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Background Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare. Methods We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges. Results Three narrative subplots were developed to consolidate experiences of unmet health need: (i) 'on paper you're normal': narratives of complex need, (ii) 'in my family, everyone had issues': narratives of whole family need and (iii) 'I'm still mummy, no matter where they are': narratives of maternal identity and health. Conclusions Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women's narratives illustrate opportunities for health intervention, especially immediately following child removal. [ABSTRACT FROM AUTHOR]

Background Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Method Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. Results The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. Conclusion The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare. [ABSTRACT FROM AUTHOR]

Background The issue of reluctance towards vaccination is becoming more worrisome. Health care workers (HCWs) are the primary point of contact with individuals who make decisions about vaccination. Therefore, it is crucial that HCWs receive sufficient training and periodic updates. The main objective of this systematic review is to evaluate the HCWs' training needs in vaccination and vaccine uptake. Methods In February 2022, a search was conducted on MEDLINE, Scopus and Google Scholar databases. The search included papers written in English, Italian, Portuguese, Spanish, French and Romanian, with a publication date ranging from 1 January 2011 to 24 February 2022 and conducted in Europe. To assess the methodological quality of the papers, the Appraisal tool for Cross-Sectional Studies was utilized. Results The search of scientific literature yielded 640 outcomes on PubMed, 556 on Scopus and 15 on Google Scholar, for a total of 1211 records. After eliminating duplicates, screening titles and abstracts and evaluating the full text of the articles, only 25 of them were found suitable for inclusion. The studies' overall quality ranged from moderate to good. The majority of the research emphasized the need for improved knowledge of vaccine-preventable diseases, vaccine efficacy, immunization schedules and vaccine adverse effects. Conclusions It is vital to prioritize educational programmes on vaccinology and vaccine hesitancy for HCWs, with the objective of improving their knowledge, awareness and attitudes. Addressing the diversity of educational backgrounds, roles and training requirements of HCWs involved in vaccination across Europe is a critical issue that must be tackled for future initiatives. [ABSTRACT FROM AUTHOR]

Skepticism about grounding is the view that ground-theoretic concepts shouldn't be used in meta-physical theorizing. Possible reasons for adopting this attitude are numerous: perhaps grounding is unintelligible; or perhaps it's never instantiated; or perhaps it's just too heterogeneous to be theor-----etically useful. Unfortunately, as currently pursued the debate between grounding enthusiasts and skeptics is insufficiently structured. This paper's purpose is to impose a measure of conceptual rigor on the debate by offering an opinionated taxonomy of views with a reasonable claim to being "skeptical." I argue that carving up logical space into pro- and anti-grounding views isn't especially helpful; rather, we should recognize various degrees of ground-theoretic involvement depending on how inflationary our understanding of the theoretical term 'ground' is. [ABSTRACT FROM AUTHOR]

Naïve yet threatening is how the South Korean news media have characterized some older adults who have taken to social media to air their political views. Labeled as "angry (digital) silver," these older adults using YouTube and other social media platforms for political activity are portrayed as digitally illiterate and aggressive. This paper examines the rhetoric surrounding older adults' digital media literacy in scholarship and popular news media with a focus on the news media's portrayal of older adults' digital political activity. By analyzing the use of language and various rhetorical strategies, I argue that specific rhetoric of caution, which warns against older adults' so-called lower digital media literacy, is used to invalidate their digital political activity. I draw upon the case of the "Taegukgi squad"—a political group mainly composed of older adults in South Korea—and the evolution of their digital presence. Addressing the media's biased portrayal of older adults' digital media literacy, this paper further invites reflection on controversies around the role of age in digital political activities around the globe. [ABSTRACT FROM AUTHOR]

Summary: Gardening has the potential to enhance health and well-being, through increased physical activity and social connectedness. However, while much is known about the benefits of garden activities, less is known about the potential health implications of more passive forms of engagement with gardens, for example, viewing gardens. In addition, much garden research is undertaken in urban settings, leaving little known about potential health impacts for rural populations. The present study explored these research gaps by gaining an understanding of the experiences and perspectives of members of a gardening appreciation group in rural Australia: The Colac Horticultural and Marvellous Property Appreciation Society (CHAMPAS). A phenomenological, qualitative methodology was applied, using semi-structured interviews for data collection. Eleven participants were selected using purposive and snowball sampling and the data were analysed by applying interpretive, reflexive thematic analysis. Four main themes and supporting sub-themes were generated. The four main themes were: (i) motivations for maintaining participation in CHAMPAS; (ii) social connections and friendships, formed from membership; (iii) sense of community and structure of CHAMPAS and (iv) the perceived health and well-being benefits of continued involvement in this group. This study found that members perceived health and well-being benefits stemmed from CHAMPAS facilitation of social connectedness, function as a community group and a way for members to share a love for home gardening. This study provides insights into the perceived and potential health-promoting effects of garden appreciation groups for rural populations. Lay Summary: There are many health and well-being benefits of gardening. However, research is predominantly focused on the active practice of gardening in urban environments, and little is known about the passive activity of garden appreciation, nor about the benefits of this activity in rural areas. This paper explores the health promotion potential of garden appreciation groups through the experiences of members of a rural group called CHAMPAS. Eleven members of CHAMPAS were asked to talk about what kept them attending, and what health and well-being benefits the group provided them. The study found that CHAMPAS benefits stemmed from its function as a social group and a way for members to share a love for home gardening. The findings suggest that garden appreciation groups potentially provide health promotion benefits for people in rural areas. A recommendation of this paper is to undertake further research to map and analyse these benefits across rural Australia. [ABSTRACT FROM AUTHOR]

