Systematic synthesis of intersectional best practices: knowledge translation for circumpolar indigenous disability.

Numerous theories, models, and frameworks (TMFs) currently exist for knowledge translation (KT), with scholarship that is increasingly inclusive of populations experiencing health inequalities. This study proposes two objectives: 1) exploring a nine-step method for synthesising best practices, acknowledging existing syntheses in the form of tailored-databases and review-style publications; and 2) collating best practices to inform KT that is inclusive to indigenous individuals living with disabilities in circumpolar regions. The resulting synthesis emphasises 10 best practices: explicitly connect the accountability of stakeholders to the wellbeing of the people they serve; recognise entanglement with existing neoliberal systems; assess impacts of KT on indigenous treatment providers; employ personal outreach visits; rectify longstanding delegitimization; avoid assuming the target group to be homogeneous, critically examine inequitable distribution of benefits and risks; consider how emphasis on a KT initiative can distract from historical and systemic inequalities; target inequitable, systemic social and economic forces; consider how KT can also be mobilised to gain power and control; assess what is selected for KT, and how it intersects with power position of external stakeholders and internal champions; and, allow people access-to-knowledge which changes inequitable systems.

Ethno-medicinal uses and cultural importance of stingless bees and their hive products in several ethnic communities of Bhutan.

BACKGROUND: Indigenous and non-indigenous people in subtropical and temperate areas of Bhutan share an intricate relationship with stingless bees for diverse purposes including ethno-medicinal uses. Stingless bees hold significant importance in the realms of social, economic, cultural, and spiritual aspects. Bhutan's cultural traditions demonstrate a strong bond with the environment, exemplified by the regular use of honey from stingless bees for remedies such as treating the common cold, cough, and sore throat. METHODS: Ethnographic research was conducted to document the ethno-medicinal uses and cultural importance of stingless in Bhutan. We deployed semi-structured interviews with stingless beekeepers and honey collectors including traditional healers who perform religious rituals for curing and preventing physical and mental illness. RESULTS: We documented 22 different uses of stingless bee honey in food, medicine, veterinary medicine, crafts, beliefs, and religious purposes. The relative cultural importance (RCI) of stingless bees among Bhutan's ethnic communities was assessed through our calculations. It was determined that these bees hold notably greater significance for the Lhotshampa communities compared to other ethnic groups in Bhutan. This finding demonstrates the dependence of Hindu ethnic communities on natural resources in their everyday life. All participant communities largely exploit these bees through destructive extraction practices. They often find the natural nests in nearby forests, transfer them as a log hive to their backyards, and practice traditional meliponiculture. CONCLUSION: The ethnic communities of Bhutan use stingless bees for various purposes and the local knowledge are persistent. However, significant efforts should be made to address the ethno-medicinal, ecological, biological, and commercial perspectives of meliponiculture in Bhutan.

UN peacekeeper health and risk factors --- a systematic scoping review.

BACKGROUND: Conflicts, natural disasters, and complex emergencies present substantial health challenges to United Nations (UN) peacekeepers deployed in mission areas. This scoping review aims at summarizing previous research on the health of UN peacekeepers and identifies issues for further investigation. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews, we systematically searched Web of Science, PubMed, EMBASE, Scopus and China National Knowledge Infrastructure (CNKI) for English and Chinese literature published from April 1997 to November 2023. A data charting form was developed by two reviewers to extract relevant themes and provided narrative descriptions. RESULTS: We screened 1079 de-duplicated records and included 143 studies in this scoping review. There were 112 studies on the health status of UN peacekeepers, with more than half on mental health problems such as stress and anxiety. Many studies explored the health status of UN peacekeepers in African countries deployed from mainly U.S., Canada, U.K., China, Australia and Norway. There were 39 studies on the health risk factors of UN peacekeepers, including natural environmental, social environmental, psychological, behavioral lifestyle, biological factors and health service factors. There were 62 articles on the health protection of UN peacekeepers, mainly based on previous deployment experience, with a lack of theoretical guidance from global health perspectives. This scoping review found that health problems of UN peacekeepers are complicated, and whose impacts are cross-border. Social environmental factors were explored the most among health risk factors. Disease prevention measures, medical and health measures, and psychosocial measures were the main health protection for UN peacekeepers. CONCLUSIONS: This scoping review highlighted that health problems of UN peacekeepers were typical global health issues with complicated and cross-border health risk factors. Therefore, comprehensive strategies could be taken from global health perspectives, including multi-phases (before-deployment, during-deployment, and post-deployment), multi-disciplines (public health, medicine, politics, health diplomacy, and others), and multi-levels (the UN, host countries, troop-contributing countries, the UN peacekeeping team, and UN peacekeepers).

