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Background: In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. Objectives: The objective of the study was to give an overview of the study designs, statistical methods, and comparison of research in identifying the predictors of melioidosis mortality in Malaysia between January 2010 to December 2021. Data sources: Pubmed/Medline. Study eligibility criteria: Original English-language articles were abstracted. The articles that identified the predictors of melioidosis from mortality in Malaysia only included. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports, and any other ineligible articles were excluded. Results: A total of eight studies were identified related to predictors of melioidosis mortality in Malaysia. From the selected articles, 87.5% were retrospectively collected. Five out of eight articles (62.5%) used the logistic regression in identifying the predictors of melioidosis mortality. Only one (12.5%) used advanced survival analysis methods of Cox regression analysis. Another 25.0% used Chi-square test. Conclusions: Logistic regression methods remain the most common methods of analysis in publications on predictors of melioidosis mortality in Malaysia while retrospective research designs are preferred. There is a limitation of research in predictors of melioidosis mortality and the use of advanced statistical techniques reported using the melioidosis data in Malaysia. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

In biology learning, the object of a virus cannot be seen directly. Augmented reality (AR) technology can help visualize the object of a virus in 3D, making it easier for students to learn about viruses. Therefore, this research aims to develop an AR-based learning media product called ARVi. ARVi was created using the ADDIE model, which consists of five stages: analysis, design, development, implementation, and evaluation. The results of the analysis revealed that students need learning media with engaging visualizations. Therefore, ARVi was designed as a mobile application with various colors, images, videos, AR, and quizzes. ARVi underwent validation tests by experts, including biology education lecturers and biology teachers. The user responses were evaluated through a small group test involving 20 students, where questionnaires were distributed. Based on the questionnaire results, the average score for the media expert was 3.84, and for the material expert was 3.80. These scores indicate that ARVi is very valid for use as a learning medium. The results of the small group test were 2.85, indicating that ARVi is valid for use after minor revisions are made. The implementation results for 60 students, as determined through a paired t-test, showed a significant difference between the pretest and posttest results, with the posttest score being higher than the pretest score. The research results concluded that ARVi is suitable as a biology learning media.

What is power? What is knowledge? What is the link between power and knowledge? This paper interrogates the relationship between knowledge and power in the context of Guinea's epidemic crises and political events. It draws on observational data collected during the Ebola epidemic (2013-2016), the COVID-19 pandemic (2020-2022), and the ongoing military transition in the country since September 2021. The article first looks at the conception of the relationship between power and knowledge in decolonial literature and the writings of Amadou Hampâté Bâ. The text then describes this relationship in the context of the Ebola and COVID-19 epidemics, and in the ongoing political transition. Finally, the analysis provides an epistemological reflection on knowledge-situated in Guinea to rethink the conceptual and empirical research perspective on the production and circulation of (academic) knowledge in the country's knowledge ecology.

Immunization is a highly cost-effective investment in health, proven to be an effective tool in controlling and eliminating dangerous infectious diseases. Health science students require evidence-based knowledge to tackle challenges in healthcare, particularly in the field of vaccination. The aim of the current study is to asses students' knowledge on vaccinations and further explore their feedback after attending Educating Vaccination Competence web-based course (EDUVAC web-based course). Students from five Higher Educational Institutes voluntarily participated in the EDUVAC web-based course. The course provided various study materials, including PowerPoint presentations, videos, quizzes, texts, and references to reputable websites. It also offered small assignments and self-tests for self-evaluation. An online questionnaire was available to students before and after they completed the EDUVAC web-based course. The mean knowledge score on vaccines increased significantly after the EDUVAC web-based course (p<0.001). The majority of the students (95%) felt that the web-based course has benefitted them for their future career and 96.4% would encourage other students to attend the EDUVAC web-based course. Overall, our findings suggest that EDUVAC is a valuable resource for those seeking to enhance their understanding of vaccination.

Cyberbiosecurity and workforce development in agriculture and the life sciences (ALS) is a growing area of need in the curriculum in higher education. Students that pursue majors related to ALS often do not include training in cyber-related concepts or expose the 'hidden curriculum' of seeking internships and jobs. Exposing students through workforce development training and hands-on engagement with industry professionals can provide learning opportunities to bridge the two and is an area of growth and demand as the workforce evolves. The objectives of this work were (1) to learn key concepts in cybersecurity, including data security, visualization, and analysis, to name a few, through class activities and engagement with professional partners and (2) to understand what knowledge students gained from participating in the course could transfer over for when they enter the workforce. Three themes emerged from the study where students, through direct engagement with industry partners, gained more insight about the industry applicable to their studies; they established work environment expectations for entering internships and official job placements and established ways in which the workforce development training informed their future careers.

Background: Disparities in school attendance exist for children with medical complexity (CMC) due to COVID-19. Longitudinal changes in family-reported school safety perceptions and predictors of full-time, in-person school attendance are unknown. Methods: This was a prospective, longitudinal cohort study with 3 survey waves (June 2021-June 2022) among English- and Spanish-speaking families of CMC aged 5 to 17 years and pre-pandemic school attendance. Changes in Health Belief Model perceptions and full-time in-person school attendance were estimated using multivariate generalized linear modeling with repeated measures. Results: Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID-19 increased. Full-time in-person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p < 0.0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in-person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p < 0.0001). Implications for School Health Policy, Practice, and Equity: Probability of full-time in-person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID-19. Conclusions: In-person school attendance improved for CMC over time. Opportunities exist to continue optimizing in-person attendance and family-perceived safety for CMC at school.