Can one have faith that something is the same as itself, or hope that a triangle has four sides? Accounts of the proper object of faith or of hope typically exclude modal cases, where the object of faith or hope is understood by the agent to be either necessary or impossible, on the basis of their intuitive implausibility or their incompatibility with beliefs that the agent has about the probability or possibility of the object of faith or hope. This paper argues that the noncognitive components of the psychology of these attitudes—evidential resistance in the case of faith and desire in the case of hope—provide a more plausible and economical explanation for restrictions on their proper objects. [ABSTRACT FROM AUTHOR]

Why should we avoid incoherence? An influential view tells us that incoherent combinations of attitudes are such that it is impossible for all of those attitudes to be simultaneously vindicated by the evidence. But it is not clear whether this view explains what is wrong with certain akratic doxastic states. In this paper, I flesh out an alternative response to that question, one according to which the problem with incoherent combinations of attitudes is that it is impossible for all of those attitudes to be simultaneously knowledgeable. This alternative response explains what is wrong with akratic combinations of attitudes using commonly accepted epistemological theses. The paper still shows how this proposal is able to explain the badness of incoherent combinations involving the absence of attitudes, suspended judgment, and credence. Finally, it is suggested that this picture can be generalized to the realm of practical rationality as well. [ABSTRACT FROM AUTHOR]

Inquiry aims at knowledge. Your inquiry into a question succeeds just in case you come to know the answer. However, combined with a common picture on which misleading evidence can lead knowledge to be lost, this view threatens to recommend a novel form of dogmatism. At least in some cases, individuals who know the answer to a question appear required to avoid evidence bearing on it. In this paper, we'll aim to do two things. First, we'll present an argument for this novel form of dogmatism and show that it presents a substantive challenge. Second, we'll consider a way those who take knowledge to be the aim of inquiry can mount a response. In the course of doing so, we'll try to get clearer on the normative connections between inquiry, knowledge and evidence gathering. [ABSTRACT FROM AUTHOR]

What is the structure of normative reality? According to X First, normativity has a monistic foundationalist structure: there is a unique normatively basic property in terms of which all the other normative properties are analysed. The main aim of this paper is to defend the view that fittingness—the property that an attitude has when it gets things right with respect to its object, as when you admire the admirable or desire the desirable—is first, or perhaps joint first. I will focus in particular on the questions whether and why fittingness is normative. [ABSTRACT FROM AUTHOR]

Background Chronic disease is a significant burden on the global population. The Helping Everyone Achieve Long Term Health (HEALTH) Passport is a paper-based approach previously utilized to help adults modify clinical risk factors through lifestyle, which may be effective in improving the long-term health of school-age children. This study investigates the feasibility of in-school use by engaging trainee teachers in primary and secondary education. Methods Two hundred and fifty six unique responses were collated to evaluate current teaching of the main health risk factors and HEALTH Passports specifically adapted for schools. Trainees attended workshops with pre- and post-questionnaires used to measure training efficacy and evaluate the Passports' suitability for in-school use. Narrative analysis of feedback was performed. Results Feedback received for both Passports was positive overall. Trainees highlighted the need for the Passports to be further age differentiated. Significantly increased confidence (P  < 0.01) in knowledge of exercise, type 2 diabetes, weight and blood pressure was shown. Confidence in smoking, drugs and alcohol knowledge was reduced highlighting the requirement for further teacher training. Conclusions The HEALTH Passport has potential as an intervention to improve health literacy in school-age children. Age adaptation is needed with references to weight measures removed. Emotional well-being should be focused on, and data management stringently assessed for child protection. [ABSTRACT FROM AUTHOR]

This paper is about attitudes toward sign languages. The paper presents an idea to help make sign language surveys better in the future. In 2018, UNESCO (the United Nations Educational, Scientific and Cultural Organization) published a sign language survey and a spoken language survey together for the first time. This was very important to show that spoken languages and signed languages are equal. But the sign language survey has some weaknesses. The idea presented in this paper says that: when people make sign language surveys, they should be aware of discrimination and negative attitudes; they should give signers access to the survey in sign language; and they should help signers decide what actions they can do to protect their sign language. [ABSTRACT FROM AUTHOR]

This paper examines a recent argument in favour of strong precautionary action—possibly including working to hasten human extinction—on the basis of a decision-theoretic view that accommodates the risk-attitudes of all affected while giving more weight to the more risk-averse attitudes. First, we dispute the need to take into account other people's attitudes towards risk at all. Second, we argue that a version of the non-identity problem undermines the case for doing so in the context of future people. Lastly, we suggest that we should not work to hasten human extinction, even if significant risk aversion is warranted. [ABSTRACT FROM AUTHOR]

This paper discusses language use and identity patterns in ethnic minority/ethnically heterogeneous multigenerational deaf families in Romania, where at least one of the family members belongs to the ethnic Hungarian minority. Early childhood and school linguistic socialization, language use within the family, and cross-generational transmission of identity to children are explored. The research is based on five ethnic minority/ethnically heterogeneous multigenerational deaf family case studies. The research results show that within ethnic-national minority/ethnically heterogeneous multigenerational deaf families, complex identity patterns may develop and multifaceted linguistic communication models may prevail, including the use of national oral languages and national sign languages of the parties involved. At the same time, a kind of special linguistic and cultural enrichment, a striving for cultural-linguistic balance, may occur. [ABSTRACT FROM AUTHOR]

