (95% CI: 39–61%) and 52% (95% CI: 39–61%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.54). For adults aged ≥18 years, VE against any influenza was 38% (95% CI: 30–45%) and 44% (95% CI: 38–50%) among those with and without high-risk conditions, respectively (P-for-interaction = 0.21). For both children aged <18 and adults aged ≥18 years, VEs against illness related to influenza A(H3N2), A(H1N1)pdm09, and influenza B virus infection were similar among those with and without high-risk conditions.ConclusionsInfluenza vaccination provided protection against medically-attended influenza among patients with high-risk conditions, at levels approaching those observed among patients without high-risk conditions. Results from our analysis support recommendations of annual vaccination for patients with high-risk conditions.  相似文献   

9.
BackgroundChildren with chronic conditions often experience numerous symptoms, but few research studies examine patterns of symptoms and quality of life (QoL) indicators.ObjectiveTo examine if reliable latent classes of children with chronic medical conditions can be identified based on the clustering of symptoms and QoL indicators.MethodsStructured interviews were conducted with children ages 9–21 living with chronic medical conditions (N = 90). Multiple symptoms (e.g., pain, sleep, fatigue, and depression) and QoL indicators (e.g., life satisfaction and social support) were measured. Physical health and emotional, social, and school functioning were measured using the Pediatric Quality of Life Inventory (PedsQL). Latent class analysis was used to classify each child into a latent class whose members report similar patterns of responses.ResultsA three-class solution had the best model fit. Class 1 (high-symptom group; n = 15, 16.7%) reported the most problems with symptoms and the lowest scores on the QoL indicators. Class 2 (moderate-symptom group; n = 39, 43.3%) reported moderate levels of both symptoms and QoL indicators. Class 3 (low-symptom group; n = 36, 40.0%) reported the lowest levels of symptoms and the highest scores on the QoL indicators.ConclusionsThe three latent classes identified in this study were distributed along the severity continuum. All symptoms and QoL indicators appeared to move in the same direction (e.g., worse symptoms with lower QoL). The PedsQL psychosocial health summary score (combining emotional, social, and school functioning scores) discriminated well between children with different levels of disease burden.  相似文献   

10.
《Vaccine》2020,38(8):1906-1914
BackgroundVaccination coverage in Bosnia and Herzegovina has been declining over recent years. A World Health Organization Tailoring Immunization Programmes (TIP) project is underway to gain insights into the underlying reasons for this, to develop tailored interventions. As part of TIP, this study aimed to investigate the views of health workers on their barriers and drivers to positive childhood vaccination practices.MethodsFace-to-face qualitative interviews explored 38 health workers’ views on vaccination coverage, their vaccination attitudes, and system, programme and institutional influences on their vaccination practices. The data were analysed using content analysis and organised by the COM (Capability, Opportunity and Motivation) factors.FindingsVery few differences in barriers and drivers were evident between high and low coverage primary care centres or across different professional roles.Capability: Drivers included awareness of the risks of low vaccination coverage, regular use of the Rulebook and Order, knowledge of how to advise parents on mild side effects and recognition of the importance of good communication with parents. Key barriers were the use of false contraindications to postpone vacination and poor skills in tailoring communication with parents.Opportunity: Drivers were sufficient time for adminstering vaccination and good availability of vaccines. Several barriers were evident: lack of implementation of mandatory vaccination, no uniform recall and reminder system or system for detecting under-vaccinated children, staff shortages and lack of time to discuss vaccination with parents.Motivation: Drivers were a belief in the value, safety and effectiveness of vaccination and seeing that they have an important role to play. Barriers were a tendency to blame external factors e.g. anti-vax movement and a fear of being blamed for adverse events.ConclusionsThe study identified complex and inter-related barriers and drivers to health worker positive vaccination practices. These insights will now inform a process to identify and prioritize interventions.  相似文献   

11.

