Public Health Information Research Articles

Manifestation of leech infestation as severe gastrointestinal bleeding in a 3-year-old boy: a case report and review of the literature

Leeches are a class of hermaphroditic parasites that can attach to various body parts and start sucking blood. Gastrointestinal (GI) bleeding due to leeches is a rare phenomenon that is more common in less developed countries. Common symptoms include melena, hematemesis, pallor, weakness, and fatigue. Due to the similar symptoms of this issue to the main differential diagnoses of GI bleeding in pediatrics, such as diarrhea, constipation, diverticulitis, esophagitis, and anal fissures, it is challenging to differentiate it from the rest. We present a three-year-old boy who was transferred to our center with hematemesis, tarry stool, and a drop in hemoglobin level. He finally was diagnosed with a leech in his stomach. In less developed counties, the inability to reach safe drinking water, swim in lakes or springs, and inadequate awareness of public health information among individuals can be risk factors for leech infestation.

Synthetic Biology: State Regulation in the Biomedical Context

Synthetic biology is an emerging, interdisciplinary research field with much promise for biomedicine. Broadly defined as "the design and construction of new biological systems to perform specific tasks," researchers and clinicians are using synthetic biology to develop targeted treatments for cancer, coronaviruses, and so forth. Because of the experimental nature of synthetic biology, regulation is necessary. Current federal frameworks, such as the Food, Drug, and Cosmetics Act, The Toxic Substances Act of 1976, Institutional Review Boards, and self-regulation are not enough. As a result, states have a unique opportunity to develop statutory and regulatory frameworks to develop a pathway for regulating synthetic biology. In developing legislation, state lawmakers should look to build a comprehensive framework that addresses businesses selling technology for synthesizing DNA codes, monitors orders for synthetic DNA, and develops statewide documentation systems. Additionally, public health information on treatments using synthetic biology can help to educate the public and reduce the prevalence of misconceptions about the technology. In the absence of federal regulation, states should step into the synthetic biology regulatory space to ensure that their citizens are not harmed by therapies developed using synthetic biology.

Information sources, trust and public health sector communication on the Covid-19 pandemic

Introduction: In the context of infodemic disorder Covid-19 pandemic is a health emergency which also became a communication one. Objectives: The research purpose was to understand how Italians have informed themselves about the pandemic, which sources they have mainly used, and their assessments of public health sector communication at a national and local level. Methodology: The quantitative research consists of a survey conducted through telephone interviews (CATI+CAMI techniques) with a structured questionnaire to a sample of Italians in June and July 2021. Results: On average, watching TV, talking with friends, relatives, or acquaintances, and consulting the Internet are the leading ways of gaining information on the pandemic. Official online sources of information are the most used, followed by institutional websites which played a leading role during the pandemic: regions, the Ministry of Health, and the Presidency of the Council of Ministers. 34% of respondents claim to consult official social media pages or messaging apps of national or local authorities. Conclusions: In the pandemic communication, Italians recognize the crucial role of national and local authorities and online information media systems, but diverse challenges are open for the future of public health sector communication.

Big Data in Health Information Systems

In the healthcare sector, Information Systems are fundamental for decision-making at all levels. This process can be strengthened with the implementation of Big Data analytics. In this context, the present study aims to describe the experiences, benefits, and applications of Big Data in Health Information Systems through a systematic literature review. The research reviewed 22 studies on the use of Big Data in the healthcare sector, applying inclusion and exclusion criteria to select relevant studies. The results of these studies indicated that the use of Big Data in healthcare can improve the quality of teleassistance services for patients, as well as logistics and financial services. It can also prevent diseases and improve patient care in public health information systems. Additionally, it can provide new knowledge and actionable information from new data sources, and promote the natural transformation of descriptive research into predictive and prescriptive research. The studies also highlighted the importance of Artificial Intelligence for data to be useful for research and medical purposes. In general, the research concluded that Big Data has a favorable impact on the healthcare sector, especially in biomedical research, and that its use can improve the efficiency and quality of medical care.

