Public Efforts Research Articles

Determinants and patterns of self-medication: A comprehensive literature review

Background- Self-medication is a major public health concern practiced worldwide. Research indicates that improper self-medication leads to adverse drug reactions, masks underlying diseases, results in incorrect diagnoses, escalates morbidity, contributes to drug interactions, fosters antibiotic resistance, and strains resources within the healthcare system. Many studies on self-treatment have been published for certain countries or diseases, in addition to specific demographics, including teenagers, senior citizens, and medical pupils. The issue of self-treatment and related antibiotic resistance poses a serious threat to global public health, as there has been a reported rise in self-medication practices over the past ten years. To obtain a thorough yet equivalent awareness of related issues and to make more definitive and practical conclusions for future action planning than those derived from reviews on the topic, it may be beneficial to integrate the current global self-medication data. Therefore, we set out to undertake a study to fully understand the prevalence, sample demographics, medications consumed, target ailment, and reasons for self-medication. Methods-Using the terms "self-medication, “Factors associated with it," and "non-prescription," a systematic review of the literature on self-medication practices was conducted using the databases PubMed, Medline, and Web of Science. The search was limited to cross-sectional study articles published between 2018 and 2022. Results- This analysis comprised 23 studies comprising 8,445 individuals in total. Headache, pain, and fever were shown to be among the most prevalent indications for self-treatment, followed by cold and cough. A summary of 20 studies inferred that Analgesics, antipyretics, and NSAIDs were the most self-practiced medications. Conclusion- Self-medication is widely practiced worldwide. It is critical to control and oversee appropriate self-medication practices through the enactment of strict laws and the involvement of legislators and medical experts. Large-scale public health awareness efforts on a variety of platforms, efficient medication distribution regulation, and legal proceedings against medical malpractice should all receive a great deal of attention. More cross-sectional studies employing a standard methodological framework are needed to have a deeper understanding of the incidence and practices of self-medication worldwide.

Examining Circumstances Surrounding Fatal Pediatric Heatstroke in the United States

Fatal Pediatric Vehicular Heatstroke (PVH) is a preventable tragedy that claims the lives of an average of 38 children each year. The purpose of this article is to explore the relationship between fatal Pediatric Vehicular Heatstroke incidents and various circumstantial factors. Data was collected through customized online searches of electronic media using tools such as Google News and Lexis-Nexus. A set of linear regression analyses were conducted to examine the relationship between fatal PVH and three circumstantial variables: geographic region, time of day, and outside temperature. The finding show that specific U.S. Regions, Time of Day, and Outside Temperature significantly predicted fatal Pediatric Vehicular Heatstroke (PVH). Understanding these relationships can aid in the development of more targeted prevention technologies, legislation, and public education efforts aimed at reducing the risk of fatal PVH within the United States.

