American journal of public health
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This study was undertaken to identify attributes of physicians associated with physicians' decisions to withdraw life support. ⋯ Physicians' personal characteristics are associated with both their preferences and their practice in the withdrawal of life support, and a greater willingness to withdraw is associated with a higher frequency of withdrawal. The influence of physician characteristics demonstrates that patient preferences and clinical circumstances do not exclusively govern such ethical decisions.
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Coincident with the licensure of Haemophilus influenzae b conjugate vaccines from 1987 to 1990, the incidence of meningitis and other invasive infections caused by H influenzae type b declined in Massachusetts children by 87% and 91%, respectively. By 1991, Neisseria meningitidis had replaced H influenzae b as the leading cause of bacterial meningitis, accounting for 57% of cases. ⋯ Streptococcus pneumoniae caused 92% of nonmeningitis invasive disease, with sero-groups 14, 6, 19, 18, 4, 23, and 9 causing 94.5% of infections. These findings have implications for the development of additional polysaccharide-protein conjugate vaccines for the prevention of childhood infections.