Strategies for Fostering HPV Vaccine Acceptance

Vaccines that protect against infection with the types of human papillomavirus (HPV) commonly associated with cervical cancer (HPV 16 and 18) and genital warts (HPV 6 and 11) are expected to become available in the near future. Because HPV vaccines are prophylactic, they must be administered prior to exposure to the virus, ideally during preadolescence or adolescence. The young age of the target vaccination population means that physicians, parents, and patients will all be involved in the decision-making process. Research has shown that parents and patients are more likely to accept a vaccine if it is efficacious, safe, reasonably priced, and recommended by a physician. Widespread education of physicians, patients, and parents about the risks and consequences of HPV infection and the benefits of vaccination will be instrumental for fostering vaccine acceptance

Le collectif au travail et la santé analysés au travers de la théorie du don. Session 1, Santé mentale et travail

La question de la cohésion sociale et du collectif au travail est analysée sous l'angle de la théorie du don telle que décrite par Marcel Mauss. Selon ce point de vue, seuls les échanges au travers de mécanismes de don produisent du lien social. Une réflexion est amorcée pour savoir quels sont, dans le monde du travail, les échanges qui relèvent de cette logique et comment ces formes d'échanges évoluent avec les nouvelles formes d'organisation du travail. [Auteurs]]]> fre oai:serval.unil.ch:BIB_CAF2BC9777BE 2023-07-29T01:34:46Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_CAF2BC9777BE Has COVID-19 had a greater impact on female than male oncologists? Results of the ESMO Women for Oncology (W4O) Survey. info:doi:10.1016/j.esmoop.2021.100131 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.esmoop.2021.100131 info:eu-repo/semantics/altIdentifier/pmid/34144778 Garrido, P. Adjei, A.A. Bajpai, J. Banerjee, S. Berghoff, A.S. Choo, S.P. Felip, E. Furness, AJS Garralda, E. Haanen, J. Letsch, A. Linardou, H. Peters, S. Sessa, C. Tabernero, J. Tsang, J. Yang, J.C. Garassino, M.C. info:eu-repo/semantics/article article 2021-06 ESMO open, vol. 6, no. 3, pp. 100131 info:eu-repo/semantics/altIdentifier/eissn/2059-7029 urn:issn:2059-7029 <![CDATA[European Society for Medical Oncology Women for Oncology (ESMO W4O) research has previously shown under-representation of female oncologists in leadership roles. As early reports suggested disproportionate effects of the COVID-19 pandemic on women, the ESMO W4O Committee initiated a study on the impact of the pandemic on the lives of female and male oncologists. A questionnaire was sent to ESMO members and put on the ESMO website between 8 June 2020 and 2 July 2020. Questions focused on the working (hospital tasks, laboratory tasks, science) and home (household management, childcare, parent care, personal care) lives of oncologists during and after COVID-19-related lockdowns. Of 649 respondents, 541 completed the questionnaire. Of these, 58% reported that COVID-19 had affected their professional career, 83% of whom said this was in a negative way (85% of women versus 76% of men). Approximately 86% reported that COVID-19 had changed their personal life and 82% their family life. Women were again significantly more affected than men: personal life (89% versus 78%; P = 0.001); family life (84% versus 77%; P = 0.037). During lockdowns, women reported increased time spent on hospital and laboratory tasks compared with men (53% versus 46% and 33% versus 26%, respectively) and a significantly higher proportion of women than men spent less time on science (39% versus 25%) and personal care (58% versus 39%). After confinement, this trend remained for science (42% versus 23%) and personal care (55% versus 36%). The COVID-19 pandemic has adversely affected the professional and home lives of oncologists, especially women. Reduced research time for female oncologists may have long-lasting career consequences, especially for those at key stages in their career. The gender gap for promotion to leadership positions may widen further as a result of the pandemic

The Role of Obstetrician/Gynecologists in the Management of Hepatitis C Virus Infection

Chronic infection with hepatitis C virus (HCV) is a major cause of liver disease-related death and is also the most frequent indication for liver transplantation in USA. Infected individuals can remain asymptomatic for 20 years or more, but they remain at risk for progressive liver disease. They also represent a potential source of infection for others. For reducing the future disease burden due to HCV, obstetrician/gynecologists and primary health care practitioners should be aware of the factors that promote HCV transmission: how to provide counseling and testing, and when specialist referral is needed

Seroprevalence of Bordetella pertussis antibodies in mothers and their newborn infants.