One Health in Europe: from concept to practice

Abstract The One Health concept is a comprehensive approach that highlights the interconnectedness of human, animal, and environmental health. Understanding these interrelationships is essential for effectively managing and mitigating emerging health threats. This approach emphasizes that health issues arise from a complex web of interactions involving humans, animals, and ecosystems. Emerging health threats, such as zoonotic diseases (e.g., mpox, Ebola, avian influenza), antibiotic resistance, and environmental degradation, pose significant risks to global health. Zoonotic diseases, which are transmitted between animals and humans, highlight the direct links between animal and human health. The increase in antibiotic resistance, driven by overuse in both human medicine and livestock farming, leads to the rise of resistant pathogens. Environmental issues like climate change, deforestation, and pollution further exacerbate these threats by altering habitats, disrupting ecosystems, and affecting disease vectors. Addressing these interconnected challenges requires a unified approach that integrates human, animal, and environmental considerations. For example, climate change can shift the distribution of disease vectors like mosquitoes, leading to the spread of diseases such as malaria and dengue fever. Likewise, deforestation can heighten the risk of zoonotic spillover by bringing humans into closer contact with wildlife. 1. To tackle these complex challenges, several measures are crucial: • Integrated surveillance systems Developing systems that monitor human, animal, and environmental health data collectively can improve early detection of outbreaks. Sharing information across sectors is a prerequisite for effective identification of emerging threats. • Strengthening veterinary and public health collaboration Joint research, surveillance, and outbreak management efforts can lead to a more coordinated approach to health emergencies. • Promoting One Health education and training Educating professionals in various fields fosters a collaborative approach to health issues. Training programmes can build a shared understanding of health interconnections. • Implementing sustainable environmental practices Adopting sustainable practices to address environmental degradation helps reduce risks associated with habitat destruction and pollution. • International collaboration and agreements facilitate resource sharing, information exchange, and best practices. 2. To enhance public health strategies within the One Health framework: • Enhance interdisciplinary research Promote research on the intersections of human, animal, and environmental health to understand how changes in one area affect others and to develop more effective interventions. • Foster community engagement Engage communities to improve the adoption of preventive measures and build resilience against health threats through public awareness and community-based programs. Leverage technology and innovation Innovations can offer valuable insights such as data analytics, remote sensing, and genomic surveillance. In our upcoming plenary session, experts from veterinary and public health sciences will present practical examples on One Health collaboration in Europe and discuss how to address challenges in implementing the approach. Moderator Ricardo Mexia Chair of the 17th EPH Conference 2024, President EUPHA Infectious diseases control section Keynote speaker Lorena Boix Deputy Director-General, Directorate General for Health and Food Safety (DG SANTE), European Commission Speakers/Panellists Stef Bronzwaer Cross-Agency One Health Task Force, European Food Safety Authority (EFSA) Barbara Häsler Royal Veterinary College, UK Susana Guedes Pombo Chief Veterinary Officer, Portugal, President World Organization for Animal Health (WOAH) Eva Zažímalová Member of European Commission's Group of Chief Scientific Advisors, Professor of Plant Anatomy and Physiology, Charles University, Czech Republic

Prevalence of E-Cigarettes in Children and Adolescents: A Failure of Public Health Prevention

The rising prevalence of e-cigarette use among children and adolescents poses a significant challenge to public health prevention efforts. As these electronic nicotine delivery systems gain popularity among youth, concerns about the health impacts and long-term consequences have escalated. In this article, we delve into the concerning trends of e-cigarette use among the younger population, exploring the factors driving this phenomenon and evaluating the failures in current public health prevention strategies. By examining the regulatory gaps in e-cigarette marketing to the youth and proposing interventions to combat this growing issue, we aim to shed light on the urgent need for stronger policies and enforcement mechanisms to protect the health and well-being of our youth.

Diplomasi Publik Cina terhadap Indonesia dalam Festival Kue Bulan Tahun 2023

The Mooncake Festival is one of China's public diplomacies through cultural activities towards Indonesia. On September 27, 2023, the Chinese Government, through its Ambassador in Indonesia, held a Mooncake Festival with the theme "Celebrating the Mid-Autumn Festival with Full Flower and Full Moon". This festival is momentum for the Chinese Government to introduce the Mooncake Festival as one of the biggest celebrations in Chinese culture to the Indonesian people. This study aims to examine China's public diplomacy efforts towards Indonesia through the 2023 Mooncake Festival. This study uses a qualitative method, with primary and secondary data sources and qualitative descriptive analysis techniques. By utilizing the concept of public diplomacy from Ingrid D'Hooge, the conclusion of this study is the implementation of China's public diplomacy towards Indonesia through the 2023 Mooncake Festival involves many non-state actors and developing and launching strategies that focus on its culture by introducing Chinese culture to Indonesia. Not only that, China also uses publication media to implement China's public diplomacy toward Indonesia's success through the 2023 Mooncake Festival.

Nafion/graphite-bismuth nanoplate with a vibration unit for portable heavy metal ion detection

Contamination of natural resources, particularly water sources, by heavy metal ions, even at low concentrations, poses a significant threat to ecosystems and human health, underscoring the importance of developing sensors with point-of-use (POU) applications. To that end, a vibration-unit-equipped portable electrochemical system (vPES) capable of extremely sensitive detection of Pb2+ and Cd2+ in water is reported herein. The vibration unit enhances sensitivity by facilitating sample diffusion, and its compactness makes it suitable for point-of-use applications through mobile phone connectivity. The system also integrates Nafion and a graphite/bismuth-nanoplate-functionalized screen-printed carbon electrode to detect heavy metals efficiently. The approach implemented in this study and validated through experiments and simulations suggests that vibration-based mixing leads to 540 % and 511 % higher Pb2+ and Cd2+ detection efficiencies, respectively, than those in the absence of vibration. Additionally, the sensor exhibits the limits of detection of 0.98 and 1.65 nM for Pb2+ and Cd2+, respectively, in laboratory environments. Samples collected from the Nakdong River in Korea and real environmental specimens—freshwater, soil, and serum—validate the detection performance. Overall, this study highlights the potential of vPES as a rapid, sensitive POU sensor for heavy metal detection, thereby bolstering environmental and public health monitoring efforts.

