Palliative care represents a vital dimension of healthcare, focusing on the relief of suffering and improvement of quality of life in individuals affected by chronic, progressive, and life-threatening illnesses¹. It adopts a comprehensive approach by addressing physical symptoms alongside psychological, social, and spiritual challenges encountered by patients and their families¹,². Traditional systems of medicine emphasize individualized, compassionate, and holistic care, which makes them particularly applicable in palliative contexts. Ayurveda, the indigenous medical system of India, offers a structured and holistic approach that corresponds closely with the fundamental objectives of palliative care³,⁴. This review examines the contribution of Ayurveda as a traditional medical system in palliative care delivery. Classical Ayurvedic descriptions of incurable (Asadhya) and manageable (Yapya) disease conditions are analyzed to illustrate the transition in therapeutic focus from disease eradication to symptom alleviation, patient comfort, and maintenance of dignity³. Core Ayurvedic principles such as Shamana chikitsa (palliative and symptom-modifying treatment), Satvavajaya chikitsa (psychological and emotional regulation), Rasayana therapy, dietary moderation, and ethical medical conduct (Vaidya sadvritta) are discussed in relation to symptom control and enhancement of overall well-being³,⁵. The review further highlights the potential advantages of integrating Ayurvedic practices with contemporary palliative care, including cultural acceptability, non-invasive therapeutic options, emotional stability, and spiritual support⁴,⁶. At the same time, limitations such as insufficient clinical evidence, lack of standardization, safety concerns, and possible herb–drug interactions are acknowledged⁷. It is concluded that Ayurveda may serve as a complementary and supportive modality in palliative care when practiced responsibly and guided by evidence, with primary emphasis on comfort, dignity, and holistic patient care.

Abstract Algae cultivation offers a transformative alternative to mitigate the environmental and social impacts of fossil fuel dependency, replacing crude oil with a renewable carbon source to produce plastics and chemicals. This policy report evaluates algae technology as a pathway to achieve the United Nations Sustainable Development Goals (UN SDGs), emphasizing scalable and sustainable solutions. Current photobioreactor designs and low productivity hinder industrial-scale adoption (>1000 tons/year/facility); however, artificial lighting and interdisciplinary innovation present viable opportunities. We propose recommendations to accelerate this transition: developing high-productivity strains, novel photobioreactors optimized for scalability; fostering continuous operation and biofilm management; and integrating algae into industrial ecosystems via robust value chains. Education is pivotal — curricula must evolve to embed green chemistry and scale-up principles, equipping students to design sustainable systems. Funding should shift to reward scalable outcomes, verified through rigorous replication, while policies must align with multiple UN SDGs holistically. Cultural acceptance of algae-based products requires reframing public perception through targeted outreach. In uniting engineering, science, and education, this report envisions a bio-based, circular economy driven by algae technology. These advancements, if supported by research, investment, and societal buy-in, can position algae as a cornerstone of long-term sustainability, reducing reliance on fossil resources and fostering a resilient future.

Access to healthcare remains a bothersome challenge, with stark inequalities between urban and hinterland settlements hindering the progress of the Universal Health Coverage. In light of this development, this study investigates the standards of accessibility of community healthcare facilities (CHFs) in Southeastern Nigeria through a detailed urban-rural comparison. A comparative cross-sectional research design was implemented, drawing on key informant interviews (KIIs), focus group discussions (FGDs), and structured questionnaires. Data were extracted from 40 CHFs across Anambra and Ebonyi states, which present extremes of urban and rural peculiarities. Access to healthcare facilities was assessed across the four dimensions: infrastructural, geographical, financial and cultural. Quantitative data were analysed using descriptive statistics, while qualitative perceptions were decoded thematically. Results showed pronounced imbalances between CHFs in urban and rural areas. Mean travel distances to urban and rural CHFs were recorded as 2.3km and 5.75km, respectively, underscoring significant geographic disparity. CHFs in rural areas showed notable infrastructural deficits and extended waiting periods, with an average delay of 59 minutes (≈1 hour). Conversely, facilities in urban locales presented non-reimbursable expenses that doubled rural expenditure, highlighting financial barriers for urban uCHFs. Despite these challenges, there is a higher cultural acceptability and contentment level observed in rural uCHFs. This shows a stronger communal cohesion, social bonding, and trust within rural social cohorts. Finally, the study affirms a region with multidimensionally unequal access to CHFs. While community members in urban locales grapple with fiscal constraints, their counterparts in rural areas contend with infrastructural rot and locational challenges. Enactment of enforceable benchmarks for accessibility and fair locational distribution of CHFs are some of the recommendations floated by the study. Others include revamped road networks and economic subsidies extended to users. This would help to curtail financial exclusion. Implementing these measures would encourage inclusive and fair delivery of healthcare across Nigeria’s diverse regions.

