Public perceptions of community pharmacists' evolving role in health promotion and pharmaceutical care: A cross-sectional study in Indonesia.

Background Climate change is increasing the frequency and severity of heatwaves across South Asia, with disproportionate impacts on vulnerable populations. Pregnant and lactating women face heightened health risks due to physiological changes, gendered social responsibilities, and constrained access to adaptive resources. Despite this, women’s lived experiences and adaptation practices during pregnancy remain understudied and largely absent from institutional climate responses. This knowledge gap hampers the development of effective, gender-sensitive adaptation policies. Methods This qualitative study, embedded within the Heat in Pregnancy (HiP)-India project, will be conducted in three climatically vulnerable sites: Gurugram (Haryana), Bilaspur (Chhattisgarh), and Puducherry. Guided by a socio-ecological framework, we will conduct in-depth interviews with pregnant and lactating women, focus group discussions with caregivers, and key informant interviews with health workers and local stakeholders, alongside non-participant observations. Interviews will take place during and shortly after the heat season to capture both real-time and reflective experiences. Using purposive sampling, we will recruit 20–25 women per site, along with caregivers and stakeholders, primarily from the HiP-India cohort who have consented to follow-up. Data will be thematically analysed using NVivo, with reporting guided by COREQ standards. Anticipated Results The study will generate contextualised insights into women’s heat-adaptation practices during pregnancy and lactation across diverse agro-climatic zones, document traditional and emerging coping strategies, and identify structural, social, and institutional barriers shaping adaptation capacity. Conclusion By centering women’s lived experiences, this research will inform the design of culturally appropriate, gender-responsive heat adaptation interventions suitable for low-resource settings. Findings will support both practical community-based solutions and evidence-based advocacy for more inclusive climate adaptation policies at local and national levels.

With the incorporation of the shipping industry’s 2050 net-zero emissions target into the global agenda in the International Maritime Organization (IMO) 2023 Strategy, the industry’s low-carbon transition has moved from policy advocacy to a phase of mandatory implementation. Against this backdrop, the achievement of macro-level emission reduction goals urgently requires support from micro-level individual cognition and behavior. From a micro-level perspective, this study explores the mechanism through which shipping practitioners’ low-carbon transition cognition (LCTC) relates to perceived corporate green practices. Grounded in Social Cognitive Theory (SCT) and Social Information Processing Theory (SIPT), the study constructed and validated a moderated serial mediation model. Based on a questionnaire survey of 416 shipping industry professionals, the results indicate that low-carbon transition cognition is positively associated with corporate green practices (CGP) both directly and indirectly through the serial mediation of green behavioral intention (GBI) and green organizational citizenship behavior (GOCB). Furthermore, professional identity and policy cognition positively moderate the relationship between low-carbon transition cognition and green behavioral intention, while perceived organizational support strengthens the positive effect of green organizational citizenship behavior on corporate green practices. This study presents microlevel psychological and behavioral mechanisms associated with the green transformation within industry-mandated emission reduction frameworks and provides evidence for policy makers and corporate managers to activate the “human factor” and advance green practices integrating compliance with innovation.

Dental hygienists (DHs) play a crucial role in promoting oral health and prevention of dental diseases. Dental hygiene educational programs must ensure that the future workforce is prepared for delivering effective and high-quality oral care to communities. The aim of this scoping review is to explore the published literature to identify gaps in the preparedness of dental hygiene students. Following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across PubMed, Google Scholar, ProQuest Central, CINAHL, and Embase, covering studies published from 1st January 2000 to 31st December 2025. Keywords and MeSH terms related to preparedness, dental hygiene students, and clinical practice guided the search. Data were synthesised narratively. Ten studies published between 2012 and 2023 were identified from Canada (30%), the United States (30%), Finland (10%), Australia (20%), and New Zealand (10%). Both qualitative and quantitative methodologies were employed. Studies focused on a wide range of attributes of dental hygiene students including clinical skills (70%), communication skills (80%), cultural competence (30%), adaptability (50%), professional resilience (30%), and policy use and advocacy (40%). Gaps were noted in research use, policy engagement, and advocacy, with graduates reporting low confidence in these areas. Baccalaureate programs provided broader preparation than diploma programs, though both lacked sufficient applied learning experiences. The review highlighted several gaps in the teaching and training of dental hygiene students in multiple countries. The findings underscore the need for educators and regulators to address these educational shortfalls to facilitate a smooth transition of dental hygiene students into professional practice.

