Mirror, motivate, or mislead? How fitspiration on RedNote affects health behaviors through appearance comparisons and self-esteem.

Beyond the shot: A framework of individual and external influences on U.S. young adults' COVID-19 vaccination decisions derived from thematic analysis.

Performing identity and risk: chemsex, misogyny, and algorithmic exclusion in queer Reddit spaces.

When health meets politics: Selective gatekeeping of health experts in Chinese media during COVID-19.

Prosocial versus self-interested appeals in offline health communication: A randomized trial of framed messages during the COVID-19 pandemic in Switzerland.

Promoting equitable mental health communications for prevention and early intervention: a scoping review

Public Health Competencies for Primary Care Clinicians.

Sexual function and supportive care: Experiences of patients after prostate cancer treatment in a Gauteng oncology centre, South Africa.

Abstract The Chernobyl nuclear disaster of 1986 is a case study of organizational secrecy, rigid political ideology, and technological malfunctions that led to the most disastrous industrial accident. The analysis principally relies on the detailed account of Adam Higginbotham’s Midnight in Chernobyl, cross-examining technical and policy factors that resulted in such a catastrophe through the lens of three overlapping themes: (1) technical and human factors contributing to the accident, (2) the culture of secrecy and its outcomes as practiced by the Soviet Union and its impacts on disaster response and public health communication, and (3) lessons for the modern industrial safety governance and ethical transparency. The paper presents the human and environmental consequences of the disaster caused by institutional secrecy and authoritarian rigidity that delayed effective response and undermined public trust. It also provides policy recommendations to mitigate the likelihood of such catastrophe in future on the basis of transparency, independent oversight, and enhanced safety culture. Keywords Culture of Secrecy, Industrial Disasters, Safety Culture, Institutional Transparency, Nuclear Ethics

ABSTRACT Fixed assessment deadlines are widely used in higher education but may disadvantage students whose learning is disrupted by competing academic, work, or personal demands. This study examined whether introducing an automatic, penalty-free grace period influences assessment submission behaviour and academic performance in an online undergraduate course. One hundred and ninety-eight students enrolled in a fully online first-year Health Communication course were analysed across two major assessments. Submission timing was categorised as on-time, grace period, extension, or non-submission, and associations with assessment marks were examined. Submission behaviour showed strong continuity across assessments: students who submitted on time initially were most likely to do so again, while early non-submission was associated with continued non-submission or withdrawal. The grace period was widely used and appeared to provide functional flexibility, with a greater proportion of students submitting on time by the second assessment; however, a substantial minority continued to rely on the grace period. Importantly, assessment marks did not differ meaningfully across submission categories, indicating that penalty-free flexibility depended on when students submitted rather than on how well they performed. These findings suggest that automatic grace periods can support equity and engagement in online learning without compromising academic standards, provided expectations are clearly communicated, and early support is directed towards students who disengage from initial assessments.

ABSTRACT Accessible and effective health education fosters values and beliefs that support positive health behaviors, particularly for parents and adolescents. As parents seek guidance to help their children through adolescence, they overwhelmingly turn to the Internet to learn about their children’s health, given the breadth and convenience of available resources. However, the deficiencies in the readability of parent-focused online health education materials, such as the use of complex vocabulary, dense sentence structures, and high reading grade levels, which can limit comprehension, have raised concerns about their effectiveness and reliability. Online health educational materials have the potential to serve as a cost-effective health communication tool by addressing gaps in knowledge and skills. This case study aimed to identify and apply effective readability-scoring methods to assess online health information for parents and adolescents. Readability scores were calculated using multiple validated algorithms: the Flesch Reading Ease, Flesch-Kincaid Grade Level, and Simple Measure of Gobbledygook. These tools evaluate factors such as sentence length, syllable count, word complexity, and average grade level required to facilitate comprehension and motivation. Results indicated that parent-focused materials had an average FRE score of 66.61, an FKGL score of 7.55, and an SMOG score of 10.15, indicating that most materials substantially exceeded the recommended reading levels for the target audiences. Our findings provide insights and practical strategies for improving the readability of online health materials. Enhancing the readability of such materials can improve understanding and positively impact overall health outcomes.