ABSTRACT Background Food security (FS) is a major problem for colleges, with food insecurity averaging 20–40% among United States (US) college students. Yet few studies have explored campus food environments and their relationship with FS. Purpose This study assessed satisfaction of a medium-sized, southern US university’s students with the food environment on all 3 campuses, comparing FS status with satisfaction with the environment. Methods Food environment and FS surveys were emailed to all students. Satisfaction with aspects of campus food environments (accessibility of food; accessibility of healthy food; affordability; cultural acceptability) were evaluated using one-way ANOVA. FS status and its relation to satisfaction were explored. Factors impacting food selection were ranked. Results were shared with stakeholders. Results Among 617 students responding, students on the suburban campus reported greater satisfaction compared to smaller, urban campuses (p < .001 for both). Students with very low FS had overall lower satisfaction (p = .009). Stakeholder discussions led to developing potential policies and implementation of additional food options on campus. Discussion Smaller campuses may struggle more with making healthy, affordable food available to students. Working with stakeholders can improve campus food environments. Translation to Health Education Practice Health educators in higher education should work with stakeholders to promote availability and consumption of healthful foods.

Alcohol is the most widely consumed psychoactive substance globally, with significant cultural acceptance. While extensive research has examined its relationship with well-being, cross-country comparisons are essential to understanding demographic variations in drinking patterns-particularly given the lack of post-pandemic data across diverse national contexts. This study aims to describe cross-national demographic variations in alcohol use among countries participating in the Global Flourishing Study (GFS). Using nationally representative data from 22 GFS countries (N = 202,898), we conducted a descriptive analysis of weekly alcohol consumption, examining (1) the mean number of drinks per week, (2) the prevalence of weekly alcohol use, and (3) the mean number of drinks per week among drinkers across demographic groups (age, gender, marital status, employment, education, religious service attendance, and immigration status). A random-effects meta-analysis was conducted to synthesize country-level estimates. We find significant variations across demographic groups and countries. Men, certain age categories, highly educated and employed individuals, as well as those who are divorced, separated, or cohabitating, report higher alcohol intake. Religious service attendance is generally associated with lower alcohol use. This study highlights significant cross-national differences in alcohol consumption, shaped by demographic, socioeconomic, and cultural factors. Western, educated, industrialized, rich, and democratic countries and those with a lower prevalence of Muslim populations tended to report higher alcohol consumption. Religious salience should be considered in demographic studies on alcohol use. These cross-national differences underscore the need for context-specific research to inform effective alcohol policies tailored to each country's characteristics.

This systematic review examines senior co-housing as an alternative to traditional care, combining private living with shared spaces. Based on 26 peer-reviewed articles (1986–2025), it identifies four key themes: social wellbeing, participatory governance, spatial design, and policy sustainability. Senior co-housing fosters autonomy and reduces loneliness, but faces challenges in affordability, scalability, and cultural acceptance. The literature is largely qualitative, with few longitudinal studies. The review highlights research gaps and calls for future work on equity, technology, and cross-cultural adaptation, positioning senior co-housing as a socially embedded response to the complexities of aging.