Background

Elderly patients with chronic obstructive pulmonary disease (COPD) are at a higher risk of hospitalization for cardiovascular complications, especially during respiratory infections. Previous studies showed that vaccination for influenza may reduce the risk of recurrent major cardiovascular events in patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate the hypothesis that influenza vaccination could reduce hospitalizations for ACS in elderly patients with COPD.

Method

Using the Taiwan Longitudinal Health Insurance Database 1996–2008, this cohort study comprised elderly patients (≥55 years old) with a recorded diagnosis of COPD (n = 7722) between January 1, 2000 and December 31, 2007. Each patient was followed until the end of 2007. A propensity score was derived by using a logistic regression model to reduce vaccine therapy selection bias. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS in elderly COPD patients was examined by Cox proportional hazards regression analysis. In addition, we categorized the patients into four groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2−3, and ≥4).

Results

We found that elderly patients with COPD receiving influenza vaccination had a lower risk of hospitalization for ACS (adjusted HR = 0.46, 95% CI (0.39–0.55), p < 0.001). We observed similar protective effects in both sexes and all age groups (55−64, 65−74, ≥75) regardless of influenza seasonality. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for hospitalization because of ACS were 0.48 (0.38−0.62) and 0.20 (0.14−0.28) for patients who received 2−3 and ≥4 vaccinations during the follow-up period.

Conclusion

Our data showed that there was a lower risk of ACS hospitalization in elderly patients with COPD receiving annual influenza vaccination.  相似文献   

12.
《Vaccine》2015,33(6):759-770
BackgroundInfluenza is a common cause of morbidity and mortality, especially among the elderly and those with certain chronic diseases. Annual influenza vaccination is recommended for individuals in at-risk groups, but rates of vaccination are particularly low in children with high-risk conditions (HRCs).ObjectiveTo conduct a systematic review of studies that have examined interventions aimed at improving influenza vaccination in children with HRCs.MethodsTwo databases – PubMed and SCOPUS – were searched (with no time or language restrictions) using a combination of keywords – Influenza AND vaccination OR immunization OR children AND asthma OR malignancy OR high-risk AND reminder. Duplicates were removed, and abstracts of relevant articles were screened using specific inclusion/exclusion criteria. Thirteen articles were selected, and five additional studies were identified following a review of the reference lists of the initial thirteen articles, bringing the total number to eighteen.ResultsMost studies were conducted in the United States. Among the 18 studies, there was one systematic review of a specific intervention in asthmatic children, seven randomized controlled trials (RCTs), six before-and-after studies, one non-randomized controlled trial, one retrospective cohort study, one quasi-experimental post-test study, and one letter to editors. Interventions reported include multi-component strategies, letter reminders, telephone recall, letters plus telephone calls, an asthma education tool and year-round scheduling for influenza vaccination, amongst others.ConclusionThere is good evidence that reminder letters will improve influenza vaccination uptake in children with HRCs, but the evidence that telephone recall or a combination of letter reminder and telephone recall will improve uptake is weak. It is not known if multiple reminder letters are more effective than single letters or if multi-component strategies are more effective than single or dual component strategies. There is a need for further research of these interventions, possibly outside the United States.  相似文献   

13.
Ferdinands JM  Belongia EA  Nwasike C  Shay DK 《Vaccine》2011,29(10):1935-1940
Estimates of influenza vaccine effectiveness from observational studies that rely on physician-ordered influenza tests may be biased if physician testing behavior is influenced by patient vaccination status. To assess the potential for differential diagnostic testing of children by vaccine status, we examined the association between receipt of a commercial influenza diagnostic test and influenza vaccination among children aged 6-59 months who sought care at the Marshfield Clinic for acute respiratory or febrile illnesses during the 2004-05 through 2007-08 influenza seasons. There was no significant association between prior influenza vaccination and receipt of a diagnostic test for influenza. These findings suggest that estimates of vaccine effectiveness derived from observational studies among children are unlikely to be biased due to differential diagnostic testing.  相似文献   

