Vaccination demand and acceptance: a literature review of key behavioural insights

This literature review examines key behavioural insights that can help explain and support vaccination demand and acceptance. The report identifies several key behavioural factors that should be considered in designing vaccination policies, including the importance of perceived vaccine safety, the impact of exposure to vaccine-critical information, the role of trust in government and healthcare professionals, the potential impact of forgetfulness and present-biasedness, the influence of prospect theory, the possibility of risk-related trade-offs, and the role of homophily and contagion in shaping vaccination behaviour. The report also notes that while existing literature is useful in understanding attitudes towards COVID-19 vaccines, the unique circumstances of the pandemic limit the generalizability of these findings. The report concludes by emphasizing the need for a new research agenda to build trust in the medical system, government, and pharmaceutical companies, and highlights the importance of healthcare workers in addressing the challenges of vaccination programs, as they are the most trusted source of health information. The report advocates for a multidisciplinary approach that includes insights from the behavioural sciences to shed light on the mechanisms at work when people make decisions about vaccination. Overall, the report provides valuable insights for policymakers seeking to promote vaccination demand and acceptance.JRC.S.1 - EU Policy Lab: Foresight, Design & Behavioural Insight

How the European Commission can use behavioural insights to combat misinformation

→ To fight misinformation, policymakers can use debunking (exposing misinformation and explaining why it is false) and prebunking (training people to recognise misinformation and defend themselves against it). → In an experiment with more than 5 000 people from four EU countries, debunking and prebunking effectively combated misinformation on climate change and COVID-19. → Debunks and prebunks were effective when their messenger was the European Commission. → The effectiveness of prebunks from the European Commission did not depend on people’s trust in the EU. → People’s levels of trust in the EU partially affected the effectiveness of debunks from the European Commission in reducing people’s beliefs in and the credibility ratings of false claims.JRC.S.1 - EU Policy Lab: Foresight, Design & Behavioural Insight

Applying lessons from behavioural sciences to vaccination acceptance and demand

This JRC technical report gives an overview of a large project on vaccination acceptance and demand and illustrates its outcomes and lessons learnt. The project started at the end of 2019 and was completed in 2022. The overarching objective of the project was to facilitate and execute research on vaccine confidence, identifying behavioural determinants of vaccine hesitancy across different subgroups of the population, like parents and healthcare workers, for specific categories of vaccines in several Member States of the EU. The project highlighted the complexity of vaccine acceptance and demand, bringing to attention several challenges and opportunities. In particular, it has brought out the importance of civic trust in increasing vaccination acceptance and demand and the crucial role played by healthcare providers. While it proposes a taxonomy of parents that allows for more effective, targeted policy interventions, it also points out that some groups are resistant to nearly all attempts at increasing vaccination uptake. Furthermore, the project seized the opportunity to take stock of the progress made in understanding the behavioural determinants of vaccination during the COVID-19 pandemic. This invaluable knowledge is fundamental to improved health emergency preparedness, response plans and infrastructures.JRC.I.2 - Foresight, Modelling, Behavioural Insights & Design for Polic

COVID-19 Vaccination: Exploring the Behavioural Determinants and Interventions through a Literature Review

During the past two years, a large quantity of research has been conducted in different countries with various populations to study the behavioural factors that explain when and why people accept to get vaccinated against COVID-19. This report presents a comprehensive review of the literature on the behavioural factors and policies that can impact COVID-19 vaccination acceptance and demand. Based on the assessment of evidence from nearly 200 articles, the report highlights seven behavioural factors associated with the acceptance of vaccines and five policy interventions that increase demand for vaccines. Furthermore, to identify policies that can be implemented at scale (in contexts different from the originally studied ones), the report discusses the COVID-19 evidence in light of findings from other infectious diseases.JRC.S.1 - EU Policy Lab: Foresight, Design & Behavioural Insight