Building public engagement and access to palliative care and advance care planning: a qualitative study.

BACKGROUND: Research evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required. METHODS: Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement. RESULTS: Three themes were generated from the data: "Visibility and relatability"; "Embedding opportunities for engagement into everyday life"; "Societal and cultural barriers to open discussion". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement. CONCLUSIONS: Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.

All of Us Program Illustrates What Less-Diverse Genomics Studies Might Be Missing.

This Medical News story discusses new findings from genomics studies involving diverse cohorts.

Community-based rehabilitation services implemented by multidisciplinary teams among adults with stroke: a scoping review with a focus on Chinese experience.

BACKGROUND: Despite the growing interest in hospital rehabilitation services for communities, studies on existing community-based rehabilitation (CBR) services remain scarce owing to limitations in the development of community health services and regional cultural diversity. As a guaranteed measure for ensuring the quality of rehabilitation services and achieving the desired service outcomes, clear roles and responsibilities in multidisciplinary teams and effective service delivery are particularly important. OBJECTIVE: This scoping review aimed to determine the scope of community stroke rehabilitation programs involving existing multidisciplinary teams and to analyze the implementation content and implementers' functional roles to provide guidance for future CBR programs. METHODS: The scoping review design followed the methodology of the Joanna Briggs Institute and was based on the normative scoping review framework proposed by Arksey and O'Malley. The comprehensive CBR framework was proposed by World Health Organization-guided data charting and analysis. RESULTS: Of the 22,849 identified citations, 74 studies were included, consisting of 6,809 patients with stroke and 49 primary caregivers, most of whom were from China. The most common working mode in CBR programs was a dual approach involving both healthcare professionals in medical institutions and community healthcare professionals. The number of programs in each discipline was in the following descending order: nursing, medical care, rehabilitation, psychology, nutrition, and public health. Among these, multidisciplinary teams comprising medical, nursing, and rehabilitation disciplines were the most common, with a total of 29 programs. Disciplinary members were mainly responsible for implementing their respective disciplinary content, with physicians providing guidance for the programs. More than 82.4% of the studies reported 2-4 intervention strategies. The intervention forms of rehabilitation content were the most diverse, whereas preventive interventions were more homogeneous than others. Physical function and socio-psychological measurements were the most commonly reported outcomes. CONCLUSION: CBR services implemented by multidisciplinary teams can effectively achieve functional and emotional improvement in patients with stroke, and nurses are the most involved in implementation, especially in community settings. The results further emphasize the importance of strengthening the exploration of nurses' maximum potential to implement CBR plans in future practice. TRIAL REGISTRATION: The registration information for this scoping review can be found at osf.io/pv7tg.

Whole-of-school physical activity implementation in the context of the Dubai Fitness Challenge.

INTRODUCTION: Physical activity (PA) promotion among school-aged youth is a global health priority. Recommendations for such promotion include implementing whole-of-school approaches that maximize resources across the school environment. This study examined schools' participation in an annual, government-led, and emirate-wide initiative in Dubai, called the Dubai Fitness Challenge, in which the goal is to accrue 30 minutes of PA every day for 30 days (as such, the initiative is colloquially referred to as "Dubai 30x30"). METHODS: A mixed-methods design was employed for this study. Three schools were recruited using convenience sampling. Participants were 18 physical education teachers, 20 classroom teachers, 2 principals and 45 students. Data sources included surveys, focus groups, and interviews. Data were analyzed using descriptive statistics, multinomial logistic regression, and open and axial coding to develop themes. RESULTS: School staff reported that most Dubai 30x30 activities were provided in physical education, at break times during school, and before and after school. Students reported that they mainly participated in Dubai 30x30 activities during physical education and occasionally participated in activities after school and on weekends. During school, students were more likely to reach higher PA intensity levels when they were in contexts other than the regular classroom setting. Among school staff, physical education teachers were most involved and classroom teachers were least involved in promoting Dubai 30x30. Parent engagement was high. Staff perceived that Dubai 30x30 brought the community together, but physical education teachers also indicated there was a lack of implementation guidance and they felt burdened. Participants believed Dubai 30x30 increased PA participation and helped to promote their schools. DISCUSSION: This study provides an initial glimpse into schools' participation in Dubai 30x30 and suggests that a whole-of-school PA lens is useful in gleaning information that could help to increase and optimize PA opportunities for students.