ABSTRACT Parent – child sexual health communication can reduce adolescents’ sexual risks and adverse sexual outcomes. However, few studies focus on how Black parents discuss sexual trauma with their children, especially within the context of intersecting systems of stigma, racism, and gendered oppression. Guided by Intersectionality theory, this qualitative study explores how 21 Black parents and caregivers perceive their children’s risk of sexual harm and navigate barriers to sexual health communication. Using Critical Thematic Analysis, findings revealed risks rooted in personal trauma, digital exposure, and racist stereotypes, as well as barriers stemming from intergenerational stigma, misinformation, and paternal disengagement. The findings emphasize how parents use protective communication strategies while navigating intergenerational trauma, silencing, and systemic injustice. This study advances family communication research by utilizing Intersectionality as a key analytical framework. Lastly, practical implications recommend trauma-informed, culturally relevant interventions that critically integrate Black family dynamics.

In the postpandemic context, the surge of digital health information has intensified public demand for clear and practical communication, particularly in China, where health literacy disparities persist. The Clear Communication Index, developed by the US Centers for Disease Control and Prevention (CDC), is a standardized tool for assessing the clarity and actionability of health materials, but no version adapted to the simplified Chinese context has been established. This study aims to translate and culturally adapt the Clear Communication Index into simplified Chinese, and subsequently validate its psychometric properties using diabetes health communication materials from provincial CDCs across Mainland China, a disease area with a substantial public health burden and strong reliance on health education. Following a standardized cross-cultural process (forward-back translation and expert review), we developed the simplified Chinese version of the Clear Communication Index (C-CCI) and finalized a 12-item scale across 4 dimensions (Main Message and Call to Action, Behavioral Recommendations, Numbers, Risk) with yes or no scoring (0-100). One top-ranked diabetes health education material was sampled from each provincial CDC website in Mainland China (30/31 included; 96.8%) on May 18, 2025. Twelve raters with multidisciplinary backgrounds completed a 3-week standardized training program and independently evaluated each article (360 ratings). Structural validity was examined using exploratory factor analysis and confirmatory factor analysis. Content validity was assessed by the item-level content validity index and the scale-level content validity index/average. Reliability was evaluated by internal consistency (Cronbach α) and inter-rater agreement (Fleiss kappa), while convergent/discriminant validity was assessed using composite reliability and average variance extracted (AVE). The 4-factor structure was supported. Content validity was high, with the scale-level content validity index/average values of 0.976 for clarity and 1 for relevance. Overall reliability was acceptable (Cronbach α=0.837), with particularly strong internal consistency in the Risk dimension (Cronbach α=0.910). Inter-rater agreement was substantial (κ=0.624). Convergent validity (composite reliability=0.897-0.914; AVE=0.645-0.831) and discriminant validity were satisfactory. Application to 30 provincial CDC websites yielded a mean C-CCI score of 53.84 (SD 29.74), well below the recommended threshold of 90. No significant regional differences were observed in total scores; however, Behavioral Recommendations scored slightly higher in western provinces than in eastern and central regions (η²=0.034), representing a small effect size with limited practical significance. The C-CCI demonstrated good validity, reliability, and feasibility for evaluating simplified Chinese health communication materials. These findings underscore the need to strengthen health communication practices in China and encourage provincial CDCs to align material development with national health literacy goals. Integrating the C-CCI into routine CDC review protocols could support evidence-based quality assurance and advance clearer, more actionable public health communication nationwide.

