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Media exposure to graphic images of violence has proliferated in contemporary society, particularly with the advent of social media. Extensive exposure to media coverage immediately after the 9/11 attacks and the Boston Marathon bombings (BMB) was associated with more early traumatic stress symptoms; in fact, several hours of BMB-related daily media exposure was a stronger correlate of distress than being directly exposed to the bombings themselves. Researchers have replicated these findings across different traumatic events, extending this work to document that exposure to graphic images is independently and significantly associated with stress symptoms and poorer functioning. The media exposure-distress association also appears to be cyclical over time, with increased exposure predicting greater distress and greater distress predicting more media exposure following subsequent tragedies. The war in Israel and Gaza, which began on October 7, 2023, provides a current, real-time context to further explore these issues as journalists often share graphic images of death and destruction, making media-based graphic images once again ubiquitous and potentially challenging public well-being. For individuals sharing an identity with the victims or otherwise feeling emotionally connected to the Middle East, it may be difficult to avoid viewing these images. Through a review of research on the association between exposure to graphic images and public health, we discuss differing views on the societal implications of viewing such images and advocate for media literacy campaigns to educate the public to identify mis/disinformation and understand the risks of viewing and sharing graphic images with others.

Introduction: HIV testing during pregnancy is an integral component and first step of prevention for mother to child transmission, initiation of antiretroviral treatment and diagnosis of HIV/AIDS. However, Ethiopia and other sub-Saharan African countries face challenges in meeting the first target of the 95-95-95 global initiatives. This study examines trends, spatial distribution, and factors influencing HIV testing among pregnant women in Ethiopia from 2005 to 2016, using data from the Ethiopia Demographic and Health Surveys. Methods: The study was based on three consecutive demographic and health survey in Ethiopia. A total weighted sample of 13,020 women who gave birth within 2 year proceeding each survey year was included in each survey. Logit based decomposition analysis technique was employed to identify factors contributing to the change in HIV testing uptake among pregnant women overtime. ArcGIS version 10.7.1 and SaT Scan version 10.1software were used for the spatial analysis and geographically weighted regression. Results: HIV testing uptake among pregnant women has significantly increased from 0.51% in 2005 to 32.4% in 2016 with 2.9% annual rate of increment in Ethiopia. About 75.9% of the overall increase in HIV testing uptake among pregnant from 2005–2016 was due to increases in women's composition with knowledge of Mother to child transmission of HIV (3.2%), HIV counseling (10.3%), 4 or more antenatal care visits (31.4%), health facility delivery (6.3%), not perceiving distance from the health facility as a big problem (1.1%), and urban residence (0.6%). Spatial variation of low proportion of HIV testing was non-random in all three surveys (Moran index, p-value<0.05). Hot spot clusters exhibited in all the three waves includes Tigray and SNNPRs in 2005 and consistent hotspot areas in Benishangul-Gumuz, Somali, SNNPR, and Gambella in 2011 and 2016 EDHS. Lack of knowledge of Mother to child transmission of HIV, lack of antenatal care visit, lack of media exposure, and health facility delivery were significant predictors for the spatial variation of low proportion of HIV testing uptake across regions in Ethiopia in 2016. Conclusion and recommendation: Over all, there has been a substantial increase in HIV testing uptake among pregnant women overtime in Ethiopia, but it still far away from achieving the 2025 HIV testing targets. Knowledge of Mother to child transmission of HIV, HIV counseling, Number of Antenatal care visit, previous place of delivery, residence and distance to health facility were significant contributing factors for the change in HIV testing uptake. There was geographical disparity in HIV testing uptake across regions in all three EDHS. Lack of knowledge of Mother to child transmission of HIV, lack of ANC visit, lack media exposure, and health facility delivery were significant predictors. Geographic-based interventions, together with broader public health strategies, are essential for advancing HIV testing uptake. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach. Design: A cross-sectional design including an online self-reported questionnaire survey was used. Methods: A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS. Findings: Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences. Conclusions: Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies. Clinical Evidence: Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses. [ABSTRACT FROM AUTHOR]

Predicting video virality is the holy grail of marketing today. Previous video virality prediction research has relied upon two processes that may lead to incomplete data or incomplete analyses: non-subconscious data collection and self-reporting. This exploratory study evaluates the potential of using a physiological manifestation of emotions captured through facial expressions and skin conductance to predict video viewer engagement across the viewing experience. In the context of video virality and user-focused emotional response, an experiment with 64 subjects viewing 13 videos collected facial expression and galvanic skin response data during the entire viewing experience. XGBoost classifier was deployed using 42 collected features (physiological data and socio-behavioural responses). The selected classifier could predict user engagement with over 80% accuracy. In addition to socio-demographic data and behavioural features, the predictive model identified several facial expression-based features, including action units (mouth open, cheek raise, eye closure, lip raise, and smile), emotions (joy), engagement and positive valence along with head movement (attention) and arousal (GSR peaks) as the most impactful. This study confirms the predictive capability of physiological data and elevates the value and need to understand further the role of viewers' physiological and subconscious responses to video content across the viewing experience. [ABSTRACT FROM AUTHOR]

Objective: This study identified rural community experiences and preferences related to available resources and their effects on stress following tornadoes and floods. Methods: The Rural Natural Disaster Stress and Recovery survey was distributed from December 2021 to February 2022 in rural disaster-affected communities. Within the analysis sample (N = 159) of self-selected participants representing both agricultural and non-agricultural occupations, 125 responded to the Resource Use and Effect survey component that evaluated the effects of 22 resources on post-disaster stress. Additional qualitative questions provided further data. Results: The most frequently used resources post-disaster were found to be talking about the event (98.3%), friends and neighbors (97.6%) and family (97.6%). Using a derived Impact per Use score, groups from the neighboring community and personal faith activities most often reduced stress. Resources that increased stress were identified as FEMA or other government organizations; repairing, replacing, or rebuilding property; and following news or social media. Participants reported help from their community (35.8%) or things they did for themselves (31.2%) most effectively decreased disaster stress. Family, friends, faith, neighbors, and community were top choices to decrease stress in a future disaster. Conclusion: Rural residents identified available resources for reducing disaster stress, but some common post-disaster activities were found to increase stress. Rural emergency management should adapt response and recovery plans and activities to leverage readily accessible people, groups, and activities to mitigate negative mental and emotional health effects. [ABSTRACT FROM AUTHOR]

Corruption is commonly defined as deviant behaviour that strays from established legal and formal norms, as well as expected conduct when fulfilling official duties and responsibilities. It is essential to stress that the acceptance or condemnation of such behaviour hinges primarily on how well evaluators comprehend these standards. This implies that citizens' assessments of the impact of corruption on their lives and society are heavily influenced by the values they hold dear within a democracy and their trust in democratic institutions to uphold and safeguard those values. Based on recently collected survey data, we demonstrate that citizens' adherence to process-oriented democratic values, their feeling of relative deprivation and their level of political trust significantly affect their egocentric perceptions of the effects of corruption and tolerance towards corruption. Furthermore, we find that control variables, such as self-reported experiences of corruption, age, education, income, and exposure to social media, also exert a significant influence on our dependent variables. By linking citizens' egocentric perceived corruption effects and intolerance towards corruption with their procedural notion of democracy, feeling of relative deprivation and political trust, this study contributes to the understanding of the resilience of this intricate phenomenon in democratic societies. [ABSTRACT FROM AUTHOR]

Background: It is widely recognized that maternal deaths in low-resource countries are attributed to deprived access to maternal health services. Therefore, the aim of this study was to assess barriers to healthcare access among reproductive age women in extremely high and very high maternal mortality countries. Methods: A community based cross sectional surveys were conducted among 181,472 reproductive age women. Stata version 17.0 was used to analyze the data. Mixed effect binary logistic regression model was analyzed. Odds ratio along with 95% CI was generated to identify factors associated with barriers to healthcare access. A p-value less than 0.05 was declared as statistical significance. Results: A total of 64.3% (95% CI: 64.06, 64.54) reproductive age women faced barriers to healthcare access. Young age, no formal education, poor wealth index, no media exposure, multiparty, no health insurance coverage, and rural residence were significantly associated with barriers to healthcare access. Conclusion: More than six in ten reproductive age women had barriers to healthcare access in extremely high and very high maternal mortality countries. Increasing extensive health education, minimizing financial hardship by expanding health insurance may minimize barriers to healthcare access with attention to rural resident reproductive age women. [ABSTRACT FROM AUTHOR]