Objectives This paper outlines the unique culturally driven cyclical migration of Alaska Native (AN) Elders, distinct from previously described migration patterns in that Elders spend extended time in more than one community. We describe this Indigenous cyclical migration of AN Elders and its influence on their identity and later life health and well-being. Methods Interviews with 124 AN Elders were conducted across 5 regions of Alaska: Bristol Bay, Interior, Norton Sound, Aleutian Pribilof Islands, and Southcentral. Within this sample, 87 participants engaged in cyclical migration. Thematic analysis was employed to identify themes related to Elders' cyclical migration between rural and urban communities and the impact on their identity and later life health and well-being. Results We identified 2 distinct patterns of Indigenous cyclical migration—Elders living primarily in rural communities migrating to urban communities and Elders living primarily in urban communities migrating to rural communities. Elders engaged in these 2 patterns of cyclical migration to maintain cultural practices, access social, and health care services to maintain their physical health and well-being, and continue their community roles contributing to their AN Elder identity. Discussion This study builds upon existing migration theories by introducing a cyclical pattern uniquely driven by AN identity, culture, and traditional practices. Findings illustrate how AN communities can support Elders who experience cyclical migration patterns to ensure they age successfully in both locations. Future research should explore cyclical migration patterns among other Indigenous populations with migration histories. [ABSTRACT FROM AUTHOR]

In the Hintikkan tradition, attitude verbs are viewed as relations between individuals and propositions. Previous work on know and believe with Content DP s like the rumour has tended to treat know CP vs. know DP as polysemy. In this paper, I show that polysemy runs into conceptual and empirical problems, and propose instead a new decompositional approach to know -verbs, which avoids polysemy; linking both know DP and know CP to the same lexical root, which describes, broadly speaking, acquaintance. This analysis thus provides an explicit and compositional morpho-semantic link between know DP and know CP that accounts for the interpretation of DPs as objects of acquaintance, and further captures the idea that knowledge, and factivity more broadly, is tied to acquaintance with a situation, the res (Kratzer 2002 , a.o.). Based on detailed examination of the morpho-syntax and interpretation of DP and CP complements of believe , I further show that DPs can either combine with believe in the same fashion as CPs, as a direct object (saturating a propositional argument slot, as in Uegaki 2016), or as an indirect object, via a type of attitudinal applicative (proposed here). The former option is defined for Content DPs and the latter for agentive DPs, so-called Source DP s. Together, these proposals account for the observation that the interpretation of believe DP sentences varies depending on the type of DP (believe the rumour vs. believe the referee), whereas for know -verbs, both types of DPs are interpreted as objects of acquaintance. At the core of the current proposal is the idea that verbs like know and believe differ fundamentally at the level of argument structure and internal morpho-semantic composition, and thus combine with DPs via different routes; contrary to uniform approaches to know and believe. Whereas believe -verbs describe relations to intensional content, and require external licensing mechanisms to combine with DPs, know -verbs describe complex relations, fundamentally anchored in the attitude holder's acquaintance with (abstract or concrete) individuals in the world, and thus make reference to individuals as part of their argument structure. The current proposal also builds on and adds to previous insights about connections between factivity, DP-complementation, and question-embedding. [ABSTRACT FROM AUTHOR]

This paper develops a new instrumental variables estimator for spatial, dynamic panels with interactive effects under large N and T asymptotics. For this class of models, most approaches available in the literature are based on quasi-maximum likelihood estimation. The approach put forward here is appealing from both a theoretical and a practical point of view for a number of reasons. First, it is linear in the parameters of interest and computationally inexpensive. Second, the IV estimator is free from asymptotic bias. Third, the approach can accommodate endogenous regressors as long as external instruments are available. The IV estimator is consistent and asymptotically normal as |$N,T\rightarrow \infty$|⁠ , such that |$N/T \rightarrow c$|⁠ , where |$0\lt c\lt \infty$|⁠. We study the determinants of risk attitude of banking institutions. The results show that the capital regulation introduced by the Dodd–Frank Act has succeeded in influencing banks' behaviour. [ABSTRACT FROM AUTHOR]

Over the past decades, changes in technology and policy have made developing and maintaining identity and community increasingly challenging for Deaf individuals. This is particularly obvious in Iceland, where the Deaf community is threatened in its existence. This paper reports on an empirical study that explores how Deaf individuals experience developing and maintaining a positive identity in various areas, including family life, working life, and social life. The study approaches deaf identities as multifaceted and dynamic, and particular emphasis is placed on the role of social interactions in identity-related processes. Qualitative interviews were conducted among members of the Icelandic Deaf community and analyzed using a phenomenological approach. The results indicate that social interactions within the Deaf community are a key factor in developing and maintaining Deaf identity. However, decreasing numbers in the Deaf community make its members explore other opportunities, and they experience being Deaf in Iceland as an insecure identity. [ABSTRACT FROM AUTHOR]

Background and Objectives Black, African, and Caribbean (BAC) families are disproportionately affected by dementia but engage less with services. Studies reporting their experiences of dementia have tended to aggregate people from diverse backgrounds, without considering the impact of this diversity, or researchers' ethnicities. We investigated participants' and researchers' ethnic identities, exploring how this relates to findings. Research Design and Methods We searched electronic databases in September 2018, for qualitative studies exploring how participants of Black ethnicity understand and experience dementia and dementia care. We reported participants' and researchers' ethnicities, and meta-synthesized qualitative findings regarding how ethnicity influences experiences and understanding of dementia. Results Twenty-eight papers reported 25 studies; in United States (n  = 17), United Kingdom (n  = 7), and Netherlands (n  = 1). 350/492 (71%) of participants were in U.S. studies and described as African American; participants in U.K. studies as Caribbean (n  = 45), African/Caribbean (n  = 44), African (n  = 28), Black British (n  = 7), or Indo-Caribbean (n  = 1); and in Netherlands as Surinamese Creole (n  = 17). 6/25 (24%) of studies reported involving recruiters/interviewers matching participants' ethnicity; and 14/25 (56%) involved an author/advisor from a BAC background during analysis/procedures. We identified four themes: Dementia does not relate to me; Inappropriate and disrespectful services; Kinship and responsibility; Importance of religion. Discussion and Implications Studies were mostly from a U.S. African American perspective, by researchers who were not of BAC background. Themes of dementia diagnosis and services feeling less relevant to participants than the majority population resonated across studies. We caution against the racialization of these findings, which can apply to many differing minority groups. [ABSTRACT FROM AUTHOR]

