Introduction of rotavirus vaccination in a Swedish region: assessing parental decision-making, obtained vaccination coverage and resulting hospital admissions.

AIM: This study evaluated the introduction of rotavirus vaccination in Jönköping County, Sweden, starting in 2014. This project explored the parental factors that influenced the decision to vaccinate and studied the obtained vaccination coverage and its potential influence on hospital admissions due to acute gastroenteritis. METHODS: This was a descriptive, cross-sectional study based on a study-specific questionnaire (n = 356) and regional statistical data on vaccination coverage and hospital admissions in Jönköping County, Sweden. RESULTS: Central aspects when deciding on vaccination were vaccine efficacy and safety, that the vaccine was offered to all children, and recommended by healthcare professionals. One in five parents expressed uncertainty about whether they had sufficient information to make a decision. However, the rotavirus vaccination coverage was elevated from 76.1% to 81.0% and the hospital admissions due to acute gastroenteritis decreased by approximately 60%. CONCLUSION: The results highlight the necessity for Child Health Services to have solid knowledge regarding vaccinations, to understand individual parental issues and to support uncertain parents. The high vaccination coverage achieved is an indication of the trust in healthcare professionals and is considered to be a major contributing factor to the substantial reduction of hospital admissions due to acute gastroenteritis.

How are different levels of knowledge about physical activity associated with physical activity behaviour in Australian adults?

People with knowledge of the benefits of physical activity tend to be more active; however, such knowledge is typically operationalized as a basic understanding that physical activity is 'good' for health. Therefore, the aim of this study was to investigate whether there are differences in how detailed a person's knowledge is about the benefits of physical activity. Participants (N = 615) completed an online survey to measure their current physical activity behaviour, as well as their level of knowledge of the benefits and risks of physical (in)activity. The majority of participants (99.6%) strongly agreed that physical activity is good for health, however on average, participants only identified 13.8 out of 22 diseases associated with physical inactivity and over half of participants (55.6%) could not identify how much physical activity is recommended for health benefits. Furthermore, 45% of the participants overestimated, 9% underestimated and 27% did not know the increased risk of disease resulting from inactivity as indicated by the Australian Department of Health. Participants were significantly more active when they correctly identified more diseases associated with physical inactivity and when they overestimated the risks associated with inactivity. Therefore, health promotion initiatives should increase knowledge of the types of diseases associated with inactivity. Low knowledge of physical activity guidelines suggest they should be promoted more, as this knowledge provides guidance on frequency, types and duration of physical activity needed for health.

Can prolonged QTc and cTNT level predict the acute and long-term prognosis of stroke?

BACKGROUND: Previous studies in patients with stroke indicate that QTc prolongation and elevated cTNT are related to increased risk of all-cause and cardiovascular mortality. METHODS: We analysed the importance of electrocardiographic (ECG) abnormalities and elevated serum cardiac troponin (cTNT)--at baseline examination--as potential predictors for acute and long-term mortalities after stroke in a follow-up of 478 patients with a mean age of 78 years. RESULTS: In a multivariate analysis, strong predictors for poor prognosis during the acute phase were: elevated cTNT (p=0.001); stroke severity (p=0.004); ischemia on ECG (p=0.044); and age (p=0.050). Prolonged QTc interval was on the limit to statistical significance (p=0.050) when using multivariate analysis, while clearly significant in a Cox-regression (when corrected for missing cTNT values). One year after stroke, when adjusted for covariates (gender, diabetes mellitus, hypertension, and ischemic heart disease), elevated cTNT (p=0.001), stroke severity (p=0.014), and age (p=0.031) retained a significant relation with mortality. Moreover, atrial fibrillation was strongly correlated with poor survival (p=0.009). Cox regression confirmed the predictive value of QTc, cTNT, age, and stroke severity, as markers of acute mortality in relation to stroke. CONCLUSION: Prolonged repolarization time independently predicts poor prognosis during the acute phase, but not one year after stroke. In the absence of acute myocardial infarction, elevated initial cTNT is strongly related to poor outcome, both during the acute phase and one year after stroke.