COVID-19 Booster Vaccine Acceptance in Ethnic Minority Individuals in the United Kingdom: a mixed-methods study using Protection Motivation Theory

Background: Uptake of the COVID-19 booster vaccine among ethnic minority individuals has been lower than in the general population. However, there is little research examining the psychosocial factors that contribute to COVID-19 booster vaccine hesitancy in this population.Aim: Our study aimed to determine which factors predicted COVID-19 vaccination intention in minority ethnic individuals in Middlesbrough, using Protection Motivation Theory (PMT) and COVID-19 conspiracy beliefs, in addition to demographic variables.Method: We used a mixed-methods approach. Quantitative data were collected using an online survey. Qualitative data were collected using semi-structured interviews. 64 minority ethnic individuals (33 females, 31 males; mage = 31.06, SD = 8.36) completed the survey assessing PMT constructs, COVID-19conspiracy beliefs and demographic factors. 42.2% had received the booster vaccine, 57.6% had not. 16 survey respondents were interviewed online to gain further insight into factors affecting booster vaccineacceptance.Results: Multiple regression analysis showed that perceived susceptibility to COVID-19 was a significant predictor of booster vaccination intention, with higher perceived susceptibility being associated with higher intention to get the booster. Additionally, COVID-19 conspiracy beliefs significantly predictedintention to get the booster vaccine, with higher conspiracy beliefs being associated with lower intention to get the booster dose. Thematic analysis of the interview data showed that barriers to COVID-19 booster vaccination included time constraints and a perceived lack of practical support in the event ofexperiencing side effects. Furthermore, there was a lack of confidence in the vaccine, with individuals seeing it as lacking sufficient research. Participants also spoke of medical mistrust due to historical events involving medical experimentation on minority ethnic individuals.Conclusion: PMT and conspiracy beliefs predict COVID-19 booster vaccination in minority ethnic individuals. To help increase vaccine uptake, community leaders need to be involved in addressing people’s concerns, misassumptions, and lack of confidence in COVID-19 vaccination

Estimating Survival in Patients with Operable Skeletal Metastases: An Application of a Bayesian Belief Network

BACKGROUND: Accurate estimations of life expectancy are important in the management of patients with metastatic cancer affecting the extremities, and help set patient, family, and physician expectations. Clinically, the decision whether to operate on patients with skeletal metastases, as well as the choice of surgical procedure, are predicated on an individual patient's estimated survival. Currently, there are no reliable methods for estimating survival in this patient population. Bayesian classification, which includes bayesian belief network (BBN) modeling, is a statistical method that explores conditional, probabilistic relationships between variables to estimate the likelihood of an outcome using observed data. Thus, BBN models are being used with increasing frequency in a variety of diagnoses to codify complex clinical data into prognostic models. The purpose of this study was to determine the feasibility of developing bayesian classifiers to estimate survival in patients undergoing surgery for metastases of the axial and appendicular skeleton. METHODS: We searched an institution-owned patient management database for all patients who underwent surgery for skeletal metastases between 1999 and 2003. We then developed and trained a machine-learned BBN model to estimate survival in months using candidate features based on historical data. Ten-fold cross-validation and receiver operating characteristic (ROC) curve analysis were performed to evaluate the BNN model's accuracy and robustness. RESULTS: A total of 189 consecutive patients were included. First-degree predictors of survival differed between the 3-month and 12-month models. Following cross validation, the area under the ROC curve was 0.85 (95% CI: 0.80-0.93) for 3-month probability of survival and 0.83 (95% CI: 0.77-0.90) for 12-month probability of survival. CONCLUSIONS: A robust, accurate, probabilistic naïve BBN model was successfully developed using observed clinical data to estimate individualized survival in patients with operable skeletal metastases. This method warrants further development and must be externally validated in other patient populations

Superfluid Helium Tanker (SFHT) study

Replenishment of superfluid helium (SFHe) offers the potential of extending the on-orbit life of observatories, satellite instruments, sensors and laboratories which operate in the 2 K temperature regime. A reference set of resupply customers was identified as representing realistic helium servicing requirements and interfaces for the first 10 years of superfluid helium tanker (SFHT) operations. These included the Space Infrared Telescope Facility (SIRTF), the Advanced X-ray Astrophysics Facility (AXAF), the Particle Astrophysics Magnet Facility (Astromag), and the Microgravity and Materials Processing Sciences Facility (MMPS)/Critical Point Phenomena Facility (CPPF). A mixed-fleet approach to SFHT utilization was considered. The tanker permits servicing from the Shuttle cargo bay, in situ when attached to the OMV and carried to the user spacecraft, and as a depot at the Space Station. A SFHT Dewar ground servicing concept was developed which uses a dedicated ground cooling heat exchanger to convert all the liquid, after initial fill as normal fluid, to superfluid for launch. This concept permits the tanker to be filled to a near full condition, and then cooled without any loss of fluid. The final load condition can be saturated superfluid with any desired ullage volume, or the tank can be totally filed and pressurized. The SFHT Dewar and helium plumbing system design has sufficient component redundancy to meet fail-operational, fail-safe requirements, and is designed structurally to meet a 50 mission life usage requirement. Technology development recommendations were made for the selected SFHT concept, and a Program Plan and cost estimate prepared for a phase C/D program spanning 72 months from initiation through first launch in 1997

Assessing Differences Between Physician\u27s Realized And Anticipated Gains From Electronic Health Record Adoption

Return on investment (ROI) concerns related to Electronic Health Records (EHRs) are a major barrier to the technology’s adoption. Physicians generally rely upon early adopters to vet new technologies prior to putting them into widespread use. Therefore, early adopters’ experiences with EHRs play a major role in determining future adoption patterns. The paper’s purposes are: (1) to map the EHR value streams that define the ROI calculation; and (2) to compare Current Users’ and Intended Adopters’ perceived value streams to identify similarities, differences and governing constructs. Primary data was collected by the Texas Medical Association, which surveyed 1,772 physicians on their use and perceptions of practice gains from EHR adoption. Using Bayesian Belief Network Modeling, value streams are constructed for both current EHR users and Intended Adopters. Current Users and Intended Adopters differ significantly in their perceptions of the EHR value stream. Intended Adopters’ value stream displays complex relationships among the potential gains compared to the simpler, linear relationship that Current Users identified. The Current Users identify “Reduced Medical Records Costs” as the gain that governs the value stream while Intended Adopters believe “Reduced Charge Capture Costs” define the value stream’s starting point. Current Users’ versus Intended Adopters’ assessments of EHR benefits differ significantly and qualitatively from one another

Implementation of lung cancer screening in Europe:challenges and potential solutions: summary of a multidisciplinary roundtable discussion

Recent randomised trials on screening with low-dose CT have shown important reductions in lung cancer (LC) mortality and have triggered international efforts to implement LC screening. Detection rates of stage I LC with volume CT approaching 70% have been demonstrated. In April 2019 'ESMO Open - Cancer Horizons' convened a roundtable discussion on the challenges and potential solutions regarding the implementation of LC screening in Europe. The expert panel reviewed the current evidence for LC screening with low-dose CT and discussed the next steps, which are covered in this article. The panel concluded that national health policy groups in Europe should start to implement CT screening as adequate evidence is available. It was recognised that there are opportunities to improve the screening process through 'Implementation Research Programmes'