Search Results (163)

African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care. Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article

Introduction: Genetic plasticity and adaptive camouflage in critical pathogens have contributed to the global surge in multidrug-resistant (MDR) infections, posing a serious threat to public health and therapeutic efficacy. Antimicrobial resistance, now a leading cause of global mortality, demands urgent action through diagnostics, vaccines, and therapeutics. In India, the Indian Council of Medical Research’s surveillance network identifies Escherichia coli as a major cause of urinary tract infections, with increasing prevalence in human gut microbiomes, highlighting its significance across One Health domains. Methods: Whole-genome sequencing of E. coli strain ECG015, isolated from a human gut sample, was performed using the Illumina NextSeq platform. Results: Genomic analysis revealed multiple antibiotic resistance genes, virulence factors, and efflux pump components. Phylogenomic comparisons showed close relatedness to pathovars from both human and animal origins. Notably the genome encoded protein tyrosine kinases (Etk/Ptk and Wzc) and displayed variations in the envelope stress-responsive CpxAR two-component system. Promoter analysis identified putative CpxR-binding sites upstream of genes involved in resistance, efflux, protein kinases, and the MazEF toxin–antitoxin module, suggesting a potential regulatory role of CpxAR in stress response and persistence. Conclusions: This study presents a comprehensive genomic profile of E. coli ECG015, a gut-derived isolate exhibiting clinically significant resistance traits. For the first time, it implicates the CpxAR two-component system as a potential central regulator coordinating antimicrobial resistance, stress kinase signaling, and programmed cell death. These findings lay the groundwork for future functional studies aimed at targeting stress-response pathways as novel intervention strategies against antimicrobial resistance. Full article

Animal health strategies in rural Colombia face significant challenges due to a gap between institutional technical approaches and the sociocultural contexts of local communities. This study examines the social representations of animal health and welfare among small- and medium-scale livestock producers in rural Huila. Through a qualitative methodology, semi-structured interviews were applied and focus groups were conducted in different municipalities with the objective of contrasting and enriching the findings obtained in the interviews. In total, the perceptions, knowledge, and practices of 263 small and medium livestock producers from 23 municipalities in Huila were explored with respect to animal vaccination campaigns and healthcare in rural settings. Findings indicate that health management is shaped not only by technical protocols but also by cultural values, collective imaginaries, and symbolic relationships with animals. Representations of animal welfare are diverse—ranging from emotional and economic to preventive and communal perspectives—and often diverge from scientific–technological frameworks. These differences influence the level of community adherence to national animal health programs. The study highlights the limitations of top–down approaches and underscores the need to incorporate local knowledge and practices into policy design. It concludes that promoting sustainable livestock farming requires acknowledging these varied representations, fostering intercultural dialogue, and adopting a territorial approach to integrated health. Recognising the sociocultural dimensions of animal care is essential for developing effective, inclusive, and context-sensitive animal health strategies. Full article

During 2022, AIDS claimed a life every minute and about 9.2 million HIV-infected people were not on treatment. In addition, a person living with HIV is estimated to be 20–30 times more susceptible to developing active tuberculosis. Every year, 130,000 infants are newly infected, with vertical transmission being the main cause of pediatric HIV infection. Thus, the development of an effective, safe, and accessible vaccine for neonates and/or adults is an urgent need to prevent or control HIV infection or progression to AIDS. An effective HIV vaccine should induce long-lasting mucosal immunity, broadly neutralizing antibodies, innate immunity, and robust stimulation of CD4+ and CD8+ T-cell responses. Recombinant BCG is a promising live-attenuated bacterial vaccine vector because of its capacity to stimulate T-cell immunity. As a slow-growing microorganism, it provides prolonged low-level antigenic exposure upon infecting macrophages and APCs, potentially stimulating both effector and memory T-cell responses. BCG is considered safe and is currently administered to 80% of infants in countries where it is part of the national immunization program. Additionally, BCG offers several benefits as a live vaccine vehicle since it is cost-effective, easy to mass-produce, and heat stable. It is also well-suited for newborns, as maternal antibodies do not interfere with its efficacy. Furthermore, BCG has a strong safety profile, having been administered to over three billion people as a TB vaccine. In this review, we provide an extensive summary of the literature relating to immunogenicity studies in animal models performed since 2011. Moreover, we provide a comprehensive analysis of the key factors influencing the design of recombinant BCG as a live vaccine vehicle: (i) expression vectors; (ii) selection of HIV immunogen; (iii) promoters to regulate gene expression; (iv) BCG strain and BCG codon optimization; (v) genetic plasmid stability; (vi) influence of preexisting immunity, route, and dose immunization; and (vii) safety profile. Full article

