Prolepsis Institute

Polysaccharide-based PEGylated hydrogels have emerged as multifunctional biomaterials that combine the favourable properties of polyethylene glycol (PEG), such as hydrophilicity, stability, and structural tunability with the biodegradability and biocompatibility of natural polysaccharides. This review presents recent progress in the synthesis and design of hybrid PEG-polysaccharide hydrogels, emphasizing structural modifications and crosslinking strategies involving biopolymers such as hyaluronic acid, alginate, chitosan, agarose, and carrageenan. These systems exhibit adjustable physicochemical properties and responsiveness to various stimuli, including temperature, light, pH, reactive oxygen species, glucose, and enzymatic activities. Such dynamic features enable precise control over drug and growth factor release and facilitate cell adhesion, proliferation, and tissue regeneration. The review also discusses the biomedical applications of these hydrogels in cancer therapy, wound healing, and tissue engineering. Furthermore, it highlights critical translational challenges related to biosafety, immunogenicity, large-scale production, and regulatory pathways, which still hinder clinical implementation. By integrating material design insights with translational perspectives, this work provides an updated overview of opportunities and limitations in advancing PEGylated polysaccharide hydrogels toward safe and effective biomedical use. Continued research on their stability, reproducibility, and functional performance is essential to unlock their full clinical potential.

Abstract Background The Health Navigator Model (HNM) is a newly developed skill-mixed model that may improve access to cancer prevention services for over 895,000 People who are currently Experiencing Homelessness (PEH) in Europe. The aim of this study was to assess the feasibility and implementation of the model in European settings. Methods A co-designed pilot implementation study was undertaken in Austria, Spain, Greece and the United Kingdom. A total of 20 trained health navigators were appointed at support centres for PEH and facilitated PEH’s access to cancer prevention activities based on a comprehensive and tailored needs assessment. The study duration was 19 months, with two follow-ups. Feasibility data (recruitment/retention/participation rates, barriers, facilitators) were monitored throughout the study. Results More than 1,981 PEH were informed about the study and 652 of them participated. Most participants were male (64%), with low or no income (42%) and had previously experienced homelessness (51.7%). The mean age of participants was 47.4 years old. Overall, 69% of participants completed the first, and 42.5% completed the second follow-up. Main dropout reasons were loss of contact, loss of interest or having other priorities. Participants undertook a range of cancer prevention activities, including education (n = 494), workshops (n = 280), health consultations (n = 251), referrals for specialist care (n = 212) and cancer screening tests (n = 169). Difficulties in accessing the healthcare system, de-prioritising cancer and PEH’s complex needs were identified as the main barriers. Building trusting relationships with PEH, increasing cancer awareness and coordinating social and health services were identified as the main facilitators. Conclusions Implementing the Health Navigator Model was a feasible and dynamic process leading to improved equity and inclusion of people experiencing homelessness in cancer preventive services. Key messages • The Health Navigator Model is a feasible model to enhance cancer prevention among people experiencing homelessness following a person-centred, destigmatising approach. • Effective liaison between health and social services under the Health Navigator Model plays a critical role in facilitating access to cancer preventive care among people experiencing homelessness.

The aim was to assess the performance of a blood assay combining measurements of MxA (myxovirus resistance protein A) and CRP (C-reactive protein) to differentiate viral from bacterial respiratory infections. In a prospective study, MxA and CRP were measured in the blood by the AFIAS panel in adults admitted with respiratory infection. Patients were split into discovery and validation cohorts. Final diagnosis was adjudicated by a panel of experts. Microbiology-confirmed cases comprised the discovery cohort, and infections adjudicated as highly probable viral or bacterial comprised the validation cohort. A total of 537 patients were analyzed: 136 patients were adjudicated with definitive viral infections and 131 patients with definitive bacterial infections. Using logistic regression analysis, an equation was developed to calculate the probability for bacterial infection using the absolute value of MxA and CRP. Calculated probability≥0.5 and/or MxA to CRP ratio less than 2 applied as the diagnostic rule for bacterial infections. This rule provided 91.6% sensitivity and 90.4% negative predictive value for the diagnosis of bacterial infections. This diagnostic sensitivity was confirmed in the validation cohort. A MxA/CRP ratio less than 0.15 was associated with unfavorable outcome. The calculation of the probability for bacterial infection using MxA and CRP may efficiently discriminate between viral and bacterial respiratory infections.

