Understanding motivations and concerns surrounding COVID-19 vaccine uptake is important to reduce vaccine hesitancy and inform strategies to mitigate concerns and increase vaccine uptake. This study aimed to explore motivations and concerns associated with COVID-19 vaccination among adults seeking their first COVID-19 vaccine in a regional Australian community with low prevalence of COVID-19, who received a medical consult prior to vaccination. Medical records from consults were audited and the modified Framework Method was used to conduct qualitative content analysis of data, generating themes and overall core concepts related to motivations for COVID-19 vaccination and associated concerns. There were 102 people included in the study, 81% of whom were aged ≥60 years. Concerns surrounding COVID-19 vaccination included five core concepts: 1. Perceived vaccine risks, 2. Perceived vaccine performance, 3. Uncertainty, 4. Autonomy, and 5. Fairness in access; and a further five core concepts were generated from motivations to seek vaccination: 1. Protection, 2. Occupational or facility responsibility or requirement, 3. Trust in primary healthcare physician, 4. Autonomy, and 5. Civic duty. These motivating factors and concerns can be used to inform strategies and education to increase vaccine uptake in ongoing and future vaccine rollouts.
Background Previous studies have yielded conflicting results on the association between human cytomegalovirus (HCMV) and cardiovascular disease (CVD). This study aimed to examine associations between HCMV and incident CVD, ischaemic heart disease (IHD) and stroke. Methods This study included 8,531 women and men of predominantly white ethnic background, aged 40–69 without prevalent CVD from the population-based UK Biobank study recruited between 2006–2010 with HCMV antibody levels measured. CVD was ascertained via linkage to health administrative records collected up to 2020. Multivariate Cox proportional-hazards models were used to determine the association between HCMV seropositivity and incident CVD, IHD and stroke. HCMV seropositive antibody levels were split into tertiles to assess dose-response associations. Results Over a mean follow-up period of 10.2 years, HCMV seropositivity was not significantly associated with CVD (Cases = 626, Hazard Ratio (HR) =1.01, 95% Confidence Interval (CI) 0.86–1.20), IHD (Cases = 539, HR=1.03, 95% CI 0.87–1.24) or stroke (Cases = 144, HR=0.96, 95% CI 0.68–1.36). There was no evidence of dose-response associations with any outcome. Conclusion We found no significant association between HCMV seropositivity and risk of CVD, IHD or stroke. Further research within understudied populations, such as those of non-white ethnicity, and other CVD subtypes is warranted.
Chronic infection with hepatitis B virus (HBV) is a significant public health issue in China. Understanding factors associated with chronic HBV is important to enable targeted screening and education and to improve early diagnosis and prevention of disease progression. This systematic review and meta‐analysis aimed to identify and describe correlates of chronic HBV among Chinese adults. Searches were conducted in MEDLINE, EMBASE and grey literature up to 25 June 2020. Eligible papers included observational studies in adults of the general population in China that reported factors associated with chronic HBV, measured by Hepatitis B surface antigen (HBsAg). Meta‐analysis was performed using fixed‐effect models of HBsAg prevalence among factors, and of adjusted odds ratios (ORs) for chronic HBV associated with each factor. Overall 39 articles were included, covering 22 factors, including a range of sociodemographic, behavioural and medical factors. In meta‐analysis of eligible studies, a range of factors were significantly associated with higher HBsAg prevalence, including middle age, male sex, being married, rural residence, lower education, smoking, having a HBsAg positive household contact, family history of HBV, history of surgery or blood transfusion. The adjusted ORs varied, from 1.11 (95% CI 1.05–1.18) for smoking to 5.13 (95% CI 4.99–5.26) for having a HBsAg positive household contact. In Chinese adults, a range of factors are associated with chronic HBV infection, which may help inform targeted screening in the general population.
Background The Townsville Hospital is a tertiary hospital in North Queensland with one of the largest regional transplant centres in Australia, performing primarily autologous haemopoietic stem cell transplants (HSCT) for various haematological malignancies. Aims This single‐centre, retrospective, observational study aims to describe the activity and outcomes of autologous HSCT at The Townsville Hospital between 2003 and 2017 to verify safety standards. Methods Patient‐level data were collected, including demographics, frequency and indication for transplant, conditioning, current clinical status and cause of death. Key outcomes included overall survival, non‐relapse mortality, incidence of therapy‐related neoplasm and causes of death. Progression‐free survival in the multiple myeloma (MM) subgroup was also assessed. Results There were 319 autologous HSCT in 286 patients, with a median age of 58 years (range 14–71 years); 62% of patients were male. Indications for transplantation were: MM 53.7%, non‐Hodgkin lymphoma 29.4%, Hodgkin lymphoma 5.0% and other 11.9%. Causes of death were: disease progression/relapse (65.2%), second malignancy (17.0%), infection (9.8%) and other (8.0%). Non‐relapse mortality was 1.2% (95% confidence interval 0.4–3.0) and 3.2% (1.7–5.7) at 100 days and 1 year, respectively, post‐HSCT. Overall survival at 2 years was 81.0% (73.8–86.4) for MM and 69.6% (58.8–78.1) for non‐Hodgkin lymphoma. The median progression‐free survival in the MM cohort was 3.3 years. Conclusion The Townsville Hospital transplant centre provides an important transplant service in regional Queensland, with outcomes comparable to national data. We reported a relatively high rate of second malignancy as a cause of death.
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