Assessment of Relevant Cultural Considerations is Essential for the Success of a Vaccine

This paper explores applications of social science research to international vaccine development and implementation. The paper discusses examples of vaccine-implementation controversies, suggesting that many of these issues could have been avoided with a greater focus on cultural issues regarding perceptions of disease, vaccination, and health services. The paper also discusses the relationship of theory-based behavioural interventions with the development of an overall vaccine strategy and examines experience of growing vaccine research with regard to perceptions of medical decision-making, acceptable practices, and authority and how these perceptions impact vaccine usage. The importance of social science in the ethical conduct of research is also discussed

Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview

Background: The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been created that decrease the rate of new HIV infections among youth and reduce morbidity among youth living with HIV. However, full benefits that should be possible based on the tools and interventions currently available are yet to be realized in youth, in large part, because efficacious interventions have not been implemented in real-world settings. Scale It Up (SIU) primarily aims to assemble research teams that will ultimately bring to practice evidence-based interventions that positively impact the youth HIV prevention and care cascades, and in turn, advance the fields of implementation science and self-management science. Objective: This paper aims to describe the structure of the U19-SIU and the effectiveness-implementation hybrid trials, as well as other center-wide protocols and initiatives, implemented within SIU. Methods: SIU will achieve its aims through 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives. Results: SIU was funded by National Institute for Child Health and Human Development (U19HD089875) and began in October 2016. As of November 2018, 6 SIU protocols have launched at least the first phase of work (ATN 144 SMART: Sequential Multiple Assignment Randomized Trial; ATN 145 YMHP: Young Men’s Health Project; ATN 146 TMI: Tailored Motivational Interviewing Intervention; ATN 153 EPIS: Exploration, Preparation, Implementation, Sustainment model; ATN 154 CM: Cascade Monitoring; ATN 156 We Test: Couples\u27 Communication and HIV Testing). Further details can be found in the individual protocol papers. Conclusions: To date, the youth HIV research portfolio has not adequately advanced the important care area of self-management. SIU protocols and initiatives address this broad issue by focusing on evaluating the effectiveness and implementation of self-management interventions. SIU is highly innovative for 5 primary reasons: (1) our research framework expands the application of “self-management”; (2) the 4 primary protocols utilize innovative hybrid designs; (3) our Analytic Core will conduct cost-effectiveness analyses of each intervention; (4) across all 4 primary protocols, our Implementation Science Core will apply implementation scales designed to assess inner and outer context factors; and (5) we shall advance understanding of the dynamics between provider and patient through analysis of recorded interactions

Pseudomonas Aeruginosa Reduces Vx-809 Stimulated F508del-Cftr Chloride Secretion by Airway Epithelial Cells

Background: P. aeruginosa is an opportunistic pathogen that chronically infects the lungs of 85% of adult patients with Cystic Fibrosis (CF). Previously, we demonstrated that P. aeruginosa reduced wt-CFTR Cl secretion by airway epithelial cells. Recently, a new investigational drug VX-809 has been shown to increase F508del-CFTR Cl secretion in human bronchial epithelial (HBE) cells, and, in combination with VX-770, to increase FEV1 (forced expiratory volume in 1 second) by an average of 3-5% in CF patients homozygous for the F508del-CFTR mutation. We propose that P. aeruginosa infection of CF lungs reduces VX-809 + VX-770- stimulated F508del-CFTR Cl secretion, and thereby reduces the clinical efficacy of VX-809 + VX-770. Methods and Results: F508del-CFBE cells and primary cultures of CF-HBE cells (F508del/F508del) were exposed to VX-809 alone or a combination of VX-809 + VX-770 for 48 hours and the effect of P. aeruginosa on F508del-CFTR Cl secretion was measured in Ussing chambers. The effect of VX-809 on F508del-CFTR abundance was measured by cell surface biotinylation and western blot analysis. PAO1, PA14, PAK and 6 clinical isolates of P. aeruginosa (3 mucoid and 3 non-mucoid) significantly reduced drug stimulated F508del-CFTR Cl secretion, and plasma membrane F508del-CFTR. Conclusion: The observation that P. aeruginosa reduces VX-809 and VX-809 + VX-770 stimulated F508del CFTR Cl secretion may explain, in part, why VX-809 + VX-770 has modest efficacy in clinical trials

Core human values and their interactions with pro-Tobacco factors on cigarette smoking: The role of factors not explicitly related to a risk behavior

More effective tobacco control requires new data on factors that are not explicitly related to smoking but are influential, such as “Terminal Values” regarding desirable end-states of existence and “Instrumental Values” regarding desirable modes of conduct. Association analysis was conducted among 36 Core Values (18 Terminal and 18 Instrumental) derived from Rokeach’s Value Survey, three risk factors (protobacco media, smoking peers and sensation-seeking), and cigarette smoking using data collected from a sample of 334 medical students in China. The participants were 18 to 24 years old (47% female) and 18.4% of them smoked in the past 30 days. Multivariate analysis indicated that cigarette smoking was negatively associated with nine Terminal Values (e.g., a Sense of Accomplishment and Self-Respect) and ten Instrumental Values (e.g., Clean and Self-Controlled). As expected, when the endorsed number of values/total value scores increased from low to high, the 30-day smoking rate declined from 32.6% - 75.0% to 13.5% - 15.9% (p < .01). The odds ratios (OR) for the endorsed Terminal Values and the total value scores were 0.50 (p < .01) and 0.64 (p < .01) respectively, and the ORs for the endorsed Instrumental Values and the total value scores were 0.42 (p < .01) and 0.44 (

