Examining Perceptions about Mandatory Influenza Vaccination of Healthcare Workers through Online Comments on News Stories

Background

The aim of this study was to understand online public perceptions of the debate surrounding the choice of annual influenza vaccinations or wearing masks as a condition of employment for healthcare workers, such as the one enacted in British Columbia in August 2012.

Methods

Four national and 82 local (British Columbia) Canadian online news sites were searched for articles posted between August 2012 and May 2013 containing the words “healthcare workers” and “mandatory influenza vaccinations/immunizations” or “mandatory flu shots and healthcare workers.” We included articles from sources that predominantly concerned our topic of interest and that generated reader comments. Two researchers coded the unedited comments using thematic analysis, categorizing codes to allow themes to emerge. In addition to themes, the comments were categorized by: 1) sentiment towards influenza vaccines; 2) support for mandatory vaccination policies; 3) citing of reference materials or statistics; 4) self-identified health-care worker status; and 5) sharing of a personal story.

Results

1163 comments made by 648 commenters responding to 36 articles were analyzed. Popular themes included concerns about freedom of choice, vaccine effectiveness, patient safety, and distrust in government, public health, and the pharmaceutical industry. Almost half (48%) of commenters expressed a negative sentiment toward the influenza vaccine, 28% were positive, 20% were neutral, and 4% expressed mixed sentiment. Of those who commented on the policy, 75% did not support the condition to work policy, while 25% were in favour. Of the commenters, 11% self-identified as healthcare workers, 13% shared personal stories, and 18% cited a reference or statistic.

Interpretation

The perception of the influenza vaccine in the comment sections of online news sites is fairly poor. Public health agencies should consider including online forums, comment sections, and social media sites as part of their communication channels to correct misinformation regarding the benefits of HCW influenza immunization and the effectiveness of the vaccine.     

基于网络点评数据的园林展会后利用评价研究

随着互联网的快速发展和大数据技术的应用,网络点评数据成为获取游客游览景区后体验感知的重要手段。从使用者的角度出发,构建基于网络点评数据的园林展会后利用评价体系,利用网络点评数据对园林展会后利用的各项因素进行分析和评价,从中总结出目前园林展会后利用面临的突出问题,并针对这些问题提出相关建议,以期为中国未来园林展会后利用提供可持续发展的新思路。     

Acceptability of HPV Vaccines and Associations with Perceptions Related to HPV and HPV Vaccines Among Men Who Have Sex with Men in Hong Kong

HPV vaccines are available to men but there are few studies investigating the acceptability of HPV vaccines among men who have sex with men (MSM), a high risk group. We assessed the intention to take up HPV vaccines among MSM in Hong Kong and the associated factors related to cognitions on HPV and HPV vaccines, basing on the Health Belief Model (n = 542). The acceptability of HPV vaccines was 20% (unconditional on efficacies and price), 29.2% (conditional on efficacies and market price), 51.7% (conditional on efficacies and discounted price) and 79.1% (conditional on efficacies and free price). Adjusting for background variables, composite scores of perceived susceptibility, perceived severity, perceived barriers and cue to actions were significantly associated with acceptability of HPV vaccines conditional on specific efficacies and the market price. Acceptability of HPV vaccines was highly price sensitive. Future studies need to use conditional measures. Implementation and translational researches are warranted.     

Public Perceptions of the Attractiveness of Restored Nature

Ecological restoration efforts often encounter public resistance. Recreational visitors resist imposition of restoration efforts they fear may result in a visually unattractive area. Public support is, however, essential for restoration efforts on public lands. This study seeks insight into hiker perceptions of perceived attractiveness of nature before and after efforts to restore exotic conifer plantations to native communities containing bog and wet forest communities. Visitors (N = 247) to a Dutch National Park sorted 32 photographs depicting landscapes before and after restoration efforts. Findings show that the most attractive landscape types (bog and wet forest communities containing visible water) are results of restoration efforts and the least attractive landscape types (young deciduous and coniferous forest) are representative of traditional nature before restoration. However, the “middle category” consists of landscape types existing both before and after restoration efforts. Visitors value old coniferous and old deciduous forests as much as products of restoration that lack water. These perceptions are unrelated to either visitor characteristics or the provision of information to visitors explaining restoration goals. The continued existence of resistance to restoration strategies despite their effect on perceived landscape attractiveness implies that the experience of nature has more than only visual dimensions. We expect that more acceptable results of restoration efforts will emerge from the active engagement of the public before restoration practices take place in processes that specifically address feelings of attachment and resistance to change.     

Impact of Vaccination on 14 High-Risk HPV Type Infections: A Mathematical Modelling Approach

The development of high-risk human papillomavirus (hrHPV) infection to cervical cancer is a complicated process. We considered solely hrHPV infections, thus avoiding the confounding effects of disease progression, screening, and treatments. To analyse hrHPV epidemiology and to estimate the overall impact of vaccination against infections with hrHPVs, we developed a dynamic compartmental transmission model for single and multiple infections with 14 hrHPV types. The infection-related parameters were estimated using population-based sexual behaviour and hrHPV prevalence data from Finland. The analysis disclosed the important role of persistent infections in hrHPV epidemiology, provided further evidence for a significant natural immunity, and demonstrated the dependence of transmission probability estimates on the model structure. The model predicted that vaccinating girls at 80% coverage will result in a 55% reduction in the overall hrHPV prevalence and a higher 65% reduction in the prevalence of persistent hrHPV infections in females. In males, the reduction will be 42% in the hrHPV prevalence solely by the herd effect from the 80% coverage in girls. If such high coverage among girls is not reached, it is still possible to reduce the female hrHPV prevalence indirectly by the herd effect if also boys are included in the vaccination program. On the other hand, any herd effects in older unvaccinated cohorts were minor. Limiting the epidemiological model to infection yielded improved understanding of the hrHPV epidemiology and of mechanisms with which vaccination impacts on hrHPV infections.     

