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3530 / 43158 Adverts
Gîte - Self Catering - Charming Small Farmhouse Detached, single storey, separate entrance, in a private property
from $A79/Night (rates)
4 people
Handicapped people welcome2 bedrooms
3 roomsLiveable floor area : 65m²
Ground surface : 1500m²
Handicapped people welcome2 bedrooms
3 roomsLiveable floor area : 65m²
Ground surface : 1500m²
- View : Village, fantastic sunset
- Children welcome
- Setting : Suitable for a relaxing break, Natural
- Pets accepted
Touristic region : discover Märkisch-Oderland
Advert No. 13122
For your guidance
Contact by phone
Contact by email
For safety and quality control reasons, we strongly recommend to contact the owner through IHA Holiday Ads.
Reviews about the Advert 13122
Be the first to provide a review about this advert!
Ferienhaus mit CharmeAdvert 13122Wuschewier - Sate of Brandenburg - Germany
Advert details 13122
Assets Farm
Advantages : Ping-pong table, 4 ping-pong bats
Interior Charming Small Farmhouse with View: village, fantastic sunset
Receive up to : 4 person(s)
Liveable floor area : 65m²
Interior layout : 3 Room(s), 2 bedroom(s), 1 bathroom, 1 WC, living room 12m², typical style kitchen
Sleeps - bed(s) : 1 double bed(s), 2 single bed(s)
Guest facilities : T.V., Hanging wardrobe, electric heating, wood-burning stove
Appliances : Crockery/cuttlery, electric coffee maker, electric kettle, toaster, electric cooker, electric hobs, oven, refridgerator, dish washer, vacuum cleaner
Exterior Gîte - Self Catering in Setting: suitable for a relaxing break, natural
Ground surface : 1500m²
Outside setting : Enclosed grounds 1500m²
Outside amenities : BBQ, garden table(s), 4 garden seat(s)
Rates Calendar Availability Gîte - Self Catering in Wuschewier
Seasons & Availability Charming Small Farmhouse in Wuschewier
Rates Charming Small Farmhouse in Wuschewier
Season Night Weekend week 2 weeks Month
Low season$A79* - - - -
Mid season - - - - -
High season - - - - -
Festive specials - - - - -
Promotional period - - - - -
ServiceFrequencyIncluded / SuppliedSupplementRates
For your guidance
Information :
Children welcome
Pets accepted
Present on site : pets
Non smoking rental
Personal transport advisable
Water : hot/cold
Local voltage supply : 110-120V / 60Hz
Electricity supply : mains
Handicapped people welcome
Wheelchair access
Booking conditions
Reservation :
Payment made upon reservation : 25% of rental sum
Payment balance : on handing over the keys
rentals :
Cleaning charge levy on departure : $A39*
Anticipated supplement for : animals
Accepted methods of payment :
Leisure, Surroundings, Location Charming House 13122
Leisure Wuschewier - Sate of Brandenburg
Leisure activities less than 20 km / 12 miles : Bathing, canoeing, mini-golf, angling
Attractions and relaxation : Restaurant, cinema, zoo/animal park, theatre
SurroundingsCountryside - Sate of Brandenburg
Amenities :
Breadshop at 7,5km
Local shops at 1km
Supermarket at 5km
Hairdressing salon at 5km
Post office at 7,5km
Bank at 7,5km
Cash point at 5km
Chemist at 7,5km
Doctor at 5km
Hospital at 15km
Location AccessFarm Wuschewier
Feldstr. 02
15320 WuschewierSate of Brandenburg
GPS coordinates of accommodation
Latitude 52°39'28"N
Longitude 14°16'2"E
Access routes Gîte - Self Catering 13122
at 59km / 1h 30min.
Airport Berlin Schönefeld
Berlin, State of Berlin, Germany
at 27km / 45min.
Train station Rehfelde
Rehfelde bei Strausberg, Sate of Brandenburg, Germany
Towns close by
Berlin (70km)
Bad Freienwalde (25km)
Seelow (25km)
Close to Dievenitz, Hute-Berg, Grenz-Berg, Grosser Kolpiner See, Narost, Sophienfliess, Lemierzyckie Lasy, Wupatzsee, Prottenlanke, Fuchs-Berg, Schutte-Berg, Brand-See, Haupt-Graben, Zeisig-Berge, Eichberge, Garz-See, Haltepunkt Hegermuhle, Pfingst-Berg, An Berge, Grenzpfuhl, Stahnsdorfer See
Towns close by
Nearby places
Photos Farm 13122
Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Southerly view, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Living room, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Hanging wardrobe, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Kitchen, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
South-westerly view, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Easterly view, Charming Small Farmhouse in Wuschewier - Advert 13122 @cc
Return to the rental listingsContact

subset: commoncrawl


text:
4th International Yoga Day Celebration at Oakridge International School, Newton Campus
Learning 'Yoga' at an early age can have lasting and immense benefits on the overall health and well-being of the student. It helps the body to relax, soothes mind, and make the body flexible as well as improves concentration power. Stuck between a variety of workload and pressures, students can gain these benefits from yoga. This will help them prepare for their exams, score excellent marks, work better and improve their performance in every field.
We are well aware of the endless emotional and physical disorders that teenage faces due to unhealthy lifestyle choices. However, the practice of Yoga can help them overcome these problems and lead a healthy lifestyle. We can always find the positive impact of yoga on the life of students. Meditation and yoga bring positive vibes among the students and if they do it regularly it will help in bringing positive outcomes which is advantageous for the scholars. To spread this awareness, we at Oakridge, one of the best IB schools in Hyderabad encourage students to perform yoga every day.
The International Yoga Day celebration was initiated by the Prime Minister of India, Shri. Narendra Modi in the year 2014. At Oakridge, we celebrated the 4th International Yoga Day with a great enthusiasm by the active participation of the students. Ms. Mani and Ms. Seema Shetty, the Yoga Facilitators conducted the session. The compering of the session was done by Aahana Jain of 5J. Ananya Tirumala of 6F recited a prayer and Vidyavini of 7L gave a speech on the importance of yoga and the significance of the International Yoga Day.
The students of Grade 6 displayed breathtaking and awesome formations. The event ended with a small note on the importance of yoga for the students in daily life by Mr. Paramesh Murali, Vice Principal, International Curriculum (MYP-DP). This event was an attempt to enhance interest in the discipline that provides physical, spiritual and mental benefits.


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Also known as a PV system or solar power system, is a power system designed to supply usable solar power by means of photovoltaics. It consists of an arrangement of several components, including solar panels to absorb and convert sunlight into electricity, a solar inverter to change the electric current from DC to AC, as well as mounting, cabling, and other electrical accessories to set up a working system. It may also use a solar tracking system to improve the system's overall performance and include an integrated battery solution, as prices for storage devices are expected to decline. Strictly speaking, a solar array only encompasses the ensemble of solar panels, the visible part of the PV system, and does not include all the other hardware, often summarized as balance of system (BOS). Moreover, PV systems convert light directly into electricity and shouldn't be confused with other technologies, such as concentrated solar power or solar thermal, used for heating and cooling.
