Vaccine discussions with parents: The experience of Australian paediatricians.

AIM: Health-care providers are crucial in maintaining parental confidence in vaccination. Health-care providers are the most commonly accessed resource by parents for vaccine-related information and are highly trusted. We investigated paediatricians' (i) frequency of vaccine discussions; (ii) specific vaccine-related topics discussed; (iii) perceived role in childhood vaccination; (iv) challenges faced when having discussions; (v) confidence in vaccine-related knowledge and communication skills; and (vi) interest in online education and training. METHODS: We invited members of the Australian Paediatric Research Network to complete an online Research Electronic Data Capture survey in 2015-2016. RESULTS: Of 383 active Australian Paediatric Research Network members, 165 (43%) completed the online survey. A total of 61% reported 'frequently' or 'almost always' having vaccine-related discussions, with 15% 'rarely' having them. 'Lack of time' was the most commonly reported barrier to having vaccine discussions (54%). Vaccine necessity was most commonly discussed (33%), followed by vaccine safety (24%), general vaccine concerns (23%) and catch-up schedules (23%). While only 25% of paediatricians lacked confidence in their vaccine-related knowledge and 11% in their communication skills, most expressed interest in online training to address vaccine knowledge (62%) and communication skills (53%). CONCLUSION: Paediatricians play a key role in maintaining public confidence in vaccination. However, opportunities to address concerns are not being maximised by Australian paediatricians. There is a need and desire for training and resources to increase vaccine knowledge and communication skills for paediatricians, to optimise the frequency and effectiveness of vaccine discussions with parents and to ensure ongoing high immunisation coverage rates in Australia.

Biomedical loopholes, distrusted state, and the politics of HIV/AIDS "cure" in Nigeria.

As socio-medical phenomena, epidemics are revealing of the cultures in which they are experienced. The HIV/AIDS epidemic in Africa exposes antecedent tensions between state and society, and, on a broader canvas, between the global north and south. As a contribution to the emerging literature on the social ramifications of HIV/AIDS, this article examines the saga of the Nigerian physician and immunologist, Dr Jeremiah Abalaka, who like other innovators in sub-Saharan Africa claims to have developed a curative HIV vaccine. Whilst articulating the social conditions that enabled Abalaka to thrive, the article explores the marked differences in the reaction to his "discovery" among state representatives, the scientific establishment, the general public, people living with HIV, and the media. Finally, the article valorizes the emergence of new actors in the African health sector, and the diversity of strategies used by ordinary people to achieve and maintain wellness.

The association between social support, intrusive thoughts, avoidance, and adjustment following an experimental cancer treatment.

A social-cognitive processing model was used to examine the association of social support with intrusive thoughts and avoidance in predicting adjustment in 53 patients receiving an experimental vaccine for the treatment of either metastatic melanoma (n=24) or metastatic renal cell cancer (n=29). Social support, intrusive thoughts/avoidance, psychological distress and quality of life were assessed on the day of the first treatment, on the day of the final treatment, and 1 month after the end of treatment during a routine follow-up visit. Social support at the beginning of treatment was negatively associated with psychological distress and positively associated with mental health quality of life (QOL) 1 month after treatment, and these associations were mediated by intrusive thoughts/avoidance at the end of treatment. There was also an interaction between social support and intrusive thoughts/avoidance at the beginning of treatment in predicting both psychological distress and mental health QOL 1 month after treatment. Specifically, for patients with lower levels of support, greater intrusive thoughts/avoidance was associated with greater psychological distress and poorer mental health QOL 1 month after treatment. However, there was no association between intrusive thoughts/avoidance and adjustment in patients with high levels of social support. These results suggest that social support buffers the negative association between intrusive thoughts/avoidance and psychological adjustment. Overall, the results are consistent with a social-cognitive processing model of post-trauma reactions among cancer patients. Our results highlight the need to assess patients' perceived support and to further develop and assess the benefits of interventions to increase patients' supportive networks and to facilitate cognitive processing of the cancer experience.