55 results
Methods and associations of suicidality in Kenyan high school students: clinical and public health implications
- David M. Ndetei, Danuta Wasserman, Victoria Mutiso, Jenelle R. Shanley, Christine Musyimi, Pascalyne Nyamai, Timothy Munyua, Monica H. Swahn, Tom L. Osborn, Natalie E. Johnson, Peter Memiah, Kamaldeep Bhui, Sonja Gilbert, John R. Weisz, Afzal Javed, Andre Sourander
-
- Journal:
- BJPsych Open / Volume 10 / Issue 3 / May 2024
- Published online by Cambridge University Press:
- 13 May 2024, e112
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world.
AimsThis study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya.
MethodThis was a cross-sectional study of 2652 high school students. We asked structured questions to determine the prevalence of various types of suicidality, the methods planned or effected, and participants’ gender, age and form (grade level). We provided descriptive statistics, testing significant differences by chi-squared and Fisher's exact tests, and used logistic regression to identify relationships among different variables and their associations with suicidality.
ResultsThe prevalence rates of suicidal thoughts, plans and attempts were 26.8, 14.9 and 15.7%, respectively. These rates are higher than those reported for Western countries. Some 6.7% of suicide attempts were not associated with plans. The most common method used in suicide attempts was drinking chemicals/poison (18.8%). Rates of suicidal thoughts and plans were higher for older students and students in urban rather than rural locations, and attempts were associated with female gender and higher grade level – especially the final year of high school, when exam performance affects future education and career prospects.
ConclusionSuicidal thoughts, plans and attempts are prevalent in Kenyan high school students. There is a need for future studies to determine the different starting points to suicidal attempts, particularly for the significant number whose attempts are not preceded by thoughts and plans.
Rights of Nature on the Island of Ireland: Origins, Drivers, and Implications for Future Rights of Nature Movements
- Rachel Killean, Jérémie Gilbert, Peter Doran
-
- Journal:
- Transnational Environmental Law / Volume 13 / Issue 1 / March 2024
- Published online by Cambridge University Press:
- 18 January 2024, pp. 35-60
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Over the course of 2021, several local councils across the island of Ireland introduced motions recognizing the ‘Rights of Nature’. To date, little research has been conducted into these nascent Rights of Nature movements, even though they raise important questions about the philosophical, cultural, political, and legal drivers in pursuing such rights. Similarly, much remains unclear as to the implications of such initiatives, both in their domestic context and for Rights of Nature movements around the world. This article contributes to addressing this gap by exploring these themes through an analysis of interviews with key stakeholders conducted across the island of Ireland in June 2022. In particular, it explores the impact of international movements, colonial legacies, cultural heritage, and years of inadequate environmental governance, in motivating local councils to pursue a Rights of Nature strategy.
The need for increased protection of Antarctica's inland waters
- Ian Hawes, Clive Howard-Williams, Neil Gilbert, Kevin A. Hughes, Peter Convey, Antonio Quesada
-
- Journal:
- Antarctic Science / Volume 35 / Issue 2 / April 2023
- Published online by Cambridge University Press:
- 18 April 2023, pp. 64-88
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Protection of Antarctica's biodiversity and ecosystem values is enshrined in the Protocol on Environmental Protection to the Antarctic Treaty, which provides for the designation of Antarctic Specially Protected Areas (ASPAs) to areas with outstanding values. Concern has been raised that existing ASPAs fail to prioritize areas to maximize the likelihood of ensuring the long-term conservation of Antarctic ecosystems and biodiversity. The absence of systematic and representative protection is particularly acute for inland aquatic ecosystems, which support a disproportionate amount of inland biodiversity. This paper promotes the case for overt inclusion of inland waters as a critical component of a representative protected area framework for Antarctica, thereby addressing their current underrepresentation. We set out a structured approach to enable the selection of representative freshwater systems for inclusion in the ASPA framework that, with modification, could also be applied across other Antarctic habitats. We acknowledge an overall lack of information on the biogeography of inland aquatic diversity and recommend increased use of remote data collection along with classification tools to mitigate this, as well as the need for the consideration of catchment-scale processes. Changes that accompany contemporary and anticipated climate change make the need for the conservation of representative biodiversity increasingly urgent.
