A Rapid Systematic Review of Factors Influencing COVID-19 Vaccination Uptake in Minority Ethnic Groups in the UK.

COVID-19 has disproportionately affected minority ethnic groups in the United Kingdom. To maximise the effectiveness of the vaccination programme, it is important to understand and address disparities in vaccine uptake. The aim of this review was to identify factors influencing COVID-19 vaccination uptake between minority ethnic groups in the UK. A search was undertaken in peer-reviewed databases, polling websites and grey literature from January 2020-May 2021. Studies were included if they reported data on vaccine uptake or the reasons for or against accepting the COVID-19 vaccination for minority ethnic groups in the UK. Twenty-one papers met the inclusion criteria, all of which were rated as either good or moderate quality. Ethnic minority status was associated with higher vaccine hesitancy and lower vaccine uptake compared with White British groups. Barriers included pre-existing mistrust of formal services, lack of information about the vaccine's safety, misinformation, inaccessible communications, and logistical issues. Facilitators included inclusive communications which address vaccine concerns via trusted communicators and increased visibility of minority ethnic groups in the media. Community engagement to address the concerns and informational needs of minority ethnic groups using trusted and collaborative community and healthcare networks is likely to increase vaccine equity and uptake.

A machine learning PROGRAM to identify COVID-19 and other diseases from hematology data.

AIM: We propose a method for screening full blood count metadata for evidence of communicable and noncommunicable diseases using machine learning (ML). MATERIALS & METHODS: High dimensional hematology metadata was extracted over an 11-month period from Sysmex hematology analyzers from 43,761 patients. Predictive models for age, sex and individuality were developed to demonstrate the personalized nature of hematology data. Both numeric and raw flow cytometry data were used for both supervised and unsupervised ML to predict the presence of pneumonia, urinary tract infection and COVID-19. Heart failure was used as an objective to prove method generalizability. RESULTS: Chronological age was predicted by a deep neural network with R2: 0.59; mean absolute error: 12; sex with AUROC: 0.83, phi: 0.47; individuality with 99.7% accuracy, phi: 0.97; pneumonia with AUROC: 0.74, sensitivity 58%, specificity 79%, 95% CI: 0.73-0.75, p < 0.0001; urinary tract infection AUROC: 0.68, sensitivity 52%, specificity 79%, 95% CI: 0.67-0.68, p < 0.0001; COVID-19 AUROC: 0.8, sensitivity 82%, specificity 75%, 95% CI: 0.79-0.8, p = 0.0006; and heart failure area under the receiver operator curve (AUROC): 0.78, sensitivity 72%, specificity 72%, 95% CI: 0.77-0.78; p < 0.0001. CONCLUSION: ML applied to hematology data could predict communicable and noncommunicable diseases, both at local and global levels.

Mapping the public first-aid training landscape: uptake, knowledge, confidence and willingness to deliver first aid in disasters/emergencies-a scoping review.

The above article from Disasters, published online on 24 June 2019 in Wiley Online Library (http://wileyonlinelibrary.com) has been withdrawn by agreement among the authors, the Journal editors and John Wiley & Sons Inc. on behalf of ODI. The withdrawal has been agreed because this is a duplicate of an article that has been published in Disasters Volume 44 Issue 1.

Mapping the public first-aid training landscape: a scoping review.

While the public can play a vital role in saving lives during emergencies, intervention is only effective if people have the skills, confidence, and willingness to help. This review employs a five-stage framework to systematically analyse first aid and emergency helping literature from 22 countries (predominately in Asia, Australia, Europe, and the United States). The review covers 54 articles that investigate public first-aid knowledge and uptake of first-aid training (40); public confidence in first-aid skills and willingness to help during an emergency (21); and barriers to or enablers of learning first aid and delivering first aid in an emergency (25). The findings identify high levels of perceived knowledge, confidence, and willingness to help, supporting the contention that the public can play a vital role during an emergency. However, the findings also point to low uptake levels, low tested skill-specific knowledge, and barriers to learning first aid and helping, indicating that the first-aid training landscape is in need of improvement.

Communicating with the Public About Marauding Terrorist Firearms Attacks: Results from a Survey Experiment on Factors Influencing Intention to "Run, Hide, Tell" in the United Kingdom and Denmark.

Effective risk communication is an integral part of responding to terrorism, but until recently, there has been very little pre-event communication in a European context to provide advice to the public on how to protect themselves during an attack. Following terrorist attacks involving mass shootings in Paris, France, in November 2015, the U.K. National Police Chiefs' Council released a Stay Safe film and leaflet that advises the public to "run," "hide," and "tell" in the event of a firearms or weapons attack. However, other countries, including Denmark, do not provide preparedness information of this kind, in large part because of concern about scaring the public. In this survey experiment, 3,003 U.K. and Danish participants were randomly assigned to one of three conditions: no information, a leaflet intervention, and a film intervention to examine the impact of "Run, Hide, Tell" advice on perceptions about terrorism, the security services, and intended responses to a hypothetical terrorist firearms attack. Results demonstrate important benefits of pre-event communication in relation to enhancing trust, encouraging protective health behaviors, and discouraging potentially dangerous actions. However, these findings also suggest that future communications should address perceived response costs and target specific problem behaviors. Cross-national similarities in response suggest this advice is suitable for adaptation in other countries.

