Search Results (1,918)

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

Low uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among Black women has been partly attributed to barriers related to patient-provider communication. The goal of this paper was to investigate the association between exposure to the #ShesWell campaign and Black women’s communication about PrEP with a healthcare provider (HCP). We conducted a cross-sectional survey of 403 sexually active, Black women after the initial phase of #ShesWell and used multivariable regression models to analyze whether exposure to #ShesWell was associated with talking to an HCP about PrEP or intention to discuss PrEP with an HCP in the future. Approximately 33% of women surveyed reported exposure to #ShesWell. Campaign exposure was significantly associated with talking to an HCP in the past year about PrEP (OR = 4.96, p = 0.001) and intention to discuss PrEP with an HCP in the next six months (B = 0.29, p = 0.038). Stronger beliefs that doctors should initiate sexual health conversations were positively associated with past PrEP conversations (OR = 2.32, p < 0.001) and future intention (B = 0.11, p = 0.029). Greater comfort discussing prevention (B = 0.35, p < 0.001), self-efficacy discussing PrEP (B = 0.29, p = 0.001), and concern about getting HIV (B = 0.51, p < 0.001) were also associated with intention to discuss PrEP with an HCP. Findings highlight the potential for communication campaigns to motivate patient-provider communication about PrEP, addressing a reported barrier to PrEP uptake among Black women. Full article

For a long time, the explanation of the various determinants of oil price fluctuations and their impact on economic activity has been based on the supply and demand mechanism. However, with various volatile changes in the international situation in recent years, such as threats to public health and an increase in regional conflicts, special attention has been paid to the geopolitical context as an additional driver of oil price fluctuations. This study examines the relationship between oil price changes and GDP growth and other macroeconomic variables from the perspective of the vulnerability of oil-importing and oil-exporting countries to unexpected oil price shocks, driven by tense geopolitical events, in three European countries (Norway, Germany, and Poland). We apply the Structural Vector Autoregressive (SVAR) model and orthogonalized impulse response functions, based on quarterly data, in regard to two samples: the first spans 1995Q1–2019Q4 (pre-2020 sample), with relatively gradual changes in oil prices, and the second spans 1995Q1–2024Q2 (whole sample), with sudden fluctuations in oil prices due to geopolitical developments. A key finding of this research is that vulnerability to unpredictable oil price shocks related to geopolitical tensions is higher than in regard to expected gradual changes in oil prices, both in oil-importing and oil-exporting countries. Different causality patterns and stronger responses in regard to GDP growth during the period, including in regard to tense geopolitical events in comparison to the pre-2020 sample, lead to the belief that economies are not more resilient to oil price shocks as has been suggested by some studies, which referred to periods that were not driven by geopolitical events. Our research also suggests that countries implementing policies to reduce oil dependency and promote investment in alternative energy sources are better equipped to mitigate the adverse effects of oil price shocks. Full article

The organization of consciousness is described through increasingly rich theoretical models. We review evidence that working memory capacity—essential to generating consciousness in the cerebral cortex—is supported by dual limbic memory systems. These dorsal (Papez) and ventral (Yakovlev) limbic networks provide the basis for mnemonic processing and prediction in the dorsal and ventral divisions of the human neocortex. Empirical evidence suggests that the dorsal limbic division is (i) regulated preferentially by excitatory feedforward control, (ii) consolidated by REM sleep, and (iii) controlled in waking by phasic arousal through lemnothalamic projections from the pontine brainstem reticular activating system. The ventral limbic division and striatum, (i) organizes the inhibitory neurophysiology of NREM to (ii) consolidate explicit memory in sleep, (iii) operating in waking cognition under the same inhibitory feedback control supported by collothalamic tonic activation from the midbrain. We propose that (i) these dual (excitatory and inhibitory) systems alternate in the stages of sleep, and (ii) in waking they must be balanced—at criticality—to optimize the active inference that generates conscious experiences. Optimal Bayesian belief updating rests on balanced feedforward (excitatory predictive) and feedback (inhibitory corrective) control biases that play the role of prior and likelihood (i.e., sensory) precision. Because the excitatory (E) phasic arousal and inhibitory (I) tonic activation systems that regulate these dual limbic divisions have distinct affective properties, varying levels of elation for phasic arousal (E) and anxiety for tonic activation (I), the dual control systems regulate sleep and consciousness in ways that are adaptively balanced—around the entropic nadir of E–I criticality—for optimal self-regulation of consciousness and psychological health. Because they are emotive as well as motive control systems, these dual systems have unique qualities of feeling that may be registered as subjective experience. Full article