Background: While HIV testing and counselling play a crucial role in preventing mother-to-child transmission, numerous pregnant women did not receive these services. Understanding the spatial variation of HIV testing and counselling and its associated factors during antenatal care in Ethiopia remains limited. Thus, this study was aimed at assessing the spatial patterns and factors associated with HIV testing and counselling during antenatal care visits in Ethiopia. Methods: A cross-sectional study design was employed with a two-stage stratified cluster sampling technique. A total of 2,789 women who gave birth in the two years prior to the survey and had at least one antenatal care visit were included in the study. Stata version 16 and ArcGIS version 10.8 software were used for analysis. A multilevel robust Poisson regression model was fitted to identify significantly associated factors since the prevalence of HIV testing and counselling was higher than 10%. A statistically significant association was declared based on multivariable multilevel robust Poisson regression analysis using an adjusted prevalence ratio with its 95% confidence interval at a p-value < 0.05. Spatial regression analysis was conducted, and the local coefficients of statistically significant spatial covariates were visualised. Results: In Ethiopia, the overall prevalence of HIV testing and counselling during antenatal care visits was 29.5% (95% CI: 27.8%, 31.2%). Significant spatial clustering was observed (Global Moran's I = 0.138, p-value <0.001). In the spatial regression analysis, high and comprehensive knowledge related to HIV, and comprehensive knowledge on the prevention of mother-to-child transmission were significant explanatory variables for the spatial variation of HIV testing and counselling. In the multivariable multilevel robust Poisson regression analysis, education, household wealth, media exposure, number of antenatal care visits, comprehensive knowledge on mother-to-child transmission, comprehensive knowledge on prevention of mother-to-child transmission, and region were significantly associated factors. Conclusion: The prevalence of HIV testing and counselling during antenatal care visits was low. Empowering women through education, promoting mass media exposure, increasing numbers of antenatal care visits, and enhancing women's knowledge related to HIV and mother-to-child transmission by targeting cold spot areas could improve HIV testing and counselling service uptake among pregnant women in Ethiopia. [ABSTRACT FROM AUTHOR]

Social confidence functions as a vital spiritual force in fostering the positive and healthy evolution of society. This paper explores how social media exposure contributes to the construction of social confidence within the framework of Media-system Dependency Theory. The research unveils the following key findings: (1) Social media exposure positively facilitates social confidence; (2) Group efficacy and group cohesion, perceived as manifestations of cognitive divergence between "efficacy" and "collective" within collective efficacy, both serve as mediating mechanisms influencing the impact of social media exposure on social confidence. The Channel Testing of Causality confirms that group cohesion plays a significantly more crucial role as a pathway compared to group efficacy; (3) The differentiated impact of social media exposure, encompassing Tencent WeChat and Sina Weibo, materializes in distinct components of social confidence and follows different influence pathways. [ABSTRACT FROM AUTHOR]

Prior research demonstrates that news-related social media posts using negative language are re-posted more, rewarding users who produce negative content. We investigate whether negative material from external news sites is also introduced to social media through more user posts, offering comparable incentives for journalists to adopt a negative tone. Data from four US and UK news sites (95,282 articles) and two social media platforms (579,182,075 posts on Facebook and Twitter, now X) show social media users are 1.91 times more likely to share links to negative news articles. The impact of negativity varies by news site and social media platform and, for political articles, is moderated by topic focus, with users showing a greater inclination to share negative articles referring to opposing political groups. Additionally, negativity amplifies news dissemination on social media to a greater extent when accounting for the re-sharing of user posts containing article links. These findings suggest a higher prevalence of negatively toned articles on Facebook and Twitter compared to online news sites. Further, should journalists respond to the incentives created by the heightened sharing of negative articles to social media platforms, this could even increase negative news exposure for those who do not use social media. [ABSTRACT FROM AUTHOR]

Intentional news avoidance is a common behavior that can be influenced by individual, content, and contextual factors. However, prior studies have primarily focused on general news avoidance and neglected selective avoidance of specific topics. Therefore, our study aimed to determine which topics people tend to avoid and the reasons behind this behavior. We conducted an online survey (N = 1071) with open-ended questions to gather information on topic-specific news avoidance and motives. Our systematic quantitative content analysis revealed that the most commonly avoided news topics were related to the pandemic, political issues, and soft news. Participants cited negative emotional reactions and lack of interest as their primary reasons for avoiding news on an individual level, while redundancy and lack of trust were cited as reasons related to content. Logistic regression analyses revealed that specific motives were related to topic-specific avoidance. Issue fatigue was the primary motivator for avoiding news about COVID-19, while anger and lack of trust were the main reasons for avoiding political news. Lack of interest and overload were the motivators for avoiding soft news. Our study highlights the importance of understanding selective news avoidance and provides insights into the reasons why people choose to avoid certain news topics. [ABSTRACT FROM AUTHOR]

Today's high-choice digital media environments allow citizens to completely refrain from online news exposure and, if they do use news, to select sources that align with their ideological preferences. Yet due to measurement problems and cross-country differences, recent research has been inconclusive regarding the prevalence of ideological self-selection into like-minded online news. We introduce a multi-method design combining the web-browsing histories and survey responses of more than 7000 participants from six major democracies with supervised text classification to separate political from nonpolitical news exposure. We find that political online news exposure is both substantially less prevalent and subject to stronger ideological self-selection than nonpolitical online news exposure, especially in the United States. By highlighting the peculiar role of political news content, the results improve the understanding of online news exposure and the role of digital media in democracy. [ABSTRACT FROM AUTHOR]

Background: Childbirth among adolescents and young mothers has been linked to various complications, including perinatal mortality, preterm births, low birth weight, and infections, which collectively contribute to the high burden of neonatal and maternal mortality. Despite some progress, the prevalence of skilled birth attendance, proven to improve maternal and newborn health outcomes, remains consistently low in Northern Nigeria. This study assessed the prevalence and determinants of Skilled Birth Attendance (SBA) among young women ages 15–24 years in Northern Nigeria. Methods: This pooled cross-sectional study included 6,461 young women aged 15–24 years from 2011, 2016 and 2021 multiple indicator cluster surveys in Nigeria. We used a binary logistic regression model to assess the factors associated with skilled birth attendance at 95% confidence intervals (CIs) with computed adjusted odds ratios (aORs). Results: The prevalence of skilled birth attendance among young women in Northern Nigeria increased from 25.6% in 2011 to 33.1% in 2021. Women who were atleast 18 years of age at first marriage had 2.48 higher odds of SBA (aOR 2.48, 95% CI = 1.54–4.00) compared those less than 18 years of age at first marriage after controlling for confounders. Young women from rich household wealth quintile were more likely to utilize SBA (aOR 1.84, 95% CI = 1.11–3.14) compared to young women from poor household wealth quintile. In terms of education, those women who had secondary (aOR = 2.52, 95% CI = 1.77–3.56) and higher education (aOR = 10.01, 95% CI = 2.21–49.31) had higher odds of SBA compared to those with no education. Individual women with media exposure had 59% higher likelihood (aOR = 1.59, 95% CI = 1.16–2.19), women who attended 4 or more antenatal care visits during their last pregnancy demonstrated 2.28 times higher odds (aOR = 2.28, 95% CI = 1.67–3.09), while those who reported no intention for their last pregnancy were 37% less likely (aOR = 0.63, 95% CI = 0.42–0.96) to utilize SBA. Conclusion: A slight increase in the prevalence of skilled birth attendance was observed over the 10-year period. For a significant boost in skilled birth attendance among young women in Northern Nigeria, particular attention needs to be paid to girls' child education, delay in marriage, economic empowerment of young women, and strategic ways of leveraging trained community health workers (CHIPs) to bring reproductive healthcare close to young women living in rural areas. [ABSTRACT FROM AUTHOR]

