Self-rated health of Latino day laborers during the COVID-19 pandemic: a cross-sectional study.

Background: This study assesses the relationship between trust in sources of information in regard to the Coronavirus Disease 2019 (COVID-19) pandemic and self-rated health (SRH) in a sample of Latino Day Laborers (LDLs) and explores whether these associations were mediated by mental health measures. Methods: A rapid needs assessment survey was conducted with 300 LDLs, recruited at randomly selected hiring locations in Houston, Texas, during November and December 2021. Two measures of trust were developed, and SRH was measured by a single item. Depression, anxiety, and stress were measured by previously validated scales. We applied the product of coefficients approach to assess our mediation model. Using Hayes' PROCESS version 4.2 in SPSS, linear regression models were generated simultaneously to assess the total effect of trust on SRH, effect of trust on the mental health mediator, and effect of the mediator on SRH, controlling for trust. Demographic characteristics were entered as covariates. Results: Greater trust in formal sources of information (such as Spanish-speaking television networks) as well as greater levels of anxiety and depression were associated with lower SRH. There were no significant associations between formal trust and mental health measures. As such, the association between formal trust and decreased SRH was not mediated by mental health. Trust in informal sources of information (conversations with friends, family, and coworkers) was not significantly associated with SRH or mental health. Higher levels of depression and anxiety, however, were associated with lower SRH. Conclusions: LDLs' perception of their health was inversely associated with their level of trust in formal sources of information and with greater levels of depression and anxiety. Nevertheless, these pathways were independent of each other. The results indicate the direct impact of COVID-19 public information on subjective well-being, a relationship that merits further exploration.

A Qualitative Study of Naturally Living Parents and Child Oral Health: Omissions and Commissions.

BACKGROUND: Oral health continues to be one of the most common and costly diseases in early childhood, and there is a need for further, innovative research. PURPOSE: We explored the ways naturally living parents (those who embody the "natural" within their parenting ideology and behavior) navigated and perceived their children's oral health. METHODS: Twelve participants who identified as being "naturally living parents" participated in semistructured interviews. Data were thematically analyzed, and findings were aligned to an omissions and commissions framework to exhibit the complexity of parent decision-making. RESULTS: Parents performed distinct omissions, including omitting fluoride, sugar, and "toxins" to maintain their children's oral health. Parents talked about having a commitment to knowledge building to protect their children's oral health (e.g., ingredient label reading and increasing knowledge of "safe" ingredients). Findings also provide insight into how parents consider and trust health information and health care providers and ways they gather information relating to oral health. CONCLUSIONS: Analysis indicated that although parents navigated both omissions and commissions, omissions were more overtly present. Compared to previous health research using this framework, omissions and commissions were not as clearly demarcated in relation to oral health. The results show that oral health is a complex interplay of omissions and commissions, and parents must navigate not only discrete elements that affect the oral health of their children but also how these are influenced by considerations including social well-being. KNOWLEDGE TRANSFER STATEMENT: The study highlights the need for dentists and early childhood health professionals to consider the complex way some parents perceive, inform, and rationalize decisions regarding their children's oral health. There is a need for nuance when considering children's oral health and naturally living parenting, especially in relation to effectively communicating health information that fosters trust and is considerate of broader lifestyle and health factors.

IOTASDN: IOTA 2.0 Smart Contracts for Securing Software-Defined Networking Ecosystem.

Software-Defined Networking (SDN) has revolutionized network management by providing unprecedented flexibility, control, and efficiency. However, its centralized architecture introduces critical security vulnerabilities. This paper introduces a novel approach to securing SDN environments using IOTA 2.0 smart contracts. The proposed system utilizes the IOTA Tangle, a directed acyclic graph (DAG) structure, to improve scalability and efficiency while eliminating transaction fees and reducing energy consumption. We introduce three smart contracts: Authority, Access Control, and DoS Detector, to ensure trusted and secure network operations, prevent unauthorized access, maintain the integrity of control data, and mitigate denial-of-service attacks. Through comprehensive simulations using Mininet and the ShimmerEVM IOTA Test Network, we demonstrate the efficacy of our approach in enhancing SDN security. Our findings highlight the potential of IOTA 2.0 smart contracts to provide a robust, decentralized solution for securing SDN environments, paving the way for the further integration of blockchain technologies in network management.

How Expectations and Trust in Telemedicine Contribute to Older Adults' Sense of Control: An Empirical Study.

