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23 pages, 31325 KB  
Article
Public Evaluation of Notre-Dame Whispers, a Geolocated Outdoor Audio-Guided Tour of Notre-Dame’s Sonic History
by Julien De Muynke, Stéphanie Peichert and Brian F. G. Katz
Heritage 2026, 9(1), 19; https://doi.org/10.3390/heritage9010019 - 9 Jan 2026
Viewed by 226
Abstract
This study presents the on-site public evaluation of Notre-Dame Whispers, a geolocated audio-guided tour that explores the sonic history of the Cathédrale Notre-Dame de Paris. The experience combines binaural reproduction, embodied storytelling, and historically informed soundscapes to immerse visitors in the cathedral’s [...] Read more.
This study presents the on-site public evaluation of Notre-Dame Whispers, a geolocated audio-guided tour that explores the sonic history of the Cathédrale Notre-Dame de Paris. The experience combines binaural reproduction, embodied storytelling, and historically informed soundscapes to immerse visitors in the cathedral’s past auditory environments. Drawing on virtually recreated acoustics, it reconstructs key components of Notre-Dame’s sound heritage, including the medieval construction site, early polyphonic chant, and the contemporary urban soundscape. An on-site evaluation was conducted to assess visitor engagement, usability, and the perceived authenticity of the reconstructed soundscapes. A mixed-methods approach integrated questionnaire responses, semi-structured interviews, and anonymized user analytics collected through the mobile application. Results indicate a high level of immersion, with participants particularly valuing the spatialised audio design and narrative depth. However, challenges were identified regarding GPS-based triggering reliability and the difficulty of situational interpretation in complex spatial environments. These findings offer insights into public reception of immersive heritage audio experiences and inform future developments in digital cultural mediation. Full article
(This article belongs to the Special Issue The Past Has Ears: Archaeoacoustics and Acoustic Heritage)
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8 pages, 209 KB  
Article
“Betrayal” and Faithfulness in Translation as Intercultural Mediation. Ethical Dilemmas and Strategies in South-Eastern Literary Discourse
by Carmen Andrei
Humanities 2026, 15(1), 9; https://doi.org/10.3390/h15010009 - 5 Jan 2026
Viewed by 155
Abstract
This paper offers a series of reflections and observations derived from my experience as a (semi-) professional literary translator and as a teacher of translation studies. I openly recognise the subjective nature of any meta-reflection on the ethical challenges faced by the translator [...] Read more.
This paper offers a series of reflections and observations derived from my experience as a (semi-) professional literary translator and as a teacher of translation studies. I openly recognise the subjective nature of any meta-reflection on the ethical challenges faced by the translator as an intercultural mediator. After briefly examining several central theses that have been defended, illustrated, and adopted to produce a translation that is politically correct from both a professional and deontological standpoint, I then list and analyse the major obstacles to the reception of a novel featuring “Romanian subject matter” written by a French author: cultural, historical, and political allusions as well as culinary and civilizational culture-specific elements. The examples come from Lionel Duroy’s novels Eugenia (2018) and Mes pas dans leurs ombres (2023), which revisit the pogroms of Iași, Bucharest, Bessarabia, and Ukraine, leading to the extermination of the Jewish population (1940–1941)—a significant and painful chapter of Romanian history, often overlooked or silenced. These cases enable us to argue more convincingly for the strategies, techniques, and procedures that can be considered when translating a text laden with profound cultural and ideological significance, aiming to help the Romanian/French and Francophone reader to understand sensitive realia and listen to History. Full article
21 pages, 3633 KB  
Article
One System, Two Rules: Asymmetrical Coupling of Speech Production and Reading Comprehension in the Trilingual Brain
by Yuanbo Wang, Yingfang Meng, Qiuyue Yang and Ruiming Wang
Brain Sci. 2025, 15(12), 1288; https://doi.org/10.3390/brainsci15121288 - 29 Nov 2025
Viewed by 463
Abstract
Background/Objectives: The functional architecture connecting speech production and reading comprehension remains unclear in multilinguals. This study investigated the cross-modal interaction between these systems in trilinguals to resolve the debate between Age of Acquisition (AoA) and usage frequency. Methods: We recruited 144 Uyghur (L1)–Chinese [...] Read more.
