Approved but non-funded vaccines: Accessing individual protection

AbstractFunded immunization programs are best able to achieve high participation rates, optimal protection of the target population, and indirect protection of others. However, in many countries public funding of approved vaccines can be substantially delayed, limited to a portion of the at-risk population or denied altogether. In these situations, unfunded vaccines are often inaccessible to individuals at risk, allowing potentially avoidable morbidity and mortality to continue to occur. We contend that private access to approved but unfunded vaccines should be reconsidered and encouraged, with recognition that individuals have a prerogative to take advantage of a vaccine of potential benefit to them whether it is publicly funded or not. Moreover, numbers of “approved but unfunded” vaccines are likely to grow because governments will not be able to fund all future vaccines of potential benefit to some citizens. New strategies are needed to better use unfunded vaccines even though the net benefits will fall short of those of funded programs.Canada, after recent delays funding several new vaccine programs, has developed means to encourage private vaccine use. Physicians are required to inform relevant patients about risks and benefits of all recommended vaccines, publicly funded or not. Likewise, some provincial public health departments now recommend and promote both funded and unfunded vaccines. Pharmacists are key players in making unfunded vaccines locally available. Professional organizations are contributing to public and provider education about unfunded vaccines (e.g. herpes zoster, not funded in any province). Vaccine companies are gaining expertise with direct-to-consumer advertising. However, major challenges remain, such as making unfunded vaccines more available to low-income families and overcoming public expectations that all vaccines will be provided cost-free, when many other recommended personal preventive measures are user-pay. The greatest need is to change the widespread perception that approved vaccines should be publicly funded or ignored

Interest in coloured objects and behavioural budgets of individual captive freshwater turtles

Recent studies showed that freshwater turtles display inter-individual differences in variousbehavioural traits, which may influence their health and welfare in captivity due to differences inresponse to husbandry and enrichment strategies and in ability to cope with the limitations of thecaptive environment. This study investigated a possible correlation between individual level ofescape behaviour under standard enrichment conditions and level of interest in coloured objects ina group of cooters Pseudemys sp. and sliders Trachemys scripta ssp. on display at a public aquarium.Interest in different colours, colour preference and individual differences in behavioural changes inthe presence of the new enrichment were also studied. Turtles categorised as ‘high’ and ‘moderateescape behaviour’ (17–34 of behavioural budget) showed more interest in coloured objects andtended to display less escape behaviour in their presence, while turtles categorised as ‘low escapebehaviour’ (<10 of behavioural budget) were less interested in coloured objects and tended todisplay more escape behaviour in their presence. Overall, there was more interest in yellow than inred, white or green objects, with more contacts with coloured objects before feeding and at the startof each observation period and a preference for yellow against red objects. The individual differencesin behavioural changes in the presence of the new enrichment suggested that more studies into colourpreference and response to novelty in turtles would be beneficial to ensure that no individuals areunduly stressed by new enrichments

Abstracts from the NIHR INVOLVE Conference 2017

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Investigating the moderating role of coping style on music performance anxiety and perfectionism

Classical musicians are under constant pressure to perform at near perfect levels, and are highly vulnerable to the negative effects of music performance anxiety. This study aimed to examine the mechanisms by which two types of perfectionism (personal standards and evaluative concerns) relate to music performance anxiety, and to explore the moderating roles of active and avoidant coping on the relationship between these perfectionism types and music performance anxiety. A sample of 118 classical performing musicians (35 males, 82 females, 1 other; Mage = 42.00, SD = 14.68) were recruited to participate in an anonymous online questionnaire assessing music performance anxiety, coping and perfectionism. Results indicated that the two dimensions of perfectionism were positively associated with music performance anxiety. Personal standards perfectionism was associated with active coping, and evaluative concerns perfectionism with avoidant coping. Active coping moderated the relationship between personal standards perfectionism and performance anxiety, but only at high and medium levels. Contrary to the prediction, avoidant coping did not moderate the relationship between evaluative concerns perfectionism and performance anxiety. These findings highlight key relationships between music performance anxiety and the interaction of personal standards perfectionism and active coping. © The Author(s) 2022

Passion moderates the relationship between exercise identity and compulsive exercise

There remains limited understanding and mixed results around predictors of compulsive exercise, especially outside of eating disorder populations and settings. Research is also limited by operationalisation of compulsive exercise as a unidimensional construct, despite evidence that it is best understood and examined as multi-dimensional. Given that compulsive exercise is also observed in the general exercise population, increased understanding around predictors of compulsive exercise is needed. This study examined the relationship between dimensions of compulsive exercise (Compulsive Exercise Test) with obsessive and harmonious passion (the Passion Scale) and exercise identity (the Exercise Identity Scale) in a sample of N = 1184 Australian general exercisers. Correlation, regression and moderation analyses indicated that exercise identity was associated with all dimensions of compulsive exercise, although strength and direction of relationships varied. Harmonious passion was related to several dimensions of compulsive exercise and also moderated relationships between identity with weight-control exercise, mood improvement and lack of exercise enjoyment, whereas obsessive passion moderated the relationship between identity and lack of exercise enjoyment only. Results highlight that compulsive exercise dimensions have nuanced relationships with other variables and that examination of dimensions can increase understanding around compulsive exercise. Harmonious passion predicted more aspects of compulsive exercise than obsessive passion. Individuals with high exercise identity, and those with low harmonious passion may be more at risk of poor outcomes including compulsive exercise pathology and other related outcomes

Passion moderates the relationship between exercise identity and compulsive exercise