Lagorin-Wicks Ranch Solar Power System and Solar Thermal System
Vagabond Ranch


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Destinations throughout the world thrive on a combination of both individual consumers and group/event business. Finding the right mix of business is key, but even more important is knowing the differences in how to market to those two audiences.
These two segments are colliding now, into what is affectionately known as "bleisure" travel.
The leisure traveler typically spends their own money on travel, and seeks pricing that will include as many amenities as possible: breakfast, parking, attraction tickets, flights, and more. Vacation packages and suggested itineraries are a paramount, providing both value and guidance on how to navigate a city for vacation. They are out all day enjoying the sights, and seek savings over several days' time (think: multi-day tickets to attractions). The printed and digital maps and guides for the area will also be translated into multiple languages to reflect the ever-growing international presence to US cities.
Event marketing, on the other hand, focuses far more on the attendee experience during the after-hours of a meeting or event. Typically, this is evening dining and entertainment that is unique and experiential to help complement the time they're spending inside a convention center or hotel walls. Their travel is primarily funded by their employer, and the radius in which they'll travel is more limited to the geography just around where the meeting is held. They want entertainment that will pack a punch in the small time they have on their own. Often times, the city in which an event is held will dictate the interest levels in attendee registration. Venues and activities that promote networking are also a plus, as they'll be more enticed to attend when their business relationships have more chances to flourish.
These two segments are colliding now, into what is affectionately known as "bleisure" travel. When business meets leisure, event attendees are either staying extra days to enjoy a destination on their own, or bringing their families with them who can enjoy the daytime action while they're attending their event. More than ever, travelers are looking to destinations to provide a roadmap for a successful trip, regardless of what brings them there. They want to do the most unique and exciting things that are worthy of social media, which will help inspire future travelers to the destination!
Written by Jessica Rienecker, CTA, CTP, CMM, HMCC.
All information provided by Visit Anaheim.


text:
Actually mine too.
I recently came across a blog that gave me the good idea of rethinking my name for domains.
Thanks to Mayo Jordanov (@oyam from Micro.Blog), now Maharba (Abraham in reverse) is a domain name possibility that I have never thought of.
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A very useful trick that will come in handy as everything Abraham (.com, .net, .org, .co, .in, .tv, etc.) have been taken or priced premium.


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5 Things That Attract Renters In Charleston
As a real estate investor, it is important to know how to attract renters in Charleston. An empty house will cost you time and money. Learn more about how to attract the best tenants in our latest post. Once you find the perfect tenant, you'll see smooth sailing as a Charleston real estate investor. Finding … Continued


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If you have international clients, you may not want to rely on a local law firm for all of your legal needs. You might want to connect with an international law firm as well. The right law firm will be able to assist you in numerous ways.
They Might Be Able To Translate Legal Documents
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As an athlete, Johanna competed against the world's best. As a broadcaster, she currently hosts the coverage of some of the biggest sporting events including the Olympic Games, The Winter Games, The Australian Open, the Brisbane International and the Medibank International.
Previous experience
TV: After announcing her retirement from swimming in May 1993, Johanna joined the Seven Network. She reported for shows such as Sportsworld and Sydney Weekender, and hosted The AFL Half Time Show.
In 1994 she became Channel Seven's first female (and youngest ever) presenter of the Weekend Sports News, a job she returns to in 2009. She is also the host of the very successful Seven Network's Better Homes and Gardens, and currently the Ambassador for New Idea, writing regularly for the magazine.
She was also a regular guest on ABC TV's sports panel show, The Fat, and ABC TV's Good News Week, also appearing on the show on the Ten Network.
Accolades: One of Johanna's greatest accolades was being chosen to host the coverage of the 2002 Olympic Winter Games for the Seven Network. This is the first time an Australian woman has solely hosted an Olympics' coverage.
The best MC I have worked with in over 20 years of event Management ... keep reading Macquarie University Sports Association


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Kincardineshire is known as a county with Aberdeenshire adjoining its northern section, the German Ocean over the east, and Forfarshire over the southern and western sections of the land. Comprising of 4 districts, namely the Dee-side, the Grampian, the Coast-side, plus the Howe of the Meams, the town is rich in natural resources and sights, particularly rivers. Among such are the Cowie Water, Carron Water located in the Burn of Pheppie, the Grampian Mountains, the lower regions of River Dee, and much more. The county expands about 243, 444 acres, having 1,280 acres with the whole county composed of bodies of water.Locals are able to appreciate nature as it likewise boasts mountain hills and wood land. Kincardinshire gives an abode for nature enthusiasts nevertheless it does not compromise in offering convenience to those who would like to undergo house relocating or clearing within the location.
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…It will come. I promise.
I'm talking, of course, about workouts.
Ah, schedules, to-do lists and, as my business coach likes to say, the "Stack of Shame." All of the things we know we should do for ourselves that we, ahem, sometimes kind of just forget to do…or shove into the corner for a while while we take this really important phone call…or, you know. We just push them off.
So until I feel better about all of this, I'm going to be scheduling my workouts. Not just saying "If it's Monday, it must be yoga," and then hoping I'll have the energy to go to a class at 4:30 after a long work day. But actually realizing that the only way for me to get a workout done is to actually do it first, before the work day gets in the way. That means – ouch – 6 a.m. for yoga class. Maybe 8:30 if I get up early and get an hour or two of work in first. But, realistically, 6 a.m. for yoga.
When I was training for what became my most successful race season three years ago, I did this exact thing – on swim day, I'd be up at 5 and in the pool by 6, because back then I was working at an office and had to be out of the gym by 7 to get there on time. On speed workout day, same deal – I'd run my mile repeats on the treadmill, often when it was still dark outside. I was a scheduling badass. And, big surprise. Stuff got done.
Getting in with a workout group accomplishes the same goal. If I know my track workout is going to be at 6:30 p.m., no questions asked, every Wednesday, then guess what gets blocked out every Wednesday? A plan for getting there and getting in my workout. (Track is my one exception to the "work out in the morning" rule. It's just way easier to do hard track workouts with a group, and my particular group happens to convene at 6:30 p.m. once a week.)
So, try this on for size for the next few weeks. Take your calendar book, and block out actual time for your workouts. Then, make a point of getting them done. Get used to the following routine:
Once you've got that routine down, things will go better. I'm dedicating myself to it this week. I'll let you know how it goes.
Yesterday's #Every48 workout: A glorious 7-mile run, first thing in the morning. Yes, I scheduled it! More thoughts on that run – and why I think it went so well – in tomorrow's post.


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OBDSTAR X300 DP Plus è la versione aggiornata di OBDSTAR X300 DP PAD e denominata anche X300 DP PAD 2, supporto ECU Clone e Toyota Tutti i tasti persi.