Decisions under uncertainty are often made with information whose interpretation is uncertain because multiple interpretations are possible. Individuals may perceive and handle uncertainty about interpretation differently and in ways that are not directly observable to a modeler. This paper identifies and experimentally examines behavior that can be interpreted as reflecting an individual's attitude toward such uncertainty. [ABSTRACT FROM AUTHOR]

While reformers view police training as an important means for improving performance, the training evidence base has historically been weak. Little research has focussed on how training impacts both attitudes and behaviour in the field, and the extent to which changes in attitudes following a training program are linked to officer behaviour in the field. This paper uses data from a multi-site randomized trial of procedural justice training in hot spots to assess the attitude–behaviour link. We ask to what extent do officers' attitudes about procedural justice impact their behaviour in the field? We find no support for officer baseline attitudes being predictive of their use of procedural justice with the public. But for trained officers, we do find evidence that attitudes following training are related to behaviour in observed interactions in the field. We conclude with a discussion of the implications for police training and training evaluation studies. [ABSTRACT FROM AUTHOR]

This study is the first to analyze data from a national survey to investigate the significance for deaf identity of the different forms of social and technological support that deaf people rely upon. Data were derived from a survey among 839 deaf people and were analyzed with regard to social identification as deaf, hearing, bicultural, and marginal. Findings showed connections between technology and identity, including the use of a range of technology to support being culturally deaf. Findings also showed that the deaf and hearing groups had strong homophilous social networks, while the bicultural group tended toward more mixed but equally strong social connectivity. The marginal group had a much thinner social connectivity and relied more upon institutional social support, findings that are in line with previous research revealing a sub-group struggling with social participation and well-being. Theoretically, the paper builds bridges between the fields of social identity and microsociology and shows how a microsociological perspective brings attention to the significance of reiterated social relations and practice for constructing social identity. [ABSTRACT FROM AUTHOR]

The global populist backlash is considered threatening to the multilateral order, but its impact on individual attitudes toward international organizations, like the International Monetary Fund (IMF), is understudied. We bridge insights from research on the IMF and populism to develop a theoretical framework centered on three propositions. We argue that populist individuals should be more prone to blame the IMF for economic problems than non-populists, but that this effect is highly conditional on sovereignty intrusion, escalating when an IMF program exists and as the program becomes more onerous. In contrast, IMF scapegoating by populist politicians should be largely ineffective. Analyzing survey data from across the European Union and an original survey experiment in Greece, we find support for each contention. The paper advances understanding of the partisan politics of the IMF and shows that the implications of the populist wave for international order are more complex than often assumed. [ABSTRACT FROM AUTHOR]

Background Snakebite envenomation (SBE) is a serious and potentially life-threatening condition that most often targets rural, subsistence-based farmers in sub-Saharan Africa. Rwanda is home to 13 venomous and medically important snake species. Those bitten are known to seek care from traditional healers and/or formal health facilities. No information is available on patient management at government health facilities. Methods This quantitative evaluation aimed to characterize knowledge, attitudes and practices related to snakebite management in Rwanda. Target respondents included physicians working at hospitals with the highest SBE caseload and medical interns. Respondents were asked to complete questionnaires on paper or online through Qualtrics. Results Overall, 105 physicians and 171 interns agreed to participate. Our findings suggest that overall knowledge scores were low for both groups (mean 49.4%, minimum–maximum 31.3–70.8%). Respondents were keen to receive SBE training but often lacked essential supplies needed to adhere to recommended guidelines for SBE management. One-third of respondents (34.8%) believed that traditional healers could manage SBE successfully and two-thirds (66.3%) felt that black stone therapy was an appropriate first aid practice. Conclusions These findings indicate a clear need for improved curricula related to SBE, enhanced supply chain management and practical mechanisms for supporting clinicians. [ABSTRACT FROM AUTHOR]

Currently in the UK and Ireland, after a hip fracture most patients do not receive bone protection medication to reduce the risk of refracture. Yet randomised controlled trial data specifically examining patients with hip fracture have shown that intravenous zoledronate reduces refracture risk by a third. Despite this evidence, use of intravenous zoledronate is highly variable following a hip fracture; many hospitals are providing this treatment, whilst most are currently not. A range of clinical uncertainties, doubts over the evidence base and practical concerns are cited as reasons. This paper discusses these concerns and provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital, in order to reduce costly re-fractures in this frail population. [ABSTRACT FROM AUTHOR]

Person-centered dementia care has been extensively integrated into music therapy practice; its central aim being to meet the core psychological needs of people with dementia, uphold personhood, and contribute to enhanced quality of life. Furthermore, Kitwood's model has been widely referenced as the theoretical framework underpinning multiple studies with people with dementia. However, few studies explore it in more concrete terms, expand on how it is implemented in practice, or describe how "positive person work" can be facilitated in music therapy with this population. This paper aims to address these lacunae, by presenting a comprehensive overview of Kitwood's model; identifying how it has informed music therapy practice, and highlighting current applications of "person-centered music therapy" in relation to meeting the core psychological needs of people with dementia. Furthermore, the authors present practical considerations on facilitating "positive person work" in music therapy, drawing on their experiences of providing music therapy in dementia care. [ABSTRACT FROM AUTHOR]