Modified reporting of positive urine cultures to reduce inappropriate antibiotic treatment of catheter-associated asymptomatic bacteriuria (CA-ASB) among inpatients, a randomized controlled trial
- Claire L. Pratt, Zahra Rehan, Lydia Xing, Laura Gilbert, Brenda Fillier, Brendan Barrett, Peter Daley
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 42 / Issue 10 / October 2021
- Published online by Cambridge University Press:
- 04 June 2021, pp. 1221-1227
- Print publication:
- October 2021
-
- Article
- Export citation
-
Objective:
To determine whether modified reporting of positive urine cultures collected from indwelling catheters improved treatment decisions without causing harm.
Design:Prospective, unblinded, randomized control trial.
Setting:Two tertiary-care hospitals.
Participants:Overall, 100 consecutive positive urine cultures collected from catheterized inpatients were randomized between standard and modified laboratory reporting between November 2018 and June 2019. Exclusion criteria were pregnancy, current antibiotic treatment, ICU or urology admission, or neutropenia.
Intervention:The modified report included significant growth without providing identification, quantification, or susceptibility. The standard report included identification, quantitation and susceptibility. Diagnosis of catheter-associated asymptomatic bacteriuria (CA-ASB) and catheter-associated urinary tract infection (CA-UTI) followed published criteria, using prospective chart review. The appropriate antibiotic treatment was defined as treatment of CA-UTI, and no treatment of CA-ASB. Patients were followed for 7 days.
Results:Of 543 urine cultures, 443 (82%) were excluded. Of 100 patients, 75 (75%) had CA-ASB and 25 (25%) had CA-UTI. Treatment was given to 45 of 75 CA-ASB patients (60%) and all 25 CA-UTI patients (100%). Appropriate treatment rate was higher in the modified reporting arm than in the standard reporting arm: 57% vs 50% (+7.4%; relative risk [RR], 1.15; P = .45). Untreated CA-ASB was higher in the modified reporting arm: 45% vs 33% (+12%; RR, 1.36; P = .30). The standard report was requested for 33% of modified reports. Furthermore, 4 deaths and 26.9% adverse events occurred in the modified reporting arm, and 3 deaths and 41.3% adverse events occurred in the standard reporting arm.
Conclusions:Modified reporting increased the appropriateness of treatment, and may be safe.
Clinical trials identifier: ClinicalTrials.gov#NCT03488355.