The bidirectional communication between liver and skeletal muscle represents a critical yet underexplored axis in human physiology. Dysfunction in either organ can accelerate pathology in the other, amplifying disease progression. Understanding this interconnected system is essential for developing targeted and effective therapeutic strategies. This comprehensive review elucidates the complex pathophysiological mechanisms underlying liver-muscle crosstalk and identifies novel therapeutic targets for simultaneous intervention in both organs. We analyzed peer-reviewed literature focusing on molecular pathways, biomarkers, and therapeutic interventions targeting the liver-muscle axis, including cardiac muscle interactions. Key parameters examined included inflammatory mediators (TNF-α, IL-6), metabolic regulators (mTOR, AMPK), hepatokines, myokines, cardiokines, and emerging biomarkers such as zonulin. The liver-muscle axis operates through multiple interconnected pathways: (1) inflammatory cascades where TNF-α inhibits muscle mTOR signaling while promoting hepatic stellate cell activation; (2) metabolic disruption through insulin resistance and AMPK pathway dysfunction affecting both organs simultaneously; (3) gut-liver-muscle crosstalk mediated by microbiome-derived metabolites and intestinal permeability markers like zonulin; (4) hepatokine-myokine signaling networks that coordinate metabolic homeostasis; and (5) liver-heart crosstalk involving cardiomyocyte-hepatocyte interactions through FGF21, IL-6/STAT3 signaling, and inflammatory pathways that distinguish cardiac muscle from skeletal muscle responses. Studying the liver-muscle axis helps in understanding metabolic diseases, transforming them from isolated organ pathologies to interconnected systemic disorders. This framework opens new avenues for precision medicine approaches, biomarker development, and therapeutic innovation that simultaneously optimize liver, skeletal muscle, and cardiac health.

Images created with generative artificial intelligence (AI) tools are increasingly used for health communication due to their ease of use, speed, accessibility, and low cost. However, AI-generated images may bring practical and ethical risks to health practitioners and the public, including through the perpetuation of stigma against vulnerable and historically marginalized groups. To understand the potential value of AI-generated images for health care and public health communication, we sought to analyze images of substance use disorder and recovery generated with ChatGPT. Specifically, we sought to investigate: (1) the default visual outputs produced in response to a range of prompts about substance use disorder and recovery, and (2) the extent to which prompt modification and guideline-informed prompting could mitigate potentially stigmatizing imagery. We performed a mixed-methods case study examining depictions of substance use and recovery in images generated by ChatGPT 4.o. We generated images (n=84) using (1) prompts with colloquial and stigmatizing language, (2) prompts that follow best practices for person-first language, (3) image prompts written by ChatGPT, and (4) a custom GPT informed by guidelines for images of SUD. We then used a mixed-methods approach to analyze images for demographics and stigmatizing elements. Images produced in the default ChatGPT model featured primarily White men (81%, n=34). Further, images tended to be stigmatizing, featuring injection drug use, dark colors, and symbolic elements such as chains. These trends persisted even when person-first language prompts were used. Images produced by the guideline-informed custom GPT were markedly less stigmatizing; however, they featured almost only Black women (74%, n=31). Our findings confirm prior research about stigma and biases in AI-generated images and extend this literature to substance use. However, our findings also suggest that (1) images can be improved when clear guidelines are provided and (2) even with guidelines, iteration is needed to create an image that fully concords with best practices.

There is a need for a comprehensive summary of qualitative research on the health-related quality of life (HRQoL) of people with advanced cancer requiring palliative care. We aim to systematically review qualitative studies on outcomes, needs, experiences, preferences, concerns and HRQoL of people in Europe with advanced cancer requiring palliative care over the last decade. Protocol registered ( www.crd.york.ac.uk/PROSPERO , CRD42024575065). The search was conducted in PubMed and Scopus, from 2013 onward. qualitative studies addressing constructs related to the HRQoL of adults with cancer requiring palliative care in Europe. Abstracts and full texts were reviewed, data extracted, and risk of bias assessed independently by two researchers. A thematic analysis stratified by study objective was performed, grouping the emerging themes into categories (primary outcome). Of 18,256 articles identified, 20 fulfilled the inclusion criteria: 10 studies with a generic objective (whole palliative process or end-of-life phase), and 10 with specific focuses. Five categories (35 themes) emerged from the studies with generic focuses: 'Psychological Function' (n = 15), 'Clinical Management' (n = 8), 'Symptoms and Physical Function' (n = 6), 'Social Function' (n = 5), and 'End-of-life' (n = 1). Themes from the 7 studies focusing on treatment, services, and self-management also fitted into these categories, adding 'Spiritual Well-being'. These findings emphasise the predominance of the psychological function domain in cancer patients requiring palliative care, including cancer-related anxiety and distress, coping mechanisms, control and decision-making, and fearing and expecting death. Additionally, clinical management unmet needs were identified in health care, information and communication, and end-of-life settings (home vs. hospital).