Background: We aimed to better understand the impact of statewide legislation removing personal belief exemptions (PBEs) for the measles, mumps, and rubella (MMR) school immunization requirement and factors associated with resulting health-seeking behaviors. Methods: We used chi-squared tests and logistic regression models to determine individual- and school-level characteristics associated with holding a MMR PBE and with post-law MMR immunization status among students linked to the Washington State Immunization Information System. Results: Of students with a MMR PBE pre-law change, 43.0% completed the MMR vaccine series and 40.4% sought another exemption type. Religious exemptions made up most new MMR exemptions signed (71.8%), followed by medical exemptions (18.5%), and religious membership exemptions (9.7%). Students were more likely to complete the vaccine series post-law change if they attended a school with a low school-level MMR exemption rate, a public school, or held a lower number of school-required immunization exemptions. Conclusions: This study confirms previous concerns that parents might replace their PBE with another exemption type; however, nearly half the students in the cohort completed the MMR vaccine series. Our findings suggest that targeted immunization policies can increase MMR coverage 1-year post-law change but must account for a replacement effect when exemption categories are eliminated.

Objective: This study examined children's representations of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as well as their pandemic experiences against the backdrop of the world having transitioned to normalcy. Design: Mixed-methods approach encompassing both qualitative and quantitative analysis. Setting: Two middle schools in Hefei city in mid-eastern China. Method: Data were collected using a qualitative task which elicited children's drawings, commentaries, answers to questions related to their pandemic experiences, followed by small-group interviews. Content analysis and emergent coding techniques were employed to analyse the data, the extracted themes of which were then quantified to reveal their incidence and distribution. Results: Analysis of the multimodal data set revealed children not only depicted viral morphology but also evoked emotions. The pandemic had brought about changes in children's lives, marked by a shift towards more academic activities, rest and relaxation and screen time. These changes also raised psychological, physical and social development concerns warranting mitigation. Multifaceted sources were identified as contributing to children's unhappiness, including restricted social interactions, educational challenges, emotional and psychological issues. Notably, children reported enhanced pre- to post-pandemic hygiene and sanitisation practices. Unsubstantiated beliefs relating to processes of recovery suggest the need for clearer communication in this regard. Conclusion: The study highlights the necessity for health education to support children in physical and psychological coping during a pandemic and build their resilience against future epidemics. Actively listening to children's account of the SARS-CoV-2 coronavirus, and their pandemic experiences paves the way for making health education initiatives more relatable and attuned to their needs.

Background: Dengue is a viral infection that spreads from mosquitoes to people. It is especially prevalent in tropical and subtropical regions of the world. To address the challenges posed by dengue in countries such as Thailand, effective prevention and control to strengthen health literacy at the community level is needed. One way of achieving this goal is to work with village health volunteers (VHVs). This article documents the use of VHVs for dengue fever prevention in Mueang district, Khon Kaen province, northeast Thailand. Method: A quasi-experimental study was conducted. The experimental group comprised 45 people who received a programme that aimed to enhance health literacy through the provision of knowledge and social support by community-based volunteers accompanied by a short drama programme. A group of 45 people receiving health services without the drama programme comprised the comparison group. The duration of the activity was 12 weeks. Data were collected by means of a pre- and post-test survey and were analysed using descriptive statistics and a comparison of mean health literacy and practice scores before and after the intervention. Results: Following programme delivery, the experimental group had a mean health literacy score which was significantly higher than that of the comparison group, while the mean practice score of the experimental group was also higher than that of the comparison group. Conclusion: The results suggest that a health literacy programme which includes a short drama programme could be effective in bringing about desired changes with respect to dengue fever prevention. The programme provided in this study was effective and easy to understand. The model developed here could also be useful in other villages in epidemic areas.

This paper presents a novel approach to teaching how vaccines work in the body, and introduces a community outreach project and activity we piloted with youth. Our Nuestra Ciencia program addresses scientific misconceptions among bilingual elementary school children in engaging and scientifically accurate ways. Utilizing analogies and storytelling, one of our lessons simplifies the complex microbiology concept of the mechanism of action of vaccines. We underscore the issue with conveying this concept through accurate visuals, supported by our research that revealed that less than 1% of cartoons available online accurately depict how vaccines work. The analogy we developed and showcase in this paper employs relatable characters: the virus as a robber, the immune system as a superhero, and the vaccine as a "most wanted" poster. The activities include a skit and storyboard session, enabling students to act out the analogy and create their own imaginative scenarios. By targeting young learners, this lesson aims to prevent long-standing misconceptions and empower future generations to make informed decisions about vaccination. Nuestra Ciencia offers a promising model for combating vaccine hesitancy and promoting public health through effective science communication.

Background: Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking. Methods: Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events. Results: One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use. Conclusion: Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

When teaching infection prevention and control (IPC), nursing education tends to focus on skills and fostering good practice rather than challenging students' thinking. Therefore, students' misconceptions about IPC receive less attention than they deserve. The purpose of the study was to make an inventory of student nurses' misconceptions about IPC before instruction and to make these misconceptions visible to teachers. The study was conducted in one vocational institute in Finland and is based on the answers of 29 practical nurse students before IPC training. The students took an online test requiring them to justify their answers to two multiple-true--false questions: 1) What is the main route of transmission between patients in healthcare facilities, and 2) What is the most effective and easiest manner to prevent the spreading of pathogens, e.g., multi-resistant bacteria in long-term care facilities? Analysis of the students' written justifications resulted in three mental models: 1) the Household Hygiene Model manifesting lay knowledge learned in domestic situations, 2) the Mixed Model consisting of lay knowledge, enriched with some professional knowledge of IPC, and 3) the Transmission Model manifesting a professional understanding of IPC. The first two mental models were considered to be misconceptions. Only one of the participants showed a professional understanding (i.e., the Transmission Model). To conclude, student nurses manifested systematic patterns of misconceptions before instruction. Unless the students are confronted with their misconceptions of IPC during instruction, it is likely that these misconceptions will impede their learning or make learning outcomes transient.