"Should I let them know I have this?": Multifaceted genetic discrimination and limited awareness of legal protections amongst individuals with hereditary cancer syndromes.

Hereditary cancer syndromes (HCS), such as Hereditary Breast and Ovarian Cancer Syndrome (HBOC) and Lynch Syndrome (LS), represent approximately 10% of all cancers. Along with medical burdens associated with the genetic risk of developing cancer, many individuals face stigma and discrimination. Genetic discrimination refers to negative treatment, unfair profiling or harm based on genetic characteristics, manifesting as "felt" stigma (ostracization without discriminatory acts) or "enacted" stigma (experiencing discriminatory acts). This study aimed to describe concerns and experiences of genetic discrimination faced by individuals with HCS. Semi-structured qualitative interviews were conducted with individuals with molecularly-confirmed HCS residing in Ontario, British Columbia and Newfoundland & Labrador, Canada. Purposive sampling was applied to obtain a diverse sample across demographic characteristics. Study procedures were informed by interpretive description; data were thematically analyzed using constant comparison. 73 participants were interviewed (39 HBOC, 34 LS; 51 females, 21 males, 1 gender-diverse; aged 25-80). Participants described multifaceted forms of genetic discrimination across healthcare, insurance, employment, and family/social settings. Participants valued the Genetic Non-Discrimination Act's protective intent, but demonstrated limited knowledge of its existence and provisions. Limited knowledge, coupled with policy constraints in non-legislatable settings and third-party use of proxy genetic information, hindered participants' ability to whistleblow or seek recourse. Our results illuminate a disconnect between intended protective effects of genetic non-discrimination legislation and ongoing genetic discrimination faced by individuals with hereditary conditions. To better support these individuals, this study encourages public outreach and knowledge translation efforts to increase awareness of non-discrimination legal protections.

Smartphones: A Catalyst for Tobacco Control Training in India

The tobacco crisis confronting low- and middle-income countries (LMICs) requires scale-up of effective tobacco control programs, such as Tobacco Free Teachers-Tobacco Free Society (TFT-TFS). We previously demonstrated the efficacy of TFT-TFS in increasing tobacco use cessation among teachers and schools’ adoption of tobacco control policies in Bihar, India. To scale TFT-TFS, we are now pioneering a smartphone-based mobile learning strategy to train principals (or their designees) in Madhya Pradesh to implement and monitor TFT-TFS in schools. Research underscores the transformative potential of mobile learning: a flexible, scalable, and cost-effective alternative to in-person training methods. Our study is a unique opportunity to test a training approach that could have implications for wider and more efficient delivery of other public health programs. The strategic use of gamification and digital storytelling enhances the TFT-TFS mobile training app. Gamification mechanics—including points, leaderboards, and digital badging—foster a dynamic learning environment to enhance learning outcomes. This approach propels continuous participant engagement toward understanding and implementation of TFT-TFS’s six monthly themes and four program components. The TFT-TFS smartphone training program weaves in elements of Indian culture, notably the symbolic use of colors and kites. The Indian kite festival celebrates communal harmony through healthy competition. Similarly, the app employs the idea of school kites, which are divided into six blank segments corresponding to the TFT-TFS monthly themes. Participants navigate each module, engaging with animated videos, digital assessments, and interactive activities. Upon a principal’s successful completion of each monthly theme’s program components, the school’s kite receives a new color, unlocking the subsequent theme. The TFT-TFS smartphone training showcases a unique interactive mobile learning application that integrates gamification and tests how to scale up an effective tobacco control program in schools in India and other LMICs. The TFT-TFS smartphone-based training app may also have relevance to other public health-related training efforts in resource-constrained areas.

Working young adults' engagement with public and workplace health promotion efforts in Singapore: A qualitative study.