Background: Citizens are expected to make informed voting decisions. Theoretical approaches suggest that people are most likely to acquire their political knowledge through media. As more people turn to social media as a source of news, the political knowledge gains from using these technologies are called into question. Previous research has shown that rather than increasing objective political knowledge, the use of social media for news only increases people's metacognitive sense of being knowledgeable (subjective knowledge), which in turn increases their political participation. However, it remains to be understood which particular forms of social media use, e.g., incidental or intentional news exposure, are related to which dimension of political knowledge. The present work examines (a) the extent to which different motivational forms of social media news consumption foster subjective knowledge, and (b) whether this metacognition is related not only to political participation as a broad concept, but also to specific democratic outcomes such as voting intentions. Methods and results: Results from a pre-registered, pre-election survey (N = 1,223) of social media users show that intentional news seeking, but not incidental news exposure on social media, is directly related to increased subjective knowledge. Subjective knowledge appears to explain the relationship between social media news use and voting. Discussion: By showing that incidental and intentional social media news use affect subjective knowledge differently, this study provides preliminary and nuanced insights into the ultimate role that social media technologies can play in democratic processes. [ABSTRACT FROM AUTHOR]

Background: Addressing the global challenge of sexually transmitted infections (STIs) is crucial and demands immediate attention. Raising awareness, improving healthcare facilities, and implementing preventive measures are necessary to reduce the spread and mitigate their adverse effects. The treatment seeking behavior of individuals in relation to STIs is an important factor in STI prevention and control. Thus, this study aimed to identify factors associated with STI-related care-seeking behavior among sexually active men in East Africa. Methods: A weighted sample of 3,302 sexually active men from recent Demographic and Health Surveys (DHSs) in East African countries were included for analysis. To accommodate the inherent clustering in DHS data and the binary nature of the dependent variable, we applied a multi-level mixed-effect logistic regression model. The deviance value was used to select the best-fitted model. The strength of the association was estimated using an adjusted odds ratio, along with a 95% confidence interval, and statistical significance was determined at a p-value < 0.05. Result: The pooled prevalence of STI-related care-seeking behavior among sexually active men in East Africa was 71% (95%CI: 69.76, 72.75). In the multivariable multilevel model, individuals in the age groups of 25–34 (AOR = 1.58, 95%CI: 1.22, 2.04) and 44 years and above (AOR = 1.44, 95%CI: 1.01, 2.02), those who were married (AOR = 1.62, 95%CI: 1.25, 2.11), had 1 (AOR = 1.88, 95%CI: 1.50, 2.35) and ≥2 (AOR = 2.53, 95%CI: 1.89, 3.39) sexual partners excluding their spouse, had ever been tested for HIV (AOR = 1.86, 95%CI: 1.52, 2.28), and had media exposure (AOR = 1.30, 95%CI: 1.04, 1.62) had a positive association with care-seeking behavior for STIs. Conclusion: Based on our findings, seven out of ten sexually active men in East Africa exhibit care-seeking behavior for STIs. It is crucial to implement policies and strategies aimed at improving the health-seeking habits of young, unmarried men. Utilizing diverse media platforms to disseminate accurate information and success stories about STI symptoms is pivotal in achieving this goal. [ABSTRACT FROM AUTHOR]

Background: The Internet is the preferred source of health information for retrieving relevant information. In Ethiopia, the Internet penetration rate is improving year to year, but it is still at a low level compared to the rest of the world and neighboring African countries. Due to a lack of adequate information, it is important to assess Internet use, spatial variation, and determinants of Internet use among reproductive-age group women in Ethiopia. Method: Secondary data from EDHS 2016 were used to analyze 15,683 women aged 15–49 years. Spatial analysis was performed using ArcGIS 10.7. The Bernoulli model was used by applying Kuldorff's methods using SaTScan 10.1.2 software to analyze the purely spatial clusters of Internet use. A multilevel mixed-effect logistic regression was applied to estimate community variance to identify individual- and community-level factors associated with Internet use. All models were fitted in STATA version 17.0, and finally, the adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was reported. Result: The magnitude of Internet use was 4.97% ± 95% CI (4.63–5.32). The overall average age of women was 24.21 ± 8.06 years, with the age range 15–24 years constituting the larger group (39.2%). Women with secondary and above education [AOR = 6.47; 95% CI (5.04, 8.31)], unmarried [AOR = 2.60; 95% CI (1.89, 3.56)], rich [AOR = 1.95; 95% CI (1.00, 3.80)], own a mobile phone [AOR = 3.74; 95% CI (2.75, 5.09)], media exposure [AOR = 2.63; 95% CI (2.03, 3.42)], and urban [AOR = 1.80; 95% CI (1.08, 3.01)] had higher odds of Internet use. The spatial variation in Internet use was found to be nonrandom (global Moran's I = 0.58, p value < 0.001). Fifty-seven primary clusters were identified that were located in Addis Ababa city with a relative likelihood of 10.24 and a log-likelihood ratio of 425.16. Conclusions: Internet use among reproductive-age women in Ethiopia is 4.97 and has significant spatial variation across the country. Both community- and individual-level factors affect Internet use in Ethiopia. Therefore, educating women, improving access to media, encouraging women to use family planning, and supporting household wealth could improve women's Internet use. [ABSTRACT FROM AUTHOR]

The October 29, 2022, Seoul Halloween Crowd Crush (SHCC) caused the loss of 159 lives, making it the deadliest global mass-gathering disaster between 2018 and 2022. Despite the fact that years have passed since the incident, there remains a significant gap in research addressing the mental health of citizens to evaluate their recovery progress. Therefore, in this study, a survey was conducted to assess citizens' anxiety, depression, post-traumatic stress disorder (PTSD), and well-being after the SHCC. The data were analyzed using t-tests, analysis of variance (ANOVA), correlations, a Kruskal–Wallis test, and post hoc tests. The citizens' well-being differed significantly by victimization status, with direct victims showing languishing well-being (p =.036). PTSD severity level was higher in victims and direct witnesses (p <.001). Victims and direct witnesses exhibited worse outcomes in subjective, social, and psychological well-being as well as in PTSD (p <.001). Well-being exhibited a significant negative correlation with PTSD (r = −.247, p <.001). The results of the analysis suggest the SHCC's psychological impact has endured not only for victims and direct witnesses but also for media-exposed citizens. Offering continuous psychological support and fostering positive self-perceptions and social interactions are crucial for their recovery and well-being enhancement. [ABSTRACT FROM AUTHOR]

Non-condom use is known as one of the risky sexual behaviors among youth and a contributing factor to the high prevalence of HIV in Nigeria. Therefore this study aimed to assess the spatial pattern and determinants of non-condom use among sexually active young people in Nigeria. The study employed a cross-sectional analysis of population-based data involving 288 males and 780 females aged 15–24 years, giving 1068 sexually active young people drawn from the 2018 NDHS. The study adopted a multi-level and spatial analysis to identify factors associated with non-condom use in Nigeria. The prevalence of non-condom use was 57.7% in this study. The spatial analysis showed that the Northeastern and South–South regions of Nigeria had a high proportion of non-condom use among young people, while the Northwest, North-Central, and Southwestern parts had low proportions of non-condom use. On multilevel analysis, the individual and community level factors associated with non-condom use included exposure to media (AOR 0.59; 95% CI 0.39–0.91) and younger age (AOR 0.72; 95% CI 0.53–0.98). Areas with a high proportion of non-condom use should receive the most attention through the promotion of condom use and education, alongside a focus on important associated factors. [ABSTRACT FROM AUTHOR]