This review investigates protein intake in early childhood (2-5 years), with particular attention to the context of climate change. Specifically, it draws on recent evidence regarding different protein sources and their respective benefits and concerns for both human and planetary health. While high protein intake, particularly from animal sources, during early childhood may contribute to excessive weight gain, both the quantity and quality of protein may shape growth trajectories and low intake of total protein or indispensable amino acids may result in growth restriction. The relevance of protein quality and amino acid composition is increasingly recognized. Plant-based and insect-derived proteins are emerging as sustainable alternatives with promising nutrient profiles, though uncertainties persist regarding digestibility, allergenicity, and long-term effects. Early childhood offers a key opportunity to introduce these proteins, yet evidence on acceptance and integration in children aged 2-5 years is still limited. Sensory preferences, food neophobia, and parental attitudes are major determinants of children's willingness to try and regularly consume alternative proteins. Meeting protein needs in early childhood requires balancing developmental demands with environmental sustainability. Alternative proteins may support this transition, but their nutritional adequacy, safety, and cultural acceptability must be ensured. Personalized nutrition strategies will be essential for guiding appropriate protein choices and promoting healthy growth during this formative period.

Diabetes mellitus is a global health challenge requiring sustained self-management. Evidence highlights the role of families in supporting adults with diabetes mellitus, yet many interventions fail to adopt structured, theory-informed, and family-centred approaches. To address this gap, the psychoeducational intervention "Juntos com a Família + Capazes" (Together with Family + Capable) was developed within the Medical Research Council Framework for Complex Interventions, integrating empirical evidence, theoretical models, and stakeholder input. This study conducted a pre-intervention conceptual validation, exploring perspectives of healthcare professionals, adults with Type 1 and Type 2 diabetes mellitus, and family members on its structure, content, and feasibility. A qualitative descriptive design was applied. Focus groups interviews with healthcare professionals, adults with diabetes mellitus, and family members, were guided by a semi-structured interview guide. Sessions were audio-recorded, transcribed, and analysed using deductive qualitative content analysis with independent manual coding and consensus discussions. Three focus groups were held (n = 19): two with healthcare professionals and one with adults with diabetes and family members, separated due to participant availability and feasibility constraints. Participants critically reflected on the pre-implementation conceptual design of the programme, described as a six-month intervention with a six-month follow-up, structured into seven modules and delivered flexibly across 7-12 sessions. They endorsed the overall structure and content while suggesting refinements to module sequencing and module titles. Participatory strategies, tailored motivational phone calls, and strong family involvement were considered essential for engagement, sustained behavioural change, and feasibility. Analysis revealed both convergent themes and stakeholder-specific perspectives, integrating clinical expertise with lived experience. The "Juntos com a Família + Capazes" programme was conceptually validated, prior to implementation, as a family-centred, theory-informed, and adaptable intervention for adults with diabetes mellitus and their families. This pre-implementation phase enables refinements to content, sequencing, language, and delivery strategies, strengthening cultural relevance, acceptability, and feasibility. Conducting conceptual validation before piloting ensured that both clinical expertise and lived experiences shaped the intervention, highlighting the value of focus groups in identifying adjustments that enhance its real-world applicability. Future research should evaluate its effectiveness, sustainability, and scalability across healthcare contexts.

This study examined the effects of acculturative stress and depression on university life adjustment among Chinese international students in South Korea by identifying how these psychological and sociocultural factors shape students’ adaptation processes. A descriptive survey was conducted with 125 students from a university in the G region, and data were collected using structured questionnaires and analyzed through descriptive statistics, group comparison tests, correlation analysis, and hierarchical regression. The findings showed that acculturative stress was positively related to depression and negatively related to university adjustment, while depression also demonstrated a negative correlation with adjustment. In the regression model, acculturative stress (β = –.66, p &lt; .001) emerged as the strongest predictor, accounting for 51.6% of the variance in university adjustment, whereas depression was not statistically significant. These results indicate that acculturative stress serves as a major barrier to successful adaptation, highlighting the importance of institutional support systems that strengthen cultural adaptation, language development, and structured interactions with faculty and Korean peers. Enhancing social integration and cultural acceptance is expected to play a crucial role in promoting the academic and psychosocial adjustment of international students.

