Health Choices Research Articles

Exploring Iranian men’s experiences of infertility through qualitative content analysis

BackgroundInfertility affects men and women differently; however, there is a scarcity of studies focusing specifically on men’s perspectives. Given the importance of understanding men’s experiences in infertility treatment, this study aimed to explore the experiences of Iranian men facing infertility.MethodsA qualitative descriptive approach was employed, utilizing purposive sampling to recruit 12 Iranian men dealing with infertility. In-depth, semi-structured interviews were conducted in Persian, the native language of the participants, to facilitate ease of communication and ensure the richness of data. The data were analyzed using conventional content analysis, following Lincoln and Guba’s criteria for trustworthiness to ensure rigor. The entire content of the interviews was transcribed in Persian and analyzed in the same language to maintain the original meaning of the participants’ expressions. After the analysis was completed, the manuscript, including the summarized findings, was translated into English. MAXQDA software version 0.9.5 was used for data management.ResultsThe findings were organized into five main themes: psychological, social, sexual, cultural, and coping dimensions. The study reveals that infertility profoundly impacts men’s psychological well-being, leading to reduced self-confidence and increased societal and familial pressures. Participants expressed feelings of inadequacy and challenges in sexual intimacy, exacerbated by cultural stigma. The social pressures included external societal expectations and dynamics within spousal relationships. Additionally, cultural beliefs significantly influence men’s experiences of infertility, affecting their mental health and treatment choices. Coping strategies such as acceptance, faith, and optimism are crucial in helping men navigate these challenges.ConclusionOverall, the results highlight the need for comprehensive support addressing the psychological, social, sexual, and cultural dimensions of infertility. This study underscores the importance of tailored interventions that consider the unique experiences of men facing infertility, emphasizing the role of coping strategies and the influence of cultural factors on mental health and treatment decisions. By fostering an understanding of these complexities, healthcare providers can better assist men in navigating the challenges of infertility.

Understanding Cardiovascular Health and Lifestyle Choices Among Healthcare Professionals in Medically Underserved Regions in Illinois.

This study assesses the prevalence of cardiovascular risk factors, such as diabetes, obesity, high blood pressure, and stress, as related to healthy lifestyle behaviors among healthcare professionals (HCPs), including medical doctors, nurses, pharmacists, laboratory scientists, and radiologists, in medically underserved regions (MURs). Using a cross-sectional study design, an online survey was administered to HCPs in MURs of West Central Illinois. A total of 316 HCPs completed the survey. The study population was predominantly White, female, and aged 55 or older. The findings of this research imply that HCPs in medically underserved regions (MURs) with high cholesterol generally do not engage in physical activity. The study showed a correlation between HCP age, high blood pressure, Type 2 diabetes, and high cholesterol, implying that as HCPs age like every other individual, the likelihood of developing these conditions increases. This study emphasizes the role of time constraints and a lack of motivation in limiting HCPs' participation in physical activity in rural areas. Additionally, the study suggests that inadequate access to nutritious food and exercise facilities in rural regions contributes to lower rates of healthy eating and physical activity. Findings demonstrate how essential it is for healthcare professionals to remain vigilant about cardiovascular disease risk factors.

Understanding unmet family planning needs and unplanned pregnancies in Malaysian women

This study presents a comprehensive analysis of unmet family planning needs among Malaysian women and their correlation with unplanned pregnancies. Leveraging a rigorous qualitative library research approach, this investigation delves into peer-reviewed literature, government reports, and international publications to identify key socio-cultural, economic, health and educational factors hindering women’s reproductive health choices. Despite Malaysia’s progress in reproductive health, significant disparities persist, particularly among marginalised women in rural and low-income communities. Limited contraceptive knowledge, cultural stigmas, and insufficient healthcare access emerge as critical barriers. By meticulously examining data sources such as the Technical Report of the National Health and Morbidity Survey (NHMS) 2022, this study highlights the urgent need for policy reforms and targeted interventions to enhance reproductive health education and expand access to diverse contraceptive options. This research directly aligns with Sustainable Development Goals (SDGs) 3 and 5, aiming to improve reproductive health outcomes and promote gender equality. By empowering women to make informed reproductive choices, this study contributes to a more equitable and sustainable future for Malaysia. The findings provide actionable recommendations for policymakers and healthcare providers to address systemic gaps and reduce unplanned pregnancies, ultimately fostering equitable access to family planning services for all Malaysian women.

