Vaccine hesitancy in cancer patients: A rapid review.

INTRODUCTION: Vaccination is a key strategy to limit the impact of the COVID-19 pandemic, among vulnerable groups such as cancer patients. However, COVID-19 vaccine hesitancy is limiting vaccination uptake in this population as in others. This study aimed to synthesise the emerging literature on vaccine hesitancy in this population and in Oncology health professionals, reasons for and factors associated with hesitancy, and interventions that address hesitancy. METHODS: A rapid review was undertaken PubMed, Ovid and Google across all years up to October 2021 for articles in English, from any country or region, addressing the above issues. Individual case studies, opinion pieces, commentary articles and conference abstracts were excluded. Article screening, data extraction and bias assessment were conducted by two authors. A narrative synthesis of the data was undertaken. RESULTS: Eighteen eligible articles were identified. Reported COVID-19 vaccine hesitancy rates varied from 76.7 % to 3.9 %, with a mean of 38.4 %. A large international study (n > 20,000) reported a more conservative hesitancy rate of 19 %. Six broad, common reasons for hesitancy were identified. Oncologist advice was valued by patients. DISCUSSION: Vaccine hesitancy remains a significant concern in the oncology context. Oncologists are key to addressing hesitancy and providing tailored advice to cancer patients. PRACTICE IMPLICATIONS: Where possible, patients appreciate personalised, tailored information about vaccination which addresses its interaction with cancer and its treatment. Education programmes for oncologists to support effective communication in this context are needed. Webinars and peer-to-peer counselling may be useful but remain to be proven.

Validation of the Knowledge of Genome Sequencing (KOGS) scale in cancer patients.

INTRODUCTION: The Knowledge of Genome Sequencing (KOGS) questionnaire was recently developed to measure knowledge of genomic sequencing (GS), with preliminary psychometric data supporting its reliability and validity. The aim of this study was to test the reliability and validity of the KOGS in a larger sample, and to confirm its utility in a cancer setting. METHODS: The Genetic Cancer Risk in the Young (RisC) study recruits participants with a personal history of cancer, to investigate heritable cancer causes and future cancer risk using germline GS. Participants (n = 261) in a psychosocial substudy of RisC completed a questionnaire after consent to RisC but before GS, including the KOGS, the Intolerance of Uncertainty Scale, the Chew health literacy scale and items assessing demographic and disease variables. Confirmatory factor analysis (CFA), Cronbach alpha and correlational analyses were undertaken. RESULTS: The CFA testing a single-factor model yielded a good model fit, χ2/df = 2.43, comparative fit index (CFI) = 0.97, root mean square error of approximation (RMSEA) = 0.07 and weighted mean root square (WRMR) = 1.03. Factor loadings of all items were above 0.60 and ranged between.66 and.93. The single factor score demonstrated excellent internal consistency (α = 0.82). KOGS scores were significantly associated with health literacy (r = 0.23, p < .001), having a university education [t(258) = -4.53, p < .001] and having a medical or science background [t(259) = -3.52, p < .001] but not with speaking a language other than English at home, time since diagnosis, previous genetic counselling/testing or intolerance of uncertainty. DISCUSSION: This study confirmed a single-factor structure for the KOGS, and its reliability and validity in a cancer population. Associations with measures of health literacy and education were significant and positive as expected, supporting the KOG's construct validity. Previous genetic counselling may not be sufficient to provide specific knowledge of GS.

Views from senior Australian cancer researchers on evaluating the impact of their research: results from a brief survey.

BACKGROUND: The interest and activity in measuring and reporting the impact of publicly funded health and medical research has grown rapidly in recent years. Research evaluation typically relies on researchers for much of the information for an impact assessment. However, the acceptability and feasibility of this activity among health researchers is unknown. The aim of this study was to understand the role and opinions of cancer researchers in the growing area of impact evaluation activity, to inform the logistics of a sustainable program of impact evaluation. METHODS: A brief anonymous online survey was administered to 95 current and past grant recipients funded through the external grants program at Cancer Council New South Wales. Eleven survey statements were constructed with Likert responses and supplemented with two open-ended questions. The statements covered the conceptual, attitudinal and practical aspects of impact evaluation. The survey targeted researchers from the full spectrum of cancer control research classifications. Descriptive analyses obtained response frequencies and percentages. RESULTS: Forty-five cancer researchers completed the survey (response rate 47%) and 77% were Associate Professors or Professors. Responses were polarised for questions relating to engaging with research end-users, perceived time-pressure to collate data, and pressure to produce research outputs. Some researchers emphasised that quality was an important goal over quantity and warned that collecting impact data created incentives and disincentives for researchers. CONCLUSION: There was mixed support and acceptance among senior cancer researchers in Australia on their perceived role and engagement with research impact activities. Sole reliance on researchers for collating and reporting impact data may be problematic. Requesting information from researchers could be minimised and confined to final reports and possible verification of externally-led evaluations.

Immunolocalization and endocytosis of the uterine secretory protein, uteroferrin, in pre-implantation pig trophectoderm on day 11 of pregnancy.

Uteroferrin is a progesterone-induced, iron-binding glycoprotein secreted by the glandular epithelium of the pig endometrium. Evidence is presented that maternal uteroferrin is present in trophectoderm of preimplantation pig blastocysts on day 11 of pregnancy. Although [35S]-methionine was not incorporated into uteroferrin during in vitro culture of blastocysts, solubilized tissue extracts from 10-20-mm-diameter blastocysts contained uteroferrin by western blotting with monospecific antiserum to uteroferrin. Uteroferrin was detected in the apical and basolateral cytoplasm of trophectoderm by immunocytochemistry of paraffin-embedded blastocysts. Immunostaining was excluded from cells of the endoderm and the inner cell mass. Furthermore, blastocysts internalized fluorescein-labeled uteroferrin from medium during in vitro culture in a temperature-dependent manner. Fluorescent label was located in apical and basolateral cytoplasm in a punctate distribution, and clustered in the supranuclear region of trophectoderm. Addition of a threefold excess of unlabeled uteroferrin to culture medium did not inhibit uptake. These results suggest that the pre-implantation pig blastocyst actively endocytoses uteroferrin from glandular secretions in utero. Uptake was restricted to trophectoderm.

Purification, characterization, and immunocytochemical localization of the major basic protein of pig blastocysts.

The major basic protein (BP) synthesized and secreted by elongating pig blastocysts was purified from medium of Day 14-17 conceptus cultures. Sequential ion-exchange and gel-filtration chromatographies resulted in isolation of BP as a single polypeptide of Mr = 43,100 or 42,800 under denaturing or native conditions, respectively. BP was found to be a glycoprotein by incorporation of [3H] glucosamine and susceptibility to N-glycopeptidase F. Two BP polypeptides were produced by N-glycopeptidase F (Mr = 39,800 and 36,300). Antiserum to BP immunoprecipitated radiolabeled BP from blastocyst culture medium. BP was not detected in medium from 1-2 mm diameter spherical (Day 10) blastocysts but was found in medium from 3-5 mm spherical (Day 10) and filamentous (less than 50 cm, Day 12) conceptuses, suggesting that BP synthesis and secretion began at the initiation of trophoblast expansion. With immunocytochemical procedures, BP was located in the apical cytoplasm of trophectoderm cells of Day 11 expanding (5-7 and 10-20 mm) blastocysts. These results suggest that trophoblast epithelium secrete BP apically toward the uterine lumen and that BP may play a role in maternal-fetal interactions during the peri-implantation period.