There remains limited understanding and mixed results around predictors of compulsive exercise, especially outside of eating disorder populations and settings. Research is also limited by operationalisation of compulsive exercise as a unidimensional construct, despite evidence that it is best understood and examined as multi-dimensional. Given that compulsive exercise is also observed in the general exercise population, increased understanding around predictors of compulsive exercise is needed. This study examined the relationship between dimensions of compulsive exercise (Compulsive Exercise Test) with obsessive and harmonious passion (the Passion Scale) and exercise identity (the Exercise Identity Scale) in a sample of N = 1184 Australian general exercisers. Correlation, regression and moderation analyses indicated that exercise identity was associated with all dimensions of compulsive exercise, although strength and direction of relationships varied. Harmonious passion was related to several dimensions of compulsive exercise and also moderated relationships between identity with weight-control exercise, mood improvement and lack of exercise enjoyment, whereas obsessive passion moderated the relationship between identity and lack of exercise enjoyment only. Results highlight that compulsive exercise dimensions have nuanced relationships with other variables and that examination of dimensions can increase understanding around compulsive exercise. Harmonious passion predicted more aspects of compulsive exercise than obsessive passion. Individuals with high exercise identity, and those with low harmonious passion may be more at risk of poor outcomes including compulsive exercise pathology and other related outcomes

Nfatc1's Role in Mammary Epithelial Morphogenesis and Basal Stem/progenitor Cell Self-renewal.

Mammary gland is an outstanding system to study the regulatory mechanisms governing adult epithelial stem cell activity. Stem cells in the basal layer of the mammary gland fuel the morphogenesis and regeneration of a complex epithelial network during development and upon transplantation. The self-renewal of basal stem/progenitor cells is subjected to regulation by both cell-intrinsic and extrinsic mechanisms. Nfatc1 is a transcription factor that regulates breast tumorigenesis and metastasis, but its role in mammary epithelial development and stem cell function has not been investigated. Here we show that Nfatc1 is expressed in a small subset of mammary basal epithelial cells and its epithelial-specific deletion results in mild defects in side branching and basal-luminal cell balance. Moreover, Nfatc1-deficient basal cells exhibit reduced colony forming ability in vitro and somewhat compromised regenerative potential upon transplantation. Thus, our study provides evidence for a detectable yet non-essential role of Nfatc1 in mammary epithelial morphogenesis and basal stem/progenitor cell self-renewal

Symptoms of depression and risk of emergency department visits among people aged 70 years and over

Abstract Background Older people experiencing depression and anxiety have higher rates of health service utilisation than others, but little is known about whether these influence their seeking of emergency care. The aim was to examine the associations between symptoms of depression and the use of emergency health care, in an Australian context, among a population of people aged 70 years and over initially free of cardiovascular disease, dementia or major physical disability. Methods We undertook secondary analyses of data from a large cohort of community-dwelling Australians aged $$\ge$$ 70 years. Multivariable logistic regression was used to compare the association of symptoms of depression (measured using the Center for Epidemiological Studies Depression Scale 10 question version, CESD at baseline) with subsequent episodes of emergency care, adjusting for physical and social factors of clinical interest. Marginal adjusted odds ratios were calculated from the logistic regression. Results Data were available for 10,837 Australian participants aged at least 70 years. In a follow-up assessment three years after the baseline assessment, 17.6% of people self-reported an episode of emergency care (attended an ED of called an emergency ambulance) in the last 12 months. Use of emergency healthcare was similar for men and women (17.8% vs. 17.4% p = 0.61). A score above the cut-off on the CESD at baseline was associated with greater use of emergency health care (OR = 1.35, 95% CI 1.11,1.64). When modelled separately, there was a greater association between a score above the cut-off on the CESD and emergency healthcare for women compared with men. Conclusions This study is unique in demonstrating how depressive symptoms among healthy older persons are associated with subsequent increased use of emergency healthcare. Improved understanding and monitoring of mental health in primary care is essential to undertake effective healthcare planning including prevention of needing emergency care

Cohort profile: investigating SARS-CoV-2 infection and the health and psychosocial impact of the COVID-19 pandemic in the Canadian CHILD Cohort

The coronavirus disease 2019 (COVID-19) pandemic has affected all Canadian families, with some impacted differently than others. Our study aims to: (1) determine the prevalence and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Canadian families, (2) identify predictors of infection susceptibility and severity of SARS-CoV-2, and (3) identify health and psychosocial impacts of the COVID-19 pandemic. This study builds upon the CHILD Cohort Study, an ongoing multi-ethnic general population prospective cohort consisting of 3,454 Canadian families with children born in Vancouver, Edmonton, Manitoba, and Toronto between 2009 and 2012. During the pandemic, CHILD households were invited to participate in the CHILD COVID-19 Add-On Study involving: (1) brief biweekly surveys about COVID-19 symptoms and testing; (2) quarterly questionnaires assessing COVID-19 exposure and testing, vaccination status, physical and mental health, and pandemic-driven life changes; and (3) in-home biological sampling kits to collect blood and stool. In total, 1,462 households (5,378 participants) consented to the CHILD COVID-19 Add-On Study: 2,803 children (mean±standard deviation [SD], 9.0±2.7 years; range, 0-17 years) and 2,576 adults (mean±SD, 43.0±6.5 years; range, 18-85 years). We will leverage the wealth of pre-pandemic CHILD data to identify risk and resilience factors for susceptibility and severity to the direct and indirect pandemic effects. Our short-term findings will inform key stakeholders and knowledge users to shape current and future pandemic responses. Additionally, this study provides a unique resource to study the long-term impacts of the pandemic as the CHILD Cohort Study continues