This paper discusses language use and identity patterns in families set up by deaf partners living in Romania, where at least one of the spouses belongs to the ethnic Hungarian minority. Language use and transmission of identity to children in ethnically homogenous (Hungarian) or heterogeneous (Hungarian–Romanian) families of deaf are explored. The research is based on a survey conducted among members of the ethnic Hungarian Deaf community (including ethnic Romanian spouses), life-path interviews with selected deaf persons and interviews with special school educators. The research results denote that in the case of deaf people living in ethnically homogeneous marriages who graduated from Hungarian language special school the transmission of Hungarian identity, Hungarian sign language/oral language knowledge—combined with the components of Deaf culture—tends to be a natural and usually undisturbed process. However, if one of the spouses is Romanian, the language of communication within the family will probably be the Romanian sign language/oral language. On the other hand, in the families where ethnic minority and ethnic majority family members are present, with typical and atypical hearing, complex, multifaceted linguistic communication models might prevail, favoring specific multicultural modes of intrafamilial identity development and transmission. [ABSTRACT FROM AUTHOR]

Risk attitudes determine decision making by individuals. Theoretically, heterogeneity in risk attitudes also affects household behaviour, increasing or decreasing marital instability, depending on whether households benefit primarily from sharing public goods or risk. Using a nationally representative sample with repeated measurements of risk attitudes, this paper shows that intrahousehold heterogeneity in risk attitudes is an economically and statistically significant predictor of future marital instability. Consistent with models of public good sharing, preference heterogeneity is associated with less public good sharing. Furthermore, risk attitudes converge within stable households over time. These findings highlight the empirical relevance of risk attitudes in explaining household behaviour. [ABSTRACT FROM AUTHOR]

In spite of the overwhelming evidence that highlights the effectiveness of routine vaccination, an increasing number of people are refusing to follow recommended vaccination schedules. While the majority of research in this area has focussed on vaccine hesitancy in parents, there is little research on the factors that promote vaccine hesitancy in health care providers (HCPs). Identifying factors that promote vaccine hesitancy in HCPs is essential because it may help broaden our understanding of vaccine hesitancy in patients. Therefore, the goal of this investigation was to review 21 studies and examine how professional autonomy and risk perception may promote vaccine acceptance, rejection and delay in physicians and nurses. We found that vaccine hesitant nurses and physicians shared similar views towards vaccines; both groups believed that their decision to vaccinate was separate from their role as an HCP. This belief comprised of three themes: decisional autonomy, personal risk perception and alternatives to vaccination. Both groups believed that mandatory vaccine policies reduced their ability to decide whether vaccination was in their best interests. We argue that decisional autonomy may weaken risk perception of disease, which in turn may encourage beliefs and behaviours that reinforce a 'hero persona' that reduces appropriate preventive and hygiene measures. We employ the Health Belief Model to discuss the crucial role that risk perceptions may play in reinforcing autonomy in vaccine hesitant physician and nurses. We conclude this paper by providing a set of recommendations that aim to improve the decision-making process surrounding mandatory vaccinations for HCPs. [ABSTRACT FROM AUTHOR]

Experts play important roles in global biotech governance. In serving their roles, they are often selected based on their expertise rather than the representativeness of social diversity. However, current biotechnology development generates many value-laden issues. This led us to ask what may affect experts' attitudes towards such issues, besides expertise. In this paper, we explored experts' attitudes towards human genetic data governance—a value-laden global challenge. Thirty-two experts from 12 countries were interviewed regarding their attitudes towards the commercialization of, global sharing of, and personal privacy protection in acquiring and using human genetic data. By analysing the interview transcripts with thematic analysis, we found that experts differ in their attitudes, and organizational affiliation and national regulatory context influence their attitudes. The results call for rethinking the role of epistemic community and facilitating inclusive participation of experts from various socioeconomic backgrounds in addressing global challenges. [ABSTRACT FROM AUTHOR]

Background Simply knowing the common symptoms of acute coronary syndrome (ACS) is not sufficient to ensure prompt care-seeking when these symptoms occur. Factors other than symptom knowledge contribute to prompt care-seeking behaviours and correct symptom attribution to the heart. Objectives To explore how perceived personal risk and perceived personal vulnerability towards ACS affect a person's ACS symptom recognition and attribution and also how this perception affects a person's response to ACS symptoms. Design An integrative review, using Whittemore and Knafl's approach. Data sources PubMed, Academic Search Complete, CINAHL Complete, APA PsycINFO, and APA PsycARTICLES Eligibility criteria for study selection We included studies that (i) were original human-subjects research or secondary analyses of human-subjects research, (ii) provided information about how perceptions of risk or perceptions of vulnerability towards ACS or heart disease affect symptom recognition, attribution, and/or response to symptoms, and (iii) were published in English. Results Thirteen articles were included. Studies were conducted in nine different countries and were descriptive or exploratory in nature. The existing evidence suggests that perceived personal risk or vulnerability towards heart disease may promote earlier care-seeking for ACS symptoms and facilitates attribution of symptoms to the heart. Conclusion The designs of the included studies limit causal attribution, and additional prospective and intervention-based research is needed to determine how perceived risk/vulnerability may affect care-seeking and ACS symptom attribution. Increasing perceptions of vulnerability towards heart disease may reduce care seeking delay. [ABSTRACT FROM AUTHOR]

Background: Political polarization may result in increased confirmation bias, strengthening of disinformation mechanisms or policy distortion. This raises the question whether it may influence the vaccination programmes. This study investigates the relationship between the level of political polarization and coronavirus disease 2019 vaccine behaviour and vaccine acceptance. Methods: In our study, we use the Partisan Polarization Index (PPI). The PPI aims to measure the gap between satisfaction with the government expressed by supporters of the ruling parties and that expressed by supporters of the opposition parties. We use the data from the latest round of the European Social Service from 23 countries. The effect of the PPI on the variability of vaccination declarations and intent across countries was verified based on a linear regression model. Results: The linear regression score for 23 countries revealed a statistically significant relationship between the vaccination variable and the level of political polarization. The model explains the variability in the vaccination levels based on the PPI in a given country at 38.6%. Conclusions: Political polarization can contribute to shaping negative attitudes towards vaccination through policy distortion, undermining the effectiveness of compliance against regulation, undermining trust in science and increasing the public's susceptibility to conspiracy theories. [ABSTRACT FROM AUTHOR]

The article discusses COVID-19 vaccination rollout strategies developed and disseminated the World Health Organization referencing recent correspondence of Cordero. Topics discussed include role of government in COVID-19 vaccines procurement and rollout which is to be proactive, transparent and efficient; analyzes the urgent need to harness the Philippine government's strategic policy-making; and efficient implementation of COVID-19 vaccination rollout in Philippines.