Ghana faces persistent maternal health challenges. This study examined Pregnancy Schools in eight Northern districts, analyzing how Model Mother selection approaches shape program effectiveness and maternal health outcomes through culturally grounded, community-based intervention strategies. Existing literature emphasizes peer credibility and cultural embeddedness as critical to maternal health success. Earlier studies highlighted literacy as a determinant of peer education. This study interrogates that assumption, revealing that trust and cultural acceptance exert stronger influence on health-seeking behavior and service uptake. A mixed-methods design was employed, combining quantitative surveys and qualitative interviews to evaluate 200 Model Mothers across eight districts. Stratified sampling ensured representation, and multivariate regression analysis assessed the impact of selection criteria on maternal health outcomes. Districts prioritizing trust and maternal experience Talensi, Kasena Nankana, East Mamprusi, and Gushegu recorded significantly higher antenatal care attendance (β = 0.32, p &lt; 0.01) and skilled delivery uptake (β = 0.28, p &lt; 0.05). In contrast, Mamprugu-Moaduri, Zabzugu, West Gonja, and Sawla-Tuuna-Kalba emphasized literacy, yielding weaker outcomes in antenatal care (β = 0.05, p = 0.42) and skilled delivery (β = 0.07, p = 0.36), both statistically insignificant. These findings indicate that technical knowledge alone does not predict influence, while trust-based social capital enhances program effectiveness. Trust and maternal experience emerged as key determinants of MM selection, surpassing literacy. The results validate community mobilization theories, challenge literacy-centered approaches, and provide evidence to guide maternal health programming in Ghana.

BackgroundIn many Organization for Economic Cooperation and Development (OECD) countries, hospital nursing care is comprehensively provided by professional nurses and multidisciplinary teams, with no reliance on family companions. By contrast, China has historically depended on family caregivers at the bedside, a practice shaped both by deep-rooted cultural traditions of filial piety and by persistent nursing workforce shortages. With the introduction of the Hospital No-Companion Care Service Pilot Work Plan (2025-2027), China is entering a critical reform phase aimed at transitioning from informal family-dependent caregiving toward a more institutionalized, standardized, and professionalized hospital nursing model.MethodsThis study employed a comparative policy analysis combined with a narrative literature review. The review followed PRISMA guidelines for transparent literature selection and applied Walt & Gilson's Policy Triangle Framework to examine policy context, content, processes, and actors. Sources included PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Organization for Economic Cooperation and Development (OECD), World Health Organization (WHO), and Chinese government policy documents, ensuring both international and domestic perspectives were incorporated.ResultsFindings indicate that China's model addresses demographic aging and nursing shortages through hybrid approaches combining nurses with supervised assistants. Compared with OECD systems, China faces lower nurse density (2.9 vs. 9.2 per 1,000) and lower nurse-to-bed ratios (0.6:1 vs. 1.4:1). Preliminary pilot outcomes suggest notable improvements in patient safety, fall prevention, and satisfaction levels. However, they also reveal ongoing financing challenges, regulatory gaps, and varying degrees of cultural acceptance among patients and families, reflecting the tension between traditional caregiving norms and new institutional practices.ConclusionChina's no-companion model is both an innovative reform and a transitional stage in health system transformation. Long-term sustainability requires systematic investment in expanding nurse education, gradual integration of no-companion services into medical insurance coverage, and deliberate efforts to foster cultural adaptation through patient and family engagement strategies. China's experience offers lessons for low- and middle-income countries seeking professionalized care models under resource constraints, highlighting how institutional restructuring can respond to workforce shortages while respecting cultural contexts. This study provides policy insights into how professional nursing reform can balance workforce capacity, cultural expectations, and institutional accountability in the context of China's hospital no-companion care initiative.

Jamu, a traditional Indonesian medicine system, has been practiced for centuries and is deeply rooted in the cultural practices and daily life of local communities. It embodies a holistic approach that integrates physical, spiritual, and emotional well-being, emphasizing harmony with nature, balance, and the interconnection of body, mind, and spirit. Jamu plays a significant role in women's health, particularly in reproductive and maternal care, due to cultural beliefs surrounding its use. Women often use Jamu during different life stages, viewing it as a cultural norm supported by generations of traditional knowledge. The potential role of Jamu in women's reproductive and maternal care is an area of emerging interest, as it aligns with the widespread use of natural remedies in similar contexts around the world. While the benefits of Jamu are culturally and historically supported, its safety and efficacy remain subjects of ongoing investigation. The integration of Jamu into modern healthcare systems presents both opportunities and challenges. Key opportunities include enhancing cultural acceptance of healthcare services, promoting holistic health benefits, and improving patient-centered care. However, challenges persist in standardization, scientific validation, and quality control. The "scientization" of Jamu, involving the transition from experience-based to evidence-based practices, is crucial for its safe and effective integration. Future directions should focus on the systematic incorporation of Jamu into mainstream healthcare, preserving its cultural elements while ensuring safety and efficacy through comprehensive regulatory frameworks, rigorous scientific research, and collaboration between traditional practitioners and modern healthcare providers.