73565 Defining tp53 tumor suppressor functions in zebrafish embryonal rhabdomyosarcoma
- Kunal Baxi, Jiangfei Chen, Amanda Lipsitt, Nicole Hensch, Long Wang, Abhik Bandopadhyay, Aaron Sugalski, Andrea Gilbert, Eleanor Chen, Peter Houghton, Gail Tomlinson, Myron Ignatius
-
- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue s1 / March 2021
- Published online by Cambridge University Press:
- 30 March 2021, pp. 19-20
-
- Article
-
- You have access Access
- Open access
- Export citation
-
ABSTRACT IMPACT: By assessing function of mutant (patient-specific) tp53 in zebrafish embryonal rhabdomyosarcoma will inform clinicians of the severity of mutant tp53 alleles. OBJECTIVES/GOALS: This study aims to define loss- and gain-of-function TP53 mutations by comparing effects in tp53-null and wild-type tumors. In addition, it aims to generate a rapid in vivo analysis platform to assign function to patient specific TP53 mutations in the clinic METHODS/STUDY POPULATION: To define tp53 function in ERMS pathogenesis, we previously generated a new tp53-null mutant (tp53-/-) in zebrafish by deleting the entire tp53 genomic locus using TALEN mutagenesis. tp53-/- zebrafish spontaneously develop a spectrum of tumors including sarcomas, leukemia and germ cell tumors (Ignatius…Baxi et. al., eLife) reminiscent of tumors observed in Trp53-null mice. Using the tp53-/- mutants to generate kRASG12D-induced ERMS, we discovered that tp53 is a potent repressor of metastases but rather surprisingly had no effect on self-renewal (Ignatius…Baxi et. al., eLife). Here, using tp53-/- zebrafish, we assessed effects of wild-type and mutant (patient specific) tp53 on tumor initiation, proliferation and apoptosis. RESULTS/ANTICIPATED RESULTS: ERMS tumor initiation in the tp53-/- background is observed in > 97% of animals whereas only <40% of wild-type animals develop ERMS. Additionally, tp53 is a potent suppressor of ERMS proliferation and its effect on apoptosis is minor. Next, we expressed either WT zebrafish or human TP53 in tp53-/- animals along with kRASG12D and both genes suppressed tumor initiation and growth. We co-expressed TP53C176F (found in two ERMS patients) and TP53P153del (identified in a patient with osteosarcoma in our clinic) in zebrafish ERMS, and find that the TP53C176F allele significantly suppressed tumor initiation with effects predominantly on enhanced apoptosis. However, the TP53P153del allele initiated tumors at similar frequency compared to tp53-/- animals but increased the initiation of tumors in the head musculature. DISCUSSION/SIGNIFICANCE OF FINDINGS: Different TP53 alleles identified in patient tumors have very different effects on tumorigenesis in vivo and can respond differently to potentially therapeutic compounds. Thus, the type of precision modeling demonstrated here promises to help further define patient-specific TP53 biology and improve clinical strategies in the future.
Palmatolepis spallettae, new name for a Frasnian conodont species
- Gilbert Klapper, Thomas T. Uyeno, Derek K. Armstrong, Peter G. Telford
-
- Journal:
- Journal of Paleontology / Volume 91 / Issue 3 / May 2017
- Published online by Cambridge University Press:
- 26 April 2017, p. 578
-
- Article
-
- You have access Access
- HTML
- Export citation
Contributors
-
- By David Biggs, Peter Boomgaard, Francesca Bray, Sui-Wai Cheung, Peter A. Coclanis, Edda L. Fields-Black, Penelope Francks, Erik Gilbert, Jonathan Harwood, Walter Hawthorne, Pieter M. Kroonenberg, Seung-Joon Lee, Olga F. Linares, Harro Maat, Lauren Minsky, Bruce L. Mouser, Edwin Nuijten, Florent Okry, Paul Richards, Dagmar Schäfer, Hayden R. Smith