Corr4A and VRT325 do not Reduce the Inflammatory Response to P. aeruginosa in Human Cystic Fibrosis Airway Epithelial Cells

P. aeruginosa chronically colonizes the lung in CF patients and elicits a proinflammatory response. Excessive secretion of IL-6 and IL-8 by CF airway cells in response to P. aeruginosa infection in the CF airway is though to contribute to lung injury. Accordingly, the goal of this study was to test the hypothesis that Corr4a and VRT325, investigational compounds that increase ΔF508-CFTR mediated Cl− secretion in human CF airway cells, reduce the pro-inflammatory response to P. aeruginosa

Associations between Leisure Activities and HIV Risk Behaviors among Rural Migrants in Urban China

Although much has been documented on factors affecting HIV risk behavior among rural-to-urban migrants in China, data are lacking on the impact of leisure activities. In this study, we examined the association between leisure activities and HIV risk behavior among a sample of rural-to-urban migrants from two large cities (Beijing and Nanjing) in China. Cross-sectional data were analyzed for a sample of 4,085 participants aged 18 to 30 years (40.5% females). Findings from the analysis indicated that although the migrants worked long hours, they engaged in a number of activities when they did not work, including watching television (60.2%), reading (59.1%), sleeping (55.6%), and chatting with friends and co-workers (45.0%). Multiple regression analysis indicated that reading, doing chores (females only), listening to radio programs/audio CDs (male only) were associated with reduced likelihood of HIV risk behavior while playing cards in groups, visiting entertaining installments, watching videos (including Xrated, males only), and wondering around (females only) were associated with increased likelihood of HIV risk behavior. Findings of this study suggest that constructive and individualized activities (e.g., reading, listening to radios, and doing chores) may prevent migrants from engage in HIV risk behaviors while group and entertaining activities related to drugs and sex may increase the odds for migrants to engage in HIV risk behaviors. Prevention research should consider leisure activities as both an influential factor (including time trends and gender differences) for program development and an important venue for program delivery

Differences in perception of dysentery and enteric fever and willingness to receive vaccines among rural residents in China.

BACKGROUND: Enteric diseases including dysentery and enteric fever remain significant public health problems in China. While vaccines offer great potential in controlling these diseases, greater understanding of factors influencing acceptance of vaccines is needed to create effective enteric disease control programs in rural China. DESIGN: Cross-sectional quantitative study with randomly sampled households from two sites in China, one experiencing high rates of shigellosis (Zengding) and the other of typhoid/paratyphoid (Lingchuan). METHODS: Sociobehavioral survey data were collected through face-to-face interviews from 501 respondents (56% female) in Zhengding regarding dysentery and 624 in Lingchuan (51% female) regarding enteric fever. Vaccine acceptability was measured by expressed need for vaccination and willingness to pay. Comparative and associative analyses were conducted to assess disease perception, vaccination service satisfaction, likelihood of improvements in water and sanitation, and vaccine acceptability. RESULTS: Nearly all respondents in Lingchuan considered enteric fever to be prevalent in the community, while only one half of the respondents in Zhengding considered dysentery to be problematic (p < 0.01). Nevertheless, more respondents in Zhengding were fearful that a household member would acquire dysentery than were Lingchuan respondents worried that a household member would acquire enteric fever (p < 0.01). Perceived vulnerability of specific subgroups (odds ratios ranging from 1.6 to 8.1), knowing someone who died of the disease (odds ratio reached infinity) and satisfaction with past vaccination services (odds ratios reached infinity) were consistently associated with perceived need for vaccines of target populations of all age groups while the association between perception of sanitary improvement and vaccine need was limited. Perceived need for a vaccine was associated with willingness to pay for the vaccine. CONCLUSIONS: Perceptions of enhanced vulnerability of specific subgroups to a disease and satisfactory experiences with vaccination services may increase the perceived need for a vaccine, leading to increased willingness to pay for vaccine. Vaccines are not perceived as important for the elderly

Examining smoking and cessation during pregnancy among an Appalachian sample: a preliminary view

Background Several transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies. Results The reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women\u27s social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be depressed, reject authority, and perceived little control over issues related to being pregnant. Conclusion These findings support the argument that standard substance use treatments and polices based on stages-of-change theories may not be effective for all individuals particularly those experiencing significant developmental changes in their lives. Greater success might be obtained from treatment programs designed to recognize the impact of these transitions as it relates to the substance use. The changing experiences of pregnant women in terms of their identity development, views of others, and their relationships have not been adequately addressed in existing cessation programs. Empirically-based interventions targeting these lifestyle characteristics may lead to increased cessation success among pregnant women