Background and Objectives Understanding the influences of marginalized cultural and social identities as experienced by the African Caribbean diaspora within the context of dementia care is essential to minimize the gaps in current practice and policy in the health care setting. This study explores the impact of marginalized identities upon the meaning-making process, access to services and experience of care provisions through a scoping review and consultancy exercises with key stakeholders. Research Design Fourteen databases were searched using key terms. Primary studies in English, any year, study design, and country of origin were eligible. Titles, abstracts, and full texts were screened for inclusion and data were extracted in stages. Thematic analysis was performed and the findings were discussed in a series of consultation meetings with people with dementia, carers, and health care professionals in Manchester (United Kingdom) and Jamaica. Results The scoping review retrieved n = 1,989 research articles. Nineteen were included, most were qualitative (n = 14), 3 quantitative, and 2 mixed-method. The findings revealed limited insight into cultural and multiple individual identities in explaining conceptualization and service access. Consultation meetings confirmed these findings and highlighted differences in health care services and systems in the United Kingdom and Jamaica. Discussion and Implications This study suggests there is a complex interaction of sociocultural processes that marginalize African Caribbean persons in and across various national settings within the context of dementia care. The study highlights the importance of acknowledging and addressing how prevalent racialized- and class-based divides and related marginalized social locations are reflected in inequities in access to and use of dementia services. [ABSTRACT FROM AUTHOR]

An introduction to articles published within the issue is presented on topics including the system changes in the Irish Child Protection and Welfare, the improvement of professional decision-making in situations of risk and uncertainty in adult social work in Canada, and the ethnic matching of Chinese social service practitioners in specialist services for Chinese immigrants in Toronto, Ontario.

Background A measles epidemic affected the Nouvelle-Aquitaine region from November 2017 to May 2018 with clusters among Travellers. This indicates that measles vaccination rates among Travellers remain lower than in the general population. The objective of this study was to estimate the 'declarative vaccination' against measles, mumps and rubella (MMR) and to propose a conceptual framework to help identify determinants of MMR vaccination uptake among adult Travellers in Nouvelle-Aquitaine in 2019–20. Methods A cross-sectional study using random sampling was performed and included 612 adult Travellers from 1 November 2019 to 31 March 2020. A conceptual framework to model vaccination adherence was tested among this underserved population by using structural equation modelling. This model included five latent variables: health literacy, attitudes toward preventive measures, stigma, accessibility to care and perceived needs and five measured variables: information received on vaccination, perception of barriers, support for administrative documents, social support and housing conditions. Results Individuals who did not answer all the questions linked to the variables included in the model were excluded, thus 347 adults were included in the final sample. The declared vaccination rate against MMR was 74.0%, and 72.4% of the participants were favorable to vaccination. Vaccination adherence was significantly correlated with favorable attitudes toward preventive measures such as having a history of MMR vaccination and not having already refused a recommended vaccine and finally satisfactory information received on vaccination. Discussion To improve vaccination adherence, health authorities should lean on personal history with vaccination and on transmitting information on vaccination. [ABSTRACT FROM AUTHOR]

Advancements in genomics have significant implications for public health, making citizens' education vital for informed decision-making. Based on two literature reviews' findings and a survey conducted with experts from the Italian Network of Genomics in Public Health, we conducted a pilot survey on Italian citizens' attitudes, knowledge and educational needs toward genetic testing and omics sciences. Our results demonstrate a widespread interest in genetic testing and uncertainties regarding associated risks, with 99% of participants acknowledging insufficient knowledge of genetic testing. There is an urgent need for educational tools to improve citizens' literacy and engagement in this rapidly evolving field. [ABSTRACT FROM AUTHOR]

Vaccination against pertussis in pregnancy is the main strategy to prevent the disease in the first trimester of life of new-borns. Effective communication is essential to successfully engage pregnant women. The use of digital devices within the outpatient setting may be helpful to engage patients before and during the consultation. The aim of this study was to develop and test an e-health tool to assess vaccine hesitancy and to deliver tailored information and education interventions to raise awareness and promote vaccine acceptance. Methods: One-hundred-and-five participants were recruited in 4 ob-gyn clinics. Participants were invited to complete a self-administered psychometric questionnaire to assess vaccine hesitancy, disease beliefs and self-efficacy perception on health behaviours on a tablet. Participants were randomly allocated to three communication-format types providing equivalent content: 1)a single video simulating a patient-doctor conversation on the topic; 2)an interactive platform with five infographics videos; 3)a paper leaflet followed by a brief consultation with the physician. The intention to get vaccinated during pregnancy was assessed through a specific question before and after the intervention. Results: In the pre-intervention phase there was no difference observed between groups in terms of the variable "intention" to get vaccinated. After the intervention, participants of groups 1 and 3 showed a higher intention to get vaccinated than group 2 at the Kruskal-Wallis test (H(2)=6.008, p < 0.05). Post-intervention intention to vaccinate correlated with Individual SelfEfficacy (rs(105)=0.30, p < 0.001) and was inversely associated with vaccine hesitancy (rs(105)=0.34, p < 0.001). Conclusions: We implemented and assessed the impact of different communication strategies to promote vaccine uptake among pregnant women. Our results suggest comparable effect may be obtained using simulated versus live patient-physician communication. Key messages: The use of digital devices allows an effective and manageable communication about vaccination to pregnant women. In the present study, the implementation of digital forms of communication allowed a comparison with standard procedures of information towards vaccination, demonstrating their equivalence. [ABSTRACT FROM AUTHOR]

