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Sarker MS, Pervez MM. Decoding impact of human papillomavirus in gynecological oncology: a narrative review. Obstet Gynecol Sci 2025; 68:30-42. [PMID: 39780583 PMCID: PMC11788691 DOI: 10.5468/ogs.24226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 10/21/2024] [Accepted: 12/12/2024] [Indexed: 01/11/2025] Open
Abstract
Human papillomavirus (HPV) is a key factor in gynecological oncology. This narrative review investigates the complex connection between HPV and various gynecological cancers. For a comprehensive exploration, we examined the association between persistent HPV infection and cervical cancer and its global prevalence. Beyond the cervix, we navigated the linkages between HPV and other gynecological malignancies, shedding light on vulvar, vaginal, anal, and oropharyngeal cancers. The narrative extends to discuss the critical role of HPV vaccination in preventing these cancers and exploring challenges, controversies, and future perspectives in the field. As we have described the impact of HPV, this review underscores the significance of ongoing research and public health endeavors in shaping the trajectory of gynecological oncology.
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Affiliation(s)
- Md. Safiullah Sarker
- Virology Laboratory, Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
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2
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Khan A, Abonyi S, Neudorf C. Barriers and facilitators in uptake of human papillomavirus vaccine across English Canada: A review. Hum Vaccin Immunother 2023; 19:2176640. [PMID: 36803510 PMCID: PMC10026928 DOI: 10.1080/21645515.2023.2176640] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Human Papillomavirus (HPV) is a highly contagious sexually transmitted infection that leads to preventable cancers of the mouth, throat, cervix, and genitalia. Despite the wide availability of HPV Vaccine (HPVV) in Canada, its uptake remains suboptimal. This review aims to identify factors (barriers and facilitators) in HPV vaccine uptake across English Canada at three levels (provider, system, and patient). We explored academic and gray literature to examine factors involved in HPVV uptake and synthesized results based on interpretive content analysis. The review identified the following factors of prime significance in the uptake of the HPV vaccine (a) at the provider level, 'acceptability' of the HPV vaccine, and 'appropriateness' of an intervention (b) at the patient level, the 'ability to perceive' and 'knowledge sufficiency' (c) at the system level, 'attitudes' of different players in vaccine programming, planning and delivery. Further research is needed to conduct population health intervention research in this area.
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Affiliation(s)
- Amal Khan
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cory Neudorf
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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3
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MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Barnabe C, Guichon JR, Colquhoun A, Ganshorn H, Bedingfield N, Vandenboogaard PD, Bednarczyk RA, Glaze S, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001406. [PMID: 36962871 PMCID: PMC10021254 DOI: 10.1371/journal.pgph.0001406] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.
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Affiliation(s)
| | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Angeline Letendre
- Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | | | - Rita Henderson
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Performance Reporting, Alberta Health, Edmonton, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Glaze
- Tom Baker Cancer Centre, University of Calgary, Calgary, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
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4
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Stratoberdha D, Gobis B, Ziemczonek A, Yuen J, Giang A, Zed PJ. Barriers to adult vaccination in Canada: A qualitative systematic review. Can Pharm J (Ott) 2022; 155:206-218. [PMID: 35813527 PMCID: PMC9266373 DOI: 10.1177/17151635221090212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Abstract
Background: In recent years, Canadian health care professionals have observed an increase in vaccine refusal. The objective of this study is to review published literature and identify the main themes related to vaccine hesitancy and barriers to vaccination in Canadian adults and recent immigrants. Methods: A qualitative systematic review was performed. A comprehensive search of MEDLINE (1946 to January 2021) and EMBASE (1974 to January 2021) was conducted to identify existing literature that addressed the primary research question. Studies were eligible for inclusion if the study population involved 1) the general population, 2) Indigenous populations, 3) recent immigrants to Canada or 4) Canadian health care professionals. Results: Thirty-four studies were included with a focus on the general population (n = 22), health care professionals (n = 10) and recent immigrant populations (n = 2). The most frequently reported barriers were lack of vaccine information (41%), lack of access to vaccination (38%), fear of adverse reactions (38%), financial reasons (29%), lack of awareness of vaccine existence (29%), antivaccine sentiments (24%), notion that older adults do not need vaccination (18%), misconceptions on vaccine effectiveness (12%), potential sexual health promotion stigma (6%) and fear of needles (3%). Interpretation: Barriers to vaccination among Canadians and recent immigrants continue to be a challenge in the health care system. Conclusions: The greatest yield in improving vaccination rates is likely to come from supporting vaccine-hesitant individuals in shifting their thinking to greater vaccine acceptance. Pharmacists are well positioned to address vaccine hesitancy and involvement through education, facilitation and administration of vaccines. Can Pharm J (Ott) 2022;155:xx-xx.