As numerous nations transition into digital and aging societies, the digital divide has emerged as a significant impediment to older adults' autonomous engagement in the digital society. Enhancing the well-being of elderly individuals through remote medical technology represents a prevailing and prospective trend. Nevertheless, remote medical technology extends beyond the realm of healthcare, offering promise for narrowing the digital divide through the deployment of digital devices and provision of intergenerational support. Therefore, this study investigates the role of trust and expectations in the use of telemedicine, indicating potential pathways for how these products can improve older adults' daily living abilities. Through the construction of a theoretical model, we collected the relevant data of 661 elderly people who use telemedicine technology in China and analyzed the data with SmartPLS4 to obtain the research results. The study discovered that, among older people using telemedicine technology, (1) healthcare expectations promote the breadth of telemedicine product use; (2) trust in product safety increases the depth of telemedicine product use; (3) trust in the service provider promotes the breadth of telemedicine product use; and (4) when compared to the depth of product use, the breadth of telemedicine product use increases older adults' sense of control over their digital lives. The findings provide new empirical data to support growing beliefs about how expectations and trust can increase a sense of control over one's life. They also provide practical contributions on how to boost older adults' usage of telemedicine products, promote their digital literacy and competency, and enhance their sense of control over their digital lives.

Trust in government, social media and willingness to vaccinate.

Vaccine hesitancy is considered one of the biggest global health threats. The prevalence of false information about vaccines on social media amplifies this challenge, making it more urgent. This study examines the relationship between social media use, trust in information sources, beliefs about vaccination rates, and willingness to adopt vaccines using data gathered in late 2023 from 975 respondents in South Africa. Our results suggest that people who rely on social media as their primary news source are more hesitant to get vaccinated for themselves and their children. Trust, which includes various sources including confidence in the government, is positively linked to vaccination decisions. Trust is especially important when it comes to less traditional vaccines such as COVID-19 and flu vaccines for both adults and children. We also note gender differences, with South African men showing more reluctance to get vaccinated as adults. Additionally, there is a negative correlation between social media use and the willingness of males to get vaccinated, but this relationship is not evident among females. Our research highlights the need for targeted interventions aimed at improving vaccine uptake, taking into account the links with information sources about vaccination and government trust.

Health concerns, access to care, and trust in research and researchers among community members with bipolar disorder.

BACKGROUND: Data are needed on differences in community-dwelling populations with bipolar disorder (BP) regarding trust in research and access to care. We characterized community members by lifetime history of bipolar disorder. We hypothesized that those with BP would have less trust in research, visit a health provider less, and participate less in research than those without BP. We also hypothesized that those with BP would be more likely to have a history of marijuana (MJ) use. METHODS: A cross-sectional design was used for this analysis. The study population consisted of 12,489 members (78.0%) from the HealthStreet community engagement program who were interviewed by a Community Health Worker about health history and demographics. RESULTS: Among the sample, the rate of BP was 10.6% (n = 1326). Those reporting BP were more likely than those who did not (n = 11,163), to report muscle, bone, and mental health problems, to be younger, female, to have visited the doctor in the past 12 months, to be interested in participating in research, and be current MJ users. Trust did not differ between BP groups. CONCLUSIONS: Our analysis found that persons with BP had higher access to care and more interest in research, thus our primary hypothesis was rejected. Our secondary hypothesis, that persons with BP were more likely to have a history of MJ use was upheld. These findings are important because they address a crucial gap in the literature surrounding BP and lay the groundwork for future community-level research.

Ethical analysis of informed consent methods in longitudinal cohort studies: A Chinese perspective.

In longitudinal cohort studies involving large populations over extended periods, informed consent entails numerous urgent challenges. This paper explores challenges regarding informed consent in long-term, large-scale longitudinal cohort studies based on the longitudinal and dynamic nature of such research. It analyzes and evaluates widely recognized broad consent and dynamic consent methods, highlighting limitations concerning their ability to adapt to evolving research objectives and participant perspectives. This paper discusses trust-based informed consent and emphasizes the needs to establish and maintain trust with research participants and to balance information disclosure with respect for participants' autonomy. Informed consent in long-term studies is an evolving process that must adapt to changing research environments. Based on participant trust, researchers should observe and assess potential research risks. Finally, the paper recommends enhancing institutional credibility, implementing reconsent procedures, and ensuring robust ethical oversight to safeguard participants' rights despite the complexity of modern biomedical research.

