Diverse People Research Articles

Gender minority stress and diurnal cortisol profiles among transgender and gender diverse people in the United States

The field of behavioral neuroendocrinology has only begun to explore the lived experiences of transgender and gender diverse (TGD) people exposed to stigma. In light of escalating attacks and legislation targeting TGD people in the United States, it is crucial to examine the physiological pathways through which gender minority stressors become embodied, impact health, and contribute to health inequities. The Trans Resilience and Health Study included baseline data collection from fall 2019 to spring 2020 from a sample of 124 TGD people, reflecting a diversity of gender identities (e.g., trans masculine, trans feminine, and nonbinary) and ages (range = 19–70 years old; M = 34.10), living in Michigan, Nebraska, Oregon, and Tennessee. These analyses examine experiences of gender-related enacted stigma in association with hypothalamic-pituitary-adrenal (HPA)-axis functioning. Among those experiencing the highest levels of enacted stigma, findings show a blunted cortisol awakening response and sluggish daily decline that resulted in elevated concentrations at bedtime compared to those experiencing less enacted stigma. These results of flattened diurnal activity are consistent with an emergent literature on discrimination as a social determinant of potential stress pathophysiology. In contrast, community connectedness was associated with a larger, more dynamic cortisol awakening response. These findings emphasize the importance of incorporating gender-minority stress and resilience measures when studying HPA-axis functioning among TGD people.

The Slow Death of the Diorama: Tribal and Ethnographic Museums in India since Independence

During colonial times, dioramas were commonly used to portray the diverse peoples of India. They depicted essentialised human types through plaster models in rural settings, engaged in typical activities, and dated back to the exhibition of human beings in universal expositions held in Calcutta, Delhi and London. Since Independence, there have been determined efforts to move away from colonial stereotypes and to decolonise government-funded museums in India. Meanwhile, Adivasi artists are finding their own way out of the curatorial confines of the museum. This paper describes how Indian museology still struggles to exorcise the ghosts of the Victorian museum and India’s own internal colonialism.

Pessoas com tuberculose pulmonar na atenção primária à saúde: redes sociais e repercussões do adoecimento

ABSTRACT Objective: to analyze the perceptions of people with pulmonary tuberculosis about their social support networks and the repercussions of becoming ill. Method: a qualitative, descriptive study, conducted with 41 individuals undergoing treatment for pulmonary tuberculosis, in Primary Health Care units in two Brazilian capitals: Belém/Pará and Campo Grande/Mato Grosso do Sul. Semi-structured individual interviews were carried out from July to December 2019. The thematic content analysis technique was applied. Results: among the participants, 21 (51.22%) were from Belém and 20 (48.78%) from Campo Grande. Males (n=23/56.10%), age group from 21 to 40 years old (n=16/39.02%), unemployed status (n=28/68.29%) and who did not receive social benefits (n=23/56.10%) predominated. Three thematic categories emerged, presenting perceptions about social networks and the types of support they offer, the impact of the disease on family budget and its impact on work activities. Final considerations: social support networks were characterized by the diversity of people and family or emotional ties maintained with the participants, as well as the diversity of types of support. In this context, they found the necessary human support to face the impact of the illness and deal with their socioeconomic condition.

DA MULTIDÃO AO PÚBLICO: IMAGENS, NARRATIVAS E TECNOPOLÍTICAS NA PRODUÇÃO DA POLARIZAÇÃO PÓS-2013

The protests in June 2013 brought to light new ways of mobilizing society and the emergence of actors who intensified conflicts in the public space. The first protests were attended by very diverse people and social groups, with different ideologies, who shared a general feeling of indignation. Between 2014 and 2015, the polarization takes place with the organization of new right-wing groups, reaching itk peak in the impeachment of former president Dilma Roussef in 2016. The article seeks to contribute to the debate on the social and political meanings of the June protests, carrying out a socio-genesis of the polarization that gripped the country. To this end, we propose a conceptual approach - the passage from the crowd to the public, as assumed by Gabriel Tarde - addressing aspects that are still lacking in analysis, such as the role of narratives, images, numbers and maps in the construction of public opinion about these events, with a focus on the media framing of these protests from 2013 to 2016.