While socioeconomic gradients in regional health inequalities are firmly established, the synergistic interactions between socioeconomic deprivation and climate vulnerability within convenient proximity and neighbourhood locations with health disparities remain poorly explored and thus require deep understanding within a regional context. Furthermore, disregarding the importance of spatial spillover effects and nonlinear effects of covariates on childhood stunting are inevitable in dealing with an enduring issue of regional health inequalities. The present study aims to investigate the spatial inequalities in childhood stunting at the district level in Pakistan and validate the importance of spatial lag in predicting childhood stunting. Furthermore, it examines the presence of any nonlinear relationships among the selected independent features with childhood stunting. The study utilized data related to socioeconomic features from MICS 2017–2018 and climatic data from Integrated Contextual Analysis. A multi-model approach was employed to address the research questions, which included Ordinary Least Squares Regression (OLS), various Spatial Models, Machine Learning Algorithms and Explainable Artificial Intelligence methods. Firstly, OLS was used to analyse and test the linear relationships among selected variables. Secondly, Spatial Durbin Error Model (SDEM) was used to detect and capture the impact of spatial spillover on childhood stunting. Third, XGBoost and Random Forest machine learning algorithms were employed to examine and validate the importance of the spatial lag component. Finally, EXAI methods such as SHapley were utilized to identify potential nonlinear relationships. The study found a clear pattern of spatial clustering and geographical disparities in childhood stunting, with multidimensional poverty, high climate vulnerability and early marriage worsening childhood stunting. In contrast, low climate vulnerability, high exposure to mass media and high women's literacy were found to reduce childhood stunting. The use of machine learning algorithms, specifically XGBoost and Random Forest, highlighted the significant role played by the average value in the neighbourhood in predicting childhood stunting in nearby districts, confirming that the spatial spillover effect is not bounded by geographical boundaries. Furthermore, EXAI methods such as partial dependency plot reveal the existence of a nonlinear relationship between multidimensional poverty and childhood stunting. The study's findings provide valuable insights into the spatial distribution of childhood stunting in Pakistan, emphasizing the importance of considering spatial effects in predicting childhood stunting. Individual and household-level factors such as exposure to mass media and women's literacy have shown positive implications for childhood stunting. It further provides a justification for the usage of EXAI methods to draw better insights and propose customised intervention policies accordingly. [ABSTRACT FROM AUTHOR]

Background: Contrast-induced nephropathy (CIN) is characterised by a rise in serum creatinine of at least 0.5mg/dL or a relative increase of more than 25% from admission baseline to 48-72 hours after intravascular iodinated contrast media exposure. The aim of this study was to evaluate the predictive value of the PRECISE DAPT score for the development of contrast induced nephropathy (CIN) in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI) and compare its predictive power to the Mehran score. Methods: One hundred patients with acute coronary syndrome had percutaneous coronary intervention at Zagazig University Hospitals and Nasr City health Insurance as part of this prospective observational cohort study. Of the included 100 acute coronary syndrome patients, 13 had developed contrast induced nephropathy and 87 didn’t develop CIN. Results: Mehran score has 76.9% sensitivity, 64.4% specificity, and 70.65% accuracy at a cutoff value >6, making it a significant predictor of the development of CIN (AUC: 0.746, p <0.001). The AUC of 0.929, p <0.001, indicates that the Precise-DAPT score is a significant predictor of the development of CIN. Witha cutoff value greater than 23, the score has 92.3% sensitivity, 83.9% specificity, and 88.1% accuracy. Compared to the Mehran score, the precise-DAPT score is a more reliable indicator of CIN (difference between both AUCs = 0.183, p = 0.005). Conclusions: In addition to early CIN prediction, PRECISE-DAPT may be helpful in selecting treatment approaches. [ABSTRACT FROM AUTHOR]

This study delved into the influential role of state media in shaping public opinion and cultivating policy support. Focusing on the Chinese government's insistence on the zero-COVID policy, we conducted a nationwide survey (N  = 665) to examine the cultivation effect of state media on Chinese people's support for the zero-COVID policy. We found that the more state media people were exposed to on social media, the more they supported the zero-COVID policy. State media exposure on social media was positively associated with trust in the government and fear of the virus among the audience, both of which mediated the effect of state media exposure on zero-COVID policy support. By applying the cultivation theory, this study contributed to our understanding of public opinion and information manipulation under authoritarian contexts in the digital age. [ABSTRACT FROM AUTHOR]

This article analyzes the extent to which certain cultural dimensions explain the intensity with which citizens of different countries perceive the presence of fake news in their daily lives. The research is based on the Flash Eurobarometer survey conducted in 2018 about fake news and disinformation online in 25 European countries, and adopts the Hofstede cultural dimensions as a model of cultural analysis. The study uses multilevel regression analysis to test individual and macro-level indicators that explain variations in perceptions of fake news. The findings reveal a clear, direct relationship between uncertainty avoidance, masculinity, and fake news exposure, as well as an interaction of these cultural dimensions with age, but not with the other individual and media use related variables. These results have theoretical and practical implications, especially from the point of view of the design of public policies to fight disinformation in the European Union (EU). [ABSTRACT FROM AUTHOR]

Recent studies have indicated the potential detrimental psychological effects of Instagram use (IU) and problematic Instagram use (PIU). PIU and IU have been associated with depression, anxiety, and negative general well-being. This study aimed to investigate that correlation through a systematic review and meta-analysis. Seven databases, including PubMed/MEDLINE, were explored in February of 2023. Studies that assessed the association between IU and/or PIU with depression, anxiety, other psychological distresses, and/or general well-being were deemed eligible. The Hunter–Schmidt random effects model and multilevel meta-analysis were applied to assess the outcomes of interest. A total of 1,927 hits were identified with 37 studies included in the quantitative analysis after removal of duplicates and screening of abstracts and full texts, with the total number of participants at 14,305. The obtained correlations between PIU and depression, anxiety, and well-being with 95% confidence interval were found to be r = 0.35, [0.25, 0.44], r = 0.31, [0.22, 0.40], r = −0.17, [−0.24, −0.10], respectively. Similarly, for IU and depression r = 0.11, [0.06, 0.16], p < 0.05 for all of the aforementioned results. The association between IU and anxiety was found to be r = 0.12, [0.04, 0.21], p < 0.05. The present meta-analysis found significant conceptual heterogeneity across the studies included due to different study designs and population heterogeneity. The results show a positive association of PIU and IU with depression, anxiety, and other psychological distress(es). There is a need for robust designed longitudinal research to explore this association. [ABSTRACT FROM AUTHOR]

Social media greatly facilitates people's access to information; however, it can also lead to information overload and exposure to uncomfortable content that may cause individuals to avoid it. As a result, two types of influencing mechanisms emerge: information exposure and information avoidance, which may impact users' behaviors. Currently, there is limited understanding of the simultaneous effects of social media information exposure and avoidance on individuals' behavioral intentions towards climate change mitigation. Using survey data for 1056 Chinese Gen-Z undergraduates and based on the extended theory of planned behavior, this paper utilizes a partial least squares structural equation model to examine the effects of social media information exposure and information avoidance on individual low-carbon behavioral intention. The results show that information exposure on social media has a positive relationship with behavioral attitude, subjective norm, and perceived behavioral control, and then increasing the low-carbon behavioral intention. Information avoidance has a negative association with three factors, respectively, and decreases the low-carbon behavioral intention. Additionally, exposure to social media information has the greatest impact on the subjective norm and the least impact on behavioral attitude; information avoidance has the greatest impact on behavioral attitude, whereas perceived behavioral control is the least affected. Drawing from the results, we propose policy recommendations that facilitate information exposure while addressing avoidance in shaping low-carbon behavioral intentions. Those implications would help reconcile the two opposing effects while promoting public engagement in climate activities. [ABSTRACT FROM AUTHOR]

