1,721,008 research outputs found
An exploratory study to assess patterns of influenza- and pneumonia-related mortality among the Italian elderly
Full text linkOlder adults are at disproportionately high risk of severe influenza-related outcomes and represent the main target of the annual influenza vaccination. The protective effect of seasonal influenza vaccination on the observed mortality indicators is controversial. In this ecological study, spatiotemporal patterns of pneumonia- and influenza-related mortality registered in the Italian elderly over seven (2011–2017) consecutive seasons were explored and the epidemiological association between the observed local pneumonia- and influenza-related mortality and influenza vaccination campaign features were modeled by using both fixed- and random-effects panel regression models. The descriptive spatiotemporal analysis showed a clear North–South gradient, where northern regions tended to report more pneumonia- and influenza-related deaths. After adjustment for potential confounders, it was found that each 1% increase in influenza vaccination coverage rate would be associated (P < .001) with a 1.6–1.9% decrease in pneumonia- and influenza-related mortality. Moreover, each 1% increase in the use of MF59®-adjuvanted trivalent influenza vaccine would be associated (P < .05) with a further 0.4% decrease in pneumonia- and influenza-related mortality. This study supports the increase in annual influenza vaccination in Italy and suggests that a higher level of use of the adjuvanted influenza vaccine in the elderly may be beneficial
Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: A systematic review and meta-analysis
No full textBackground In the elderly, traditional influenza inactivated vaccines are often only modestly immunogenic, owing to immunosenescence. Given that adjuvantation is a means of enhancing the immune response, the trivalent inactivated vaccine adjuvanted with MF59 (MF59-TIV) was specifically designed to overcome this problem. Considering that, for ethical reasons, the absolute effectiveness of an influenza vaccine in the elderly cannot be demonstrated in placebo-controlled studies, the present study aimed to assess the effectiveness of MF59-TIV in preventing influenza-related outcomes in the elderly. Methods We conducted a systematic review of observational studies aimed at evaluating the effectiveness of MF59-TIV against influenza-related outcomes. Results of single studies were pooled whenever possible. Results Of the 1993 papers screened, 11 (6 case-control, 3 cohort and 2 prospective case-control) studies were identified. Hospitalization due to pneumonia/influenza and laboratory-confirmed influenza were reported in more than one study, while other outcomes (influenza-like illness, cardio- and cerebrovascular accidents) were investigated only by one study each. Pooled analysis of four case-control studies showed an adjusted MF59-TIV effectiveness of 51% (95% CI: 39–61%) against hospitalizations for pneumonia/influenza among community-dwelling seniors. Pooled results of the adjusted vaccine effectiveness against laboratory-confirmed influenza were also high (60.1%), although the 95% CI passed through zero (−1.3 to 84.3%). Other single community-based studies showed very high effectiveness of MF59-TIV in preventing hospitalizations for acute coronary [87% (95% CI: 35–97%)] and cerebrovascular [93% (95% CI: 52–99%)] events. MF59-TIV proved highly effective [94% (95% CI: 47–100%] in reducing influenza-like illness among institutionalized elderly. Furthermore, MF59-TIV displayed greater efficacy than non-adjuvanted vaccines in preventing hospitalizations due to pneumonia/influenza [adjusted risk ratio 0.75 (95% CI: 0.57–0.98)] and laboratory-confirmed influenza [adjusted odds ratio 0.37 (0.14–0.96)]. Conclusions Our results suggest that MF59-TIV is effective in reducing several influenza-related outcomes among the elderly, especially hospitalizations due to influenza-related complications
Flucelvax (Optaflu) for seasonal influenza
No full textConventional egg-based manufacturing technology for seasonal influenza vaccines has several drawbacks, including its inflexibility, reliance on egg supplies, risk of contamination, absence of growth of some isolates and egg-adaptive viral mutations that threaten vaccine matching. To overcome these limitations, cell culture-derived vaccines have been designed, including the trivalent inactivated vaccine Flucelvax®/Optaflu® (brand names in the US/EU, respectively). Flucelvax/Optaflu has gained wide regulatory approval and is currently implemented in several countries. Non-clinical studies have assuaged hypothetical concerns regarding oncogenicity and use in persons allergic to dogs. Ample clinical data suggest the non-inferiority of Flucelvax/Optaflu to egg-based vaccines in terms of immunogenicity, safety and tolerability, and it has fulfilled American and European mandatory requirements. Although Flucelvax/Optaflu is currently indicated only for adults and the elderly, pediatric data indicate its good immunogenicity and safety. This paper provides an update on the clinical development of Flucelvax/Optaflu, its seasonal trials and available post-marketing surveillance data
Neisseria meningitidis B vaccines: recent advances and possible immunization policies.
No full textSince the development of the first-generation vaccines based on outer membrane vesicles (OMV), which were able to contain strain-specific epidemics, but were not suitable for universal use, enormous steps forward in the prevention of Neisseria meningitidis B have been made. The first multicomponent vaccine, Bexsero(®), has recently been authorized for use; other vaccines, bivalent rLP2086 and next-generation OMV vaccines, are under development. The new vaccines may substantially contribute to reducing invasive bacterial infections as they could cover most Neisseria meningitidis B strains. Moreover, other potentially effective serogroup B vaccine candidates are being studied in preclinical settings. It is therefore appropriate to review what has recently been achieved in the prevention of disease caused by serogroup B
Demand-based web surveillance of sexually transmitted infections in Russia.
