ABSTRACT
AIMS: To evaluate the effects on absenteeism and on costs for the health care system (HCS) of influenza vaccination offered to nurses in a paediatric hospital; the factors associated with vaccination acceptance and non-acceptance; the motivations of vaccine-recipient and non-recipient nurses. METHODS: Cohort study. During the 2005-2006 influenza season we observed the entire nurse population of a Paediatric Hospital (n = 327) who were offered influenza vaccination at no cost at the working place. An anonymous questionnaire was also administered. RESULTS: Vaccination rate was 30.3%. Mean days of sick leave of vaccinated nurses (3.4 per 100 calendar days) and non vaccinated nurses (4.5 per 100 calendar days) differed but not significantly. The saving for HCS due to vaccination of less than 1/3 of nurses was equal to 0.67 nurse-years. Age > or = 40 years (RR 1.47, p = 0.01), length of service > or = 20 years (RR 1.81, p = 0.0003) and working in oncology ward (RR 2.09, p = 0.002) were predictors of adhesion to the vaccination campaign. Among motivations given for vaccination were: not to transmit influenza to hospitalised children (62.8%), to avoid getting sick (55.6%), to protect own family members (49.4%). Only 34% of vaccinated nurses would have made vaccination even if not offered for free. Among non-recipients' main motivations were: vaccination is unnecessary (62.4%), no trust in its efficacy (8.8%). No differences were found in the incidence of influenza symptoms reported by vaccinated and non vaccinated nurses. DISCUSSION: The utility of influenza vaccination to reduce absenteeism of nurses remains unclear. Strategies for influenza vaccination campaigns should particularly address younger nurses and should take into account the beliefs of each nurse in regards to own health.
Subject(s)
Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Nursing Staff, Hospital , Adult , Chi-Square Distribution , Cohort Studies , Female , Health Care Costs , Hospitals, Pediatric , Humans , Influenza, Human/economics , Italy , Male , Motivation , Prospective Studies , Sick Leave , Surveys and QuestionnairesABSTRACT
BACKGROUND: Exercise is integral to the life of T1DM subjects. Several factors influence the metabolic response to exercise in these patients. Despite physical and psychological benefits of exercise, its hypo- and hyperglycemic effects may cause discouragement from participation in sports and games. AIM: To use existing evidence from literature to provide practical indications for the management of insulin therapy in subjects with T1DM who practice sports or physical activities. METHODS: Bibliographic research was performed on PubMed and the main Systematic Review and Guidelines database were also searched. RESULTS: Existing guidelines are useful but the exact adjustments of insulin dose must be made on an individual basis and these adjustments can be made only by "trial and error" approach. CONCLUSIONS: These clinical indications may be a starting point from which health care providers can find practical advices for each patient.
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Exercise , Insulin/therapeutic use , Absorption , Adolescent , Blood Glucose/metabolism , Blood Glucose Self-Monitoring , Child , Circadian Rhythm , Combined Modality Therapy , Diabetes Mellitus, Type 1/diet therapy , Diabetes Mellitus, Type 1/physiopathology , Diabetes Mellitus, Type 1/therapy , Doping in Sports , Drug Administration Schedule , Eating , Exercise Therapy/adverse effects , Humans , Hyperglycemia/etiology , Hyperglycemia/prevention & control , Hypoglycemia/etiology , Hypoglycemia/prevention & control , Injections, Subcutaneous , Insulin/administration & dosage , Insulin/pharmacokinetics , Insulin Infusion Systems , Meteorological Concepts , Practice Guidelines as Topic , SportsSubject(s)
Cystic Fibrosis/complications , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Liver Transplantation , Lung Transplantation , Waiting Lists , Adult , Cystic Fibrosis/surgery , Diabetes Mellitus, Type 1/etiology , Diabetes Mellitus, Type 1/surgery , Follow-Up Studies , Humans , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Insulin Infusion SystemsABSTRACT
OBJECTIVE: To examine whether the birth weight (BW) and the risks of being pre-term, low birth weight (LBW), and small for gestational age (SGA) of children with cystic fibrosis (CF) are different from nonaffected children. STUDY DESIGN: Retrospective cohort study. We examined all the children with CF born in Tuscany, Italy, from 1991 to 2002 (n = 70) comparing them to the entire population of non-CF-affected children born in the same period (n = 290,059). RESULTS: The mean BW of newborns with CF was 246.2 g lower than the mean BW of the non-CF neonatal population (P = .0003). Children with CF had a higher risk of being born pre-term (RR 2.62, P = .001), LBW (RR 2.66, P = .0009), and SGA (RR = 1.74, P = .04) than the non-CF-affected children. The mean BW of term newborns with CF was 205.7 g lower than that of term non-CF-affected babies (P = .0002). CONCLUSIONS: Our data show an association between CF and reduced BW and show a greater risk of being pre-term for babies with CF.