Integrated RNA and DNA sequencing reveals early drivers of metastatic breast cancer.

Breast cancer metastasis remains a clinical challenge, even within a single patient across multiple sites of the disease. Genome-wide comparisons of both the DNA and gene expression of primary tumors and metastases in multiple patients could help elucidate the underlying mechanisms that cause breast cancer metastasis. To address this issue, we performed DNA exome and RNA sequencing of matched primary tumors and multiple metastases from 16 patients, totaling 83 distinct specimens. We identified tumor-specific drivers by integrating known protein-protein network information with RNA expression and somatic DNA alterations and found that genetic drivers were predominantly established in the primary tumor and maintained through metastatic spreading. In addition, our analyses revealed that most genetic drivers were DNA copy number changes, the TP53 mutation was a recurrent founding mutation regardless of subtype, and that multiclonal seeding of metastases was frequent and occurred in multiple subtypes. Genetic drivers unique to metastasis were identified as somatic mutations in the estrogen and androgen receptor genes. These results highlight the complexity of metastatic spreading, be it monoclonal or multiclonal, and suggest that most metastatic drivers are established in the primary tumor, despite the substantial heterogeneity seen in the metastases.

Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications.

In recent years, a series of large-scale, high-profile natural disasters and terrorist attacks have demonstrated the need for thorough and effective disaster preparedness. While these extreme events affect communities and societies as a whole, they also carry specific risks for particular population groups. Crises such as Hurricane Katrina and the 2011 earthquake and tsunami disaster in Japan have illustrated the risk of significant and disproportionate morbidity and mortality among older adults during disasters. Age does not necessarily equate to vulnerability, but many physical and psychological consequences of the aging process can increase the risk of adverse outcomes. As the older population grows, so too does the need to ensure that adequate, practical, and appropriate measures exist to offset the specific risks from extreme events associated with this subpopulation. Effective risk and crisis communication plays a key role in mitigating the extent to which older adults are differentially affected during extreme events. By identifying the specific issues affecting older adults, this review highlights important areas for action for practitioners and policy-makers, particularly in the realm of crisis communication. (Disaster Med Public Health Preparedness. 2017;11:127-134).

A systematic review of factors affecting intended and actual adherence with antiviral medication as treatment or prophylaxis in seasonal and pandemic flu.

The aim of this review was to identify factors predicting actual or intended adherence to antivirals as treatment or prophylaxis for influenza. Literature from inception to March 2015 was systematically reviewed to find studies reporting predictors of adherence to antivirals and self-reported reasons for non-adherence to antivirals. Twenty-six studies were included in the review; twenty identified through the literature search and six through other means. Of these studies, 18 assessed predictors of actual adherence to antivirals, whereas eight assessed predictors of intended adherence. The most commonly found predictor of, and self-reported reason for, non-adherence was the occurrence of side effects. Other predictors include perceptions surrounding self-efficacy, response efficacy and perceived personal consequences as well as social influences of others' experiences of taking antivirals. Predictors identified in this review can be used to help inform communications to increase adherence to antivirals in both seasonal and pandemic influenza.

Communicating with the public following radiological terrorism: results from a series of focus groups and national surveys in Britain and Germany.

INTRODUCTION: Incidents involving the exposure of large numbers of people to radiological material can have serious consequences for those affected, their community and wider society. In many instances, the psychological effects of these incidents have the greatest impact. People fear radiation and even incidents which result in little or no actual exposure have the potential to cause widespread anxiety and behavior change. The aim of this study was to assess public intentions, beliefs and information needs in the UK and Germany in response to a hidden radiological exposure device. By assessing how the public is likely to react to such events, strategies for more effective crisis and risk communication can be developed and designed to address any knowledge gaps, misperceptions and behavioral responses that are contrary to public health advice. METHODS: This study had three stages. The first stage consisted of focus groups which identified perceptions of and reactions to a covert radiological device. The incident was introduced to participants using a series of mock newspaper and broadcast injects to convey the evolving scenario. The outcomes of these focus groups were used to inform national telephone surveys, which quantified intended behaviors and assessed what perceptions were correlated with these behaviors. Focus group and survey results were used to develop video and leaflet communication interventions, which were then evaluated in a second round of focus groups. RESULTS: In the first two stages, misperceptions about the likelihood and routes of exposure were associated with higher levels of worry and greater likelihood of engaging in behaviors that might be detrimental to ongoing public health efforts. The final focus groups demonstrated that both types of misunderstanding are amenable to change following targeted communication. CONCLUSION: Should terrorists succeed in placing a hidden radiological device in a public location, then health agencies may find that it is easier to communicate effectively with the public if they explicitly and clearly discuss the mechanisms through which someone could be affected by the radiation and the known geographical spread of any risk. Messages which explain how the risk from a hidden radiological device "works" should be prepared and tested in advance so that they can be rapidly deployed if the need arises.