Analysing differences of leadership styles in the economies of the United States and India has provoked discourse. Finding the ‘sweet spot’ as a tool for community engagement will resolve the issues that exist. Those skills previously required in policy development, advocacy, teaching and stakeholder engagement that socially impact communities have been transferred into an operational model. In this article, sustainability discourse was addressed by finding the ‘sweet spot’ as it is related to management practice in the holistic implementation of programmes that improved human welfare, education and mental health. Implementation of sustainable programmes can now be used as a model for those that stagnate. Objectives developed that reflect the model that moved organizations towards goal achievement have been elucidated. The methodologies of Appreciative Sharing of Knowledge (ASK) and Positive Design have been reflected as proposed frameworks for developing trans-organizational collaborations among stakeholders and nonprofit government organizations (NGOs) to improve lives in the United States and India. The qualitative methodology adopted in this article is based on the case method and ethnographic approach. The study is relevant as it presents real examples of the implementation of best community practices advancing SDG 3 and SDG 17.

The Tharus are a prominent group of tribes who have lived in the Tarai belt of Nepal and India for centuries, relying on the forest for their survival. This ethnozoological study focuses on turtle collection and consumption by the Tharu community in the Rupandehi district of Nepal, discussing the distribution and abundance of turtle species and this community’s unique spearing method of turtle hunting. In this study, Tharu turtle hunters were hired to collect living specimens using the spearing method from nine locations, and interviews were conducted with local community members. Twenty-three living turtle specimens from three species were recorded, and an additional 81 shells were recovered from Tharu households. The Indian flapshell turtle (Lissemys punctata andersoni; Tharu: Gauriya Kachhuwa) was the most abundantly distributed species in the district. The survey of shells in households revealed that all specimens were Indian flapshell, while the two other specimens were Indian peacock softshell turtle (Nilssonia hurrum; Tharu: Supahawa kachhuwa) and Indian roofed turtle (Pangshura tecta; Tharu: Khapadahawa kachhuwa). During interviews all interlocutors described eating Gauriya kachhuwa and avoiding other land turtles for consumption. Spearing is used to hunt turtles, and it is utilized in marshes, ponds, and lakes. These reptiles are killed for their meat and for medicinal uses, and the community reports that a decline in the turtle populations has been observed near Tharu settlements. Therefore, we argue that an escalation of public awareness and policy advocacy is essential, particularly in rural areas where Tharu communities live, to ensure the survival of these reptiles in the face of mounting anthropogenic challenges.

Although gender diversity management (GDM) practices in the so-called Global North have seen success, gender equality remains elusive, especially in culturally complex Global South regions such as the Middle East, in which these practices often overlook local disparities. This study examines women’s lived experiences of diversity and equality in two public-sector higher education institutions in Saudi Arabia, employing Amartya Sen’s capabilities approach to explore the alignment between organisational policies and women’s substantive freedoms to achieve valued outcomes. Based on semi-structured interviews with 34 women, the findings reveal three context-specific gaps in Saudi Arabia’s GDM practices: (1) a disconnect between organisational policies and women’s lived realities, (2) inequitable access to opportunities and favouritism towards women with privileged networks, and (3) superficial policy advocacy and implementation that fails to challenge systemic barriers. To address these challenges, this study introduces polychronous GDM, a framework that operationalises the capabilities approach by advocating flexible, phased human resource management (HRM) interventions responsive to immediate and evolving inequalities while sensitive to local sociocultural and institutional contexts. Situated within international debates on gender equality, this study advances the strategic HRM literature by critiquing one-size-fits-all GDM and the power dynamics perpetuating workplace inequalities, proposing polychronous GDM as a transformative, context-sensitive framework for advancing gender equality in the Global South.

