广州市荔湾区替牙期儿童龋齿及错畸形综合防治效果分析

目的探讨广州市荔湾区替牙期儿童窝沟封闭防龋、前牙反和开防治的效果及影响因素。方法对广州市荔湾区2009年至2013年全区适龄儿童实施窝沟封闭防龋项目;同时于2012年对荔湾区9-11岁儿童错畸形进行调查,并对前牙反和开进行干预性治疗,收集的相关数据进行统计分析。结果在广州市荔湾区,实施儿童第一恒磨牙窝沟封闭最佳对象是二年级学生（7-8岁）;荔湾区窝沟封闭项目进展相对顺利,影响项目的主要因素包括民众的认知度以及医护人员规范化操作和责任心;替牙期前牙反矫治成功率高,复发率低;前牙开矫治成功率高,但复发率也高;前牙反和开儿童就诊治疗率低。结论广州市荔湾区二年级学生（7-8岁）应尽早实施窝沟封闭;政府加强宣传教育有助于提高窝沟封闭的普及率。替牙期前牙反的早期矫治疗效显著,值得推广;前牙开早期治疗对形态功能的恢复及矫治后的稳定性有事半功倍的效果;政府可考虑加大力度推广替牙期错畸形的防治工作。     

HLA epitopes – Empirically defined as conformational amino acids sequences of the HLA antigen and are likely to be part of the binding sites of anti-HLA antibodies

Antibodies against HLA antigens are ubiquitous in the sera of transplant patients. Analysis of anti-HLA antibodies specificity has gone through a long history of development using assays like agglutination and lymphocytotoxicity, which utilize lymphocytes, and flow cytometry, which utilize multiplex beads coupled with single antigens. Hundreds of HLA antigens are identified to date, and the realization that antibody reactivity against the antigens is multispecific presented difficulties in accurately defining antibody specificity. Although Cross Reacting Groups (CREG), describing cross reactivity among HLA antigens, were helpful with determining specificity, they proved to be inadequate for the highly sensitized patients. Amino acid sequencing and three-dimensional modeling of the HLA molecules significantly advanced our understating of the HLA antigens and their epitopes. Although sensitive assays for antibody testing advanced analysis, they unmasked additional specificities undetectable by traditional methods, and the presence of naturally occurring anti-HLA antibodies in sera further complicated analysis and underscored the need to understand antibody reactivity and their epitopes. Hundreds of HLA class-I and class-II epitopes were defined by the Tekasaki and Duquesnoy groups and their usefulness in organ transplants were further advanced by a great number of transplant centers. Alloantibody specificities, CREGs, and nondonor specific antigens (NDSA) are now explained by public epitopes     

Perceptions of politicization and HPV vaccine policy support

BackgroundSince its FDA approval in 2006, the Human papillomavirus (HPV) vaccine has been politically-charged, given its association with sexual health among young women and its history of controversial, and largely unsuccessful, legislative mandates. The extent to which perceived politicization is related to public support for the vaccine’s use, however, is not clear. We sought to examine the relationship between public perceptions of politicization of the HPV vaccine and public support for HPV vaccine policies.MethodsWe fielded a survey from May-June 2016 using a nationally representative sample of U.S. adults (18–59 years). Among respondents aware of the HPV vaccine (n = 290), we predict support for HPV vaccine policies based on respondents’ perceptions of three characteristics of the vaccine’s portrayal in public discourse: degree of controversy, certainty of the scientific evidence supporting the vaccine’s use, and frequency with which the vaccine appears in political discussion.ResultsRespondents who perceived greater certainty about the scientific evidence for the HPV vaccine were more supportive of HPV vaccine policies (p < 0.0001) than respondents who perceived the scientific evidence to be uncertain, after adjusting for respondents’ characteristics, including demographics and partisanship.ConclusionsPublic perceptions of the HPV vaccine’s politicization, particularly the portrayal of scientific evidence, are associated with receptivity to legislative mandates.Policy implicationsHow the certainty of a body of evidence gets communicated to the public may influence the policy process for a critical cancer prevention intervention.     

Impact of the single-dose universal mass vaccination strategy against hepatitis A in Brazil

Universal vaccination of children against hepatitis A was introduced in 2014 in Brazil as a single-dose schedule. We analyzed the numbers of reported cases of hepatitis A virus infection (HAV) from 2010 to 2017 to evaluate the initial impact of that intervention. Data were assessed and has been freely available on the Brazilian Ministry of Health website. The HAV incidence was steady around 6000 cases per year until 2014. Between 2014 and 2016, there was a 85.5% cumulative drop, independent of gender and geographical macroregions. The fall was especially significant among toddlers (96.8%). In 2017, cases increased due to an outbreak among male adults in São Paulo. Decrease in incidence continued to occur for females and for those under 15?years of age. Data show that there was a significant decrease in HAV cases number in Brazil from 2015 after the introduction of single-dose HAV vaccine program.     