Video on Demand (VOD) has become the most popular way for adolescent viewers to consume entertainment media, often without parental supervision. Given the potential for modeling, this study aims to investigate the prevalence and nature with which risky health behaviors are portrayed in popular VOD programs. A quantitative content analysis of trending programs (N = 529) from popular VOD-platforms investigated the prevalence, co-occurrence, tone, social context, and consequences with which alcohol use, tobacco use, drug use, unsafe sexual behavior, reckless behavior, and self-harm behaviors are portrayed in popular VOD programs. In addition, we analyzed the demographic characteristics of the characters who portrayed the risk behaviors Risk behaviors were portrayed frequently, with substance use behaviors (i.e. alcohol, smoking, drugs) being most prevalent and most likely to co-occur. Reckless behavior, self-harm behaviors, and explicitly unsafe sexual behaviors were much less common. Findings show that risk behavior was often portrayed in a normalized manner, with alcohol and smoking, in particular, being portrayed as neutral behaviors that rarely have consequences. Most risk-taking characters were (young) adult white males, mirroring the general overrepresentation of this demographic in popular media. Risk behavior was rarely problematized in popular on demand content. Potential consequences for adolescent viewers are discussed. [ABSTRACT FROM AUTHOR]

Nanoparticles are increasingly implemented in biomedical applications, including the diagnosis and treatment of disease. When exposed to complex biological media, nanoparticles spontaneously interact with their surrounding environment, leading to the surface-adsorption of small and bio- macromolecules- termed the "corona". Corona composition is governed by nanoparticle properties and incubation parameters. While the focus of most studies is on the protein signature of the nanoparticle corona, the impact of experimental protocols on nanoparticle size in the presence of complex biological media, and the impact of nanoparticle recovery from biological media has not yet been reported. Here using a non-degradable robust model, we show how centrifugation-resuspension protocols used for the isolation of nanoparticles from incubation media, incubation duration and shear flow conditions alter nanoparticle parameters including particle size, zeta potential and total protein content. Our results show significant changes in nanoparticle size following exposure to media containing protein under different flow conditions, which also altered the composition of surface-adsorbed proteins profiled by SDS-PAGE. Our in situ analysis of nanoparticle size in media containing protein using particle tracking analysis highlights that centrifugation-resuspension is disruptive to agglomerates that are spontaneously formed in protein containing media, highlighting the need for in situ analytical methods that do not alter the intermediates formed following nanoparticle exposure to biological media. Nanomedicines are mostly intended for parenteral administration, and our findings show that parameters such as shear flow can significantly alter nanoparticle physicochemical parameters. Overall, we show that the centrifugation-resuspension isolation of nanoparticles from media significantly alters particle parameters in addition to the overall protein composition of surface-adsorbed proteins. We recommend that nanoparticle characterization pipelines studying bio-nano interactions during early nanomedicine development consider biologically-relevant shear flow conditions and media composition that can significantly alter particle physical parameters and subsequent conclusions from these studies. [Display omitted] • We investigate the impact of protein corona experimental pipelines on particle colloid stability. • We show that physiologically relevant flow conditions alter nanoparticle parameters. • Using a model system, we demonstrate that more gentle separation or in situ techniques are needed for analysis of the nanoparticle protein corona. [ABSTRACT FROM AUTHOR]

Facebook was a major conduit to fake news exposure during the 2016 U.S. Presidential election. This article explores factors that predict liking pages for "fake news" websites on the Facebook platform. Leveraging paired survey and digital trace data from 806 American Facebook users, we determine that 18.4% of subjects liked at least one page for a website that published fake news. A substantial share of fake news page likes (23.9%) came from lifestyle sites that also published misinformation. Regression analyses determine that age, male sex, Trump support, and political participation are associated with liking fake news pages. A network analysis based on audience overlap finds three page clusters of fake news content—two right-leaning and one left-leaning—that also contain a majority of political and news pages. Results add nuance to our understanding of fake news by illustrating the role of non-political sources in providing potential exposure to misinformation on Facebook. [ABSTRACT FROM AUTHOR]

We examined rural and urban prevalence and correlates of overweight/obesity among women of reproductive age using survey data from Nigeria. Overweight and obesity prevalence increased from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, while underweight prevalence consistently averaged at 12%. Regardless of the residential setting, age, marital status, education, occupation, wealth, and year were associated with higher risk of overweight/obesity, whereas breastfeeding showed a protective effect. Unique risk factors for overweight/obesity in urban areas were higher parity and female-headed households, while ethnicity, media exposure, and state of residence were unique risk factors in rural areas. [ABSTRACT FROM AUTHOR]

We aimed to explore the relationship between media exposure to the Kahramanmaraş earthquakes and its impact on children's mental health difficulties. This cross-sectional study was conducted with 409 parents between March and July 2023. Parents were invited to participate in an online survey through social media platforms. The data was collected using the 'Descriptive Characteristics Form', the 'Media Exposure Form Related to the Earthquake', and the 'Strengths and Difficulties Questionnaire'. The results indicated that exposure to images of earthquake-related events on the first day after the earthquake (p < 0.001), people rescued alive from the rubble on television (p < 0.001), earthquake victims staying on the streets/in tents on television (p = 0.006), and earthquake-related events while alone on the Internet (p = 0.02) were significantly associated with the impact of children's mental difficulties. Furthermore, exposure to images of people pulled deceased from the rubble (p < 0.001), exposure to images of demolished houses on the Internet (p = 0.007), and exposure to images of destroyed roads on the Internet (p = 0.01) were found to significantly predict the impact of children's mental difficulties (r2 = 0.29; p < 0.001). This study has shown that children who are exposed to screen media may experience difficulties in coping mentally, leading to emotional and behavioral problems. Children who have experienced natural disasters may be exposed to distressing images on screen, which can lead to difficulties and stress. To reduce the risk of mental health problems related to disasters, nurses may suggest that victims limit their exposure to television footage. • There is no research about media exposure and mental health in children following Kahramanmaraş earthquakes. • Internet and TV media images of dead people, earthquake victims on the streets/tents negatively affect children. • Internet and TV media images of destroyed houses and roads negatively affect children. [ABSTRACT FROM AUTHOR]

Background: The second most common cause of death for children under five is diarrhea. Early Predicting diarrhea disease and identify its determinants (factors) using an advanced machine learning model is the most effective way to save the lives of children. Hence, this study aimed to predict diarrheal diseases, identify their determinants, and generate some rules using machine learning models. Methods: The study used secondary data from the 12 east African countries for DHS dataset analysis using Python. Machine learning techniques such as Random Forest, Decision Tree (DT), K-Nearest Neighbor, Logistic Regression (LR), wrapper feature selection and SHAP values are used for identify determinants. Result: The final experimentation results indicated the random forest model performed the best to predict diarrhea disease with an accuracy of 86.5%, precision of 89%, F-measure of 86%, AUC curve of 92%, and recall of 82%. Important predictors' identified age, countries, wealth status, mother's educational status, mother's age, source of drinking water, number of under-five children immunization status, media exposure, timing of breast feeding, mother's working status, types of toilet, and twin status were associated with a higher predicted probability of diarrhea disease. Conclusion: According to this study, child caregivers are fully aware of sanitation and feeding their children, and moms are educated, which can reduce child mortality by diarrhea in children in east Africa. This leads to a recommendation for policy direction to reduce infant mortality in East Africa. [ABSTRACT FROM AUTHOR]

A growing number of older adults are using social media to acquire health information through active information search (i.e., information seeking) and routine exposure to media sources (i.e., information scanning). In China, as in other societies, social media platforms have become a mixed source of credible and unreliable health information that could impact older adults' health self-management. Understanding factors associated with their use of social media to acquire health information is crucial for promoting smart online information practices among older adults. Against this backdrop, this study explored the association between two cognitive factors (outcome expectancy and efficacy) and two relational factors (social support and health opinion leadership) with older WeChat users' health information seeking and scanning behaviors. We conducted a paper-and-pencil survey with 407 older adults aged 60 and above (M = 68.54, SD = 6.21) in an eastern city in China. The results indicated that older WeChat users' health information scanning was associated with their health status, efficacy, social support, and health opinion leadership. Additionally, their health information seeking was associated with their education, efficacy, health opinion leadership, and frequency of health information scanning. This paper concludes with discussions on the theoretical and practical implications of the findings. [ABSTRACT FROM AUTHOR]