The present research emphasizes the role of learning in response changes to infection threats and suggests a new instrument. This preliminary study aims to develop a brief tool (SITS: Sensitivity to Infection Threats Scale) that measures individuals' health sensitivity to infection threats. The present research utilized the Brief Symptom Inventory-phobic anxiety and hostility subscales and the newly developed SITS. The reliability and validity of SITS were examined through construct, divergent, and convergent validity as well as internal consistency and test-retest reliability. The underlying dimensions were explored through an exploratory factor analysis (EFA N = 142; Mage = 20.29, SDage = 2.34), and the EFA dimensions were confirmed through a confirmatory factor analysis (CFA N = 236; Mage = 20.36, SDage = 2.24). The EFA and CFA results supported a correlated four-factor model and the 20-item structure of the SITS. These four factors included Preoccupied, Avoidant, Physiological, and Cautionary Sensitivities. The overall scale and subscales had good internal consistency, test-retest reliability, and convergent and divergent validity. The SITS is a reliable scale and has the potential to deepen our understanding of human behaviour in responding to infection threats.

Research on the effects of social media has evidenced their influence on public opinion concerning health issues. However, there are scarce analyses that pay attention to this influence when health advice generalizes certain groups' sexual practices. This generalization occurred with monkeypox, men who have sex with men, after two World Health Organization's (WHO) recommendations launched in 2022. Therefore, this is the issue that will be deeply explored in the article. Drawing on the methodological strategy of social media analytics (SMA), 2313 tweets have been reviewed focused on people's reactions in front of WHO's statements of July 2022 about monkeypox and men who have sex with men behaviours. Findings illustrate that there is positioning against the generalizations caused due to WHO's statement creating a public discourse against the stigma of homosexual and bisexual men. This positioning is directly linked with people's claims to follow the evidence and valid claims on public health issues. Using social networks for claiming the use of rigorous data and evidence may contribute to a significant change in public opinion and health organizations.

The world is changing: both a conventional and a vaccine passport are now needed to travel internationally. Mask mandates, and social distancing are the new norm in a rapidly changing society. These measures were put in place to control the spread of the highly infectious and often fatal COVID-19, caused by a viral agent, a microorganism, a zoonosis, and the cause of death for over 6 million people around the world. Considering this, maintaining biosecurity is important around the world to ensure public health. Biosecurity in New Zealand supposes that people including young people understand different pests and diseases that can harm public health. This qualitative study was conducted to gauge the biosecurity knowledge of 171 young people (14-15-year-olds). Young people were tested on their knowledge about biosecurity related plants, animals, and microorganisms. This paper reports specifically on the results of knowledge of microorganisms of young people. Results show that negative anthropocentric views dominate adolescents understanding of microorganisms and anthropomorphism is widely used to explain microorganism activity. An educational programme, targeted at developing a conceptual understanding about microorganisms starting at primary education may help develop a more educated global citizen, one versed in understanding the biology of microorganisms.

Objective: This study examines Chinese international students' underlying beliefs and overall perception of the flu vaccination to inform effective health promotion efforts on U.S. college campuses. Participants: Data were collected in March 2020. Participants (N = 189) were recruited via email at a southeastern university in the U.S. Methods: Incorporating theory recommendations and recent vaccine-related research findings, this study designs a Four-Factor Measurement Model through confirmatory factor analysis (CFA) to examine Chinese international students' perception of flu vaccination. Results: Chinese international students' health beliefs, particularly their perceived susceptibility of the influenza virus, was the most important factor to explain their perception of flu vaccination. While normative beliefs were the least influential factor to account for Chinese international students' perception of flu vaccination, these students valued healthcare providers' opinions immensely. Conclusions: This study suggests the Four-Factor Measurement Model will help measure Chinese international students' perception of flu vaccination and can be applied to future vaccine-related research.

Objective: We investigated the preliminary efficacy of a tailored human papillomavirus (HPV) vaccination on-line intervention designed to increase HPV vaccination intention. Participants: Female college students (N = 101; 18-26 years), who have not received the HPV vaccine. Methods: Participants were randomized to either a control group to read standard Center for Disease Control information or a narrative intervention group to read two narrative messages about HPV/HPV vaccination that were tailored based on the individual's sexual history and told from the perspectives from a peer and an expert. Participants were assessed at baseline (T1) and immediately after the intervention (T2). Results: The narrative intervention group reported a greater increase from T1 to T2 in vaccination intention compared with control group. Both groups reported increases in knowledge, positive attitude, self-efficacy, social norm, and perceived susceptibility to HPV from T1 to T2. Conclusions: A narrative intervention is promising to effectively increase HPV vaccination intention.