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H108 is designed by OBDSTAR Company for PSA vehicles immobilizer programming and dashboard reset. In the software, obdstar H108 can perform BSI model automatic identification and pin code reading when all keys lost, can read write EEPROM, FLASH etc. In the hardware, the device adopts the upgraded main board which allows user to test more freely, operate more easily and offer better user experience. obdstar H108 can be widely used on after-sale market, repair shops, car technicians and car owners.
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- 1 Red Sparrow 2018 Hollywood New Movie Review
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Red Sparrow 2018 Hollywood New Movie Review
Jennifer Lawrence is tied to a chair, beaten and tortured. She is the victim of rape and attempted rape. She is forced to strip naked in private and in public.
She is slashed, stabbed and has a gun put to her head. Ostensibly, such graphic ordeals are intended to demonstrate the physical and psychological fortitude of her character, a Russian spy named Dominika Egorova.
But ultimately, these shocking and violent sequences become repetitive and gratuitous, making "Red Sparrow" feel more like a cheap exercise in exploitation than a visceral tale of survival. Surely there's more to spycraft than knowing the perfect spot to caress on a target's thigh, or how delicately to whisper into his ear.
But this is about the extent of the training she receives. (Oh! She also learns how to pick locks.) Dominika is right when she complains that she's been sent to "whore school" alongside other attractive and tough-minded young people who are being molded to serve Russia's secret intelligence.
What she endures is more than just degrading—it's destructive. And as a solitary tool set, it wouldn't seem to prepare her for the many dangers headed her way.
Red Sparrow 2018 Hollywood Movie Details
Francis Lawrence
Justin Haythe (screenplay by), Jason Matthews (based upon the book by)
Jennifer Lawrence, Joel Edgerton, Matthias Schoenaerts
Drama | Mystery | Thriller
Release Date:
1 March 2018 (UK)
Also Known As:
Operación Red Sparrow
Red Sparrow 2018 Movie Full Cast


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Gone with the Wind Novel by Margaret Mitchell pdf
Gone with the Wind is a novel by means of American author Margaret Mitchell, first published in 1936. The tale is about in Clayton County and Atlanta. The duration of the Yankee Civil battle and Reconstruction generation. It depicts the struggles of young Scarlett O'Hara. The spoiled daughter of a properly-to-do plantation proprietor. This historical novel features a Bildungsroman or coming-of-age story. The title is taken from a poem written by using Ernest Dowson.
The Wind changed into famous with American readers. The top American fiction bestseller in 1936 and 1937. As of 2014. A Harris poll determined it to be the second one favorite ebook of American readers, simply in the back of the Bible.
Written from the attitude of the slaveholder. The Wind is Southern plantation fiction. African individuals have been considered controversial. The novel has grown to be a reference point for subsequent writers of the South. Students at American universities talk over with, interpret, and study it in their writings. The radical has been absorbed into American popular culture.
Mitchell acquired the Pulitzer Prize for Fiction for the ebook in 1937. It becomes tailored into a 1939 American movie. The Wind is the best novel by using Mitchell posted throughout her lifetime.
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text: Commentary This is all commentaries on WVPE including Friday's Michiana Chronicles Feature and occasional one-time contributors. "Bat Man" By Andrew Kreider • Jul 30, 2016 Bat man At two am, my cell phone wakes me. It's my daughter. She is calling from her bedroom. Dad, there's a bat in my room, she whispers. What do I do? I imagine her standing bravely on top of her bedspread, staring into the eyes of a mammal hanging from her ceiling fan. She is no coward, my girl. But the sound of beating wings and the feathery touch of passing skin would concern the bravest of us all. She knows: somehow this incident must be contained. "Peter Pan Still Flies" By Jeanette Saddler-Taylor • Jul 22, 2016 "Oh for crying out loud, act your age." I can't remember what juvenile antic I had performed. (Selective memory is a wonderful thing! You get to pick and choose and clean up your autobiography just by blanking.) Whatever it was though, brought out this hissing directive from my mother, and unlike my action, I clearly remember her reaction. "Big Weeds and Small Weeds" By David James • Jul 15, 2016 Big Weeds and Small Weeds "Downtown Fireworks way up Close" By Ken Smith • Jul 8, 2016 Downtown Dancing and Fireworks It was just the two of us this time, more or less empty-nesters, with beach chairs slung over our shoulders walking toward downtown, heading for the fireworks. We can see them in miniature from our front yard, but once in a while we go see them up close, the full sound and fury. In Howard Park, people were setting out blankets and lawn chairs on the grassy slope down to the river, but we craved the maximum experience, as close as we could get. "In Defense of Expertise" By April Lidinsky • Jul 1, 2016 In this summer of politics going to heck in a hand basket, I want to offer a defense — of expertise. Who knew we'd need to say it … and yet, here we are, with sincere folks on both sides of the Atlantic spurning the experts, spurning facts, even. One critic of the Brexit vote Tweeted: "We now live in a "post-factual democracy; when the facts met the myths, they were as useless as bullets bouncing off the bodies of aliens in an H.G. Wells novel." "Uncle Wally" By Sid Shroyer • Jun 24, 2016 I'm at "The Cove, " home of the South Bend White Sox, on a Saturday afternoon 26 years ago, when I happen upon the pitching of Uncle Wally. I'm out of the sun because my seat was too hot for my bare legs Right after the national anthem, eight people mosey down my aisle. I see a grandma and grandpa, their daughter and her husband, three kids, and a young woman. The older ones make sure the younger ones' seat numbers match their tickets and they remain in their seats, across the aisle and two rows away from my shade, as the temperature passes 90. "Simple Pleasure, Denied" By Heather Curlee-Novak • Jun 17, 2016 I am embarrassed to admit this, but I am spoiled. Spoiled rotten and maybe a skosh lazy. And again, pampered and spoiled. Our front door is to blame for this revelation. We live in a lovely little bungalow from 1920 and all of the things do not work all of the time. This front door of ours actually still has the original doorknob and skeleton key slot. It is quite the physical challenge to close it, involving several slammings and a hopping leg dance to get the key to slide the deadbolt. "Temples and Shrines" By Joe Chaney • Jun 10, 2016 Temples and Shrines "This call may be recorded" By Andrew Kreider • Jun 3, 2016 This call may be recorded For the record, I like foreigners. But it's been forty-five minutes now. I certainly hope they are recording this call for training purposes. But more likely the HR department is just saving it to replay later over drinks. "Toilet Article" By Jeanette Saddler-Taylor • May 27, 2016 A TOILET ARTICLE "Bad decisions make good stories." Not so long ago, my son, Joseph, said that to me. I'm sure that he mentioned it regarding some personal incident, but it turns out that it can work for public policy too. Thus, I'm going to muscle my way onto turf that usually is held by my co-Michiana Chronicler, April Lidinsky: Women's Issues—except this topic really is an Everybody Issue. My apologies for the encroachment, April. Freedom Summer By David James • May 20, 2016 FREEDOM SUMMER The Traditional Music of Graduation By Ken Smith • May 13, 2016 According to some crazy expert at the London Philharmonic, the graduation march, otherwise known as