Pandemic and seasonal H1N1 influenza hemagglutinin-specific T cell responses elicited by seasonal influenza vaccination

Understanding whether seasonal influenza vaccines can elicit antibody and T cell responses against the 2009 pandemic H1N1 strain is important. We compared T cell and antibody responses elicited by trivalent inactivated influenza vaccine (TIV) and live attenuated influenza vaccine (LAIV) in healthy adults. Both vaccines boosted pre-existing T cells to the seasonal and pandemic hemagglutinin (HA) but responses were significantly greater following immunization with LAIV. Antibody titers were significantly boosted only by TIV. The relationship between antibody and T cell responses and the effect of the magnitude of pre-existing immunity on vaccine-induced responses were also evaluated. Cross reactive T cell responses to the pandemic H1N1 HA existed among the cohort before the circulation of the virus to varying degrees and these responses were boosted by seasonal vaccination.     

Real numbers tell real stories in health services management

In the words of one hospital manager, "hospital data is currently indigestible and alien to the average user." Drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a Clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. This article identifies lessons for hospital board governance, media relations, employee communications, and citizen and patient engagement that are applicable across the healthcare industry in many countries. If healthcare is to be a caring industry, then care should be taken in the public reporting of data and information.     

Diagnostic Errors in Primary Care Pediatrics: Project RedDE

Objective

Diagnostic errors (DEs), which encompass failures of accuracy, timeliness, or patient communication, cause appreciable morbidity but are understudied in pediatrics. Pediatricians have expressed interest in reducing high-frequency/subacute DEs, but their epidemiology remains unknown. The objective of this study was to investigate the frequency of two high-frequency/subacute DEs and one missed opportunity for diagnosis (MOD) in primary care pediatrics.

Patient-Reported Experiences with Dialysis Care and Provider Visit Frequency

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Heterosexual experiences of secondary school pupils in Ireland: sexual coercion in context

This paper reports on data from a wider study of young people's heterosexual experiences in Ireland, but focuses in particular on issues of sexual coercion. Data were gathered from 29 focus group interviews with 102 young women and 124 young men and were analysed using a qualitative research strategy. Drawing on concepts of social coercion and interpersonal coercion, we argue that both female and male participants reported a general sense of social coercion to lose their virginity by a certain age. However, narratives of interpersonal coercion were far stronger in the case of the young women compared with their male counterparts, while the young men reported a particular type of social coercion that propelled them to subscribe to conventional heterosexual male behaviour. We argue that while the distinction between social coercion and interpersonal coercion is far from watertight, it is a useful conceptual tool in identifying broad variations in women's and men's sexually coercive experiences.     

Women with diagnosed diabetes across the life stages: underuse of recommended preventive care services

Diabetes is a common and costly disease. In 2007, an estimated 24 million people in the United States had diabetes, with almost half of these being women. Diabetes increases the risk of morbidity and mortality from several conditions, including cardiovascular disease, several types of cancers, influenza and pneumococcal infection, and kidney, eye, and periodontal diseases. The aim of this study was to examine the quality of care that women with diabetes receive and to assess how receipt of some clinical preventive services and screening for common conditions associated with diabetes vary according to socioeconomic factors. Our findings indicate that use of diabetes-specific preventive care among women is low, with the youngest women (< or =45 years) and those with low educational levels being the least likely to receive the recommended services. Women with diabetes were less likely than women without diabetes to receive a Pap smear, with the oldest women (> or =65 years) being the most vulnerable. Women with diabetes who were poor and nonwhite were less likely than more affluent and white women to receive a pneumococcal vaccination. This study's findings suggest that having a chronic disease may serve as a barrier to the receipt of recommended preventive care among women. Effective interventions should be designed to meet the needs of the most vulnerable women with diabetes, in particular, those who are at the extremes of the life cycle, are poor, and have low levels of education. Programs should use a life stage approach to address the unique needs of women with diabetes.     

Using GIS to facilitate community-based public health planning of diabetes intervention efforts

Data from a community survey were analyzed geographically to help facilitate local diabetes prevention efforts. Data were available from the Speak to Your Health! Community Survey, designed and implemented by The Prevention Research Center of Michigan (PRC/MI), whose central mission is to strengthen community capacity to improve health. This survey was developed collaboratively by the university and community partners that comprise the PRC/MI and focuses on health and social issues at the heart of the community of Genesee County, Michigan. Survey data were used to calculate and geographically map diabetes-risk scores and mapped diabetes-screening rates. These maps indicated that those areas where the estimated risk of diabetes was the highest had only moderate rates of diabetes screening relative to other areas. It is hoped that these results will reach those involved in local diabetes-intervention programs with the intent that the data will be used in planning local prevention and intervention efforts.