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment-needed within hours to achieve best outcomes-remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial intelligence-assisted robots for thrombectomy. Objectives included standardizing effectiveness metrics and defining reference testbeds across in silico, invitro, exvivo, and invivo environments. To achieve this, we convened experts in neurointervention, robotics, data science, health economics, policy, statistics, and patient advocacy. Consensus was built through an incubator day, a Delphi process, and a final position statement. We identified that the 4 essential testbed environments each had distinct validation roles. Realism requirements vary: simpler testbeds should include realistic vessel anatomy compatible with guidewire and catheter use, whereas standard testbeds should incorporate deformable vessels. More advanced testbeds should include blood flow, pulsatility, and disease features, such as atheromatous plaques. There are 2 macroclasses of effectiveness metrics: one for in silico, invitro, and exvivo stages focusing on technical navigation (eg, path-following error), and another for invivo stages, focused on clinical outcomes (eg, modified treatment in cerebral infarction scores). Patient safety is central, and not a barrier, to this technology's development. One requisite patient safety task needed now is to correlate invitro measurements to invivo complications.

This Spotlight article explores opportunities for the use of generative artificial intelligence (AI) to support real-world eating disorders (ED) prevention policy advocacy campaigns. Through two case studies, we illustrate ongoing applications of generative AI to enhance core activities to drive public health policy advocacy campaigns. Case Study 1 describes an interactive, sociotechnical system that trains community advocates for effective legislative advocacy. Case Study 2 discusses an online chatbot that supports legal research into statute, case law, and proposed legislation. Generative AI can power applications that can scale public health policy advocacy training and improve understanding of legal contexts. When deployed properly, they can reduce time spent on manual legal research and enhance policy advocacy skills and strategy. Generative AI offers practical solutions for strengthening community-based public health policy advocacy. When integrated with established public health advocacy frameworks, these tools can help advocacy teams scale training efforts and garner strategic insights for robust advocacy campaigns.

Sustainable development calls for extending the creative and responsive capacities of civil society to develop and employ social-change approaches that are feasible within the confines of current political and cultural contexts. Enhancing civil society offers a key strategic pathway for advancing the United Nations (UN) Sustainable Development Goals (SDGs). However, there has been a void in research to date that is aimed at identifying specific and promising non-governmental organization (NGO) influence approaches that promote SDGs. With foreign-donor support, Vietnam has experienced a “mushrooming” and strengthening of registered and unregistered civic development organizations. Although progress is being made and procedural equity is advancing, NGO efforts still exert a limited impact in bringing about equitable community and social development in Vietnam. In general, local NGO social-development roles are constrained by “uncertain and unpredictable” operational implementation of Government regulations and by the lack sustainable funding as well as office and administrative support. Based on insights from interviews with the leaders of two Vietnamese NGOs that stand out in terms of the distinctively strategic influence methods they employ, this contribution introduces and conceptually analyzes several promising civil-society-organization approaches to social and community development in Vietnam. The two highlighted culturally, socially, and politically sensitive NGOs offer inspiring influence methods s that possess potential for wider application. The study findings suggest that implementation by Vietnamese civil-society organizations (CSOs) of action approaches that employ broad-based equality appeals, strategic communication, collaborative community relationships, network coordination, and enhanced and sustained multi-level policy advocacy offer promising pathways forward.