14.
15.
目的:以W市为例研究慢性病住院患者所致医保支出的分布特征,并测算基本医疗保险的实际报销水平和患者的自付水平,为完善医疗保险慢性病政策提供决策依据。方法:依据ICD-10编码,从W市医保局的系统数据中提取主要慢性病患者的住院信息并进行分类整理。结果:2018年慢性病对职工医保和城乡居民医保所带来的住院负担分别达到了40.6亿元和10.7亿元。其中,两种共病患者和中老年人是医保支出占比最高的群体,而三级医院则是医保支出流向最多的机构。虽然医保基金的实际报销比例随着慢性病患者年龄的增大而呈上升趋势,但是患者自付水平却没有稳定下降。结论:慢性病在很大程度上加重了医保基金的支付压力,应该转变传统的医保管理理念,强化慢性病门诊保障力度,加强对于医保基金的监管,并优化慢性病患者的医保待遇结构。  相似文献   

16.
《Vaccine》2018,36(45):6790-6795
BackgroundIn Australia, the influenza vaccine is funded for Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) children aged 6 months to <5 years old. In Victoria, only 2% of Aboriginal children are vaccinated against influenza.ObjectiveTo evaluate whether sending a letter or sending a pamphlet directly to parents/guardians would improve influenza vaccine uptake amongst Aboriginal identified children.DesignThe study involved a multi-arm, parallel, randomised controlled trial with two intervention groups and one control group.Participants & settingParticipants included parents or guardians of Victorian children (aged 6 months to <5 years) who identified as Aboriginal. Households (n = 5534) were randomised (using a random number generator) to receive either a personalised letter (n = 1845), a pamphlet (n = 1845), or no direct communication (control) (n = 1844). The letter and the pamphlet were designed using the INSPIRE framework – a set of behaviour change techniques for action-oriented communication.Main outcome measureThe proportion of households where all eligible children received the influenza vaccine between 2 May 2017 and 1 September 2017.ResultsThe control group’s vaccination rate was 4.4%, higher than previous years. The pamphlet group achieved a similar vaccination rate (4.5%). The letter group’s vaccination rate of 5.9% was significantly higher than the control group [χ2 (1, n = 3689) = 4.33, p = .037].ConclusionsSending a personalised letter directly to parents/guardians was an effective strategy for increasing influenza vaccination among Aboriginal children. The ineffectiveness of the pamphlet may be due to the lack of personalisation and the authority associated with the letter. Additional research is required to understand participant responses to the material.Trial registrationThis research was retrospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) on 13 September 2017 (ACTRN12617001315303).  相似文献   

17.
Promotional campaigns recommend immunisation against influenza in healthcare workers (HCWs) but the uptake in this group remains low. We conducted a survey study during the 2008–2009 influenza vaccination period amongst future HCWs to quantify uptake and identify barriers to immunisation. Overall uptake was 8.0% (95% CI 5.9–10.8%), which is lower than the uptake amongst current HCWs (13.4%) and short of current government targets (75%). Knowledge about influenza was good but insufficient to encourage HCWs to get vaccinated. Promotional campaigns are needed that emphasise the role of vaccination in personal and patient protection.  相似文献   