The early introduction of effective nutritional educational programs is pivotal for instilling sustainable healthy behaviors. The present work aims to present a best practice example of a nutrition and overall lifestyle school-based training program, the Nutritional Adventures (“Diatrofoperipeteies”). Conducted during 2020–2022 in Greek primary schools, this synchronous, online educational initiative included two 1-school-hour activities with a nutrition instructor. Additionally, schools were randomly assigned to supplementary “at-home” supported-by-parents or “in-class” supported-by-educators educational activities. In total, n = 12,451 students of 84 primary schools participated. Parent-completed questionnaires were selected in the recruitment and post-intervention phase (40% participation rate); overall, the working sample was n = 1487 students. In the post-intervention phase, a significant increase in Mediterranean diet adherence was observed (KIDMED score: mean increment = 0.25 units; p < 0.001), particularly fruit and vegetable consumption. Time spent on physical activity increased, while screen time decreased. Students’ total quality of life significantly improved (PedsQL; mean increment = 1.35 units; p < 0.001), including on all of its subscales (physical, emotional, social, and school function). Supplementary educational activities that were supported by educators rather than parents yielded a more favorable impact on students’ lifestyle and quality of life. The Nutritional Adventures program can be regarded as a successful initiative in primary schools, yielding immediate advantages that extend beyond promoting healthy dietary habits.

Abstract Background People experiencing homelessness (PEH) are a vulnerable population, having higher cancer morbidity and mortality compared to the housed population. Reasons for this may be due to higher prevalence of risky health behaviors but also owning to barrier to access and utilize healthcare services. This study aimed to show the prevalence of risky health behavior and utilization of healthcare services in PEH in Austria, Greece, Spain and the UK. Methods Data from 262 PEH participating in an ongoing longitudinal study on cancer prevention and early detection were included in a preliminary analysis (03/2023). Participants were adults, with no history of cancer recruited during their visits to social and healthcare services. Demographic data, high-risk health behaviors and visits to healthcare services were collected via questionnaires. Results Mean age of participants was 47.6 years (SD = 12.9) with 56.2% identifying themselves as male. The majority (50.4%) were homeless for up to 3 years and 61.6% had no history of homelessness. On average, 13.6 (SD = 10.2) cigarettes per day were reported by 62% of active smokers, 51% reported regular alcohol intake and 20.6% reported use of illicit drugs. Multimorbidity (co-occurrence of two or more chronic illnesses) was prevalent in 20.2% of participants. Half of participants reported having health insurance and 55% reported utilizing health care services in the past 12 months. The average number of visits to general practitioners and medical specialists was 3.9 (SD = 5.5) and 2.1 (SD = 5.1), respectively with an average of 2.2 (SD = 7.3) nights spent in hospital. Conclusions The proportion of PHE engaging in high-risk health behaviors is higher and utilization of health services is lower compared to the housed population. PEH may benefit from improved access to preventive and community health services, which is currently assessed by implementing the Health Navigator Model as part of the Horizon 2020 CANCERLESS project (GA965351). Key messages • High prevalence of risky health behaviors and multimorbidity in PEH was observed. • The reported low health care utilization among PEH may be due to structural barriers.

SummaryBackgroundPeople experiencing homelessness (PEH) have a higher prevalence of adverse health outcomes and premature mortality compared to the non-homeless population. These include a higher burden of cancer and cancer-specific morbidity and mortality—outcomes that may be a consequence of significant barriers to accessing primary and secondary prevention and community health services. This study aimed to better comprehend the health needs and barriers to accessing preventive cancer care for PEH across four European countries as well as necessary considerations for developing interventions around cancer prevention for this population.MethodsIn this exploratory qualitative study, 69 semi-structured interviews were conducted across Austria, Greece, Spain, and the UK, with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Interviews took place between August 1 and October 31, 2021, and data were analysed inductively and iteratively following a thematic approach.FindingsFindings were organised into two overarching themes: (1) Experiences and understanding of cancer prevention and treatment and (2) Considerations for program interventions. While cancer was a significant worry among PEH across all settings, they generally had minimal knowledge and understanding of cancer symptoms and prevention. Specific programs for cancer prevention for PEH were described as almost non-existent. Health professionals in some settings indicated that cancer in PEH was often missed in the early stages and instead diagnosed when the severity of symptoms intensified.InterpretationOverall, our findings indicate many commonalities in the health needs of PEH and the barriers they face when they seek access to cancer-specific healthcare services in the European context.FundingThis study received funding from the 10.13039/501100007601European Union’s Horizon 2020 Research and Innovation Programme under GA 965351.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Abstract Background People experiencing homelessness (PEH) have higher prevalence of adverse health outcomes and premature mortality compared to the general population, and often experience significant barriers in accessing healthcare services. This study aimed to better understand the health needs of PEH, as well as to identify the barriers and facilitators to their timely and equitable access to health services from the perspective of PEH and relevant health professionals and social care workers. Methods During autumn 2021, a cross-national qualitative study was conducted within the framework of the Horizon 2020 funded CANCERLESS project. Semi-structured interviews were conducted across four European settings (Austria, Greece, Spain and the UK). Interviews were audio-recorded, transcribed verbatim and analyzed according to the inductive thematic approach set out by Saldaña (2021). Results In total, 69 interviews were completed with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Three overarching themes relating to the research question were identified: (a) Health needs of people experiencing homelessness; (b) Barriers to access healthcare services and (c) Facilitators to access healthcare services. Overall, the general health of PEH was depicted as extremely poor and mainstream health services were portrayed as ill-equipped to respond to the needs of this population, with many organizational and system-level barriers noted. Tailored approaches to care, and in particular involving trusted professionals in the delivery of care, were identified as a key strategy for overcoming existing barriers. Conclusions While a number of context-specific findings were identified, results indicated there to be a high degree of overlap and consistency in the health needs of PEH, and in the barriers and facilitators that exist when accessing healthcare across four different healthcare systems. Key messages • Homelessness is a determinant of health that is linked to poor health outcomes. Tailored approaches that draw upon trusting relationships have the potential to overcome this problem. • The array of identified barriers indicates that general healthcare services are not currently structured in a way that facilitates timely and equitable access and appropriate care for PEH.

