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Some factors affecting the decision on non-mandatory vaccination in an influenza pandemic: comparison of pandemic (H1N1) and seasonal influenza vaccination

Background: The 2009 influenza pandemic caused by the influenza A (H1N1) 2009 virus was accompanied by a debate about whether or not to be vaccinated. The percentage of people who decided to be vaccinated was lower than in the case of seasonal influenza vaccination. We therefore compared factors influencing the decision on pandemic and seasonal influenza vaccination.

Method: Slovene inhabitants aged 18 and over (N=1383) completed an internet based survey on socio-demographic and health behaviour-related characteristics, personality traits, and characteristics of decision-making. Two stepwise logistic regression analyses were performed, one with an uptake of the pandemic influenza vaccine and the other with an uptake of the seasonal influenza vaccine as a dependent variable.

Results: In addition to common predictors of a decision in favour of the two vaccinations (age, gender, chronic illnesses, working in healthcare, trust in media news and vaccination side-effects in someone close), deciding in favour of vaccination against the pandemic virus was related to living with children and thoroughness in decision-making. It was also related to being vaccinated against seasonal influenza, trust in pandemic vaccine safety and professional information in favour of vaccination, and the decision of someone close.

Conclusions: In the face of the pandemic threat and lack of information, people behaved as they had in previous similar situations and according to the behaviour of people close to them and information from trusted sources. Concern for children and decision-making characteristics also became important. These factors should be considered in future crisis interventions.

Abstract

In diagnosing the aspiration of the foreign body (AFB) in children most important are: medical history, clinical signs and positive radiography of the lungs. Common dilemmas in the diff erential diagnosis are life-threatening asthma attacks or difficult pneumonia. Conventional rigid bronchoscopy (RB) is not recommended as a routine method. Virtual bronchoscopy (VB) can be a diagnostic tool for solving dilemmas. Fiber-optic bronchoscopy (FOB) has a therapeutic stake in severe cases. Herein, we describe a girl, at the age of 6, who was hospitalized due to rapid bronchoconstriction and based on the anamnesis, clinical symptoms and physical fi ndings the suspicion was that she aspirated the foreign body. Due to the poor general condition and possible sequel, the idea of RB was dropped out. Multidetector computed tomography of the chest and VB was performed and AFB was not found. Due to positive epidemiological situation, virus H1N1 was excluded. FOB established that the foreign body does not exist in the airways. During bronchoscopy numerous castings are aspirated from the peripheral airways which lead to faster final recovery. With additional procedures, the diagnosis of asthma was confirmed and for girl that was the first attack. Along with inhaled corticosteroids as prevention she feels well.

Virtual bronchoscopy can be successfully used as a valid diagnostic procedure in suspected foreign body in the children’s lungs, but fiber-optic bronchoscopy remains most important diagnostic and therapeutic method.

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