Nationwide Campaign Research Articles

Factors influencing influenza vaccination rates among healthcare workers in Greek hospitals

Influenza vaccination rates are generally low among healthcare workers (HCWs) worldwide. In September 2005, the Hellenic Center for Disease Control and Prevention conducted a nationwide campaign to promote influenza vaccination in hospital HCWs. During the 2005-2006 influenza season, the overall vaccination rate among HCWs was 16.36% (range: 0-85.96%). The self-reported vaccination rate during the previous season was 1.72%, indicating a 9.5-fold increase. Compared with physicians, significantly fewer technical personnel were vaccinated, whereas administrative personnel were more likely to receive the vaccine. Among clinicians, rates for internal medicine departments exceeded those of surgical departments by a factor of 2.71 and laboratory medicine departments by a factor of 2.36. Multivariate analysis showed lower vaccination rates in large hospitals (>200 beds) than in smaller hospitals and lower rates in hospitals with specialist services (intensive care unit, psychiatry or dermatology) than in general hospitals. Factors associated with higher rates included working in northern Greece, in a paediatric or an oncology hospital, or in a prefecture with avian influenza H5N1 activity. In conclusion, in Greece influenza vaccination rates among HCWs remain low, but the implementation of a nationwide campaign had a considerable impact. Efforts should focus on hospital- and HCW-associated factors to increase vaccination uptake.

Teaching teachers to teach ICT integration—T3

Based upon a nation wide campaign called Public Private Partnership—Schools in the Net (PPP-SiN) (Public Private Partnership—Schule im Netz (PPP-SiN), 2000) we were able to initiate an externally financed project of in-service teacher education. The paper describes the realization of this project. Reflections are given on why teachers hesitate to integrate ICT into their teaching. Media competencies are recognized to be key in this context. We reflect upon the following five questions: 1. How do we educate the right thing as well as educate the right way? 2. Which ambient conditions must be met? 3. Which preliminary actions have to be taken and implemented? 4. Which tools, methods and instruments do we need? 5. How do we make sure that the transfer of learned knowledge will take place to find its way into successful teaching?

Studies on knowledge, attitude and perceptions of dracunculiasis in Ebonyi State, Nigeria

Randomly selected guinea worm patients from several communities of endemic dracunculiasis in Ebonyi State were examined and interviewed on knowledge, attitude and perceived cause of dracunculiasis between April 1999 and March 2000. Of the 450 guinea worm patients, there were 254 and 196 males and females respectively. In the age distribution, those in their productive years (11-60 years old) accounted for 88%, the very young 2%, while those from 61 years and above accounted for 9%. About 15% of the respondents associated infection with the supernatural, 55% with drinking of contaminated water, while 21% believed it was a familiar trait. About 0.9% had no idea about the causes of the disease. Treatment of the disease was mainly in the hospitals/clinics and herbalists homes. A few others consult and appease oracles, while a negligible proportion still use the old time honored method only. Over 92% of them kept their sores dry by refraining from immersing them in water. Despite all the efforts by various agencies concerned towards guinea worm eradication, Guinea worm is posing a trait to life of some people especially in rural areas. This study however discusses the results of some behavioral aspects in relation to their uses in the final nationwide campaign on dracunculiasis eradication. Keywords : dracunculiasis, Guinea worm, perception, attitude, Nigeria International Journal of Natural and Applied Sciences Vol. 1(1) 2005: 46-52

Translating Quality and Infection Control into Tangible Terms: A Tertiary Care Center's Contribution to the Institute of Heathcare Improvement (IHI) 100K Lives Campaign

BACKGROUND/OBJECTIVES: It is difficult for quality and infection control services to show tangible benefits of their programs. The IHI has launched a nationwide campaign to prevent healthcare-associated deaths with a goal to save 100,000 lives ( http://www.ihi.org/IHI/Programs/Campaign ). METHODS: A tertiary care center examined mortality rates since 2001. In 2002 a variety of quality and infection control initiatives (i.e. strict enforcement of and real time feedback of compliance with evidence based measures for prevention of ventilator-associated pneumonia, bloodstream infections, urinary tract infections, and surgical site infections) were instituted in its intensive care units. Active surveillance was performed in all intensive care units in the hospital. Mortality projections were constructed for each fiscal year had the mortality rates remained the same from the baseline period, and calculations were made of the “saved lives” taking into account the actual mortality for each period. RESULTS: As the infection control and quality initiatives reached widespread acceptance, important changes occurred in the infection rates in the different units, such as remaining under the NNIS 50th percentile at least 60% of the time or the total absence of certain infections for prolonged periods of time in exemplary units. As seen in the graph below, global hospital mortality was reduced from 4 to 3%, projecting a total of 383 avoided deaths since 2002. Download : Download full-size image CONCLUSIONS: Quality and infection control initiatives may have a substantial impact on hospital mortality rates. The benefits of these programs need to be translated into tangible terms that motivate the hospital staff, such as “lives saved”.