Objectives: This study assessed the effectiveness of a cognitive behavioral therapy (CBT)-based fine dust education program, grounded in the Health Belief Model (HBM), on elementary students’ fine dust knowledge, related behaviors, and mental health (depression, anxiety, stress, sleep quality). Methods: From September to November 2024, 95 students (grades 4–6) living near a coal-fired power plant in midwestern South Korea were assigned to either an intervention group (n = 44) or a control group (n = 51). The intervention group completed a three-session CBT-based education program; the control group received stress management education. Assessments were conducted at weeks 1, 2, 4, and 8 using standardized mental health and behavior scales (PHQ: Patient Health Questionnaire, GAD: Generalized Anxiety Disorder Assessment, PSS: Perceived Stress Scale, ISI: Insomnia Severity Index). Results: A chi-square test was conducted to compare pre- and post-test changes in knowledge and behavior related to PM2.5. The intervention group showed significant improvements in seven fine dust-related knowledge and behavior items (e.g., PM2.5 awareness rose from 33.3% to 75.0%; p < 0.05). The control group showed limited gains. Regarding mental health, based on a mixed-design ANCOVA, anxiety scores significantly declined over time in the intervention group, with group and interaction effects also significant (p < 0.05). Depression scores showed time effects, but group and interaction effects were not significant. No significant changes were observed for stress, sleep, or group × PM2.5 interactions. Conclusions: The CBT-based education program effectively enhanced fine dust knowledge, health behaviors, and reduced anxiety among students. It presents a promising, evidence-based strategy to promote environmental and mental health in school-aged children. Full article

Oral health during pregnancy is essential for maternal and child well-being, as hormonal and physiological changes increase women’s susceptibility to oral diseases. Despite the recognized importance of prenatal dental care, adherence to dental services remains a challenge in the public health context. This study aimed to analyze oral health and the use of dental services during pregnancy through the perception of pregnant women. It represents the qualitative phase of a mixed-method study conducted with 25 pregnant women (with and without dental care) receiving prenatal care in the Brazilian Unified Health System (SUS). Participants were selected through saturation sampling, and data were collected via semi-structured interviews, followed by content analysis. The findings revealed four major themes: barriers and facilitators to dental care, changes during pregnancy and oral health. Discomfort from oral changes was a common concern. Barriers included misinformation, fear, cultural beliefs, and service organization. In contrast, facilitating factors were identified, such as care prioritization, support from healthcare teams, health education, and access through SUS. This study concludes that emotional, cultural, and contextual aspects shape the use of dental services during pregnancy. Access through SUS is perceived as an important facilitator, which simultaneously presents organizational weaknesses that need to be addressed. Full article

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

Extreme heat is a pressing public health threat. This study assesses and describes the interrelationships between beliefs about heat waves, individuals’ precautionary behaviors during heat waves, and demographic factors. In May 2022, we surveyed 1051 residents (aged 25–90 years) in Southern Spain, a region that experiences frequent heat waves. We found that many participants engaged in heat wave avoidance (80.5%, e.g., spending more time indoors), impact reduction (63.7%, e.g., drinking more water), or prosocial behavior (31.6%, e.g., helping others). However, one in four (25.9%) respondents also indicated that they personally do not need to worry about heat waves. Heat wave beliefs and behaviors were modestly correlated with demographic characteristics. Individuals who view themselves as less vulnerable to heat-related health risks (“impervious” beliefs) were less likely to report altering their behavior during heat waves. Public health efforts aiming to change behavior during heat waves may anticipate “impervious” beliefs and demographic differences in risk perception and heat-related behaviors. Full article

Background: This study explores the potential of outdoor physical activity (OPA) to support physical, mental, and social health, while contributing to the One Health strategy. Methods: Based on Eurobarometer 97.3 data, 570 physically active individuals were compared by activity setting using descriptive statistics, chi-square tests with odds ratios, and the Mann–Whitney U test. Results: The analysis reveals that OPA is often driven by personal beliefs and a strong connection to nature, yet participants may overlook their environmental and social impact. Conclusions: The findings underscore the need for intersectoral cooperation and civic education to realise OPA’s role in promoting health, inclusion, and sustainability. Full article

The uptake of the COVID-19 and seasonal influenza (SI) vaccines have decreased in Europe and especially in Malta. The present study aimed to investigate the attitudes toward COVID-19 and SI vaccines and determine if individuals perceive that these vaccines are relevant to protect their health and identify reasons for their responses. A cross-sectional study using an anonymous questionnaire, informed by the Theory of Planned Behavior, addressing behavior beliefs and attitudes, and targeted at adult residents in Malta, was designed on Google Forms and disseminated using social media between January and March 2024. A total of 555 responses were received. The majority of respondents did not take/intend to take the COVID-19 (75%, n = 417) or SI (64.3%, n = 362) vaccines, with females being less likely to do so (p = 0.033). Perceived lack of safety (31.3%, n = 174) was the primary reason for rejecting the COVID-19 vaccine, and perceived lack of a threat from SI (26%, n = 144) was the reason for rejecting the SI vaccine. Those having chronic conditions were positively associated with uptake of both vaccines. In the post-pandemic era, these vaccines are not envisaged as having a major role in protecting one’s health. A high degree of skepticism especially toward the combined COVID-19 and SI vaccine in terms of safety, mostly in women, is still present. Full article