Pomp and Circumstance, is one of the fifty greatest pieces of classical music. Seems to me it's one of humanity's fifty greatest sleep-aids. But you be the judge: (Music.) Please, turn that thing off! Thank you. See what I mean? Graduation is supposed to be a happy occasion. People have accomplished something, we're trying to have a celebration here. Come on! Political Awakenings By April Lidinsky • May 9, 2016 Well, Indiana has had its moment of political glory — serving as the iceberg that sank Ted Cruz's ship. Despite the ugliness, this political season has had an upside — reminding seasoned voters how exciting it is to be new to voting and crazy in love with your candidate. Creating Habitat By Sid Shroyer • Apr 29, 2016 On a cold Wednesday night this month, on a drive home from open mic night at Wild Rose Moon in Plymouth, I pondered a clear-eyed interpretation of "You Are My Sunshine." Chad Fletcher, a stocky guy in black knee shorts, with a guitar, big arm tattoos, and a goatee, got me to hear the song like it was brand new, and forced me to wipe away a tear. Wow, that was good. Sweet Spring Swing By Heather Curlee-Novak • Apr 23, 2016 Sweet Spring Swing By Heather Curlee Novak Spring is now here and those fresh, balmy mornings on my tiny front porch have begun. We often eat breakfast on the front porch and dinner on the backyard patio. Being outside is so enjoyable, especially after that endless winter! With these warm Spring days we just drift outside to enjoy the sunshine. Pages« first ‹ previous … 12 13 14 15 16 17 18 19 20 … next › last »


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How an audiologist can lend an ear to help hearing loss
Lisa Davidson, Reed Norwood
Wednesday, Nov 6, 2013
In today's world of health care, most of the body's organs or systems have specialists, both medically and non-medically trained, who evaluate and treat or manage disorders of those organs or systems. For example, vision problems are evaluated and treated by optometrists, who are non-medical degreed specialists, while medical and/or surgical treatment of the eye is performed by ophthalmologists, who are M.D.'s and surgeons. Likewise, hearing and balance problems are evaluated and treated by audiologists who are non-medical degreed specialists, while otolaryngologists (ENT's) are trained in the medical and surgical treatment of the ear.
Audiology is a relatively new profession and is often unfamiliar to many laypersons, but is the only profession whose sole purpose is the evaluation and management of hearing and balance disorders. The practice of audiology requires licensure by the state of Tennessee, just as the practice of medicine, dentistry or optometry does. The minimum requirements to practice audiology require a master's degree in audiology from an accredited university.
Now all audiologists trained have either an AuD (doctor of audiology), which is the clinical training degree, or a Ph.D. (doctor of philosophy in hearing science), which is the education and research degree. Most audiology training programs are comprised of four additional years of education and training beyond the standard four-year undergraduate college degree. Audiology training includes classes in anatomy and physiology of the ear, hearing and balance mechanisms, acoustics, speech science, evaluation of hearing, evaluation of balance, psychological aspects of hearing loss, and hearing aid technology. During their period of study, audiology students also observe and then participate in the evaluation and management of patients with hearing and balance disorders. Generally, the fourth year of training is an externship in which the student works in an audiology practice under the supervision of a licensed audiologist. After meeting these requirements, an audiologist may apply for and be licensed by the state to practice and then be credentialed as a provider of services for Medicare, Medicaid and private insurance companies.
Not everyone who evaluates hearing loss patients is an audiologist. Most states allow licensed hearing aid salespersons to evaluate hearing for the purpose of fitting and selling a hearing aid. In Tennessee, there are no requirements that these licensed salespersons have any formal college level training in the aspects of hearing loss. Hearing aid salespersons are not licensed
to perform diagnostic evaluations nor are they recognized by Medicare to be able to provide services. Some offices use "audio techs" for hearing testing, however, the state of Tennessee currently does not license "audio techs" and the few training programs for them recommend that they perform only very limited portions of a complete hearing evaluation under the supervision of a licensed audiologist.
Audiologists are trained and licensed to evaluate all types of hearing loss and then to refer to a physician if the hearing loss requires medical or surgical intervention. Studies have shown that medical treatment is indicated in only about 20 percent of adult hearing loss cases. Doctors of audiology have in depth, post graduate training in hearing aids and in Tennessee are licensed to dispense hearing aids as well as perform comprehensive assessment of hearing loss.
Our ability to hear requires a wondrous and complicated auditory system involving many different anatomical structures that must work in concert with one another to function. Appropriate evaluation of hearing loss requires specialized professional training and experience. Appropriate treatment of hearing loss likewise requires a skilled professional who understands the auditory mechanism and the treatment must be highly individualized for each person in order to be successful. If you or someone you know is having difficulty hearing, seek out an evaluation by a licensed audiologist for your best hearing health care.
Lisa Davidson and Reed Norwood are doctors of audiology and co-owners of McMinnville Hearing Center, located at 904 N. Chancery St., Suite 1, McMinnville, and Cookeville Audiology & Hearing Aids, located at 728 S. Jefferson Ave., Suite 8, Cookeville. They can be reached at (931) 473-3833 or (931) 854-9499.
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Our regulatory practice has many facets, and is able to advise on regulation in all its manifestations.
We have a strong banking and financial services capability, experienced in providing advice in areas including regulatory reporting, authorisation and approval applications, and the implications of the new senior managers regime.
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Soner Sertan Kara,1 Meltem Polat,1 Burcu Ceylan Yayla,1 Tugba Bedir Demirdag,1 Anil Tapisiz,1 Hasan Tezer1 and Aysu Duyan Camurdan2
Background Personal and herd immunity require durability in high vaccination coverage rates, and this mainly depends on the interaction between parental and service/provider factors.
Aims: The aim of this study was to assess Turkish parents' knowledge and behaviours concerning childhood vaccination and their association with familial sociodemographic characteristics.
Methods: A cross-sectional survey, including a questionnaire, was conducted with parents of children aged between 1 day and 120 months.
Results: Of the 903 index children, 881 (97.6%) were up to date for all vaccinations by age. Demographic variables were not related to belief in protection through vaccination or rejection of obligatory vaccines. Mean age, education level, occupation of mother (P = 0.006, P < 0.001, and P = 0.01, respectively) and father (P = 0.002, P < 0.001, and P = 0.006, respectively), average monthly household income (P < 0.001), and experience of vaccine side-effects (P = 0.02) were associated with knowledge about optional childhood vaccines. Father's education level was independently associated with knowledge about optional childhood vaccines.
Conclusions: Having any experience of vaccine side-effects and parental sociodemographic characteristics, especially father's education level, affect Turkish parents' knowledge of childhood optional vaccines.