Recent research based on samples from Western countries has shown that the framing of information influences judgments of its truth, with negative framed statements perceived as more credible than formally equivalent positive framed statements. However, these findings may not apply to all Chinese residents because of China's unique news contexts that adhere to positive reporting and a collectivist culture. Although the equivalence framing also affects people's judgment of the truth of the information in China, it differs from people in Western countries. Chinese people believe statements with positive framed statements are more credible than statements with formally equivalent negative frames. They are more likely to associate positive information with news and show no obvious reactance to the persuasive intention perceived from positive framed statements. In addition, exposure to information from non-official media is changing this particular outcome, and people with frequent access to non-official media show similar responses to those in the West along these paths. [ABSTRACT FROM AUTHOR]

This study investigates households' willingness to pay (WTP) for better water systems, clean water availability, and water quality in Gadaizi tehsil, District Buner, Pakistan. This research aims to shed light on various aspects of water quality, health impacts, and socioeconomic factors influencing households' ability to pay for superior water services. This research also looks into waterborne infection and water purification methods residents utilize to mitigate the risk of water pollution. Utilizing a mixed‐method approach with a structured questionnaire, data from 62 households were collected. SPSS was used for data analysis. Findings reveal awareness of water contamination issues, primarily attributed to marble industries. Most households use untreated water, boiling, chemicals, or candle filters. Water purification methods are influenced by media exposure and higher income. Common waterborne diseases, such as typhoid and diarrhea, are treated in private hospitals. Consumer WTP for better water systems depends on income, education, and media exposure, in which income has a statistically significant positive effect on WTP for improved water services. Although 76% of households do not use any water purification method. 84% of households are willing to adopt a private sector‐provided system. Importantly, this study highlights the necessity for public health initiatives and a thorough understanding of socioeconomic issues to guide political choices for better water delivery. These insights can inform policies that prioritize public health and ensure better access to clean water for all. [ABSTRACT FROM AUTHOR]

In 2015, the UK government placed teachers in England and Wales at the forefront of efforts to prevent radicalisation in young people. Radicalisation as a concept is complex and confusing, and addressing it in schools may be perceived as controversial. This article investigates how secondary school teachers and Prevent practitioners across England understand the concept of radicalisation in education and the impact of the Prevent Duty on teachers' professional role. Both groups are public service officials who work with or within secondary schools under different capacities. Thirteen teachers and fourteen Prevent practitioners were interviewed using semi-structured interviews, allowing for in-depth discussions. A thematic analysis approach was used to analyse and organise the data. The findings highlight discrepancies between teachers' and Prevent practitioners' understanding of radicalisation, due to different levels of knowledge, job expertise, personal interest, media exposure and training. This inquiry sheds light on how teachers' and Prevent practitioners' conceptualisation of radicalisation impacts the way they understand and comply with state policy – in this case, the Prevent Duty, within education. [ABSTRACT FROM AUTHOR]

Sports, traditionally pregnant with aggression and violence, are now a breeding ground for online abuse, where toxicity and malicious campaigns on social media have even afflicted national sports role models together with their huge fan base. Drawing on an online survey of 917 Chinese volleyball enthusiasts, this study investigated the psycho-behavioral outcomes of sports fans’ social media exposure to abusive messages about their idols through the lens of rejection-(dis)identification theory. Findings indicate that fans’ subjective frequency of negative social media exposure is significantly negatively associated with their sport-related well-being but has no direct connection with their offline sport engagement. The study particularly delves into the mediating roles of fans’ multiple identities, namely sport identity as a competitive mediator and national identity as a complementary mediator. Furthermore, with multi-group structural equation modeling and mediation analyses on gender sub-groups, gender differences were determined such that male fans, compared with female fans, were more likely to marshal their identity capital, which effectively enhanced their well-being and participation in sports. By linking classic theoretical propositions, this study offers a nuanced understanding of the sociopsychological consequences of online abuse in sports for ordinary social media users, contributing to both theoretical insights and practical implications. [ABSTRACT FROM AUTHOR]

The efficacy of fake news corrections in improving memory and belief accuracy may depend on how often adults see false information before it is corrected. Two experiments tested the competing predictions that repeating fake news before corrections will either impair or improve memory and belief accuracy. These experiments also examined whether fake news exposure effects would differ for younger and older adults due to age-related differences in the recollection of contextual details. Younger and older adults read real and fake news headlines that appeared once or thrice. Next, they identified fake news corrections among real news headlines. Later, recognition and cued recall tests assessed memory for real news, fake news, if corrections occurred, and beliefs in retrieved details. Repeating fake news increased detection and remembering of corrections, correct real news retrieval, and erroneous fake news retrieval. No age differences emerged for detection of corrections, but younger adults remembered corrections better than older adults. At test, correct fake news retrieval for earlier-detected corrections was associated with better real news retrieval. This benefit did not differ between age groups in recognition but was greater for younger than older adults in cued recall. When detected corrections were not remembered at test, repeated fake news increased memory errors. Overall, both age groups believed correctly retrieved real news more than erroneously retrieved fake news to a similar degree. These findings suggest that fake news repetition effects on subsequent memory accuracy depended on age differences in recollection-based retrieval of fake news and that it was corrected. [ABSTRACT FROM AUTHOR]

Background: Contraceptive usage in Ethiopia is significantly influenced by the decision-maker at the household level. Joint decision-making involving both women and their husbands/partners is considered ideal for improving contraceptive uptake among women and for managing health outcomes related to contraceptive side effects. However, there is a lack of substantial evidence regarding the prevalence and impact of joint decision-making on contraceptive use in Ethiopia. Therefore, the current study aimed to assess the magnitude of joint decision-making on contraceptive use and its determinant factors among married, contraceptive-using, reproductive-age women in Ethiopia. Methods: This study was conducted based on the Ethiopian Demographic and Health Survey (EDHS) 2016 data. A total weighted sample of 3,669 married, contraceptive-using, reproductive-age women were included in the study. Multilevel logistic regression was employed due to the hierarchical nature of the data. Variables with a p-value of ≤ 0.2 in the bivariate multilevel analysis were included in the multivariable multilevel analysis. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine the direction and strength of associations. Variables with a p-value of < 0.05 in the multivariable multilevel analysis were considered statistically significant for joint decision-making on contraceptive use. Results: The prevalence of joint decision-making on contraceptive use in Ethiopia was 78.81% [95% CI: 71.35-74.23%]. Several factors were found to be statistically significant in relation to joint decision-making on contraceptive use: Women educational level primary, secondary, and higher (Adjusted odds' ratio (AOR = 1.5; CI 1.2–1.9), (AOR = 1.9; CI 1.3–2.9), and (AOR = 2.1; CI 1.2–3.5) respectively, protestant in religion (AOR = 1.7; CI 1.7–2.5), wealth status rich (AOR = 1.4; CI 1.1–1.9), media exposure (AOR = 1.4; CI 1.1–1.9), and community poverty high (AOR = 0.6; CI 0.6–0.9). Conclusions: In Ethiopia, the majority of contraceptive users are married, reproductive-age women, and their decision to use contraceptives is typically made jointly with their husbands or partners. Factors positively associated with joint decision-making on contraceptive use include women's educational level (primary, secondary, and higher), being Protestant, having a higher wealth status, and media exposure. Conversely, women living in communities with high poverty levels are less likely to make joint decisions about contraceptive use. Health care providers, health care programmers and policy makers should be focused on these determinant factors to enhance joint decision-making in women's contraceptive use in Ethiopia. [ABSTRACT FROM AUTHOR]