From ECG to Ablation: A Modern Review of Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a clinical manifestation of pre-excitation syndrome, characterized by the congenital presence of an additional conduction pathway in the form of a muscle fibre - Kent's bundle between the atria and ventricles, resulting in paroxysmal supraventricular tachycardia and increasing the risk of sudden cardiac death when atrial fibrillation occurs. The aim of this study is to show a structured knowledge of the pathophysiology and epidemiology, clinical manifestations, diagnosis, risk assessment and management of Wolff-Parkinson-White syndrome based on a review of the literature, Pubmed and Google Scholar databases. Based on current data, the prevalence of electrographic features of pre-excitation is estimated at 0.15-0.25% in the general population. The presence of an additional conduction pathway between the ventricles, predominantly conducting impulses like healthy His and Purkinje fibres, results in a characteristic ECG pattern, allowing the diagnosis of pre-excitation syndrome. Each excitation from sinoatrial node is conducted not only by the physiological pathway, but also by an accessory pathway, the clinical consequences of which will be the occurrence of supraventricular tachycardias such as an orthodromic and antidromic atrioventricular reentrant tachycardia (AVRT), atrial fibrillation or even the ventricular fibrillation, which can be the first symptom of the syndrome. The diagnosis is aided by electrophysiology studies (EPS) to confirm the presence of an accessory pathway, with usually simultaneous invasive treatment - percutaneous ablation, which is also a causal therapy with an efficacy of approximately 92%. Pharmacological treatment of patients with WPW is based on group IA and IC antiarrhythmic drugs, but these act only for symptoms, they are  ineffective in eliminating the underlying cause of disease.&nbsp

Auricular Hematoma in Athletes: Treatment and Risks of Neglect

  Introduction: Auricular hematoma is most often caused by direct blunt trauma to the outer ear and is frequently seen in individuals who engage in full-contact sports such as boxing, wrestling, and rugby. This condition occurs when blood accumulates between the cartilage and skin, resulting in pressure that compresses the perichondrium, leading to ischemia. If untreated, it can cause infections, perichondritis, necrosis, and permanent deformity, commonly referred to as "cauliflower ear". Standard treatment includes hematoma evacuation and the application of pressure dressings or sutures. However, alternative methods and modifications of standard approaches are currently under investigation.   Aim of the Study: The aim of this study is to evaluate the current understanding of auricular hematoma and cauliflower ear in athletes, with an emphasis on new treatment approaches, prevention and the potential complications associated with untreated cases.  Materials and Methods: A review of research literature was conducted through databases such as PubMed, Google Scholar, ResearchGate, and the Cochrane Library. Conclusion: Auricular hematoma is a prevalent injury in contact sports, requiring prompt and effective treatment to prevent complications. New evidence indicates that untreated auricular hematoma may lead to complications such as hearing loss and infections.  Recent advancements in drainage techniques, surgical approaches, and non-invasive approaches offer promising management options. However, current research is limited by small sample sizes, underscoring the need for larger clinical trials and long-term studies.&nbsp

A Comprehensive Review of Avascular Necrosis (AVN) Treatment Modalities in Orthopedics

Avascular necrosis (AVN), also known as osteonecrosis, aseptic necrosis, or ischemic bone necrosis, describes a pathological condition characterized by bone tissue death due to disrupted blood supply, leading to bone death and potential joint collapse. This review aims to provide an overview of the current treatment strategies for AVN, encompassing both conservative and surgical interventions. Emphasis is placed on recent advancements, including biological therapies and novel surgical techniques, to guide orthopedic practitioners in evidence-based decision-making

Hypertension in Children: A Comprehensive Review of Contemporary Knowledge and Future Perspectives