Keywords: Childhood, vaccine, immunization, parental knowledge, Turkey
Citation: Kara SS; Polat M; Cura Yayla B; Bedir Demirdag T; Tapisiz A; Tezer H; et al. Parental vacccine knowledge and behaviours: a survey of Turkish families. East Mediterr Health J. 2018;24(5):451-458. https://doi.org/10.26719/2018.24.5.451
Received: 07/04/16; accepted: 15/05/17
Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
Vaccination is one of the main preventive measures in national public health policies. Over the last few decades, newer vaccines have been rapidly added to the Turkish national immunization programme and are provided free and without obligation by the Ministry of Health (1). Except for optional vaccines [rotavirus, meningococcal, human papillomavirus (HPV), and influenza virus], the Turkish national immunization programme offers vaccines that protect against most of the vaccine-preventable diseases typically addressed by equivalent programmes in developed countries (2,3).
According to Ministry of Health data, very high vaccination coverage rates of 96–97% were reported for the vaccines in the national immunization programme in 2012 [for diphtheria, tetanus, acellular pertussis vaccines (DTaP)-1-2-3, measles, mumps, rubella (MMR), 7-valent pneumococcal conjugate vaccine (PCV7) and hepatitis B (HBV)-1-2-3] (4), enough to achieve herd immunity for these diseases, and thus protect even unvaccinated children.
Recommending optional vaccines is considered an integral part of the health services provided in paediatric clinics. While ensuring that all babies are up to date with their compulsory immunizations, counselling can give parents the choice of accepting one or more optional vaccines (5). The coverage for optional vaccines may vary in different populations for various reasons, such as low awareness and the perceived costs of obtaining these vaccines (6).
Turkey's geographical position, its close proximity to countries in a state of war and with low vaccination coverage, and receiving extensive immigration always raises the possibility of a reintroduction of formerly eradicated vaccine-preventable diseases such as polio (7). In addition to these epidemiological risks, parents' negative perceptions and attitudes and lack of knowledge regarding immunization may gradually lower the high vaccination rates achieved so far. In different populations, under-vaccination has been shown to be related to inadequate immunization services and parental knowledge, attitudes and concerns (8,9).
In order to sustain high vaccination coverage rates and to maintain positive family attitudes towards vaccination, vaccination interventions must be targeted on the basis of areas of interest, such as parents' knowledge, attitudes and beliefs or levels of hesitancy, in addition to how parents assess vaccination (10).
The aim of this study was to assess the current knowledge and behaviours of Turkish parents concerning childhood vaccines and vaccination, and to demonstrate the associations between vaccination status, belief in the protective effects of vaccination, parental thinking regarding rejected childhood vaccines, knowledge concerning childhood optional vaccines and sociodemographic characteristics.
This cross-sectional survey of a non-randomized sample of 903 parents (57% of 1560 eligible parents) was carried out at paediatric outpatient clinics (paediatrics, paediatric infectious diseases, and well-child care) in Gazi University Hospital between 1 January and 31 December 2014. Data for the study were based on interviews with parents of index children aged between 1 day and 120 months at the time of the study, and who consented to participate while attending for various medical reasons. The interviews were conducted by 2 specialists in paediatric infectious diseases, who also explained the medical terms involved. The vaccination status of the index children was determined by checking written vaccination records or on the basis of parental declarations if no such a card was available, and this was later compared with the digital records of the hospital.
The study questionnaire included open and closed questions. Some items in the survey were drafted by modifying similar, previously published surveys (11–14). In addition to general demographic variables (age and sex of index children; age, level of education and occupation of both parents; average monthly household income) and underlying disease of index children, the questionnaire also enquired into parents' knowledge and behaviours concerning vaccines (whether vaccines were thought to be protective, whether any vaccines in the national immunization programme were unacceptable, whether the optional vaccines were known, which optional vaccines had been administered, whether any adverse reactions related to vaccines had been experienced, and from which person/setting the caregivers first seek assistance in the event of adverse reactions during vaccination).
In order to assess belief in the protective effects of vaccination, caregivers were asked if they thought the vaccines were protective or not, and their answers were scored on a 5-point Likert-type scale. Answers ranged from "yes, certainly" to "no, certainly not".
In order to assess attitudes to routine vaccines, caregivers were asked whether there were any unacceptable vaccines for their child in the national immunization programme. Answers on a 5-point Likert-type scale ranged from "There is no routine vaccine that I refuse to use for my child(ren)" to "I refuse to vaccinate my child(ren) with any of the routine vaccines". In order to assess knowledge of optional vaccines, caregivers were asked whether there were any optional vaccines not included in the national immunization programme that they could pay for and have their children vaccinated with. Answers ranged from "Yes, I certainly agree" to "No, I certainly do not agree" on a 5-point Likert-type scale.
Children's vaccination status was defined as completely immunized if they had been immunized up to age and partially immunized if they had missed at least 1 of the vaccines in the programme. Children in our study who had not received either hepatitis A or varicella-zoster vaccines were nonetheless regarded as completely immunized because the majority of the children were older than the recommended age for these vaccines.
Verbal informed consent was obtained from all parents. Approval was granted for the study from the Institutional Ethical Committee of the Faculty of Medicine, Gazi University. The patient's identity and other personal information were kept confidential at data analysis by using unique codes for each patient.
Data were analysed using SPSS, version 16.0. The Kolmogorov–Smirnov test was used to verify that continuous variables were normally distributed. Continuous variables were expressed as mean and standard deviation (SD) or median (minimum–maximum), and categorical variables were expressed as percentages. The independent samples t-test was used for continuous variables and the chi-squared test for categorical variables. Those variables identified as significant for possession of knowledge of optional childhood vaccines at univariate analysis (sex of child and parent, education level of mother and father, and presence of any experience of vaccine side-effects) were included in binary logistic regression analysis in order to explore independent associations with knowledge of these vaccines (the answers to the parental knowledge of optional childhood vaccines on the 5-point Likert-type scale were grouped into 2 in this analysis: "yes, I certainly agree" and " yes I agree" were included in 1 group and the rest were included in the other group). Statistical significance was set at P < 0.05.
We surveyed 903 parents for this study. Most were from the Paediatric Infectious Diseases clinic (n = 567, 62.8%) and were mothers (n = 651, 72.1%).
Personal characteristics of the children investigated
Characteristics of the index children and parents are shown in Table 1. The median age was 36 months (range 6 days to 120 months). There were 470 male children (52.0%) and 433 females (48.0%), a male to female ratio of 1.08. We found that 135 children (14.9%) had a chronic disease, the most common being immunodeficiency (n = 23, 2.5%). Most of the caregivers involved in the child's vaccination were mothers (n = 507, 56.1%). The mean ages of mothers and fathers was 32.2 (SD 6.2) and 35.7 (SD 6.4) years, respectively. The majority of mothers and fathers had graduated from secondary or high school (n = 450, 49.8% and n = 477, 52.8%, respectively). Average monthly household incomes mostly fell into the highest category (> 4000 TL/month) (n = 274, 30.3%). Nearly half (54.2%) of the families had average monthly incomes above the rural poverty threshold, while 30.3% were over the poverty threshold for whole of Turkey determined by the Turkish Statistical Institute (15).
