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Parent decision-making in vaccinating children against COVID-19 – Open Access Government

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Study examines the scientific evidence, political and social pressures parents face when vaccinating children

Deciding whether to vaccinate your child against SARS-CoV-2 is complex. Parents are influenced by everything from scientific evidence, political and social pressures, and views about individual versus collective benefits of vaccinating children says a new study published in CMAJ (Canadian Medical Association Journal).

In order to understand what influenced a parent’s decision to vaccinate a child – or not – researchers conducted a qualitative study with in-depth interviews with 20 parents. The aim of the study is to support future vaccination initiatives.

“Given the observed discrepancy between parental intention and the decision to vaccinate their children against SARS-CoV-2, it is important to understand how and why parents make their decisions,” explains Dr. Jonathon Maguire, a pediatrician at St. Michael’s Hospital, a site of Unity Health Toronto, and the University of Toronto.

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“Understanding the factors that influence parents’ decisions about SARS-CoV-2 vaccination for their children would help improve public health policies and interventions as well as inform health care professionals about parents’ perspectives and concerns.”

Exploring decision-making regarding vaccinating children

There have only been a few previous studies that have looked at how parents make decisions to vaccinate or not vaccinate their children once they are eligible for vaccination.

Most parents involved in the study found the topic of vaccinating children a challenging one. Parents had the following considerations:

  • How recent SARS-CoV-2 vaccines are evidence supporting their use
  • Perceived politicization of vaccination guidance
  • Societal pressures surrounding SARS-CoV-2 vaccination
  • Weighing up the individual versus collective benefits of vaccination

These findings have implications for communicating information on SARS-CoV-2 vaccination.

“Future guidance should highlight both individual and collective benefits of SARS-CoV-2 vaccination for children; however, healthcare providers should prioritize individualized discussions with parents to help interpret evidence, consider their understanding of risks and benefits, and provide tailored recommendations,” said Dr. Janet Parsons, a research scientist at St. Michael’s Hospital, a site of Unity Health Toronto, and an associate professor at the University of Toronto.

Healthcare providers must support parental decision-making

Dr Parsons concludes, “It is important for health care providers to understand that parents who seem hesitant to vaccinate their children may have a variety of reasons for feeling this way and maybe reticent to ask questions to health care providers for fear of stigma”.

The authors recommend that these conversations surrounding vaccinating children are approached with empathy and openness.

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'Worrisome' deadly fungus spreading through US at alarming rate – Sky News

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A drug-resistant and potentially deadly fungus is spreading rapidly through US health facilities, according to a government study.

Researchers from the Centres for Disease Control and Prevention (CDC) reported the fungus, a type of yeast called Candida auris or C. auris, can cause severe illness in people with weakened immune systems.

The number of people diagnosed, as well as the number who were found through screening to be carrying C. auris, has been rising at an alarming rate since the fungus was first reported in the US in 2016.

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Image:
A strain of Candida auris cultured in a petri dish at the Centers for Disease Control and Prevention (CDC) in 2019

The fungus was identified in 2009 in Asia, but scientists have said C. auris first appeared around the world about a decade earlier.

Dr Meghan Lyman, chief medical officer of the CDC’s mycotic diseases branch, said the increases, “especially in the most recent years, are really concerning to us”.

“We’ve seen increases not just in areas of ongoing transmission, but also in new areas,” she said.

Dr Lyman also said she was concerned about the increasing number of fungus samples resistant to the common treatments for it.

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Dr Waleed Javaid, an epidemiologist and director of infection prevention and control at Mount Sinai Downtown in New York, said the fungus was “worrisome”.

“But we don’t want people who watched ‘The Last Of Us’ to think we’re all going to die,” Dr Javaid said.

“This is an infection that occurs in extremely ill individuals who are usually sick with a lot of other issues.”

Read more:
Is The Last Of Us’ real ‘zombie’ fungus an actual threat?

The fungus, which can be found on the skin and throughout the body, is not a threat to healthy people.

But about one-third of people who become sick with C. auris die.

The fungus has been detected in more than half of all US states. The number of infections in the US increased by 95% between 2020 and 2021.

Read more:
Species of fungus discovered in Scotland
Fungal infections ‘increased significantly’ during COVID pandemic

The new research comes as Mississippi is facing a growing outbreak of the fungus.

Since November, 12 people in the state have been infected with four “potentially associated deaths”, according to the state’s health department.

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More dead birds found in Caledon could be linked to bird flu

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Possible cases of bird flu have been found in Caledon as potential outbreaks of the virus are popping up in Brampton and across southern Ontario.

