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Abstract Background Beginning with the 2004–05 influenza season, the Advisory Committee on Immunization Practices (ACIP) strengthened their existing encouragement that children aged 6–23 months receive influenza vaccination by creating a formal recommendation. Methods Well-functioning sentinel project immunization information systems (IIS) in Arizona (AIIS) and Michigan (MIIS) were used to calculate vaccination coverage among children aged 6–23 months during the 2004–05 influenza season. We calculated 2 measures of vaccination coverage: a) receipt of 1 or more doses of influenza vaccine September 2004-March 2005 and b) receipt of 2 or more doses (ie, fully vaccinated). We compared the dose administration distribution among children needing 1 and 2 doses and by provider type. Coverage by age and timeliness of vaccine doses entered into the IIS were also analyzed. Results Influenza vaccination coverage levels among children were 30% and 27% in AIIS and MIIS, respectively, for receipt of 1 or more doses; 13% and 11% of children, respectively, were fully vaccinated. Peaks in dose administration among children needing 1 and 2 doses were similar. There were differences in vaccine administration between public and private providers. Coverage was higher among younger children and over 75% of all influenza vaccine doses were entered into the IIS within 30 days after receipt of vaccine. Conclusion Though almost 1/3 of children received 1 or more doses of vaccine in 2 IIS sentinel projects during the first season of the new recommendation, emphasis needs to be placed on increasing the proportion of children fully vaccinated. IIS data can be used for timely monitoring of vaccination coverage assessments.

Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an important determinant for quality of life, we assessed this in a large international adult CHD cohort., Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross-sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models., Results: Median age was 32 years (IQR 25-42) and 94% of patients had at least a high school degree. Overall employment rate was 69%, but varied substantially among countries. Higher education (OR 1.99-3.69) and having a partner (OR 1.72) were associated with more employment; female sex (OR 0.66, worse NYHA functional class (OR 0.67-0.13), and a history of congestive heart failure (OR 0.74) were associated with less employment. Limitations at work were reported in 34% and were associated with female sex (OR 1.36), increasing age (OR 1.03 per year), more severe CHD (OR 1.31-2.10), and a history of congestive heart failure (OR 1.57) or mental disorders (OR 2.26). Only a university degree was associated with fewer limitations at work (OR 0.62)., Conclusions: There are genuine differences in the impact of CHD on employment status in different countries. Although the majority of adult CHD patients are employed, limitations at work are common. Education appears to be the main predictor for successful employment and should therefore be encouraged in patients with CHD., (© 2019 The Authors. Congenital Heart Disease Published by Wiley Periodicals, Inc.)

Objective: First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL., Design: Cross-sectional observational study., Setting: Twenty-four cardiology centers from 15 countries across five continents., Patients: Four hundred thirty-five adult patients with congenital heart disease (177 Fontan and 258 ASD/VSD) ages 18-83 years., Outcome Measures: QOL and illness perceptions were assessed by the Satisfaction With Life Scale and the Brief Illness Perceptions Questionnaire, respectively., Results: Patients with a Fontan circulation reported lower QOL (Wald Z = -3.59, p = <.001) and more negative perceptions of their CHD (Wald Z = -7.66, p < .001) compared with patients with ASD/VSD. After controlling for demographics, anxiety, depressive symptoms, and New York Heart Association functional class, path analyses revealed a significant mediation model, αβ = 0.15, p = .002, 95% CI = 0.06-0.25, such that CHD diagnosis was indirectly related to QOL through illness perceptions., Conclusions: The Fontan sample's more negative perceptions of CHD were likely a reflection of life with a more complex defect. Illness perceptions appear to account for unique differences in QOL between groups of varying CHD complexity. Psychosocial screening and interventions may be important treatment components for patients with CHD, particularly those with Fontan circulations., (© 2018 Wiley Periodicals, Inc.)

Fairy grass (Lachnagrostis filiformis) is an Australian native grass that has recently become a major concern for rural communities. Its dried inflorescences are blown by the wind and build up against fences and buildings, becoming a severe fire hazard. Understanding the ecology of fairy grass and its impacts on rural communities is relevant to its management. Four dry lake beds in Western Victoria were selected to determine if environmental factors, such as lake, location, direction, altitude and road type and the covariates of pH, soil salinity, soil moisture and distance to nearest road, are related to the presence of fairy grass. The 'lake' factor was the only environmental parameter that was significantly associated with the presence of this weed.