Background/Objectives: Medical and nursing students, as future healthcare professionals, influence public trust and vaccine acceptance. Knowledge gaps or misconceptions regarding immunization may undermine their confidence and effectiveness in addressing vaccine hesitancy. This study explores perceptions and attitudes toward childhood vaccination among Bulgarian healthcare students and factors shaping these outcomes. Methods: A cross-sectional survey was conducted in 2024, using an online self-administered questionnaire completed by 374 medical and nursing students. Descriptive statistics were used to analyze vaccine-related responses, comparing attitudes between healthcare programs and education years. Binomial logistic regression was applied to identify predictors of support for mandatory vaccination, first considering demographic and academic variables, and then adding students’ beliefs and common misconceptions. Results: Medical students showed more positive attitudes toward vaccination than nursing students, with 96.8% of medical students versus 89.4% of nursing students believing vaccines are effective (p = 0.005). Students in advanced years demonstrated stronger belief in vaccine effectiveness (p = 0.038). Additionally, misbeliefs about the measles vaccine causing autism decreased significantly, with most students in higher years rejecting this misconception (p = 0.009). Logistic regression revealed that belief in following the vaccine schedule (OR = 22.71; p < 0.001) and confidence in vaccine effectiveness (OR = 10.20; p < 0.001) were the strongest predictors of support for mandatory vaccination, with attitudinal factors explaining over half of the variance. Conclusions: Healthcare students’ attitudes about vaccination influence public health outcomes, as their perspectives reflect experience and beliefs. Targeted vaccine education helps address misconceptions and improve vaccination rates. Full article

The demand for sustainable animal production is increasing. Microalgae such as Chlorella and Spirulina show promise as sustainable and functional ingredients in animal (poultry) feed. However, little is known about consumer perceptions regarding the use of algae in broiler diets and potential effects of algae on chicken meat. Residents of Flanders (Belgium) were surveyed to evaluate consumer knowledge, attitudes and willingness to buy chicken meat produced with algae-supplemented feed. Demographic data were collected, and both descriptive and inferential statistics were applied to assess influencing factors (n = 275 respondents who purchase chicken meat). While most respondents (69.6%) had tasted macroalgae (seaweed), only 11.4% and 24.6% indicated having tasted Chlorella and Spirulina before, respectively. Health, taste and safety were the most important drivers for consuming algae. Meat quality was the most important factor when purchasing chicken meat, while organic production was least valued. Regarding algae-fed chicken, 72.5% expressed willingness to purchase meat labeled as such, and 83.7% would buy algae-fed chicken regardless of its color. Sustainability beliefs significantly influenced willingness to accept a yellower meat color (β = 0.42 to 0.66, p < 0.001). Educational level and age also played a role, with higher-educated consumers showing greater acceptance. The influence of age was also related to the price of the meat, with consumers over 30 expressing a greater willingness to pay more than young people (under 30). Despite limited general knowledge about microalgae, the consumers surveyed are open to the idea of algae-fed chicken meat, particularly when it is framed as more sustainable. Clear ingredient labeling and consumer education may further support market acceptance. Full article

Plant supplements are frequently used by diabetes mellitus (DM) patients in the management of their disease. Background/Objectives: The present study aimed to identify the prevalence of plant supplement use in DM patients from Romania and to evaluate patients’ practices, profiles, and beliefs regarding plant supplements and the impact of their use on glycemic control. Methods: A cross-sectional online survey was conducted among Romanian diabetic patients. Results: Out of 329 validated responses, 44.07% reported supplement use. Momordica charantia L. (35.17%) was the most used. Female patients were statistically significantly more prevalent in the plant supplement user group. Plant supplement use was associated with statistically significantly lower HbA1c (7.11% vs. 7.66%, p < 0.01) and basal glycemia (127.75 mg/dL vs. 136.08 mg/dL, p < 0.01) over the previous three months. Diabetic polyneuropathy was statistically significantly less prevalent among patients who used plant supplements (31.03% vs. 42.39%, p = 0.035). The greatest proportion of responders reported that they started to use plant supplements for improving blood glycemia (88.97%), followed by the purpose of preventing DM complications (27.59%). A significant improvement in health status was reported by 53.79% of patients using herbal supplements. Conclusions: Plant supplement use was common and associated with improved glycemic parameters and lower complication prevalence. Full article

Aim: To explore the experiences, beliefs, and values of patients who participated in a two-arm randomized clinical trial assessing a nurse-led intervention program for chronic pain self-management, which demonstrated positive effects on pain reduction, depression, and anxiety, and on health-related quality of life 24 months after completion of the program. Design: Descriptive phenomenological qualitative study. Methods: Patients were recruited via telephone, informed about the study, and invited to participate in an individual interview at a place of their choice (hospital or home). All interviews were audiotaped, and an inductive thematic analysis was performed. Results: Seven interviews were carried out between both groups. Six emerging categories were found: effective relationship with the healthcare system, learning to live with pain, family and social support, behaviors regarding pain, resources for self-management, and concomitant determinants. Conclusions: Patients report key aspects that help us to understand the impact of this type of nurse-led group intervention: the intrinsic therapeutic effect of participating in the program itself, the ability to learn to live with pain, the importance of family and social support, the modification of pain-related behaviors, and the identification of resources for self-care. The findings highlight the need for gender-sensitive, individualized care approaches to chronic pain, addressing stigma and social context. Expanding community-based programs and supporting caregivers is essential, as is further research into gender roles, family dynamics, and work-related factors. Full article

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article