We explore ways in which statistics can be used to understand disease spread and support decision-making by governments. "Past performance does not guarantee future results"--we hope. We discuss and show examples from the National Science Foundation (NSF)-funded COVID-Inspired Data Science Education through Epidemiology (CIDSEE) project. Throughout, the emphasis is on the relationships between evidence, modeling and theorizing, and appropriate action. Statistics should be an essential element in all these aspects. We point to some "big statistical ideas" that underpin the whole process of modeling, which can be illustrated vividly in the context of pandemics. We argue that statistics education should emphasize the application of statistics in practical situations, and that many curricula do not equip students to use their understandings of statistics outside the classroom. We offer a framework for curriculum analysis and point to some rich teaching resources.

Objectives: Before the Fall 2020 semester, college presidents and the NCAA made decisions about playing college football. The current study aims to examine the association between college football games and COVID-19 infections at universities. Participants: More than 1,800 college campuses nationwide from "The New York Times" database on COVID-19 cases on college campuses. Methods: Random effects negative binomial regression is used to analyze the association between college football games, membership to college football organizations, and COVID-19 cases at the universities studied. Results: The number of football games played was significantly associated with higher COVID-19 cases at the universities studied. Membership to certain college football organizations was also significantly associated with higher COVID-19 cases, particularly FBS and Power Five conferences. Conclusions: These findings provide a baseline for subsequent analyses across other sports and advocates for continued assessment of protocols that ensure the safety and well-being of student-athletes, fans, and university communities.

Objective: To explore whether/how the willingness of Chinese college students to receive the influenza vaccines in the sample is affected by different information channels. Participants: Two hundred and four volunteers were recruited to participate in an anonymous online survey. All participants were college students, mainly undergraduates (81.86%), with a higher proportion of women (56.86%). Methods: Participants answered anonymous questionnaires through the website, including demographic data (age, gender, education, etc.), media exposure channels and frequency, views and attitudes toward influenza vaccines, etc. An ordered logistic regression analysis was conducted to explore the effects of different information sources on influenza vaccination among college students. Results: Exposure to traditional media, digital media, and interpersonal communication promotes college students' understanding of influenza vaccines. Exposure to digital media alleviates college students' hesitation to vaccinate, while interpersonal interaction and digital media exposure promote college students' willingness to vaccinate. Conclusions: Digital media is increasingly important in the lives of Chinese college students to promote healthy behaviors such as influenza vaccinations.

On college campuses, effective management of vaccine-preventable transmissible pathogens requires understanding student vaccination intentions. This is necessary for developing and tailoring health messaging to maximize uptake of health information and vaccines. The current study explored students' beliefs and attitudes about vaccines in general, and the new COVID-19 vaccines specifically. This study provides insights into effective health messaging needed to rapidly increase COVID-19 vaccination on college campuses--information that will continue to be informative in future academic years across a broad scope of pathogens. Data were collected from 696 undergraduate students ages 18-29 years old enrolled in a large public university in the Northeast during fall 2020. Data were collected via an online survey. Overall, we found COVID-19 vaccine hesitancy in college students correlated strongly with some concerns about vaccines in general as well as with concerns specific to COVID-19 vaccines. Taken together, these results provide further insight for message development and delivery and can inform more effective interventions to advance critical public health outcomes on college campuses beyond the current pandemic.

Purpose: This study explored undergraduate college students' opinions of the CDC's online "Solve the Outbreak" (StO) game, a recommended aid in higher education for teaching concepts epidemiological outbreak investigations. Methods: The study was conducted as a game debriefing, in which 16 students enrolled in an undergraduate-level epidemiology course were interviewed to receive feedback about their experiences of StO after completing the game. Results: A total of four common themes emerged from the interveiews as framed by the Persuasive Game Design model--(1) Enjoying the Game World, (2) Cheating the Game's Elements, (3) Suggesting Improvements to the Game's Elements, and (4) Inverted Transfer Effect. Conclusions: Students reported that they enjoyed playing StO, and that it was effective for applying their knowledge of epidemiology course content on the process of investigating outbreaks. However, students found ways to cheat the game's answers, and they recommended ways that the game's elements could be improved. Instructors should consider using StO as a tool for teaching their students about investigating infectious outbreaks. Designers of the game should consider adapting the game based on students' constructive feedback.

Background: Despite the overwhelming benefits of vaccinations, suboptimal public confidence in vaccines keeps immunization rates in the U.S far from ideal levels. Purpose: To assess the efficacy of a high school video set curriculum, on vaccine history, science, and safety, in improving vaccine knowledge. Methods: Sample included high school students in Virginia, who had completed required biology coursework. After being assigned to either the control or experimental group, their knowledge on vaccines was assessed before and after viewing the curriculum videos. Results: Experimental group students showed greater knowledge increases after viewing the videos. Examined by individual question, twelve out of eighteen questions in the experimental group had significant improvement in accuracy/knowledge, compared to one out of eighteen among the controls. Discussion: Our study demonstrates the value of using videos to convey vaccine-related knowledge to high schoolers. This knowledge can favorably impact rates of acute infectious disease as well as chronic conditions such as polio, cervical cancer, and long COVID syndrome. Translation to Health Education Practice: Such educational videos may be integrated into the state curricula so high school students can understand the impact, safety, and efficacy of vaccines and make informed public health decisions as adults.