Recent digital platforms have also changed the nature of citizen interaction within foreign policy, particularly as it concerns the Israel-Palestine conflict. This paper explores this debate in the case of online advocacy in Indonesia, highlighting the process of networked boycott diplomacy." In so doing, the state maintains its ceremonial posture in diplomatic forums, whilst a distributed, non-hierarchical network of state, semi-state, and non-state actors leverages social media to advance massive socio-economic boycotts to geo-economic effect. This research employs a qualitative netnographic approach through two datasets of Twitter (X) discourse spanning from January to December 2024. This study fills three important research gaps that stem from the existing literature: the absence of exhaustive mapping of multi-actor engagement in boycott movements; the insufficient theorization of the impact of decentralized digital networks on foreign policy at the level of the nation-state; and the lack of theoretical approaches that conceptualize the hybrid nature of socio-economic boycotts as tools of diplomacy. The results of our analysis demonstrate that the Indonesian digital boycott movement takes shape as a collaborative network of multiple actors, comprising organized interests (e.g., religious institutions, such as the Indonesian Ulema Council [MUI], and journalistic media) and ordinary citizens. Such decentralized connective action is a powerful enabler to mediate between state-centric diplomacy and collective public sentiment. Additionally, the socio-economic ramifications of such boycotts constitute a legitimate form of digital activism that serves as a hybrid diplomatic tool. This paper conceptualizes networked boycott diplomacy," creating a new framework that moves beyond existing paradigmatic notions of public diplomacy to illustrate how the domestic processes of digital mobilization become constitutive of international diplomatic petitions and formations.

ABSTRACT Background Universities are well suited for tobacco-free advocacy efforts; university tobacco policy can change social norms around tobacco use, reduce secondhand smoke exposure, and help prevent occasional tobacco users from transitioning to daily use. Purpose This study took place in 2019 at a Midwestern public regional comprehensive university as part of a campaign to update campus tobacco policy. Researchers sought to increase the visibility of tobacco waste on campus under the current policy. Methods Researchers invited undergraduate students to create collages using nonhazardous tobacco waste collected on campus and participate in focus group discussions about their experiences. After verbatim transcription, researchers conducted template analysis to identify key themes. Results Undergraduate students (N = 16) shared concerns about human health and the natural environment on campus. Though students were passionate about reducing tobacco use on campus, they were uncertain that policy changes would be effective. Discussion In addition to engaging students in advocacy, policy change, and research, collages were displayed on campus and via social media. Students were able to create art to express their feelings about tobacco use and contribute to successful efforts to update university policy. Translation to Health Education Practice Collage can be an effective way to elicit discussion and create powerful visuals to use in advocacy. Engaging young adults in policy advocacy as students and increasing their civic engagement may help them develop skills and self-efficacy for advocacy activities in the future.

Cardiovascular Disease (CVD), which incorporates heart disease and stroke, remains the world's leading cause of death, and the burden across the globe continues to escalate. Cardiovascular nurses play a vital role in reducing the global burden of cardiovascular disease through their multiple leadership opportunities and focus on prevention. From serving as an informal or formal clinical leader, case manager, educator, mentor for emerging cardiovascular nurses or nurse leaders, champion for quality of care, or policy advocate, as examples, cardiovascular nurse leaders can have a profound impact on improving outcomes for individuals, families, and communities. As leaders, cardiovascular nurses must be prepared for their roles through development of leadership competencies to ultimately shape decisions in their settings, whether in clinical care, management, education, advanced practice, and research or through community and professional organizations. This article revisits the competencies required of nurse leaders to be effective in cardiovascular disease prevention and improving outcomes in a changing global healthcare environment. Case scenarios exemplifying leadership competencies in action were also provided.

Cardiovascular disease (CVD) is the leading cause of death and disability globally, disproportionately affecting vulnerable populations, including women and infants. Despite its preventability, CVD continues to be underfunded and overshadowed by cancer in terms of policy attention, creating a significant health inequity. This article advocates for a shift in international health policy to prioritize CVD through targeted, disease-specific interventions and multilevel strategies addressing both modifiable and primordial risk factors. It highlights the crucial role of nurses and healthcare professionals in influencing CVD prevention and treatment, from individual behavior changes to policy advocacy. The article concludes that collaboration across sectors, including healthcare, policymakers, and communities, is essential to implement effective CVD strategies and reduce global mortality and morbidity. Clinically, nurses are positioned to lead in patient education, support community-based initiatives, and advocate for stronger policies to combat CVD worldwide.

Addressing Risks of Violence to Children and Adolescents Through Oregon's Extreme Risk Protection Order Law.