Lifestyle and the Gut-Brain Axis Insights into Mental Health and Microbiome Interactions

Introduction: The intricate relationship between lifestyle factors and gut health has become a focus of recent research, emphasizing the significant role of the gut-brain axis (GBA) in regulating both physical and emotional well- being. Unhealthy lifestyle choices, including a diet high in ultra-processed foods, irregular sleep patterns, physical inactivity, and substance abuse, have been closely associated with gut dysbiosis, leading to gastrointestinal (GI) symptoms and mood disturbances such as anxiety and depression. The gut microbiota, through the production of neurotransmitters like serotonin and dopamine, as well as short-chain fatty acids (SCFAs), influences mood and mental health via the GBA. Maintaining a healthy lifestyle, characterized by balanced nutrition, regular physical activity, and good sleep quality, is critical in fostering a diverse and stable gut microbiome, which in turn supports emotional stability.  Aim: This review aims to examine the existing literature on the impact of lifestyle factors, such as diet, physical activity, sleep, smoking, alcohol consumption, and stress management, on gut health and emotional well-being. The goal is to highlight the importance of gut microbiota in mental health and the potential therapeutic strategies to enhance gut health for improved emotional outcomes.  Methodology: A comprehensive search of peer-reviewed journal articles was conducted using databases such as PubMed, Google Scholar, and Web of Science. Keywords like "lifestyle," "gut health," "emotional well-being," "dietary habits," "physical activity," "sleep patterns," and "gut-brain axis" were used to identify relevant studies. Inclusion criteria focused on human clinical trials and observational studies published within the last 16 years. Studies involving animal subjects, non-peer- reviewed articles, and outdated research were excluded.  Results: The literature shows that diets high in fiber and low in processed foods support a healthier gut microbiome, while high consumption of ultra-processed foods disrupts gut bacteria, leading to GI symptoms and mood disorders. Regular physical activity was found to enhance gut microbiota diversity, contributing to better emotional well-being. Conversely, poor sleep quality and chronic stress were linked to gut dysbiosis, which exacerbated mood disturbances. Smoking and excessive alcohol consumption further damaged gut health, contributing to mood dysregulation. Probiotic and prebiotic interventions, particularly synbiotics, were found to restore gut balance and improve both GI and mental health outcomes.  Conclusion: This review underscores the pivotal role of lifestyle choices in shaping gut health and emotional well-being. A balanced diet, regular exercise, sufficient sleep, and stress management are essential for maintaining a healthy gut microbiome, which, in turn, supports emotional stability. Therapeutic strategies involving prebiotics, probiotics, and synbiotics offer promising avenues for improving both gut health and mood. Addressing lifestyle factors and promoting gut health can potentially serve as an effective approach for enhancing overall well-being and preventing mood disorders.

“Vaccines protect both you and your newborn:” A discourse analysis of risk and uncertainty in information about vaccination in pregnancy

