The Nature of Immune Responses to Influenza Vaccination in High-Risk Populations.

The current pandemic has brought a renewed appreciation for the critical importance of vaccines for the promotion of both individual and public health. Influenza vaccines have been our primary tool for infection control to prevent seasonal epidemics and pandemics such as the 2009 H1N1 influenza A virus pandemic. Certain high-risk populations, including the elderly, people with obesity, and individuals with comorbidities such as type 2 diabetes mellitus, are more susceptible to increased disease severity and decreased vaccine efficacy. High-risk populations have unique microenvironments and immune responses that contribute to increased vulnerability for influenza infections. This review focuses on these differences as we investigate the variations in immune responses to influenza vaccination. In order to develop better influenza vaccines, it is critical to understand how to improve responses in our ever-growing high-risk populations.

Antimicrobial resistance in critical care.

Patients presenting with active infections or at increased risk for infections pose a significant challenge in critical care nursing. It is important for critical care nurses to use effective antimicrobial strategies in patient management to reduce the potential development of antimicrobial resistance. They should be involved actively in promoting patient management through development of research-based nursing guidelines and protocols.

Managing the infected heart.

Most infective processes are straightforward and can be diagnosed from bacterial findings in a single test. IE does not always follow this tenet, so establishing the diagnosis can be difficult. The salient features of IE may present atypically or be obscured by the presence of preexisting and coexisting diseases. Flulike symptoms may mask the beginning of this devastating disease. Early diagnosis of IE is important because of its high risk of morbidity and mortality. Management of the patient who has IE is complex and requires interventions by infectious disease specialists, cardiologists, respiratory therapists, and critical care nurses to address the many multifaceted complications. Early evaluation, diagnostic validation, multidisciplinary management, prompt pharmaceutical initiation, and intense critical care nursing intervention are necessary to reduce the probability of long-standing complications and to improve patient outcomes.

Use of vasopressors in the treatment of cardiac arrest.

Intervention for cardiac arrest may require intervention for electrical abnormalities or hemodynamic instability. These actions can result in ineffective cardiac functioning and systemic hypotension. Vasopressors are capable of improving severe hypotension that can result from reduced cardiovascular contractility or heart rate. These vasopressor actions are critical to successful resuscitation efforts for patients.

Antibiotic resistance.

Resistance to antibiotics is economically and physiologically costly. Control of antibiotic resistance will require aggressive implementation of numerous strategies. Ongoing surveillance is needed to monitor known antibiotic types and to be able to identify the development of other potential types. Early intervention is needed to combat the rising rate of resistance. Persistent use of hygiene measures and controlled use of antibiotics will limit the spread of antibiotic resistance. Health care providers need to monitor adherence to control measures. Hand and environmental control measures remain a critical component of staff education activities. Active management of infections with non-pharmacologic treatments should be promoted. Motivational campaigns will reinforce positive infection control behaviors. Consistent surveillance of antibiotic use will help fulfill the CDC directive to combat antibiotic resistance and keep the population healthy.

Health promotion and disease prevention through sanitation education in South African Zulu and Xhosa women.

Poor sanitation and hygiene facilitate transmission of environmental diseases and pose a threat to the health of South African residents. This study focused on identifying sanitation needs from the perspective of informal community residents, addressing need related issues, and empowering Zulu and Xhosa women. The study used a multistep approach to identify and access communities of interest, reflexive critique during data collection from 300 heads of households, and a reiterative process to identify major themes. A process, which impacted 1,467 residents, was developed; it included culturally sensitive presentation styles and educational materials that facilitated understanding of sanitation concepts. Main sanitation themes were health knowledge and community role models. Educational sessions incorporated women. Using women as educators elevated their status and validated their community importance. Project participation added to the educational background of the Zulu and Xhosa women. It empowered them and provided an opportunity for them to articulate community needs.

Peer led HIV/AIDS prevention for women in South African informal settlements.

South African women who live in informal settlement communities are at high risk of HIV/AIDS infection due to their poor economic and social status. Prevention programs must include methods for improving their social conditions as well as their sexual risk behaviors. Members of Partners trained 24 women from informal settlements to lead HIV/AIDS education workshops for 480 residents. When these participants reached out to their neighbors, this participatory community-based approach resulted in providing HIV/AIDS prevention messages to more than 1,440 residents. Program leaders from three settlements said in focus group discussions that results from this social influences peer led approach demonstrated that women residents are a valuable resource in providing effective HIV/AIDS prevention programs to South Africa's most vulnerable residents.