Routine pediatric vaccinations have resulted in dramatic declines in the incidence and complications of several vaccine-preventable diseases (VPDs) over the past fifty years. At the same time, the prolongation of life expectancy and the large number of adults living with chronic medical conditions changed the demographic profile and, accordingly, the healthcare needs. The recognition of the burden and effects of several VPDs in adults and in particular risk groups and the comprehension of the age-dependent deterioration of immune responses have driven the extension of routine vaccination programs beyond adolescence. In addition, several VPDs emerged or re-emerged over the past decades, and new vaccines have been developed or are under clinical assessment. Currently, vaccination programs in many countries include vaccinations for adults, aiming to expand and strengthen protection throughout the lifespan and promote healthy aging. Moreover, there are needs for new or more effective vaccines against common or emerging pathogens and public health threats, including chronic diseases. This article reviews the current status of several adult vaccinations and discusses challenges for adult vaccinations, including new vaccines, emerging or re-emerging VPDs, and strategies to overcome low vaccination rates. Full article

Awareness about the attitudes towards the vaccination of persons with schizophrenia is essential, as this group has a greater likelihood of experiencing serious consequences if infected with COVID-19 or other infectious processes. For this reason, 141 persons with schizophrenia completed a survey addressing different aspects of receiving the vaccine for COVID-19. In general, the results are similar to those of people without a severe mental disorder. Persons with schizophrenia were willing to get vaccinated, perceived vaccination as being as safe and effective as the general population did, and reported that they usually followed preventive measures to avoid the spread of the virus. However, their concerns were frequently related to possible health problems or fears about the vaccination. There is no influence from sociodemographic variables, though limited social life, perceived risk in people in their immediate environment, and a negative self-assessment of their own health were associated with increased acceptance of vaccination. Thus, the present study provides useful information on this topic and encourages the development of programs and interventions that promote preventive actions for this group of people. Full article

Introduction: Sexual and reproductive health is a critical aspect of medical education, yet significant knowledge gaps persist even among future healthcare professionals. This study aimed to evaluate the knowledge, behaviors, and attitudes of Romanian medical students regarding sexually transmitted infections (STIs) and contraceptive practices. Materials and Methods: A cross-sectional observational study was conducted on 510 undergraduate medical students, using a validated 30-item online questionnaire assessing socio-demographic data, sexual behaviors, STI knowledge, and attitudes towards sexual health. Descriptive statistics, chi-square, and Spearman correlation tests were used to analyze the data. Results: Participants demonstrated a good understanding of common STI pathogens and transmission routes, with 99.02% identifying unprotected vaginal intercourse as a risk factor. However, only 58.82% correctly identified Chlamydia trachomatis, and awareness of less common pathogens remained low. Long-term complications such as infertility (85.29%) and cervical cancer (87.25%) were well recognized, although misconceptions about STI severity persisted, with over 40% believing that STIs are not dangerous because they are treatable. Male students reported earlier sexual debut and more frequent high-risk behaviors, while females were more likely to consult specialist doctors and receive HPV vaccination. The level of knowledge correlated positively with parental education and faculty program. Conclusions: Despite generally high awareness of STI-related topics, considerable gaps and misconceptions persist among Romanian medical students. These findings highlight the need for comprehensive, structured sexual health education integrated into medical curricula to ensure future healthcare providers are well-equipped to promote public health. Full article

Cervical cancer ranks third in mortality and fourth in incidence among women worldwide as one of the leading causes of death from cancer in females. The main reason behind cervical carcinogenesis is long-term infection with high-risk human papillomavirus (HPV) genotypes, particularly HPV16 and HPV18. This review investigates HPV distribution across the world, along with cervical cancer molecular development mechanisms and current treatment strategies. Epidemiological data show that disease patterns vary significantly between different geographic regions because underdeveloped nations bear a higher disease burden. The molecular mechanisms of oncogenes E6 and E7 disrupt tumor suppressor pathways, while epigenetic modifications through DNA methylation and miRNA dysregulation promote malignant cell transformation. The reduction in HPV infection through prophylactic vaccination has shown promise, yet barriers related to accessibility and coverage still exist. The therapeutic technologies of gene expression inhibitors together with immunotherapies and epigenetic targeting agents show promise but require optimization to achieve specific targeting while minimizing off-target effects. A combined approach that integrates HPV vaccination with early diagnosis and molecular-specific therapies represents the most effective method to manage cervical cancer impact. The future care of patients will require increased translational research along with better immunization programs to drive prevention and therapeutic outcomes. Full article