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Affiliation(s)
- Doris Stratoberdha
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Barbara Gobis
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Adrian Ziemczonek
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Jamie Yuen
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Annita Giang
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, BC
| | - Peter J. Zed
- Faculty of Pharmaceutical Sciences and the Faculty of Medicine, the University of British Columbia, Vancouver, BC
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Nath S, Poirier B, Ju X, Kapellas K, Haag D, Jamieson L. Prevalence of periodontal disease among Indigenous and non-Indigenous populations: protocol for systematic review and meta-analysis. Syst Rev 2022; 11:43. [PMID: 35279195 PMCID: PMC8917471 DOI: 10.1186/s13643-022-01913-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 03/01/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Indigenous populations globally experience worse oral health than their non-Indigenous counterpart. Globally, the occurrence of periodontal diseases such as gingivitis and chronic periodontitis is high among Indigenous people. This systematic review aims to quantify, at a global level, the prevalence of periodontal disease among Indigenous populations compared to non-Indigenous populations. METHODS This review will only consider studies that have reported the prevalence (%) of periodontal disease among Indigenous and compared against non-Indigenous populations. Studies that have no comparative population or data only on one particular population or lack of data on periodontal clinical assessment will be excluded. An electronic search will be conducted using keywords and appropriate MeSH terms across several databases capturing both published and unpublished articles. The search will be conducted from the time of database inception to February 2021. After the initial search, duplicates will be removed, and the remaining titles and abstracts will be assessed for eligibility. The full text of eligible studies will be assessed by two independent reviewers who will also complete the critical appraisals and data extraction. Outcomes measures would be the mean prevalence (%) and standard deviation of periodontal disease among Indigenous and non-Indigenous populations. From the selected studies, we will conduct a random-effects meta-analysis using standardized mean difference as the effect measure. Forest plots will be used for the visualization of differences in the prevalence of periodontitis. A subgroup analysis will be conducted based on the definition of periodontitis, age, publication type, and geographical location. Heterogeneity among studies will be assessed by I2 and chi-square test. Egger's test and funnel plots will be used to assess publication bias. DISCUSSION Our systematic review and meta-analysis will facilitate an increased understanding of the magnitude of periodontal disease inequalities that exist globally for Indigenous populations through pooled prevalence estimates. The findings will be helpful to design selective targeted preventive and interventional strategies for periodontal disease for reducing oral health inequalities at a global level. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020188531.