Health governance during pregnancy is grounded in cultural norms about good mothering, which centre around self-sacrifice and perceived conflicts between maternal and fetal bodies. Nonetheless, many health choices in pregnancy should have mutual benefits and risks for maternal and fetal bodies, including vaccination during pregnancy. This manuscript presents results from a discourse analysis of 440 texts about vaccines that are recommended in pregnancy in Canada, including inactivated influenza, tetanus-diphtheria-acellular-pertussis, and COVID-19 vaccines. Texts include publicly available online information (e.g., webpages, printouts, posters, videos, and other materials) developed by various authoritative institutions (e.g., public health services, professional organizations, vaccine manufacturers). This study contributes to feminist and risk theorist critiques of public health discourse by exploring how texts deploy emotionally laden technical discourses that govern pregnant individuals towards divergent goals. Specifically, they are governed towards socially desirable health decisions (e.g., vaccination acceptance) and towards agonizing over decision-making as “good mothers.” I analyze how texts pursue this divergent governance in three ways, by deploying discourses that reify conflict between maternal and fetal bodies, organizing the work of making choices around gendered power relations, and activating emotions around mothering responsibilities. My analysis compares how such governance differs across products by available evidence and by the intended purpose of vaccination to protect maternal and/or fetal bodies. I conclude by discussing the value of combining governmentality and cultural approaches to risk theory to understand how the interface of public health and mothering discourses reproduce power relations, and suggest recommendations on how to lessen that reproduction.

Considering patient-centred care and patient empowerment as essential to quality health care delivery in Ghana.

Rising cases of non-communicable diseases (NCDs), poor health choices, mistrust of the health system, self-medication, resistance of diseases to medication and dissatisfaction with the service experience serve as red flags on the path to Universal Health Coverage (UHC). This study explored the importance of patient-centred care (PCC) and patient empowerment (PE) within the context of healthcare service delivery in Ghana. The study considered PCC and PE from the perspective of three public healthcare facilities within the Greater Accra region. The researcher adopted a qualitative exploratory research approach. The study employed purposive sampling for the selection of healthcare facilities and healthcare providers. Convenience sampling was applied to select patient participants. A total of 33 in-depth interviews and 4 focus group discussions (FGDs) were conducted across the three sampled facilities as part of the data collection process. Healthcare providers and patients unanimously view quality as essential for effective healthcare delivery. The application of the capacitating role of PE and PCC is inexact and largely left to subjective interpretation. The Ministry of Health (MOH) has recognised that patient experiences, a key indicator of care quality, have often been suboptimal and is actively working to address these weaknesses. This study supports the call for health systems to remain committed to efforts to achieve UHC, with a focus on PCC and PE.

Biology of kindness: Six daily choices for health, well‐being, and longevity By ImmaculataDe Vivo and DanielLumera, Cambridge, MA: The MIT Press. 2024. pp. 264. $24.95 (Paperback); $24.99 (eBook). ISBN: 9780262547659

Biology of kindness: Six daily choices for health, well‐being, and longevity By ImmaculataDe Vivo and DanielLumera, Cambridge, MA: The MIT Press. 2024. pp. 264. $24.95 (Paperback); $24.99 (eBook). ISBN: 9780262547659

Information seeking behaviour of informal caregivers at the premier tertiary teaching hospital in Nigeria

This study was conducted to examine the information behaviour of informal caregivers in a university college hospital in Ibadan, Nigeria. Informal caregivers in the teaching hospitals constitute critical pubic health care players whose information behaviours have not been studied. Data was collected from 208 caregivers using a questionnaire that consisted of structured and open-ended questions. The study found that healthcare providers were the primary source of health for caregivers, with 34.1% actively seeking information from them. The caregivers seldom utilised sources like the internet, community organizations, books, family, and friends. The preference for healthcare providers as sources is due to their accessibility and ability to provide prompt and accurate answers. Caregivers have diverse information needs, including medication-related information, first aid techniques, nutrition, exercise, mental health, and lifestyle choices. They seek this knowledge to make informed decisions that improve their loved ones’ well-being. The study also revealed that caregivers heavily rely on information technology for health information due to its accessibility and reliability. The study highlights the need for ongoing training and proactive information sharing by healthcare providers to better support informal caregivers in Nigeria, emphasizing the importance of integrated support systems within healthcare facilities. To meet diverse information needs, healthcare institutions should diversify dissemination strategies, including culturally sensitive materials and digital literacy programs, while developing tailored mobile applications and online support communities for caregivers. Policymakers must focus on creating supportive healthcare policies, funding caregiver programs, and expanding insurance coverage to alleviate financial burdens, ensuring that caregivers have access to necessary resources and information.