- Edited by Francesca Bray, University of Edinburgh, Peter A. Coclanis, University of North Carolina, Chapel Hill, Edda L. Fields-Black, Carnegie Mellon University, Pennsylvania, Dagmar Schäfer, University of Manchester
-
- Book:
- Rice
- Published online:
- 05 February 2015
- Print publication:
- 19 February 2015, pp xi-xii
-
- Chapter
- Export citation
Notes on Contributors
-
- By Fran Brearton, Sarah Cole, Neil Corcoran, Santanu Das, Simon Featherstone, Christine Froula, Sandra M. Gilbert, David Goldie, Margaret R. Higonnet, Peter Howarth, Tim Kendall, Edna Longley, Michael Longley, Andrew Motion, Adrian Poole, Mark Rawlinson, Vincent Sherry, Jon Stallworthy, Elizabeth Vandiver, Jay Winter
- Edited by Santanu Das, King's College London
-
- Book:
- The Cambridge Companion to the Poetry of the First World War
- Published online:
- 18 December 2013
- Print publication:
- 11 November 2013, pp xiii-xvii
-
- Chapter
- Export citation
Cross-sectional study of factors that influence the 25-hydroxyvitamin D status in pregnant women and in cord blood in Germany
- Catrin Wuertz, Peter Gilbert, Wolfgang Baier, Clemens Kunz
-
- Journal:
- British Journal of Nutrition / Volume 110 / Issue 10 / 28 November 2013
- Published online by Cambridge University Press:
- 23 May 2013, pp. 1895-1902
- Print publication:
- 28 November 2013
-
- Article
-
- You have access Access
- HTML
- Export citation
-
There is increasing evidence of an association between a low maternal vitamin D status and a high risk of adverse pregnancy outcomes. In a cross-sectional study, we investigated the vitamin D status of pregnant women to determine potentially influencing factors. Between December 2010 and February 2012, 261 maternal blood samples and 328 cord blood samples were collected for the analysis of 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone, alkaline phosphatase and Ca concentrations. Demographical characteristics and clinical data were recorded by a questionnaire and from medical files. The overall median maternal and cord blood 25(OH)D levels were 25·0 (interquartile range 12·6–45·5) nmol/l and 34·1 (interquartile range 17·7–58·6) nmol/l, respectively. During the winter months, 98 % of the maternal blood samples and 94 % of the cord blood samples had 25(OH)D levels < 50 nmol/l. In the summer months, 49 % of the women and 35 % of the cord blood samples were vitamin D deficient. Using logistic regression models, significant risk factors for maternal vitamin D deficiency were found to be physical inactivity (adjusted OR (aOR) 2·67, 95 % CI 1·06, 6·69, P= 0·032) and a non-European country of origin (aOR 3·21, 95 % CI 1·0, 10·28, P= 0·047) after controlling for season and independent risk factors. These results are the first 25(OH)D data for pregnant women in Germany. They indicate the need for urgent implementation of strategies to prevent vitamin D deficiency by healthcare authorities that are in charge of preventing vitamin D deficiency, especially during these sensitive stages of life.
Contributors
-