DA MULTIDÃO AO PÚBLICO: IMAGENS, NARRATIVAS E TECNOPOLÍTICAS NA PRODUÇÃO DA POLARIZAÇÃO PÓS-2013

The protests in June 2013 brought to light new ways of mobilizing society and the emergence of actors who intensified conflicts in the public space. The first protests were attended by very diverse people and social groups, with different ideologies, who shared a general feeling of indignation. Between 2014 and 2015, the polarization takes place with the organization of new right-wing groups, reaching itk peak in the impeachment of former president Dilma Roussef in 2016. The article seeks to contribute to the debate on the social and political meanings of the June protests, carrying out a socio-genesis of the polarization that gripped the country. To this end, we propose a conceptual approach - the passage from the crowd to the public, as assumed by Gabriel Tarde - addressing aspects that are still lacking in analysis, such as the role of narratives, images, numbers and maps in the construction of public opinion about these events, with a focus on the media framing of these protests from 2013 to 2016.

Toward the integration of speciation research

Abstract Speciation research—the scientific field focused on understanding the origin and diversity of species—has a long and complex history. While relevant to one another, the specific goals and activities of speciation researchers are highly diverse, and scattered across a collection of different perspectives. Thus, our understanding of speciation will benefit from efforts to bridge scientific findings and the diverse people who do the work. In this paper, we outline two ways of integrating speciation research: (i) scientific integration, through the bringing together of ideas, data, and approaches; and (ii) social integration, by creating ways for a diversity of researchers to participate in the scientific process. We then discuss five challenges to integration: (i) the multidisciplinary nature of speciation research, (ii) the complex language of speciation; (iii) a bias toward certain study systems; (iv) the challenges of working across scales; and (v) inconsistent measures and reporting standards. We provide practical steps that individuals and groups can take to help overcome these challenges, and argue that integration is a team effort in which we all have a role to play.

Healthcare experiences of LGBTQ+ people: non-binary people remain unaffirmed.

Lesbian, gay, bisexual, transgender, queer, and all sexually and gender diverse (LGBTQ+) people experience discrimination across many contexts, including healthcare environments. While some research has shown transgender people and non-binary people often endure higher rates of marginalization than cisgender, sexually diverse people, past data are limited. A sample of LGBTQ+ people (N = 173) in the United States completed an anonymous, online, self-reported survey, which included the Consumer Assessment of Healthcare Providers and Systems and healthcare experience questions. Groups, including people who identified as cisgender, sexually diverse (n = 116), transgender (n = 24), and non-binary (n = 33), were compared using chi-square and multivariate analysis of covariance tests. Compared to cisgender, sexually diverse people, non-binary people were less likely to report feeling comfortable with a physical exam, having good mental health, respected by providers, that providers had adequate medical information, that providers could care for someone going through gender affirmation, and that hospital staff were comfortable interacting with them. Additionally, non-binary people were more likely to report hospital staff misgendering them. These unique LGBTQ+ subgroup differences may be secondary to identity-specific stigma that non-binary people face. More international studies are needed to elucidate these subgroup-specific healthcare experiences across LGBTQ+ identities.

Transgender and gender diverse people with endometriosis: A perspective on affirming gynaecological care.

Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care.

MIDWIFERY CARE FOR TRANS AND GENDER DIVERSE PEOPLE

Research shows that many healthcare professionals lack knowledge of the unique reproductive needs of trans and gender diverse people, leading to possible bias. This opens potential for reduced information sharing, lack of trust and disempowerment.1 Midwives are bound by the Nursing and Midwifery Council (NMC) Code2 to provide care to the best available evidence, keep up-to-date and maintain knowledge and skills to provide safe, holistic care. However, ‘transgender’ is not yet a health research analytic category. Thus, there is a poor evidence base, making it more challenging to understand trans-specific health concerns due to lack of data.3