Background/Objectives: The functional architecture connecting speech production and reading comprehension remains unclear in multilinguals. This study investigated the cross-modal interaction between these systems in trilinguals to resolve the debate between Age of Acquisition (AoA) and usage frequency. Methods: We recruited 144 Uyghur (L1)–Chinese (L2)–English (L3) trilinguals, a population uniquely dissociating acquisition order from social dominance. Participants completed a production-to-comprehension priming paradigm, naming pictures in one language before performing a lexical decision task on translated words. Data were analyzed using linear mixed-effects models. Results: Significant cross-language priming confirmed an integrated lexicon, yet a fundamental asymmetry emerged. The top-down influence of production was governed by AoA; earlier-acquired languages (specifically L1) generated more effective priming signals than L2. Conversely, the bottom-up efficiency of recognition was driven by social usage frequency; the socially dominant L2 was the most receptive target, surpassing the heritage L1. Conclusions: The trilingual lexicon operates via “Two Rules”: a history-driven production system (AoA) and an environment-driven recognition system (Social Usage). This asymmetrical baseline challenges simple bilingual extensions and clarifies the dynamics of multilingual language control. Full article
(This article belongs to the Topic Language: From Hearing to Speech and Writing)
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17 pages, 268 KB  
Article
Noah’s Ark on Irish Shores: German Historicism and the Religious Politics of Ancient Origins
by Tamar Kojman
Religions 2025, 16(11), 1386; https://doi.org/10.3390/rel16111386 - 30 Oct 2025
Viewed by 585
Abstract
In 1844, Hermann Müller, a Catholic law professor from Würzburg, published a hefty volume on Nordic Greekdom and the Original History of North-Western Europe. The study claimed to hold definitive proof of the north-European origins of Hellenism, Abrahamic monotheism, and the entire [...] Read more.
In 1844, Hermann Müller, a Catholic law professor from Würzburg, published a hefty volume on Nordic Greekdom and the Original History of North-Western Europe. The study claimed to hold definitive proof of the north-European origins of Hellenism, Abrahamic monotheism, and the entire human race. Germanic history was not German at all, Müller argued, but Celtic, and underneath it lay another hidden history of Nordic Greekdom, of which Southern Hellenism had been but a minor branch. Though it is today largely forgotten, Müller’s book elicited several responses upon publication and as late as the 1920s in Nazi literature. This article examines the reception of Nordic Greekdom as a striking example of the politicization of antiquity as an origin myth, arguing that the array of modern historicizations of antiquity and of Christianity’s place within it forms a ruptured and incoherent continuity of which ideologies as dissimilar as liberalism, Christian conservatism, and fascism—to name but a few—were all a part. Tracing this variety across ideological divides avoids overly rigid dichotomies such as the distinction between theological and racial antisemitism, while acknowledging the persistent, vast significance of Christianity within these discussions, whether as a living faith or as a discarded inheritance. Full article
(This article belongs to the Special Issue Traditional and Civil Religions: Theory and Political Practice)
13 pages, 243 KB  
Article
Objecting to the Burden: Yosef Hayim Yerushalmi’s Zakhor and American Jewish Literature
by Ariel Horowitz
Humanities 2025, 14(10), 204; https://doi.org/10.3390/h14100204 - 20 Oct 2025
Viewed by 555
Abstract
In his seminal book Zakhor: Jewish History and Jewish Memory (1982), renowned historian Yosef Hayim Yerushalmi argues that it is literature and culture, and not historiography, that shaped Jewish collective memory for generations. In Yerushalmi’s telling, the boundaries between historiography and literature, “truth” [...] Read more.