Young adults entering the workforce are at increased risk of becoming overweight or obese. Yet, internationally, young adults are rarely targeted in health campaigns, and little is known on how to improve their interest and participation in health promotion efforts. Through 33 semi-structured interviews with young adults working in Singapore, we explored their engagement with existing public and workplace health promotion efforts that encouraged healthy eating and increased physical activity, and their subjective health in the context of their daily lives. Interviews were coded and thematically analysed, taking an inductive and deductive approach. Despite some interest in health messaging, participating working young adults rarely adopted health-promoting activities such as meeting daily recommended servings of fruits and vegetables and exercising regularly. Participants reported that the health promotion campaigns they were aware of, suggested actions that they couldn't incorporate in their lives as they did not address the barriers that they are facing from socio-environmental contributors such as long working hours, personal and social commitments, and the food environment. Furthermore, some considered their health to be good enough and therefore had little reason to change existing practices. Affordable and accessible health screenings were an objective way for young adults to re-evaluate their perceptions of their own health which motivated some to favourably change their behaviours. Our findings suggest that future health promotion campaigns would benefit from more fully addressing some of the existing barriers that young working adults face, in tandem with policy changes to directly tackle the socio-environmental conditions for young workers.

Iranian single-child couples’ perceptions and experiences regarding childbearing incentives

BackgroundThe single-child issue is a significant contributor to population decline, which adversely affects both parents and children. Despite government-approved incentives, the single-child problem remains a major population challenge. This study was conducted to explore the perceptions and experiences of single-child couples regarding childbearing incentives.MethodsThis qualitative study used conventional content analysis and was performed on 21 single-child couples in Mashhad, North East Iran, selected through purposive sampling from urban health centers. Data were collected using semi-structured interviews until saturation was reached. The data were analyzed using the Elo and Kyngas (J Adv Nurs 62(1):107-15, 2008. 10.1111/j.1365-2648.2007.04569.x) method with MaxQDA10 software.ResultsTwo generic categories emerged from the data analysis including (1) “Advertising and providing information as an influencing factor to encourage childbearing”, which included two subcategories of “Attention to the key lever of advertising” and “Necessity of adopting advertising policies and creating a culture of respecting maternal role”, and (2) “Focusing on effective incentive policies”, which consisted of three subcategories of “Adopting incentive policies to reduce people’s financial problems”, “Avoiding punitive policies” and “Need to adopt incentive policies for working women and elites”.ConclusionsIncentive policies should focus on the culture building of the general public, implementing effective incentive policies, and addressing economic challenges, particularly for specific groups such as working women and higher education students. In addition, a public mobilization effort is needed to effectively implement population laws.

Collaborations between Public Library Educators and Practitioners to Apply a Theory of Change and Promote Civic Engagement for Racial Justice in the American South

The Institute of Museum and Library Services’ National Leadership Grants for Libraries program recently awarded a $332,939 grant titled “Civic Engagement for Racial Justice in Public Libraries” (RJ@PL) to the University of Alabama and the Chicago State University. The grant’s purpose is to build the capabilities of public librarians and selected communities to promote civic engagement for racial justice and achieve the following objectives: 1) Assessment of public library efforts to advance racial justice (externally and internally); 2) Operationalization of strategic participatory planning process using a theory of change to develop roadmaps and action plans that further racial justice in select community domains (economy, education, health, etc.); 3) Implementation of key strategic components of information-based offerings in six/eight library settings. This paper reports ongoing collaboration to further the three design components via applying a theory of change for an intended impact of increased community wellbeing resulting from improved racial climate.

Does it matter that an ally is democratic during crises? Public diplomacy and attitudes towards international allies in times of crisis

Abstract Can public diplomacy in times of crisis shape citizens’ attitudes towards international politics? Using a survey experiment in Italy, we evaluated whether information cues about public diplomacy efforts by the United States and China to assist the country in dealing with the COVID-19 emergency shifted the importance citizens attached to Italy’s international allies being democracies. We found that citizens who receive positive cues about USA efforts to assist Italy report a stronger preference for Italy interacting with democracies. At the same time, when they received positive cues about China’s efforts to assist Italy, they discounted the importance attached to international allies being democracies. We further found that these effects are conditional on the participants’ support for democracy at home. We argue that these findings are consistent with a cognitive dissonance framework where citizens update their attitudes to decrease dissonant cognitions when they receive information that challenges prior beliefs or expectations.