Influenza vaccination in German health care workers: Effects and findings after two rounds of a nationwide awareness campaign

In Germany, despite longstanding recommendations for influenza vaccination, uptake among health care workers (HCW) is poor. We conducted and evaluated a 2-year nationwide campaign to increase influenza vaccination rates among German HCW. The campaign was tailored to the results of a baseline survey and included the distribution of information material to all German hospitals ( n ∼ 2000) and engagement of stakeholders, such as professional HCW associations. Human and financial resources consisted of one full-time public health scientist (2 months) and approximately USD 45,000 to produce and distribute materials. We evaluated the intervention in a survey among a systematic sample of HCW in a sample of selected 20 hospitals. HCW were stratified by profession and asked to self-administer a questionnaire inquiring about self-perceived risk for influenza, belief of effectiveness of the vaccine, and influenza vaccination before the starting season (2003/2004) as well as the previous two seasons (2001/2002, 2002/2003). Three hundred and ninety-six of 800 (50%) HCW who were addressed in the evaluated hospitals participated in the evaluation survey. The overall influenza vaccination rate among respondents increased from 21% (2001/2002) to 26% (2003/2004), which was mostly due to a significant increase among physicians (2001/2002: 21%; 2003/2004: 31%; nurses: 20% and 22%, respectively). Significantly more physicians than nurses felt at increased risk for influenza and believed that the vaccine is very effective. Increased uptake among physicians (compared to nurses) was likely due to physicians’ higher awareness of their risk and trust in the vaccine. In the future it may be necessary to address nurses differently than physicians. We conclude that a national campaign with very limited resources is feasible and capable of achieving measurable results in a short time frame.

Advocates Say Part D Reforms Could Save Billions of Dollars

Advocates Say Part D Reforms Could Save Billions of Dollars

Zhou Yongkang and the Recent Police Reform in China

This article is an attempt to understand the conflicting imperatives of police reform and the underlying constraints affecting it in a one-party state. When China entered the 21st century, police abuse of powers was a conspicuous national problem. Facing mounting public outcry, as crystallised in the series of scandals before 2003, the police, under the leadership of the powerful new Minister, started a nationwide campaign to control police abuses. The article analyses the competing explanations for police abuses in China and the conflicting demands placed on the police in China's social and economic transition. The article concludes that the ultimate restriction on police reform in China is its politicisation. As long as China remains an authoritarian state, which uses police to maintain its political stability, the police will still be unable to be truly responsive and accountable to public need.

Zhou Yongkang and the Recent Police Reform in China

AbstractThis article is an attempt to understand the conflicting imperatives of police reform and the underlying constraints affecting it in a one-party state. When China entered the 21st century, police abuse of powers was a conspicuous national problem. Facing mounting public outcry, as crystallised in the series of scandals before 2003, the police, under the leadership of the powerful new Minister, started a nationwide campaign to control police abuses. The article analyses the competing explanations for police abuses in China and the conflicting demands placed on the police in China's social and economic transition. The article concludes that the ultimate restriction on police reform in China is its politicisation. As long as China remains an authoritarian state, which uses police to maintain its political stability, the police will still be unable to be truly responsive and accountable to public need.

Lutando contra a AIDS entre meninas adolescentes: os efeitos da Campanha de Carnaval de 2003 do Ministério da Saúde do Brasil

In 2003, the Brazilian Ministry of Health launched a nationwide campaign aimed at promoting condom use by adolescent girls. The "Carnival Campaign" was broadcast on television and radio from February 16 to March 3 and targeted adolescent girls (13-19 years), a group which had shown an increase in the number of cases of AIDS and other sexually transmitted diseases. The MoH hired Kelly Key, a Brazilian pop singer, to star the television and radio ads and deliver the campaign message. One of the objectives was to empower girls and encourage them not to be ashamed of purchasing condoms or of demanding that their partners use them. The article presents the results of a nationwide survey with 1,006 adolescent girls in 86 municipalities, sponsored by the MoH. The results show that campaign materials reached the main target public and were evaluated in a very positive light. Finally, the survey data show that the Carnival Campaign had important effects, stimulating discussions in the adolescent social environment and reinforcing positive attitudes towards condom use.