The Philosophy of Black Education and the Promise of Democratic Organizing

ABSTRACT: To progress toward fulfilling the “promise of democracy” articulated in the 1963 March on Washington requires America’s self-understanding as a diverse people full of tremendous potential and capacity to address our problems. To meet that challenge requires lessons from African American community and cultural organizing in the black freedom movement and the concept of pedagogical personalism from African American education, which affirms the inviolable dignity, worth, and potential of every person. The potential and the dignity of the people came alive in the Rosenwald schools and libraries, which were organized by a network called Jeanes Teachers, some of the most remarkable community organizers in American history. Most of them were educated in HBCUs. This legacy and its vision needs to be put into conversation with community organizing today.

Answering the Call for Community Pharmacists to Improve Healthcare Delivery to Trans and Gender Diverse People: Guide for Designing, Implementing, and Evaluating an Online Education Program in Australia.

Trans and gender-diverse people visiting pharmacies may not always receive optimum care due to pharmacists' lack of knowledge and confidence to provide such care. This situation prompts a need for training. This paper aimed to describe a guide to the design, implementation, and evaluation of a training program on transgender healthcare for pharmacists in Australia. The Implementation Mapping Framework provided a foundation for the design, implementation, and evaluation of this training program. Through active involvement in the program development, trans and gender diverse people and pharmacists guided the program design, ensuring alignment with the cultural, social, and healthcare contexts. The needs analysis highlighted the necessity for training for pharmacists to improve their cultural awareness and pharmacotherapeutic knowledge about transgender healthcare. Applying a novel Gender Inclusivity in Pharmacy Framework, online modules-(1) Transgender healthcare-language, terminology, and key healthcare issues, (2) Gender-affirming therapies, and (3) Case studies in transgender healthcare-were developed to enable the implementation of a training program. The Implementation Mapping Framework and the Gender Inclusivity in Pharmacy Framework proved effective tools for providing an education program for pharmacists.

التخييل في أدب الرحلة

The literature of travel, or travel literature, has roots that extend back to ancient times. In fact, one could argue that travel and exploration are fundamental to the human experience, starting with the first journey undertaken by humanity—the journey from non-existence to existence. From there, the human journey began, and with the journey of our father Adam (AS) from heaven to earth, the human journey started from the very beginning of human existence. Over time, humans started documenting their memories and experiences during their journeys. As new worlds were unveiled, a new perspective emerged in writing about those travels. These journeys revealed diverse lands, peoples, and nations, shedding light on their daily lives, history, traditions, culture, language, clothing, and cuisine. Travel literature serves as a window into the world, offering readers a glimpse into the experiences and perspectives of travelers. It allows us to explore different landscapes, encounter foreign cultures, and gain a deeper understanding of the interconnectedness of our global community. Through travel literature, we can embark on journeys vicariously, expanding our horizons and fostering empathy and appreciation for the richness and diversity of human existence.
 
 Keywords : Travel literature, philosophy of fiction or Imagination ,fictions trends.

Principles and methods to advance value for money

Value for money poses the question, “What is good resource use?” It is often answered with a narrow economic analysis that does not adequately address what diverse people value. We suggest new principles and methods that may help evaluators answer the question better. First, we define value for money, which sits at the intersection of evaluation and economics. Next, we make the case for a holistic assessment of value for money that evaluators can conduct with tools they already have, like rubrics. We introduce three principles that further align value for money with evaluation: value depends on the credibility of estimates; things do not have value, people place value on things; and people value the same things differently. Together, they suggest evaluators should arrive at multiple, possibly conflicting conclusions that represent diverse value perspectives. We demonstrate how this may be done using a value-for-money rubric to improve resource allocation for impact.

Engaging Everyone: Co-building diverse and inclusive patient partnerships to promote health equity.