The evidence on the epidemiology of hypertension in Greece is limited. The prevalence and control of hypertension was assessed in randomly selected adults of the general population in Greece within the nationwide epidemiological study EMENO. On the basis of 2011 census, EMENO applied a multistage stratified random sampling method involving 577 areas throughout Greece (2013-2016). Participants were assessed at home visits with standardized questionnaires, blood tests and triplicate seated blood pressure (BP) measurements (validated upper-arm automated oscillometric device Microlife BPA100 Plus). Hypertension was defined as BP at least 140/90 mmHg (average of second--third measurement) and/or use of antihypertensive drugs. Sampling weights were applied for study design and post-stratification weights to match the age/sex distribution to the general population in Greece. Nonresponse was adjusted by inverse probability weighting. A total of 6006 individuals were recruited and 4699 with valid data were analysed [mean (SD) age 49.2 (18.6) years, men 48.6%, BMI 28.2 (5.7) kg/m2]. The prevalence of hypertension was 39.6% and was higher in men than women (42.7 vs. 36.5%, P < 0.001). Among patients with hypertension, 31.8% were unaware (men/women 39.2/23.6%, P < 0.001), 2.7% aware but untreated (men/women 2.9/2.5%, P = NS), 35.1% treated uncontrolled (32.1/38.3%, P < 0.01) and 30.5% treated controlled (25.8/35.6%, P < 0.001). The prevalence of hypertension in Greece seems to be rising and affects 40% of the adults. One-third of them are undiagnosed and only 30% are controlled with treatment. Nationwide programmes are needed to prevent hypertension and improve its awareness and control aiming at reducing the rate cardiovascular diseases.

Abstract Background In recent decades there has been keen research interest in the concept of procrastination and its impact on the student population with few studies being conducted in the Greek student population. The present study aimed to contribute to our knowledge regarding the causes that bring about academic procrastination and to further explore participants’ characteristics regarding these causes. Methods A cross-sectional study conducted in Greece with 628 college students at the University of Ioannina. Specially designed instruments were used to record students’ sociodemographic characteristics and causes of procrastination (CP). Factor Analysis (FA) with principal components (PCA) was used to derive the main students’ causes of procrastination, though Analysis of Covariance was used to examine the effect of their characteristics on these causes. Results 5 main causes of procrastination were identified explaining 48% of the total variation. Students’ lack of duty/ low tolerance for frustration was significantly associated with their gender (p = 0.005), year of study (p = 0.048) and grades (p = 0.008), while their dependency/difficulty of claim was significantly affected by students’ gender (p = 0.042), way of living (p = 0.034), place of residence (p = 0.001) and their age (p = 0.006). Moreover, their place of residence was significantly associated with their fear of failure (p = 0.001) and their difficulties in time management and decision making (p = 0.049), with those not living in the place of origin presenting greater values in relation to the aforementioned factors. Conclusions Procrastination is a widespread phenomenon in academic settings that affects differently each gender and is also affected by the sociodemographic factors. This study demonstrates the importance of investigating the causes of procrastination as a concept that helps us understand students’ behaviour and patterns associated with it. Key messages There is a great need for further studies on the causes of procrastination in order to help Universities to design learning environments that will be helpful for their students. The college instructors should train students not to procrastinate via preventing interventions.