Since the introduction by Kermack and McKendrick in 1927, the Susceptible-Infected-Recovered (SIR) epidemic model has been a foundational model to comprehend and predict the dynamics of infectious diseases. Almost for a century, the SIR model has been modified and extended to meet the needs of different characteristics of various infectious diseases including recent COVID-19 breakouts, which stimulates the advance in mathematical epidemiology theory significantly. Some of the mathematical ideas and techniques developed are also relevant to motivate teaching various topics in differential equations by connecting students' life experiences with current pandemics to meaningful classroom learning activities. Here, various pedagogically relevant topics from the SIR model are provided for undergraduate differential equation class, which includes (1) compartmental modelling and mass action kinetic modelling, (2) conservation rule and model reduction, (3) introduction to phase plane by removing time variable to derive trajectory equations, (4) transformation of equations to equivalent forms, (5) transformation of second-order system to second-order ODE, (6) deriving an analytic solution to the SIR equation by solving Bernoulli's equation, (7) deriving an analytic solution to the SIR equation from trajectory equations and (8) deriving an analytic solution to the SIR equation from exponential substitutions.

The SIR model is a differential equations based model of the spread of an infectious disease that compartmentalises individuals in a population into one of three states: those who are susceptible to a disease (S), those who are infected and can transmit the disease to others (I), and those who have recovered from the disease and are now immune (R). This "Classroom Note" describes how to initiate teaching the SIR model with two concrete physical simulations to provide students with first-hand experience with some of the nuanced behaviour of how an infectious disease spreads through a closed population. One simulation physically models disease spread by the exchange of fluids, using pH to simulate infection. A second simulation incorporates randomness through the use of a probability game to keep track of the state of each individual at each time step. Both simulations invite students to ask questions about what factors influence disease spread. The concrete experience from the physical simulations enables students to make connections to the abstract mathematical representation of the SIR model and discuss the sources of stochasticity present in the spread of an infectious disease.

Objective: To evaluate college students' awareness of an educational initiative to increase campus influenza vaccination rates and strategies to improve it. Participants: Students attending a large public comprehensive university. Methods: An investigator-developed, online survey evaluated awareness of the initiative, the students' perception of incentives, and other motivations to receive seasonal influenza vaccine. Results: The vaccination rate was 43%, despite low awareness of the initiative (28%). Awareness was significantly higher among vaccinated students (p = 0.0013). Having knowledge that appointments to receive vaccine were not needed increased the motivation of vaccinated students more than unvaccinated students (p = 0.0001). Personal influencers increased motivation of vaccinated students only when they were aware of the initiative (p = 0.04). Tangible incentives did not motivate students. Conclusions: Campus vaccination rates increased despite low initiative awareness. Improvements to the initiative should include strategies to increase emphasis on vaccination program conveniences like accessibility and perhaps engage personal influencers more.

Understanding the school nurse's experience in human papillomavirus (HPV) vaccine promotion can reduce vaccine disparities. HPV vaccination is critical to cancer prevention. Despite the importance of the school nurse in vaccine promotion, there is a lack of understanding. This article aims to examine the knowledge, attitude, experience, and role of school nurses related to HPV vaccination and promotion in school settings. A systematic search for school nurses and their experiences related to HPV vaccination was conducted. A thematic synthesis was undertaken using the socioecological model. This review highlights the complexity of HPV vaccine promotion in schools over time. Multilevel factors impact nursing practice. Nurses have good vaccine knowledge and positive attitudes. Poor workflow processes, competing demands, and vaccine communication challenge school nurses. The themes that were synthesized informed the LEADS model. With the support of school nurses, reaching the goal of eliminating cervical cancer as a public health problem is possible.

In this paper, we discuss challenges associated with implementing a policy for Ancillary Care (AC) for related and unrelated (serious) adverse events during an Ebola vaccine trial conducted in a remote area of the Democratic Republic of the Congo. Conducting clinical trials in resource-constrained settings can raise context-related challenges that have implications for study participants' health and wellbeing. During the Ebola vaccine study, three participants were injured in road traffic accidents, but there were unexpected difficulties when trying to apply the AC policy. First, because of the nature of the adverse events, the insurer refused to cover the costs. Second, the AC policy did not address treatments by traditional medicine, even though traditional medicines are frequently used and highly trusted in the study community. This highlighted a contrast between the researchers' well-intentioned AC approach and the participants' legitimate preferences. The way in which researchers should address their responsibility to provide AC is not straightforward; it requires contextualization. Our experience highlights the importance of involving community representatives and the local ethics committee to ensure development of an AC policy that is culturally and ethically appropriate. Additionally, the insurance contract should clearly stipulate which adverse events are linked to the trial participation, and thus eligible for coverage, to avoid controversies when claims are made.

Objective: The purpose of this study was to compare the effect of text and video formats of an online theory-based Meningitis B (MenB) health message intervention on college students. Participants: College freshmen and transfer students admitted at a Southern U.S. University. Methods: In a 2-arm randomized study, knowledge, perceptions, and intention to receive the vaccine were compared pre- and post-intervention. Results: Post intervention, participants in both the written and video interventions had significantly higher scores of knowledge, perceptions, and intentions. Upon comparing the change in scores pre- to post-intervention between both text and video groups, no significant differences were found between both groups. Conclusions: This study, a first in using a theory-based MenB online education intervention and questionnaire to compare text and video formats, suggests that both text and video formats are equally effective in raising young adults' awareness about the MenB vaccine.