The City of Brampton issued a warning about two possible avian flu incidents on Friday after dead birds were found in the area of Professor’s Lake and Duncan Foster Valley South.​

Now the Town of Caledon says a number of dead birds have also been found in a pond near Coleraine Dr. and Harvest Moon Dr. and that the deaths may be related to bird flu.

The Town has closed a trail in the area out of precaution and says testing is being conducted by the Canadian Wildlife Health Cooperative to determine the birds’ cause of death.

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Peel Public Health says that while avian influenza is a threat to birds, the risk to humans is very low.

“Most cases of human avian flu have been traced to handling infected poultry or their droppings,” said Dr. Nicholas Brandon, acting Medical Officer of Health for PPH. “Residents are asked to follow the recommended guidance to limit the spread of avian flu and protect the health and safety of residents and pets.”

Peel Public Health is recommending residents and pet owners are asked to take the following precautions:

  • Keep animals away from any waterfowl or fecal matter
  • Do not feed or otherwise interact with the waterfowl
  • Keep cats indoors
  • Keep dogs on a leash (as required under the municipal by-law)
  • Do not feed pets (e.g., dogs or cats) any raw meat from game birds or poultry
  • Pet birds, if not normally kept indoors, should be restricted to the indoors
  • Bird feeders should be removed or washed with soap and water frequently to reduce the chance of bacterial or viral contamination

The cause of the birds’ death in all three of the cases in Peel has not been confirmed but Brampton Animal Services is actively monitoring the areas.

If the birds test negative for Avian Influenza a full necropsy will be conducted to determine the cause of death, the City of Brampton said on Friday.

Last week the Toronto Zoo shut down some of its bird enclosures after an avian flu case was detected at a southern Ontario poultry farm.

A highly pathogenic type of H5N1 avian flu has been tearing through Canadian flocks since early 2022, killing millions of birds and infecting a record number of avian species.

The Canadian Food Inspection Agency detected a case at a commercial poultry operation southeast of Hamilton on Tuesday, the second reported Ontario site in a week after a lull in detected cases going back to the end of December.

With files from The Canadian Press

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Developing postoperative delirium associated with a faster rate of cognitive decline, says study

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Credit: Unsplash/CC0 Public Domain

Research published today (March 20) in the JAMA Internal Medicine finds that developing postoperative delirium is associated with a 40% faster rate of cognitive decline over those who do not develop delirium.

“Delirium is associated with faster cognitive decline,” said Zachary J. Kunicki, Ph.D., MS, MPH Assistant Professor located at the Warren Alpert Medical School of Brown University, the first author. “Whether causes this faster rate of decline, or is simply a marker of those who are at risk of experiencing faster rates of decline, is still to be determined.”

“This study has the longest follow-up period of any study examining persons with delirium following ,” said Sharon K. Inouye, MD, MPH Director, Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research, the senior author and principal investigator on the work. “While future studies are needed, this study raises the possibility that delirium may predispose to permanent cognitive decline and potentially dementia. This highlights the importance of delirium prevention to preserve brain health in who undergo surgery,” she said.

Delirium is the most common post-operative complication in older adults and is associated with poor outcomes, including long-term cognitive decline and incident dementia.

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Richard N. Jones, ScD, Warren Alpert Medical School of Brown University is co-senior author of the article, “Six-year cognitive trajectory in older adults following and delirium.”

“The SAGES cohort has followed 560 older adults (age 70 and older), measuring their cognition every six months for 36 months, then annually afterwards for up to six years. Using a detailed cognitive testing battery, comprised of 11 different tests, we found that cognitive changes after surgery are complex and that delirium influences every timepoint. The average cognitive changes seen after surgery include an abrupt drop at one month after surgery, an increase at two months after surgery, a stable period from 6–30 months after surgery, and then steady decline from 3–6 years after surgery.

“Delirium is associated with a sharper drop at one month, greater recovery at two months, and faster decline in all time periods from six months to six years, respectively. The results suggest that either delirium itself may contribute to cognitive decline after surgery, or that delirium may serve to identify those at risk for future more rapid cognitive decline. Future research will be needed to examine whether either or both of these hypotheses best explain the relationship between delirium and ,” say the authors.

More information:
Six-Year Cognitive Trajectory in Older Adults Following Major Surgery and Delirium, JAMA Internal Medicine (2023). DOI: 10.1001/jamainternalmed.2023.0144

Provided by
Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research

Citation:
Developing postoperative delirium associated with a faster rate of cognitive decline, says study (2023, March 20)
retrieved 20 March 2023
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