The World Health Organization (WHO) recommends vaccination of health workers against influenza, but uptake in low-resource settings remains low. To complement routine global data collection efforts we conducted a detailed survey on influenza vaccination policies for health workers in low-income and middle-income countries (LMICs) in early 2020.
Health worker vaccination policy data were collected via a web-based survey tool sent to Expanded Programme on Immunization managers or equivalent managers of all eligible countries. High-income countries and countries with active civil war were excluded from the participation. The survey was sent by email to 109 LMICs in all WHO Regions to invite participation. Data were analyzed by World Bank income category and WHO Region. Statistical methods were applied to assess mean vaccination rates across countries.
Sixty-eight (62%) out of 109 invited LMICs were studied. Thirty-five (51.5%) reported to have a policy for influenza vaccination of health workers. VaccinatiDespite policies being in place in more than half LMICs studied, gaps remain in translating vaccination policies to action, particularly in low-income and African Region countries. To optimize the operationalization of policies, further research is needed within countries, to enable evidence-based introduction decisions, categorization of health workers for vaccination, identification of factors impacting effective service delivery, strengthening monitoring and estimation of vaccination uptake rates and ensure sustainability of funding.
A lower conversion vaccination rate and a more rapid decline in antibody titers over time in dialysis patients raise concerns about the effectiveness of pneumococcal vaccination (PV) in this population, which has not been systematically reviewed.
We searched PubMed, Cochrane Library, Embase and three Chinese databases from inception until February 29th, 2020 for interventional, cohort and case-control studies evaluating PV alone or combined with influenza vaccination (IV) on outcomes (all-cause mortality, pneumonia, cardiovascular events, antibody response and safety). Independent reviewers completed citation screening, data extraction, risk assessment, meta-analysis, and GRADE rating of the quality of evidence.
Five cohort studies and one quasirandomized control trial enrolling 394,299 dialysis patients with high to moderate quality were included. Compared with unvaccinated individuals, those receiving PV had lower risk of all-cause mortality [Adjusted relative risk (RR) 0.73, 95% CI 0.67-0.79, I
=31.ll-cause mortality but may be affected by residual confounding/healthy vaccinee bias.Sjögren's Syndrome (SjS) is a chronic, systemic autoimmune disease causing xerostomia, xerophthalmia, and systemic symptoms. The principal pathological finding in SjS is the accumulation of lymphocytes in exocrine glandular tissue and elsewhere, leading to secretory dysfunction and other abnormalities. A rational therapeutic approach might be to interfere with lymphocyte migration to the periphery from central lymphoid tissues. We thus examined in an animal model of SjS the effects of Fingolimod (FTY720, Gilenya™), which interferes with migration of lymphocytes to peripheral sites. Fingolimod induces sequestration of lymphocytes in lymphoid organs by altering lymphocyte expression of sphingosine-1-phosphate receptors. In the C57Bl/6. NOD.Aec1Aec2 (AEC) model of SjS, Fingolimod reduced circulating T and B cell numbers. Treatment of AEC mice with Fingolimod increased salivary output and decreased the size of salivary gland infiltrates. Oral Fingolimod thus merits further consideration in the management of SjS in humans.
This study was conducted to investigate the effect of perceived social support of mothers who were Syrian refugees in Turkey on attitudes toward feeding their babies.
This study used a cross-sectional design and investigated the demographic characteristics, perceived social support, and infant feeding attitudes of the mothers who migrated from Syria and came to the Health Education Center for Immigrants to receive healthcare services.
The mean age of the mothers (n=150) who participated in the study was 24.51+5.84years, and the mean duration of their stay in Turkey was 4.12±1.57years. The mean number of pregnancies of the mothers was 2.62±1.4, and the mean number of children was 2.33±1.28. As a result of the analysis, we have determined that thesub-dimension of perceived social support from a special person significantly affects the continuation of breastfeeding of mothers during the first six months (p<0.05). The perceived social support of mothers and other variables in the model were found to explain 14.6% of the breastfeeding attitude.
The attitudes of Syrian mothers toward feeding their babies were affected by perceived social support from a special person. It is recommended to aidsocial support systems for immigrant women to develop positive attitudes toward breastfeeding.
The attitudes of Syrian mothers toward feeding their babies were affected by perceived social support from a special person. It is recommended to aidsocial support systems for immigrant women to develop positive attitudes toward breastfeeding.
Female and male critically ill septic patients might differ with regards to risk distribution, management, and outcomes. We aimed to compare male versus female septic patients in a large collective with regards to baseline risk distribution and outcomes.
In total, 17,146 patients were included in this analysis, 8781 (51%) male and 8365 (49%) female patients. The primary endpoint was ICU-mortality. Baseline characteristics and data on organ support were documented. Multilevel logistic regression analyses were used to assess sex-specific differences.
Female patients had lower SOFA scores (5±5vs. https://www.selleckchem.com/products/2-bromohexadecanoic-acid.html 6±6; p<0.001) and creatinine (1.20±1.35vs. 1.40±1.54; p<0.001). In the total cohort, the ICU mortality was 10% and similar between female and male (10% vs. 10%; p=0.34) patients. The ICU remained similar between sexes after adjustment in model-1 (aOR 1.05 95% CI 0.95-1.16; p=0.34); model-2 (aOR 0.91 95% CI 0.79-1.05; p=0.18) and model-3 (aOR 0.93 95% CI 0.80-1.07; p=0.29). In sensitivity analyses, no major sex-specific differences in mortality could be detected.