PUBLIC HEALTH INFORMATICS IN RECENT TRENDS

Public health informatics (PHI) as the name suggests, it is the inculcation of the Computer Science and Information Technology in the Health Sector to improve the Health Standards of the General Public. It became useful and handy in many of the critical health related disease situations. The data which is collected from the general public is used for many purposes like research, analysis, practice and developing of Health Care Systems in the region. Keywords: Public health, Healthcare system, Health Standards, Health information sector

Childhood Influenza Vaccination and Its Determinants during 2020-2021 Flu Seasons in China: A Cross-Sectional Survey.

Young children aged 6−59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020−2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77−3.54), safety (OR: 1.60; 95%CI: 1.29−1.99), and effectiveness (OR: 1.54; 95%CI: 1.23−1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00−1.77), family members, or friends (OR: 1.30; 95%CI: 1.14−1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions.

Community Health Workers in Time of Crisis: A COVID-19 Case Study

This article focuses on the lived experiences of those implementing community health worker (CHW) programs during the COVID-19 pandemic. Based in an upper mid-west state, this qualitative case study is bounded by the state-level context and two distinct local case sites—one rural and one urban—and includes the experiences of five CHWs, two program directors, and a state-level administrator. The acute crisis response galvanized the ongoing need for CHWs, not only because they are trusted health messengers, but because they advocate for—and organize with—communities to address inequalities and inform public health institutions. Author-practitioners described personal and community identity as intertwined, a perspective in solidarity with decolonized approaches to humanistic psychology. Highlights discussed include: (a) Personal relationships motivated author-practitioners to join the pandemic response; (b) All pandemic response efforts were interconnected with social determinants of health; (c) The pandemic was as an opportunity to do things differently with more flexibility, personally and organizationally; and (d) Privately funded opportunities enabled local areas to implement quick responses, which influenced eventual state-level responses. All authors described structural racism as a constant context of this work. This article fills gaps in the literature related to the implementation of crisis responses and CHW programs.

Antibody tests for identification of current and past infection with SARS-CoV-2.

Antibody tests for identification of current and past infection with SARS-CoV-2.

Public understanding and awareness of and response to monkeypox virus outbreak: A cross-sectional survey of the most affected communities in the United Kingdom during the 2022 public health emergency.

Our objective was to examine the public response to public health and media messaging during the human monkeypox virus (MPXV) outbreak in the UK, focusing on at-risk communities. A co-produced, cross-sectional survey was administered in June and July 2022 using community social media channels and the Grindr dating app. Basic descriptive statistics, logistic regression, and odds ratio p values are presented. Of 1932 survey respondents, 1750 identified as men, 88 as women, and 64 as gender non-conforming. Sexual identity was described as gay/lesbian/queer (80%), bisexual (12%), heterosexual (4%), and pansexual (2%); 39% were aged <40 years; 71% self-identified as White, 3% as Black, 8% as Asian, 2%as LatinX, and 11% as 'Mixed or Other' heritage groups. In total, 85% were employed and 79% had completed higher education. A total of 7% of respondents identified themselves as living with HIV. Overall, 34% reported limited understanding of public health information, 52% considered themselves at risk, 61% agreed that people with MPXV should isolate for 21 days, 49% reported they would first attend a sexual health clinic if symptomatic, 86% reported they would accept a vaccine, and 59% believed that MPXV originated from animals. The most trusted sources of information were healthcare professionals (37%), official health agencies (29%), and mainstream media (12%). Vaccine acceptability was very high, yet the understanding and acceptance of public health information varied. Social determinants of health inequalities already shaping the UK landscape risk were compounded in this new emergency. Engagement with structurally disadvantaged members of affected communities and better dissemination of public health messaging by trusted healthcare professionals are essential for the public health response.

