EUROPA DONNA: has strength in its heterogeneity.

EUROPA DONNA, a non-profit-making organisation, is a pan-European movement against breast cancer; it is a coalition that is active in 29 countries, each organised into national independent Fora. In each Forum, a postal survey was conducted between 2001 and 2002. A standardised questionnaire was used to collect information about Forum characteristics and activities, and perceptions of the adequacy of the local health service in relation to the prevention, diagnosis and treatment of breast cancer. Twenty-seven Fora (93%) participated in the survey. The results show the heterogeneity between the Fora in the services offered and activities in the different countries. The Fora also perceived a range of deficiencies in the prevention, diagnosis and treatment of breast cancer within their national health systems. These results highlight the importance of a coalition to establish a consensus among the Fora, and the need for coordinated initiatives in different European countries.

Impact of an algorithm-guided nurse intervention on the use of immunization opportunities.

OBJECTIVE: To determine if a nurse intervention guided by an immunization algorithm was associated with an increased use of immunization opportunities at non-well-child care visits. DESIGN: A controlled intervention trial of an algorithm-guided nurse intervention during a 5-month period. The use of immunization opportunities at an intervention site was compared with the use at this site during the previous year (the retrospective control group) and with that at a similar pediatric practice during the same period (the concurrent control group). STUDY POPULATION: Children aged 2 to 60 months at 2 hospital-based pediatric practices that serve children of families with low to moderate incomes in Rochester, NY. RESULTS: During the study periods, 2814 study children in the 3 groups made 5464 visits for non-well-child care. The use of immunization opportunities for diphtheria-tetanus-pertussis vaccine, live oral poliovirus vaccine, and measles-mumps-rubella vaccine at intervention visits was significantly better than at the visits of the retrospective or concurrent control groups (range of odds ratios, 1.9-2.5). CONCLUSIONS: An algorithm-guided nurse intervention improved the use of immunization opportunities at non-well-child care visits.