Background: After rising for years, vaccination rates in Italy fell until 2015 because of unfounded safety concerns, abetted by some government and court actions. Public education and a 2017 law on mandatory vaccination have boosted rates since then. So far only a few papers have examined the correlation between beliefs and attitudes towards vaccines and the level of trust in the scientific community regarding vaccinations in the general population. Methods: Data were extracted from the Italian section of the last two editions of the European Social Survey (ESS), the first carried out between September and November 2017, the latter between December 2018 and March 2019. A descriptive analysis was conducted using survey data. In the two editions respectively 2,626 and 2,745 persons were interviewed. The main outcomes assessed was comparing the two surveys, so as to highlight the key changes in public opinion on vaccines. Results: In the 2017 edition, 19% of the respondents believed in the harmfulness of vaccines, out of them 29% did not even have trust in the scientific community while those confident in the safety of vaccines were 50%. In the 2019 survey, the proportion of those who believed vaccines to be harmful fell to 15%, the undecided rose to 15%, those opposed to the idea that vaccines are harmful became 63%, not responding people were 8%. Correspondingly, trust in the scientific community about vaccines has increased from 57% in the first survey to 70% in the last one. Conclusions: The scientific community and research bodies in the last years, in support of the Ministry of Health, have made a huge effort in the public debate on vaccines. This might play a role in increasing the public confidence in the safety of vaccines and the adherence to vaccination campaigns, changing the climate with regard to vaccination in general. Key messages: Italians changed their opinions on vaccines between two ESS surveys. The scientific community had a relevant role in the public debate on vaccines. [ABSTRACT FROM AUTHOR]

Background: High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods: A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English; 2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; 3) utilized validated measurements techniques; 4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies. Results: 73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority. Conclusions: Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates. Key messages: • It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. • It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic. [ABSTRACT FROM AUTHOR]

Background Direct-to-consumer genetic tests (DTC-GTs) are genetic tests for a medical or non-medical trait that are sold directly to the public, usually ordered without the engagement of a healthcare professional. Our aim was to explore the knowledge, attitudes and behaviors toward DTC-GTs among European citizens. Methods We updated the most recent systematic review on citizens' perspectives toward DTC-GTs. Relevant English language studies were searched on PubMed, ISI Web of Science, Scopus, Embase and Google Scholar from October 2014 to April 2019. We extended our search on Scopus without publication date restriction, since it was not included in the former review. Eligible studies were conducted in European countries and reported original data. The quality of the studies was evaluated using a checklist developed by Kmet et al. Results We included six studies conducted in European countries between 2015 and 2018. The studies were performed among general population in the Netherlands, students in Italy and Greece, laypeople in Germany and older adults in Switzerland. The level of awareness, in overall low, differed by country and population group. Most of the participants were interested in undergoing a DTC-GT, mainly for knowing the risk predisposition to a common disease. Concerns were raised about tests' validity and utility and data privacy. Conclusions Our review shows that European citizens, overall, have a low level of knowledge on DTC-GTs and a high interest in their purchase. This understanding might contribute to the development of educational programs in order to the increase of general public capabilities to make appropriate health decisions. [ABSTRACT FROM AUTHOR]

Background Misinformation hampers vaccine uptake. The European Union (EU) employed a coordinated effort to curb misinformation during the Covid-19 pandemic. In this context, we investigated relationships between sources of information, vaccine safety/effectiveness, satisfaction with government vaccination strategy, and vaccination intent. Methods We used cross-sectional survey data (May 2021) from Flash Eurobarometer 494, a population-adjusted dataset comprised of a representative sample of those ≥15 years from 27 EU nations. We employed a latent class analysis to create clusters of information sources as the independent variable and beliefs in vaccine safety/efficacy, satisfaction with government vaccination strategy, and vaccine intent as four outcome variables. We first estimated the association between source clusters and each of the first three outcomes separately. Then, using these three as intermediate variables, we employed structural equation modeling to estimate the relationship between sources and vaccine intent. We adjusted for individual and country-level variables. Results Among 23 012 respondents, four clusters of information sources emerged: (1) national authorities/health professionals (n  = 9602; 42%), (2) mostly health professionals (6184; 27%), (3) mixed (n  = 1705; 17%) and (4) social media/family/friends (n  = 5524; 24%). Using cluster (3) as the referent, we found decreasing odds of beliefs in vaccine safety/effectiveness, satisfaction and vaccine intent across clusters (1), (2) and (4), respectively. Demographics played a role. Conclusion In the context of the Covid pandemic, these results provide the first EU-wide estimates of the association between sources of information about vaccine safety/effectiveness, satisfaction and vaccine intent. The coordinated approach promulgated by the EU to minimize misinformation provides a model for managing future pandemics. [ABSTRACT FROM AUTHOR]

In Indonesia, controversy about the COVID-19 vaccination is still going on, there is a group of people who believe in this vaccine, and another group chooses not to believe. There are those who support this as mandatory, but there are also those who think that this is optional. Hopefully through this letter, we can all respect the decisions of every human being who has free will and has full rights over their own life. [ABSTRACT FROM AUTHOR]

The article presents the discussion on conspiracy theorists and naysayers. Topics include respondence underscoring adverse outcomes and greater anxiety levels when conspiracy and disinformation beliefs being present; and emphasizing prevention and prognosis while promoting discussions on dangers in public health emergencies by employing social media literacy.