The faculty at Massachusetts College of Pharmacy and Health Sciences (MCPHS) recognized the potential benefits for collaborative teaching and learning across disciplines. Research and development of an Interprofessional Case Learning Project (ICLP) laid the foundation for the creation and implementation of a problem-based learning course. This course, Interdisciplinary Perspectives of an Infectious Disease--Malaria, introduced innovative interdisciplinary pedagogy into the curriculum of the MCPHS School of Arts & Sciences. Designed by biologists, chemists, historians, and public health faculty, this course introduced senior pre-medicine majors to varied methods and theories as they worked in groups to solve problems related to the incidence, prevention, and treatment of an infectious disease. Students' deliverables included journal-quality research papers and posters presented at the MCPHS School of Arts & Sciences Undergraduate Research Conference.

There is a need for public health undergraduates to acquire skills in data collection, statistical programming, and infectious diseases modeling. Public health officials and accreditation bodies underline the importance of a cumulative, "real-world" experience as part of a student's education. The Watermelon Meow Meow (WMM) outbreak is a cumulative experience that teaches upper-level undergraduate/graduate students about infectious disease dynamics by asking students to: participate in a fictitious outbreak; collect and analyze outbreak data. Innovative to our approach is the use of DataCamp as a technology to support learning statistical programming and framing WMM under principles of Universal Design Learning (UDL). We evaluated 27/32 student responses using a mixed-methods approach. We found WMM: augmented traditional lecture-style instruction and increased student awareness of heterogeneous risks associated with infectious diseases. We identified three student typologies: students who learn best from: (i) integrating traditional lecture plus WMM; (ii) participating in WMM data collection but not coding; and (iii) from lecture and classroom-based learning from peers. WMM is an example of a more general approach - which we call Slate, Operate, Translate - that instructors can follow to combine technology and a hands-on experiment to satisfy both UDL principles and increasing demands of public health education in a mathematics/statistics class.

This is part II of a two-part series on integrating a physical activity component in delivering health lessons to elementary and middle school students. The purpose of this series is to illustrate how health content can be implemented with hands-on activities, physical experiments, visual illustrations that are associated with a specific lesson focus, or physical tasks that require students to repeatedly practice memory recall. Two physical activities in the following five health education topics are provided in this article: (1) alcohol, tobacco and other drugs; (2) communicable and chronic diseases; (3) consumer and community health; (4) environmental health; and (5) injury prevention and safety. Corresponding National Health Education Standards and twenty-first-century skills for each activity are also provided. Similar to part I of the series, a few of the designs can be implemented with a different lesson focus or health topic. Examples are discussed at the end of the article.

Objective: This longitudinal study tested the relationship between cigarette and e-cigarette use and SARS-CoV-2 seroconversion among US college students. Participants: Undergraduate students (n = 764), drawn from a randomly selected invitation-only pool from a large Midwestern university, that were initially negative for SARS-CoV-2 antibodies and were re-tested in November were included in this study conducted in Fall 2020. Methods: Demographics and cigarette and e-cigarette use behaviors (nicotine use) were collected in a baseline survey. SARS-CoV-2 antibody tests were administered in September (baseline) and November (endline) of 2020. Log-binomial regression analyses were conducted to test the association between nicotine use and SARS-CoV-2 seroconversion. Results: SARS-CoV-2 seroconversion was 5.2%. No statistically significant associations were found between nicotine use and SARS-CoV-2 seroconversion. Conclusions: Contrary to prior results, we found no association between nicotine use and SARS-CoV-2 seroconversion. Nicotine use may not be a key risk factor for COVID-19 acquisition in predominantly healthy college-aged populations.

Objective: Participating in an escape room is not just an entertainment but can also be a form of education. Because of this, the New Jersey Department of Health (NJDOH), Project Firstline (PFL) created an escape room interactive training tool and skills-building exercise to encourage the identification and use of key infection control principles by current and future healthcare workers. Design and Setting: PFL is a US initiative that aims to provide infection prevention and control (IPC) knowledge to frontline healthcare workers. This article details health educators' descriptions and experiences of an escape room developed as part of this initiative; guidance on how to incorporate this modality of learning into present and future teaching; and assessment data and feedback from participants to begin to understand the impact and effectiveness of this approach to learning. Methods: A total of 8 sessions, conducted in 3 locations, with 64 participants, yielded survey assessment data from 41 participants. Results: Quantitative results indicated that participants were highly satisfied with the escape room experience and reported an increased level of knowledge after participation. In addition, participants reported extremely high levels of intention to implement the training they received, and all would recommend the escape room experience to a friend or a colleague. Qualitative data supports the overall findings and provides specific examples of how participants said they would implement the knowledge they learned, along with additional positive feedback. Conclusion: Current and continuing efforts to promote PFL's escape room are described, along with improvements and future actions.

Cryogenic electron microscopy (cryo-EM) is a powerful technique capable of characterizing large protein complexes that are otherwise impossible to characterize using traditional crystallography methods. Cryo-EM has played a pivotal role in our understanding of the structure--function relationship of the spike proteins on the COVID-19 viral capsule, allowing for the rapid development of therapeutics and vaccines in our quest to end the COVID-19 pandemic. The relevance of cryo-EM to this global event advocates for its incorporation into undergraduate chemistry curricula. In fact, highlighting the importance and applicability of a technique to students allows for a better retention of knowledge. Therefore, in this laboratory exercise, we introduce the concepts and application of cryo-EM as a structural characterization tool in an upper-year undergraduate class. Furthermore, with the aid of three-dimensional (3D) printing, the concepts of tomography are introduced, allowing students to understand the construction of a 3D model from a collection of 2D images through cryo-EM. According to student responses, this lab module was well-received, and the 3D-printed model indeed added to their learning experience. While cryo-EM is a specialized technique that may not be available to some educational institutions, those with access should consider its incorporation into their curriculum, thereby exposing students to a breadth of structural characterization techniques that broaden their learning experience.

