Search Results (258)

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

Background: It is estimated that in Italy, there were 364,000 new diagnoses of neoplasms each year and that the overall incidence of blood cancers was 10% of these. Leukemia and lymphomas represented the ninth and eighth places, respectively, among the causes of death from neoplasia. Hematopoietic stem cell transplantation represented an effective treatment option for many of these malignancies, and not only that: benign and congenital diseases could also be treated. Objective: To assess knowledge among the Apulian population regarding stem cell donation and factors that could influence this choice, focusing especially on the knowledge of the residents of Puglia, Italy on how stem cells were harvested and their functions, their reasons for joining the National Registry, and the reasons that hold them back from making such a choice. Study Design: An observational and cross-sectional study was conducted, through snowball sampling methodology, until data saturation. An online survey was conducted, which included several Italian associations. The questionnaire administered contained five main sections, such as sociodemographic data, knowledge of the existence of National Registries and their adherence, the nationwide presence of various associations that promote donation, knowledge with respect to the structure, use and functions of stem cells, sources of procurement, such as bone marrow, peripheral blood and umbilical cord, and related procedures, beliefs, attitudes, values, and opinions of the Italian population regarding the topic, and degree of information and education regarding bone marrow donation. Results: A total of 567 Apulian citizens were enrolled. Of these, 75.3% were female and 96.8% were aged between 18 and 65 years. Most of participants were single (46.9%) and married (47.3%) and had a diploma (44.4%), and less had a degree (35.8%). Significant differences were recorded between gender, singles, and married participants, and participants with a diploma or a degree and the items proposed. Conclusions: A true culture of donation in our region was not clearly spread. Although something has been accomplished in recent years in terms of deceased donor donation, still a great deal needs to be achieved for living donation, which encountered a great deal of resistance. It has been deemed necessary to seek winning solutions to this issue in terms of communication and information campaigns, raising awareness and empowering citizens to express consciously their concerns about organs and tissues and to stand in solidarity with those who suffered. Full article

Background/Objectives: Children with cancer suffer due to the underlying disease and prescribed cancer-directed therapies, and non-pharmacologic modalities may offer improved symptom control without additional medications. We sought to elicit knowledge, attitudes, and beliefs of Pediatric Hematology Oncology (PHO) providers surrounding the incorporation of acupuncture for symptom management for their patients. Methods: A cross-sectional survey instrument was created, formatted, and delivered to physicians and advanced practice providers (APPs) at a single US pediatric cancer center. Survey responses were summarized by descriptive statistics. Results: A total of 78 PHO clinicians participated (response rate 29%). Most participants were interested in learning more about acupuncture (n = 42, 56.0%), yet rarely (n = 17, 22.7%) or never (n = 46, 61.3%) recommend acupuncture to patients. Most (n = 51, 73.9%) noted that they would support institutional development of an acupuncture program. Over half (n = 37, 52.2%) indicated their threshold for minimum hematologic indices for acupuncture includes a platelet count greater than 20,000 and absolute neutrophil count (ANC) greater than 500 (n = 37, 54.4%). Approximately two-thirds (n = 52, 66.7%) of participants noted that acupuncture could improve their patient’s quality of life, and most (n = 46, 67.6%) were not worried about harm. Conclusions: Acupuncture for symptom management is an evidenced-based, guideline-concordant recommendation for adults with cancer, but robust data in the pediatric oncology population are lacking. PHO providers do not routinely recommend acupuncture for patients but note that it may improve quality of life. Given their high symptom burden, rigorous studies of non-pharmacologic strategies for pediatric symptom management are vital. Acupuncture should be examined as a potential beneficial adjunct. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

Background: Spiritual care is vital for the holistic well-being of hospitalized cancer patients, addressing their emotional, psychological, and spiritual needs. This study addresses gaps in the relevant literature by evaluating spiritual perspectives among Peruvian oncology patients, offering culturally grounded insights that can inform nursing practice and healthcare management. The main objective of this research was to measure the overall level of Spiritual Perspective among hospitalized oncology patients using the Spiritual Perspective Scale (SPS) developed by Pamela Reed in 1987, which reflects early aspects of spirituality later integrated into her broader Spiritual Perspective theory. Materials and methods: This study aimed to evaluate the perceived levels of Spiritual Perspective among oncology patients in a hospital setting. Adopting a quantitative, descriptive, cross-sectional design, data were gathered from 137 patients at a national hospital in Lima, Peru. Results: The majority of participants were older adults, with a high school education, and predominantly single. Findings revealed that most patients experienced moderate levels of Spiritual Perspective, spiritual practices, and beliefs. Patients commonly practiced prayer, meditation, and spiritual reading. Beliefs centered on a higher power and forgiveness. Essential support networks also provided emotional aid, complementing spiritual care. Conclusions: This study highlights the importance of spiritual care in nursing for oncology patients. Findings advance understanding of spirituality in illness and support interventions to improve patient outcomes. Full article

