Factors associated with the uptake of the UK routine childhood immunization schedule in a bi-ethnic population.

BACKGROUND: Various factors associated with vaccination uptake in children have been identified, but no study has examined their overall immunization status and individual vaccine coverage at 1, 2 and 5 years in the UK. METHODS: Data from 6977 participants in the Born in Bradford cohort were linked to primary care records. Overall immunization status and individual vaccine uptake of the UK routine childhood vaccination schedule was estimated in White British and Pakistani children born between 2007 and 2011, and factors associated with partial uptake in each ethnic group were identified using Poisson regression. RESULTS: Vaccine uptake was greater in Pakistani compared with White British children at all ages and for each year examined in this study. Children of foreign-born White British women were more likely to be partially immunized and those of foreign-born Pakistani women were more likely to be fully immunized. Socio-economic factors were strongly associated with uptake, especially among White British women. CONCLUSIONS: Vaccination uptake is influenced by social and economic environment, ethnicity and maternal country of birth. This suggests that current health education and service delivery may not be effective for some families, including those from different cultural and ethnic backgrounds, who may require targeted interventions to improve immunization uptake.

Tratamento cirúrgico em fratura de mandíbula atrófica: uma revisão de literatura / Surgical treatment of atrophic jaw fracture: a literature review

Analisar o manejo de fraturas em mandíbula atrófica voltado para a abordagem cirúrgica com ênfase na melhor técnica indicada. A perda óssea alveolar tem sido uma das consequências do edentulismo, que tem o potencial de levar a atrofia óssea. As fraturas de mandíbulas atróficas, normalmente são consideradas um procedimento desafiador, devido ser encontrada em pacientes idosos ou em virtude da perda dentária precoce resultando em um reparo dessas fraturas mais complexo. Os principais fatores etiológicos têm sido os acidentes automobilísticos, seguidos de queda e agressão. Geralmente, as causas das quedas decorrem de desequilíbrio, fraqueza muscular, tontura, e uso crônico de medicamentos como sedativos. As opções terapêuticas objetivam restaurar forma, função e imobilização apropriada desse possível evento. A individualização do tratamento de escolha é de grande importância, pois geralmente o paciente apresenta alterações fisiológicas decorrentes do envelhecimento e ossos mais fragilizados com potencial osteogênico reduzido, que dificultam a abordagem cirúrgica. Entretanto, deve ser considerado para o manejo dessas fraturas, a idade do paciente, as condições e quantidade de tecido ósseo e tecido mole. Porém, vale ressaltar que o envelhecimento não apresenta contraindicação, apenas exige condições especiais que devem ser consideradas. Nesse sentido, quando há oportunidade de dispositivos tecnológicos, como os biomodelos que contribuem significativamente para procedimentos cirúrgicos bucomaxilofaciais, esses fornecem maior previsibilidade de resultados, bem como redução do tempo cirúrgico.

To analyze the management of fractures in atrophic mandible aimed at the surgical approach, emphasizing which technique is best indicated. Alveolar bone loss has been one of the consequences of edentulism, which has the potential to lead to bone atrophy. Atrophic jaw fractures are usually considered a challenging procedure, as they are found in elderly patients or due to early tooth loss, resulting in a more complex repair of these fractures. The main etiological factors have been described as car accidents, followed by falls and aggression. Commonly, the causes of falls stem from imbalance, muscle weakness, dizziness, and chronic use of medications such as sedatives. The therapeutic options aim to restore form, function and appropriate immobilization of this possible event. The individualization of the treatment of choice is of great importance, as the patient usually presents physiological changes resulting from aging and more brittle bones and a reduced osteogenic potential, which makes the surgical approach difficult. However, the patient's age, conditions and amount of bone and soft tissue must be taken into consideration for the management of these fractures. However, it is noteworthy that aging has no contraindication, it only requires special conditions that must be considered. In this sense, when there is an opportunity for technological devices, such as biomodels that significantly contribute to maxillofacial surgical procedures, it provides greater predictability of results, as well as reduced surgical time.