Background: To address the challenge of engaging diverse people, discover a novel model of engagement where diverse members of community bring a health equity lens to healthcare projects, policies and research.
 Workshop description: This workshop is designed to introduce participants to challenges and opportunities in diverse patient engagement. Participants will learn about the Equity-Mobilizing Partnerships in Community (EMPaCT) model. Through group discussions, participants will explore how they can adapt the EMPaCT approach to their own settings. Through tools and resources developed by EMPaCT, participants will learn how to co-design sustainable and scalable models of patient engagement to promote health equity. In particular, participants will learn about:
 1.Conceptual frameworks that make explicit the relationships between social, political and economic inequities and health outcomes;
 2.Strategies to involve communities experiencing the most inequities in policy and decision-making; and
 3.Methods to design programs that are scalable. 
 Intended audience: Anyone who is:
 1.interested in learning how to engage in patient partnerships that promote health equity; 
 2.interested in engaging with diverse and seldom-heard communities for practice, research or policy development;
 3.involved in system-level healthcare redesign and resourcing.
 
 
 Workshop overview & agenda (90 mins workshop)
 1.Introductions (10 mins) – Alies, Ambreen, Emily
 2.Section: Getting to know the audience (10 mins ) – Emily 
 Approach: Interactive polls. Responses reviewed in real-time.
 Outcome: Understand which stakeholder category participants identify with and their experiences in patient engagement including engagement with diverse voices as well as level of decision-making authority.
 3.Section: Introduction to the challenges and opportunities in diverse patient engagement and the need for scalable equity-oriented patient partnerships (10 mins) – Ambreen 
 Approach: Presentation by workshop facilitators. 
 Outcome: Participants will have foundational knowledge needed to engage in interactive workshop.
 4.Section: Identifying and using conceptual frameworks that recognize how health inequities drive health outcomes (15 mins) – Emily 
 Approach: Overview of frameworks and interactive discussion using Padlet-based questions.
 Outcome: Participants will engage in learning and discussion about health and social inequities.
 5.Section: Involving communities experiencing the most inequities in policy and decision-making (15 mins) – Alies 
 Approach: Facilitators will share how EMPaCT was co-designed using an equity-oriented lens to patient engagement. Participants will learn how to apply the same lens to their setting using interactive group discussion through Padlet. 
 Outcome: Participants will learn about different ways to involve communities experiencing the most inequities in policy and decision-making.
 6.Section: Designing programs that are scalable and sustainable (15 mins) – Ambreen 
 Approach: Facilitators will share how EMPaCT was co-developed as a scalable unit. Participants will engage in interactive discussions through Padlet to identify the resources available to them to co-create a scalable unit in their setting. 
 Outcome: Participants will learn about different ways to scale and sustain patient engagement activities that promote health equity. 
 7.Closing summary (15 mins) – Alies 

Bans on Evidence-Based Care for Transgender and Gender Diverse People Present Risks for Clients and Dilemmas for Mental Health Providers

Despite efforts to improve the sociopolitical landscape for sexual and gender minorities, including legislation to ban sexual orientation and gender identity change efforts (SOGICE), new threats have arisen with a sharp increase in state legislatures enacting anti-TGD (transgender and gender diverse) legislation. Some of these laws and the accompanying hostile climate may prevent mental health providers from providing the best evidence-based care for their TGD clients. This paper briefly reviews the current sociopolitical climate, the impact of the climate on TGD people, and challenges faced by mental health providers serving TGD clients. We conclude with recommendations for supporting TGD clients in the current sociopolitical context and a call for advocacy to continue efforts to ban SOGICE and protect access to social, legal, and medical gender affirmation for youth and adults.

Analysis Of The Effect Of Service Quality, Marketing Mix, On Interest In Service Reuse Hospitalization