The first methadone clinic in Beijing

In December 2004 one of the authors (R.H.) had the opportunity to spend a day with Professor Zhao Chengzheng from the National Institute of Drug Dependence and her colleagues at the Ankang Hospital methadone clinic in Beijing—the first methadone clinic to be approved in the area. The visit was part of a review of their site, which is part of the WHO study on Substitution Treatment of Opioid Dependence and HIV/AIDS being co-ordinated by the WHO Collaborating Centre in Adelaide, in conjunction with the Zurich team led by Ambros Uchtenhagen. The study is being conducted in China, Indonesia and Thailand as well as Eastern Europe (Lithuania, Ukraine, the Czech Republic and Iran). Ankang Hospital had received approval from the Chinese government to dispense methadone for therapeutic maintenance purposes only a few weeks prior to the visit. In the 2 or so years prior to this time, methadone had been approved for research purposes only to investigate its long-term maintenance properties. However, methadone has been available in China since the early 1990s and approved by the government for short-term detoxification from opioids such as opium and heroin. In these instances, methadone is administered in tapered doses for up to 3 weeks and has been shown to be effective for detoxification [1]. Initially methadone was approved for use only in the southern provinces of China where opioid use was a greater problem, due to the closer proximity to south east Asia where opioids are more freely available. As opioid use spread to other regions of China, so did the approval to use methadone as a detoxification medication. The modern opium trade has historical roots dating back approximately 200 years to the Qing dynasty (1636 – 1909) when western colonialists brought opium into the country. The impact of colonialism on China, which involved Portugal and Britain among other countries, resulted in two major Opium Wars arising from Chinese opposition to the trade. At the end of the second Opium War in 1858 the Chinese legalized the opium trade while regulating domestic trade and maintaining control of the customs duty. This resulted in considerable growth in opium production in China itself, with southern areas of China becoming the provinces where production was highest. The southern provinces exported opium to south-east Asia and the rest of China, resulting in high rates of dependence in the general population of China. Following the founding of the Peoples Republic of China by Mao Zedong in October 1949, a nation-wide anti-drugs campaign was executed along with the many other anticampaigns initiated by the new communist government. During the 3-year campaign, people involved with production or trafficking of opioids were punished according to the new laws. Accordingly, opium availability decreased rapidly and it was reported that 20 million opioid-dependent people became drug free again [2]. The next 30 years of the history of China were reported to be relatively drug-free until the 1980s, when the political tide of China slowly began to change with new market reforms and increased openness and trade with the rest of the world. Slowly drugs, particularly opium, were reintroduced to China, initially near the borders of south-west China and rural areas in the north-west, but spread quickly throughout other parts of the country. Opioid use has increased markedly from 1990 until the current time. The re-

Raising awareness of gas poison.

A nationwide campaign to raise awareness of the symptoms of carbon monoxide (CO) poisoning has been launched by CORGI, which regulates gas installers, and the Health and Safety Executive. About 30 people a year die from CO poisoning caused by faulty gas appliances, with many more becoming chronically ill. Older people are more likely to be victims. All GP surgeries are to be supplied with awareness-raising posters.

Framing Falun Gong: Xinhua news agency's coverage of the new religious movement in China

Falun Gong caught the eyes of the Beijing leadership when more than 10,000 of its practitioners gathered at the Zhongnanhai government compound in Beijing on April 25, 1999. It attracted the attention of the world when the Chinese Communist Party (CCP) started cracking down on the group three months later, claiming this to be the most serious political incident since the student uprising at Tiananmen Square on June 4, 1989. Scholars have attempted to contextualize the cultural, political, and economic climate in contemporary China that allowed this group to rise in a relatively short period and to assess the causes of the CCP's nationwide campaign oppressing the group. Relatively little attention, however, has been paid to exploring the media's role in supporting the government's cause in this campaign. This study examines journalistic narrative and framing of Falun Gong as a social threat in one news organization's attempt to legitimize the government's crackdown against the group. Although the economic reforms and political relaxation since the 1980s might have expanded the media's latitude, the press, especially state-owned media outlets, still functions as an agent for the Beijing regime in important political and social issues. This paper shows how journalists, through news frames, construct particular parameters within which to assess the ‘reality’ about Falun Gong.

Measles eradication in the Americas: progress to date.

The region of the Americas has shown extraordinary progress in its fight to interrupt measles transmission. The Pan American Health Organization's recommended strategy includes the following: a 1-time nationwide campaign targeting 1- to 14-year-old children; routine vaccination among 1-year-olds; and nationwide campaigns conducted every 4 years, targeting all 1- to 4-year-olds. Rapid house-to-house monitoring of vaccination and measles surveillance are other essential components of the strategy. During 2001, only 541 cases were confirmed in the region. In 2002, only Venezuela and Colombia had indigenous transmission. After important vaccination efforts in both countries, the last reported case occurred on 20 September 2002, in Venezuela. Since then, no confirmation exists of indigenous measles circulation anywhere else in the region. Nonetheless, important challenges remain, including insufficient coverage during routine and campaign vaccination and inadequate investigation of some cases.