Rehabilitation models for community integration of adults with acquired brain injury in rural areas: a scoping review.

INTRODUCTION: Community integration (CI) is recognised as an overarching goal for the rehabilitation of individuals with acquired brain injury (ABI). However, adults with less severe ABI often experience a lack of support when they return home after discharge from hospital or inpatient rehabilitation, despite having persistent impairments and ongoing needs. Individuals living in rural areas are even less likely to receive adequate support during this period, which is often marked by challenges and uncertainty. This review aims to map and explore the research literature to identify existing models for rehabilitation service provision aimed at promoting the CI of home-dwelling adults with ABI living in rural areas. METHODS: A scoping review of the research literature was conducted. The study followed the Joanna Briggs Institute guidelines for scoping reviews and the PRISMA extension for scoping reviews. The databases searched were MEDLINE, Embase, AMED, CINAHL, Web of Science, Cochrane Library, PsycInfo, and Google Scholar. No limitations were set for the study design, time of publication, or country of origin, but only literature in English, Danish, Norwegian, or Swedish was considered for inclusion. RESULTS: Twenty-seven articles were included. All of them originated from four Western and predominantly English-speaking countries: Australia, Canada, the UK, and the US. A thematic analysis identified six model categories that reflect different strategies for providing rehabilitation that promote CI in adults with ABI in rural areas. Sorting the model categories into micro (individual, interpersonal), meso (organisational, community), and macro (policy, society) levels highlighted that most of the included literature concentrates on microlevel issues at the individual or interpersonal level. Microlevel model categories encompass self-management and education, the use of navigators, and the incorporation of everyday life activities into rehabilitation. Far fewer articles addressed mesolevel issues such as service development in rural areas or the development of inclusive rural communities, and only a single article addressed policy development at the macro level. CONCLUSION: The relatively low number of included articles and limited geographical distribution of studies indicate that more research is needed on rehabilitation models aimed at promoting CI in adults with ABI in rural areas. Although we identified several existing approaches to rehabilitation service provision in rural areas, there is still a need to develop models that fully consider the complexity and long-term nature of CI after ABI. The results also demonstrate that CI in rural areas not only is dependent on professional service delivery aimed at the individual with ABI but also can be promoted by supporting significant others, developing inclusive communities, and improving policies. More knowledge on such issues may facilitate a wider reorganisation of care systems to enhance the CI of adults with ABI in rural areas. However, this will require more research with a wider scope than microlevel service delivery.

Reducing health inequalities through general practice: a realist review and action framework.