Nutrigenomics and nutrigenetics often grouped under nutritional genomics investigate how nutrients and bioactive food compounds modulate gene expression and related molecular phenotypes, and how genetic variation modifies individual responses to diet. These approaches are increasingly operationalized through multi‑omics (transcriptomics, epigenomics, metabolomics, proteomics, microbiomics) and data-driven dietary interventions, including randomized controlled trials in personalized nutrition. In parallel, Indonesian jamu an ancestral system of multi‑herb preparations used for health maintenance and symptom management represents a rich, under‑modeled source of phytochemical diversity and culturally embedded dietary practices. This review synthesizes evidence at the intersection of nutrigenomics and jamu by (1) outlining core concepts and methodological standards in nutritional genomics; (2) summarizing translational frameworks for connecting botanical complexity to molecular mechanisms using systems biology, network pharmacology, and multi‑omics; and (3) appraising representative jamu‑relevant botanicals (e.g., Curcuma longa, Zingiber officinale, Andrographis paniculata, Centella asiatica) for nutrigenomic effects on inflammatory, antioxidant, metabolic, and mitochondrial pathways. We propose an implementation pathway for “precision jamu nutrition” that aligns cultural acceptability with clinical governance, quality systems, and evidence hierarchies, emphasizing standardized extracts, rigorous phenotyping, genotype‑aware subgroup analyses, and safety monitoring. Key challenges include botanical variability, confounding from complex diets, population genetic diversity, limited prospective trials, and regulatory harmonization. Future research should prioritize pragmatic trials embedded in health services, mechanistic sub-studies leveraging omics, and equitable governance to prevent widening health disparities in precision nutrition.

Technology acceptance is the most crucial part of the organization since it can enhance productivity and efficiency along the process of performing the job. Having the most up-to-date technology allows the organization to stay competitive and give the highest quality service or products to end users. Technology aids the organization in keeping well-organized because the managers can easily supervise workplace activities. Many findings show that technology has made a significant contribution to the improvement of employees’ performance. Although it contributes numerous advantages to organization, constraints might exit, such as the resistance to making change. Usually, most employees resist change because they may not have the competence to use new technologies, especially when they have a negative side to the advancement of technology. Subsequently, technology acceptance is measured by employees’ perceptions, including the usefulness of technology, ease of use, and user satisfaction. Thus, it is important to address technology acceptance in the government sector. This study aims to find the mediating roles of psychological stress towards the relationship between organizational culture and technology acceptance. This study employes a quantitative approach, collecting data through structured questionnaires. The sample for this study consists of employees in selected government sectors, of which the respondents come from working groups such as professional, administration, clerical, service, and maintenance with the total sample size was 123. Data was quantitatively analyzed using SPPS software to establish demographic characteristics, data reliability and uncover connections between factors contributing to technology acceptance and the psychological stress factor as the mediating factor. The results demonstrate a significant relationship between the independent variables which are perceived of usefulness, ease of use, organizational culture and technology acceptance as the dependent variable among employees in the selected governments agencies. Employees believed that adopting technology improves their job performance and productivity and they were more inclined to accept technology that is easy to operate. In terms of organizational culture, role characteristics, work group functioning and supervision significantly influenced technology acceptance. However, the results also showed that psychological stress, represented by anxiety and daily life stress, does not mediate the relationship between organizational culture and technology acceptance. These findings suggest that organizational and technological factors play a more dominant role than psychological stress in determining technology acceptance behaviors among government employees. This study provides practical guidelines for policymakers and administrators to strengthen technology acceptance through supportive culture elements while minimizing unnecessary stressors in the workplace.