Assessing perceptions about hazardous substances (PATHS): the PATHS questionnaire.

How people perceive the nature of a hazardous substance may determine how they respond when potentially exposed to it. We tested a new Perceptions AbouT Hazardous Substances (PATHS) questionnaire. In Study 1 (N = 21), we assessed the face validity of items concerning perceptions about eight properties of a hazardous substance. In Study 2 (N = 2030), we tested the factor structure, reliability and validity of the PATHS questionnaire across four qualitatively different substances. In Study 3 (N = 760), we tested the impact of information provision on Perceptions AbouT Hazardous Substances scores. Our results showed that our eight measures demonstrated good reliability and validity when used for non-contagious hazards.

Communicating public health advice after a chemical spill: results from national surveys in the United Kingdom and Poland.

OBJECTIVE: The aim of this study was to enhance public health preparedness for incidents that involve the large-scale release of a hazardous substance by examining factors likely to influence public responses to official guidance on how to limit their exposure. METHODS: An online demographically representative survey was conducted in the United Kingdom (n = 601) and Poland (n = 602) to test the strength of association of trust in authorities, anxiety, threat, and coping appraisals with the intention to comply with advice to shelter in place following a hypothetical chemical spill. The impact of ease of compliance and style of message presentation were also examined. RESULTS: Participants were more likely to comply if at home when the incident happened, but message presentation had little impact. Coping appraisals and trust were key predictors of compliance, but threat appraisals were associated with noncompliance. Anxiety was seen to promote behavioral change. UK participants were more likely to comply than Polish participants. CONCLUSIONS: Successful crisis communications during an emergency should aim to influence perceptions regarding the efficacy of recommended behaviors, the difficulties people may have in following advice, and perceptions about the cost of following recommended behaviors. Generic principles of crisis communication may need adaptation for national contexts.

The calibration of parallel-plate electron ionization chambers at NPL for use with the IPEM 2003 code of practice: summary data.

The most recent electron dosimetry code of practice for radiotherapy written by the Institute of Physics and Engineering in Medicine was published in 2003 and is based on the NPL electron absorbed dose to water calibration service. NPL has calibrated many Scanditronix type NACP-02 and PTW Roos type 34001 parallel plate ionization chambers in terms of absorbed dose to water, for use with the code of practice. The results of the calibrations of these chamber types summarized here include the absorbed dose to water sensitivity, where the mean calibration factor standard deviations are 5.8% for NACP-02 chambers and 1.1% for PTW Roos chambers. The correction for the polarity effect is shown to be small (less than 0.2% for all beam qualities) but with a discernible beam quality dependence. The correction for recombination is shown to be consistent and reproducible, and an analysis of these results suggests that the plate separation of the NACP-02 chambers is more variable from chamber to chamber than with the PTW Roos chambers. The calibration of these chambers is shown to be repeatable within +/-0.2% over 2-3 years. It is also shown that check source measurements can be repeated within +/-0.3% over several years. The results justify the use of NACP-02 and PTW 34001 chambers as secondary standards, but also indicate that the PTW 34001 chambers show less variation from chamber to chamber.

The characterization of the Advanced Markus ionization chamber for use in reference electron dosimetry in the UK.

The IPEM Code of Practice (IPEM 2003) for electron dosimetry for radiotherapy beams recommends design requirements for parallel-plate ionization chambers used to determine absorbed dose to water in an electron beam. The Classic Markus design has been found not to meet these requirements. The Advanced Markus ionization chamber has been designed to rectify the problems associated with the Classic Markus ionization chamber. The response of three Advanced Markus ionization chambers was investigated and compared to the designated chamber types. Absorbed dose to water calibration factors were derived at the National Physical Laboratory (NPL) for each ionization chamber at seven electron energies in the range nominally 4-19 MeV. Investigations were carried out into chamber settling, polarity effects, ion recombination and the chamber perturbation. The response of the ionization chambers in a clinical beam was also investigated. In general all three Advanced Markus ionization chambers showed the same energy response. The magnitude of the polarity effect was typically 5% at a nominal energy of 4 MeV. There was discrepancy between the polarity measurements made at the NPL and in the clinic. The recommendation of this study is that this chamber type is not suitable for reference dosimetry in electron beams.