Background: Socio-economic inequalities in health have been in the public agenda for decades. General practice has an influential role to play in mitigating the impact of inequalities especially regarding chronic conditions. At the moment, general practice is dealing with serious challenges in relation to workforce shortages, increasing workload and the impact of the COVID-19 pandemic. It is important to identify effective ways so that general practice can play its role in reducing health inequalities. Objectives: We explored what types of interventions and aspects of routine care in general practice decrease or increase inequalities in health and care-related outcomes. We focused on cardiovascular disease, cancer, diabetes and/or chronic obstructive pulmonary disease. We explored for whom these interventions and aspects of care work best, why, and in what circumstances. Our main objective was to synthesise this evidence into specific guidance for healthcare professionals and decision-makers about how best to achieve equitable general practice. Design: Realist review. Main outcome measures: Clinical or care-related outcomes by socio-economic group, or other PROGRESS-Plus criteria. Review methods: Realist review based on Pawson's five steps: (1) locating existing theories, (2) searching for evidence, (3) selecting articles, (4) extracting and organising data and (5) synthesising the evidence. Results: Three hundred and twenty-five studies met the inclusion criteria and 159 of them were selected for the evidence synthesis. Evidence about the impact of general practice interventions on health inequalities is limited. To reduce health inequalities, general practice needs to be: • connected so that interventions are linked and coordinated across the sector; • intersectional to account for the fact that people's experience is affected by many of their characteristics; • flexible to meet patients' different needs and preferences; • inclusive so that it does not exclude people because of who they are; • community-centred so that people who receive care engage with its design and delivery. These qualities should inform action across four domains: structures like funding and workforce distribution, organisational culture, everyday regulated procedures involved in care delivery, interpersonal and community relationships. Limitations: The reviewed evidence offers limited detail about the ways and the extent to which specific interventions increase or decrease inequalities in general practice. Therefore, we focused on the underpinning principles that were common across interventions to produce higher-level, transferrable conclusions about ways to achieve equitable care. Conclusions: Inequalities in general practice result from complex processes across four different domains that include structures, ideas, regulated everyday procedures, and relationships among individuals and communities. To achieve equity, general practice needs to be connected, intersectional, flexible, inclusive and community-centred. Future work: Future work should focus on how these five essential qualities can be better used to shape the organisational development of future general practice. Study registration: This trial is registered as PROSPERO CRD42020217871. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130694) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 7. See the NIHR Funding and Awards website for further award information.

Health inequalities are unfair differences in health across different groups of the population. In the United Kingdom, the health inequality gap in life expectancy between the richest and poorest is increasing and is caused mostly by differences in long-term conditions like cancer and cardiovascular disease and respiratory conditions, such as chronic obstructive pulmonary disease. Partly National Health Service inequalities arise in delays in seeing a doctor and care provided through doctors' surgery, such as delays in getting tests. This study explored how general practice services can increase or decrease inequalities in cancer, cardiovascular disease, diabetes and chronic obstructive pulmonary disease, under what circumstances and for whom. It also produced guidance for general practice, both local general practices and the wider general practice system, to reduce inequalities. We reviewed existing studies using a realist methodology. This methodology helps us understand the different contexts in which interventions work or not. We found that inequalities in general practice result from complex processes across different areas. These include funding and workforce, perceptions about health and disease among patients and healthcare staff, everyday procedures involved in care delivery, and relationships among individuals and communities. To reduce inequalities in general practice, action should be taken in all these areas and services need to be connected (i.e. linked and coordinated across the sector), intersectional (i.e. accounting for the fact that people's experience is affected by many of their characteristics like their gender and socio-economic position), flexible (i.e. meeting patients' different needs and preferences), inclusive (i.e. not excluding people because of who they are) and community-centred (i.e. working with the people who will receive care when designing and providing it). There is no one single intervention that will make general practice more equitable, rather it requires long-term organisational change based on these principles.

A multifaceted approach to global health.

World Health Day underscores the scientific community's commitment to achieving health equity for all. It is paramount to eliminate bias in research that has traditionally focused on men, neglecting the specific needs of diverse populations. Innovative clinical trial designs are being developed with more inclusive enrollment. Ensuring equitable access to essential antibiotics, coupled with robust infection prevention and control measures, is vital to safeguarding public health. The pursuit of health equity extends beyond the realm of medicine. Investments in local food production and robust social safety nets are critical for mitigating the effects of climate change on access to healthy diets. Additionally, in times of polycrisis, prioritizing the unique needs of children and empowering community-led healthcare initiatives in conflict zones are essential steps. By taking these actions, we can move closer to realizing everyone's fundamental right to health.

Navigating Aged Care Services with GIS: Trends, Developments, and Future Directions.