Introduction: Hypertension is one of the most common, well-documented and potentially reversible risk factors of cardiovascular incidents in the adult population. However, studies are much scarcer when it comes to children. With the obesity epidemic on the rise around the world, clinicians must try and ensure the best possible care is given to the patients in order to avoid potential unfavourable outcomes.  Aim of the Study: This study aims to evaluate and summarise current knowledge regarding arterial hypertension in the paediatric population, especially emerging trends, causes, risk factors, and long-term outcomes and outline possible future avenues of research. Materials and Methods: A systemic search of currently available literature was conducted through databases such as PubMed, Google Scholar, ResearchGate, and the Cochrane Library using combinations of keywords such as “paediatric hypertension,” “ treatment,” “screening,” “epidemiology,” and “complications.” The current guidelines by associations around the world, such as the American Academy of Pediatrics (AAP), European Society of Hypertension (ESH) and the Canadian Cardiovascular Society (CCS) were also reviewed.  Conclusions: Arterial hypertension has emerged as a condition of growing prevalence within the paediatric population. Research indicates that it is prevalent among individuals with a Body Mass Index (BMI) equal to or exceeding 25. Furthermore, the potential complications associated with this condition are numerous, and prompt diagnosis alongside effective treatment, through lifestyle modifications or pharmacotherapy, is essential to mitigate these risks. Nonetheless, numerous avenues for further research remain available to enhance understanding and treatment strategies of paediatric hypertension

MTARC1 and HSD17B13 Variants Have Protective Effects on Non-Alcoholic Fatty Liver Disease in Patients Undergoing Bariatric Surgery

The severity of hepatic steatosis is modulated by genetic variants, such as patatin-like phospholipase domain containing 3 (PNPLA3) rs738409, transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, and membrane-bound O-acyltransferase domain containing 7 (MBOAT7) rs641738. Recently, mitochondrial amidoxime reducing component 1 (MTARC1) rs2642438 and hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13) rs72613567 polymorphisms were shown to have protective effects on liver diseases. Here, we evaluate these variants in patients undergoing bariatric surgery. A total of 165 patients who underwent laparoscopic sleeve gastrectomy and intraoperative liver biopsies and 314 controls were prospectively recruited. Genotyping was performed using TaqMan assays. Overall, 70.3% of operated patients presented with hepatic steatosis. NASH (non-alcoholic steatohepatitis) was detected in 28.5% of patients; none had cirrhosis. The increment of liver fibrosis stage was associated with decreasing frequency of the MTARC1 minor allele (p = 0.03). In multivariate analysis MTARC1 was an independent protective factor against fibrosis ≥ 1b (OR = 0.52, p = 0.03) and ≥1c (OR = 0.51, p = 0.04). The PNPLA3 risk allele was associated with increased hepatic steatosis, fibrosis, and NASH (OR = 2.22, p = 0.04). The HSD17B13 polymorphism was protective against liver injury as reflected by lower AST (p = 0.04) and ALT (p = 0.03) activities. The TM6SF2 polymorphism was associated with increased ALT (p = 0.04). In conclusion, hepatic steatosis is common among patients scheduled for bariatric surgery, but the MTARC1 and HSD17B13 polymorphisms lower liver injury in these individuals

MARC1 p.A165T variant is associated with decreased markers of liver injury and enhanced antioxidant capacity in autoimmune hepatitis

The clinical picture of autoimmune hepatitis (AIH) varies markedly between patients, potentially due to genetic modifiers. The aim of this study was to evaluate genetic variants previously associated with fatty liver as potential modulators of the AIH phenotype. The study cohort comprised 313 non-transplanted adults with AIH. In all patients, the MARC1 (rs2642438), HSD17B13 (rs72613567), PNPLA3 (rs738409), TM6SF2 (rs58542926), and MBOAT7 (rs641738) variants were genotyped using TaqMan assays. Mitochondrial damage markers in serum were analyzed in relation to the MARC1 variant. Carriers of the protective MARC1 allele had lower ALT and AST (both P < 0.05). In patients treated for AIH for ≥ 6 months, MARC1 correlated with reduced AST, ALP, GGT (all P ≤ 0.01), and lower APRI (P = 0.02). Patients carrying the protective MARC1 genotype had higher total antioxidant activity (P < 0.01) and catalase levels (P = 0.02) in serum. The PNPLA3 risk variant was associated with higher MELD (P = 0.02) in treated patients, whereas MBOAT7 increased the odds for liver cancer (OR = 3.71). None of the variants modulated the risk of death or transplantation. In conclusion, the MARC1 polymorphism has protective effects in AIH. Genotyping of MARC1, PNPLA3, and MBOAT7 polymorphisms might help to stratify patients with AIH