In his seminal book Zakhor: Jewish History and Jewish Memory (1982), renowned historian Yosef Hayim Yerushalmi argues that it is literature and culture, and not historiography, that shaped Jewish collective memory for generations. In Yerushalmi’s telling, the boundaries between historiography and literature, “truth” and “myth,” are set and strict. However, the reception of Yerushalmi’s work itself challenges this assumption and obscures the clear-cut distinctions between literature and historiography. This paper reads Yerushalmi’s book alongside its preface, written by Harold Bloom, in an attempt to understand Zakhor not only as a historiographic argument, but as a narrative of Jewish modernity, a literary meditation, embodying the very shift in collective memory that Yerushalmi himself lamented. The paper then explores the ways in which Yerushalmi’s work has inspired two prominent contemporary American Jewish writers: Joshua Cohen, in his novel The Netanyahus (2021), and Nicole Krauss, in her short story “Zusya on the Roof” (2013). In their literary work, one can hear echoes of Yerushalmi’s work, distinct and identifiable, yet incorporated in a fictional, imaginative world. Zakhor thus serves not only as an inspiration but as a catalyst for a deep, insightful rendering of Jewish history and one’s grappling with it. Full article
(This article belongs to the Special Issue Comparative Jewish Literatures)
23 pages, 387 KB  
Article
The Afterlife of Petrarch’s Liber sine nomine in Catholic and Protestant Contexts: The Case of Bernhard von Kraiburg’s Epistle on the Fall of Constantinople (1453)
by Péter Ertl
Religions 2025, 16(10), 1318; https://doi.org/10.3390/rel16101318 - 17 Oct 2025
Viewed by 912
Abstract
Petrarch’s Liber sine nomine is a collection of satirical letters against the Avignon Curia, remarkable for its stylistic refinement. It offered later readers multiple possibilities of interpretation and reuse, serving both as a rhetorical model and as a resource for anti-papal argumentation. While [...] Read more.
Petrarch’s Liber sine nomine is a collection of satirical letters against the Avignon Curia, remarkable for its stylistic refinement. It offered later readers multiple possibilities of interpretation and reuse, serving both as a rhetorical model and as a resource for anti-papal argumentation. While literary application predominated in the fifteenth century, the collection was later repurposed in religious debates between Protestants and Catholics. This paper examines a little-known episode in its afterlife, namely the epistle on the fall of Constantinople in 1453 by Bernhard von Kraiburg, chancellor of the Archbishop of Salzburg and later Bishop of Chiemsee. Close philological analysis shows that Bernhard adapted extensive passages from the Liber sine nomine and, along with a few other authors, established a distinct line of reception by reinterpreting selected letters as prayers. In the second half of the seventeenth century, however, Bernhard’s work met an analogous fate to that of its model. It was read and reframed from a Lutheran perspective by Johann Konrad Dieterich, professor of Greek and history at the University of Gießen, and was subsequently subjected to indirect censorship in the Index librorum prohibitorum. Full article
(This article belongs to the Special Issue Peccata Lectionis)
24 pages, 2380 KB  
Article
Resisting Chauvinist Stereotypes: The Impertinence of Russian Painting at London’s International Exhibition of 1862
by Rosalind Polly Blakesley
Arts 2025, 14(5), 118; https://doi.org/10.3390/arts14050118 - 30 Sep 2025
Viewed by 1192
Abstract
The Russian empire’s displays of applied and decorative art at the Great Exhibition of 1851 and its immediate successors have long galvanised scholars for their semantic complexity. By contrast, Russia’s first selection of paintings for this fiercely competitive arena, shown at London’s International [...] Read more.