Buonocore Memorial Lecture 2023: Longevity of Dental Restorations or Longevity of Teeth: What Matters?

This paper aims to raise a discussion from the perspective of maintaining long-term oral health, posing a critical question: What holds greater significance for maintaining oral health, the longevity of restorations or teeth? This question explores the aspects that truly matter in ensuring sustained oral health throughout an individual's life. Restoration longevity is well-researched, and evidence shows several risk factors influencing longevity. The dentist's decision-making factor may be of utmost importance, and further studies are needed to investigate its relevance. The critical risk factors for restoration longevity are active pathology (high caries risk), less prominent parafunction, and extensive defects such as endodontic treatment. However, tooth longevity and the main risk factors for tooth loss are not well-researched. The evidence shows dental caries, and its sequelae, are the principal reasons for tooth loss. Patient-related risk factors, especially those associated with lifestyle and health choices, play a major role in the longevity of restorations and, more importantly, tooth longevity. To provide personalized dental care with maximum patient benefit, clinicians should identify and record potential risk factors, promoting a healthy lifestyle to ensure tooth and dentition longevity. Moreover, the evidence suggests that decision-making frameworks based on minimal intervention principles offer the best standard for clinical practice, promoting a longstanding healthy oral environment.

How Racism and Discrimination Impacts Black Young Women’s Sexual Health: The Influence of Racial and Sexual Stereotypes on Educational Access

PurposeStructural racism and racial discrimination may increase adverse sexual health outcomes in Black adolescent girls. However, the influence of racism on sexual health has not been well-described in qualitative studies. The purpose of this study was to explore definitions of structural racism and determine how experiences of racial discrimination impact sexual health and decision-making in a sample of adolescent Black girls. MethodsBlack girls aged 13–19 years were recruited from an ongoing longitudinal study. Virtual focus groups and individual interviews were facilitated, inquiring about understandings of structural racism, experiences with discrimination, and factors that influence sexual health decision-making and healthcare-seeking. Transcripts were professionally transcribed and coded by two independent, blinded team members. Thematic content analysis was used to identify emergent themes. ResultsFour themes emerged as follows: (1) slavery and medical racism in the United States impact the sexual and reproductive health (SRH) choices of Black girls; (2) stereotypes and oversexualization of Black girls are considered a barrier to SRH education; (3) adults serve as both barriers and facilitators to SRH and resource utilization; and (4) Black girls often seek information from friends or social media outlets to make SRH decisions. DiscussionReproductive health education for Black girls should integrate historical influences of systemic oppression. Practitioners should include reproductive justice to build trust in clinical and community spaces. Engaging caregivers in health education may reduce barriers for youth to engage in care.

Development of a framework of potential adverse effects of interventions to improve critical thinking about health choices: A mixed methods study.

Background People need critical thinking skills to make well-informed health choices and avoid waste and unnecessary suffering. However, educational interventions can have adverse effects, which is often overlooked. We created a framework of potential harms of interventions to improve critical thinking about health choices. The objective was to identify potential effects and articulate potential mechanisms. We intended to use the framework to inform the development and evaluation of an intervention in Kenya, Rwanda, and Uganda. Methods We created an initial framework drawing on two earlier frameworks. We surveyed external experts using Likert-scale and open-ended items, including researchers, educators, and others, in a variety of relevant fields. We emailed the survey to an international advisory network, and all other experts recommended by respondents. We analyzed the quantitative data using descriptive statistics. We conducted a thematic analysis of the qualitative data. We revised the framework based on those results. To identify any effects missing from the revised framework, we individually interviewed a convenience sample of one teacher from each of Kenya, Rwanda, and Uganda. Results We received responses from 38 of 70 external experts (54%). The quantitative survey data suggested respondents agreed with the initial framework overall. However, the qualitative data led to substantial revisions. The revised framework consists of categories of adverse outcomes; outcomes within each category; sub-outcomes; individuals, groups, and populations that might experience each adverse outcome; beneficial outcomes corresponding with adverse outcomes; and potential mechanisms of adverse effects. There are six categories: decision-making harms, psychological harms, equity harms, group and social harms, waste, and other harms. In the interviews with teachers, we did not identify any effects missing from the revised framework. Conclusions As far as we know, the framework is the first tool of its kind for education research. It can be improved upon and adapted.