Prenatal Bisphenol A exposure and early childhood neurodevelopment in Shandong,China

BackgroundSeveral epidemiological studies suggest that prenatal exposure to BPA may interfere with the neurodevelopment of pre-school and school-age children. However, a limited number of studies are available for effects during children at a younger age, especially in China.MethodsBased on Laizhou Wan Birth Cohort (LWBC), BPA concentrations were measured in urine among 506 pregnant women during their hospital admission for delivery and neurodevelopment of their children was assessed using the Gesell Development Schedules at 12 months (n = 368) and 24 months (n = 296). Linear regression and generalized linear models were used to analyze the association between prenatal BPA exposure and the children's developmental quotient scores (DQs).ResultsThe median of maternal BPA concentration was 0.48 μg/L or 1.05 μg/g creatinine. Maternal BPA concentrations were adversely associated with children DQs at 12 months of age, with a 10-fold increase in prenatal BPA concentrations correlated to 1.43-point decrease in DQs in the adaptive domain (β = ?1.43; 95% CI: ?2.30 to ?0.56, p = 0.001). When stratified by gender, prenatal BPA concentrations were adversely associated with the adaptive domain DQs among boys (p-trend = 0.012) and girls (p-trend = 0.028) and the social domain DQs (p-trend = 0.019) only among girls. At 24 months of age, the significant adverse association was only found in the language domain among girls (β = ?1.69; 95% CI: ?3.23 to ?0.15, p = 0.032).ConclusionBased on a Chinese population, we found potential impacts of prenatal BPA exposure on childhood neurodevelopment at 12 and 24 months of age, especially among girls.     

Effectiveness of a community-based water,sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007–2015) in rural Bangladesh

Diarrhoea, the most common disease directly related to water, sanitation, and hygiene (WASH), still remains one of the most significant health problems among children under-five worldwide. In this reality, BRAC, the largest NGO in the world initiated a comprehensive WASH intervention in 50 upazilas (sub-districts) of Bangladesh in 2007 which was later scaled up to cover 150 upazilas in two subsequent phases. The intervention period of the programme was 2007–2011.The present study encompassed 30 upazilas of the first phase of intervention. The aim of the study was to investigate the effectiveness of this intervention on reduction of diarrhoea among under-five children, and to identify the factors associated with childhood diarrhoea. A repeated cross-sectional study design was followed, and a population-based survey was carried out on four occasions: baseline (2007), midline (2009), endline (2011), and post-endline (2015) among 4,775 households. This analysis considers only households having at least one under-five children.Absence of handwashing practice with soap after defecation and before eating food, unclean latrine condition, and unsafe disposal of child faeces were identified as significant risk factors associated with under-five diarrhoea from Log-binomial regression. The prevalence of under-five diarrhoea within the past 2 weeks of the survey declined from 13.7% at baseline to 3.6% at end-line (p < 0.001) in the WASH intervention area. However, the progress seemingly stalled after 2011, which may have occurred due to the lack of improvement in unsafe disposal of child faeces and unclean latrine condition after the intervention period.Study findings suggest that, to reduce the prevalence of childhood diarrhoea it is important to promote safe disposal of child faeces, maintaining cleanliness of latrines, and washing hand with soap at critical times, beyond merely increasing the sanitation coverage. Findings also underline the necessity of maintaining a small-scale monitoring component involving local community, such as a WatSan committee (a local committee comprising the user communities for supervising WASH related activities) for periodic monitoring at household level for a certain period after the program intervention works to make the behavioural change more sustainable and to keep the reduction rate of under-five diarrhoeal prevalence steady.     

Closure of ‘third places’? Exploring potential consequences for collective health and wellbeing

In unassuming neighborhood locales, such as coffee shops, hair salons, and malls, people meet to socialize, express themselves, and support one another. These ‘third places’ enrich social interaction, sense of community, and belonging outside of the home and workplace. Yet third places are closing across the United States. Americans may be losing access to key services, goods, and amenities, in addition to community sites that help buffer against loneliness, stress, and alienation. The relevance of third places to health and quality life is under-researched. These sites may support wellbeing through mechanisms of stimulation, support, protection, and care. We call on researchers to investigate how third places contribute to wellbeing and consider the consequences that the disappearance of such places has for public health. Future research on third places may be mobilized to innovatively reduce health disparities and improve quality of life.     

Research Priorities in Post-acute and Long-term Care: Results of a Stakeholder Needs Assessment

ObjectivesConduct a needs assessment among post-acute and long-term care (PA-LTC) stakeholder groups to identify (1) research topics of highest priority and (2) perspectives on research, including concerns/barriers to conducting research in the PA-LTC setting.DesignMixed methods multistakeholder engagement process. Needs assessment conducted with tailored strategies per stakeholder group: interview, survey, and focus group.Setting and ParticipantsFour stakeholder groups—medical directors/providers (n = 89), administrative leadership (n = 5), frontline staff (n = 17), and family members of residents and residents themselves (n = 11)—were recruited from the Colorado PA-LTC community through an academic-community partnership between the University of Colorado and Colorado Medical Directors Association.Main Outcome(s)Stakeholder perspectives on research and high priority PA-LTC research topics.ResultsResearch priorities common across stakeholder groups included polypharmacy (overuse of medication generally and overuse of antibiotics specifically), care transitions, mental health (including dementia, Alzheimer's disease, behaviors), chronic pain, urinary tract infection, and quality of life issues. Providers specifically prioritized heart failure, Parkinson's, and other chronic illnesses. Administrators and directors of nurses emphasized hospitalizations. Staff prioritized medication/therapy compliance. Families/residents prioritized neurologic disease. Concerns included staff burden, consenting process, privacy, and family involvement.Conclusions/ImplicationsPA-LTC patients have a lot to offer as participants and decision makers in research, frontline staff are enthusiastic about participation, family members want to be involved, and providers value research findings in their practice but need a more supportive environment to produce and participate in research.