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In the Netherlands, parents of newborns typically participate in two-, four-, and eight-week medical consultations to monitor their children's development and discuss vaccinations, which will not be administered before eight weeks. During these visits, healthcare professionals routinely ask parents if they intend to vaccinate their children (i.e. to participate in the National Immunization Program). Using Conversation Analysis, we examine 62 videotaped consultations and present two lines of evidence to argue that the sequence initiated by professionals wherein they solicit parents' intent to vaccinate is dispreferred. First, this action is routinely deferred by preliminary sequences. Second, when professionals eventually initiate this action (i.e. if it is not preempted by parents during pre-sequences), they orient to its dispreferred status, for example by highlighting benefactive details of vaccination. We discuss the possible existence of asymmetrical (initiator-sided) pre-sequences, why soliciting parents' vaccination intent might be dispreferred, and implications for the design of communication interventions.

Childhood vaccination consultations are considered an important phase in parents' decision-making process. To date, only a few empirical studies conducted in the United States have investigated real-life consultations. To address this gap, we recorded Dutch vaccination conversations between healthcare providers and parents during routine health consultations for their newborns. The data were analysed using Conversation Analysis and Discursive Psychology. We found that the topic of vaccination was often initiated with 'Have you already thought about vaccination?' (HYATAV), and that this formulation was consequential for parental identity work. Exploring the interactional trajectories engendered by this initiation format we show that: (1) interlocutors treat the question as consisting of two types of queries, (2) conversational trajectories differ according to which of the queries is attended to and that (3) parents work up a 'good parent' identity in response to HYATAV, by demonstrating that they think about their child's vaccination beforehand and make their decisions independently. Our findings shed new light on the interactional unfolding of parental vaccination decisions., (© 2023 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for the Sociology of Health & Illness.)

Purpose: To assess the efficiency and long-term patency of the Cragg EndoPro System I in patients with peripheral arterial aneurysms., Materials and Methods: In 10 patients, 13 stent-grafts were used to treat 15 arterial aneurysms. Aneurysms were located in the common iliac (n = 4), superficial femoral (n = 4), popliteal (n = 3), and subclavian arteries (n = 2), and in a femoropopliteal bypass-graft (n = 2). Follow-up ranged between 2 and 46 months (mean, 36 months). Examination included clinical status, color-coded duplex sonography, computed tomography angiography, and intra-arterial digital subtraction angiography (DSA)., Results: Technical success was achieved in all patients. Primary patency was four of four in iliac vessels and three of nine in non-iliac vessels; secondary patency in noniliac vessels was four of nine. Repairs included one local lysis, four percutaneous transluminal angioplasties, one surgical thrombectomy, and one bypass surgery. Stent wire disintegration was detected in one of four iliac stent-grafts and in seven of nine noniliac stent-grafts. In noniliac grafts, significant stenoses occurred in three of nine; occlusion occurred in five of nine. One complication at the iliac level was a vessel wall penetration at the proximal stent edge, with development of a new aneurysmal formation. No late endoleaks were found., Conclusion: Exclusion of peripheral arterial aneurysms with stent-grafts is feasible. Long-term results are excellent in iliac vessels. Mechanical weakness of the stent assembly and frequent re-stenoses or occlusions are significant drawbacks in noniliac vessels with low patency rates.