Search Results (516)

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: Breast cancer remains a major public health challenge in Latin America, where access to personalized risk assessment tools is still limited. This study aimed to evaluate the implementation of a polygenic risk score (PRS)-based stratification model combined with remote genomic counseling in Colombian women with sporadic breast cancer and healthy women. Methods: In 2023, an embedded mixed-methods observational study was conducted in Medellín involving 1997 women aged 40–75 years who underwent clinical PRS testing. The intervention integrated PRS-based risk categorization with individualized risk factor assessment and lifestyle recommendations delivered through a remote counseling platform. Results: PRS analysis classified 9.7% of women as high risk and 46% as low risk. Healthier lifestyle patterns were significantly associated with lower PRS categories (p = 0.034). Physical activity showed a protective effect (OR = 0.60, 95% CI: 0.5–0.8), while prior smoking, elevated BMI, and sedentary behavior were associated with higher risk. The counseling model achieved high delivery (93%) and satisfaction (85%) rates. Qualitative insights revealed improved understanding of genomic risk and greater engagement in preventive behaviors. Only one new case of breast cancer was detected among intermediate-risk participants, with a diagnostic lead time of 12 months. Conclusions: These findings support the feasibility, acceptability, and potential impact of integrating PRS and genomic counseling in cancer prevention strategies in middle-income settings. Full article

Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation—including diagnostics and potential vaccine research—are critical to controlling the global syphilis epidemic. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

Reproductive health literacy (RHL) is essential to women’s ability to make informed reproductive health (RH) decisions and is a key determinant of RH outcomes. Resettled refugee women often experience poorer RH outcomes, yet there is limited research on their RHL and its influence on RH decision-making. This scoping review aims to (1) to evaluate existing methods for measuring RHL among resettled refugee women and (2) to characterize the relationship between RHL, RH decision-making, behavior, and outcomes among refugee women residing in high-income countries. A search of peer-reviewed literature published in English found limited direct measurement of RHL. Measurement methods were primarily qualitative or based on unvalidated survey instruments, limiting comparability and generalizability. The current methodologies do not adequately capture RH knowledge or RHL proficiency. A range of additional factors were found to influence RH decision-making and behavior, supporting the need for a means to accurately measure RHL. Further quantitative research is needed to clarify the extent to which RHL and knowledge influence RH behavior and outcomes. The development of a culturally relevant, validated RHL instrument that integrates knowledge and contextual influences would support healthcare providers and public health agents in serving and designing effective interventions for refugee women post-resettlement. Full article

Temperature increases due to climatic changes have been increasingly recognized as posing significant public health challenges, with wide-ranging socio-economic implications. This scoping review examines the relationship between high temperatures and violence against women (VAW) globally. Nine studies from both high-income and low- and middle-income countries were included in this review. The findings suggest an overall positive association between high temperatures and rates of VAW. Theoretical frameworks, including the temperature–aggression hypothesis and routine activity theory, offer insights into the mechanisms driving this relationship. Key risk factors such as socioeconomic status, urban heat island effects, rurality, patriarchal norms, and alcohol consumption were considered to be risk factors affecting rates of VAW. Despite growing evidence, research gaps persist, particularly in regions with high rates of VAW and in the form of qualitative studies that capture women’s lived experiences. The positive associations between temperature and VAW underscore the urgency of integrating gender-sensitive strategies into climate adaptation policies to mitigate the compounding risks of climate change and gender-based violence. Full article

Background/Objective: The impact that lifestyle has on someone’s health has been widely proven. And the lifestyle can also be highly influenced by the sociodemographic background; however, there is less literature that focuses on this matter. Hence, the objective of the present study is to analyze the influence of sociodemographic variables on the lifestyle of the adult population. Methods: A cross-sectional multicenter study was conducted in 20 health centers of the Community of Madrid (Spain). A total of 365 participants were scheduled for nursing consultations and recruited through systematic probabilistic sampling. Lifestyle was assessed using the “Ponte a 100” questionnaire; based on the total score achieved by the participants, these were categorized into four groups depending on their need to adopt healthier lifestyle habits: minimal need (80–100 points), mild need (60–79 points), moderate need (40–59 points), and high need (<39 points). Results: Values ranged from 23 to 98 points in the Lifestyle Index (ISEV), with an average of 71.8 (SD = 14.6 points). Older individuals had better eating habits (β = −1.982), while younger individuals had better physical activity habits and a higher consumption of toxic substances. Men consumed more alcohol (β = −2.307) and felt happier with their lives, while women took more active breaks. Being a student was associated with higher levels of stress and anxiety, lower physical activity and leisure time, and higher alcohol consumption. Retirees had better emotional well-being indices (β = 0.999). Lower income levels were associated with occasional drug use and poorer emotional well-being. People with university degrees had better emotional states (β = 0.861) and better eating habits (β = 1.652) and engaged in more intense physical activity. Having no chronic diseases was related to being more physically active (β = 1.789). Conclusions: The study population generally presents a healthy lifestyle. The dimension of emotional well-being was the most influenced by sociodemographic factors. This study contributes to understanding the impact of socioeconomic variables on lifestyle. 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/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community. Full article

