Vaccine information-seeking behaviour: its predictors and influence on vaccination during pregnancy

Pregnancy represents a high information need state, where uncertainty around medical intervention is common. As such, women often engage in vaccine information-seeking behaviour, a process that involves the gathering and use of information to inform the vaccine decision-making process. If this seeking occurs outside of official healthcare system channels, many healthcare professionals are concerned that this behaviour may lead women towards less reliable, potentially misleading information. The concept of vaccine information-seeking during pregnancy therefore warrants examination. In this thesis, I present two systematic reviews and two quantitative research papers related to the topic of vaccine information-seeking behaviour. These studies investigate the predictors of and influences on vaccine information-seeking behaviour both in general and specifically relating to UK women making a decision regarding the pertussis vaccination for pregnant women. In the systematic reviews, I synthesise the literature related to the measurement of trust in vaccination and how vaccine information-seeking behaviour has previously been investigated throughout the vaccine attitude and decision-making literature. The literature from these two review papers informed the design of two quantitative questionnaire studies. The first of these investigates the determinants of satisfaction with official information and the additional information-seeking behaviour of recently pregnant women in regards to the pertussis vaccination given during pregnancy. The second investigates how previously held attitudes towards vaccination influence vaccine information-seeking behaviour, and how such behaviours may in turn influence the vaccine decision-making process. Findings from the first quantitative study indicate that a higher trust in one’s healthcare professional, a perceived ability to seek out accurate information about vaccines, and actively engaging with problems as a means of coping with stress, predicts satisfaction in the official vaccine information. While a large minority (approximately 40%) of women searched for additional information about the pregnancy pertussis vaccine during their pregnancy, neither satisfaction related to official information, nor attitudes towards vaccination, predicted vaccine information-seeking behaviour. From my second quantitative study, the length of time that individuals spend seeking information was associated with a higher perceived risk of pertussis disease and a lower confidence in vaccination. Intention to vaccinate was found to relate to the perceived influence of such found information, with higher intention to vaccinate being associated with respondents reporting that the information they found pointed them towards vaccination and lower levels of intention to vaccinate being associated with respondents reporting that the information they found pointed them away from vaccination. When I examined attitudes across the course of a pregnancy, a significant shift in risk perception occurred whereby women became more risk averse to the disease of pertussis as compared to the vaccine that protects against pertussis. This shift was not found to be associated with vaccine information-seeking behaviour, strength of vaccine recommendation for respondent’s healthcare professional or vaccine uptake. This line of research demonstrates the role of vaccine information-seeking behaviour within the vaccine decision making process. Information related to the pertussis during pregnancy vaccination is rarely judged on its own intrinsic qualities instead it is viewed through a range of pre-existing beliefs and social contexts. With midwives being the health care professional that conducts the majority of the vaccine communication in regards to this particular programme, it is vital that midwives are given the time and available resources to build strong relationships with their patients and feel that they have the self-efficacy to effectively communicate vaccine information. This would undoubtably be of benefit to the pertussis during pregnancy vaccination programme, but would also better guide women towards reliable information sources in regards to subsequent childhood vaccinations

The International Crop Information System manages geneological; phenotypic and genotypic data in a wheat breeding program

Lysyl hydroxylase 2b (LH2b) is known to increase pyridinoline cross-links, making collagen less susceptible to enzymatic degradation. Previously, we observed a relationship between LH2b and osteoarthritis-related fibrosis in murine knee joint. For this study, we investigate if transforming growth factor-beta (TGF-) and connective tissue growth factor (CTGF) regulate procollagen-lysine, 2-oxoglutarate 5-dioxygenase 2 (PLOD2) (gene encoding LH2b) and LH2b expression differently in osteoarthritic human synovial fibroblasts (hSF). Furthermore, we investigate via which TGF- route (Smad2/3P or Smad1/5/8P) LH2b is regulated, to explore options to inhibit LH2b during fibrosis. To answer these questions, fibroblasts were isolated from knee joints of osteoarthritis patients. The hSF were stimulated with TGF- with or without a kinase inhibitor of ALK4/5/7 (SB-505124) or ALK1/2/3/6 (dorsomorphin). TGF-, CTGF, constitutively active (ca)ALK1 and caALK5 were adenovirally overexpressed in hSF. The gene expression levels of PLOD1/2/3, CTGF and COL1A1 were analyzed with Q-PCR. LH2 protein levels were determined with western blot. As expected, TGF- induced PLOD2/LH2 expression in hSF, whereas CTGF did not. PLOD1 and PLOD3 were not affected by either TGF- or CTGF. SB-505124 prevented the induction of TGF--induced PLOD2, CTGF and COL1A1. Surprisingly, dorsomorphin completely blocked the induction of CTGF and COL1A1, whereas TGF--induced PLOD2 was only slightly reduced. Overexpression of caALK5 in osteoarthritic hSF significantly induced PLOD2/LH2 expression, whereas caALK1 had no effect. We showed, in osteoarthritic hSF, that TGF- induced PLOD2/LH2 via ALK5 Smad2/3P. This elevation of LH2b in osteoarthritic hSF makes LH2b an interesting target to interfere with osteoarthritis-related persistent fibrosis