- By Ashok Agarwal, Linda D. Applegarth, Nelson E. Bennett, Nancy L. Brackett, Melissa B. Brisman, Mark F. H. Brougham, Cara B. Cimmino, Owen K. Davis, Rian J. Dickstein, Michael L. Eisenberg, Mikkel Fode, Gretchen A. Gignac, Bruce R. Gilbert, Ellen R. Goldmark, Marc Goldstein, Wayne J. G. Hellstrom, Wayland Hsiao, Jack Huang, Kathleen Hwang, Ann A. Jakubowski, Keith Jarvi, Loren Jones, Hey-Joo Kang, Joanne Frankel Kelvin, Mohit Khera, Thomas F. Kolon, Kate H. Kraft, Andrew C. Kramer, Dolores J. Lamb, Andrew B. Lassman, Helen R. Levey, Larry I. Lipshultz, Charles M. Lynne, Akanksha Mehta, Marvin L. Meistrich, Gregory C. Mitchell, Mark A. Moyad, John P. Mulhall, Lauren Murray, Craig Niederberger, Ariella Noy, Robert D. Oates, Dana A. Ohl, Kutluk Oktay, Ndidiamaka Onwubalili, Fabio Firmbach Pasqualatto, Elena Pentsova, Susanne A. Quallich, Gwendolyn P. Quinn, Alex Ridgeway, Matthew T. Roberts, Kenny A. Rodriguez-Wallberg, Allison B. Rosen, Lisa Rosenzweig, Edmund S. Sabanegh, Hossein Sadeghi-Nejad, Mary K. Samplaski, Jay I. Sandlow, Peter N. Schlegel, Gunapala Shetty, Mark Sigman, Jens Sønksen, Peter J. Stahl, Eytan Stein, Doron S. Stember, Raanan Tal, Susan T. Vadaparampil, W. Hamish, B. Wallace, Leonard H. Wexler, Daniel H. Williams
- Edited by John P. Mulhall, Memorial Sloan-Kettering Cancer Center, New York
- Edited in association with Linda D. Applegarth, Robert D. Oates, Peter N. Schlegel
-
- Book:
- Fertility Preservation in Male Cancer Patients
- Published online:
- 05 March 2013
- Print publication:
- 21 February 2013, pp vii-x
-
- Chapter
- Export citation
Contributors
-
- By Kumar Alagappan, Janet G. Alteveer, Kim Askew, Paul S. Auerbach, Katherine Bakes, Kip Benko, Paul D. Biddinger, Victoria Brazil, Anthony FT Brown, Andrew K. Chang, Alice Chiao, Wendy C. Coates, Jamie Collings, Gilbert Abou Dagher, Jonathan E. Davis, Peter DeBlieux, Alessandro Dellai, Emily Doelger, Pamela L. Dyne, Gino Farina, Robert Galli, Gus M. Garmel, Daniel Garza, Laleh Gharahbaghian, Gregory H. Gilbert, Michael A. Gisondi, Steven Go, Jeffrey M. Goodloe, Swaminatha V. Gurudevan, Micelle J. Haydel, Stephen R. Hayden, Corey R. Heitz, Gregory W. Hendey, Mel Herbert, Cherri Hobgood, Michelle Huston, Loretta Jackson-Williams, Anja K. Jaehne, Mary Beth Johnson, H. Brendan Kelleher, Peter G Kumasaka, Melissa J. Lamberson, Mary Lanctot-Herbert, Erik Laurin, Brian Lin, Michelle Lin, Douglas Lowery-North, Sharon E. Mace, S. V. Mahadevan, Thomas M. Mailhot, Diku Mandavia, David E. Manthey, Jorge A. Martinez, Amal Mattu, Lynne McCullough, Steve McLaughlin, Timothy Meyers, Gregory J. Moran, Randall T. Myers, Christopher R.H. Newton, Flavia Nobay, Robert L. Norris, Catherine Oliver, Jennifer A. Oman, Rita Oregon, Phillips Perera, Susan B. Promes, Emanuel P. Rivers, John S. Rose, Carolyn J. Sachs, Jairo I. Santanilla, Rawle A. Seupaul, Fred A. Severyn, Ghazala Q. Sharieff, Lee W. Shockley, Stefanie Simmons, Barry C. Simon, Shannon Sovndal, George Sternbach, Matthew Strehlow, Eustacia (Jo) Su, Stuart P. Swadron, Jeffrey A. Tabas, Sophie Terp, R. Jason Thurman, David A. Wald, Sarah R. Williams, Teresa S. Wu, Ken Zafren
- Edited by S. V. Mahadevan, Stanford University School of Medicine, California, Gus M. Garmel
-
- Book:
- An Introduction to Clinical Emergency Medicine
- Published online:
- 05 May 2012
- Print publication:
- 10 April 2012, pp xi-xvi
-
- Chapter
- Export citation
Cerebellar function: On-line control and learning
- Peter F. C. Gilbert, Christopher H. Yeo
-
- Journal:
- Behavioral and Brain Sciences / Volume 15 / Issue 4 / December 1992
- Published online by Cambridge University Press:
- 19 May 2011, pp. 743-744
-
- Article
- Export citation
How and what does the cerebellum learn?