Health service readiness (HSR) is considered the foundation for delivering quality healthcare and achieving Universal Health Coverage (UHC), particularly in resource-constrained settings. The World Health Organization’s Service Availability and Readiness Assessment (SARA) tool is a global instrument for assessing and measuring both general and specific service readiness across diverse contexts. This commentary reflects on field experiences from a health facility readiness assessment conducted in Baitadi, a relatively disadvantaged district in Nepal. The study focused on primary-level public health facilities and applied the SARA tool to assess service readiness, using a proportionate stratified sampling method to select 68 health facilities. This commentary highlights the practical experiences, contextual challenges, and methodological reflections encountered during the tool’s application in the field. The tool’s standardized and globally recognized framework facilitated comparisons with national and international benchmarks. However, its cross-sectional design limited its ability to reflect seasonal variations or long-term readiness, and its reliance on binary indicators failed to capture stock levels, supply chain efficiency, or service regularity. While it effectively measured structural readiness, it overlooked critical dimensions such as patient satisfaction, cultural acceptability, and governance. The SARA tool’s limitations in contextual adaptability and its sole reliance on quantitative metrics may reduce its utility for local health planning and policy formulation. The tool could be even more useful by integrating mixed-method approaches, incorporating contextual nuance, and ensuring alignment with local governance mechanisms to strengthen health systems.

Ethiopia has made significant strides in adopting comprehensive smoke-free laws aligned with the World Health Organization's Framework Convention on Tobacco Control, which mandates that all public places, including hospitality venues, public transportation, and workplaces, be 100% smoke-free. However, effective implementation across regions remains uneven. This study examines the barriers and facilitators influencing the enforcement of smoke-free legislation in Ethiopia. This qualitative study was conducted in 10 major cities in Ethiopia, involving 41 key informant interviews with individuals working on tobacco control. For this study, a framework comprising five key concepts, namely, institutions, agendas, networks, socioeconomic conditions, and ideas, was employed. Semi-structured interview guides were developed in English and then translated into local languages. All audio-recorded interviews were transcribed verbatim and translated into English. Deductive thematic analysis was conducted using ATLAS. Ti Scientific Software. The study identified several key facilitators of compliance with smoke-free laws in Ethiopia, including a well-established legal framework, clear institutional structures, especially in the capital city (Addis Ababa), strong political leadership, stakeholder collaboration, supportive cultural and religious norms, and growing public awareness of the harms associated with tobacco use. However, significant barriers remain, particularly in regional areas. These include the absence of dedicated tobacco control units, lack of region-specific implementation guidelines, competing policy priorities, limited budget and human resources, and insufficient law enforcement engagement. Cultural acceptance of smoking in some communities, economic reliance on tobacco farming, and misconceptions about products like shisha further undermine compliance with smoke-free laws. Additionally, weak coordination across sectors and limited ownership of tobacco control responsibilities among non-health actors hinder effective implementation. The study highlights the need for region-specific guidelines, accountable institutions, improved coordination, targeted education, and the addressing of socioeconomic barriers. Leveraging existing strengths and addressing identified challenges will be critical to achieving equitable and effective enforcement of smoke-free laws nationwide.

Since the millennium, China’s online literature has achieved phased results in spreading overseas and cultural dissemination. Chinese online literature is not only a carrier of commercial products such as novels, but also an excellent achievement in spreading Chinese culture. However, despite its excellent performance on foreign online literature platforms, there is neither a comprehensive review of existing literature on cultural dissemination phenomena nor a detailed exercise on how to fully analyze its role. Therefore, this article reviews multiple articles and analyzes and summarizes the theories of cultural information extraction and cultural knowledge graph construction, considers the effectiveness of online literature dissemination worldwide from the perspectives of cultural differences and acceptance, and uses CANDLE, an end-to-end methodology, to extract high-quality cultural information on a large scale. Common Sense Knowledge (CCSK). By utilizing natural language processing (NLP) technology, the emotional resonance of online literature in cross-cultural communication is analyzed, providing theoretical support and practical guidance for enhancing the overseas acceptance of online literature. Finally, a cultural knowledge graph is used to provide basic information for understanding the possible role of Chinese culture in various cultures.