Hurricane Harvey was the second costliest storm to impact the U.S. More research is needed to understand the mental health consequences of these extreme events in children and adolescents extending beyond the acute recovery period. Daily anonymized Crisis Text Line (CTL) conversations were used to understand patterns in crisis responses for youth one year before and after Harvey's landfall. A quasi-experimental difference-in-differences analysis compared changes in texts for stress/anxiety, depression, thoughts of suicide, and self-harm following Harvey between exposed and unexposed youth in Texas. CTL users with Texas-based area codes (N = 23,016) were compriesd largely of youth who self-identified as female (78.1 %), 14–17 year old (50.4 %), white (38.9 %), and LGBTQ+ (51.2 %). We observed parallel increases in crisis texts for depression and thoughts of suicide in most months following Harvey among exposed and unexposed youth. However, non-impacted youth had significantly larger increases in texts for depression up to three months post-Harvey and thoughts of suicide one year after Harvey compared to directly impacted communities. Sample size was restricted to texters who completed the post-conversation demographics survey, who may fundamentally differ from those who declined to respond. Harvey exposure was determined using texter area code and county-level disaster declarations, limiting our ability to guarantee individual-level exposure. Texas youth traditionally considered unexposed experienced nearly identical increases in concerns of depression and thoughts of suicide to those directly exposed. Findings suggest spillover effects (e.g., economic concerns, media exposure) may contribute to statewide impacts on youth mental health after natural disasters. • More research on mental health impacts of climate disasters in youth is needed. • Causal difference-in-difference model measured crisis response in youth post-Harvey. • Depression and thoughts of suicide increased statewide in Texas youth after Harvey. • Findings suggest need for broader dissemination of crisis support services in youth. [ABSTRACT FROM AUTHOR]

Background: Many married women of reproductive age with husbands or partners are less cooperative in using contraceptives, often resulting in unintended pregnancies or secret contraceptive use. This private use of contraceptives causes women to suffer from side effects without proper support, and many women in Ethiopia die due to unintended pregnancies. However, the involvement of husbands or partners in the contraceptive decision-making process in Ethiopia is often neglected. There is also a lack of evidence regarding the determinants of husbands' or partners' decision-making power on contraceptive use in Ethiopia. Objective: This study aimed to assess the determinants of low involvement of husbands/partners in women's contraceptive use decision-making processes in Ethiopia. Methods: This study was based on Ethiopian Demographic and Health Survey data, collected from January 18 to June 27, 2016. Weighted samples of 3,669 reproductive-age women were included. Husbands'/partners' independent decision-making was measured by whether the husband/partner decided independently or alone about contraceptive use, categorized as "Yes" or "No". A multilevel logistic regression model was fitted, and ICC (Intra-class Correlation Coefficient), MOR (Median Odds Ratio), PCV (Proportion Change in Variance), and deviance were used to assess model fitness and comparison. Variables with a p-value of ≤ 0.2 in the bivariate analysis were considered candidates for multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval was used to determine both the direction and strength of the association, and a p-value of < 0.05 was used to declare statistical significance. Results: Husbands'/partners' independent decision-making in women's contraceptive use was found to be 5.41% [4.72-6.19%]. Significant factors associated with this included: Husbands/partners aged 31–59 years (Adjusted Odds Ratio (AOR) = 1.3; Confidence Interval (CI) 2.3–5.4) and over 59 years (AOR = 2.3; CI 1.2–4.3), Educational level of husbands/partners: primary education (AOR = 3.2; CI 2.9–4.3), secondary education (AOR = 3.9; CI 2.7–4.4), and higher education (AOR = 4.3; CI 2.8-5.0), Media exposure (AOR = 4.5; CI 2.2–5.4), History of pregnancy termination (AOR = 3.3; CI 2.6–4.1), Perception that distance to health facilities is not a significant problem (AOR = 3.0; CI 1.7–4.7) and Urban residency (AOR = 3.5; CI 1.6–4.2). Conclusions: In Ethiopia, the involvement of husbands/partners in the contraceptive use decision-making process is low. To increase their decision-making power, attention should be given to factors such as age, educational level, media exposure, history of pregnancy termination, distance to health facilities, and urban residency. [ABSTRACT FROM AUTHOR]

Background: The development, approval and adoption of the malaria vaccine has provided effective supplemental protection against malaria for children in Ghana. However, heightened awareness of the new vaccine will play a critical role in its mass deployment and acceptance among potential recipients. This study therefore determined the sociodemographic characteristics associated with malaria vaccine awareness and ascertained the influence of traditional media exposure on awareness in Ghana. Methods: The study used the Demographic and Health Survey 2019 Malaria Indicator Survey Data. After necessary recoding, chi-square and complex survey bivariate/multivariate logistic regression analyses were performed using STATA 18.0. Results: Among the participants, 35.65% (95% CI: 33.83%–37.51%) had heard about the malaria vaccine. Positive predictors of awareness included higher education attainment (AOR = 1.92, 95% CI: 1.28–2.88), rural residency (AOR = 1.28, 95% CI: 1.05–1.56) and being in the northern part of the country (AOR 1.54, 95% CI: 1.14–2.07). Other positive predictors of awareness were Guan ethnicity (AOR = 1.75, 95% CI: 1.09–2.81), malaria health education (AOR = 1.73, 95% CI: 1.45–2.07) and radio set ownership (AOR = 1.39, 95% CI: 1.19–1.62). Television ownership (AOR = 0.84, 95% CI: 0.69–1.01) showed no significant relationship with awareness. Conclusion: The general nationwide awareness has not yet reached a desirable level. This study suggests that, the awareness drive, preferably through radio campaigns, must target individuals with less than tertiary education and urban communities. Awareness campaigns on televisions should be evaluated and possibly redesigned for effectiveness. [ABSTRACT FROM AUTHOR]

The main thrust of this study was to explore the English language learning experiences of five Grade 6 Bangsamoro honor pupils at Mapayag Elementary School during the 2022-2023 academic year, employing a phenomenological research design. It uncovered that learners acquire English through various channels including parental assistance, media exposure, and peer interactions at home, while relying on personal efforts, teacher guidance, and peer engagement at school. In the community, learning occurs through interactions with playmates, friends, and relatives. However, learners encounter barriers such as embarrassment, mockery, and limited parental education. The findings underscored the challenges faced by Bangsamoro learners in English language usage due to constrained opportunities and social pressures. The study concluded by recommending initiatives to increase English usage across different contexts, foster interactions with English speakers, expand vocabulary, and emphasize correct language usage to enhance learners' confidence. [ABSTRACT FROM AUTHOR]

The ongoing Israel‐Hamas war is posing additional challenges for mental health workers in an already stressful workplace. This study centres on the psychological effects of the shared traumatic reality on mental health workers, arising from the Israel‐Hamas war. One month after exposure to the terrorist attack of 7 October 2023 and the outbreak of war following this event, 147 mental health workers completed questionnaires regarding a variety of variables such as demographics, anxiety symptoms, acute stress symptoms, media‐induced secondary trauma, personal resilience, National resilience (NR), and post‐traumatic growth (PTG). The study found that mental health workers with previous trauma displayed higher anxiety symptoms, acute stress symptoms, and media‐induced secondary trauma. Additionally, acute stress and anxiety were positively correlated with media‐induced secondary trauma. Religiosity, personal resilience, and NR were found associated with lower anxiety and acute stress symptoms. Religiosity was also positively correlated with personal resilience, NR, and PTG. The PTG of mental health workers working with trauma survivors and evacuees was higher compared to that of other mental health workers. Both adverse and adaptive reactions were evident among mental health workers. While traumatic stress is expected, individual, professional, and NR factors may mitigate its effects. Providing training, social support, regulated media exposure, stress management, and meaning‐focused coping strategies can help safeguard workers' well‐being. [ABSTRACT FROM AUTHOR]

This study examines the factors influencing resilience among high-risk groups in Malacca, Malaysia, during the COVID-19 endemic. High-risk groups, such as the elderly and frontline workers, face unique challenges and vulnerabilities during the public health crisis, which has brought about significant socio-economic disruptions, psychological distress, and uncertainty. The residents of Malacca have been significantly affected by the endemic, potentially leading to diminished resilience among the population. The study aims to measure the levels of knowledge, family support, media exposure, optimistic thinking, and resilience regarding COVID-19 prevention among the at-risk groups in Malacca. Secondly, it aims to assess the relationships between knowledge, family support, media exposure, optimistic thinking, and resilience within this population. Thirdly, it seeks to identify the best predictor of resilience among these high-risk groups. A quantitative research design was employed to achieve these objectives. A total of 384 respondents participated in an online survey, revealing that optimistic thinking significantly contributed to increasing resilience levels, particularly among those anxious about their safety. Optimistic thinking also positively impacted coping abilities. However, family support and media exposure did not show significant associations with resilience. Developing holistic support systems that consider all factors affecting resilience, including knowledge, family support, media exposure, and optimistic thinking, is essential for high-risk groups in Malacca. This study offers valuable insights into the factors influencing resilience among high-risk groups in Malacca during the COVID-19 endemic. Integrating these findings into public health and social welfare initiatives can create a comprehensive approach to supporting vulnerable individuals during challenging times. [ABSTRACT FROM AUTHOR]