BACKGROUND: With the growing challenge of an aging population, emerging technologies are increasingly being integrated into the production, organization, and delivery of aged care services. Geographic Information System (GIS), a computer-based tool for spatial information analysis and processing, has made significant strides in the allocation of care recources and service delivery for older adults, a notably vulnerable group. Despite its growing importance, cross-disciplinary literature reviews on this theme are scare. This scoping review was conducted to encapsulate the advancements and discern the future trajectory of GIS applications in aged care services. METHODS: A comprehensive search across nine databases yielded 5941 articles. Adhering to specific inclusion and exclusion criteria, 61 articles were selected for a detailed analysis. RESULTS: The 61 articles span from 2003 to 2022, with a notable increase in publications since 2018, comprising 41 articles (67% of the total) published between 2018-2022. Developed countries contributed 66% of the papers, with 45% focusing on accessibility issues. In the domain of aged care services, GIS has been predominantly utilized for model construction, mapping, and site selection, with a growing emphasis on addressing the unique needs of different subgroups of older adults. CONCLUSION: The past two decades have seen substantial growth in the application of GIS in aged care services, reflecting its increasing importance in this field. This scoping review not only charts the historical development of GIS applications in aged care services but also underscores the need for innovative research approaches. Future directions should emphasize the integration of GIS with diverse methodologies to address the heterogeneous needs of older adults and improve the overall delivery of aged care services. Such advancements in GIS applications have the potential to significantly enhance the efficiency, accessibility, and quality of care for the aging population.

Embodiment of discrimination: a cross-sectional study of threats, humiliating treatment and ethnic discrimination in relation to somatic health complaints among Sámi in Sweden.

BACKGROUND: Ethnic discrimination is acknowledged as a social determinant of health for Indigenous populations worldwide. This study aimed to investigate embodiment of perceived ethnic discrimination among the Sámi population in Sweden. METHODS: A population-based health study was conducted among the Sámi population aged 18-84 years in 2021. Perceived discrimination was assessed by three variables: exposure to threat, humiliation treatment and ethnic discrimination. To capture current physical health, complaints of headache, back pain, stomach pain, sleeping problems, dizziness and tiredness were used. An overall somatic complaints score was created by summing up the six individual symptoms. The magnitude of the association between the independent variables and the outcomes was summarised with the ß coefficients and prevalence ratios using 95% credible intervals (95% CrI) for inferential purposes. RESULTS: Overall, 4.3% reported to have been exposed to threat, 26.1% to humiliation and 11.2% and 32.3% to ethnic discrimination in the last 12 months and beyond 12 months, respectively. After mutual adjustment, threat (ß=1.25; 95% CrI=0.88 to 1.60), humiliation (ß=1.29; 95% CrI: 1.14 to 1.44) and the two categories of discrimination (ß=0.92; 95% CI: 0.64 to 1.21 in the last 12 months and ß=0.68; 95% CI: 0.54 to 0.83 beyond) remained significantly associated to the overall somatic complaints score. Similar results were found for individual complaints. CONCLUSIONS: This study has shown a strong relationship between different expressions of perceived ethnic discrimination and a series of somatic complaints among the Sámi in Sweden. Efforts to alleviate interpersonal and institutional discrimination against the Sámi would contribute to improve their health.

Non-binary gender, vulnerable populations and mental health during the COVID-19 pandemic: Data from the COVID-19 MEntal health inTernational for the general population (COMET-G) study.

BACKGROUND: The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations. METHODS: Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them. RESULTS: The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use. CONCLUSIONS: Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research. LIMITATIONS: Online data collection may have resulted in the underrepresentation of certain population groups.

Optimized Case Finding of tuberculosis among key populations in Ukraine. A follow up study.

INTRODUCTION: In 2021, there were 4 million tuberculosis (TB) cases that were not detected by health systems, globally. Many of those cases are among hard-to-reach populations or key population groups. An Optimized Case Finding (OCF) strategy was introduced in Ukraine to enhance case detection and identify those "missing" cases. OCF included screening of up to eight referred household and social network contacts of an index TB case. Following the OCF project implementation, TB detection and characteristics of index cases and contacts were assessed. METHODOLOGY: A cohort study using project data (July 2018 - April 2022) was conducted. RESULTS: In total 7,976 close contacts were engaged in the project from 1,028 index TB cases. Among the contacts, 507 were diagnosed with TB. The TB case detection was 6,356/100,000 and the number needed to investigate was 16. Multiple factors were identified as associated with TB detection including smoking, HIV, poverty, etc. About 90% of cases were identified at the initial screening of the contacts. OCF was proven to be 5.8 times more effective than the standard active case finding using household surveys and 106 times more effective than passive case finding in the general public. CONCLUSIONS: Our study demonstrated the effectiveness of OCF in detecting cases among key population groups and their social networks. We encourage adaptation and use of OCF by civil society organizations that already work with key vulnerable populations around the globe.

