Effectiveness of Catch-Up Vaccination Interventions Versus Standard or Usual Care Procedures in Increasing Adherence to Recommended Vaccinations Among Different Age Groups: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Before-After Studies

Background: To address the global challenge of vaccine hesitancy, the Strategic Advisory Group of Experts on Immunization strongly promotes vaccination reminder and recall interventions. Coupled with the new opportunities presented by scientific advancements, these measures are crucial for successfully immunizing target population groups. Objective: This systematic review and meta-analysis aims to assess the effectiveness of various interventions in increasing vaccination coverage compared with standard or usual care. The review will cover all vaccinations recommended for different age groups. Methods: In February 2022, 2 databases were consulted, retrieving 1850 studies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 79 manuscripts were included after the assessment phase. These comprised 46 trials/randomized controlled trials (RCTs) and 33 before-after studies. A meta-analysis using a random-effects model was performed with STATA software (version 14.1.2). The selected outcome was the risk ratio (RR) of vaccination coverage improvement effectiveness. Additionally, meta-regression analyses were conducted for the included manuscripts. Results: The analyses showed an overall efficacy of RR 1.22 (95% CI 1.19-1.26) for RCTs and RR 1.70 (95% CI 1.54-1.87) for before-after studies when considering all interventions cumulatively. Subgroup analyses identified multicomponent interventions (RR 1.58, 95% CI 1.36-1.85) and recall clinical interventions (RR 1.24, 95% CI 1.17-1.32) as the most effective in increasing vaccination coverage for RCTs. By contrast, educational interventions (RR 2.13, 95% CI 1.60-2.83) and multicomponent interventions (RR 1.61, 95% CI 1.43-1.82) achieved the highest increases for before-after studies. Meta-regression analyses indicated that the middle-aged adult population was associated with a higher increase in vaccination coverage (RCT: coefficient 0.54, 95% CI 0.12-0.95; before-after: coefficient 1.27, 95% CI 0.70-1.84). Conclusions: Community, family, and health care-based multidimensional interventions, as well as education-based catch-up strategies, effectively improve vaccination coverage. Therefore, their systematic implementation is highly relevant for targeting undervaccinated population groups. This approach aligns with national vaccination schedules and aims to eliminate or eradicate vaccine-preventable diseases

A crítica da colonização Peruana e das tensões culturais em Yawar fiesta, de José María Arguedas

Culture plays an extremely important role for society, it dictates human functions, behaviors, beliefs and the way in which the being sees and appreciates the elements of nature. Cuche (2002) points out that the meeting of cultures is not limited to global societies, but also between subjects who share the same social space. Thus, the work in question proposes to analyze in the work Yawar Fiesta (2006), initially published in 1941, by the Peruvian writer José María Arguedas, the meeting of cultures (Quechua and Spanish) in the social practices that generate inequalities between groups in Peru . The title of the work produces a symbolic adornment that runs through the entire narrative. Merging statements in Quechua and Spanish, the author presents particularities of both cultures. To support this investigation, we will use the contributions of Cuche (2002) when he states that the cultural identity of a people can only be understood by studying their relations with neighboring groups; Walter Mignolo (2005) when questioning the European discourse regarding progress and salvation, which leads to a division between peoples; Aníbal Quijano (2005). The methodology used will be qualitative bibliographical research.O encontro das culturas, como afirma Cuche (2002), não se limita às sociedades globais, mas também entre os sujeitos que compartilham o mesmo espaço social. Dessa forma, o trabalho em questão propõe analisar na obra Yawar Fiesta (2006), publicada inicialmente em 1941, pelo escritor peruano José María Arguedas, o encontro das culturas (quéchua e espanhola) nas práticas sociais que geram as desigualdades entre os grupos no Peru. O título da obra produz adorno simbólico que atravessa toda a narrativa. Mesclando enunciados em quéchua e em espanhol, o autor apresenta particularidades de ambas as culturas. Para respaldar essa investigação, utilizamos as contribuições de Cuche (2002) ao afirmar que a identidade cultural de um povo só pode ser compreendida ao estudar suas relações com os grupos vizinhos; Walter Mignolo (2005) e Aníbal Quijano (2005) ao questionar o discurso do europeu no que tange ao progresso e salvação, que conduz a uma divisão entre os povos. A metodologia utilizada para a realização do estudo se pauta na pesquisa bibliográfica de cunho qualitativo. Esse trabalho traz em seu bojo os fundamentos teóricos propostos por Quijano (2005); Cuche (2002) e Walter Mignolo (2005). Os resultados revelam que o reconhecer pelas indumentárias, cores, adereços e interesses, há um sentido social e cultural simbólico, pois é o reflexo de uma sociedade dividida, classista e racista em que um determinado grupo busca preservar a identidade cultural dos antepassados, e outra a nega, por considerar “atrasada”. Dessa forma, conclui-se, que as desigualdades geradas entre os grupos no Peru foram nutridas por um discurso de desenvolvimento e, assim, comprometeu o social e o cultural