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Affiliation(s)
- Sonia Nath
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Health & Medical Sciences Building, The University of Adelaide, Adelaide, SA, 5005, Australia
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Poirier B, Sethi S, Garvey G, Hedges J, Canfell K, Smith M, Ju X, Jamieson L. HPV vaccine: uptake and understanding among global Indigenous communities - a qualitative systematic review. BMC Public Health 2021; 21:2062. [PMID: 34758805 PMCID: PMC8582096 DOI: 10.1186/s12889-021-12147-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous populations have a high prevalence of Human Papillomavirus (HPV) infection and a high incidence of HPV associated cancers, such as cervical and oropharyngeal cancer. There is an effective HPV vaccination program in almost all developed countries to prevent the incidence of cervical cancer, but reports suggest that the uptake of these vaccinations by Indigenous populations is low. The objective of this qualitative systematic review was to explore the knowledge and beliefs of global Indigenous populations regarding HPV vaccines. This review was performed to identify the barriers faced by Indigenous peoples and to provide evidence for more effective and acceptable execution of vaccination policies for Indigenous peoples. METHODS Two investigators independently searched MEDLINE, PubMed, SCOPUS, and Web of Science databases using a pre-specified search strategy to identify qualitative studies on narratives of Indigenous peoples regarding HPV vaccine awareness, knowledge and experiences across all geographic and income-level settings. RESULTS After performing the literature search and quality appraisals 5 papers were included in the final review. Three core synthesised findings were identified: reasons for acceptance or hesitancy, and areas for improvement. Lack of correct knowledge and mistrust in the healthcare system were important categories observed in all papers included in the review. Other categories within the conceptual model included prioritising disease prevention, health professional guidance, family support and supportive community environment. CONCLUSION Qualitative systematic reviews are an excellent means of exploring the gaps in current healthcare practices. Indigenous healthcare research should be grounded in community experiences and feedback. This review provides insights into HPV vaccination understanding and acceptance amongst Indigenous populations, from which recommendations for increasing resonance of vaccination strategies with Indigenous communities can be formed.
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Affiliation(s)
- Brianna Poirier
- Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia.
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - Karen Canfell
- The Daffodil Centre at the University of Sydney, A Joint Venture with Cancer Council, PO Box 572, Kings Cross, NSW, 1340, Australia
| | - Megan Smith
- The Daffodil Centre at the University of Sydney, A Joint Venture with Cancer Council, PO Box 572, Kings Cross, NSW, 1340, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, 4 North Terrace, 4 North Terrace, Adelaide, SA, 5000, Australia
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Application of theoretical frameworks on human papillomavirus vaccine interventions in the United States: systematic review and meta-analysis. Cancer Causes Control 2021; 33:15-24. [PMID: 34705121 DOI: 10.1007/s10552-021-01509-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Theoretical frameworks are useful tools to explain the dynamics of behavioral change, develop, and implement intervention studies. The purpose of this systematic review and meta-analysis is to evaluate the application of theoretical frameworks and models to HPV vaccination intervention studies in the United States (US) from January 2006 to December 2019. METHODS A comprehensive search across databases, including PubMed, EMBASE, ERIC, CINAHL, Academic Search Complete, Scopus, Web of Science, and PsycINFO, was conducted. Articles were included in the systematic analysis if at least one theory was used to develop the intervention phase. All intervention studies targeting populations in the US without restrictions of age, income, sex, and ethnicity were included. Articles were included in the meta-analysis if vaccine uptake and/or vaccine completion was addressed. RESULTS The Health Belief Model, Motivational Interviewing, Theory of Planned Behavior, and Information-Motivation-Behavioral Skills were the most used theories. Based on theory integrity, theory rationale, and theory operationalization, most of the studies (60%) were rated high for the application of the theoretical frameworks. Our results suggest a preference for theoretical frameworks targeting individual change rather than community change and the existence of gender disparities in the application of theoretical frameworks. The association between theory and increase of likelihood in vaccine uptake and completion was not supported. CONCLUSION This review spotlights common issues in the application of theoretical frameworks in HPV vaccine interventions in the US. Our results suggest we are still in a developmental phase on several aspects of theory application to HPV vaccination.
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Dick A, Holyk T, Taylor D, Wenninger C, Sandford J, Smith L, Ogilvie G, Thomlinson A, Mitchell-Foster S. Highlighting strengths and resources that increase ownership of cervical cancer screening for Indigenous communities in Northern British Columbia: Community-driven approaches. Int J Gynaecol Obstet 2021; 155:211-219. [PMID: 34496052 PMCID: PMC9293094 DOI: 10.1002/ijgo.13915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/07/2021] [Accepted: 09/03/2021] [Indexed: 11/18/2022]
Abstract
Objective To examine the unique and diverse strengths held by rural and remote Indigenous communities in northern British Columbia, including multi‐generational support systems in health and wellness, profound connections to the land, and strong cultural foundations, and harness these strengths, allowing communities to engage in innovative and empowering health and wellness programs. Methods Building on these pre‐existing and fundamental strengths, an alternative option to cervical cancer screening was introduced to nine Carrier Sekani health centers located in northern interior British Columbia in response to disparities in screening rates. Introduced in 2019, CervixCheck uses a self‐collection approach that is private, safe, convenient, and offered at local community health centers by trained and supportive health staff. Results Using a strengths‐based and community directed and descriptive approach, the process was outlined for a successful and ongoing health screening opportunity that is put into the hands of community members within Indigenous communities in the region of northern British Columbia. Conclusion Through collaborative partnerships, in‐person engagement sessions, and the utilization of pre‐existing infrastructure and health and wellness teams, this project was successfully integrated into primary care centers using culturally safe and community‐based approaches. Building on inherent strengths within rural and remote Indigenous communities leads to successful development and implementation of cervical cancer screening alternatives.