Urban Entrepreneurship on the Fringe: Action Research on the Challenges of Street Vendors in Manila

The presence of street vendors in metropolitan cities has been a cause for debate as vending provides these vendors with a source of livelihood but at the expense of regulatory oversight and urban order. Vending as a business emerged due to the lack of work opportunities available despite the growing demand. Vendors, however, remain crucial stakeholders of the informal economy as their existence fills a need for the minimum-income working class. As such, the objective of the study is to determine and understand the different factors that affect the business of street vendors and their coping mechanisms to these challenges and propose an action plan. This study is unique in its focus on the informal economy, specifically street vendors in Manila, an often overlooked yet vital part of urban livelihoods. By employing a qualitative approach, it delves deeply into the lived experiences of street vendors, uncovering the cultural, socioeconomic, and regulatory challenges they face in a highly urbanized Southeast Asian city. The study highlights human-centered narratives often missed in quantitative research and provides valuable insights into the dynamics between street vendors and government regulations. Its findings could influence inclusive policies that better support informal entrepreneurs, contributing to broader discussions on inclusive business practices. The results reveal that factors affecting street vendors relate to interpersonal dynamics, family dynamics and obligations, educational aspirations, financial vulnerability, market competition, operational challenges, supply chain dependency, health and labor, and enforcement of regulations. To manage these factors, vendors have adopted mechanisms to combat these issues through debt and financial management, operational adaptation, community assistance and support, adaptation to regulation, and emotional resilience. In the end, this research proposes a five-point agenda to support street vendors' adherence to social and legal norms, beginning with developing inclusive policies that formally recognize and regulate street vending, ensuring legal protection and designated vending zones. It then focuses on economic empowerment through improved access to financial services, microcredit, and financial literacy programs while introducing social security measures. Health and safety programs are implemented to enhance vendors' well-being, providing access to healthcare, ergonomic training, and sanitation standards. Governance improvements, anti-harassment initiatives, and transparent law enforcement to protect vendors from exploitation should also materialize. Finally, community engagement and public relations efforts aim to foster positive perceptions of street vendors, highlighting their contributions to the economy and encouraging cooperation with local businesses and authorities.

Toward a public outreach and community engagement strategy on cancer in Newfoundland and Labrador: an initial road map and recommendations

Abstract Background: The province of Newfoundland and Labrador has one of the highest incidence and mortality rates for cancer among the Canadian provinces. Sharing accessible knowledge on cancer is an important part of cancer control and population health efforts. However, bringing useful health information and knowledge exchange events to residents requires an efficient and accessible system. Objectives: We aimed to create a road map and recommendations for effective public outreach and community engagement on cancer in Newfoundland and Labrador. Methods: We used the following information, experience, or public engagement tools to gather information to inform our work: discussions with the members of the Public Interest Group on Cancer Research, researchers' experiences with recruitment and knowledge translation activities, feedback provided to 2 public conferences delivered (Public Conference on Genetics delivered in 2020 and Public Conference on Cancer delivered in 2022—where the target audience was general public), and 2 public town halls (one in-person, one virtual) and 2 individual consultation sessions with key stakeholders. Information gathered was then summarized. Results: We identified a rich set of cancer-related topics for which to organize public events on cancer. In addition, a large number of public outreach and engagement options were identified, emphasizing the fragmented, inefficient, and resource-intensive nature of public outreach and community engagement efforts in the province. Based on the information collected, we developed an initial road map and recommendations to inform future public engagement activities and strategies. In addition, our group has started to implement the road map for our current and future public engagement activities. Conclusions: We present key cancer-related topics that are of public interest and issues and opportunities for recruitment and delivery of knowledge and events to residents of Newfoundland and Labrador. This information can be useful for researchers, organizations, and the health care system in the province. However, more inclusive consultations, larger collaborations, funding, and systematic data collection are needed to build a province-wide public outreach network on cancer and to identify more comprehensive public engagement options. The work presented here can potentially guide these efforts. Our work is also expected to inspire other provinces, states, and communities to assess their public outreach status and help develop road maps co-led by patients to progress their public engagement efforts in cancer.

The cost of doing business: Drug costs in federally sponsored cancer clinical trials.