A crítica da colonização Peruana e das tensões culturais em Yawar fiesta, de José María Arguedas

O encontro das culturas, como afirma Cuche (2002), não se limita às sociedades globais, mas também entre os sujeitos que compartilham o mesmo espaço social. Dessa forma, o trabalho em questão propõe analisar na obra Yawar Fiesta (2006), publicada inicialmente em 1941, pelo escritor peruano José María Arguedas, o encontro das culturas (quéchua e espanhola) nas práticas sociais que geram as desigualdades entre os grupos no Peru. O título da obra produz adorno simbólico que atravessa toda a narrativa. Mesclando enunciados em quéchua e em espanhol, o autor apresenta particularidades de ambas as culturas. Para respaldar essa investigação, utilizamos as contribuições de Cuche (2002) ao afirmar que a identidade cultural de um povo só pode ser compreendida ao estudar suas relações com os grupos vizinhos; Walter Mignolo (2005) e Aníbal Quijano (2005) ao questionar o discurso do europeu no que tange ao progresso e salvação, que conduz a uma divisão entre os povos. A metodologia utilizada para a realização do estudo se pauta na pesquisa bibliográfica de cunho qualitativo. Esse trabalho traz em seu bojo os fundamentos teóricos propostos por Quijano (2005); Cuche (2002) e Walter Mignolo (2005). Os resultados revelam que o reconhecer pelas indumentárias, cores, adereços e interesses, há um sentido social e cultural simbólico, pois é o reflexo de uma sociedade dividida, classista e racista em que um determinado grupo busca preservar a identidade cultural dos antepassados, e outra a nega, por considerar “atrasada”. Dessa forma, conclui-se, que as desigualdades geradas entre os grupos no Peru foram nutridas por um discurso de desenvolvimento e, assim, comprometeu o social e o cultural

Attitude to Co-Administration of Influenza and COVID-19 Vaccines among Pregnant Women Exploring the Health Action Process Approach Model

: Respiratory tract diseases caused by influenza virus and SARS-CoV-2 can represent a serious threat to the health of pregnant women. Immunological remodulation for fetus tolerance and physiological changes in the gestational chamber expose both mother and child to fearful complications and a high risk of hospitalization. Vaccines to protect pregnant women from influenza and COVID-19 are strongly recommended and vaccine co-administration could be advantageous to increase coverage of both vaccines. The attitude to accept both vaccines is affected by several factors: social, cultural, and cognitive-behavioral. In Palermo, Italy, during the 2021-2022 influenza season, a cross-sectional study was conducted to evaluate pregnant women's intention to adhere to co-administration of influenza and COVID-19 vaccines. The determinants of vaccination attitude were investigated through the administration of a questionnaire and the Health Action Process Approach theory was adopted to explore the cognitive behavioral aspects. Overall, 120 pregnant women were enrolled; mean age 32 years, 98.2% (n = 118) of Italian nationality and 25.2% (n = 30) with obstetric or pathological conditions of pregnancy at risk. Factors significantly associated with the attitude to co-administration of influenza and COVID-19 vaccines among pregnant women were: high level of education (OR = 13.96; p < 0.001), positive outcome expectations (OR = 2.84; p < 0.001), and self-efficacy (OR = 3.1; p < 0.001). Effective strategies to promote the co-administration of the influenza vaccine and the COVID-19 vaccine should be based on the communication of the benefits and positive outcomes of vaccine co-administration and on the adequate information of pregnant women