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Affiliation(s)
- Alexanne Dick
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, British Columbia, Canada.,First Nations Studies, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Darlene Taylor
- BC Women's Hospital, Women's Health Research Institute, Vancouver, British Columbia, Canada
| | | | - Judith Sandford
- Carrier Sekani Family Services, Prince George, British Columbia, Canada
| | - Laurie Smith
- BC Women's Hospital, Women's Health Research Institute, Vancouver, British Columbia, Canada.,BC Cancer, Cancer Control Research, Vancouver, British Columbia, Canada
| | - Gina Ogilvie
- BC Women's Hospital, Women's Health Research Institute, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexandra Thomlinson
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Sheona Mitchell-Foster
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Pei XD, He ZL, Yao HL, Xiao JS, Li L, Gu JZ, Shi PZ, Wang JH, Jiang LH. 6-Shogaol from ginger shows anti-tumor effect in cervical carcinoma via PI3K/Akt/mTOR pathway. Eur J Nutr 2021; 60:2781-2793. [PMID: 33416981 DOI: 10.1007/s00394-020-02440-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE 6-Shogaol, an active phenolic compound from ginger (Zingiber officinale), can inhibit the growth of a variety of human cancer cells. Nevertheless, its underlying molecular mechanisms in cervical cancer remain unclear. In this study, we systematically examine the inhibitory effect of 6-shogaol on cervical cancer in vitro and in vivo. METHODS Cell proliferation was assessed by CCK8 assay and colony formation assay in HeLa and SiHa cells. We analyzed cell cycle and apoptosis through flow cytometry. GFP-LC3 puncta and transmission electron microscopy were used to observe autophagic bodies. Wound-healing assay and transwell assay were used for evaluating the migration of cells. Western blot was applied to detect protein expression levels. RESULTS 6-Shogaol could suppress cell proliferation and migration, cause cell cycle arrest in the G2/M phase in HeLa and SiHa cells. Moreover, 6-shogaol triggered the apoptosis process through the mitochondrial pathway by downregulating the expression levels of p-PI3K, p-Akt and p-mTOR. Further research indicated that the induction of apoptosis by 6-shogaol was remarkably decreased after the treatment of ROS scavenger and PI3K agonist. Additionally, 6-shogaol increased the number of LC3-positive puncta and autophagic bodies per cell in both HeLa and SiHa cells. Pretreatment of cells with Bafilomycin A1, an autophagy inhibitor, accelerated 6-shogaol mediated cell apoptosis, suggesting that induction of autophagy by 6-shogaol is suppressive to apoptosis. Furthermore, in vivo data revealed that 6-shogaol significantly inhibited tumor growth and cell proliferation in tumor tissues. CONCLUSION These findings suggested that 6-shogaol could be developed as a functional food ingredient, which is potentially used as therapeutic agents for patients with cervical cancer.