Background/Objectives: Mental health conditions represent a growing global health concern, disproportionately impacting populations in low- and middle-income countries like Pakistan. Limited epidemiological data, coupled with recent socioeconomic and environmental disruptions, has intensified the need for current insights into psychological burden and coping capacities in the Pakistani population. Methods: A descriptive, cross-sectional survey was conducted from January to May 2023 among 400 community-dwelling adults attending outpatient departments in Islamabad and Rawalpindi. A structured 75-item questionnaire incorporating validated tools (PHQ-9, GAD-7, WHO-5, CSES, and SRQ-20) was used to assess depression, anxiety, well-being, coping self-efficacy, and mental distress. Descriptive statistics, χ² and Fisher’s exact tests, and Spearman’s rank correlation (r_s) analyses were performed using IBM SPSS 22.0. Results: Most respondents were male (73.0%), aged 25–34 (60.0%), and urban-dwelling (80.0%). Clinically relevant depression and anxiety were observed in 57.0% and 19.5% of participants, respectively; 38.0% reported mental distress. Conversely, 76.5% demonstrated fair-to-good coping efficacy and 51.0% had high well-being scores. Younger age (≤34 years), higher income, urban residence, and male gender were associated with significantly better mental health outcomes. Strong positive correlation was found between PHQ-9 and GAD-7 scores (r_s = 0.672), and moderate negative correlations were found between GAD-7 and WHO-5 (r_s = −0.496), and PHQ-9 and WHO-5 (r_s = −0.310). Conclusions: Our findings highlight the significant psychological burden among urban Pakistani adults, alongside promising levels of resilience and coping self-efficacy. These results emphasize the urgent need for early, culturally adapted mental health screening and intervention programs in outpatient settings. Integrating such strategies into primary care, particularly for vulnerable subgroups like women, older adults, and those with lower income could facilitate timely diagnosis, improve outcomes, and reduce stigma surrounding mental health. Full article

Cervical cancer remains one of the main causes of female mortality, especially in middle- and low-income countries, despite efforts towards the implementation of global vaccination against human papillomavirus (HPV). The aim of this study was to review and compare the most recently published international guidelines providing recommendations on cervical cancer screening strategies among average and high-risk women. Thus, a comparative review of guidelines by the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO), the World Health Organization (WHO), the Canadian Task Force on Preventive Health Care (CTFPHC), the Cancer Council Australia (CCA), and the European Guidelines (EG) was conducted. There is an overall agreement regarding the suggestions made for women younger than 21 and those older than 65, with all guidelines stating against routine screening, with the exceptions of CTFPHC and CCA that expand the age group to up to 70 and 75 years, respectively. Continuation of screening in older women is also suggested in those with a history of a precancerous lesion and those with inadequate screening. Most guidelines recommend routine screening at 30–65 years, while the WHO advises that screening should be prioritized at 30–49 years. HPV DNA testing is the method of choice recommended by most guidelines, followed by cytology as an alternative, except for CTFPHC, which refers to cytology only, with self-sampling being an acceptable method by most medical societies. Agreements exist regarding recommendations for specific groups, such as women with a history of total hysterectomy for benign reasons, women with a complete vaccination against HPV, individuals from the lesbian, gay, bisexual, transgender, and queer communities and women with multiple sexual partners or early initiation of sexual activity. On the other hand, the age group of 21–29 is addressed differently by the reviewed guidelines, while differentiations also occur in the screening strategies in cases of abnormal screening results, in women with immunodeficiency, those with in utero exposure to diethylstilbestrole and pregnant women. The development of consistent practice protocols for the most appropriate cervical cancer screening programs seems to be of major importance to reduce mortality rates and safely guide everyday clinical practice. Full article

Background: Late-life depression is a critical public health concern, particularly among older adults with chronic multimorbidity. Existing studies often focus on single-disease associations, neglecting the complex interplay of coexisting conditions. Understanding how multimorbidity patterns contribute to depression risk and identifying high-risk subgroups through integrated statistical and machine learning approaches remain underexplored, limiting targeted prevention strategies. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), latent class analysis (LCA) was employed to cluster multimorbidity patterns. Associations between these patterns and depression were analyzed using multivariable logistic regression, while predictive performance and interaction effects were evaluated via an XGBoost machine learning model. Results: Four distinct multimorbidity patterns were identified: cardio-metabolic, digestive–joint, respiratory, and cardiovascular–digestive pattern. All clusters showed significant independent associations with depression, with the cardiovascular–digestive pattern exhibiting the strongest association (OR = 4.56). However, the digestive–joint pattern demonstrated the highest predictive effects for depression. Sociodemographic factors—low income, limited education, female gender, and rural residence—emerged as robust predictors, amplifying depression risk in older adults with multimorbidity. Conclusions: This study bridges epidemiological insights with predictive analytics to inform depression risk stratification. We recommend routine depression screening for all individuals with cardiovascular–digestive diseases and prioritize screening for women with digestive–joint diseases. Additionally, low-income and rural-dwelling older adults with chronic conditions warrant heightened clinical vigilance. These findings provide a framework for integrating multimorbidity profiling into depression prevention protocols, addressing both biological and socioeconomic determinants. Full article