There were no unvaccinated children, but 22 (2.4%) were only partially immunized. Reasons cited for partial immunization were wishing the child to acquire immunity through natural infections (n = 8, 36.3%), lack of interest (n = 6, 27.2%), thinking that vaccination causes serious side-effects (n = 4, 18.1%), believing vaccination to be useless (n = 3, 13.6%), and thinking that vaccination causes illness (n = 1, 4.5%). No statistically significant association was observed between the immunization status of the index children and the characteristics of the study population (age of the index children and their parents, gender and underlying diseases of the index children, education level and occupation of both parents, and average monthly household income of the family).
Knowledge and beliefs of parents regarding childhood vaccines and vaccination
Most parents (n = 859, 95.1%) reported believing in the protective effects of vaccination. No statistically significant association was determined between belief in vaccination's protective effects and the characteristics of the study population (P > 0.05).
In our study population, 2.7% (n = 25) of parents considered one or more vaccines in the childhood national immunization programme unacceptable. Levels of rejection of hepatitis B (n = 13, 52.0%), Bacillus Calmette–Guérin vaccine (BCG) (n = 10, 40.0%), hepatitis A (n = 10, 40.0%), diphtheria, tetanus, acellular pertussis, inactivated polio, Haemophilus influenza type B vaccine (DTaP-IPV-Hib) (n = 10, 40.0%), MMR (n = 9, 36.0%), varicella (n = 8, 32.0%), and oral polio vaccine (OPV) (n = 7, 28.0%) were all similar. No association was determined between the characteristics of the study population and parental thinking regarding unacceptable childhood vaccine(s) (P > 0.05).
Two-thirds of parents (n = 602, 66.6%) knew about optional vaccines. Of these, 33.4% (n=302) had their children inoculated with optional vaccines. Influenza (n = 97, 32.1%) and rotavirus (n = 94, 31.1%) were the mostly popular and implemented vaccines. Three hundred one (33.3%) parents were completely uninformed about optional vaccines, and 78.7% (n = 237) of these felt that health-care professionals, especially doctors, should have informed them about optional vaccines. The relationship between the characteristics of the study population and parental knowledge of the optional vaccines is shown in Table 2. While the median age of the index children was not associated with knowledge of optional childhood vaccine(s), the mean ages of the mothers and fathers were statistically significantly correlated with such knowledge (P = 0.006 and P = 0.002, respectively). Parents' education level, occupation of mothers and fathers, average monthly household income and any experience of vaccine side-effects were also statistically significantly correlated with knowledge of optional childhood vaccines (Table 2).
Regression analysis showed that the father's education level was independently associated with knowledge of optional childhood vaccines (Table 3). Fathers who had graduated from secondary/high school had a 1.8-fold greater knowledge of optional childhood vaccines and university graduate fathers a 4.1-fold greater knowledge compared to fathers who had graduated from elementary school.
Adverse events and medical information
Adverse events caused by any vaccine were reported by 811 (89.8%) parents. The most common adverse event was fever (n = 670; 74.1%), followed by local reactions (n = 456, 50.4%) and irritability n = 257; 28.4%). The first place where caregivers sought information about vaccinations and adverse reactions when these occurred during vaccination were the paediatrician (n = 456, 50.4%), followed by the family physician (n = 296, 32.7%), the nurse who administered the vaccine (n = 112, 12.4%), the internet (n = 21, 2.3%), and finally parents of other children who may have experienced similar side-effects (n = 3, 0.3%).
This study represents an evaluation of Turkish parental beliefs, knowledge, attitude, and behaviours toward childhood vaccines and vaccination. The study population exhibited a slightly higher percentage of immunization than the Turkish national data reported by the Ministry of Health for each vaccine (4). This may be associated with the city, Ankara, where the study was performed. Ankara is the capital of Turkey, and health care services are more available and caregivers' education levels are higher than the average national values. The parents in the study population were generally young adults, and most were educated to secondary/high school level or above. Occupation of both parents, and older parental age, education level and family income were associated with parental knowledge of optional vaccines. We believe that a certain level of economic status and knowledge and understanding of vaccines and their benefits are important if a vaccine involving additional costs is to attract the interest of parents. Data concerning optional vaccines are scarce in the Turkish-language literature, and the results of this study are particularly significant from that perspective. Logistic regression analysis showed that levels of paternal knowledge of optional vaccines increased in line with education level. However, that association did not apply to mothers. In Turkey it is mostly mothers who are responsible for child care. Similarly, among the caregivers in this study it was predominantly mothers who were involved in the children's vaccinations. Strikingly, however, fathers still desired to receive information about vaccination. This may be attributed to the sociocultural structure in Turkey, which may impact on vaccination coverage because of fathers' roles in decision-making on behalf of all family members. Previous experience with any vaccine side-effects was also associated with knowledge concerning optional childhood vaccines. It is likely that such experience may have resulted in hypervigilance on the part of caregivers, so they were anxious to learn more about the subject.
Influenza and rotavirus vaccines were the most frequently administered optional vaccines in this study. Although no nationwide data are available, similar coverage rates to those in our study have been reported in previous research. Gunduz et al. (16) reported levels of 8.8% for influenza and 37% for rotavirus vaccinations among a Turkish study population. Camurdan et al. reported an influenza vaccination rate of 50% among diabetic children (17). In a 2014 study from Hong Kong, which has immunization coverage rates for mandated vaccines similar to those in Turkey, the coverage rate for seasonal influenza vaccine was 15%, lower than in our study (3). In the present study, parents with no knowledge about optional vaccines felt that health care professionals should have informed them. Similarly, Bardenheier et al. reported that not having received a doctor's or health department recommendation for the Hep A vaccine was cited as the factor most strongly associated with not receiving that vaccination (18). In a previous Turkish study (16), parents of children who did not receive the influenza vaccine tended to believe that vaccination was not essential, rather than citing a lack of recommendation.
Most of the index children (97.6%) in this study were up-to-date for all vaccinations. Only 2.7% of the respondents declared an unwillingness to vaccinate their children with one or more of the routine vaccines in the national immunization programme. These low percentages made it impossible to determine statistically significant associations with familial sociodemographic characteristics. In contrast, nearly 12% of American parents have been reported to refuse at least one recommended childhood vaccine (14). The American Academy of Pediatrics advises physicians to respond to vaccine refusal by respectfully listening to parents' concerns and discussing the risks associated with nonvaccination (19). For partially immunized children, although routine vaccines are provided free of charge by the government, other costs such as transportation may account for children not being up-to-date for all vaccinations. Parental uncertainty regarding the importance of immunization may have resulted in undervaccination, and such anxiety also needs to be alleviated with adequate information (20). Providing better information for parents (9), mass immunization campaigns and proper vaccine delivery systems all play an important role in vaccination uptake in other countries (21). Parents may prefer disease-induced immunity to vaccination (22). In our study, no specific vaccine was the subject of particular reluctance, while some vaccines, e.g. measles, HBV and influenza, have been unpopular owing to safety concerns in some parts of the world (23,24).