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Affiliation(s)
- Xiao-Dong Pei
- College of Light Industry and Food Engineering, Guangxi University, Nanning, 530004, Guangxi, People's Republic of China
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, People's Republic of China
| | - Zhi-Long He
- College of Light Industry and Food Engineering, Guangxi University, Nanning, 530004, Guangxi, People's Republic of China
| | - Hong-Liang Yao
- Guangdong Key Laboratory of Animal Conservation and Resource Utilization, Guangdong Public Laboratory of Wild Animal Conservation and Utilization, Institute of Zoology, Guangdong Academy of Sciences, Guangdong, 510260, People's Republic of China
| | - Jun-Song Xiao
- Beijing Higher Institution Engineering Research Center of Food Additives and Ingredients, Beijing Technology and Business University-BTBU, Beijing, 100048, People's Republic of China
| | - Lan Li
- School of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, People's Republic of China
| | - Jian-Zhong Gu
- School of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, People's Republic of China
| | - Pei-Zhao Shi
- School of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, People's Republic of China
| | - Jin-Hua Wang
- School of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, People's Republic of China
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Li-He Jiang
- College of Light Industry and Food Engineering, Guangxi University, Nanning, 530004, Guangxi, People's Republic of China.
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, People's Republic of China.
- School of Basic Medical Sciences, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, People's Republic of China.
- Medical College, Guangxi University, Nanning, 530004, Guangxi, People's Republic of China.
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Human Papillomavirus (HPV) Vaccine Knowledge, Awareness and Acceptance among Dental Students and Post-Graduate Dental Residents. Dent J (Basel) 2020; 8:dj8020045. [PMID: 32397425 PMCID: PMC7345517 DOI: 10.3390/dj8020045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/28/2020] [Accepted: 05/07/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: The recent development of a vaccine that is highly effective against the human papillomavirus (HPV) has been met with widespread clinical and public health professional acceptance. However, social and societal barriers to vaccination may hamper public health efforts to prevent HPV-mediated diseases. Although a few studies have evaluated knowledge or awareness of HPV vaccination among dentists or dental educators, few studies have evaluated the acceptance, knowledge and awareness of HPV vaccination among dental students and post-graduate dental residents. The primary goal of this study is to evaluate survey responses regarding acceptance, knowledge and awareness of HPV vaccination among dental students and post-graduate dental residents. Methods: This study was a retrospective analysis of a previously administered and collected questionnaire. The original protocol was reviewed by the UNLV Biomedical Institutional Research Board (IRB) and was deemed excluded from IRB review (OPRS#0811-2911). Results: Two hundred and ninety-three (N = 293) dental student and forty-one (N = 41) post-graduate dental resident questionnaires were available for a total sample size of N = 334. In brief, although the majority of dental students and residents agreed that vaccines are safe and effective, less than half of dental students (37.5%) or dental residents (48.7%) had discussed the HPV vaccine with a physician or had received the vaccine themselves. In addition, a significant percentage of dental students and residents felt they did not have enough information regarding the HPV vaccine (25.6% and 26.8%, respectively) or had significant concerns about the side effects (17.1%). Conclusions: The data suggest more specific information in dental school microbiology and immunology courses might be needed to increase awareness and knowledge of the safety and effectiveness of vaccines, including the HPV vaccine. This enhanced education might also serve as a curricular focal point to answer questions regarding vaccine-related side effects and provide a mechanism for answering important questions regarding this vaccine.
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11
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Nixon LL, Marlinga JC, Hayden KA, Mrklas KJ. Barriers and facilitators to office-based opioid agonist therapy prescribing and effective interventions to increase provider prescribing: protocol for a systematic review. Syst Rev 2019; 8:186. [PMID: 31345258 PMCID: PMC6657163 DOI: 10.1186/s13643-019-1076-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 06/24/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Opiate agonist therapy (OAT) prescribing rates by family physicians are low in the context of community-based, comprehensive primary care. Understanding the factors that support and/or inhibit OAT prescribing within primary care is needed. Our study objectives are to identify and synthesize documented barriers to, and facilitators of, primary care opioid agonist prescribing, and effective strategies to inform intervention planning and support increased primary care OAT prescribing. METHODS/DESIGN We will systematically search EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, MEDLINE, and gray literature in three domains: primary care providers, opioid agonist therapy, and opioid abuse. We will retain and assess primary studies reporting documented participation, or self-reported willingness to participate, in OAT prescribing; and/or at least one determinant of OAT prescribing; and/or strategies to address determinants of OAT prescribing from the perspective of primary care providers in comprehensive, community-based practice settings. There will be no restrictions on study design or publication date. Studies limited to specialty clinics with specialist prescribers, lacking extractable data, or in languages other than English or French will be excluded. Two reviewers will perform abstract review and data extraction independently. We will assess the quality of included studies using the Joanna Briggs Institute Critical Appraisal Tool. We will use a framework method of analysis to deductively code barriers and facilitators and to characterize effective strategies to support prescribing using a combined, modified a priori framework comprising the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. DISCUSSION To date, no synthesis has been undertaken of the barriers and facilitators or effective interventions promoting OAT prescribing by primary care clinicians in community-based comprehensive care settings. Enacting change in physician behaviors, community-based programming, and health services is complex and best informed by using theoretical frameworks that allow the analysis of the available data to assist in designing and implementing interventions. In light of the current opioid crisis, increasing the capacity of primary care clinicians to provide OAT is an important strategy to curb morbidity and mortality from opioid use disorder. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD86835.