Background: Impaired quality of life (QOL) is associated with congenital heart disease (CHD) and country of residence; however, few studies have compared QOL in patients with differing complexities of CHD across regional populations. The current study examined regional variation in QOL outcomes in a large multinational sample of patients with a Fontan relative to patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs)., Methods: From the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study (APPROACH-IS), 405 patients (163 Fontan and 242 ASD/VSD) across Asia, Europe, and North America provided consent for access to their medical records and completed a survey evaluating QOL (0 to 100 linear analog scale). Primary CHD diagnosis, disease complexity, surgical history, and documented history of mood and anxiety disorders were recorded. Differences in QOL, medical complications, and mood and anxiety disorders between Fontan and ASD/VSD patients, and across geographic regions, were examined using analysis of covariance. Hierarchical regression analyses were conducted to identify variables associated with the QOL ratings., Results: Patients with a Fontan reported significantly lower QOL, and greater medical complications and mood and anxiety disorders relative to patients with ASD/VSD. Inpatient cardiac admissions, mood disorders, and anxiety disorders were associated with lower QOL among patients with a Fontan, and mood disorders were associated with lower QOL among patients with ASD/VSD. Regional differences for QOL were not observed in patients with a Fontan; however, significant differences were identified in patients with ASD/VSD., Conclusions: Regional variation of QOL is commonplace in adults with CHD; however, it appears affected by greater disease burden. Among patients with a Fontan, regional variation of QOL is lost. Specific attempts to screen for QOL and mood and anxiety disorders among CHD patients may improve the care of patients with the greatest disease burden., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Congenital heart disease (CHD) affects approximately 1% of all live births today. With improvements in diagnostic, medical, surgical, and interventional procedures, 85% or more of all infants with CHD will reach adulthood. The number of adults living with CHD has been estimated to exceed 1 million and now exceeds the number of pediatric CHD patients. Because residual problems following intervention for congenital heart lesions can present during the adult years and complicate the well-being of these patients, ongoing care is warranted. Adult care providers have a limited knowledge of the complexities of CHD. The American College of Cardiology recommends the establishment of adult CHD clinics with both pediatric and adult cardiologists. Although our clinic is located in a pediatric hospital, little attention has been placed on where these clinics should be located-an adult setting or a pediatric setting. We sought to determine the adult CHD patient's perspective on being seen in a pediatric setting., Objective: The objective of the study was to determine the perspective of adults with CHD receiving follow-up care in a pediatric setting., Methods: A pilot 11-question anonymous patient satisfaction survey with no personal identifiers and no diagnoses was sent to all patients who had attended the adult congenital heart disease clinic at our pediatric hospital medical center during a 2-year period., Results: From our respondents, 96% did not have any concerns with being seen in a pediatric setting for adult congenital heart care, and 98% would recommend our clinic to other patients., Conclusion: Care for the adult with CHD involves multiple care providers. The most important finding from the patient's perspective is knowledge of the complexities of congenital heart lesions and possible future complications. There was little impact from being seen in a pediatric hospital setting., (Copyright © 2011 Lippincott Williams & Wilkins.)

Saturation analysis with [3H]-dexamethasone was employed to measure glucocorticoid binding in purified preparations of human eosinophils and neutrophils. Eosinophils contained 10.8 +/- 1.3 x 10(3) high-affinity receptor sites per cell, with a dissociation constant (Kd) of 15.3 +/- 0.6 nM dexamethasone. Cortisol was capable of competing with [3H]-dexamethasone in the binding reaction, whereas progesterone, estradiol, estriol, and testosterone were less effective. Saturable glucocorticoid binding in neutrophils had a Kd of 17.7 +/- 0.8 nM dexamethasone with 11.1 +/- 0.8 x 10(3) sites per cell and displayed similar steroid specificity. These data indicate that normal human eosinophils have glucocorticoid receptors with characteristics similar to those in neutrophils and that in these cells ligand-receptor interaction can occur at physiologic glucocorticoid concentrations. Furthermore, these results suggest that certain glucocorticoid effects on eosinophils and neutrophils may be mediated through specific receptors.