10 Background: Federally sponsored cancer clinical trials (FS-CCTs) address a broad set of clinical cancer research questions that are avoided by industry sponsors, including combining treatment modalities, examining whether approved drugs may work in other cancers, or examining de-escalation therapy. FS-CCTs routinely extend the lives of patients with cancer and inform treatment guidelines. However, FS-CCTs must often be conducted in partnership with industry sponsors since the cost of drugs is high and cannot be paid for by the government. This limits the independence of FS-CCTs. We aimed to examine the drug costs for trials with federal sponsorship. Methods: We included all US-based cancer treatment trials registered in ClinicalTrials.gov that examined pharmaceuticals and/or biological products and started from 2018-2022. Trials with any NIH or other federal sponsorship (as the sole, lead, or other sponsor) were included. Drug names and number of enrollments per arm and drug were extracted from ClinicalTrials.gov and study protocols. The Wholesale Acquisition Cost (WAC) was obtained from IBM Micromedex RED BOOK (2023) by matching the product name, dose strength and administration route. The product acquisition cost (“cost”) per trial was computed by summing the WAC for each drug and multiplying by the number of enrollments. Results: Overall, N=1020 trials were examined (phase I = 343, phase II = 611, phase III = 66). The mean (median) drug costs were $53.9 million (m) ($7.4m) overall, including $73.8m ($19.8m), $47.2m ($8.7m), and $44.7m ($5.8m) for trials solely sponsored, led by, or with secondary/tertiary participation by federal sponsors, respectively. Trial-level drug costs were $19.2m ($3.6m), $51.9m ($9.4m), and $244.9m ($38.8m) for phase I, II, and III trials, respectively. Drug costs were much greater for trials involving immune and/or targeted therapies ($60.1m [$11.4m]) than those with conventional chemotherapies ($30.8m [$1.5m]). In the subset of n=128 phase 2 or 3 comparative trials, drug costs were $97.7m ($21.8m) for experimental arms and $24.1m ($1.4m) for control arms. Conclusions: The costs for drugs in FS-CCTs were very high, especially for the experimental arms, highlighting the necessity for federally sponsored researchers to collaborate with industry partners to conduct trials. Drug costs for immune and/or targeted therapies were higher yet, suggesting that the cost burden to conduct trials for federal sponsors may continue to increase. These findings also suggest that systemwide costs for cancer drugs in clinical practice will continue to increase substantially. These results have implications for how FS-CCTs are designed and conducted, since the necessity of collaboration between federal and industry sponsors likely limits the independence of federal research. Future public policy efforts should focus on mechanisms for independent investigation of new pharmacologic agents.

Data gap or biodiversity gap? Evaluating apparent spatial biases in community science observations of Odonata in the east-central United States

Odonates (dragonflies and damselflies) have become popular study organisms for insect-based climate studies, due to the taxon’s strong sensitivity to environmental conditions, and an enthusiastic following by community scientists due to their charismatic appearance and size. Where formal records of this taxon can be limited, public efforts have provided nearly 1,500,000 open-sourced odonate records through online databases, making real-time spatio-temporal monitoring more feasible. While these databases can be extensive, concerns regarding these public endeavors have arisen from a variety of sources: records may be biased by human factors (ex: density, technological access) which may cause erroneous interpretations. Indeed, records of odonates in the east-central US documented in the popular database iNaturalist bear striking patterns corresponding to political boundaries and other human activities. We conducted a ‘ground-truthing’ study using a structured sampling method to examine these patterns in an area where community science reports indicated variable abundance, richness, and diversity which appeared to be linked to observation biases. Our observations were largely consistent with patterns recorded by community scientists, suggesting these databases were indeed capturing representative biological trends and raising further questions about environmental drivers in the observed data gaps.

Environmental Activism in Ukraine: Everyday Concerns as Reasons for Civic Mobilization1

ABSTRACT Based on the results of a representative survey and 30 semi-structured interviews with environmental CSO leaders, we argue that citizens in Ukraine are more likely to participate in public mobilization efforts when they relate to unmet day-to-day problems such as environmental protection. Despite the relatively weak professionalization of many environmental organizations and weak citizen involvement, environmental activism has been strengthened in recent decades by growing awareness of its importance and potential to bring desirable changes, especially locally. This problem-based research asks how civic potential to address everyday problems by citizens themselves and the evolving political opportunity structure including the new civil society development strategy and decentralization reform impact environmental activism and the condition of civil society in Ukraine. Our findings demonstrate that environmental and animal protection have a particularly strong impact on civic activism, which has several important public and social functions from service providing and raising awareness to advocacy. Yet this activism to be sustained requires supportive and collaborative relationship between civil society actors and the state.