Internal radiation dose assessment of radiopharmaceuticals prepared with cyclotron-produced 99m Tc

Technetium-99m (99m Tc) is the radioisotope most widely used in diagnostic nuclear medicine. It is readily available from 99 Mo/99m Tc generators as the \u3b2- decay product of the 99 Mo (T\ubd =66 h) parent nuclide. This latter is obtained as a fission product in nuclear reactors by neutron-induced reactions on highly enriched uranium. Alternative production routes, such as direct reactions using proton beams on specific target materials [100 Mo(p,2n)99m Tc], have the potential to be both reliable and relatively cost-effective. However, results showed that the 99m Tc extracted from proton-bombarded 100 Mo-enriched targets contains small quantities of several Tc radioisotopes (93m Tc, 93 Tc, 94 Tc, 94m Tc, 95 Tc, 95m Tc 96 Tc and 97m Tc). The aim of this work was to estimate the dose increase (DI) due to the contribution of Tc radioisotopes generated as impurities, after the intravenous injection of four radiopharmaceuticals prepared with cyclotron-produced 99m Tc (CP-99m Tc) using 99.05% 100 Mo-enriched metallic targets

PVF velocity pattern in patients with heart failure: Transesophageal echocardiographic assessment

In order to assess the role of the pulmonary venous flow (PVF) velocity pattern in the evaluation of patients with congestive heart failure (CHF), we studied 41 CHF patients by means of transthoracic echocardiography (TTE) and multiplane transesophageal echocardiography (TEE). The etiology of CHF was idiopathic or ischemic dilated cardiomyopathy in 19 patients and hypertensive heart disease in 22. Sixteen subjects without cardiovascular disease were selected as normal controls. PVF peak systolic and peak early diastolic (D) velocities were recorded by TEE and TTE and the systolic fraction (SF) was measured (i.e., the systolic velocity-rime integral - VTI - expressed as a fraction of the sum of systolic and early diastolic VTI). TEE tracings were obtained in all patients and had more laminar-appearing spectral signals, thus were used for analysis. By TTE the mitral flow velocity patterns were also evaluated: peak early diastolic velocity (E), peak velocity at atrial contraction, E velocity normalized for VTI (E/VTI), deceleration time (DT), and left ventricular isovolumic relaxation time (LVIRT). The left ventricular ejection fraction (LVEF) was calculated by two-dimensional echocardiographic images using the modified Simpson method. The SF was lower in CHF patients as compared with normal controls (p 50 cm/s; type B: SF similar to 50%, D > 50 cm/s) were recognized in patients with a low LVEF (type A) and a nearly normal or normal LVEF (type B). Patients with LVEF 40% (33.26 +/- 10.84 vs. 51.00 +/- 4.00%, p 40%. Thus in CHF patients TEE PVF velocity patterns help in distinguishing patients with systolic dysfunction (low LVEF and SF) from patients with predominant diastolic impairment (normal or nearly normal LVEF, high D velocities)

Epilepsy and suicide: pathogenesis, risk factors, and prevention

Depression and suicide tendencies are common in chronic diseases, especially in epilepsy and diabetes. Suicide is one of the most important causes of death, and is usually underestimated. We have analyzed several studies that compare mortality as a result of suicide in epileptic patients and in the general population. All the studies show that epileptic patients have a stronger tendency toward suicide than healthy controls. Moreover it seems that some kinds of epilepsy have a higher risk for suicide (temporal-lobe epilepsy). Among the risk factors are surgery therapy (suicide tendency five times higher than patients in pharmacological therapy), absence of seizures for a long time, especially after being very frequent, and psychiatric comorbidity (major depression, anxiety-depression disorders, personality disorders, substance abuse, psychoses). The aim of the review was to analyze the relationship between suicide and epilepsy, to identify the major risk factors, and to analyze effective treatment options

Milk-derived bioactive peptides exhibit antioxidant activity through the Keap1-Nrf2 signaling pathway