Vaccine-hesitant individuals accumulate additional COVID-19 risk due to divergent perception and behaviors related to SARS-CoV-2 testing: a population-based, cross-sectional study

PurposeTo investigate the perception of SARS-CoV-2 detection methods, information sources, and opinions on appropriate behavior after receiving negative or positive test results.MethodsIn a questionnaire-based, cross-sectional study conducted between September 1 and November 17, 2021, epidemiological, behavioral, and COVID-19-related data were acquired from the public in Munich, Germany.ResultsMost of the 1388 participants obtained information from online media (82.8%) as well as state and federal authorities (80.3%). 93.4% believed in the accuracy of SARS-CoV-2 PCR testing and 41.2% in the accuracy of rapid antigen tests (RATs). However, RATs were preferred for testing (59.1%) over PCR (51.1%). 24.0% of all individuals were willing to ignore hygiene measures and 76.9% were less afraid of SARS-CoV-2 transmission after receiving a negative PCR test (5.9% and 48.8% in case of a negative RAT). 28.8% reported not to self-isolate after receiving a positive RAT. Multivariate analyses revealed that non-vaccinated individuals relied less on information from governmental authorities (p = 0.0004) and more on social media (p = 0.0216), disbelieved in the accuracy of the PCR test (p ≤ 0.0001) while displaying strong preference towards using RATs (p ≤ 0.0001), were more willing to abandon pandemic-related hygiene measures (p ≤ 0.0001), less afraid of transmitting SARS-CoV-2 after a negative RAT (p ≤ 0.0001), and less likely to isolate after a positive RAT (p ≤ 0.0001).ConclusionInsights into preferred information sources as well as perception, preferences, and behavior related to SARS-CoV-2 testing and hygiene measures are key to refining public health information and surveillance campaigns. Non-vaccinated individuals’ divergent believes and behaviors possibly increase their COVID-19 risk.

COVID-19 vaccine acceptance among pregnant women attending antenatal care in public hospitals in eastern Ethiopia: A multi‐center facility‐based cross‐sectional study

ObjectivesThe Ethiopian government had planned to vaccinate the total population and started to deliver the COVID-19 vaccine but, there is limited evidence about vaccine acceptance among pregnant women. Thus, this study aimed to assess COVID-19 vaccine acceptance and associated factors among pregnant women attending an antenatal care unit clinic in Eastern Ethiopia. Study designA facility-based cross-sectional study. MethodsA study was conducted from June 01 to 30/2021 among systematically selected pregnant women. Data were collected using a pre-tested structured questionnaire, which was adapted from previous studies, through a face-to-face interview. Predictors were assessed using a multivariable logistic regression model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value less than 0.05. ResultsIn this study, data from 645 pregnant women were used in the analysis. Overall, 62.2% of pregnant women were willing to be vaccinated if the vaccine is approved by the relevant authority. Fear of side effects (62.04%), a lack of information (54.29%), and uncertainty about the vaccine's safety and efficacy (25%) were the most common reasons for refusal to take the COVID-19 vaccine. The odds of unwillingness to accept the COVID-19 vaccine among pregnant women were increased significantly among mothers who were able to read and write [AOR = 2.9, 95% CI: (1.16, 7.23)], attain 9-12 grade level [AOR = 4.2, 95% CI: (2.1, 8.5)], lack information [AOR = 2.2, 95% CI: (1.41, 3.57)], and having a history of chronic diseases [AOR = 2.52, 95% CI: (1.34, 4.7)]. ConclusionLess than two-thirds of pregnant women were willing to accept the COVID-19 vaccine. Extensive public health information dissemination aimed at women with lower educational backgrounds and a history of chronic disease could be critical.

Social Media-Based Surveillance Systems for Healthcare using Machine Learning

One of the most popular domains that have caught the attention of researchers is real-time surveillance in the health and informatics segment. Many initiatives have been discovered due to this real-time surveillance surrounding public health informatics. Real-time surveillance in the health and informatics field has used the information from social media to predict the outbreak of diseases as well as to look after the diseases. There is no doubt in the fact that the availability of the data from social media in the recent past, especially the data from Twitter, has offered the researchers real-time syndromic surveillance in making quick analyses and conclusions in investigating the disease outbreak. The paper will get to know about the recent work of machine learning trends and text classification that has been utilized by the surveillance system by using the data from social media in the field of healthcare. Apart from this, the paper has also discussed the various limitations and challenges by taking into account the future direction that can be considered in this domain further.