INDUCTION OF LABOUR WITH SUBLINGUAL MISOPROSTOL COMPARED TO VAGINAL DINOPROSTONE IN TERMS OF NEONATAL OUTCOME IN WOMEN WITH PROLONGED PREGNANCY

Labor induction in postdate pregnancies can impact neonatal outcomes, including Apgar scores and the need for NICU care. Various induction agents, such as sublingual misoprostol and vaginal dinoprostone, offer differing efficacies. This study aims to compare the neonatal outcomes of these two agents to determine the more effective option for labor induction in postdate pregnancies. Objective: To compare neonatal outcomes, specifically Apgar scores <7 at 1 minute and NICU admissions within the first 24 hours, between neonates born to postdate women induced with sublingual misoprostol versus vaginal dinoprostone. Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, Unit 1, Holy Family Hospital, Rawalpindi, from January 2024 to July 2024. After Institutional Research Forum approval, 200 women meeting the selection criteria were randomized via the lottery method into two groups. Group I received 25 mcg of sublingual misoprostol every 4 hours up to 4 doses, and Group II received 3 mg vaginal dinoprostone every 6 hours up to 2 doses. Neonatal Apgar scores were recorded at delivery, and NICU admissions were monitored within 24 hours. Data were documented on structured proforma and analyzed using SPSS. Results: The mean maternal age in Group I was 27.17±4.71 years and in Group II 28.33±4.25 years. Both groups had comparable gestational ages (41.60±0.49 vs. 41.68±0.46 weeks) and parity (1.64±0.79 vs. 2.05±0.83). Group I neonates had higher mean Apgar scores at 1 minute (7.25±2.08) compared to Group II (6.62±2.07), with significant group differences (p=0.04). NICU admissions were required in 30% of neonates, with 48.8% needing NICU care, and fewer admissions in Group I (p=0.04). NICU care showed a significant association with maternal age over 28 years (p=0.000) and nulliparous status (p=0.007) but was not significantly different for those under 28 years or multiparous. Conclusion: Sublingual misoprostol demonstrated superior efficacy to vaginal dinoprostone in labor induction for prolonged pregnancies, with improved neonatal outcomes, including higher Apgar scores and fewer NICU admissions. Age and parity influenced outcomes, highlighting sublingual misoprostol as an effective choice for better neonatal health.

Effects of the informed health choices secondary school intervention after 1 year: a prospective meta-analysis using individual participant data

BackgroundCritical thinking about health choices is essential to avoid being misled by unreliable information and to use reliable information appropriately. The aim of this prospective meta-analysis was to synthesize the results of 1-year follow-up data from three cluster-randomized trials of an intervention designed to teach lower secondary school students to think critically about health choices. Only one other randomized trial has evaluated a school-based intervention to teach adolescents to think critically about health choices. That trial compared two teaching strategies to teach statistical reasoning. It did not assess long-term learning-retention.MethodsWe conducted the trials in Kenya, Rwanda, and Uganda. The intervention included providing a 2–3-day teacher training workshop and digital resources for ten lessons. The intervention focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥ 9 of 18 multiple-choice questions answered correctly). We performed random effects meta-analyses to estimate the overall intervention effects. We calculated learning retention as the test results in the intervention schools after 1 year relative to just after the intervention, adjusted for chance.ResultsAltogether, 244 schools (11,344 students) took part in the three trials. Follow-up data was collected for 8298 students (73%). The overall odds ratio for the primary outcome after 1 year was 3.6 (95% CI: 1.9–7.1; p = 0.0001) in favor of the intervention, whereas it was 5.5 (95% CI: 3.0–10.2) just after the intervention. This corresponds to 25.6% (95% CI: 21.1–30.0%) more students in the intervention schools passing the test after 1 year versus 33.3% (95% CI: 28.7–37.8%) just after the intervention. Overall, 2273 (52.6%) of 4324 students in intervention schools had a passing score after 1 year compared to 3397 (58.1%) of 5846 students just after the intervention, indicating 88.3% learning retention.ConclusionsOne year after the intervention, we still found a positive effect on the ability of students to think critically about health choices, but 5.5% fewer students in the intervention schools had a passing score. The certainty of the evidence was also lower due to 27% of students being lost to follow-up.Trial registrationThe protocol for this prospective meta-analysis was registered with PROSPERO May 31, 2022, ID 336580. The three randomized trials were registered in the Pan African Clinical Trial Registry February 15, 2022, PACTR202203880375077; April 5, 2022, PACTR20220488391731; and April 14, 2022, PACTR202204861458660.

