BackgroundSchool-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits.MethodsFor the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida.ResultsVaccination of ∼50% of 5–17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0–4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13.ConclusionWider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities.
School-based influenza immunization programs are increasingly recognized as a key component of community-based efforts to control annual influenza epidemics. Computer modeling suggests that immunizing 70% of schoolchildren could protect an entire community from the flu. Most of the school-based influenza immunization programs described in the literature have had support from industry or federal grants. This article describes a program that used only community resources to administer live, attenuated influenza vaccine supplied by the state health department. Beginning in 2006, the Alachua County Health Department and school system, working in collaboration with the University of Florida, began exploration of a non-mandatory community-wide school-based influenza immunization program, with the goal of achieving high levels of immunization of the ~22,000 public and private pre-K through grade 8 students in the county. In 2009-10 the program was repeated. This report describes the procedures developed to achieve the goal, the barriers that were encountered, and solutions to problems that occurred during the implementation of the program. Preliminary data suggest that the crude immunization rate in the schools was approximately 55% and that at least 10% more students were immunized by their health providers. At an operational level, it is possible to achieve high immunization rates if the stakeholders share a common vision and there is extensive community involvement.
When universities became corporate universities, the constraints that defined universities changed. The values of the old university, of scholarship, truth and freedom, were replaced by the values of the market. Education became a product, the university a firm, and the university system an industry. This paper considers the decline in academe as universities converge towards for-profit corporate universities. The paper explores why universities have become corporations, how they have become corporations, and how academics survive within those corporations. In the corporate university, the academic becomes accountable to management and to students. Collegiality is sacrificed for managerialism, and freedom for accountability. The academic role is inverted. The academic becomes the academic of the production line, producing standardised teaching and research. The paper suggests that the corporate university risks sacrificing too much scholarship and too much freedom for the principles of the market, thereby diluting the integrity of the university. "On his way to the Ministry, the Minister learns that there is a new hospital in Northern London that is staffed with 500 administrators and ancillary workers, but has no doctors, nurses or patients. The Minister is aghast." From The Compassionate Society. Yes Minister, BBC (1981).
For a long time research into deaf children's language acquisition and development has focused on the mechanics of hearing, listening and speech production. Recently, however, there has been a move towards considering other aspects of their lives and how these can impact on their future. This book is the outcome of one such study that addressed the vast area of deaf children and their parents and identifies particular issues for consideration. It is based on the results of a survey completed by 404 parents of deaf and hard of hearing 6-7-year-olds living in the United States. The questionnaire was followed up by interviews with 80 parents, which set out to detail the experiences of a group of American parents and their deaf or hard of hearing children. It moves away from a clinical study to provide a broad view of life with a deaf child. It does, however, retain sufficient scientific scrutiny to ensure it holds it credibility as a research project. The use of anecdotal illustration shapes the whole book, making it readable and accessible, and it realistically highlights the complexity of this area of research.The responses to the survey were wide and varied and have provided a wealth of information regarding the choices, experiences and attitudes of parents, to circumstances and professionals, that is presented in a clear and accessible way. The layout of the book has been determined by the information obtained and each chapter tackles a different area such as 'Communication Conundrums: Family Solutions' and 'Additional Conditions; It takes A Te am'. Within each chapter the main points addressed are clearly Book reviews 127
Rapid changes in the health care environment have challenged educators to find more efficient methods of developing nurses. These demands are leading to the use of collaborative approaches to education. Nurse educators have also found that they have to rely on preceptors for orientation of new employees. The Texas Medical Center Collaborative Preceptor Program was developed in 1989 to prepare nursing preceptors for all nine participating institutions. The goals of the program were to increase efficient use of instructor time, standardize preceptor preparation in the Texas Medical Center, and offer more programs and prepare more nurses per year than each individual institution could do alone. There were many unexpected benefits as well, and future plans for collaboration are already being formulated.
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