The Russian empire’s displays of applied and decorative art at the Great Exhibition of 1851 and its immediate successors have long galvanised scholars for their semantic complexity. By contrast, Russia’s first selection of paintings for this fiercely competitive arena, shown at London’s International Exhibition of 1862, failed to ignite the public imagination and has largely evaded the historian’s gaze. While the three-dimensional artworks provided a recurrent source of wonderment for their superlative craftsmanship, stupendous materials, and often hyperbolic proportions, the paintings were apparently flat in every sense of the word: derivative, lacklustre, and incapable of capitalising on the opportunity that international exhibitions offered to present a national school. The dismissive comments they attracted set the tone for many later accounts, embedding the idea that Russian painting prior to the twentieth century was of limited consequence—a perception that would prove convenient to those asserting the originality of the avant-garde. Yet renewed consideration of Russia’s display of paintings in 1862 suggests that their critical reception speaks to concerns that went well beyond the pictures’ supposed obligation to represent a national school. Notably, a small but significant number of history and portrait paintings by academically trained and often well-travelled artists challenged notions of Russians as primitive and parochial. The technically adventurous of these parried the belief that Russian art was insufficiently mature to experiment in painterly effect. Most audacious of all, they broached unspoken national boundaries by daring to suggest that Imperial Russian artists could innovate in areas on which the success of British painting rested. The attitudes towards Russian painting in 1862 thus invite fresh scrutiny, revealing as they do a disruptive arena in which aesthetic rivalries and chauvinist sensibilities came to the fore. Full article
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16 pages, 354 KB  
Article
Revisiting Biblical Studies in Light of Reception Theory: Christian and Jewish Arabic Sources on Psalms 110 and 137
by Miriam Lindgren Hjälm and Meira Polliack
Religions 2025, 16(10), 1218; https://doi.org/10.3390/rel16101218 - 23 Sep 2025
Viewed by 1255
Abstract
The purpose of the present paper is to revisit the interface between biblical studies, reception exegesis, and reception theory. In the first part of the paper, we discuss what we believe to be the most important lessons learned from recent scholarship on the [...] Read more.
The purpose of the present paper is to revisit the interface between biblical studies, reception exegesis, and reception theory. In the first part of the paper, we discuss what we believe to be the most important lessons learned from recent scholarship on the relationship between these fields and highlight what we think is still an underestimated conclusion: if we assume that “meaning” is contextual rather than essential, the full(er) capacity of a biblical text is not discoverable until we have examined how it has appeared in various contexts. Related to this is the question of why and how texts survive and even thrive in new contexts and in what way later authors utilize the “capacity” of the biblical texts, because even if “meaning” is ultimately brought to texts by their readers, texts are in some senses agents as well. To exemplify these discussions and the connection between reception exegesis and biblical criticism, two short examples from the reception of Psalms 110 and 137 in medieval Christian Arabic and Judeo-Arabic sources are presented. In the first example, we recapitulate findings on how inner-biblical reception generates a complex web of potential interpretations but also how the ambivalence created in the process may be the greatest asset of that text. It is also an example of where interpretation may teach us about the life and thought of ancient and medieval communities and how they interacted with one another over the meaning of the biblical text. In contrast, the second example is more centered on the “capacity” of the text and in what sense communities exploit that potential for their larger purposes. Full article
(This article belongs to the Special Issue The Hebrew Bible: A Journey Through History and Literature)
13 pages, 291 KB  
Article
Effectiveness of Ethnic-Cultural Educational Strategies for the Promotion of Breastfeeding
by José Fabián Hidrobo-Guzmán, Gladys Edelmira Morejón-Jácome, Edison Daniel Cárdenas-Robles, Lizbeth Dayana Pilco-Vargas, Doménica Vanesa Posso López and Estefany Tatiana Iguago Angamarca
Int. J. Environ. Res. Public Health 2025, 22(9), 1416; https://doi.org/10.3390/ijerph22091416 - 11 Sep 2025
Viewed by 995
Abstract
Introduction: The implementation of pedagogical tactics with ethnic-cultural approaches represents essential mechanisms for promoting breastfeeding, ensuring greater effectiveness in knowledge dissemination. These are supported by cultural ideologies that integrate didactic processes tailored to the beliefs and practices of each ethnic group, thus facilitating [...] Read more.