O papel da saliva na pandemia por COVID-19: alternativa diagnóstica para um problema de saúde pública global / The role of saliva in the COVID-19 pandemic: diagnostic alternative for a global public health problem

O objetivo desse estudo foi relatar as evidências disponíveis sobre o papel da saliva no diagnóstico da Covid-19. Trata-se de uma revisão narrativa da literatura de cunho qualitativo com buscas realizadas a partir das bases de dados eletrônicas PubMed, Google Acadêmico e Scielo, nos idiomas português e inglês utilizando os termos "Covid-19", "Diagnóstico" e "Saliva". Foi observado a utilização da saliva com a finalidade de se monitorar o estado de saúde e da doença de uma pessoa cujo objetivo tem se tornado extremamente desejável quanto à promoção da saúde e à pesquisa de cuidados em saúde. Nesse sentido, amostras de saliva podem ser usadas no diagnóstico da Covid-19. Um obstáculo crítico para o diagnóstico salivar pode ser a validação de amplo espectro em pacientes com Covid-19 durante o período de incubação, a fase de resposta viral e a fase inflamatória do hospedeiro de indivíduos assintomáticos e sintomáticos. Conclui-se que a saliva pode ter aplicações potenciais no contexto da Covid-19, mas, são necessários mais estudos para investigar o potencial diagnóstico da Covid-19 na saliva e seu impacto na transmissão desse vírus.

The aim of this study was to review the available evidence on the role of saliva in the diagnosis of Covid-19. This is a narrative review of the literature of a qualitative nature whose search was carried out from the digital databases PubMed, Academic Google and Scielo, in Portuguese and English, using the terms "Covid-19", "Diagnosis" and "Saliva". It was observed that the use of saliva in order to monitor a person's state of health and illness it became an objective extremely desirable in terms of health promotion and health care research. In this sense, saliva samples can be used in the diagnosis of Covid-19. A critical obstacle for salivary diagnosis may be broad-spectrum validation in patients with Covid-19 during the incubation period, the viral response phase, and the host inflammatory phase in asymptomatic and symptomatic patients. It is concluded that saliva may have potential applications in the context of Covid-19, but further studies are needed to investigate the diagnostic potential of Covid-19 in saliva and its impact on the transmission of this virus.

Actual and preferred contraceptive sources among young people: findings from the British National Survey of Sexual Attitudes and Lifestyles.

OBJECTIVE: To describe actual and preferred contraceptive sources among young people in Britain and whether discordance between these is associated with markers of sexual risk behaviour or poor sexual health. DESIGN: Cross-sectional probability sample survey. SETTING: British general population. PARTICIPANTS: 3869 men and women aged 16-24 years interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) between 2010 and 2012. MAIN OUTCOME MEASURES: Reported source of contraceptive method(s) and preferred source if all were available and easily accessible. RESULTS: Of the 75% of young people (aged 16-24) who were heterosexually active (1619 women, 1233 men), >86% reported obtaining contraceptives in the past year. Most common sources were general practice (women, 63%) and retail (men, 60%): using multiple sources was common (women 40%, men 45%). Healthcare sources were preferred by 81% of women and 57% of men. Overall, 32% of women and 39% of men had not used their preferred source. This discordance was most common among men who preferred general practice (69%) and women who preferred retail (52%). Likelihood of discordance was higher among women who usually used a less effective contraceptive method or had an abortion. It was less likely among men who usually used a less effective method of contraception and men who were not in a steady relationship. CONCLUSIONS: Most young people in Britain obtained contraception in the past year but one-third had not used their preferred source. Healthcare sources were preferred. Discordance was associated with using less effective contraception and abortion among young women. Meeting young people's preference for obtaining contraception from healthcare sources could improve uptake of effective contraception to reduce unwanted pregnancies.