Vaccine Rejecting Parents' Engagement With Expert Systems That Inform Vaccination Programs.

In attempting to provide protection to individuals and communities, childhood immunization has benefits that far outweigh disease risks. However, some parents decide not to immunize their children with some or all vaccines for reasons including lack of trust in governments, health professionals, and vaccine manufacturers. This article employs a theoretical analysis of trust and distrust to explore how twenty-seven parents with a history of vaccine rejection in two Australian cities view the expert systems central to vaccination policy and practice. Our data show how perceptions of the profit motive generate distrust in the expert systems pertaining to vaccination. Our participants perceived that pharmaceutical companies had a pernicious influence over the systems driving vaccination: research, health professionals, and government. Accordingly, they saw vaccine recommendations in conflict with the interests of their child and "the system" underscored by malign intent, even if individual representatives of this system were not equally tainted. This perspective was common to parents who declined all vaccines and those who accepted some. We regard the differences between these parents-and indeed the differences between vaccine decliners and those whose Western medical epistemology informs reflexive trust-as arising from the internalization of countering views, which facilitates nuance.

Disaster preparedness and response: challenges for Australian public health nurses - a literature review.

To date, Australia has not had to respond to a nationwide catastrophic event. However, over the past decade, heat waves, bushfires, cyclones, and floods have significantly challenged Australia's disaster preparedness and the surge capacity of local and regional health systems. Given that disaster events are predicted to increase in impact and frequency, the health workforce needs to be prepared for and able to respond effectively to a disaster. To be effective, nurses must be clear regarding their role in a disaster and be able to articulate the value and relevance of this role to communities and the professionals they work with. Since almost all disasters will exert some impact on public health, it is expedient to prepare the public health nursing workforce within Australia. This paper highlights issues currently facing disaster nursing and focuses on the challenges for Australian public health nurses responding to and preparing for disasters within Australia. The paper specifically addresses public health nurses' awareness regarding their roles in disaster preparation and response, given their unique skills and central position in public health.