Search Results (628)

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

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

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

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

The COVID-19 pandemic caused immense physical disruptions, affecting young adults in the U.S. The Health Belief Model is a social psychological framework that predicts the likelihood of adopting health behavior. The purpose of this research is to investigate COVID-19-related health beliefs and dietary behaviors among undergraduate students during the pandemic. Using convenience sampling, a cross-sectional survey was completed by 304 individuals at a New Jersey state university. Survey data included the frequency of COVID-19 prevention behaviors (e.g., wearing an indoor mask, handwashing), and consumption of fruit and vegetables. The Health Belief Model constructs measured perceived susceptibility to COVID-19, severity, benefits, barriers, and self-efficacy. Frequency distributions, t-tests, and Kruskal–Wallis tests were investigated for racial subgroups (Whites, Blacks, Latinos, and Asians). The mean age of the sample was 21.7, with 27% males, and 46% self-identified as White. Whites adopted fewer COVID-19 prevention behaviors (p < 0.001) than non-Whites. Black students perceived less COVID-19 severity (p < 0.01) and stronger perceived benefits (p < 0.05) than the other subgroups. Latino students perceived greater susceptibility (p < 0.01) and greater barriers than non-Latinos. Asians practiced higher mask wearing frequency (p < 0.05) but less daily fruit intake than their counterparts (p < 0.01). This research highlights the importance of handwashing, wearing indoor masks, and consuming produce among university students. Addressing barriers to health action while promoting the benefits of enacting behaviors to mitigate the risk of COVID-19 is warranted. 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

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

Older adults make up about 12% of the public sector, primary care, and hospital use and represent a large proportion of the users of healthcare services. Older people are also more vulnerable to serious injury from unexpected falls due to tripping, slipping, or illness. This underscores the immediate necessity of stable and cost-effective e-health technologies in maintaining independent living. Artificial intelligence (AI) and machine learning (ML) offer promising solutions for early fall prediction and continuous health monitoring. This paper introduces a novel cooperative AI model that forecasts the risk of future falls in the elderly based on behavioral and health abnormalities. Two AI models’ predictions are combined to produce accurate predictions: The ${AI}_1$ model is based on vital signs using Fuzzy Logic, and the ${AI}_2$ model is based on Activities of Daily Living (ADLs) using a Deep Belief Network (DBN). A meta-model then combines the outputs to generate a total fall risk prediction. The results show 85.71% sensitivity, 100% specificity, and 90.00% prediction accuracy when compared to the Morse Falls Scale (MFS). This emphasizes how deep learning-based cooperative systems can improve well-being for older adults living alone, facilitate more precise fall risk assessment, and improve preventive care. Full article

Domestic violence is a public health problem that has important consequences for the physical, mental and social well-being of individuals and their families, leading to negative effects on future generations, which are exacerbated or inhibited by individual, social and cultural factors. This qualitative study aimed to explore the intergenerational transmission of domestic violence in Peruvian families. Semi-structured interviews were conducted with an adolescent, a mother and a grandfather from nine families. Data were analyzed using reflexive thematic analysis. The analysis revealed the importance of traditional gender norms, machismo and marianismo, in intergenerational transmission. Other important subthemes in maintenance were irritability, social learning, alcohol consumption and economic dependence. On the other hand, support networks, overcoming trauma, knowing how to choose a partner, education and separation were subthemes identified as protective factors and, finally, religious beliefs were associated with contradictory effects, since they can perpetuate violence or serve as a protective factor against violence. The implications of these findings are discussed and a proposal based on the socioecological model of domestic violence is elaborated, covering the four levels: individual, relationship, community and societal. Full article

Planetary health is a transdisciplinary concept that erases the dividing lines between individual and community health, and the natural systems that support the wellbeing of humankind. Despite planetary health’s broad emphasis on justice, the promotion of science-based policies, and stated commitments to fairness, equity, and harm reduction, the criminal justice system has largely escaped scrutiny. This seems to be a major oversight, especially because the criminalization of mental illness is commonplace, and the system continues to be oriented around a prescientific compass of retribution and folk beliefs in willpower, moral fiber, and blameworthiness. Justice-involved juveniles and adults are funneled into landscapes of mass incarceration with ingrained prescientific assumptions. In non-criminal realms, such as obesity, there is a growing consensus that folk psychology ideas must be addressed at the root and branch. With this background, the Nova Institute for Health convened a transdisciplinary roundtable to explore the need for a ‘Copernican Revolution’ in the application of biopsychosocial sciences in law and criminal justice. This included discussions of scientific advances in neurobiology and omics technologies (e.g., the identification of metabolites and other biological molecules involved in behavior), the need for science education, ethical considerations, and the public health quarantine model of safety that abandons retribution. Full article