Factors distinguishing general practitioners who more readily participated in a large randomized trial were identified

ObjectiveTo investigate factors associated with the successful recruitment of general practices to a randomized controlled trial.Study Design and SettingAnalysis of accrual of primary care centers to a randomized controlled trial in the UK.ResultsThose practices promptly agreeing to take part had better target achievement and a higher proportion of white British residents locally. Participating practices had a mean Quality and Outcomes Framework attainment of 92% of the points available, whereas nonparticipating practices achieved 88% (P = 0.009). Participating practices were located in areas with a higher proportion of white British residents (mean 89%), in comparison to nonparticipating practices (mean 84%, P = 0.004). Reasons given by practices to explain nonparticipation were primarily related to internal factors, with 38% of practices approached saying that they could not participate for such reasons.ConclusionThere are some small differences between participating practices and nonparticipants in achievement of government targets and in the local ethnic mix. The primary reason given by practices for nonparticipation was workload or time pressures, with over a third of practices reporting being prevented by issues relating to practice organization. It may be that practices with workload or organizational difficulties require additional support to participate in research.     

Parents' COVID-19 vaccine intentions for children under 5 years: Brief reflections from a qualitative study

Aim

Australian authorities made COVID-19 vaccines available for children aged under 5 years old with serious comorbidities in August 2022. There is presently no universal programme for young children, but crucial to any rollout's success is whether parents are motivated and able to vaccinate. By examining parents' vaccine intentions, this study aims to inform current and future COVID-19 vaccine roll-outs for children aged under 5 years.

Methods

As part of the mixed methods project ‘Coronavax: Preparing Community and Government’ we interviewed 18 Western Australian parents of young children about their intentions in late 2021.

Results

Two thirds intended to vaccinate if and when they could, with one third intending to delay for reasons including risk and safety perceptions, fears about side effects and influence from their social networks. However, even those choosing to delay were waiting rather than refusing.

Conclusions

To improve uptake, targeted messaging should emphasise that COVID-19 can be a serious disease in young children, with such messaging drawing on the reputability and esteem of scientific and technical authorities. Such messaging should be oriented towards parents of children with serious comorbidities at the present time. It will be important to emphasise that government vaccine recommendations are based on supporting families to protect their children and keep them healthy.     

Sensitivity of alpha and beta oscillations to sensorimotor characteristics of action: An EEG study of action production and gesture observation

The sensorimotor experiences we gain when performing an action have been found to influence how our own motor systems are activated when we observe others performing that same action. Here we asked whether this phenomenon applies to the observation of gesture. Would the sensorimotor experiences we gain when performing an action on an object influence activation in our own motor systems when we observe others performing a gesture for that object? Participants were given sensorimotor experience with objects that varied in weight, and then observed video clips of an actor producing gestures for those objects. Electroencephalography (EEG) was recorded while participants first observed either an iconic gesture (pantomiming lifting an object) or a deictic gesture (pointing to an object) for an object, and then grasped and lifted the object indicated by the gesture. We analyzed EEG during gesture observation to determine whether oscillatory activity was affected by the observer's sensorimotor experiences with the object represented in the gesture. Seeing a gesture for an object previously experienced as light was associated with a suppression of power in alpha and beta frequency bands, particularly at posterior electrodes. A similar pattern was found when participants lifted the light object, but over more diffuse electrodes. Moreover, alpha and beta bands at right parieto-occipital electrodes were sensitive to the type of gesture observed (iconic vs. deictic). These results demonstrate that sensorimotor experience with an object affects how a gesture for that object is processed, as measured by the gesture-observer's EEG, and suggest that different types of gestures recruit the observer's own motor system in different ways.     

Primary transitional cell carcinoma of the fallopian tube

The fallopian tube is the least common site for origin of malignancy in the female genital tract. Most primary fallopian tube malignancies are adenocarcinomas. Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor with a small number of cases reported in the literature. We present a 67-year-old woman who was found incidentally to have a left adnexal mass on a screening pelvic ultrasound. Subsequently the patient underwent laparoscopic left salpingo-oophorectomy and the specimen was submitted for intraoperative frozen section, which revealed a high-grade carcinoma; therefore, she underwent a laparotomy and total abdominal hysterectomy, right salpingo-oophorectomy and omentectomy. Histopathology revealed high-grade transitional cell carcinoma in the left fallopian tube. Post-surgery she was treated with four cycles of adjuvant chemotherapy with carboplatin and paclitaxel with no complications. Our patient had a family history of malignancy, so genetic testing for BRCA1 and BRCA2 mutations was undertaken and did not reveal any mutation or unclassified variants. Multiplex ligation-dependent probe amplification (MLPA) was normal.     

University students’ drinking as a social practice and the challenge for public health

In this paper, we explore the relational dynamics of alcohol consumption by university students, drawing on qualitative interviews with fifty undergraduates in Victoria, Australia. We argue that university drinking is a social practice comprised of a bundle of activities that operate together to reinforce excessive consumption. Drawing on a distinct version of social practice theory, we conceptualise drinking as an organising principle of university social life with interacting elements – meanings, materials and competences. The meanings of drinking include cultural conventions, expectations and socially shared meanings that alcohol is central to student life. Materials of drinking include objects and infrastructures such as, beverage choice, drinking venues and mobile phones. Drinking competences include managing bodily effects of alcohol but also social relationships while consuming alcohol. The distinct social practice perspective we utilise can assist public health to address the interrelated dynamics of alcohol consumption as a social practice, with its own trajectory into which students are recruited and become carriers of the practice while at university.     

KLRG1—more than a marker for T cell senescence

The co-inhibitory receptor killer-cell lectin like receptor G1 (KLRG1) is expressed on NK cells and antigen-experienced T cells and has been postulated to be a marker of senescence. Whilst KLRG1 has frequently been used as a marker of cellular differentiation, data are emerging indicating that KLRG1 plays an inhibitory role. In this review we examine evidence highlighting this view of KLRG1 with emphasis on the functional defects that arise during T cell differentiation with age that may, in part, be actively maintained by inhibitory receptor signalling.     

Renal cysts and diabetes due to a heterozygous HNF-1beta gene deletion.

Sir, Diabetic nephropathy has become the major cause of end-stagerenal failure in Western countries. However, in the renal cystsand diabetes (RCAD) syndrome, nephropathy is an independentfeature rather than a direct consequence of the diabetes. ThisRCAD syndrome is caused by mutations of the hepatocyte nuclear