Impact of Mass Media on Attitude and Practice of Public Health Knowledge among Urban Population of Bangladesh

This descriptive type of cross-sectional study was conducted among 180 persons of different socio-economic conditions of Dhaka city using semi-structured questionnaire through face-to-face interview to identify the impact of mass media in disseminating public health related messages to the urban population of Bangladesh. Convenience sampling was the process of selecting the subjects. Among 180 respondents mean age of the respondents was 28.75±8.55 years. Majority of the respondents were graduate (29.0%). Of the total 180 respondents 121 (67.2%) read newspaper and among them, 46 (38.32%) read Public Health related articles in the newspaper regularly. On the other hand out of the total 180 respondents 170 (95.0%) watch television and of them 36 (21.18%) watch public health related programme in the television regularly. Highest 140 (77.8%) respondents said television as the source of information in TB prevention. Majority (90%) of the respondents said of television as the information source on prevention of diarrhoeal diseases. Magazine and internet were mentioned by 20 (11%) respondents in each group as the information source. Regarding the sources of information on pregnancy related problems and solutions television was mentioned as the source of information by 156 (86%) of the respondents. Friends or relatives or teachers (67%), newspaper (64%), billboard (45%) and radio (44%) were other sources. Television was found as the main source of public health information to the people. Impact of print media in disseminating public health messages was mentioned very satisfactory by 24% and electronic media by 77% respondents. The mass media can be very much effective in getting public health messages to the community in developing countries. In view of our findings, it may be recommended that television, newspaper and billboards may be used as tools for reaching out that the use of these media should be strengthened further.&#x0D; EMCJ. January 2022; 7(1): 21-25

Public health community engagement with Asian populations in British Columbia during COVID-19: towards a culture-centered approach

ObjectivesCOVID-19 has posed significant challenges to those who endeavour to provide equitable public health information and services. We examine how community leaders, advocates, and public health communication specialists have approached community engagement among Asian immigrant and diaspora communities in British Columbia throughout the pandemic.MethodsQualitative interviews with 27 participants working with Asian communities in a healthcare, community service, or public health setting, inductively coded and analyzed following the culture-centred approach to health communication, which focuses on intersections of structure, culture, and agency.ResultsParticipants detailed outreach efforts aimed at those who might not be reached by conventional public health communication strategies. Pre-existing structural barriers such as poverty, racial disparities, and inequitable employment conditions were cited as complicating Asian diaspora communities’ experience of the pandemic. Such disparities exacerbated the challenges of language barriers, information overload, and rapidly shifting recommendations. Participants suggested building capacity within existing community service and public health outreach infrastructures, which were understood to be too lean to meet community needs, particularly in a pandemic setting.ConclusionA greater emphasis on collaboration is key to the provision of health services and information for these demographic groups. Setting priorities according to community need, in direct collaboration with community representatives, and further integrating pre-existing bonds of trust within communities into public health communication and engagement strategies would facilitate the provision of more equitable health information and services. This mode of engagement forgoes the conventional focus on individual behaviour change, and focuses instead on fostering community connections. Such an approach harmonizes with community support work, strengthening the capacity of community members to secure health during public health emergencies.

The COVID HOME study research protocol: Prospective cohort study of non-hospitalised COVID-19 patients.

Guidelines on COVID-19 management are developed as we learn from this pandemic. However, most research has been done on hospitalised patients and the impact of the disease on non-hospitalised and their role in transmission are not yet well understood. The COVID HOME study conducts research among COVID-19 patients and their family members who were not hospitalised during acute disease, to guide patient care and inform public health guidelines for infection prevention and control in the community and household. An ongoing prospective longitudinal observational study of COVID-19 outpatients was established in March 2020 at the beginning of the COVID-19 pandemic in the Netherlands. Laboratory confirmed SARS-CoV-2 infected individuals of all ages that did not merit hospitalisation, and their household (HH) members, were enrolled after written informed consent. Enrolled participants were visited at home within 48 hours after initial diagnosis, and then weekly on days 7, 14 and 21 to obtain clinical data, a blood sample for biochemical parameters/cytokines and serological determination; and a nasopharyngeal/throat swab plus urine, stool and sperm or vaginal secretion (if consenting) to test for SARS-CoV-2 by RT-PCR (viral shedding) and for viral culturing. Weekly nasopharyngeal/throat swabs and stool samples, plus a blood sample on days 0 and 21 were also taken from HH members to determine whether and when they became infected. All participants were invited to continue follow-up at 3-, 6-, 12- and 18-months post-infection to assess long-term sequelae and immunological status.