No full textOBJECTIVES:
To investigate the possibility of using HIV- and syphilis-related web queries to predict incident diagnosis rates of sexually transmitted infections in Russia.
METHODS:
The regional volume of HIV/syphilis queries, normalized to the total number of queries submitted to the most popular search engine, was used to predict the notification rates of HIV/syphilis in each region by applying both global non-spatial and spatial statistics.
RESULTS:
Nationwide, both search volumes and regional HIV/syphilis diagnosis rates were positively spatially auto-correlated, indicating a clustered pattern of spatial distribution. A high positive correlation between notification rates and search volume was observed. Compared with linear models, spatially explicit geographically weighted models adjusted for broadband Internet diffusion proved superior in predicting the regional level of the HIV/syphilis epidemic on the basis of their search volume.
CONCLUSIONS:
Timeliness, easy availability, low cost, and transparency make HIV- and syphilis-related web queries a promising addition to traditional methods of disease surveillance in Russia. Geographically weighted regression provides useful insights, as it is able to capture the spatial heterogeneity of the relationship between search volume and disease incidence
Uncontrolled Web-based administration of surveys on factual health-related knowledge: a randomized study of untimed versus timed quizzing
No full textBackground: Health knowledge and literacy are among the main determinants of health. Assessment of these issues via Web-based surveys is growing continuously. Research has suggested that approximately one-fifth of respondents submit cribbed answers, or cheat, on factual knowledge items, which may lead to measurement error. However, little is known about methods of discouraging cheating in Web-based surveys on health knowledge.
Objective: This study aimed at exploring the usefulness of imposing a survey time limit to prevent help-seeking and cheating.
Methods: On the basis of sample size estimation, 94 undergraduate students were randomly assigned in a 1:1 ratio to complete a Web-based survey on nutrition knowledge, with or without a time limit of 15 minutes (30 seconds per item); the topic of nutrition was chosen because of its particular relevance to public health. The questionnaire consisted of two parts. The first was the validated consumer-oriented nutrition knowledge scale (CoNKS) consisting of 20 true/false items; the second was an ad hoc questionnaire (AHQ) containing 10 questions that would be very difficult for people without health care qualifications to answer correctly. It therefore aimed at measuring cribbing and not nutrition knowledge. AHQ items were somewhat encyclopedic and amenable to Web searching, while CoNKS items had more complex wording, so that simple copying/pasting of a question in a search string would not produce an immediate correct answer.
Results: A total of 72 of the 94 subjects started the survey. Dropout rates were similar in both groups (11%, 4/35 and 14%, 5/37 in the untimed and timed groups, respectively). Most participants completed the survey from portable devices, such as mobile phones and tablets. To complete the survey, participants in the untimed group took a median 2.3 minutes longer than those in the timed group; the effect size was small (Cohen's r=.29). Subjects in the untimed group scored significantly higher on CoNKS (mean difference of 1.2 points, P=.008) and the effect size was medium (Cohen's d=0.67). By contrast, no significant between-group difference in AHQ scores was documented. Unexpectedly high AHQ scores were recorded in 23% (7/31) and 19% (6/32) untimed and timed respondents, respectively, very probably owing to "e-cheating".
Conclusions: Cribbing answers to health knowledge items in researcher-uncontrolled conditions is likely to lead to overestimation of people's knowledge; this should be considered during the design and implementation of Web-based surveys. Setting a time limit alone may not completely prevent cheating, as some cheats may be very fast in Web searching. More complex and contextualized wording of items and checking for the "findability" properties of items before implementing a Web-based health knowledge survey may discourage help-seeking, thus reducing measurement error. Studies with larger sample sizes and diverse populations are needed to confirm our results
Impact of different scoring algorithms applied to multiple-mark survey items on outcome assessment: an in-field study on health-related knowledge
No full textHealth-related knowledge is often assessed through multiple-choice tests. Among the different types of formats, researchers may opt to use multiple-mark items, i.e. with more than one correct answer. Although multiple-mark items have long been used in the academic setting - sometimes with scant or inconclusive results - little is known about the implementation of this format in research on in-field health education and promotion
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Clustering of health-related behaviors among early and mid adolescents in Tuscany: results from a representative cross-sectional study
Full text linkBackground A huge amount of literature suggests that adolescents' health-related behaviors tend to occur in clusters, and the understanding of such behavioral clustering may have direct implications for the effective tailoring of health-promotion interventions. Despite the usefulness of analyzing clustering, Italian data on this topic are scant. This study aimed to evaluate the clustering patterns of health-related behaviors. Methods The present study is based on data from the Health Behaviors in School-aged Children (HBSC) study conducted in Tuscany in 2010, which involved 3291 11-, 13- and 15-year olds. To aggregate students' data on 22 health-related behaviors, factor analysis and subsequent cluster analysis were performed. Results Factor analysis revealed eight factors, which were dubbed in accordance with their main traits: 'Alcohol drinking', 'Smoking', 'Physical activity', 'Screen time', 'Signs & symptoms', 'Healthy eating', 'Violence' and 'Sweet tooth'. These factors explained 67% of variance and underwent cluster analysis. A six-cluster -means solution was established with a 93.8% level of classification validity. The between-cluster differences in both mean age and gender distribution were highly statistically significant. Conclusions Health-compromising behaviors are common among Tuscan teens and occur in distinct clusters. These results may be used by schools, health-promotion authorities and other stakeholders to design and implement tailored preventive interventions in Tuscan
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