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Affiliation(s)
- Lara L. Nixon
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Jazmin C. Marlinga
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Room G012 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - K. Alix Hayden
- Libraries & Cultural Resources, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 4N1 Canada
| | - Kelly J. Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
- Strategic Clinical Networks™, System Innovation and Programs, Alberta Health Services, 403 - 29th Street NW, Calgary, AB T2N 2T9 Canada
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Janetschek G, Weitzel D, Stein W, Müntefering H, Alken P. Prenatal diagnosis of neuroblastoma by sonography. Urology 1984; 38:93. [PMID: 30791957 PMCID: PMC6385443 DOI: 10.1186/s13046-019-1109-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 02/15/2019] [Indexed: 12/24/2022]
Abstract
Background Zoledronic acid is the most potent osteoclast inhibitor and is widely used for advanced cancer patients with bone metastasis, but its role on cancer stem cells (CSCs) remains unclear. In the present study, we aimed to identify the stemness phenotypic characteristics of CSCs derived from cervical cancer cells and explore the anti-cancer efficiency of zoledronic acid on these cells, as well as the possible molecular mechanisms. Methods Stemness phenotypic identification of cervical cancer cells derived CSCs was performed via sphere formation efficiency (SFE), tumorigenesis, immunofluorescence staining, Transwell assay, and western blot. Anti-cancer efficiency of zoledronic acid on these cells (including proliferation, stemness phenotype, apoptosis, and cell cycle) was carried out through MTT assay, SFE, transwell, DAPI staining, flow cytometry, immunofluorescence, TUNEL staining, and western blot, both in vitro and in vivo. Results Enhanced self-renewal ability, including SFE and tumorigenesis, was verified in cervical cancer cells derived CSCs compared to parental cervical cancer cells. Specifically, the expression of ALDH1, Sox2, CD49f, Nanog, and Oct4 was significantly up-regulated in cervical cancer cells derived CSCs. Furthermore, enhanced migratory ability was observed in these cells along with up-regulated N-cadherin and Vimentin and down-regulated E-cadherin. Zoledronic acid inhibited cervical cancer cells derived CSCs proliferation in vitro and in vivo. The stemness phenotype of these CSCs including tumor sphere formation, migration, as well as the expression of the aforementioned associated markers was also suppressed. In addition, zoledronic acid significantly induced apoptosis and cell cycle arrest of cervical cancer cells derived CSCs in a dose-dependent manner. Mechanistically, the expression of phosphorylated Erk1/2 and Akt was significantly increased in cervical cancer cells derived CSCs compared to parental cervical cancer cells. Zoledronic acid inhibited phosphorylated Erk1/2 and Akt in cervical cancer cells derived CSCs. IGF-1, a potent stimulator for Erk1/2 and PI3K/Akt, attenuated the aforementioned anti-cancer effect of zoledronic acid. Conclusions Zoledronic acid inhibited the growth of cervical cancer cells derived CSCs through attenuating their stemness phenotype, inducing apoptosis, and arresting cell cycle. The suppression of phosphorylated Erk1/2 and Akt was involved in this process. Electronic supplementary material The online version of this article (10.1186/s13046-019-1109-z) contains supplementary material, which is available to authorized users.
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