- Peter F. C. Gilbert
-
- Journal:
- Behavioral and Brain Sciences / Volume 19 / Issue 3 / September 1996
- Published online by Cambridge University Press:
- 19 May 2011, pp. 449-450
-
- Article
- Export citation
-
Information for motor learning is likely to be stored by groups of Purkinje cells in the cerebellum as suggested by HOUK et al., though their proposal that Purkinje cells act as bistable elements is open to question. THACH's excellent article breaks new ground on what type of information the cerebellum may store. I have queries on whether the cerebellum can generate “thought” or is likely to engage in the purely mental learning of movements, [HOUK et al.; THACH]
Contributors
-
- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
-
- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
-
- Chapter
- Export citation
Validation of a web-based dietary questionnaire designed for the DASH (Dietary Approaches to Stop Hypertension) diet: the DASH Online Questionnaire
- Caroline M Apovian, Megan C Murphy, Diana Cullum-Dugan, Pao-Hwa Lin, Kathryn Meyers Gilbert, Gerald Coffman, Mark Jenkins, Peter Bakun, Katherine L Tucker, Thomas Joseph Moore
-
- Journal:
- Public Health Nutrition / Volume 13 / Issue 5 / May 2010
- Published online by Cambridge University Press:
- 16 November 2009, pp. 615-622
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objective
With the upsurge in online dietary modification programmes, online dietary assessment tools are needed to capture food intake. Although the DASH (Dietary Approaches to Stop Hypertension) diet is recommended by the US Department of Agriculture, there are no online instruments that capture DASH food servings. Our objective was to assess the validity of a new, short, online dietary questionnaire developed to capture intake of DASH food servings. The DASH Online Questionnaire (OLQ) was validated against the well-known Block Food Frequency Questionnaire (FFQ).
DesignThis was a cross-sectional validation of the DASH OLQ, which contained eleven food groups (breakfast cereals; dairy; drinks; fats and oils; fruits; grains and snacks; meat, fish and poultry; mixed dishes; sweets; vegetables; and nuts, seeds and legumes). Each subject completed a DASH OLQ once weekly for four weeks and one 98.2 Block FFQ (110 questions) between weeks 2 and 4. DASH OLQ were averaged and then compared with the Block FFQ for nutrient intakes as well as intakes of DASH food groups.
SettingBoston University Medical Center, Boston, Massachusetts.
SubjectsOne hundred and ninety-one faculty and staff at Boston University Medical Center aged 20–70 years.
ResultsThere were significant positive correlations between the Block FFQ and the DASH OLQ for all food groups ranging from r = 0·8 for the nuts/seeds/legumes category to r = 0·3 for vegetables and mixed dishes. A comparison of nutrient intakes found strong positive correlations in all nutrient categories. Of particular interest in the DASH diet and the web-based nutrition and physical activity programme were total fat (r = 0·62), total carbohydrate (r = 0·67), total K (r = 0·68), total Ca (r = 0·69), total vitamin C (r = 0·60) and total energy intake (r = 0·68).
ConclusionsThe DASH OLQ captures food and nutrient intake well in relation to the more established Block FFQ.
10 - Spiritual care in the NHS
-
- By Sarah Eagger, Department of Psychological Medicine, Peter Richmond, Kent and Medway NHS and Social Care Partnership Trust, UK, Peter Gilbert, Staffordshire University
- Edited by Chris Cook, Andrew Powell, Andrew Sims
-
- Book:
- Spirituality and Psychiatry
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017
- Print publication:
- 01 June 2009, pp 190-211
-
- Chapter
- Export citation
-
Summary
Spirituality has been a part of the professional code of practice for physicians and other healthcare professionals in the UK since the inception of the National Health Service (NHS) in 1947. At that time, legislation was passed to ensure that the religious and faith needs of patients were met in the healthcare system (Speck, 2005). This was reinforced by The Patient's Charter (Department of Health, 1991) and in a subsequent health service guidance letter, The Provision of Spiritual Care to Staff, Patients and Relatives (Department of Health, 1992). This guidance was replaced in 2003 to reflect new organisational relationships and to provide better support for the multi-faith needs of patients (Department of Health, 2003a).