Beyond “Pressure”: Peer Influences on e-Cigarette Use in Young Australian Narratives of Vaping

Background In the early 2020s, Australian media and public health organizations described the rapid rise in youth e-cigarette uptake, portraying this as a “peer pressure” problem wherein vulnerable young people were being led or bullied into vaping by the “cool” kids. Yet, the peer pressure framing of vaping fails to account for young people's rituals of nicotine consumption and ways social drug economies are organized. Methods In 2023, we conducted qualitative interviews and ethnographic research with 24 young people ages 17 to 25, both vapers and nonvapers, in New South Wales, Australia. We investigated their embodied experiences of vaping, observations of peers’ vaping practices, and beliefs about vaping policy. We analyzed their accounts for themes and here report our findings, illustrated with participants’ quotes and an ethnographic portrait of a Sydney high school vape seller. Results The notion that young people are “pressured” into vaping lacked emic meaning for our participants. Their accounts reveal three ways that vaping is social beyond “pressure.” First, social vape market offers entrepreneurial teens money-earning opportunities, mediated by social networks and markers of peer esteem, prestige, and trust. Second, vapes are exchanged as both gifts and commodities in sharing economies, offering social opportunities and scripts for recreational interactions. Third, e-cigarettes as material objects provide esthetic and gustatory pleasures that are both individually enjoyed and socially performed in rituals of taste and display. Discussion These three perspectives on the sociality of vaping help nuance our understanding of how and why young people vape, and also suggest why public health outreach efforts may not be effective when they reduce youth vaping uptake to peer pressure. As youth vape use is on the rise in Australia, these perspectives matter for understanding this important social phenomenon and may help policy development move beyond simplifications of youth cultural motivations.

Exploring the Psychological Side of Fentanyl: A Scoping Review to Disclose the Psychosocial Dimensions of Illicitly Manufactured Fentanyl Users

Background Fentanyl is a powerful opioid. The abuse and overdoses related to Illicitly Manufactured Fentanyl (IMF) have become more prevalent. The majority of clinical studies on fentanyl have focused on its medical and biological aspects, particularly its addictive properties. Few studies have delved into the psychological aspects of illicit fentanyl use, and there is currently no comprehensive review providing a structured psycho-social profile of the population groups most vulnerable to its effects. The goal of this Scoping Review was to construct a psychological and social profile of individuals at risk of using illicit fentanyl. This profile will serve as a guiding force for shaping behavioral policies and public health prevention efforts necessary to face the recent pandemic. Methods Following the PRISMA guidelines we conducted a Scoping Review focused on the following research question: What are the practical psycho-social implications of illicit fentanyl use in the global population? Results The bibliographic research was carried out in the databases of Medline, Scopus, and PsycNet. The articles resulting from the research phase in the databases listed above produced a total of 17737 reports. After the screening process, 10 studies were included in the scoping review. Discussion and Conclusion This scoping review was the first to consistently and systematically outline the psychosocial implications of fentanyl dependence. Users of IMF are consistently younger than other drug users. People using fentanyl have a relatively low perception of risk. On the psycho-social levels, there is a significant correlation between fentanyl use and mental disorders such as suicidal thoughts, anxiety disorders, and depression. The development of psychotherapy, along with digital tools such as apps and online platforms, can be an initial step in addressing this challenge.

Data-driven prioritization of genetic disorders for global genomic newborn screening programs.

Genomic sequencing is poised to expand newborn screening for treatable childhood-onset disorders. Over 30 international research studies and companies are exploring its use, collectively aiming to screen more than 500,000 infants. A key challenge is determining which genes to include in screening. Among 27 newborn sequencing programs, the number of genes analyzed ranged from 134 to 4,299, with only 74 genes included by over 80% of programs. To understand this variability, we assembled a dataset with 25 characteristics of 4,389 genes included in any program and used a multivariate regression analysis to identify characteristics associated with inclusion across programs. These characteristics included presence on the US Recommended Uniform Screening panel, evidence regarding the natural history of disease, and efficacy of treatment. We then used a machine learning model to generate a ranked list of genes, offering a data-driven approach to the future prioritization of disorders for public health newborn screening efforts.