Selective exposure literature indicates that not all users take away the same messages from their media exposure; it is suggested that viewers are not merely exposed but rather reactive to multiple—and possibly opposing—messages. The current study aims to introduce an active media-processing perspective, focusing specifically on the media-body image association among an early adolescent sample. Results of a three-wave longitudinal survey among 971 early adolescents (Mage = 11.14; SD = 1.13) show that media-focused peer interactions (W1), but not media exposure (W1), were associated with contradictory perceptions of attractiveness (i.e., perceived benefits and perceived costs for investing in appearance) (W2). Polynomial regression analyses pointed out that the association between these contradictory perceptions (i.e., interaction between benefits and costs; W2) was curvilinearily related to body image investment (W3). The findings emphasize the variable vulnerability of adolescents to the media effect and the importance of acknowledging multi-layered media messages. [ABSTRACT FROM AUTHOR]

The empirical study aimed to explore the relationships among social media exposure, job stress, anxiety, and identity disturbance in a nonclinical setting in the COVID-19 pandemic context. An online questionnaire was administered to 282 participants in the United States of America (USA) during the COVID-19 pandemic. The study utilized a two-step Structural Equation Modeling (SEM) approach consisting of both measurement model and structural model testing. Relationships between the model variables of social media exposure, identity disturbance, anxiety, and job stress were analyzed using standardized beta coefficients, standard errors, t-values, and p-values. The results indicate that both social media exposure and job stress are associated with increased anxiety levels, which, in turn, influence identity disturbance. Moreover, there is a moderating effect of job stress on the relationship between social media exposure and anxiety, as well as the mediating effect of anxiety on the relationship between social media exposure and identity disturbance. The findings are valuable for organizations and can be used to develop programs aimed at mitigating the adverse effects of social media exposure on mental health. Prioritizing employee mental health through awareness and support initiatives is paramount, especially for those facing high stress and extensive social media use. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought unprecedented challenges to healthcare and public health messaging in the United States. One area of focus has been vaccination uptake among Black Americans, who have experienced COVID-19 deaths disproportionate to their share of the United States population, raising questions about the processes involved in vaccination perceptions and behaviors. Guided by the Risk Information Seeking and Processing model, this study explored the roles of medical mistrust and social media as a source of risk information in Black Americans' vaccine hesitancy. Survey results from a YouGov panel sample of Black Americans (n = 1,136; 53.5% female) showed that social media use and medical mistrust were positively associated with belief in misinformation related to the COVID-19 vaccine, which, in turn, was positively related to vaccine hesitancy through perceived information insufficiency and information seeking intentions. Furthermore, we found that belief in misinformation and subjective norms toward anti-vaccination also serially mediated the association between social media use and medical mistrust with vaccine hesitancy. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Health communication scholars have provided ample evidence demonstrating the ways in which freedom-threatening language used in persuasive health messages evokes freedom-threat perceptions, state psychological reactance, and intentions to engage in behaviors opposite of those recommended by the health message. This study examined a novel mitigation strategy for diminishing these outcomes. We examined whether prior exposure to entertainment portrayals of moral virtue (versus a neutral video) can dampen audiences' psychological reactance, intentions to consume alcohol, and defensive message processing via their psychophysiological responses to a subsequent, freedom-threatening excessive alcohol consumption public service announcement (PSA). The results revealed that participants who viewed entertainment portrayals of moral virtue (N = 50 college-aged participants) self-reported higher levels of elevation, moved, and inspiration relative to participants in the control condition (N = 50 college-aged participants). Participants who were exposed to entertainment portrayals of moral virtue prior to the excessive alcohol consumption PSA also self-reported less psychological reactance and fewer behavioral intentions to consume alcohol following the excessive alcohol consumption PSA than participants in the control condition. Consistent with these self-report data, participants in the entertainment portrayals of moral virtue condition exhibited less defensive message processing of the excessive alcohol consumption PSA via their psychophysiological responses relative to the control group. The results indicate that initial exposure to entertainment portrayals of moral virtue can dampen audiences' cognitive, emotional, and behavioral responses to a subsequent, freedom-threatening health message, thereby increasing the chances of improved health outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this article is to study the effects of media communication regarding COVID-19 on the adoption of healthy behaviors. Specifically, we investigated the role of fear in the relationship between media exposure and adoption of healthy protective measures while also identifying individual effects for traditional media (TV and newspapers) versus social media. The study was based on a large sample of university students (n = 7554) during April 2020 in Brazil. Results showed that controlling for self-efficacy, age, and gender, total media exposure had greater indirect effect than direct effect on the adoption of healthy behaviors. The indirect effect was through the perception of fear of becoming ill (with COVID-19). We discuss the theoretical implications of the findings. [ABSTRACT FROM AUTHOR]

Despite the benefits of pre-exposure prophylaxis (PrEP) in preventing HIV and its potential for reducing racial/ethnic HIV inequities, PrEP remains underutilized among African Americans who may benefit from it. Factors of PrEP uptake include awareness and acceptability of this prevention strategy among this group, yet few community-informed interventions have been developed and evaluated to address these challenges. Thus, this study evaluates the effectiveness of a community-informed, six-month multimedia campaign (print, digital media, internet radio, social media) for African American young adults (age 18–29) in Louisville, Kentucky to increase PrEP awareness and PrEP use intentions. Pretest surveys, posttest surveys, and digital analytic metrics were used to determine campaign effectiveness. Logistic regressions indicate increased PrEP awareness over time (p ≤ 0.0001) and greater PrEP intention among participants reporting greater campaign affinity (p ≤ 0.05). Campaign digital analytic performance was similar to or exceeded that of industry competitors (e.g., healthcare organizations). Findings indicate that a community-informed multimedia campaign increased PrEP use intentions among those exhibiting greater campaign affinity (the extent to which participants report a favorable view of the campaign) and demonstrated similar or greater effectiveness in digital elements as industry competitors at a cost-effective price. Future studies should incorporate community-engaged approaches in developing health communication products for greater PrEP acceptability and efficiency. Trial registration: ClinicalTrials.gov identifier: NCT0355959. [ABSTRACT FROM AUTHOR]

Sexual violence among adolescents represents a significant problem in society. In this study, we aimed to examine risk factors for sexual violence perpetration in adolescent men and victimization in adolescent women among a community sample of Norwegian high school students. The participants (560 men and 751 women, aged between 16 and 21 years) responded to online questionnaires covering physical and non‐physical forms of sexual harassment and possible risk factors identified in the literature. Last year's prevalence rate of physical sexual perpetration reported by adolescent men was 7%. Comparably, the prevalence of physical sexual victimization reported by adolescent women was 30%. Path analyses suggest that sociosexuality was associated with adolescent men's sexual perpetration indirectly through sexual risk taking, alcohol intoxication, porn exposure, and sexual underperception that in turn was positively associated with undesirable non‐physical solicitation from and toward women. In addition, rape stereotypes were associated with perpetration behavior in adolescent men. For adolescent women, sociosexuality was associated with being sexually victimized primarily through sexual risk behavior, alcohol intoxication, and sexual overperception. These factors were again positively associated with sexual derogation from adolescent women and solicitation from adolescent men. Prior sexual abuse victimization was only indirectly associated with victimization. The factors associated with adolescent men's perpetration and adolescent women's victimization were highly similar. Future work aimed at reducing sexual violence in adolescence within the educational context might find it more effective to specifically target non‐physical forms of sexual harassment. [ABSTRACT FROM AUTHOR]