Cross-sectional survey of health literacy among high school students in Armenia

Abstract Background We assessed the level of health literacy (HL) and explored its predictors among 15-17 years old adolescents in Armenia. Methods We conducted a survey among adolescents in public and private schools in the capital Yerevan and an adjacent province in 2023. The instrument included items on HL, general interest in health and socio-demographics. Ten questions measuring HL with four answer options were summed into the HL score (0-30). Multivariable regression model explored the independent associations of socio-demographic factors and interest in health issues with the HL. Results Overall, 366 students completed the survey. About 64% were females. The majority were interested in health issues (80.7%). Most participants felt they, in general, received sufficient health information (75.1%), could follow physician’s instructions (80.1%), were confident in advising family or friends on health improvements (70.5%), could easily give examples of health-promoting actions (76.8%), and explain their choices for health (77.6%). Additionally, 82.2% could judge the environmental impact of their actions, 82.0% could find understandable health information when needed, and 85.3% could assess how their behavior affects their health. Fewer respondents were confident in figuring out if the health information is correct (68.2%) or identifying correct health information when faced with conflicting data (67.1%). The average HL score was 17.41 (SD = 4.47), with a 58.0% percent score. In the regression analysis, being from private school vs. public and being interested in health vs. not were significant predictors of higher HL. Conclusions Despite having moderate HL level, a significant portion of Armenian adolescents lacked confidence in discerning correct health information. Interventions should prioritize enhancing HL, emphasizing critical evaluation skills and providing accessible and reliable health information resources tailored to adolescents, particularly in public schools. Key messages • The health literacy among Armenian adolescents was moderate with many lacking confidence in identifying correct health information and differentiating when faced with conflicting data. • Attending a private school and having an interest in health were significant predictors for higher health literacy, emphasizing the need for targeted health and policy interventions.

1.G. Scientific session: Forecasting dietary habits trends, human and planetary health

Abstract Extensive research has elucidated that dietary factors are pivotal in influencing both human health and the ecological stability of the planet. Suboptimal dietary patterns are implicated in over 10 million annual fatalities attributable to non-communicable diseases. Concurrently, the agricultural sector, a major component of food production, contributes significantly to environmental degradation. This sector is responsible for more than a quarter of global greenhouse gas emissions and utilizes approximately 50% of the planet’s habitable land. Moreover, it accounts for over 70% of global freshwater consumption and is a primary contributor to marine ecosystem disruption through nutrient runoff leading to ocean eutrophication. Despite these critical linkages, current global trends related to dietary practices show little alignment with the improvements needed to achieve the Sustainable Development Goals set for 2030. The existing policy framework and interventions lag considerably in addressing these concerns. Historical and ongoing discussions have repeatedly highlighted these issues, yet the allocation of resources necessary to counteract the pervasive influence of industry-driven marketing promoting less healthful dietary choices remains markedly inadequate. There is an urgent need to intensify dialogues and enhance the conceptual framework regarding the role of diet in sustaining global health and environmental integrity among public health professionals. Such measures are crucial for facilitating a shift towards more sustainable and health-promoting dietary habits globally. The EUPHA Food and Nutrition Section, the Chronic Diseases Section, in collaboration with the World Health Organization (WHO) Regional Office for Europe, aim to propose a joint workshop to share innovative research and activities held in the context of diet and environment. The workshop aims to provide new findings and stimulate the debate about the projections for the future of human and planetary health. Key messages • Human health and environmental preservation require an adaptation of dietary habits globally: are we going in the right direction? • Current evidence suggests that there is an wide area of intervention to improve actual dietary habits, reduce the environmental impact, and improve human health.