Background: During a medical crisis, emergency physicians often discuss life-saving interventions with seriously ill patients and their families. Crisis conversations require strong communication skills and a patient-centered approach. Objective: To culturally adapt and assess the acceptability of an existing English crisis conversation guide for use by emergency physicians in Thailand. Materials and Methods: A three-stage mixed-method study was conducted. The initial stage included the translation and cultural adaptation of an English crisis conversation guide to Thai using a modified Delphi method with an expert panel’s consensus. The expert panel included four emergency physicians and four palliative care clinicians. The second stage involved surveying Thai emergency physicians on the perceived necessity of each step of the conversation guide using a 5-point Likert scale. In the third stage, the expert panel reviewed the survey results and incorporated feedback to produce the final Thai crisis conversation guide. Results: The Thai crisis conversation guide was initially adapted from the English original via Thai word adaptation and practical rearrangement. In the refinement stage, the expert panel modified several strategies for exploring patient values and added a new step to the conversation guide, which the authors term “gathering the decision makers”. The acceptability survey was completed by 180 Thai emergency physicians, with a 36% response rate. These physicians reported that the step with the strongest perceived necessity in the conversation guide was “summarize goal of care” with 176 participants (98%) responding “agree” and “strongly agree”. Conclusion: The crisis conversation guide was culturally adapted for clinical practice in Thailand. More than 88% of Thai emergency physicians reported the conversation guide to be acceptable in their clinical practice.

Neurological disorders constitute a major contributor to global morbidity and disability, with both monogenic diseases (e.g., spinal muscular atrophy) and complex polygenic conditions (e.g., Alzheimer’s disease) presenting significant diagnostic and therapeutic challenges. Advances in public health genomics-the application of genomics to improve population health-offer unprecedented opportunities for early detection, risk prediction, and targeted interventions in the context of neurological disease. This manuscript aims to examine the role of public health genomics in enhancing the diagnosis, prevention, and management of neurological disorders at the population level. It critically evaluates how genomic tools, including next-generation sequencing, polygenic risk scoring, and population screening, can be integrated into public health systems to enable precision medicine approaches. Particular emphasis is placed on the potential of genomics to reduce diagnostic delays, inform individualized treatment strategies, and facilitate pre-symptomatic interventions. Despite these advances, the equitable implementation of genomic technologies remains constrained by a range of barriers, including limited infrastructure, insufficient genomic literacy, ethical concerns regarding data use and consent, and sociocultural sensitivities-especially in low- and middle-income countries (LMICs). Through case studies and comparative policy analysis, this paper identifies key challenges and enablers in translating genomic science into equitable public health practice. We propose a framework for the integration of genomics into national health systems that includes strategic investment in genomic infrastructure, capacity-building of healthcare professionals, development of ethical and regulatory standards, and community engagement to ensure cultural acceptability. Ultimately, the incorporation of genomics into public health policy has the potential to transform the landscape of neurological care and reduce global health disparities if implemented with scientific rigor and a commitment to equity.

The research studies how fan culture and cultural acceptance influence consumption preferences and the intention to purchase Korean products among Peruvian university students. To this end, the structural equation modelling (SEM) approach was used. The main purpose was to understand whether fan culture drives cultural acceptance and how this, in turn, affects the way young people consume, and purchase products linked to the Korean wave. The study took a quantitative approach, with a cross-sectional and explanatory design. A sample of 384 randomly selected students was used. The information was obtained through a validated questionnaire and analysed using SmartPLS 4.0 software. The reliability and validity of the data were ensured through tests such as AVE, Cronbach's alpha and VIF. The main results showed that cultural acceptance significantly influences consumption preferences (β=0.658, p&lt;0.001). It was also found that fan culture has a direct effect on both cultural content consumption (β=0.705, p&lt;0.001) and emotional influence (β=0.625, p&lt;0.001). Furthermore, it was evident that emotional influence acts as a bridge between fan culture and cultural acceptance, strengthening the emotional bond with Korean products. Consequently, cultural acceptance and positive emotions are decisive elements that drive both consumer interest and purchase intention. This indicates that marketing strategies should focus on generating emotional experiences and cultural narratives that connect with young audiences. It is also suggested that community spaces and immersive activities be promoted to strengthen consumers' relationship with Korean products, especially in emerging markets such as Peru.