This study applied the constructs of the health belief model (HBM) to assess women's knowledge and attitudes (i.e., perceived susceptibility, perceived severity, perceived benefits and perceived barriers) regarding cervical cancer, HPV, and the HPV vaccine and determine whether they predict women's intentions to receive the HPV vaccine. Women aged 18 to 26 years were surveyed from a convenience sample, and were primarily well-educated White women. Using Polytomous Universal Model (PLUM) ordinal regression, it was determined that the constructs of this model could not predict women's intentions of receiving the HPV vaccine.

abstract: Recent studies have shown that human papillomavirus (HPV) plays a role in development of cancers, one of which is head and neck cancer. There is strong and consistent molecular evidence demonstrating that human papillomavirus (HPV) is an etiological cause of these oropharyngeal cancers. Despite the introduction of HPV vaccines, there is still an increase in human papillomavirus associated OPC (HPVOPC) and it is expected that the incidence of head and neck cancer, specifically oropharyngeal cancer (OPC) will increase. The aim of this study is to utilize human papillomavirus (HPV) seropositivity for rapid detection of HPV early specific antigen-antibodies using a lateral flow assay. Human papillomavirus (HPV) 16 proteins of interest, E7, E6 and CE2 were expressed and purified in E. coli for detection of specific antibodies using lateral flow assay because viral and host factors impact the serologic responses to HPV early antigens in HPV-positive oropharyngeal cancer. 17 samples and 5 controls with already known antibody reactivity from ELISA analysis were selected for HPV serologic responses. The lateral flow strip was evaluated for its color band intensity using Image J software. Peak area was used to quantify the color intensity of the lateral flow strip. Out of the 17 samples, 11 (64.7%) showed high antibody levels to E7, 12 (70.6%) showed high Ab levels to E6 and 6 (35.3%) showed high Ab levels to CE2. Correlation coefficient between antibody detection by sight and ELISA for E7, CE2 and E6 were 0.6614, 0.4845 and 0.2372 respectively and correlation coefficient between lateral flow assay and ELISA for E7, CE2 and E6 were 0.3480, 0.1716 and 0.1644 respectively. This further proves patients or samples with HPV 16 oropharyngeal cancer have detectable antibodies to early E7, E6 and E2 proteins, which are potential biomarkers for HPV-associated oropharyngeal cancer. / Dissertation/Thesis / Masters Thesis Molecular and Cellular Biology 2019

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Thesis (MPH.) -- University of Limpopo, 2020 / The South African government provides human papillomavirus (HPV) vaccination to public school girls for free. The study aimed to investigate knowledge, attitudes and practices towards HPV vaccination, of caregivers of girls aged ≥9 years in grade 4 to 7 attending private schools in South Africa. Objectives included determining levels of knowledge; describing attitudes; describing practices; and investigating levels of knowledge and attitudes of caregivers associated with HPV vaccination coverage in these girls. Turfloop Research Ethics Committee granted ethical clearance. A link to an online survey (Survey Monkey®, USA) was circulated to caregivers via an email to school principals and a Facebook advert. Epi InfoTM was used for data analysis. While 76.5% of caregivers had good knowledge about cervical cancer and HPV vaccination, 45.3% had positive attitudes towards HPV vaccination and 19.4% of the girls were vaccinated. Caregivers with good knowledge were 3.6 (95% CI: 1.6-8.0; p<0.005) times more likely to have vaccinated their daughters/wards, while caregivers with a positive attitude were 5.2 (95% CI: 2.9-9.2; p<0.05) times more likely. The low HPV vaccination uptake is concerning. Results suggest that a positive attitude towards HPV vaccination is a strong predictor of its uptake. / University of Limpopo, Anova Health Institute and National Research Foundation (NRF)

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In the United States, parents' health beliefs affect HPV vaccination decisions for children. Our team acquired insights into mothers' health beliefs from their reactions and comments to posts on HPV vaccination in a social media adolescent health campaign in a randomized trial (n = 881 mothers; 63.1% reported daughters had 1+ doses of the HPV vaccine) evaluating communication intended to reduce daughters' indoor tanning. A total of 10 HPV vaccination messages in didactic (n = 7) and narrative (n = 3) formats were posted on vaccination need, uptake, and effectiveness and stories of young women who died from cervical cancer and a mother's decision to vaccinate her daughters. These posts received 28 reactions (like, love, and sad buttons; mean = 2.8 per post) and 80 comments (mean = 8.0 per post). More comments were favorable (n = 43) than unfavorable (n = 34). Data was not collected on views for posts. The most common favorable comment reported that daughters were vaccinated (n = 31). Unfavorable comments cited safety concerns, lack of physician support, distrust of pro-vaccine sources, and increased sexual activity of daughters. Mothers posting unfavorable (18.2%) as opposed to favorable (78.6%) comments or not commenting (64.0%) were less likely to have had their daughters vaccinated (chi-square = 22.27, p < 0.001). Favorable comments often did not state reasons for vaccinating. Concerns about lack of vaccine safety remain a barrier. Mothers may express distrust in pro-vaccine sources to reduce discomfort with not vaccinating daughters to reduce their risk for HPV infection. Many mothers who remained silent had vaccinated daughters, which suggests they did not resisit HPV vaccination.

