Understanding parental hesitancy toward children's COVID-19 vaccinations: The influence of government, media and interpersonal communication

In March 2022, the UK Health Security Agency and the National Health Service issued guidance for parents of children aged 5–11 concerning vaccinations. The guidance stated that parents of all children in this age bracket should be offered the chance to have their child vaccinated and that the procedure was particularly important for children who have health conditions that put them at high risk. However, expressions of child vaccine hesitancy rose steeply in the UK at the start of 2022 with 35.4% of primary school parents saying they were unlikely to vaccinate their children. Vaccination programmes are part of the global strategy for mitigating the effects of coronavirus disease, but their effectiveness is reliant upon high levels of uptake and administration. Vaccine hesitancy, for children in particular is an important concern, given that children can play a major role in coronavirus transmission within both families and schools. Listening to parental perspectives regarding the decision-making processes for vaccinating this age group, becomes fundamental in understanding childhood vaccine intentions. Through the analysis of semi-structured interviews, this paper is able to reveal detailed qualitative insights into the thoughts of UK parents and their attitudes toward children's vaccinations that quantitative statistics are otherwise unable to show. In the following article, we have identified a triangular relationship between government, media and interpersonal communication in shaping parental perspectives, leading to a mixture of both “pro-vax” and “anti-vax” attitudes [often simultaneously] in regards to the vaccination or non-vaccination of children. Our data provides original findings that will inform both policymakers and practitioners, building upon and extending the existing vaccination literature, furthering current debate and guiding future research.</jats:p

Understanding parental hesitancy towards children's Covid-19 vaccinations:the influence of government, media and interpersonal communication

In March 2022, the UK Health Security Agency and the National Health Service issued guidance for parents of children aged 5–11 concerning vaccinations. The guidance stated that parents of all children in this age bracket should be offered the chance to have their child vaccinated and that the procedure was particularly important for children who have health conditions that put them at high risk. However, expressions of child vaccine hesitancy rose steeply in the UK at the start of 2022 with 35.4% of primary school parents saying they were unlikely to vaccinate their children. Vaccination programmes are part of the global strategy for mitigating the effects of coronavirus disease, but their effectiveness is reliant upon high levels of uptake and administration. Vaccine hesitancy, for children in particular is an important concern, given that children can play a major role in coronavirus transmission within both families and schools. Listening to parental perspectives regarding the decision-making processes for vaccinating this age group, becomes fundamental in understanding childhood vaccine intentions. Through the analysis of semi-structured interviews, this paper is able to reveal detailed qualitative insights into the thoughts of UK parents and their attitudes toward children's vaccinations that quantitative statistics are otherwise unable to show. In the following article, we have identified a triangular relationship between government, media and interpersonal communication in shaping parental perspectives, leading to a mixture of both “pro-vax” and “anti-vax” attitudes [often simultaneously] in regards to the vaccination or non-vaccination of children. Our data provides original findings that will inform both policymakers and practitioners, building upon and extending the existing vaccination literature, furthering current debate and guiding future research

Effects of the Antimicrobial Peptide LL-37 and Innate Effector Mechanisms in Colistin-Resistant Klebsiella pneumoniae With mgrB Insertions

Background Colistin is a polypeptide antibiotic drug that targets lipopolysaccharides in the outer membrane of Gram-negative bacteria. Inactivation of the mgrB-gene is a common mechanism behind colistin-resistance in Klebsiella pneumoniae (Kpn). Since colistin is a cyclic polypeptide, it may exhibit cross-resistance with the antimicrobial peptide LL-37, and with other innate effector mechanisms, but previous results are inconclusive. Objective To study potential cross-resistance between colistin and LL-37, as well as with other innate effector mechanisms, and to compare virulence of colistin-resistant and susceptible Kpn strains. Materials/Methods Carbapenemase-producing Kpn from Oman (n = 17) were subjected to antimicrobial susceptibility testing and whole genome sequencing. Susceptibility to colistin and LL-37 was studied. The surface charge was determined by zeta-potential measurements and the morphology of treated bacteria was analyzed with electron microscopy. Bacterial survival was assessed in human whole blood and serum, as well as in a zebrafish infection-model. Results Genome-analysis revealed insertion-sequences in the mgrB gene, as a cause of colistin resistance in 8/17 isolates. Colistin-resistant (Col-R) isolates were found to be more resistant to LL-37 compared to colistin-susceptible (Col-S) isolates, but only at concentrations &gt;= 50 mu g/ml. There was no significant difference in surface charge between the isolates. The morphological changes were similar in both Col-R and Col-S isolates after exposure to LL-37. Finally, no survival difference between the Col-R and Col-S isolates was observed in whole blood or serum, or in zebrafish embryos. Conclusion Cross-resistance between colistin and LL-37 was observed at elevated concentrations of LL-37. However, Col-R and Col-S isolates exhibited similar survival in serum and whole blood, and in a zebrafish infection-model, suggesting that cross-resistance most likely play a limited role during physiological conditions. However, it cannot be ruled out that the observed cross-resistance could be relevant in conditions where LL-37 levels reach high concentrations, such as during infection or inflammation.</p

Data_Sheet_1_Effects of the Antimicrobial Peptide LL-37 and Innate Effector Mechanisms in Colistin-Resistant Klebsiella pneumoniae With mgrB Insertions.pdf

BackgroundColistin is a polypeptide antibiotic drug that targets lipopolysaccharides in the outer membrane of Gram-negative bacteria. Inactivation of the mgrB-gene is a common mechanism behind colistin-resistance in Klebsiella pneumoniae (Kpn). Since colistin is a cyclic polypeptide, it may exhibit cross-resistance with the antimicrobial peptide LL-37, and with other innate effector mechanisms, but previous results are inconclusive.ObjectiveTo study potential cross-resistance between colistin and LL-37, as well as with other innate effector mechanisms, and to compare virulence of colistin-resistant and susceptible Kpn strains.Materials/MethodsCarbapenemase-producing Kpn from Oman (n = 17) were subjected to antimicrobial susceptibility testing and whole genome sequencing. Susceptibility to colistin and LL-37 was studied. The surface charge was determined by zeta-potential measurements and the morphology of treated bacteria was analyzed with electron microscopy. Bacterial survival was assessed in human whole blood and serum, as well as in a zebrafish infection-model.ResultsGenome-analysis revealed insertion-sequences in the mgrB gene, as a cause of colistin resistance in 8/17 isolates. Colistin-resistant (Col-R) isolates were found to be more resistant to LL-37 compared to colistin-susceptible (Col-S) isolates, but only at concentrations ≥50 μg/ml. There was no significant difference in surface charge between the isolates. The morphological changes were similar in both Col-R and Col-S isolates after exposure to LL-37. Finally, no survival difference between the Col-R and Col-S isolates was observed in whole blood or serum, or in zebrafish embryos.ConclusionCross-resistance between colistin and LL-37 was observed at elevated concentrations of LL-37. However, Col-R and Col-S isolates exhibited similar survival in serum and whole blood, and in a zebrafish infection-model, suggesting that cross-resistance most likely play a limited role during physiological conditions. However, it cannot be ruled out that the observed cross-resistance could be relevant in conditions where LL-37 levels reach high concentrations, such as during infection or inflammation.</p

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)