ABSTRACT
BACKGROUND: Vaccination rates in adolescents in Germany are not sufficient. An intervention programme, which has been launched by the community health centre in Essen, should significantly increase vaccination coverage. METHODS: In 2001 the Children and Youth Health Service at the Community Health Centre in Essen implemented a specific strategy to improve vaccination rates in adolescents. Vaccination rates were determined by control of vaccination certificates of all 6 (th) graders in Essen (n=5 589). After control of vaccination records the parents got a written, individual vaccination counselling for their child as well as a referral to the paediatrician to get the missing vaccinations. After 6 months the vaccination certificates were looked at again and vaccination coverage was determined. RESULTS: At the initial vaccination record control of 6 (th) graders in 2001 only 15% of the students, who presented their vaccination certificate, had an appropriate age related immunisation status. 84% of the students had had the tetanus/diphtheria and polio booster. But only 43% had been given a second measles, mumps and rubella (MMR) immunisation and only 24% had a complete hepatitis B coverage. The intervention programme (e. g., individual vaccination counselling) improved vaccination rates for hepatitis B and MMR by 16%. From 2001 to 2008 vaccination coverage in this age group could be improved from 43% to 87% for the second MMR vaccination and from 24% to 85% for hepatitis B. CONCLUSIONS: A remarkable improvement in vaccination coverage in children and adolescents could be achieved by a single, individual, written vaccination reminder. As a prerequisite a good cooperation between schools/paediatricians and the health authorities is needed.
Subject(s)
Health Education/methods , Patient Acceptance of Health Care/statistics & numerical data , Vaccination/statistics & numerical data , Adolescent , Child , Female , Germany , Humans , Immunization Schedule , Immunization, Secondary/statistics & numerical data , Male , Mass Screening , Referral and Consultation , Utilization Review/statistics & numerical dataABSTRACT
Isolated left guinea-pig atria were used to examine the influence of D 600 and papaverine on baseline contractile function and inotropic response to isoprenaline, under variable conditions of temperature (27 degrees to 42 degrees C) and rate of beat (0.125 to 4 Hz). The inotropic stimuli, caused by increasing the frequency of stimulation and decreasing the temperature, could not overcome the depressive action of D 600 on basal systolic tension. In addition the inotropic effects evoked by papaverine at low rates of beat and high temperatures were converted into cardiodepressive effects at high stimulation rates and low temperatures. The inotropic response to isoprenaline appeared to be by far more resistant to the depressive actions of D 600 and papaverine than the baseline contractile function. Only at a stimulation frequency of 2 Hz, high concentrations of D 600 (3 X 10(-7)M) and papaverine(3 X 10(-5)M) reduced the response caused by isoprenaline. At a stimulation frequency of 0.5 Hz, however, D 600 left the inotropic responses to isoprenaline unchanged, whereas papaverine potentiated these responses. It appears from the present results that the frequency of stimulation and the temperature greatly modify the cardiodepressive actions evoked by D 600 and papaverine.