Housing mobilization in Calcutta – empowerment for the masses or awareness for the few?

This paper describes the evolution of the Calcutta NGO Unnayan and the two related movements which it initiated and supported, Chhinnamul and the National Campaign for Housing Rights (NCHR). Unnayan was concerned with the situation of the poor in Calcutta, and was very active in housing issues. Chhinnamul Sramajibi Adhikar Samity (Chhinnamul for short) was a local movement intended to mobilize the squatter population and involve them directly in political activism. NCHR was a nationwide campaign that sought to link housing activists throughout India and lobby for the legal housing rights of the poor. The paper describes Unnayan’s successes, both in stimulating a national debate on housing issues and in creating a platform for popular protest. It also explains the organizational challenges faced by this small NGO, and the conflicts which led to its funding being cut after 20 years. In particular, it highlights the frustrations of poor citizens, whose immediate material needs loomed larger than the longer-term gains envisioned by the organization.

Echoes of violence: considerations on radio and genocide in Rwanda*

For some 100 days in the spring and summer of 1994, millions of Rwandans witnessed, participated in, or otherwise lived through a nationwide campaign of extermination, a collective effort whose rhy...

Emergency contraception: a “fire extinguisher” for unintended pregnancies

The American College of Obstetricians and Gynecologists defines emergency contraception, also known as post-coital contraception and the “morning after pill,” as “a therapy for women who experience an act of unprotected sexual intercourse.” It has been estimated that post-coital contraception could reduce the number of unintended pregnancies by 2 million and the number of induced abortions by 1 million. Several methods of emergency contraception are widely accepted including an estrogen-progestin combination, progestin only, mifepristone (RU486), and the copper intrauterine device (IUD). The major side effects of post-coital contraception include nausea, vomiting, and menstrual cycle abnormalities. Currently, the biggest obstacles to post-coital contraception in the United States are limited experience among practitioners and lack of awareness and accessibility among patients. Analogous to a fire extinguisher in homes, emergency contraception requires immediate access for success. There is a nationwide campaign, supported by major national medical organizations, to increase physician acceptability and to make hormonal emergency contraception available over-the-counter, thereby increasing visibility and patient convenience. Until the availability improves, it is prudent for physicians to prescribe emergency contraception as well as provide prevention counseling during routine visits.

A nationwide campaign addressing the appropriate use of HRT has been launched by the US FDA.

A nationwide campaign addressing the appropriate use of HRT has been launched by the US FDA.

A nationwide campaign addressing the appropriate use of HRT has been launched by the US FDA.

A nationwide campaign addressing the appropriate use of HRT has been launched by the US FDA.

Equity in health care access to: assessing the urban health insurance reform in China

This study evaluates changes in access to health care in response to the pilot experiment of urban health insurance reform in China. The pilot reform began in Zhenjiang and Jiujiang cities in 1994, followed by an expansion to 57 other cities in 1996, and finally to a nationwide campaign in the end of 1998. Specifically, this study examines the pre- and post-reform changes in the likelihood of obtaining various health care services across sub-population groups with different socioeconomic status and health conditions, in an attempt to shed light on the impact of reform on both vertical and horizontal equity measures in health care utilization. Empirical estimates were obtained in an econometric model using data from the annual surveys conducted in Zhenjiang City from 1994 through 1996. The main findings are as follows. Before the insurance reform, the likelihood of obtaining basic care at outpatient setting was much higher for those with higher income, education, and job status at work, indicating a significant measure of horizontal inequity against the lower socioeconomic groups. On the other hand, there was no evidence suggesting vertical inequity against people of chronic disease conditions in access to care at various settings. After the reform, the new insurance plan led to a significant increase in outpatient care utilization by the lower socioeconomic groups, making a great contribution to achieving horizontal equity in access to basic care. The new plan also has maintained the measure of vertical equity in the use of all types of care. Despite reform, people with poor socioeconomic status continue to be disadvantaged in accessing expensive and advanced diagnostic technologies. In conclusion, the reform model has demonstrated promising advantages over pre-reform insurance programs in many aspects, especially in the improvement of equity in access to basic care provided at outpatient settings. It also appears to be more efficient overall in allocating health care resources by substituting outpatient care for more expensive care at emergency or inpatient settings.

Cancer control in Thailand.

Cancer in Thailand is becoming a significant health problem. It is the leading cause of death in Thailand. Several cancers can be prevented by a nationwide campaign of health education to prevent raw fish intake and an antismoking campaign. An appropriate cervical cancer and breast cancer screening program can improve the recent prevalence of both and lead to better results of treatment. Research related to the carcinogenesis mechanism of certain cancers can lead to greater understanding and a better plan of control.