18.
《Vaccine》2019,37(31):4268-4274
ObjectivesTo assess influenza immunisation rates and coverage in adult patients from Australian general practice and identify whether practice or patients’ characteristics are associated with vaccination uptake.DesignOpen cohort study.Setting550 Australian general practices included in the MedicineInsight database.ParticipantsPatients aged 18+ years who had at least one consultation during influenza season between 2015 and 2017. Two samples were considered: (1) ‘active’ patients (at least three consultations in any two consecutive years) and (2) ‘every year’ patients (at least one consultation per year).Main outcome measuresInfluenza vaccination rates per 1,000 consultations and coverage (% vaccinated among those who consulted) from 2015 to 2017.ResultsBetween 2015 and 2017 the influenza vaccine rate changed from 57.4 to 51.7 and 67.0 per 1,000 consultations, while correspondent values for coverage were 29.3%, 25.2% and 27.6% (in ‘active’ patients). Vaccine coverage was at least 30% higher in inner regional areas, among patients aged 65+ years or those with comorbidities. Similar associations were found among ‘every year’ patients, but average coverage across the three years was higher (41% vs 27%). Aboriginal and Torres Strait Islander people, either with or without comorbidity, showed a vaccine coverage 10–30% higher than non-Indigenous people for those aged less than 65 years (p-value for interaction < 0.001).ConclusionMedicineInsight data is a useful and low-cost method to monitor influenza immunisation coverage. Independent of the sample used, vaccination coverage among Indigenous people or patients with comorbidities could be improved. Targeted strategies for high-risk groups need to be developed.  相似文献   

19.
Objectives The aim of this study was to shorten the Health-Related Quality of Life (HRQL) DISABKIDS Chronic Generic Measure (DCGM) for children and adolescents and to test its reliability, construct, and external validity. Study design 1153 children and adolescents (8–16 years) with chronic health conditions (asthma, arthritis, epilepsy, cerebral palsy, diabetes, atopic dermatitis, cystic fibrosis) and their family were recruited from different paediatric clinical settings in seven European countries. A two-time assessment comprised reports on sociodemographics, health status and HRQL of children/adolescents. Results The 37-item DCGM describes six dimensions (Independence, Physical Limitation, Emotion, Social Inclusion, Social Exclusion and Treatment) confirmed by Confirmatory Factor Analysis, multi-item scaling and item-goodness of fit to Rasch model. Internal consistency (Cronbach’s alpha: 0.70–0.87) and test-retest reliability (ICC: 0.71–0.83) were satisfactory. Correlations between DCGM-37 and other HRQL instruments were the highest between dimensions evaluating similar concepts. Regarding discriminant validity of the DCGM-37, girls and older adolescents reported lower emotional we ll-being. Children belonging to families with low level of affluence and those with severe health conditions were found to have worse HRQL in all domains. Conculsion Reliability, construct validity as well as convergent and discriminant validity of the DCGM-37 were shown. The DISABKIDS Group comprises a coordinating group (Prof. Monika Bullinger, Dr. Silke Schmidt, Dr. Corinna Petersen, Institute of Medical Psychology, University Clinic Hamburg-Eppendorf) and study centres in seven countries: Prof. Michael Quittan, Dr. Othmar Schuhfried, Department of Physical Medicine and Rehabilitation, University of Vienna, Austria; Dr. Marie Claude Simeoni, Dr. David Debensason, Delphine Orbicini, Department of Public Health, University Hospital of Marseille, France; Dr. Ute Thyen and Dipl.-Psych. Esther Müller-Godeffroy, Department of Paediatrics, Medical University of Lübeck, Germany; Dr. Athanasios Vidalis, Department of Psychiatry, Ass. Prof. John Tsanakas, Dr. Elpis Hatziagorou and Dr. Paraskevi Karagianni, Department of Paediatrics, Hippocratio Hospital, Greece; Dr. Hendrik Koopman and Dr. Rolanda Baars, Department of Paediatrics, Leiden University Medical Centre, Netherlands; Dr. John Eric Chaplin, Department of Paediatrics, University Hospital Lund, Sweden; Prof. Mick Power, Dr. Clare Atherton and Dr. Peter Hoare, Clinical and Health Psychology, University of Edinburgh, United Kingdom.  相似文献   

20.
《Vaccine》2018,36(20):2809-2815
BackgroundTo date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1–15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting.MethodsWe conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies.The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination.ResultsTotal study population throughout the four consecutive influenza seasons was over 116,000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons.ConclusionsWe confirmed the clinical effectiveness of influenza vaccination in children aged 1–15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications.  相似文献   

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