Seaweeds represent a vital yet often understudied component of the diet and cultural heritage of many coastal communities globally. This study investigated seaweed consumption practices in coastal communities of Tawi-Tawi, Philippines, through one-to-one interviews (n = 280) and focus group discussions (n = 7). The study revealed that nearly all (99%) of the population consumes seaweeds, with women comprising the majority of consumers who have done so since childhood (68% female vs. 32% male). These consumers were predominantly married (79%), within the 21–40 age group (53%), with families of 5–7 members (43%), practicing Islam (97%), and belonging to the Sama tribe (71%). A significant portion (48%) had resided in the area for 21–30 years, attained elementary to high school education (66%), and had a monthly income ranging from 1000 to 10,000 Philippine pesos (72%). Seaweed consumption was a family-wide practice (88%), including children, who typically started around 4–8 years old (61%), driven by perceived nutritional benefits (43%), preferred flavor (80%), affordability (19%), ease of preparation (33%), and cultural integration (23%). The primary edible seaweeds identified were Kappaphycus alvarezii (63%), K. striatus (58%), Kappaphycus spp. (47%), Eucheuma denticulatum (57%), Caulerpa lentillifera (64%), Caulerpa spp. (51%), C. cf. macrodisca ecad corynephora (45%), C. racemosa (30%), and Solieria robusta (49%), with less frequent consumption of K. malesianus (8%), Chaetomorpha crassa (3%), Gracilaria spp. (0.72%), and Hydroclathrus clathratus (0.36%). Specific plant parts were preferred for certain species, and preparation predominantly involved raw (75%) or cooked (77%) salads with spices, primarily prepared by mothers (72%). Consumers generally avoided seaweeds showing signs of ice-ice disease (95%), pale coloration (91%), or epiphyte infestation (84%). Consumption frequency was typically 1–3 times per week (45%), with knowledge largely passed down through generations (95%). Seaweed salads were primarily consumed as a viand (92%) at home (97%), with locals perceiving seaweed consumption as contributing to a healthy diet (40%) and overall well-being [e.g., aiding hunger (76%), improving digestion (20%), preventing obesity (14%), and aiding brain development (3%)]. The study’s findings emphasize the significant yet often overlooked role of seaweeds in the food systems and cultural heritage of Tawi-Tawi’s coastal communities. Future efforts should prioritize the sustainable management of wild resources, explore the cultivation of diverse edible species, and enhance nutritional awareness. Further research into traditional seaweed knowledge holds broader value. Full article

Background/Objectives: Cervical cancer (CC) is a significant global health challenge, particularly in low- and middle-income countries (LMICs), where limited access to human papillomavirus (HPV) vaccination and effective CC screening results in a majority of cases and fatalities among women. Moreover, existing vaccines do not target HPV-independent cancers. Current screening methods are expensive and time-consuming, with a limited emphasis on CC protein biomarkers. Therefore, we aimed to validate critical markers that allow the development of affordable point-of-care screening tests for resource-limited settings. Methods: This study first optimized a cell lysis and protein extraction protocol for CC cell lines and clinical cervical swabs. Subsequently, four proteins—topoisomerase II alpha (TOP2A), minichromosome maintenance complex component 2 (MCM2), valosin-containing protein (VCP), and cyclin-dependent kinase inhibitor 2A (p16INK4a)—were quantified in the resulting lysates using enzyme-linked immunosorbent assays, as well as in cervical tumors and squamous intraepithelial lesions (SILs) using immunohistochemistry for further validation. Results: Acetone precipitation allowed for efficient cell isolation, and radioimmunoprecipitation assay buffer yielded the highest protein recovery. VCP and p16INK4a were overexpressed across all cancer cell lines compared to primary cells. All four biomarkers were overexpressed in high-grade SIL (HSIL) swab specimens and tumor samples, including CC subtypes, G1–G3 tumor grades, and HSILs. Lastly, we showed that the proteins could accurately classify swabs and tissue specimens into clinically relevant groups. Conclusions: The quantitative analysis of these biomarkers, along with the subsequent sensitive and specific clinical classification, highlights their potential application in SIL early detection and CC prevention, particularly in LMICs. Full article