A qualitative study of parental views of HPV vaccination in Ireland.

BACKGROUND: Despite significant evidence supporting the Human Papillomavirus (HPV) vaccine in the prevention of cervical cancer, uptake of this vaccine is below target in many countries. HPV uptake in Ireland has declined from 87% in 2014-15 to 51% in 2016-17 and currently remains suboptimal at 64.1% in 2017-18. OBJECTIVES: This study aimed to explore parental views of the HPV vaccine; elucidate specific concerns relating to this vaccine and to identify relevant influences on the decision to vaccinate against HPV to inform strategies to optimise uptake. METHODS: An in-depth qualitative study, using semi-structured interviews was conducted among parents of 11-13-year-old girls (n = 18) who had not yet been offered the HPV vaccine. Convenience sampling was used. Interviews, conducted in the Republic of Ireland over six-months in 2018, were audio-recorded, transcribed, and analysed by thematic analysis. RESULTS: Eighteen interviews were conducted (14 female and 4 male participants). Parents favoured HPV vaccination to protect their daughters and prevent disease. Barriers to vaccination included; the fear of long-term side effects, lack of knowledge and the risk versus benefit ratio. General practitioners (GPs) were identified as having a strong influence over parental vaccination decisions, as did media reports and the recent cervical screening programme controversy in Ireland. CONCLUSION: This study suggests that significant parental concerns remain to the HPV vaccine. More comprehensive information on the research surrounding this vaccine's safety profile is required. GP's may play a pivotal role in HPV vaccination going forward.

Efficacy of the CathRite system to guide bedside placement of peripherally inserted central venous catheters in critically ill patients: a pilot study.

OBJECTIVES: To assess the efficacy of the CathRite system as a tool to guide clinicians in placement of peripherally inserted central catheters (PICCs) into the superior vena cava (SVC) in critically ill patients. DESIGN: Prospective, randomised, parallel controlled trial. PARTICIPANTS AND SETTING: three8 critically ill patients (mean APACHE II score, 16.6) in a mixed medical and surgical intensive care unit from 200four to 2006. INTERVENTIONS: Participants were randomised to receive PICC placement using either the CathRite system or a standard "blind" technique (control). Peripheral vein cannulation was performed for both groups under ultrasound monitoring, and the PICC was placed using the modified Seldinger technique, with position confirmed using standard chest x-ray. MAIN OUTCOME MEASURES: Proportion of PICCs guided into the SVC; placement into the lower third of the SVC; and time to complete placement. RESULTS: There was no significant difference between groups in sex distribution or age (CathRite: 12 men, 7 women; mean age +/- SEM, 61.1 +/- 3.4 years; control: 15 men, 4 women; 55.9 +/- 4.7 years). The PICC was successfully guided into the SVC in 19 patients (100%) in the CathRite group, compared with 14 (74%) in the control group (P < 0.05). Placement of catheters into the lower third of the SVC was achieved in 14 patients (74%) in the CathRite group, compared with eight (42%) in the control group (P < 0.05). Time to completion of catheter insertion was 31.4 +/- 16.2 minutes in the CathRite group compared with 24.6 +/- 14.5 minutes in the control group (P = 0.18). CONCLUSIONS: The CathRite system enabled placement of PICCs into the SVC from peripheral insertion sites and avoided ectopic placements that occurred with the blind technique.