Citizen needs towards personalised medicine and genetic testing: results from a European survey

Abstract Introduction Personalised Medicine (PM) aims to tailor diagnostic and therapeutic pathways for patients. Despite technological advancements in this field, public awareness of PM remains limited, representing a barrier to its clinical integration. Methods We conducted a survey across eight European Countries (France, Germany, Hungary, Italy, Netherlands, Poland, Romania, Spain) via the private platform YouGov, in April 2023. Our web questionnaire explored knowledge of PM, willingness to embrace it, and trust in information delivered by mass media. Results Of 6,581 respondents, approximately 42% lacked sufficient knowledge of PM and genetic testing, while 36.3% found information about the topic not easily accessible. Healthcare providers were the most trusted source of information (according to 80% of responders), followed by educational institutions (71.4%). Education, age, and gender significantly influenced the acceptance of PM and mass media trust, highlighting the association between high education level, readiness to embrace PM, and high trust in academic sources of information. Additionally, age, gender, and geographical location influenced the perception of PM and genetic tests in various ways across Europe. Despite the geographical differences, 63.2% of respondents want to know more about PM, and 60% support its implementation in clinical practice. Conclusions Although the growing interest in PM genetic, and -omics technologies, large sections of the population still lack access to information and understanding, indicating a disconnection between technological advancements and public awareness. The study emphasizes the importance of providing focused citizen engagement initiatives to implement PM approaches. Citizen participation in defining personalised diagnostic and therapeutic pathways is vital to empower individuals and enable them to make informed health choices. Key messages • Understanding European citizens’ attitudes and needs regarding Personalised Medicine is crucial for creating policies and facilitating access to new technologies and treatments. • Despite limited knowledge, European Citizen recognize the importance of Personalised Medicine for their health, seek further understanding, and place trust in Academic Sources of Information.

Comparing role of religion in perception of the COVID-19 vaccines in Africa and Asia Pacific

BackgroundIn the midst of the global COVID-19 vaccine distribution challenge, religion stands out as a key determinant of vaccine hesitancy and health choices. Notably, the multifaceted religious environments of Africa and the Asia Pacific remain under-researched in this context.MethodsUtilizing data from two survey waves conducted between 2021 and 2022, this cross-sectional study investigated the effects of religious beliefs on perceptions of compatibility between religion and vaccines and COVID-19 vaccine acceptance in Africa and Asia Pacific. Logistic regression models were employed, with interaction terms between socio-economic factors incorporated to account for variations among diverse subpopulations.ResultsAmong the eight religious groups identified, Atheists and Buddhists in the Asia Pacific exhibit the lowest agreement, with fewer than 60% acknowledging the religious compatibility of vaccines. Willingness to accept vaccines, however, is consistently higher in Asia Pacific by at least four percentage points compared to Africa, with the disparity widening further in the second wave. Impacts of education on vaccine perceptions vary across religious groups, while acknowledging vaccine compatibility with religion positively contributed to vaccine acceptance. Dynamics between region, religion, and other socio-demographic factors have changed substantially over time. All but Atheists and Muslims exhibit a higher propensity to endorse vaccines during Survey Wave 2.ConclusionsOur study reveals complex, context-dependent connections between vaccine attitudes and religion and the heterogeneous effects of time and education among different religious affiliations. Understanding the underlying drivers of these temporal variations helps inform tailored approaches aimed at addressing vaccine hesitancy, promoting vaccine uptake, and improving the well-being of each religious group.