Health information seeking on social media: the diversification approach

PurposeInternet studies have rarely addressed gender and/or ethnic differences in health information seeking on social media. Moreover, the role of locality size in explanation of this phenomenon has been overlooked. This study proposed a diversification approach to address these issues. According to it, belonging to numerous disadvantaged groups increases the probability of health-related Internet/social media use.Design/methodology/approachThe data were collected via telephone survey. The sample consisted of 798 Israeli Internet users who reported using social media for any purpose, gender, ethnic affiliation and locality of residence. The data were analysed using a logistic regression technique.FindingsArab female social media users, who resided in small localities, were more likely than the other studied social groups to seek both non-medical and medical information on social media. Furthermore, Arab female social media users were found having the highest likelihood among all studied social groups to seek information regarding physical activity and medications on social media.Practical implicationsThe findings largely supported the diversification approach and signal a major need for a greater supply of public health information for members of minority groups, especially those residing in small localities.Originality/valueThe study investigates triple social disadvantage in health-related social media use.

Linking Lyme disease ecology and epidemiology: reservoir host identity, not richness, determines tick infection and human disease in California

Understanding the community ecology of vector-borne and zoonotic diseases, and how it may shift transmission risk as it responds to environmental change, has become a central focus in disease ecology. Yet, it has been challenging to link the ecology of disease with reported human incidence. Here, we bridge the gap between local-scale community ecology and large-scale disease epidemiology, drawing from a priori knowledge of tick-pathogen-host ecology to model spatially-explicit Lyme disease (LD) risk, and human Lyme disease incidence (LDI) in California. We first use a species distribution modeling approach to model disease risk with variables capturing climate, vegetation, and ecology of key reservoir host species, and host species richness. We then use our modeled disease risk to predict human disease incidence at the zip code level across California. Our results suggest the ecology of key reservoir hosts—particularly dusky-footed woodrats—is central to disease risk posed by ticks, but that host community richness is not strongly associated with tick infection. Predicted disease risk, which is most strongly influenced by the ecology of dusky-footed woodrats, in turn is a strong predictor of human LDI. This relationship holds in the Wildland-Urban Interface, but not in open access public lands, and is stronger in northern California than in the state as a whole. This suggests peridomestic exposure to infected ticks may be more important to LD epidemiology in California than recreational exposure, and underlines the importance of the community ecology of LD in determining human transmission risk throughout this LD endemic region of far western North America. More targeted tick and pathogen surveillance, coupled with studies of human and tick behavior could improve understanding of key risk factors and inform public health interventions. Moreover, longitudinal surveillance data could further improve forecasts of disease risk in response to global environmental change.

An online community peer support intervention to promote COVID-19 vaccine information among essential workers: a randomized trial