Introduction: The implementation of pedagogical tactics with ethnic-cultural approaches represents essential mechanisms for promoting breastfeeding, ensuring greater effectiveness in knowledge dissemination. These are supported by cultural ideologies that integrate didactic processes tailored to the beliefs and practices of each ethnic group, thus facilitating greater acceptance and adherence to health recommendations. Objective: The study aims to analyze the effectiveness of culturally sensitive educational strategies from the prenatal stage at the Quiroga Health Center, Ecuador, exploring how indigenous cultural dynamics influence the receptivity of education. Methodology: The research is quantitative, quasi-experimental, and employs a descriptive, documentary, bibliographic, and analytical cross-sectional cohort design to thoroughly analyze collected data and identify cause-and-effect factors influencing breastfeeding knowledge and practice. Results: The effectiveness of the educational intervention in promoting cognitive awareness of breastfeeding was confirmed using the McNemar statistic applied to related samples. Conclusions: Breastfeeding knowledge levels are closely tied to reproductive history, a constantly evolving process affected by various social factors. Health education is implemented and strengthened through teaching programs as these strategies can significantly contribute to maternal and child health promotion, adapting to the specific needs and contexts of each community. Full article
17 pages, 264 KB  
Article
The Prince’s Two Bodies: The Machiavellian Hero as a Literary Character Between History and Invention
by Carmelo Tramontana
Humanities 2025, 14(9), 177; https://doi.org/10.3390/h14090177 - 29 Aug 2025
Viewed by 1229
Abstract
This article discusses how in De principatibus Machiavelli defines the status of the treatise main character (the Prince) through the intersection of three levels: (a) history (as a character born from the symbolic fusion of traits and characteristics of historical personalities who actually [...] Read more.
This article discusses how in De principatibus Machiavelli defines the status of the treatise main character (the Prince) through the intersection of three levels: (a) history (as a character born from the symbolic fusion of traits and characteristics of historical personalities who actually existed); (b) politics (as a character who is the sign of an abstract political function); and (c) literary invention (as a fictional character constructed according to the rhetorical and logical strategies of literary invention). This case study shows how rhetoric, historiography, oratory, and political analysis are mixed together in a coherent organism, thanks to the creation of a character (the Prince) who constantly oscillates between historical–political reality and literary fiction. The analysis, both theoretical and historical, of the status of the protagonist of De principatibus is accompanied by the study of the critical readings of Francesco De Sanctis, Antonio Gramsci, and Luigi Russo, whose reception is strongly conditioned by the ambiguous nature of the character of the Prince, both in terms of critical categories and argumentative strategies. Full article
15 pages, 2451 KB  
Article
Systematic Comparison of Temperature Effects on Antibody Performance via Automated Image Analysis: A Key for Primary Ciliary Dyskinesia Diagnostic
by Hanna Przystalowska-Maciola, Malgorzata Dabrowska, Ewa Zietkiewicz and Bukowy-Bieryllo Zuzanna
Cells 2025, 14(16), 1236; https://doi.org/10.3390/cells14161236 - 11 Aug 2025
Viewed by 2953
Abstract
Immunofluorescence (IF) microscopy of ciliated epithelium is gaining increased popularity as a pre-genetic diagnostic method in primary ciliary dyskinesia (PCD). Ensuring reliable IF-based diagnostics in PCD requires robust standardization of staining methods and antibody performance. We applied whole slide scanning and automated image [...] Read more.
Immunofluorescence (IF) microscopy of ciliated epithelium is gaining increased popularity as a pre-genetic diagnostic method in primary ciliary dyskinesia (PCD). Ensuring reliable IF-based diagnostics in PCD requires robust standardization of staining methods and antibody performance. We applied whole slide scanning and automated image analysis to systematically evaluate the influence of various sample storage conditions on the specificity of IF staining. We tested eight polyclonal antibodies targeting diverse axonemal protein epitopes, routinely used for PCD diagnostics, under seven different temperature and time combinations. The storage conditions simulated handling of epithelial brushing on glass slides: after material collection at the clinic, during transport, or after reception at the diagnostic laboratory. Our study revealed that proper slide storage conditions are essential for the reliable PCD diagnosis via IF staining. We suggest continuous storage at −80 °C or −20 °C for slides prepared at the diagnostic laboratory, and storage at −20 °C or 4 °C for slides prepared remotely and shipped. Moreover, the IF sensitivity to slide storage conditions differs among antibodies targeting various ciliary elements, with molecular ruler proteins being particularly sensitive to prolonged storage at room temperature. We emphasize the inclusion of additional control slides to mitigate the inter-individual differences and the crucial correlation of IF results with comprehensive patient clinical history for enhanced diagnostic reliability. Full article
(This article belongs to the Special Issue Imaging Methods in Cell Biology)
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34 pages, 492 KB  
Article
Who’s the Dude? A Historical Profile of the Critical Reception of Johannes De Hauvilla’s Architrenius
by Lorenzo Carlucci and Laura Marino
Humanities 2025, 14(8), 156; https://doi.org/10.3390/h14080156 - 25 Jul 2025
Viewed by 834
Abstract
Medieval and modern readers of Johannes de Hauvilla’s late XII-century Latin poem Architrenius have proposed an array of discordant interpretations of the eponymous protagonist. This paper offers a historical profile of the critical reception of this peculiar fictional character, tracing responses from the [...] Read more.