A Strategic Framework of SARS-CoV-2 Genomic Surveillance in Bangladesh.

The global pandemic caused by SARS-CoV-2 has underlined the significance of strict genomic surveillance to track virus evolution and the possible emergence of new variants, particularly in densely populated countries like Bangladesh. This study outlines a strategic framework of genomic surveillance to track the evolution of the virus in Bangladesh between June 2021 and December 2022 through the National SARS-CoV-2 Variant Surveillance (NSVS) program involving collaboration across 4 major institutes and 13 hospitals nationwide. We aimed to capture the variants of SARS-CoV-2 throughout the country utilizing standardized procedures, modern sequencing technology, and stringent quality control, promoting data accuracy and the timely detection of new variants of concern. We sequenced over 2200 genomes, documenting the prevalence of the Delta variant initially, followed by the emergence of Omicron variants BA.1, BA.2, BA.5, and XBB, each affecting transmission rates and vaccine efficacy differently. The clinical manifestations of the variants differed, with some symptoms occurring more frequently in Delta cases and vice versa. Vaccinated individuals were more affected by Omicron cases compared to Delta cases. These variants were responsible for two major COVID-19 waves in the country, each with significant clinical effects. Phylogenetic analyses placed the local SARS-CoV-2 variants within a global context, indicating the Delta variant likely entered from India and Omicron from Europe. This research highlights the significance of collaborative surveillance strategies for guiding public health choices and the critical role of genomic analysis in monitoring virus evolution, shaping targeted pandemic responses. Bangladesh's contributions significantly enhance global insight into COVID-19's genomic evolution.

“The Lung Disease as an Evanescent Rainbow”: Indigenous Languages as Agency in Communicating COVID-19 in Multilingual Kham Tibetan Region in China

The role of language is one of the most critical elements in communicating COVID-19 public health mandates globally. This study aims to explore how Tibetans in the multilingual Kham region came to understand COVID-19 and develop health choices. To accomplish this goal, we used a culture-centered approach to examine how the words/phrases of COVID-19 influence Kham Tibetans’ agency [the ability to develop actions (or lack thereof)] to work on the infectious disease and the pandemic management policy in China. This analysis explores the interactions among social structure, culture, and agency in the creation of transformative practices for negotiating the digital biomedical environment. Based on 30 in-depth interviews with Tibetans in the Kham region, we illustrate that the dialogical praxis to co-construct languages significantly impacts Tibetans’ deliberate agency, the capacity to act that is conscious or intended, to work on COVID-19 and the pandemic-control policy.

Wellness tourism destination loyalty formation: the role of mental health and eudaimonic well-being

PurposeWellness tourism is growing in importance as increasing numbers of travelers place a priority on their health and well-being by traveling. This study examined the relationships between wellness tourism destination attributes, perceived quality, perceived mental health, eudaimonic well-being, overall satisfaction and behavioral loyalty to corroborate a model explaining wellness tourism destination loyalty in Thailand.Design/methodology/approachThe conceptual model of this study was examined using a survey research design. The survey questionnaire was distributed to Chinese tourists who had previously traveled to Thailand and engaged in wellness tourism activities during their trip.FindingsThe findings revealed that healthful food choices, core facilities and staff service significantly influenced perceived quality. This perceived quality was a crucial factor in determining perceived mental health, which in turn impacted eudaimonic well-being. Overall satisfaction was directly influenced by perceived quality, perceived mental health and eudaimonic well-being. Additionally, perceived quality had a direct effect on behavioral loyalty.Practical implicationsWith the growing global interest in wellness and travel, this study offers valuable insights for tourism marketers in Thailand to enhance their wellness tourism strategies. Tourism organizations should emphasize the quality of food, facilities and staff service to attract wellness-oriented travelers.Originality/valueThis study highlights the interconnectedness of perceived quality, good mental health and eudaimonic well-being. High-quality experiences contribute to improved mental health and in turn enhance eudaimonic well-being.