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Objective: To characterise factors associated with COVID-19 vaccine uptake among people with kidney disease in England., Design: Retrospective cohort study using the OpenSAFELY-TPP platform, performed with the approval of NHS England., Setting: Individual-level routine clinical data from 24 million people across GPs in England using TPP software. Primary care data were linked directly with COVID-19 vaccine records up to 31 August 2022 and with renal replacement therapy (RRT) status via the UK Renal Registry (UKRR)., Participants: A cohort of adults with stage 3-5 chronic kidney disease (CKD) or receiving RRT at the start of the COVID-19 vaccine roll-out was identified based on evidence of reduced estimated glomerular filtration rate (eGFR) or inclusion in the UKRR., Main Outcome Measures: Dose-specific vaccine coverage over time was determined from 1 December 2020 to 31 August 2022. Individual-level factors associated with receipt of a 3-dose or 4-dose vaccine series were explored via Cox proportional hazards models., Results: 992 205 people with stage 3-5 CKD or receiving RRT were included. Cumulative vaccine coverage as of 31 August 2022 was 97.5%, 97.0% and 93.9% for doses 1, 2 and 3, respectively, and 81.9% for dose 4 among individuals with one or more indications for eligibility. Delayed 3-dose vaccine uptake was associated with younger age, minority ethnicity, social deprivation and severe mental illness-associations that were consistent across CKD severity subgroups, dialysis patients and kidney transplant recipients. Similar associations were observed for 4-dose uptake., Conclusion: Although high primary vaccine and booster dose coverage has been achieved among people with kidney disease in England, key disparities in vaccine uptake remain across clinical and demographic groups and 4-dose coverage is suboptimal. Targeted interventions are needed to identify barriers to vaccine uptake among under-vaccinated subgroups identified in the present study., Competing Interests: Competing interests: BG’s work on better use of data in healthcare more broadly is currently funded in part by: the Bennett Foundation, the Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied Research Collaboration Oxford and Thames Valley, the Mohn-Westlake Foundation; all Bennett Institute staff are supported by BG's grants on this work. BG is a Non-Executive Director at NHS Digital. EJW holds grants from MRC., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Over the past decade, the Internet's e3 ect has transformed nursing education, particularly at the graduate level. Schools of nursing have embraced Internet-based course delivery technology to broaden students' access to academic degrees. However, the rush to stay competitive in online education raises questions. What is the quality of these online programs? To what extent are schools of nursing systematically evaluating the programs beyond the course level? What evaluation tools are used? What are the findings? How are the evaluation data used? By answering these questions, nurse educators can develop strategies for evaluating the quality and worth of online learning, thus improving instruction and learning outcomes. This integrative review of nursing and adult education literature identified as the current trends in program evaluation of online nursing education at the graduate level. Research articles were analyzed and perspectives were synthesized from a research agenda viewpoint. Recommendations and needs for future research are discussed., (Copyright 2012, SLACK Incorporated.)

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There are no hard and fast rules when it comes to weaning babies, but it can be an emotional time for both parents and child. The information given by health professionals can have a radical effect on the success of this stage.