Structure and superconductivity of LiFeAs

The lithium ions in Lithium iron arsenide phases with compositions close to LiFeAs have been located using powder neutron diffraction. These phases exhibit superconductivity at temperatures at least as high as 16 K demonstrating that superconductivity in compounds with [FeAs]- anti-PbO-type anionic layers occurs in compounds with at least three different structure types and occurs for a wide range of As-Fe-As bond angles.Comment: 3 pages, 3 figures, 3 table

Dilemmas in doing insider research in professional education

This article explores the dilemmas I encountered when researching social work education in England as an insider researcher who was simultaneously employed as an educator in the host institution. This was an ethnographic project deploying multiple methods and generating rich case study material which informed the student textbook Becoming a Social Worker the four-year period of the project. First, ethical dilemmas emerged around informed consent and confidentiality when conducting surveys of students and reading their portfolios. Second, professional dilemmas stemmed from the ways in which my roles as a researcher, academic tutor, social worker and former practice educator converged and collided. Third, political dilemmas pertained to the potential for the project to crystallize and convey conflicts among stakeholders in the university and community. Since the majority of research in social work education is conducted by insiders, we have a vital interest in making sense of such complexity

Climate Change and invasibility of the Antarctic benthos

Benthic communities living in shallow-shelf habitats in Antarctica (<100-m depth) are archaic in their structure and function. Modern predators, including fast-moving, durophagous (skeleton-crushing) bony fish, sharks, and crabs, are rare or absent; slow-moving invertebrates are the top predators; and epifaunal suspension feeders dominate many soft substratum communities. Cooling temperatures beginning in the late Eocene excluded durophagous predators, ultimately resulting in the endemic living fauna and its unique food-web structure. Although the Southern Ocean is oceanographically isolated, the barriers to biological invasion are primarily physiological rather than geographic. Cold temperatures impose limits to performance that exclude modern predators. Global warming is now removing those physiological barriers, and crabs are reinvading Antarctica. As sea temperatures continue to rise, the invasion of durophagous predators will modernize the shelf benthos and erode the indigenous character of marine life in Antarctica

Heterogeneity of Myc expression in breast cancer exposes pharmacological vulnerabilities revealed through executable mechanistic modeling

Cells with higher levels of Myc proliferate more rapidly and supercompetitively eliminate neighboring cells. Nonetheless, tumor cells in aggressive breast cancers typically exhibit significant and stable heterogeneity in their Myc levels, which correlates with refractoriness to therapy and poor prognosis. This suggests that Myc heterogeneity confers some selective advantage on breast tumor growth and progression. To investigate this, we created a traceable MMTV-Wnt1-driven in vivo chimeric mammary tumor model comprising an admixture of low-Myc- and reversibly switchable high-Myc-expressing clones. We show that such tumors exhibit interclonal mutualism wherein cells with high-Myc expression facilitate tumor growth by promoting protumorigenic stroma yet concomitantly suppress Wnt expression, which renders them dependent for survival on paracrine Wnt provided by low-Myc-expressing clones. To identify any therapeutic vulnerabilities arising from such interdependency, we modeled Myc/Ras/p53/Wnt signaling cross talk as an executable network for low-Myc, for high-Myc clones, and for the 2 together. This executable mechanistic model replicated the observed interdependence of high-Myc and low-Myc clones and predicted a pharmacological vulnerability to coinhibition of COX2 and MEK. This was confirmed experimentally. Our study illustrates the power of executable models in elucidating mechanisms driving tumor heterogeneity and offers an innovative strategy for identifying combination therapies tailored to the oligoclonal landscape of heterogenous tumors

Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: a cross-sectional, descriptive analysis

Background: Cochrane systematic reviews collate and summarise studies of the effects of healthcare interventions. The characteristics of these reviews and the meta-analyses and individual studies they contain provide insights into the nature of healthcare research and important context for the development of relevant statistical and other methods. Methods: We classified every meta-analysis with at least two studies in every review in the January 2008 issue of the Cochrane Database of Systematic Reviews (CDSR) according to the medical specialty, the types of interventions being compared and the type of outcome. We provide descriptive statistics for numbers of meta-analyses, numbers of component studies and sample sizes of component studies, broken down by these categories. Results: We included 2321 reviews containing 22,453 meta-analyses, which themselves consist of data from 112,600 individual studies (which may appear in more than one meta-analysis). Meta-analyses in the areas of gynaecology, pregnancy and childbirth (21%), mental health (13%) and respiratory diseases (13%) are well represented in the CDSR. Most meta-analyses address drugs, either with a control or placebo group (37%) or in a comparison with another drug (25%). The median number of meta-analyses per review is six (inter-quartile range 3 to 12). The median number of studies included in the meta-analyses with at least two studies is three (interquartile range 2 to 6). Sample sizes of individual studies range from 2 to 1,242,071, with a median of 91 participants. Discussion: It is clear that the numbers of studies eligible for meta-analyses are typically very small for all medical areas, outcomes and interventions covered by Cochrane reviews. This highlights the particular importance of suitable methods for the meta-analysis of small data sets. There was little variation in number of studies per metaanalysis across medical areas, across outcome data types or across types of interventions being compared