In 2025, widespread sociopolitical changes in the United States deeply influenced the experiences of healthcare professionals, including Black, Indigenous, and People of Color (BIPOC) genetic counselors. Cascading harms, including economic instability, healthcare policy changes, and restrictive immigration and reproductive measures, affected marginalized communities across the country, intersecting with existing social determinants of health. This brief report presents qualitative findings from semi-structured interviews conducted with participants who were enrolled in a longitudinal study about the experiences of BIPOC genetic counselors. The 25 participants were recruited from North American genetic counseling programs in 2022 and interviewed regularly throughout their training and after graduating. These results pertain to one specific question participants were asked in November/December 2025 about how sociopolitical policies had impacted them in their personal or professional lives. Using reflexive thematic analysis, we found that financial strains, changes in insurance and telehealth regulations, and anti-immigration enforcement created barriers to patient care. Distrust and privacy concerns regarding genetic data impacted patient care and research projects. These sociopolitical changes and systemic inequities created emotional burdens for participants, negatively impacting their well-being. While complex and systemic in nature, these challenges underscore the need for genetic counselors and genetic counseling organizations to acknowledge the broader context affecting patients and colleagues, promote supportive environments and dialogue, and advocate for equitable policies. This brief report offers timely insight into how 2025 has impacted the lives of BIPOC genetic counselors.

International vs. domestic climate justice in India: comparing policy beliefs and advocacy coalition during Copenhagen, Paris, and Glasgow climate conferences

Black adults experience diabetes complications and mortality in disproportionate rates in the United States, with barriers to care driven by factors such as limited access to quality healthcare, socioeconomic disparities, racial discrimination contributing to mistrust and health misperceptions, and social determinants of health such as food insecurity. Poor diabetes outcomes occur, in part due to insufficient access to novel diabetes medications and technologies, and low participation in diabetes management education programs. Within care teams across various healthcare settings, limited health literacy, and poor patient-provider communication, often influenced by implicit bias, further hinders effective diabetes management. Peer support, especially when integrated effectively into a multidisciplinary care team, is a promising approach to address these challenges. Peer supporters, individuals with shared lived experience and cultural backgrounds can foster trust, translate medical guidance in lay terms, and provide ongoing and sustained emotional, social, and tangible support. Peer-led interventions reduce diabetes distress and improve self-efficacy, medication adherence, and clinical outcomes, especially when tailored for Black adults. To effectively integrate peer supporters into care teams, defined roles, structured workflows, and strategically engaging them in patient care planning and team meetings is needed. Comprehensive and robust training, certifications, and continuing education ensure their competence, while maintaining role authenticity. Visibility within clinic and healthcare spaces, role clarity, administrative support, funding and continuous evaluation enhance the sustainability of peer supporters. Facilitators of their role include policy advocacy and funding avenues including Medicaid and Medicare reimbursements. Future efforts should focus on policy reforms to address structural inequities, support the expansion of peer supporters within care teams, including focused roles to thrive professionally, and establish sustainable models through participatory designs and robust evaluations. To address diabetes inequities in Black adults, culturally tailored peer support within multidisciplinary teams is critical, requiring collaborative engagement of healthcare systems, communities, and policy makers.

The revision of the 2025 TNI Law raises concerns about expanding military authority into civilian domains and weakening civilian supremacy. The Akbar Faizal Uncensored podcast serves as a discursive arena for public criticism of these developments. This study employs Van Dijk’s Critical Discourse Analysis covering text, social cognition, and social context using document study and note-taking techniques. The discourse centers on the theme “The TNI Law for Generals,” supported by diction, argumentation, and rhetorical strategies. Informants’ social cognition reflects a pro-democracy perspective, while the social context underscores the role of digital media in facilitating state critique. Findings reveal risks of strengthening OMSP, reviving ABRI’s dual function, and restricting civilian space. The analysis highlights the need for a democratic reassessment of the 2025 TNI Law. Academically, the study enriches CDA scholarship in the digital era; practically, it informs policy advocacy and democracy literacy.

The importance of young surgeons in surgical health policy advocacy engagement.