Background: Per Centers for Disease Control and Prevention guidance, students with COVID-19 may end isolation after 5 days if symptoms are improving; some individuals may still be contagious. Rapid antigen testing identifies possibly infectious virus. We report on a test-to-return (TTR) program in a Massachusetts school district to inform policy decisions about return to school after COVID-19. Methods: During the 2021-2022 Omicron BA.1 surge, students with COVID-19 could return on day 6-10 if they met symptom criteria and had a negative rapid test; students with positive rapid tests and those who declined TTR remained isolated until day 11. TTR positivity rates were compared by grade level, vaccination status, symptom status, and day of infection. Results: 31.4% of students had a positive TTR rapid test; there were no differences by grade or vaccination status. Ever-symptomatic students were more likely to have a positive rapid test (75/174 [43.1%] vs 18/104 [17.3%]). For ever-symptomatic students, TTR positivity decreased by day of infection. Conclusions: A substantial proportion of students may still be contagious 6 days after onset of COVID-19 infection. TTR programs may increase or reduce missed school days, depending on when return is otherwise allowed (day 6 or 11). The impact of TTR programs on school-associated transmission remains unknown.

This study aims to determine the mathematical model of student learning behavior. The model is built by analogizing the spread of learning behavior with infectious diseases, which is called the SEIR model. The survey was conducted through filling out a questionnaire on the learning behavior of junior high school students with a population of 1,143 students. The results of the simulation model show that the peak of students' vulnerability to changes in learning behavior increases rapidly in the first two days and will be stable when passing the 150th day. The results of the simulation of the SEIR mathematical model with an incubation period of 365 days found that student learning behavior in Non-Boarding Schools will be stable in on day 198, while in Boarding Schools it will be stable on day 201. Infection cases in Boarding Schools fell to 0 on day 25 while in Non-Boarding Schools decreased on day 21, meaning that infections occurring in Boarding Schools were slower and more resistant long, meaning that the influence of the social environment is very significant on student learning behavior. This study also serves as material for policy formulation for the Aceh Provincial Government regarding the junior high school curriculum.

According to today's understanding of health, the most important responsibility for the protection of one's health falls on him. For this, it is necessary to develop a positive attitude and value towards the subject. Considering this, the importance of bringing cleanliness, hygiene and being healthy to our children as a value, especially in epidemic conditions, increases even more. Therefore, in this study, it is aimed to apply and test the effectiveness of the activities developed by using value education methods in order to help students who have negative or low attitudes towards cleanliness and being healthy to gain an understanding of hygiene and cleanliness as a value. For this purpose, experimental design with pretest posttest control group, which is one of the quantitative research designs, was used. In the collection of data, a scale form was used for cleaning, hygiene and COVID-19 pandemic measures. In the analysis of the collected data, Mann-Whitney U test was used for comparison between groups. As a result, it was seen that the application of the activities developed in accordance with the values education methods significantly increased the attitude scores of the experimental group students towards cleanliness and being healthy. No significant change was observed in the control group.

The development of a vaccine marks a breakthrough in the fight against infectious diseases. However, to eradicate highly infectious diseases globally, the immunization of large parts of the population is needed. Otherwise, diseases, such as polio, measles, or more recently COVID-19, will repeatedly flare-up, with devastating effects on individuals and, in the worst case, on significant shares of the world population. For example, polio has been almost eradicated over the past three decades through an unprecedented global effort, but complete immunization has not yet been achieved. In this article, we use polio as an example to show how the global effort of developing and administering a vaccine can be understood as solving a complex problem since it involves cultural, political, and geographical barriers that demand solutions in dynamically changing and highly versatile environments. Referring to the literature on problem-solving, higher-order thinking, and complex reasoning, we demonstrate how the ability to deal with real-world environments that are complex and dynamically changing, adapting initial solutions to new circumstances and collaborate efficiently with others, has been essential for this endeavor. We argue that problem-solving abilities form one basis for solving consequential world problems.

This study was carried out to determine the views of science teachers about the inclusion of epidemic diseases in science curriculum. Phenomenology, one of the qualitative research designs, was used as the research design in the study. The study group consists of six science teachers who have at least five years of experience and have participated in the development of science curriculum in previous years. A semi-structured interview form consisting of five questions, whose content validity was provided by taking expert opinion, was used as a data collection tool. Code, category and themes were created by analyzing the content of the teachers' opinions. As a result of the study, inclusion of epidemic diseases, which has become a current topic all around the world, into the science curriculum; reasons, advantages and disadvantages, class level, achievements that can be included in the program were evaluated according to the views of science teachers in terms of teaching methods-techniques and materials also it was emphasized that the subject of epidemic diseases should be included in the science course curriculum. Suggestions that in line with the findings of the research were made to the developers of the science course curriculum and researchers.

The COVID-19 pandemic has caused adverse effects on instrumental music teaching and concerts, including those involving wind instruments. Many schools now use bell covers and air filters during rehearsals and performances to help prevent aerosol transmission of disease. This study sought to examine if the use of these bell covers and filters might have an effect on mean instrument pitch. A sample of pitches in the low, middle, and high tessitura of each wind instrument were collected in three groups: no treatment, bell cover only, and bell cover with air filter. The data was then entered into the analytical software package "R." T-tests and Analysis of Variance were run on the data to compare the three groups. Additional comparisons of mean pitch deviation were also made as to instrument family (brass/woodwind) and note (low tessitura to high). The analysis showed that when using both bell cover and filter, there is a small degree of sharpness when compared to performing with no treatment.