BACKGROUND: Pertussis is a highly communicable, vaccine-preventable respiratory disease. Although the largest number of reported cases is among young infants, the most rapidly increasing incidence in the USA is in adolescents and young adults. Importantly, adult family members are the likely major reservoir, infecting susceptible infants before completion of childhood vaccination. We studied maternal-neonatal paired blood samples for the presence of pertussis-related antibodies to assess level of immunity and passive transplacental antibody passage. METHODS. Unselected maternal-neonatal cord blood samples were collected from 101 term deliveries in a single urban uninsured/underinsured hospital setting. Sera were analyzed for anti-pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN) IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Antibody titers were calculated using reference line methodology. Antibody values were log-transformed to establish geometric mean titers (GMT) for analysis. Student's t-test, Mann-Whitney, Pearson correlation and chi square were used for statistical comparisons as appropriate. RESULTS. Mean (SD) maternal age, gestational age and birth weight were 26.8 (6.8) years, 38.9 (1.4) weeks and 3239 (501) g, respectively. Detectable maternal levels of anti-PT, FHA and PRN were found in 34.7%, 95.0% and 80.2%, respectively. Maternal GMT (SD) for PT, FHA and PRN were 4.4 (2.6), 26.6 (3.1) and 12.3 (2.9), respectively. There was no significant relationship between PT, FHA or PRN detection or antibody GMT and maternal age. Maternal anti-PT, FHA and PRN were highly correlated with neonatal cord blood values. CONCLUSION: Despite previous childhood immunization, a large number of parous women have low or undetectable pertussis-related antibody levels, suggesting susceptibility to infection. Even with efficient transplacental passage of these antibodies, neonates similarly have limited measurable protection as detected by cord blood sampling. These data support the need for adolescent or adult vaccination against Bordetella pertussis. Healthcare providers and their clients should be aware of the risk for infant infection via family member transmission

Septic Shock and Sepsis Syndrome in Obstetric Patients

Septic shock is a life-threatening clinical syndrome that, despite its rare occurrence in obstetrics, remains a leading cause of maternal mortality. Its pathophysiology is explained by a profound systemic response to a complex variety of host cellular and humoral mediators elaborated after exposure to microbial toxins. Early recognition, prompt diagnostic workup, and immediate initiation of therapy improve outcomes. Therefore, recent publications have popularized the concept of the “sepsis syndrome,” a preshock list of clinical criteria associated with progressive sepsis. Needed diagnostic studies should never be withheld because of “pregnancy concerns.” With critically ill patients, the risk-to-benefit ratio supports the use of these diagnostic studies in almost all circumstances. Standard therapy is directed principally at restoring tissue perfusion by intravascular volume expansion and in some instances vasoactive pharmacological intervention. Simultaneously, identification of the source of infection and commencement of appropriate empiric antibiotic treatment are critical. In some cases, surgical abscess drainage or debridement of infected necrotic tissue will need to be considered. Novel approaches to treatment that attempt to reduce the systemic response to microbial toxins are promising and under active investigation. Pregnancy-specific considerations include the following: 1) initial signs or symptoms of septic shock may be masked by normal physiologic alterations of pregnancy; 2) a mixed polymicrobial group of organisms, consistent with lower genital tract flora, should be anticipated; and 3) initial therapy should be directed at maternal concerns since adverse fetal effects are most likely the result of maternal decompensation

Adjustable Algorithmic Tool for Assessing the Effectiveness of Maternal Respiratory Syncytial Virus (RSV) Vaccination on Infant Mortality in Developing Countries

Acute lower respiratory infection (ALRI) due to RSV is a common cause of global infant mortality, with most cases occurring in developing countries. Using data aggregated from priority countries as designated by the United States Agency for International Development’s (USAID) Maternal Child Health and Nutrition (MCHN) program, we created an adjustable algorithmic tool for visualizing the effectiveness of candidate maternal RSV vaccination on infant mortality. Country-specific estimates for disease burden and case fatality rates were computed based on established data. Country-specific RSV-ALRI incidence rates for infants 0-5 months were scaled based on the reported incidence rates for children 0-59 months. Using in-hospital mortality rates and predetermined “inflation factor,” we estimated the mortality of infants aged 0-5 months. Given implementation of a candidate maternal vaccination program, estimated reduction in infant RSV-ALRI incidence and mortality rates were calculated. User input is used to determine the coverage of the program and the efficacy of the vaccine. Using the generated algorithm, the overall reduction in infant mortality varied considerably depending on vaccine efficacy and distribution. Given a potential efficacy of 70% and a maternal distribution rate of 50% in every USAID MCHN priority country, annual RSV-ALRI-related infant mortality is estimated to be reduced by 14,862 cases. The absolute country-specific reduction is dependent on the number of live births; countries with the highest birth rates had the greatest impact on annual mortality reduction. The adjustable algorithm provides a standardized analytical tool in the evaluation of candidate maternal RSV vaccines. Ultimately, it can be used to guide public health initiatives, research funding, and policy implementation concerning the effectiveness of potential maternal RSV vaccination on reducing infant mortality

Randomized Prospective Study Comparing Erythromycin, Amoxicillin, and Clindamycin for the Treatment of Chlamydia trachomatis in Pregnancy

Objective: The purpose of this study was to compare the efficacy and side effects of erythromycin, amoxicillin, and clindamycin in eradicating Chlamydia trachomatis from the lower genital tract of pregnant women