Introduction The discovery and continued development of vaccines is arguably one of the most important innovations in human history. Vaccination greatly reduces the worldwide incidence and transmission of diseases, preventing permanent injury and premature death. Mass vaccination campaigns have led to the eradication or partial eradication of severe infectious such as smallpox and polio, have reduced childhood mortality, and has led to an overall increase in average health in the human population globally. Despite the documented benefits of vaccination, vaccine hesitancy is increasing, and the uptake of some vaccines is low. Vaccines have been so successful at preventing disease that portions of the population are now more afraid of the possible side-effects of vaccines then they are of the serious symptoms and maladies that vaccines prevent. Vaccine hesitancy is a serious concern for the global medical community. The incidence of infectious disease is inversely proportional to vaccine uptake; as fewer people are vaccinated against preventable diseases, the frequency at which people get sick increases. A reduction in vaccination rates due to vaccine hesitancy reduces herd immunity, which increases the risk for the whole population, especially immunocompromised individuals who are unable to receive vaccines. Vaccines that protect against high-risk strains of Human Papillomavirus (HPV) have recently been developed and released to the worldwide population. High-risk HPV strains can cause persistent infection and various cancers. Although HPV vaccines have been extensively tested and are recommended by the Centers for Disease Control and Prevention and the World Health Organization, uptake among some demographics is low. Understanding what factors impact HPV vaccine hesitancy can guide the design of effective interventions which can increase vaccine uptake. High HPV uptake will lead to a reduction of HPV associated cancers and reduce the transmission of high-risk subtypes. Research Significance Vaccine hesitancy is a growing challenge for the medical community and could potentially put global health at risk by undermining 200 years of progress towards eliminating infectious diseases. A better understanding of what factors impact vaccine hesitancy allows public health professionals to design better policies and interventions policies and helps primary care providers better address concerns the concerns of their patients. Better understanding of the factors which cause vaccine hesitance can be used to tailor education about vaccines. This leads to higher vaccine uptake and better community health overall. Methodology Electronically distributed surveys and statistical analysis were the primary tools used in this research. Surveys were used to generate data from a sample population, including: demographic factors, attitudes towards vaccination, and intent to vaccinate against HPV. Barriers to HPV vaccine uptake and factors that impact HPV vaccine acceptance were identified through statistical analysis, including confirmatory factor analysis, structural equation modeling, regression and univariate analysis. Findings We found that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Parents who view vaccination positively intend to vaccinate their children against HPV or have already vaccinated their children against HPV. Parents who are somewhat unsure about vaccines are more hesitant about vaccinating their children against HPV. Knowledge about HPV increases intent to vaccinate. We found that traditionally religious parents who felt that religious adherence provided some protection against HPV were more hesitant about HPV vaccinations. We found that both a religious-focused intervention and an education-focused interventions increased parental intent to vaccinate more than a control intervention. Our study of Utah residents confirmed our earlier findings that general attitudes toward vaccination had the greatest impact on the intent of parents to vaccinate their children against HPV. Our study also confirmed that knowledge about HPV increases intent to vaccinate. We found that high religious practice negatively impacts parental intent to vaccinate. Cautious sexual attitudes also negatively impact intent to vaccinate against HPV. High religious practice is correlated with cautious sexual attitudes which explains the negative impact of high religious practice on intent to vaccinate. The findings of this research work will be used to inform future religious and educational based interventions in Utah and beyond.

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<p>  </p> <p>Ubiquitination is a post-translational modification that activates a variety of signaling pathways. The process of tagging ubiquitin (Ub) onto a substrate protein requires three proteins. First, the E1-activating protein primes Ub for attachment to the E2-conjugating enzymes. The E2-conjugating enzyme then brings Ub to E3 ligases, which also recruit the substrate proteins. The final step of this cascade is the transfer of Ub onto the substrate protein. More commonly, ubiquitinated proteins are then degraded via the proteasome. This cascade to downregulate proteins is employed as a cellular adaptation mechanism in response to various threats, including bacterial and viral pathogens. Although the Ub system exists exclusively in eukaryotes, in recent years many bacterial effector proteins and viral factors have been shown to hijack the system through highly regulated mechanisms. In my Ph.D. work, I characterized the hijacking mechanism of a protein produced by human papillomavirus (HPV) that causes downregulation of p53. Downregulation of p53 leads to the oncogenic effects of HPV infection. A strain of oncogenic HPV, HPV-16, produces the E6 protein, which forms a complex with the human ubiquitin E3 ligase, E6AP. This allows E6AP to recognize p53 for ubiquitination. Furthermore, the ability of E6 to act as an adaptor protein to target unnatural substrate proteins has been employed by medicinal chemists as the basis of <u>pro</u>teolysis <u>ta</u>rgeting <u>c</u>himeras (PROTACs). To this extent, my thesis covers three broad ideas that will add to our understanding of <strong>1) Cellular adaptor protein regulation, 2) viral adaptor protein hijacking, and 3) PROTAC ligand development.</strong></p>

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