Cervical cancer (CC) remains a critical global health issue which disproportionately affects low- and middle-income countries. In Chile, the Arica and Parinacota region experiences high CC mortality and low Papanicolaou (Pap) test coverage, with indigenous Aymara women facing significant screening barriers. Understanding health beliefs surrounding CC prevention is essential for improving adherence, particularly in under-represented populations. This study assesses the psychometric properties of the CPC-28, an instrument measuring beliefs about CC and Pap testing, among Aymara women in Chile. A cross-sectional survey of 299 Aymara women (25–64) was conducted using stratified probabilistic sampling. Confirmatory factor analysis (CFA) confirmed the CPC-28’s six-factor latent structure, demonstrating strong model fit (CFI = 0.969, TLI = 0.965, RMSEA = 0.058). Reliability indices ranged from acceptable to excellent (α = 0.585–0.921; ω = 0.660–0.923). Moderate correlations emerged between severity, susceptibility, and perceived benefits of Pap testing, although CPC-28 results did not predict adherence. These findings support CPC-28’s validity evidence for Aymara women but highlight cultural influences on screening behaviors. Structural barriers, including language and healthcare inaccessibility, are likely to affect perceived susceptibility. Future research should explore indigenous perspectives and socio-cultural determinants of Pap testing, incorporating mixed-method approaches to identify culturally relevant interventions and improve screening adherence. Full article

Background: Cancer is a worldwide public health issue that impacts individuals in many ways. Family caregivers (FCGs) play a crucial role in providing care for cancer patients; as a result, they face several challenges as caregivers that sometimes go unreported. Aim: The purpose of this study was to explore the lived experiences of family caregivers with a developing burden of caring for a relative with a cancer diagnosis in Saudi Arabia. Methods: A qualitative study employing thematic analysis was conducted with ten family caregivers recruited through purposive sampling from the Prince Sultan Military City Hospital’s oncology department. Semi-structured interviews were conducted from July to August 2023 until data saturation was achieved. Results: Ten family caregivers participated in the study. Four main themes emerged from the data: antecedents to the caregiving burden, attributes of the caregiving burden, consequences of the burden, and religion and beliefs. Across these four main themes, there were 12 sub-themes. Conclusions and Implications: Family caregivers are crucial in caring for and supporting cancer patients. Thus, it is essential to shed light on family caregivers, who often remain invisible as secondary patients in healthcare systems, to understand the factors associated with developing caregiver burden. Education and support for family caregivers may decrease the burden on the family caregiver, which can positively impact the whole family unit, including the relative with the cancer diagnosis. Full article

Cancer patients use cannabis for medicinal purposes; however, few studies have examined hematology patients’ use of cannabis and no research to our knowledge has investigated the use of cannabis amongst hematology patients before and after hematopoietic stem cell transplant (HCT). The purpose of this longitudinal survey study was to assess aspects of cannabis use in patients who underwent HCT. Eligible patients (N = 30) completed two surveys before and 90 days following their HCT. The surveys inquired about several aspects of cannabis (e.g., rate of use, beliefs and attitudes, access to information) and physical and psychological outcomes (e.g., anxiety, comorbidities, graft-versus-host-disease). Rates of cannabis use decreased following HCT (n = 14, 46% to n = 11, 40%). Conversations on cannabis that were initiated by an oncology health care provider increased post-transplant (n = 3, 10% to n = 11, 37%). This coincided with fewer who were smoking cannabis as a primary consumption method (n = 5, 38 to n = 2, 18) and an increase in the use of pharmaceutical cannabinoid products (n = 4, 13% to n = 6, 21%) as well as oils and topicals. Of the total sample, 63% (n = 17) experienced post-treatment complications and 33% (n = 10) developed GVHD, six of whom where recent cannabis users. This study provided insight into cannabis use amongst HCT patients and warrants further research with this population, including more exploration of the relationship between GVHD and cannabis. Full article