One could, however, be forgiven for not having a clear picture of how spiritual care is provided within today's NHS. The issues around delivering such care are indeed complex. Orchard (2001: p. 17) notes that ‘the NHS is an organism that demands of its services an ability to think through its considerable complexities and to respect its need for a degree of discipline in the way care is developed and delivered’. However, this does not appear to be the case with services for spiritual care and Orchard calls for those services to be ‘effective, equitable and better able to respond to those who call on them’. There is a lack of published material on the provision of formal spiritual care services within the health sector. It certainly appears to be a hotchpotch of policies and influences. It would seem that in the reforms that saw mental health trusts splitting off from acute and community trusts, many pastoral care departments were left behind. With no specific service level agreements or funding streams, this area of care was, and still is, often ignored.
What is spiritual care?
It is not only chaplains who provide spiritual care to patients. In chapter 2, ‘Assessing spiritual needs’, the authors call for collaboration between professionals in this area of patient care. The notion of what spiritual care actually entails requires consideration. Murray et al (2004), in a study of patients with life-threatening illnesses, defined spiritual needs as ‘the needs and expectations which humans have to find meaning, purpose and value in their life.
10 - Spiritual care in the NHS
-
- By Sarah Eagger, Imperial College London, Peter Richmond, Kent and Medway NHS, Peter Gilbert, Staffordshire University
- Edited by Christopher C. H. Cook, Andrew Powell, Andrew Sims
-
- Book:
- Spirituality and Psychiatry
- Published online:
- 02 January 2018
- Print publication:
- 01 June 2009, pp 190-211
-
- Chapter
- Export citation
-
Summary
Meeting the varied spiritual needs of patients, staff and visitors is fundamental to the care the NHS provides [Department of Health, 2003a: p. 5]
Spirituality has been a part of the professional code of practice for physicians and other healthcare professionals in the UK since the inception of the National Health Service (NHS) in 1947. At that time, legislation was passed to ensure that the religious and faith needs of patients were met in the healthcare system (Speck, 2005). This was reinforced by The Patient's Charter (Department of Health, 1991) and in a subsequent health service guidance letter, The Provision of Spiritual Care to Staff, Patients and Relatives (Department of Health, 1992). This guidance was replaced in 2003 to reflect new organisational relationships and to provide better support for the multi-faith needs of patients (Department of Health, 2003a). One could, however, be forgiven for not having a clear picture of how spiritual care is provided within today's NHS. The issues around delivering such care are indeed complex. Orchard (2001: p. 17) notes that ‘the NHS is an organism that demands of its services an ability to think through its considerable complexities and to respect its need for a degree of discipline in the way care is developed and delivered’. However, this does not appear to be the case with services for spiritual care and Orchard calls for those services to be ‘effective, equitable and better able to respond to those who call on them’. There is a lack of published material on the provision of formal spiritual care services within the health sector. It certainly appears to be a hotchpotch of policies and influences. It would seem that in the reforms that saw mental health trusts splitting off from acute and community trusts, many pastoral care departments were left behind. With no specific service level agreements or funding streams, this area of care was, and still is, often ignored.
What is spiritual care?
It is not only chaplains who provide spiritual care to patients. In chapter 2, ‘Assessing spiritual needs’, the authors call for collaboration between professionals in this area of patient care. The notion of what spiritual care actually entails requires consideration. Murray et al (2004), in a study of patients with life-threatening illnesses, defined spiritual needs as ‘the needs and expectations which humans have to find meaning, purpose and value in their life.