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>The diversity of people's needs for health products and services means that hospitals are competing as much as possible to serve consumers. Hospitals must improve the quality of service and also hospitals need to design marketing programs so that products/services get a response from the target market and run successfully. The marketing mix is a set of marketing tools used by the company to continuously achieve one of the marketing goals, namely to provide satisfaction to the wants and needs of consumers and to generate profits for the company from the mix market. The purpose of this study was to determine the effect of service quality and marketing mix on the intention to reuse inpatient services at RSU Royal Prima Medan in 2022. This research is a type of quantitative research. The research design used was an analytic observational method with a cross sectional approach. The population in this study was the average patient who came for treatment at the Inpatient Installation of RSU Royal Prima Medan in the last 3 months, totaling 1,653 patients. Sampling used SEM analysis where the number of samples was 150 patients. Data analysis used univariate, bivariate and multivariate analysis. The results showed that service quality had a positive and significant effect on the intention to reuse inpatient services at RSU Royal Prima Medan p-value <0.05, the marketing mix had a positive and significant effect on the intention to reuse inpatient services at RSU Royal Prima Medan p-value < 0.05. Simultaneously or simultaneously service quality and marketing mix have a positive and significant effect on the intention to reuse inpatient services at RSU Royal Prima Medan p-value <0.05. The independent variable that has the most influence on the dependent variable in this study is the service quality variable.</em></p><p><em><br /></em></p></td></tr></tbody></table></div><p><strong><em>Keywords: Hospital, Interest in reus, Marketing mix, Quality of service</em></strong></p>

Effectiveness and Safety of Different Estradiol Regimens in Transgender Women (TREAT Study): Protocol for a Randomized Controlled Trial.

Current guidelines for gender-affirming hormone therapy (GAHT) for transgender women are mostly based on clinical experience from experts in the field and treatments used on postmenopausal women. While care is currently provided with the best available evidence, there is a critical gap in knowledge about the safest and most effective estradiol routes of administration for GAHT in transgender women; this statement is supported by the World Professional Association for Transgender Health on their Standards of Care for the Health of Transgender and Gender Diverse People, version 8. Furthermore, the reported rates of cardiometabolic adverse events in transgender women highlight the importance of investigating changes in lipoproteins, glucose, and insulin sensitivity, among other markers while receiving GAHT. This study aims to evaluate the degree of testosterone suppression achieved at 1, 6, and 12 months in treatment-naive transgender women when randomized to GAHT with estradiol and spironolactone as antiandrogens. As a secondary aim, this study will assess the treatment effect on metabolic and coagulation factors from baseline to 6 and 12 months after initiating GAHT. This is a prospective pilot, open-label, randomized clinical trial conducted at an adult transgender clinic in a tertiary medical center. The 3 treatment arms include once-daily sublingual 17-β estradiol, twice-daily sublingual 17-β estradiol, and transdermal 17-β estradiol. All participants received spironolactone as an antiandrogen. Transgender women aged 18 to 45 years who are being evaluated for the initiation of GAHT with 17-β estradiol and did not have a history of coagulopathy, cigarette smoking, liver disease, dyslipidemia requiring treatment, or use of gonadotropin-releasing hormone agonist were eligible to enroll. The main outcome is the total testosterone suppression at 1 and 6 months after the initiation of GAHT, and the secondary outcome is to assess treatment effect in a lipid panel; homeostatic model assessment for insulin resistance; coagulation factors II, IX, and XI; Von Willebrand factor; activated protein C resistance; protein C; and protein S at baseline, 6 months, and 12 months after therapy is initiated. This study was funded in March 2022, and enrollment concluded in August 2022. It was concluded in July 2023, and currently, the results are being analyzed for publication. The Transgender Estradiol Affirming Therapy (TREAT) study offers a rigorous and reproducible approach to answer important questions regarding GAHT in transgender women, specifically, the most effective 17-β estradiol regimen to suppress testosterone levels to 50 ng/dL, as currently recommended. ClinicalTrials.gov NCT05010707; https://clinicaltrials.gov/study/NCT05010707. DERR1-10.2196/53092.

The final ecosystem goods and services Voltron: the power of tools together.