After the era of multidrug resistance (MDR) against cytotoxic chemotherapy, the development of resistance against newly developed molecularly targeted drugs also seems inevitable. While the mechanisms involved in resistance against these two categories of anticancer drugs are different, the principles are similar: inherent resistance (also known as primary resistance) is a result of heterogeneity in cancer cells where a subpopulation of the cells do not show a favorable initial response to the drug, while acquired resistance (or secondary resistance), as the name suggests, is developed after repeated treatments due to the plasticity of cancer cells. Despite the introduction of a variety of molecularly targeted drugs to clinical practice, chemotherapy is still at the forefront of the battle against cancer. In this manuscript, we review the major mechanisms involved in MDR and resistance against different categories of molecularly targeted drugs separately, and review some of the strategies studied to overcome the resistance against cancer therapy. While MDR mechanisms have been reviewed previously, the molecular mechanisms of resistance to the latest generations of anticancer drugs are rarely reviewed as a group, and the connection between the two categories of resistance is often missing in this type of publication. Our aim is to illustrate a comprehensive picture of what the landscape of cancer treatment is today with respect to resistance. While this picture seems bleak, and it is the common belief that resistance is inevitable, understanding the mechanisms involved could potentially lead to more efficient approaches to overcoming this so far unbeatable obstacle. Full article

Background: Despite the significant global disease burden associated with HPV infection, the vaccination coverage among female college students in China remains suboptimal. This study aimed to examine HPV vaccination coverage, knowledge levels, and determinants influencing vaccination behavior among female college students in northern China, utilizing the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional online survey was conducted from December 2024 to January 2025, involving 4076 female students from six universities in Jinan, China. The participants were categorized into three groups: vaccinated (VG), willing-to-vaccinate (WTG), and unwilling-to-vaccinate (UTG). Data on sociodemographic characteristics, HPV knowledge, health beliefs, and vaccination behavior were analyzed using ANOVA, chi-square tests, correlation analysis, and multivariate logistic regression. Results: The vaccination rate was 18.11%, with 40.19% expressing willingness to vaccinate and 41.71% expressing unwillingness. Vaccinated students demonstrated higher levels of HPV knowledge (6.66 ± 2.67 compared to 4.76 ± 3.10 in the UTG, p < 0.001) and were predominantly from urban areas (OR = 0.64, p < 0.001). The key determinants of vaccination uptake included perceived benefits (OR = 1.54, p < 0.001), perceived barriers (OR = 3.34, p < 0.001), self-decision-making ability (OR = 1.80, p < 0.001), and social motivation (OR = 0.21, p < 0.001). Notably, increased knowledge was associated with vaccine hesitancy in the WTG group (OR = 0.45, p < 0.001), indicating that information overload may adversely affect decision-making processes. Structural barriers, such as cost (42.63%), safety concerns (46.59%), and misconceptions (e.g., 57.76% cited “no sexual activity” as a reason for refusal), significantly impeded vaccine uptake. Conclusions: The low coverage of HPV vaccination is indicative of deficiencies in knowledge, socioeconomic disparities, and cultural perceptions. Tailored interventions should focus on educational efforts to correct misconceptions, provide subsidized access to vaccines, and implement empowerment strategies that enhance self-efficacy and informed decision-making. Policymakers should incorporate these findings into national cervical cancer prevention programs to address the gap between vaccination intention and behavior among young women in China. Full article

Objectives: Human papillomavirus (HPV) is a leading cause of several cancers, yet HPV vaccination rates among U.S. young adults remain low. This study evaluated the effect of a brief educational video, co-developed with college students, in increasing HPV vaccination intention among unvaccinated college-aged individuals. Methods: A two-group randomized controlled trial was conducted among 215 college students aged 18–26 who had not received the HPV vaccine. Participants were randomly assigned to two interventions: a video group (n = 111) or a leaflet group that viewed a CDC-based educational sheet (n = 104). Pre- and post-intervention surveys assessed HPV knowledge, perceived risk, facilitators and barriers to vaccination, cultural beliefs, and vaccination intention. Data were analyzed using descriptive statistics, t-tests, Wilcoxon Signed-Rank, and Mann–Whitney U tests. Results: At baseline, approximately 56% of the sample (n = 215; mean age = 23.5, 71.2% male) have learned about HPV in the past. Although both groups improved in HPV knowledge, perceived lower risk, and cultural beliefs, between-group differences in these theoretical mediators were not statistically significant. Vaccination intention (those who responded “Yes” or “Maybe”) increased by 10.8% in the video group but decreased by 11.6% in the leaflet group following the intervention; the difference between the two groups was statistically significant (p = 0.03). Conclusions: A brief, participatory, and theory-based video significantly increased HPV vaccination intent among unvaccinated college students. Compared to the leaflet intervention, the video intervention offers a promising and scalable public health strategy for promoting HPV vaccination in this high-risk population. Full article