Abstract Bioactive peptides are relevant nutritional factors that exhibit many functions including antioxidant, antihypertensive, anticancer and antimicrobial properties. In this paper, four synthetic peptides ARHPHPHLSFM (A-11-M), AVPYPQR (A-7-R), NPYVPR (N-6-R) and KVLPVPEK (K-8-K) with sequences present in milk proteins were examined for their antioxidant properties. The compounds show moderate free radical scavenging activity in the ABTS and crocin assays (A-7-R and N-6-R) and lipid peroxidation inhibition in Caco-2 cells (N-6-R and K-8-K). All peptides, in particular K-8-K, activate the Keap1-Nrf2 system by allowing the translocation of the transcription factor Nrf2 from the cytosol to nucleus. This activation triggers the overexpression of the antioxidant enzymes Trx1, TrxR1, GR, NQO1 and SOD1. Furthermore, molecular modeling shows that K-8-K is able to hinder the interaction of Nrf2 with Keap1. The reported results show that the antioxidant action in cells of these bioactive peptides is mostly due to the activation of Keap1-Nrf2 signaling pathway

A SHort course Accelerated RadiatiON therapy (SHARON) dose-escalation trial in older adults head and neck non-melanoma skin cancer

Objectives: To assess feasibility and safety of a SHort-course Accelerated RadiatiON therapy (SHARON) regimen, in the treatment of non-melanoma skin cancers (NMSC) in older patients.Methods: Old patients (age >= 80 years) with histological confirmed non-melanoma skin cancers were enrolled. The primary endpoint was to determine the maximum tolerated dose (MTD). Radiotherapy regimen was based on the delivery of four radiotherapy fractions (5 Gy per fraction) with a twice daily fractionation in two consecutive days, Three different level of dose were administered: 20 Gy (one cycle), 40 Gy (two cycles) and 60 Gy (three cycles).Results: Thirty patients (median age: 91 years; range: 80-96) were included in this analysis, Among fourteen patients who completed the one cycle, only one (7%) experimented acute G4 skin toxicity. Twelve patients reported an improvement or resolution of baseline symptoms (overall palliative response rate: 85.8%). Nine and seven patients underwent to two and three RT cycles, respectively: of these, no G3 toxicities were recorded. The overall response rate was 100% when three cycles were delivered. The overall six-month symptom-free survival was 787% and 77.8% in patients treated with one course and more courses, respectively.Conclusions: Short-course accelerated radiotherapy in older patients with non-melanoma skin cancers is well tolerated. High doses seem to be more effective in terms of response rate.Advances in knowledge: This approach could represent an option for older adults with NMSC, being both palliative (one course) or potentially curative (more courses) in the aim, accordingly to the patient's condition

Pregnant teenagers treated at the obstetric center of a university hospital

According to the definition of the World Health Organization, adolescence is the phase of life between 10 and 19 years of age, a period marked by physiological and biopsychosocial changes, in which pregnancy is considered a risk factor for both mother and fetus from the biomedical point of view. Several factors have been associated with teenage pregnancy with negative maternal and neonatal impacts, such as: social vulnerability, low levels of education, income, and sexual education. This is a descriptive cross-sectional study with a quantitative approach, which aimed to identify obstetric factors and neonatal outcomes of greater frequency among pregnant adolescents treated at the obstetric center of a university hospital. Data collection was performed through a logbook of daily procedures at the obstetric center, so that all parturients under 19 years of age treated in 2018 were included in the study. The variables studied were age, parity, type of delivery, gestational age, diagnosis of syphilis and HIV, number of prenatal consultations, and insertion of an intrauterine device (IUD). As for the newborn, the following were analyzed: weight and hospital destination after birth. The data were processed using the SOFA.5.2 software (Statistics Open for All) and the significance level established was 95%, with a value of (P ≤ 0.05). Three thousand four hundred and thirty pregnant women were evaluated. There was a birth rate of 19.3% among adolescents, with a correlation between the low weight of the newborn with the longest hospital stay and the number of prenatal visits, and also the identification of low insertion of contraceptive methods immediately after delivery. Adolescent pregnancy was correlated with low-birth-weight newborns and a longer stay in neonatal units, consequences often associated with the insufficient number of prenatal consultations. Public health policies for the inclusion of qualified nursing professionals in the management of insertion of the intrauterine device for the prevention of subsequent pregnancies deserve special attention