Medieval and modern readers of Johannes de Hauvilla’s late XII-century Latin poem Architrenius have proposed an array of discordant interpretations of the eponymous protagonist. This paper offers a historical profile of the critical reception of this peculiar fictional character, tracing responses from the Middle Ages to the present day. Given the poem’s limited dissemination and the modest critical attention it has received in modern times, it is possible to provide a nearly comprehensive overview of the reception history of the Architrenius. We analyze and classify the terminology and the argumentative strategies used by critics in constructing their portrait of the hero of Johannes’ poem and observe how these choices interact with the overall critical assessment of the Architrenius. Our analysis identifies two principal families of readers—both philologically and thematically—suggesting a dual trajectory in the reception of the poem throughout the centuries. Full article
19 pages, 2336 KB  
Case Report
Infectious Proctitis Mimicking Advanced Rectal Cancer: A Case Report and Update on the Differential Diagnosis of Rectal Ulcerations
by Anca Maria Pop, Roman Zimmermann, Szilveszter Pekardi, Michela Cipriani, Angelika Izabela Gajur, Diana Moser, Eva Markert and Alexander Kueres-Wiese
J. Clin. Med. 2025, 14(15), 5254; https://doi.org/10.3390/jcm14155254 - 24 Jul 2025
Viewed by 2445
Abstract
Background: Infectious proctitis remains an underrecognized entity, although sexually transmitted diseases, especially bacterial infections, exhibit a marked increase in their incidence. Methods: Here, we report a case of a 44-year-old man who presented to the emergency department with lower abdominal and [...] Read more.
Background: Infectious proctitis remains an underrecognized entity, although sexually transmitted diseases, especially bacterial infections, exhibit a marked increase in their incidence. Methods: Here, we report a case of a 44-year-old man who presented to the emergency department with lower abdominal and rectal pain, tenesmus, fever and night sweats for the past 6 days. Results: The computed tomography initially revealed a high suspicion of metastatic rectal cancer. The endoscopic findings showed a 5 cm rectal mass, suggestive of malignancy. The histologic examination showed, however, no signs of malignancy and lacked the classical features of an inflammatory bowel disease, so an infectious proctitis was further suspected. The patient reported to have had unprotected receptive anal intercourse, was tested positive for Treponema pallidum serology and received three doses of intramuscular benzathine penicillin G. A control rectosigmoidoscopy, imaging at 3 months and histological evaluation after antibiotic treatment showed a complete resolution of inflammation. Conclusions: Syphilitic proctitis may mimic various conditions such as rectal cancer or inflammatory bowel disease and requires a high degree of suspicion. Clinicians need to be aware of infectious proctitis in high-risk populations, while an appropriate thorough medical history may guide the initial diagnostic steps. Full article
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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41 pages, 424 KB  
Article
Rationalising the First Crusade (1095–1099): Rupert of Deutz, the Roman Conquest of Jerusalem, and the Twists of Salvation History
by Alexander Marx
Religions 2025, 16(7), 919; https://doi.org/10.3390/rel16070919 - 16 Jul 2025
Viewed by 2640
Abstract
Many contemporaries considered the crusader conquest of Jerusalem in 1099 as a significant moment in Salvation History. This article investigates how the reception of the Roman conquest of the city (70 CE) contributed to such an understanding. The important Benedictine exegete Rupert of [...] Read more.