Rabies remains a significant public health and economic concern in Kazakhstan, particularly in rural livestock-farming communities. This study aimed to assess the knowledge, attitudes, and practices (KAPs) related to rabies among livestock farmers in the Aktobe and Oral regions of West Kazakhstan. A cross-sectional survey was conducted between April and August 2022, involving 688 randomly selected participants. The data were collected through structured interviews and analyzed using descriptive and inferential statistics. The findings revealed that 89% of respondents were aware of rabies, yet significant knowledge gaps existed regarding clinical signs, transmission, and prevention. While 87% recognized the importance of rabies vaccination in dogs, 81% were unaware of pre-exposure prophylaxis (PrEP) for cattle, and 72% lacked knowledge of PrEP for humans. Awareness of the post-exposure prophylaxis (PEP) regimen was significantly higher in the Aktobe region (p < 0.002). Attitudinal differences were observed, with the Oral region participants exhibiting more favorable perceptions of rabies control programs (p < 0.01). Additionally, the χ² test revealed that the proportion of female respondents (p < 0.02), those with school-aged dependents (p < 0.003), respondents owning both exotic and indigenous cattle breeds (p < 0.002), and those possessing more than five cattle (p < 0.025) was statistically different in the Oral region. Practices such as free grazing, lack of protective equipment use, and improper carcass disposal were identified as potential risk factors for rabies transmission. This study highlights the need for targeted educational initiatives to improve rabies awareness and promote safer livestock management practices. Enhancing veterinary surveillance, strengthening community engagement, and expanding vaccination efforts could mitigate rabies transmission risks. Full article

Background/Objectives: Maternal vaccination and breastfeeding are important aspects of public health that should be recommended by medical staff caring for pregnant and postpartum women. We aimed to analyze factors affecting women’s likelihood of dual vaccination during pregnancy and their infant feeding strategies. Methods: A cross-sectional study was conducted with 953 Polish mothers. An online questionnaire was used and included questions on sociodemographic and obstetric variables, women’s attitudes towards COVID-19 and influenza vaccination, and breastfeeding practices. Results: COVID-19 vaccination was reported by 66.0%, influenza vaccination by 18.2%, and dual vaccination by 15.6% of Polish mothers. Increasing willingness to receive vaccines was significantly associated with older maternal age, lower BMI, living in urban areas with >100,000 residents, and high levels of knowledge regarding vaccination. No significant association between dual vaccination and neonatal feeding strategy was detected. The group of exclusively breastfeeding mothers, in comparison to formula- and mixed-feeding women, was characterized by having lower pre-pregnancy BMI and previous maternal experience. Conclusions: Rates of vaccination against seasonal influenza and dual (influenza and COVID-19) vaccination remain low among Polish mothers. The promotion of antenatal vaccination and reliable information about short- and long-term advantages related to breastfeeding are crucial to perinatal health care for the mother–infant dyad. Young, primiparous women who are overweight or obese should be targets of preventive programs focused on the health of the mother–infant dyad. Full article

Respiratory viruses, such as influenza virus, rhinovirus, coronavirus, and respiratory syncytial virus (RSV), continue to impose a heavy global health burden. Despite existing vaccination programs, these infections remain leading causes of morbidity and mortality, especially among vulnerable populations like children, older adults, and immunocompromised individuals. However, the current therapeutic options for respiratory viral infections are often limited to supportive care, underscoring the need for novel treatment strategies. Autophagy, particularly macroautophagy, has emerged as a fundamental cellular process in the host response to respiratory viral infections. This process not only supports cellular homeostasis by degrading damaged organelles and pathogens but also enables xenophagy, which selectively targets viral particles for degradation and enhances cellular defense. However, viruses have evolved mechanisms to manipulate the autophagy pathways, using them to evade immune detection and promote viral replication. This review examines the dual role of autophagy in viral manipulation and host defense, focusing on the complex interplay between respiratory viruses and autophagy-related pathways. By elucidating these mechanisms, we aim to highlight the therapeutic potential of targeting autophagy to enhance antiviral responses, offering promising directions for the development of effective treatments against respiratory viral infections. Full article