More than half of women will experience a urinary tract infection (UTI) in their lifetime. Despite the prevalence of this illness, information about UTIs may be considered private, and some women may find it difficult to seek care and support while managing a UTI. The theory of Communication Privacy Management (CPM) explains why individuals decide to open or close a boundary around the private information. A second, novel theory in health communication, the Theory of Communicative Disenfranchisement (TCD), explicates how communication deprives individuals of their rights and privileges through disenfranchising talk (DT). The current study leverages these two frameworks to examine how DT informs privacy boundary management among women who have experienced a UTI, either enabling or constraining their access to care and support across contexts of the workplace, clinical communication, friendships, and romantic relationships. Semi-structured interviews reveal a privacy management system that draws on various catalyst and core rule criteria informed by enactments of (dis)enfranchising talk. The (im)material consequences of DT have the potential to inform understanding of CPM and TCD as well as improve interpersonal communication about UTIs.

Adopting the functionalist perspective of Malinowski and the health belief model (HBM), we showed how the perception of susceptibility to the novel coronavirus disease 2019 (COVID-19) has been blunted by social media-driven myths and conspiracy theories. We used Google Forms to conduct a cross-sectional survey to measure the awareness level of the COVID-19 pandemic among the staff of the University of Nigeria, Nsukka and the impact of frequently exchanged myths on social media on staff members. The findings indicate inter alia that the majority of the respondents, who are highly literate, associated the claim of strong immune systems (35.8%) and high-temperature levels (28.5%) of the weather conditions with the lower death rate in Africa. Nonetheless, many participants (42%) demonstrated sufficient/significant knowledge of COVID-19 symptoms and preventive measures and gained such knowledge through social media (42.5%). These findings, apart from underlining the potency of social media in health information and its tendency to spread myths, call attention to the need for confidence and trust-building measures from public institutions engaged in the national response to the pandemic. In effect, the resilience of myths, even among educated people in Africa, challenges us to reframe health communication to counter these myths.

Background Early in the COVID-19 pandemic, mainstream news outlets sensationalized that 30-40% of all coronavirus deaths in the United States occurred among individuals with diabetes. It was unclear why this would be news-worthy because 30-40% is approximately the prevalence of diabetes in older adult, the age group most at risk for mortality from COVID-19. Thus, we sought to quantify the proportion of decedents from COVID-19 who had diabetes. To understand the proportion in context, we also calculated the proportion of decedents from influenza who had diabetes. Methods For assessing COVID-19 decedents who had diabetes, we used the National COVID Cohort Collaborative (N3C) data enclave, a nationally-representative, harmonized, and de-identified electronic health record database. For assessing influenza decedents who had diabetes, we used Medicare data. We restricted the N3C sample to > 65 years to align with Medicare eligibility. Results Among seniors with inpatient mortality due to COVID-19, 46.6% (95% CI: 46.1-47.0) had diabetes. Among seniors with inpatient mortality from influenza, the crude percent with diabetes was 61.2%. When age-standardized to match the N3C COVID-19 data, the percentage of influenza decedents with diabetes was 63.1% (95% CI: 59.1-67.1). Conclusions Among seniors with inpatient mortality from respiratory viruses, a very large proportion had diabetes before infection: 63% of influenza decedents and 47% of COVID-19 decedents. Thus, a high proportion of decedents having diabetes is not new or unique to COVID-19. These findings highlight the value of using available data to contextualize health communication to the public.

ABSTRACT This study examined associations between perceived use of specific conflict styles and mental health outcomes during the COVID-19 pandemic in a nationally representative sample of Swiss participants. Specifically, this study investigated how conflict styles and conflict profiles related to anxiety, depression, and loneliness during the pandemic. Indirect fighting emerged as the most consistent predictor of the three negative mental health outcomes. The combination of high indirect fighting and high yielding was associated with anxiety, the combination of high indirect fighting and low collaborating with depression, and high indirect fighting alone with loneliness. Moreover, Direct Conflict Managers—individuals who reported high collaboration and low use of indirect conflict styles—tended to report lower levels of anxiety, depression, and loneliness than those with other conflict profiles. Building on existing health and interpersonal communication scholarship, these findings highlight the potential psychological risks associated with indirect conflict behaviors during crises such as the COVID-19 pandemic and suggest that collaborative approaches to conflict may be linked to better mental health outcomes.