In this study, it was aimed to determine high school students' cognitive structures regarding to the immunity, infection, allergy and autoimmunity. In this study, it was tried to reveal the cognitive structures of high school students on immunity, infection, allergy and autoimmunity just before COVID-19. The study was carried out with 77 students. The data collection tool was Words Association Test. The data collection tool was prepared separately for each stimulus word which were immunity, infection, allergy and autoimmunity. These stimulus words were chosen since these are the subthemes of the Immune system in the Turkish Secondary Biology Curriculum. Data analysis was performed for each stimulus word. The content analysis and coding of the data resulted in the categorization of the data. Considering the categories, models of the students' cognitive structures were drawn. In addition, the correlation coefficient was calculated according to the similarity between the answers given to each stimulus word. As a result, in our study, it is seen that the basic concepts of immunity, infection, allergy and autoimmunity are not predominantly structured in the minds of the students. It is worrying that basic concepts such as antibodies, passive immunity, and T cells are very rare or absent in the study.

The integration of course-based undergraduate research experiences (CUREs) into science, technology, engineering, and mathematics (STEM) laboratory curricula has provided new avenues to engage students at all levels in discovery-based learning. Empirical research demonstrates that CUREs have the potential to foster students' development of scientific process and reasoning skills, attitudes, motivations, and persistence in STEM. Yet, these outcomes are largely reported for studies conducted in the United States, Canada, Europe, and Australia. It therefore remains unclear to what extent CUREs are impactful for students enrolled in alternate international university contexts. To address this concern, we conducted a quasi-experimental mixed methods study to investigate the impact of a one-semester food microbiology and public health (FMPH) CURE on nonmajors students' development of science identity, science communication and process skills, science community values, and science-society perceptions at a private institution in Côte d'Ivoire, West Africa. Content analysis of students' end-of-semester research poster products and thematic analysis of student responses to post-semester open-ended survey items revealed positive gains with respect to student learning and student perceptions of the relevancy of their research to diverse audiences. Paired t-test analyses of pre-/post-semester closed-ended survey responses likewise indicated significant gains in students' science identity and science community values development as well as their confidence in handling and treating foods to reduce the bacterial load on those foods. Collectively, these findings suggest that the FMPH CURE was a meaningful and relevant learning experience capable of promoting students' growth as scientists and scientifically-minded citizens.

We developed a hands-on activity using the game Jenga to demonstrate the links between health behaviors, chronic and infectious diseases, and community well-being and resilience. For the activity, K-12 students worked together in small teams (4-8 students) and were given two Jenga towers ("tower A" and "tower B"), each representing a community of individuals. The goal was to keep both towers standing. Teams were presented with strips of paper labeled with either a "health behavior" (e.g., nutrition, body weight maintenance, physical activity) or a "disease" (e.g., heart disease, diabetes, COVID-19) and instructions on whether to add or remove blocks from each tower. When presented with a health behavior, students added blocks to "tower A" for positive health behaviors (e.g., not smoking) and removed blocks from "tower B" for negative health behaviors (e.g., smoking). When a disease was presented students removed blocks from both towers, but fewer blocks were removed from "tower A" compared with "tower B," demonstrating lower disease rates or severity in that community. As the activity progressed, "tower A" retained more blocks than "tower B". For the finale, students observed that the greater strength and stability of "tower A" allowed it to withstand a simulated natural disaster such as an earthquake better than "tower B". This activity was delivered to 15 science classes and 225 students ranging from 6th to 12th grade. Students were able to describe the connections between positive health behaviors and lower rates of disease and how, taken together, these impact community health, well-being, and resilience.

As COVID-19 accelerated through spring of 2020 the question became how will schools cope with protracted closure? Devising strategies to engage and educate students through full-time, online learning became a priority. At Tufts CSE we specialize in creating high school biomedical science curricula that foster engagement with science and build scientific and health literacy, however our popular 'Great Diseases' curricula is wholly classroom-based. In response our scientist/teacher co-design team created a new, fully online curriculum: 'The Great Pandemic of 2020'. The materials are targeted to 10th -12th grades and use student-centered and self-paced approaches to learning. It retains our signature format with multiple pedagogical approaches, and extensive scientific reading and math while focusing on both the underlying science and public health measures needed to mitigate COVID-19. Here we describe how we created the curriculum and the challenges we encountered: Which emerging information is reliable? Which topics do we select and how do we keep them current? What constitutes an engaging, effective and seamless online learning experience? How can teachers monitor and assess student work? How can we instill confidence to use the curriculum when teachers may lack the basic information underlying it? How can we evaluate and disseminate it effectively? We also discuss lessons learned in the context of teaching about 21st century biomedical science, and the growing acknowledgement by teachers and students that it is encroaching constantly on daily life.

COVID-19 pandemic has eroded gains towards Kenya Vision 2030's poverty eradication goal by denying Kenyan children and youth with disabilities access to (quality) education. Situational analysis on the impact of COVID-19 pandemic on education of primary and secondary school-age individuals from March 2020 to December 2020 reveal that the education opportunities for learners with disabilities remained unpredictable as the disease ravaged communities to the end of the year. Learners with disabilities fell behind academically after school closure and COVID19 related biases predisposed them to academic failure and failed adulthood. Then, the implementation of disaster education and recovery plans are overdue and must intentionally target education of children and youth with disabilities.