Background/Objectives: Human papillomavirus (HPV) is a predominant cause of cervical cancer globally in women. HPV-related cancers in men are also on the rise. Immunization against HPV infection is a highly effective preventative against these cancers. However, HPV vaccine programs are not easily implemented globally. The objective of this systematic review was to identify multilevel strategies associated with improved pediatric HPV vaccination in high-income countries (HICs) and low- and middle-income countries (LMICs) that target parent, provider, and practice points of interventions. Methods: Through a systematic search of electronic databases, we identified 159 peer-reviewed articles published between the years 2011 and 2023. Results: Ninety-five percent of the included studies were conducted in HICs. Just eight studies were set in LMICs. A variety of HPV vaccination outcomes were assessed including uptake, initiation of the series, continuation of the series, missed opportunities, time, and refusal. Eighty percent of studies reported improved pediatric HPV vaccination, including a third of studies with mixed findings. Parent-centered strategies included education programs and reminder/recall procedures. Provider-centered strategies also included education programs and training in communication. Practice-centered strategies included vaccine access programs, vaccine bundling protocols, provider prompts, standing orders, vaccine messaging, and lowering the initiation age to 9 years. Multilevel, multi-component programs were highly effective. Conclusions: Multilevel strategies can be adopted in a variety of settings to promote HPV vaccination among youth globally. However, this research is disproportionately conducted in high resource environments. Further work is needed in LMIC settings as more countries begin to adopt HPV immunization programs. Full article

Rodents on farms are a substantial issue due to the damage they cause to produce and infrastructure, and the risk they pose to food safety. As a result, farmers need to control rodent populations around farms. In a previous study, farmers indicated a preference for working cats, stating that they are a more efficient, safer, and cheaper alternative to rodenticide baits, and they provide companionship. However, farmers’ options for managing cat populations are often limited to lethal methods because of time and financial constraints. Through semi-structured interviews, this study explored the impacts of lethal cat management methods on farmers, their experience with a free cat sterilization program, and their views on a Barn Cat Program, whereby healthy stray cats would be vaccinated, sterilized, and made available to farmers. Our results indicated that farmers had a relationship with the cats on their farms and that using lethal methods to manage these cats had a negative impact on farmers’ wellbeing. Farmers supported the free cat sterilization program, as it reduced the cat population and their impact on wildlife, improved cat behavior and welfare, and benefited farmers. Farmers also generally supported a Barn Cat Program and gave suggestions on how best to promote it to other farmers. Funding should be provided for cat sterilization programs, as they support farmers, who value cats for rodent control and companionship, improve cat behavior and welfare, and reduce working cat populations and their impact on wildlife. Full article

Background/Aims: The global promotion of HPV vaccines has underscored the importance of vaccination for both males and females in reducing disease transmission and associated complications. Despite robust evidence supporting male HPV vaccination, China has yet to approve it. Public discussions on male HPV vaccination, influenced by policy delays, gender norms, and commercialization, reveal diverse attitudes and significant challenges in achieving equitable health outcomes. This study investigates public perceptions and attitudes toward male HPV vaccination in China by analyzing cognitive frames and the social, cultural, and economic factors shaping these discussions. Methods: This study employs a cross-sectional design to analyze 4997 Sina Weibo posts using the Analysis of Topic Model Networks (ANTMN), identifying five frames: Disease Risk and Prevention, Virus Transmission, Gender Roles and Perceptions, Vaccine Promotion and Acceptance, and Market Dynamics and Consumption. Results: The findings reveal a significant gap between policy implementation and public awareness of male HPV vaccination in China. Despite growing recognition of its benefits, entrenched gender norms and biases hinder equitable health outcomes. Social media, as a pivotal platform for health communication, plays a dual role in facilitating public discourse while also amplifying misinformation. Policy delays and concerns over vaccine commercialization heighten public hesitancy, emphasizing the need for inclusive policies and targeted education. Conclusions: This study highlights the necessity for systemic efforts to address gender biases, enhance public education on male HPV vaccination, and rebuild trust in vaccination programs. A multifaceted approach is required to bridge these gaps, integrating policy reforms, inclusive health communication strategies, and equitable vaccine access. These measures aim to promote awareness and increase vaccination uptake among males in China, ultimately contributing to more comprehensive and equitable public health outcomes. Full article