Environmental decision-making benefits from considering ecosystem services to ensure that aspects of the environment that people rely upon are fully evaluated. By focusing consideration of ecosystem services on final ecosystem goods and services (FEGS), the aspects of the environment directly enjoyed, used, or consumed by humans, these analyses can be more streamlined and effective. The U.S. Environmental Protection Agency has developed a set of tools to facilitate this consideration. The central feature of FEGS is that ecosystems are viewed through the diverse ways people directly benefit from them. The National Ecosystem Services Classification System (NESCS) Plus provides a framework for describing and identifying FEGS consistently. The standardization made available by NESCS Plus allows other tools and databases to interact using the NESCS Plus architecture and taxonomy, providing diverse insights for decision makers. Here, we examine the synergy of using the following four tools together: (1) the FEGS Scoping Tool; (2) the FEGS Metrics Report; (3) the EnviroAtlas; and (4) the EcoService Models Library. The FEGS Scoping Tool helps users determine what ecosystem services are relevant to a decision by harnessing FEGS understanding to enable communities to identify the relative importance of beneficiaries relevant to a decision and biophysical aspects of the environment of direct relevance to those beneficiaries. The FEGS Metrics Report can guide which metrics to monitor or model to represent those priority services. The EnviroAtlas, a powerful tool containing geospatial data and other resources related to ecosystem services, chemical and non-chemical stressors, and human health, and the EcoService Models Library, a database of ecosystem models, are two tools that support users in mapping and modeling endpoints relevant to priority services. While each of these tools is valuable on its own, together, they provide a powerful approach to easily incorporate and operationalize ecosystem services efforts into different parts of decision-making processes across different types of decisions. We illustrate how these integrated tools can be used together with a hypothetical example of a complex environmental management case study and the combined benefit of using the FEGS tools together.

RECEIPT OF GENDER-AFFIRMING SURGERY AMONG MEDICARE BENEFICIARIES

Abstract While transgender and gender diverse (TGD) people may never seek treatment related to their gender identity, many require access to gender-affirming treatments, including surgery. Starting in 2014, Medicare began covering gender-affirming surgery (GAS) on a case-by-case basis. In this study, we use national Medicare data to compare receipt of GAS by beneficiary characteristics. We classified TGD beneficiaries using an algorithm that combines diagnosis and procedure codes. Our study compared characteristics for all TGD identified beneficiaries and those who received GAS using a population-averaged logistic model using a generalized estimating equation (GEE) adjusting for dual status, age group, race/ethnicity, original reason for entitlement, and CMS region. Our sample accounted for 49,945 observations for 11,162 individuals, with a total of 290 identified records of GAS. In our adjusted analysis, we found that TGD beneficiaries in certain parts of the country had lower odds of GAS compared to their counterparts. Compared to CMS Region 1 (which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont), those living in Region 3 (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia), Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee), and Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) had a significantly lower odds of receiving GAS. Access to gender-affirming care may be influenced by CMS regional contractors, as well as state-by-state variation in Medicaid coverage for gender-affirming care. Further research is needed to explain why beneficiaries may have lower access to GAS to inform policy recommendations.

Strategic Integration and Geopolitical Repositioning: Bosnia and Herzegovina’s Path Towards the European Union

Bosnia and Herzegovina, rich in cultural diversity, is challenged by religious, national, and ethnic divides, leading to societal deadlock. Despite making strides towards internal peace and security, ongoing economic struggles continue to hamper its development. As the country advances towards European integration, prioritizing its own interests and goals is crucial, rather than merely aligning with those of the European Union. The country needs to meet fourteen key conditions to open negotiations for joining the EU. These conditions can serve as a guiding framework to transform the state from its current negative geopolitical position into one where it can become an engaged player in international relations. Its diverse constituent peoples already have established influences with peoples from diverse backgrounds such as Arab and Muslim countries, the European Union’s member states, Russia, and the Eastern European states. These influences have never been utilized in a coordinated and constructive way, but were rather always seen through the prism of conflict. The state can leverage these relationships and position itself as a symbolic bridge between the Western, Eastern, and Muslim Arab worlds. This strategic geopolitical repositioning will not only enhance Bosnia and Herzegovina’s prospects for a brighter future for its citizens but also enable it to play a significant role in regional dynamics. Focused on its unique interests and values, Bosnia and Herzegovina must ensure its voice and values are reflected in the European integration process, shaping a beneficial future, lasting stability, and long-term prosperity for its citizens and the region.