Health beliefs, disease acceptance, and self-efficacy significantly influence patients’ behavior. This study examined factors associated with self-efficacy and illness acceptance in patients with heart failure (HF). The study, conducted from June 2022 to June 2024, included 231 patients aged ≥ 65 years hospitalized for HF. Self-efficacy and illness acceptance were assessed using the Generalized Self-Efficacy Scale (GSES) and Acceptance of Illness Scale (AIS). The median age of participants was 80 years (72–86); a total of 63.6% were women. The AIS score median was 25, indicating moderate disease acceptance, while the GSES score median was 30, reflecting relatively high self-efficacy. Lower GSES scores were associated with a history of cancer (p = 0.002) and geriatric depression (p = 0.000). Poor illness acceptance was linked to prior myocardial infarction (p = 0.020), atrial fibrillation (p = 0.008), stroke (p = 0.040), depression (p = 0.000), and frailty (p = 0.000). Frailty (OR 0.81) and cancer history (OR 3.08) independently predicted self-efficacy, while lower illness acceptance was linked to older age (OR 0.95), stressful events (OR 0.53), stroke (OR 0.26), and improved by physical activity (OR 1.22). Our results indicated that older HF patients exhibit high self-efficacy but moderate illness acceptance. Self-efficacy is influenced by frailty and cancer history, while illness acceptance by age, stress, stroke, and physical activity. Full article

The decline in colorectal cancer (CRC) due to screening success in the U.S. is inconsistent across populations and age groups. CHamorus (Chamorros) and Filipinos constitute minorities in the U.S. but comprise over 70% of the population in Guam where steep increases in CRC incidence occur before the age of 50, and only 53.9% of persons have met national screening standards. This preliminary study explored knowledge, cultural beliefs, and age-specific recommendations associated with CRC and screening. Five focus groups segregated by age and gender were conducted with persons aged 40 and above. Data were collected on knowledge, attitudes, beliefs, and screening education recommendations. Focus group participants (n = 25) were predominantly CHamoru (60%), Filipino (32%), and female (56%). The mean age was 55. Participants preferred interventions that integrated storytelling from CRC survivors with emphasis on family education rather than limiting to screening-age adults. Multicoders performed an iterative collaborative analysis for the main themes: knowledge of CRC/screening primarily derives from family experiences; increased outreach is needed for men; use of personal narratives; and screening is motivated by family values and intergenerational consciousness. Findings can inform future studies on age- and culturally-tailored early detection strategies to improve CRC screening participation in Pacific populations. Full article

Objective: Oophorectomy is a common procedure for benign uterine conditions, historically recommended for women aged 40–45 and older due to the belief that ovarian preservation had no significant benefits. This review evaluates the literature on the optimal age for oophorectomy in women with benign conditions to assess its risks and benefits and guide clinical decision-making. Methods: A narrative review was conducted using a literature search of articles published between January 2000 and February 2025, focusing on the age-related outcomes of ovarian conservation versus removal. Results: Oophorectomy remains a complex decision in gynecological surgeries, especially among perimenopausal and postmenopausal women. Evidence supports ovarian conservation in average-risk women, highlighting reduced risks of cardiovascular disease, osteoporosis, and all-cause mortality. Conversely, oophorectomy is favored in high-risk populations, such as BRCA mutation carriers, due to significantly lower risks of ovarian and breast cancers. Despite declining rates, unnecessary oophorectomies persist, influenced by age, socioeconomic status, comorbidities, and surgical approaches. The development of a risk stratification tool offers promise for improving individualized decision-making. Conclusions: The decision to perform oophorectomy for benign conditions should be personalized, balancing patient-specific factors to optimize outcomes and long-term health benefits. Full article

Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally, with the majority of cases detected at advanced stages when curative options are limited. Current systemic therapies, including immune checkpoint inhibitors, demonstrate limited efficacy with durable responses in only 15–20% of patients. This poor response is largely attributed to HCC’s immunosuppressive microenvironment, which blunts effective T-cell responses. By illustrating that innate immune cells can acquire memory-like characteristics through a process known as trained immunity, recent evidence has challenged the conventional belief that innate immunity is devoid of memory. This review investigates the potential of trained immunity, which is defined by the long-term functional reprogramming of innate immune cells through epigenetic, transcriptomic, and metabolic changes, to provide new therapeutic opportunities for HCC. We discuss mechanisms by which trained immunity can transform the HCC microenvironment, including enhanced inflammatory cytokine production, repolarization of tumor-associated macrophages toward anti-tumor phenotypes, increased immune cell infiltration, and improved bridging to adaptive immunity. We further evaluate emerging therapeutic strategies leveraging trained immunity principles, including BCG vaccination, β-glucan administration, cytokine-trained NK cell therapy, and innovative combination approaches. Finally, we address potential resistance mechanisms and future directions for clinical application. By integrating trained immunity into conventional immunotherapeutic regimens, we may significantly improve outcomes for HCC patients, potentially transforming advanced disease into a more manageable condition. Full article