Introduction Vaccine hesitancy is still rampant in the United States, including health care personnel. Vaccination of frontline essential workers (e.g. health care workers) is very important, especially during a pandemic. We tested the efficacy of a 4-week online, peer-led intervention (Harnessing Online Peer Education) to promote requests for COVID-19 vaccine information among essential workers. Methods Participants (N = 120) and peer leaders (N = 12) were recruited through online advertisements from July 23 to August 20, 2021. Eligibility criteria included: 18 years or older, U.S. resident, English speaker, part of phase 1a or 1 b of COVID-19 vaccine rollout (e.g. frontline essential workers), hadn’t received a COVID-19 vaccine but able to receive one. This was a parallel assignment randomised trial. STATA was used to create a randomisation using a random number generator so that all possible assignments of participants and peer leaders to groups were equally likely. Participants were randomly assigned to intervention or control arms that consisted of two private, hidden Facebook groups, each with 30 participants. Peer leaders were randomly assigned to an intervention group, each with six peer leaders. Participants in the intervention arm were randomly assigned to three peer leaders. Participants were blinded after assignment. Peer leaders were tasked with reaching out to their assigned participants at least three times each week. Participants completed a baseline and a post intervention survey. The study is registered on ClinicalTrials.org under identifier NCT04376515 and is no longer recruiting. This work was supported by the NIAID under grant 5R01AI132030-05. Results A total of 101 participants analysed (50 intervention and 51 control). Six people in the intervention group and 0 people in the control group requested vaccine information. Ten people in the intervention group and six people in the control group provided proof of vaccination. The odds of requesting vaccine information in the intervention group was 13 times that in the control group (95% confidence interval: (1.5, 1772), p-value = 0.015). Thirty-seven participants in the intervention group and 31 in the control group were engaged at some point during the study. Conclusions Results suggest peer-led online community groups may help to disseminate health information, aid public health efforts, and combat vaccine hesitancy. Key Messages The odds of requesting vaccine information was 13 times in the intervention group. Peer-led online communities may help to disseminate information and aid public health efforts to combat vaccine hesitancy.

Temporal trends in anxiety and depression prevalence and their association with adverse outcomes in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease in Beijing, China, from 2004 to 2020.

To investigate the temporal trend in anxiety and/or depression prevalence in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing and their association with adverse outcomes. Hospital admission records from 2004 to 2020 with a primary discharge diagnosis of AECOPD were retrieved from Beijing Public Health Information Centre database. The anxiety and depression were identified from discharge diagnoses of each record. Joinpoint regression was used to analyze the temporal trend and calculate the annual percentage change (APC) for the prevalence of anxiety and/or depression. Generalized linear model was used to analyze the associations between anxiety and/or depression and patients' adverse outcomes. A total of 382,125 records were included, most of which were male (66.0%) and aged ≥ 75 years (59.7%). Three segments in the temporal trend were observed, with a mild increase during 2004-2009 (APC: 5.9%, 95% CI: -14.9 to 31.7%), followed by a sharply increase during 2009-2012 (APC: 60.4%, 95% CI: 10.6 to 132.7%), then stabilized at about 3% during 2012-2020 (APC: 1.9%, 95% CI: -0.4 to 4.3%). On average, anxiety, and/or depression was more prevalent in females, the aged and those admitted in secondary hospitals (all P < 0.001). Patients with anxiety and/or depression had lower in-hospital mortality (IHM) (OR = 0.74, 95% CI: 0.63-0.88), but longer hospital stay (OR = 1.10, 95% CI: 1.07-1.13), more medical costs (OR = 1.12, 95% CI: 1.08-1.17) and higher risks of readmission for AECOPD at 30-, 90-, 180-day, and 1-year (ORs ranged from 1.22 to 1.51). The prevalence of anxiety and/or depression in patients hospitalized for AECOPD in Beijing stabilized at approximately 3% after 2012. Anxiety and/or depression is associated with a heavier burden on patients, health care, and medical insurance systems. Appropriate diagnosis and effective treatment of anxiety and depression is crucial for patients with AECOPD.

Mask communication: The development of the face covering as a semiotic resource through government public health posters in England and Wales

This paper will explore the multi-modal semiotic properties of a selection of key public health information posters issued by the UK Westminster government on the use of masks and face coverings during the first year of the COVID-19 pandemic. Using multi-modal critical discourse analysis, we show how the posters featuring masks sustained consistent government-led branding, while drawing upon what we describe as “synthetic personalisation” to manage the orientation of the crisis as the pandemic progressed. Through this analysis, the article will highlight the possible contribution of these posters to an environment characterised by political confusion and enabling of a relatively widespread rejection of mask-wearing as a public health responsibility. Examining this within a broader decline in trust in government, we suggest the various attempts to produce a positive message about mask-wearing contributed instead to the appropriation of masks as symbols of individual alignment within a contested political field.