Background: More than 50% of non-smoking women and children are exposed to second-hand smoke (SHS) in Middle Eastern countries. This review aims to synthesize the evidence on experiences and views of parents, children, and professionals towards SHS exposure prevention in Middle Eastern countries. Methods: We included qualitative studies exploring experiences and views on prevention of SHS exposure among women and children in all settings in Middle Eastern countries. A systematic review was undertaken according to the Joanna Briggs Institute (JBI) guidelines for qualitative systematic reviews. Nine databases were searched from inception to January 2021. Meta-aggregation was used to synthesize the findings. Results: Out of 5229 records identified, two qualitative studies reported in three publications met the eligibility criteria and were included. Using the JBI checklist for qualitative research, the critical appraisal scores of all papers were high. One study was conducted in Turkey and the other one in Israel, and study participants were parents of children. A total of 49 findings were extracted and aggregated into 8 categories, based on the similarity of meaning. Parents were aware that SHS is harmful, although the hazards of SHS exposure were not commonly discussed during pregnancy. However, there were conflicting views on ways of SHS exposure and approaches to minimise it. Parents implemented rules to decrease SHS exposure among children. While some parents were uncertain about the effectiveness of protective measures. Most common perceived barriers to reducing SHS exposure were beliefs about traditional values and personal psychological factors. Conclusions: Parents in Middle Eastern countries knew that children's SHS exposure is harmful, though knowledge was not comprehensive and did not translate into actions to protect children. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures. Key messages: Parents' risk-awareness of SHS exposure is inadequate. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures in Middle Eastern countries. [ABSTRACT FROM AUTHOR]

Background: Most of the countries in the world adopted isolation measures during the COVID-19 pandemic. According to Kola L. et. al (2021), ‘‘in most settings in low and middle-income countries (LMICs), ongoing in-person mental health services have been disrupted and patients with severe mental conditions and substance abuse disorders are often unable to obtain medications, attend to treatment centres, or receive social services’’. The aim of this paper is to describe the effects of the COVID- 19 pandemic on the demand for attention in a mental health service as reported by healthcare workers. Methods: A quantitative cross-sectional descriptive study was conducted and a survey designed by the Secretarı´a de Polı´ticas Integrales sobre Drogas de la Nacio´n Argentina was applied to a total of 29 healthcare workers of a mental health centre in the Province of Co´ rdoba, Argentina, during the month of November, 2020. Results: The perception of healthcare workers towards the demand for attention shows that the 3 main reasons for consultation during the first three months of isolation measures were drug abuse (50%), request for treatment (10.3%), and order for medication (10.3%). During the three subsequent months, the reasons for consultation were drug abuse (62.1%), request for treatment (44.8%) and remote treatment modality (24.1%). Healthcare workers state that drug abuse consultations increased 65.5% and the self-inflicted violence consultations increased 44.8%. Conclusions: The isolation measures generate a change in the demand for attention. There are differences between various phases of the isolation measures, where an increase in the drug abuse consultations and remote treatment modality could be observed. Key messages: · To develop predictability according to the variations in the demand for attention produced during public health crisis. · To train healthcare workers in order to make interventions in public health crisis. [ABSTRACT FROM AUTHOR]

Background: Migrants in Europe are at risk of under-immunisation and may also have lower COVID-19 vaccination intent and uptake. There is an urgent need to better understand the drivers of uptake in these groups to inform the development of migrantsensitive interventions for COVID-19 vaccination and routine vaccination beyond the pandemic. Methods: We did a systematic review (PROSPERO: CRD42020219214) following PRISMA guidelines to explore factors influencing vaccine uptake in migrants in the EU/EEA and identify determinants of under-immunisation. We also held 3 participatory workshops with multinational migrant community leaders (n = 23) in London, to explore solutions and approaches to strengthen COVID-19 vaccine roll-out. Results: We included 66 papers reporting data on 262,761 migrants in the review. Numerous access-related factors (e.g. government policy, communication barriers) influenced uptake. Vaccine hesitancy was attributed to lack of information, concerns [ABSTRACT FROM AUTHOR]

Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n  = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change. [ABSTRACT FROM AUTHOR]

Objectives We test whether higher awareness of age-related gains (AARC-gains), lower awareness of age-related losses (AARC-losses), and more positive attitudes toward own aging (ATOA) are cross-sectionally related to more frequent social media use. We also investigate the strength and direction of the associations of AARC-gains, AARC-losses, and ATOA with social media use over 1 year, from before to after the onset of the coronavirus 2019 pandemic. Methods We used cross-sectional data from 8,320 individuals (mean age = 65.95 years; standard deviation = 7.01) and longitudinal data from a subsample of 4,454 individuals participating in the UK PROTECT study in 2019 and 2020. We used ordered regression models, linear regression models, and tests of interaction. Models were adjusted for age, sex, education, and employment. Results Higher AARC-gains and more positive ATOA, but not AARC-losses, were cross-sectionally associated with more frequent social media use. Social media use became more frequent at follow-up. In the longitudinal models controlling for baseline levels of the outcome variable, more frequent baseline social media use predicted increases in AARC-gains, whereas baseline AARC-gains did not significantly predict the frequency of social media use at follow-up. Baseline frequency of social media use did not significantly predict AARC-losses, nor ATOA at follow-up, whereas lower levels of AARC-losses and more positive ATOA predicted more frequent social media use at follow-up. Discussion Although effect sizes were small, decreasing negative views on aging may help increase the engagement of middle-aged and older people with social media. At the same time, fostering social media use could promote positive self-perceptions of aging. [ABSTRACT FROM AUTHOR]