The attitude of contemporary Iranian directors and screenwriters toward patients with mental disorders in comparison with general population.

BACKGROUND: Mental disorders are accountable for 16% of global disability-adjusted life years (DALYs). Therefore, accessible, cost-effective interventions are needed to help provide preventive and therapeutic options. As directors and screenwriters can reach a great audience, they can use their platform to either promote stigma or educate the public with the correct definition and conception of mental disorders. Therefore, we aimed to measure the stigmatizing attitude of contemporary Iranian directors and screenwriters toward patients with mental disorders in comparison with a general population group. METHODS: In this comparative study, we included 72 directors and screenwriters between 18 and 65 years of age with a minimum involvement in at least one movie/television show, and 72 age and educationmatched controls. We collected the demographic data of the participants, and used the Persian version of the Level of Contact Report (LCR) to measure their familiarity with mental disorders, and used the Persian version of Social Distance Scale (SDS) and Dangerousness Scale (DS) to measure their attitude toward them. RESULTS: Compared to the general population group, directors and screenwriters had significantly lower SDS (12.51 ± 3.8 vs. 13.65 ± 3.73) and DS (12.51 ± 3.8 vs. 13.65 ± 3.73) scores (P < 0.001), indicating a more positive attitude toward patients with mental disorders. Familiarity with mental disorders was not significantly different between the groups. Female sex was associated with a more negative attitude among the directors and screenwriters group. Additionally, among the SDS items, 'How would you feel about someone with severe mental disorder marrying your children?' and 'How would you feel about someone with severe mental disorder taking care of your children for a couple of hours?' received the most negative feedback in both groups. And among the DS items, 'there should be a law forbidding a former mental patient the right to obtain a hunting license' received the most negative feedback in both groups. CONCLUSIONS: Iranian contemporary directors and screenwriters had a more positive attitude toward patients with mental disorders, compared to general population. Due to this relatively positive attitude, this group of artists can potentially contribute to anti-stigma initiatives by offering educational materials and resources, promoting mental health care, and improving access to mental health care.

Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: a cross-sectional study.

OBJECTIVES: This study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia. DESIGN: A population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals. SETTING: All administrative units of Armenia including 10 provinces and capital city Yerevan. PARTICIPANTS: The study frame was the general adult population of Armenia aged ≥18 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models. RESULTS: The seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93). CONCLUSION: This study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention.

Cancer Screening Services: What Do Indigenous Communities Want? A Systematic Review.

PURPOSE: Indigenous communities experience worse cancer outcomes compared with the general population partly because of lower cancer screening access. One-size-fits-all screening programs are unsuitable for reaching Indigenous communities. In this review, we summarize available evidence on the perspectives of these communities; with a view to informing the improvement of cancer screening services to achieve equitable access. METHODS: We undertook a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the databases MEDLINE, Scopus, PubMed, and Google Scholar. The search terms used were "Indigenous community or Indigenous communities," "cancer screening," and "facilitators, enablers, desires, or needs." Qualitative studies published up to the August 30, 2022 investigating the perspectives of Indigenous communities on factors encouraging screening participation were included in the study. The included studies were reviewed and analyzed inductively by two independent reviewers, and key themes regarding indigenous access to cancer screening were then extracted. RESULTS: A total of 204 unique articles were identified from the search. The title and abstracts of these studies were screened, and 164 were excluded on the basis of the exclusion and inclusion criteria. The full texts of the remaining 40 studies were examined and 18 were included in the review. Four key themes were identified pertaining to culturally tailored education and information dissemination, community involvement, positive relationships with health care providers, and individual empowerment and autonomy. CONCLUSION: Improvements, on the basis of the key themes identified from this review, must be made at all levels of the health care system to achieve equitable screening participation in Indigenous communities. However, we recommend an investigation into the perspectives of the local Indigenous communities before the initiation of cancer screening programs.