Many contemporaries considered the crusader conquest of Jerusalem in 1099 as a significant moment in Salvation History. This article investigates how the reception of the Roman conquest of the city (70 CE) contributed to such an understanding. The important Benedictine exegete Rupert of Deutz (c. 1070–1129) refers to the Roman conquest in 79 passages within his opus, notably in his various biblical commentaries. This case study shows how the past event provided a rationale, exegetical and providential in nature, to understand three dimensions: (a) the role of the Jews, especially that it had been necessary to deprive them of the Holy Land; (b) the current situation of and purpose of Christians in the Holy Land; and (c) the End of Time, which was expected in Jerusalem, and which Rupert anchored already significantly in his own present. His commentary on John’s Revelation even asserted that the Roman conquest had opened the sixth of seven seals (Rev. 6:12). Therefore, the Apocalypse had been ongoing since 70 CE—but only in the Holy Land, a fact that made it necessary for Christians to travel there. The article thus demonstrates that biblical commentaries are potent sources for both crusade studies and historical research in general. Full article
12 pages, 704 KB  
Article
Challenges in Integrating Influenza Vaccination Among Older People in National Immunisation Program: A Population-Based, Cross-Sectional Study on Knowledge, Attitudes, Practices, and Acceptance of a Free Annual Program
by Mohd Shaiful Azlan Kassim, Rosnah Sutan, Noor Harzana Harrun, Faiz Daud, Noraliza Noordin Merican, Sheleaswani Inche Zainal Abidin, Ho Bee Kiau, Azniza Muhamad Radzi, Nagammai Thiagarajan, Norhaslinda Ishak, Tay Chai Li, Radziah Abdul Rashid, Sally Suriani Ahip, Nor Hazlin Talib, Saidatul Norbaya Buang, Noor Ani Ahmad, Zamberi Sekawi and Tan Maw Pin
Vaccines 2025, 13(6), 636; https://doi.org/10.3390/vaccines13060636 - 12 Jun 2025
Cited by 1 | Viewed by 3073
Abstract
Background: Influenza poses a significant threat to the health of Malaysians, particularly among the elderly population. It results in high levels of illness and mortality, becoming a financial burden on the government. Vaccination is widely recognised as the most effective measure for controlling [...] Read more.
Background: Influenza poses a significant threat to the health of Malaysians, particularly among the elderly population. It results in high levels of illness and mortality, becoming a financial burden on the government. Vaccination is widely recognised as the most effective measure for controlling the spread and impact of influenza. Objectives: This study sought to assess the knowledge, attitudes, and practices (KAP) regarding influenza and influenza vaccination among older adults attending primary healthcare centres in different states of Malaysia. Additionally, the study assessed the level of acceptance for a proposed free annual influenza vaccination program. Methods: A nationwide survey was conducted involving 672 older people aged 60 and above who visited nine primary healthcare centres in Malaysia. These centres were selected using proportionate to population size (PPS) sampling to ensure representation from each zone. Participants completed a validated self-reported questionnaire. Descriptive statistics were used to determine the levels of KAP, and a binomial logistic regression model was used to determine the predictors of acceptance for the proposed free annual vaccination program. Results: Most participants displayed a strong understanding of influenza illness (74.0%) and the vaccine (65.9%). Moreover, 76.4% of respondents exhibited a positive attitude towards influenza vaccination. However, the prevalence of good vaccination practices was relatively low, with only 29.2% of participants having a history of previous vaccination, and just 55.2% of these consistently practicing annual vaccination. The group acceptance rate for the proposed free annual influenza vaccination was 62.3%. Significant predictors of acceptance included a history of previous vaccination (good practice) (OR = 6.438, 95% CI = 1.16–35.71, p < 0.001), a positive attitude towards vaccines (OR = 21.98, 95% CI = 5.44–88.87, p = 0.033), and a good level of knowledge about the influenza vaccine (OR = 0.149, 95% CI = 0.03–0.79, p = 0.026). Conclusions: Increasing the uptake of influenza vaccination among the older population in Malaysia remains a significant challenge. It is recommended that a targeted, free annual influenza vaccination program be implemented for high-risk populations, particularly those with comorbidities and those who have shown greater receptiveness. In addition, health education strategies aimed at raising awareness and understanding of influenza should be prioritised. Strengthening epidemiological data collection and establishing systematic monitoring mechanisms are also essential to support these efforts. Full article
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