(O69) Video-Assisted Telemedicine System Improves Triage and Situational Awareness in Disaster Response
- Peter F. Hu, Colin F. Mackenzie, Ayan Sen, Steven Johnson, John Spearman, Steven Seebode, Timothy Brooks, David Gagliano, Dale Yeatts, Gary R. Gilbert, Ronald K. Poropatich
-
- Journal:
- Prehospital and Disaster Medicine / Volume 24 / Issue S1 / February 2009
- Published online by Cambridge University Press:
- 17 February 2017, p. s82
- Print publication:
- February 2009
-
- Article
-
- You have access Access
- Export citation
Contributors
-
- By Nicholas B. Allen, Joan Rosenbaum Asarnow, Jeanne Brooks-Gunn, Ronald E. Dahl, Joanne Davila, Laura M. DeRose, Lea R. Dougherty, Nancy Eisenberg, Erika E. Forbes, Wyndol Furman, Paul Gilbert, Julia A. Graber, Danielle M. Hessler, Erin C. Hunter, Chris Irons, Lynn Fainsilber Katz, Amanda Kesek, Daniel N. Klein, Annette M. La Greca, Rebecca S. Laptook, Reed W. Larson, Primrose Letcher, Peter M. Lewinsohn, Marc D. Lewis, Christine McDunn, James W. McKowen, Christopher S. Monk, Amanda Sheffield Morris, Thomas M. Olino, Tomáš Paus, Daniel S. Pine, Ann V. Sanson, John R. Seeley, Lisa B. Sheeber, Rebecca Siegel, Jennifer S. Silk, Diana Smart, Martha C. Tompson, Julie Vaughan, Brennan J. Young, Philip David Zelazo
- Edited by Nicholas B. Allen, University of Melbourne, Lisa B. Sheeber
-
- Book:
- Adolescent Emotional Development and the Emergence of Depressive Disorders
- Published online:
- 14 September 2009
- Print publication:
- 20 November 2008, pp ix-xiv
-
- Chapter
- Export citation
Use of a Mandatory Declination Form in a Program for Influenza Vaccination of Healthcare Workers
- Bruce S. Ribner, Cynthia Hall, James P. Steinberg, William A. Bornstein, Rosette Chakkalakal, Amir Emamifar, Irving Eichel, Peter C. Lee, Penny Z. Castellano, Gilbert D. Grossman
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue 4 / April 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. 302-308
- Print publication:
- April 2008
-
- Article
- Export citation
-
Objective.
To evaluate the utility and impact of using a declination form in the context of an influenza immunization program for healthcare workers.
Methods.A combined form for documentation of vaccination consent, medical contraindication(s) for vaccination, or vaccination declination was used during the 2006-2007 influenza season in a healthcare system employing approximately 9,200 nonphysician employees in 3 hospitals; a skilled nursing care facility; a large, multisite, faculty-practice plan; and an administrative building. Responses were entered into a database that contained files from human resources departments, which allowed correlation with job category and work location.
Results.The overall levels of influenza vaccination coverage of employees increased from 43% (3,892 of 9,050) during the 2005-2006 season to 66.5% (6,123 of 9,214) during the 2006-2007 season. Of 9,214 employees, 1,898 (20.6%) signed the declination statement. Among the occupation groups, nurses had the lowest rate of declining vaccination (13.2% [393 of 2,970]; P < .0001), followed by pharmacy personnel (18.1% [40 of 221]), ancillary personnel with frequent patient contact (21.9% [169 of 771), and all others (24.7% [1,296 of 5,252]). Among the employees who declined vaccination, nurses were the least likely to select the reasons “afraid of needles” (3.8% [15 of 393], vs. 9.1% [137 of 1,505] for all other groups; P < .001) and “fear of getting influenza from the vaccine” (13.5% [53 of 393], vs. 20.5% [309 of 1,505]; P = .002). Seven pregnant nurses had been advised by their obstetricians to avoid vaccination. When declination of influenza vaccination was analyzed by age, 16% of personnel (797 of 4,980) 50 years of age and older declined to be vaccinated, compared with 26% of personnel (1,101 of 4,234) younger than 50 years of age {P < .0001).
Conclusions.Implementing use of the declination form during the 2006-2007 influenza season was one of several measures that led to a 55% increase in the acceptance of influenza vaccination by healthcare workers in our healthcare system. Although we cannot determine to what degree use of the declination form contributed to the increased rate of vaccination, use of this form helped the vaccination program assess the reasons for declination and will help to focus future vaccination campaigns.