Most of the index children in this study were healthy. No association was determined with immunization status. Excepting cases of valid medical contraindications for immunization, as well as children who are too young to be vaccinated or whose vaccinations could not reach adequate efficacy and effectiveness, unvaccinated children are not only more prone to vaccine-preventable diseases but may also transmit these diseases to other individuals (13). Children with chronic diseases therefore need to be carefully evaluated in terms of vaccination.
The parents in this study generally agreed that vaccines protected their children against vaccine-preventable diseases; nevertheless, family sociodemographic characteristics were not associated with the decision to vaccinate. Gust et al. observed that their study population generally believed in the protective effect of vaccines, but parents in the lowest income category and parents with lower levels of education exhibited a significantly lower level of belief in the protective value of vaccines than parents in other categories (12). Characteristics such as parental age, education and family income have been associated with belief in the protective properties of vaccination in other studies (19,20,22,23,25,26).
A history of vaccine-related adverse events was reported by almost 90% of parents. Such events may be expected to occur more frequently as vaccination coverage levels increase (12). An increased frequency of vaccine-related adverse events may result in the global perception that vaccines are hazardous, despite continued improvements in vaccine safety (11). Incorrect information given by, or a mistrust of, health professionals may lead to refusal of immunization (27). Nevertheless, paediatricians and family physicians were reported to be the most trusted sources of information regarding vaccines and vaccinations in this study. Unfriendly or disrespectful attitudes and behaviour toward mothers on the part of health workers in developing countries have frequently been cited as discouraging the vaccination of children (8). Physicians are a most important source of reliable information regarding vaccines and vaccination, and good communication with concerned parents to provide them with the information required is therefore particularly important (28). Some populations may place greater trust in other individuals or systems than in health care professionals (29). Some people obtain information from other sources such as family, friends and the internet (11), which may result in the dissemination of uncontrolled information without editorial control or peer review (12). Our study population reported resorting less to the media and internet for information, in agreement with Serpell et al. (9).
The findings of this study should be interpreted in the light of a number of limitations. The findings may not represent all Turkish parents: this was a cross-sectional study and the study population was sampled from health clinics. The study population therefore consisted of caregivers who were least able to travel to a hospital. The study was not designed to evaluate the reason(s) for partial immunization, or which measures might be taken to resolve problems identified in it. It also did not evaluate the presence of any underlying parental disease, the characteristics of siblings or parental attitude towards combination vaccines, all of which may influence parental decisions, perceptions and attitudes concerning vaccination. The age range of the children was also very wide. This may have resulted in inconsistencies in recalling vaccine-related experiences, especially among the parents of older children. Additionally, nonsignificant associations were determined between children's immunization status, parents' beliefs in the protective effects of vaccinations and the demographic characteristics of the study population due to the disproportional distribution of the groups. A larger study population and a multicentre design may have elicited more homogeneous population characteristics.
In conclusion, this study may represent a useful source of information concerning Turkish parental beliefs, knowledge, attitudes and behaviours toward childhood vaccination. Vaccination coverage in this study was similar to national levels, although some important demographic variables differed somewhat from national averages. Parents' sociodemographic characteristics, and particularly paternal education level, were shown to affect knowledge of optional vaccines in the Turkish population.
Funding: None.
Competing interests: None declared.
Connaissance parentale des vaccins et comportements à cet égard : étude de familles turques
Contexte : L'établissement d'une immunité personnelle et collective nécessite que les taux de couverture vaccinale demeurent durablement élevés, ce qui dépend grandement de l'interaction entre les parents et les services/prestataires de vaccination.
Objectifs : La présente étude avait pour objectif d'évaluer les connaissances et les comportements des parents turcs en termes de vaccination durant l'enfance, ainsi que leur association avec les caractéristiques socio-démographiques familiales.
Méthodes : Une étude transversale, incluant un questionnaire, a été menée auprès des parents d'enfants dont l'âge était compris entre 1 jour et 120 mois.
Résultats : Sur les 903 enfants index, 881 (97,6 %) étaient à jour pour toutes les vaccinations par groupe d'âge. Les variables démographiques n'étaient pas liées au fait de croire à une protection induite par la vaccination ou à un rejet des vaccins obligatoires. L'âge moyen, le niveau d'éducation, la profession de la mère (p = 0,006, p < 0,001, et p = 0,01, respectivement) et du père (p = 0,002, p < 0,001, et p = 0,006, respectivement), le revenu mensuel moyen du foyer (p < 0,001), et des antécédents d'effets secondaires des vaccins (p = 0,02) étaient associés à une connaissance des vaccins facultatifs pour les enfants. Le niveau d'éducation du père avait une association indépendante avec la connaissance des vaccins facultatifs pour les enfants.
Conclusions : Les antécédents d'effets secondaires liés aux vaccins ainsi que les caractéristiques socio-démographiques parentales, notamment le niveau d'éducation du père, influencent les connaissances des parents turcs en termes de vaccins facultatifs pour les enfants.
معلومات أولياء الأمور بالتطعيمات وسلوكياتهم تجاهها: دراسة استقصائية للأسر التركية
صونر سيرتان قارا، ملتم بولاد، برجو سيلان يايلا، طوبى بدير دميرداغ، انيل طابسز، حسن ته زر، ايصو دويان جاموردان
الخلفية: تستلزم المناعة الشخصية ومناعة القطيع استمرارية الحفاظ على معدلات تغطية مرتفعة للتطعيمات، وهو ما يعتمد أساساً على التفاعل بين أولياء الأمور ومقدمي الخدمة.
الأهداف: هدفت هذه الدراسة إلى تقييم معلومات أولياء الأمور الأتراك وسلوكياتهم إزاء تطعيم الأطفال وارتباط ذلك بالسمات الاجتماعية السكانية للأسرة.
طرق البحث: أجري مسح مقطعي شمل إجراء استبيان، لأولياء أمور أطفال تتراوح أعمارهم بين يوم واحد و120 شهراً.
الاستنتاجات: إن وجود خبرة سابقة بالآثار الجانبية للتطعيمات وسمات الوالدين الاجتماعية السكانية، لا سيما مستوى تعليم الأب، له تأثير على معلومات أولياء الأمور الأتراك بالتطعيمات الاختيارية في مرحلة الطفولة.
- Arisoy ES, Ceyhan M, Ciftci E, Hacimustafaoglu M, Kara A, Kuyucu N, et al. The national vaccination schedule in previously healthy children: the practical recommendations about additional vaccines. Çocuk Enfeksiyon Dergisi [J Pediatr Inf]. 2014;8:1–6.
- Recommended immunization schedule for persons aged 0 through 18 years – United States. Atlanta: Centers for Disease Control and Prevention; 2015 (https://www.cdc.gov/vaccines/schedules/downloads/past/2015-child.pdf, accessed 01 December 2015).
- Wang LD, Lam WW, Wu JT, Liao Q, Fielding R. Chinese immigrant parents' vaccination decision making for children: a qualitative analysis. BMC Public Health. 2014;14:133. PMID:24507384
- Turkish Ministry Health Annual of health statistics. Ankara: General Directorate of Health Research; 2013 (in Turkish).