Analysis of Risk-Structured Vaccination Model for the Dynamics of Oncogenic and Warts-Causing HPV Types

A new deterministic model is designed and used to assess the community-wide impact of mass vaccination of new sexually active individuals on the dynamics of the oncogenic and warts-causing HPV types. Rigorous qualitative analyses of the model, which incorporates the two currently available anti-HPV vaccines, reveal that it undergoes competitive exclusion when the reproduction of one HPV risk type (low/high) exceeds unity, while that of the other HPV risk type is less than unity. For the case when the reproduction numbers of the two HPV risk types (low/high) exceed unity, the two risk types co-exist. It is shown that the sub-model with the low-risk HPV types only has at least one endemic equilibrium whenever the associated reproduction threshold exceeds unity. Furthermore, this sub-model undergoes a re-infection-induced backward bifurcation under certain conditions. In the absence of the re-infection of recovered individuals and cancer-induced mortality in males, the associated disease-free equilibrium of the full (risk-structured) model is shown to be globally asymptotically stable whenever the reproduction number of the model is less than unity (that is, the full model does not undergo backward bifurcation under this setting). It is shown, via numerical simulations, that the use of the Gardasil vaccine could lead to the effective control of HPV in the community if the coverage rate is in the range of 73–95 % (84 %). If 70 % of the new sexually active susceptible females are vaccinated with the Gardasil vaccine, additionally vaccinating 34–56 % (45 %) of the new sexually active susceptible males can lead to the effective community-wide control (or elimination) of the HPV types.     

Impact of Visual Context on Public Perceptions of Non-Human Primate Performers

Prior research has shown that the use of apes, specifically chimpanzees, as performers in the media negatively impacts public attitudes of their conservation status and desirability as a pet, yet it is unclear whether these findings generalize to other non-human primates (specifically non-ape species). We evaluated the impact of viewing an image of a monkey or prosimian in an anthropomorphic or naturalistic setting, either in contact with or in the absence of a human. Viewing the primate in an anthropomorphic setting while in contact with a person significantly increased their desirability as a pet, which also correlated with increased likelihood of believing the animal was not endangered. The majority of viewers felt that the primates in all tested images were “nervous.” When shown in contact with a human, viewers felt they were “sad” and “scared”, while also being less “funny.” Our findings highlight the potential broader implications of the use of non-human primate performers by the entertainment industry.     

Cost of Preventing,Managing, and Treating Human Papillomavirus (HPV)-Related Diseases in Sweden before the Introduction of Quadrivalent HPV Vaccination

Objective

Costs associated with HPV-related diseases such as cervical dysplasia, cervical cancer, and genital warts have not been evaluated in Sweden. These costs must be estimated in order to determine the potential savings if these diseases were eradicated and to assess the combined cost-effectiveness of HPV vaccination and cervical cancer screening. The present study aimed to estimate prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts from a societal perspective in Sweden in 2009, 1 year before the quadrivalent HPV vaccination program was implemented.

Methods and Materials

Data from the Swedish cervical cancer screening program was used to calculate the costs associated with prevention (cytological cervical cancer screening), management (colposcopy and biopsy following inadequate/abnormal cytological results), and treatment of CIN. Swedish official statistics were used to estimate treatment costs associated with cervical cancer. Published epidemiological data were used to estimate the number of incident, recurrent, and persistent cases of genital warts; a clinical expert panel assessed management and treatment procedures. Estimated visits, procedures, and use of medications were used to calculate the annual cost associated with genital warts.

Results

From a societal perspective, total estimated costs associated with cervical cancer and genital warts in 2009 were €106.6 million, of which €81.4 million (76%) were direct medical costs. Costs associated with prevention, management, and treatment of CIN were €74 million; screening and management costs for women with normal and inadequate cytology alone accounted for 76% of this sum. The treatment costs associated with incident and prevalent cervical cancer and palliative care were €23 million. Estimated costs for incident, recurrent and persistent cases of genital warts were €9.8 million.

Conclusion

Prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts are substantial. Defining these costs is important for future cost-effectiveness analyses of the quadrivalent HPV vaccination program in Sweden.     

Effects of Reading Health and Appearance Exercise Magazine Articles on Perceptions of Attractiveness and Reasons for Exercise

Objective

To examine the effects of reading exercise-related magazine articles (health, appearance, or control) and the moderating effects of exercise self-identity on reasons for exercise and perceptions of attractiveness, among women in first year university. An additional purpose was to use a thought listing technique, the results of which were examined for evidence of internalization of the exercise-related messages.

Participants

Female students in their first year of studies between September 2010 and April 2011 (N = 173; mean age = 19.31 years, mean body mass index = 22.01).

Methods

Participants read a health, appearance, or control article, listed thoughts, and completed questionnaires measuring reasons for exercising, physical self-perception, and exercise self-identity.

Results

Participants in the health condition rated exercise for health significantly higher than control condition participants. Participants with high exercise self-identity rated attractiveness as a reason for exercising significantly higher than low exercise self-identity participants in both the health and appearance conditions. Participants with higher internalization scores (i.e., accepted societal norms of appearance) reported exercising for attractiveness reasons more so than participants with lower internalization scores.

Conclusions

The good news is that health messages may be influential and result in wanting to exercise for health purposes. However, exercising for attractiveness was rated highly by participants with high exercise identity who read either the health or appearance articles. Health and appearance are not necessarily distinct concepts for female undergraduate students and the media may influence cited reasons for exercise.