- Kannan Kutty P, Pathmanathan G, Salleh NM. Analysis of factors in response to rotavirus vaccination counselling in a private paediatric clinic. Med J Malaysia. 2010;65(2):127–32. PMID:23756797
- Manthiram K, Blood EA, Kuppuswamy V, Martins Y, Narayan A, Burmeister K, et al. Predictors of optional immunization uptake in an urbansouth Indian population. Vaccine. 2014;32(27):3417–23. PMID: 24736005
- Vancelik S, Guraksin A, Ayyildiz A, Beyhun NE. Seroepidemiology of poliovirus antibody among the children in Eastern Turkey. Indian J Med Res. 2007;126(6):528–33. PMID:18219079
- Favin M, Steinglass R, Fields R, Banerjee K, Sawhney M. Why children are not vaccinated: a review of the grey literature. Int Health. 2012;4(4):229–38. PMID:24029668
- Serpell L, Green J. Parental decision-making in childhood vaccination. Vaccine. 2006;24(19):4041–6. PMID:16530892
- Brunson EK. How parents make decisions about their children's vaccinations. Vaccine. 2013;31(46):5466–70. PMID:24076175
- Downs JS, de Bruin WB, Fischhoff B. Parents' vaccination comprehension and decisions. Vaccine. 2008;26(12):1595–607. PMID:18295940
- Gust DA, Woodruff R, Kennedy A, Brown C, Sheedy K, Hibbs B. Parental perceptions surrounding risks and benefits of immunization. Semin Pediatr Infect Dis. 2003;14(3):207–12. PMID:12913833
- Kennedy AM, Brown CJ, Gust DA. Vaccine beliefs of parents who oppose compulsory vaccination. Public Health Rep. 2005;120(3):252–8. PMID:16134564
- Opel DJ, Taylor JA, Mangione-Smith R, Solomon C, Zhao C, Catz S, et al. Validity and reliability of a survey to identify vaccine-hesitant parents. Vaccine. 2011;29(38):6598–605. PMID:21763384
- Income distribution and Living Conditions Statistics 2011. Ankara: Turkish Statistical Institute; 2014 (TUIK website) (http://www.tuik.gov.tr/PreHaberBultenleri.do?id=16083, accessed 05 November 2015) [in Turkish].
- Gunduz S, Yuksel NC, Aktoprak HB, Canbal M, Kaya M. Attitudes towards influenza vaccination in high socioeconomic status Turkish parents. Turk J Med Sci. 2014;44(4):649–55. PMID: 25551937
- Camurdan MO, Camurdan AD, Beyazova U, Bideci A. The rate of seasonal influenza vaccination in diabetic children, the effect of recommendation and the factors influencing the acceptance of recommendation: an interventional study. Balkan Med J. 2012;29(4):434–9. PMID: 25207049
- Bardenheier B, González IM, Washington ML, Bell BP, Averhoff F, Massoudi MS, et al. Parental knowledge, attitudes, and practices associated with not receiving hepatitis A vaccine in a demonstration project in Butte County, California. Pediatrics. 2003;112(4):e269. PMID: 14523210
- Diekma DS; American Academy of Pediatrics Committee on Bioethics. Responding to parental refusals of immunization of children. Pediatrics. 2005;115(5):1428–31. PMID: 15867060
- Tickner S, Leman PJ, Woodcock A. Factors underlying suboptimal childhood immunisation. Vaccine. 2006;24(49–50):7030–6. PMID:16890330
- Barreto TV, Rodrigues LC. Factors influencing childhood immunisation in an urban area of Brazil. J Epidemiol Community Health. 1992;46(4):357–61. PMID:1431706
- Streefland PH. Public doubts about vaccination safety and resistance against vaccination. Health Policy. 2001;55(3):159–72. PMID:11164965
- Alfredsson R, Svensson E, Trollfors B, Borres MP. Why do parents hesitate to vaccinate their children against measles, mumps and rubella? Acta Paediatr. 2004;93(9):1232–7. PMID:15384890
- Langer-Gould A, Qian L, Tartof SY, Brara SM, Jacobsen SJ, Beaber BE, et al. Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases. JAMA Neurol. 2014;71(12):1506–13. PMID:25329096
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- Smith PJ, Humiston SG, Marcuse EK, Zhao Z, Dorell CG, Howes C, et al. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the health belief model. Public Health Rep. 2011;126(Suppl. 2):135–46. PMID:21812176
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Another season bites the dust! I can't believe an entire season of MTV's The Challenge:Battle of the Seasons has come and gone. It felt like yesterday we were writing about who we thought would be the winners. My bets were on Team Austin…but who even remembers them being on the show? With Team Austin being the Veteran team getting booted off in the first two weeks- we knew this season would a bring a lot more rookie drama.
We also knew halfway through the season, Team San Diego was looking mighty fine for the first place spot, since they were clearly the team that was controlling the game. Vegas seemed like a good competitor, up until Nany and Alton were booted off and Vegas was left with Dustin and Trishelle. With a big surprise win last week, Vegas solidified their entrance into the final challenge by winning power team. They made it to the finish line and came in second place, which is amazing for the only 2 person team left in the game.
Of course Team San Diego came in first winning the grand prize of $250,000. That had to be split between4 players but hey $62k isn't too shabby. Now some people might argue that it should've been split between 3 of their teammates, since Sam was the useless player. Like it or not, she made it across the finish line, and she had to endure the abuse from Zach and Frank for the weeks leading up to the final. I will say this, if you're not in great physical shape, don't agree to do one of these shows because you're making yourself look like an idiot, and you're straight up screwing over your team. Devyn was easily holding her team back during the final race, but at least she was funny about it. Besides Devyn looks like she's in shape, but she's a big booty *** and it was slowin' her down!
The challenge itself didn't look that intense. I've seen a few of these final races and I was definitely expecting a lot more. They did have to sleep overnight in the desert…regardless it didn't look as harsh as when Johnny Bananas had to do it with Tyler.
The reunion was up right after the final episode. Frank and Sam still hate each other, and Sam looks like she ate all her money because she gained weight. She def can't do a challenge now. Devyn was looking stunnin' in her pageant dress, and admitted her and Eric broke up a few weeks after she left Africa. Marie and Robb were civil, and Marie was calm throughout the hour which I was happy to see.
Surprisingly, Zach and Jonna have since broken up, apparently because Zach is immature and not ready for a serious relationship. During the show Jonna tweeted, 'WE. Are never ever ever…'- hmmm. Drrrrama. BTW, Zach looked horrendous with his even longer hair and trashy clothing, but still looked better than Sam.
Johnny Moseley was hosting the reunion show…and he obviously needs to re-evaluate his hairstyle because it's just not doing anything for him.
Until next time!
PS. Word around the net is the new season of The Real World Season 28 will be in Portland,Oregon.
Follow Natasha on Twitter @TheTashaIC


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