The influence of the perception, attitude, and level of trust on the uptake of COVID-19 vaccinations among pregnant women attending antenatal care clinic in mbeya urban, Tanzania.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has been associated with adverse effects and death among people with low immunity, including pregnant women. Despite introducing the vaccine as the proper means to curb the spread of the pandemic, vaccine uptake is still low. This study assessed the influence of perception, attitude, and trust toward COVID-19 vaccine uptake among pregnant women attending Antenatal Care Clinics. METHODS: A cross-sectional study design was used, utilizing a quantitative approach with a cross-sectional analytical design conducted in Mbeya urban, distribution of sample size during data collection based on client's volume at three government health facilities (one tertiary health facility, one secondary health facility, and one primary health facility) in Mbeya Urban, Tanzania. Data were collected from 333 pregnant women who attended ANC during the data collection period using a questionnaire with closed-ended questions administered to respondents face-to-face. Data cleaning and analysis were done using Excel and Stata/SE 14.1 software for bivariate and multivariate data; Pearson's chi-squire and Fisher's test were used to analyze the independent determinants of COVID-19 vaccine uptake. RESULTS: The proportion of pregnant women vaccinated with the COVID-19 vaccine was 27%. There was a statistically significant association between the respondents' vaccine uptake with primary education and < 5 work experience to vaccine uptake P = 0.015 (AOR = 6.58; 95% CI; 1.45-29.85), and P = 0.046 (AOR = 2.45; 95% CI; 1.02-5.89) respectively. The association of attitude influence to COVID-19 vaccine uptake was statistically significant (acceptance of vaccine due to its availability, vaccine acceptance for protection against COVID-19 pandemic to respondent and her baby, experience from other vaccines) was statistically significant at P = 0.011 (AOR = 4.43; 95% CI; 1.41-13.93), P = 0.001 (AOR = 45.83; 95% CI; 18.6-112.89) respectively. The level of trust in the COVID-19 vaccine influenced respondents' association with vaccine uptake in the 2nd and 3rd trimesters of pregnancy (P = 0.633 (AOR = 1.23; 95% CI; 0.53-2.48), respectively. CONCLUSION: Pregnant women's positive attitude and trust in the COVID-19 vaccine influenced them to uptake it; our conclusion supports the WHO guidelines that the COVID-19 vaccine should be administered to pregnant women since it is a safer means to curb COVID-19 pregnancy-related complications.

Taking it to the extreme: prevalence and nature of extremist sentiment in games.

More than half of all game players report experiencing some form of hate, harassment or abuse within gaming spaces. While prevalence assessments of these actions in digital gaming spaces are ongoing, little remains known about the more extreme forms of these behaviors. Specifically, experiences of extremism. This paper addresses the gap in research knowledge around the expression of extremist sentiment in games by evaluating their prevalence, location, and nature, and impact. Assessing experiences via an online survey, game players (n = 423) reported an alarmingly high rate of frequency for being the direct target of, as well as a witness to, all forms of extremist content. Most of these experiences were text-based, reported to be happening in-game. Most players endorsed statements relating to a normalization of extreme ideologies within gaming cultures. It is promising that reporting these behaviors was the primary action taken by players for most of the players; however, "ignoring" these actions was also a common strategy. It is possible that player inaction reflects the embeddedness and normalization of these actions in gaming spaces and/or a lack of trust in moderation systems to be responsive. The prevalence of extreme sentiment in gaming cultures should raise concern from game makers, members of the gaming community, parents, and policy makers alike.

Dual-band millimetre wave MIMO antenna with reduced mutual coupling based on optimized parasitic structure and ground modification.

In this study, a high-isolation dual-band (28/38 GHz) multiple-input-multiple-output (MIMO) antenna for 5G millimeter-wave indoor applications is presented. The antenna consists of two interconnected patches. The primary patch is connected to the inset feed, while the secondary patch is arc-shaped and positioned over the main patch, opposite to the feed. Both patches function in the lower 28 GHz band, while the primary patch is accountable for inducing the upper 38 GHz band. An expedited trust-region (TR) algorithm is employed to optimize the dimensions of the antenna components, ensuring the antenna operates efficiently with high reflection at both bands. The antenna demonstrates a gain exceeding 7 dBi at both frequencies. An array of four antennas is configured orthogonally to create a MIMO system with isolation surpassing 19 dB. The isolation is further enhanced through the addition of a circular parasitic patch at the front and modifications made to the ground. The TR method is employed again to optimize their parameters and achieve the desired isolation, exceeding 32 dB at both bands. The MIMO system demonstrates outstanding diversity performance at both frequencies, characterized by low values of the envelope correlation coefficient (ECC) (< 10 - 4), channel capacity loss (CCL) (< 0.03 bit/s/Hz), and total active reflection coefficient (TARC) (< - 10 dB). Additionally, it secures a diversity gain (DG) exceeding 9.99 dB. The MIMO system is manufactured and tested, showing good alignment between simulation and measurement data for all performance metrics.

Automated driving experiences, attention, and intentions following extensive on-road usage of a level 2 automation vehicle.

INTRODUCTION: An on-road study was conducted to examine the effects of level 2 automation on the stressfulness and enjoyment of driving and driving attention following prolonged usage. The study also examined the changes in the automated driving experience and attention over time as well as important predictors such as pre-driving trust in technology and attitudes toward automated systems. METHOD: Motorists who had never used automated systems drove a level 2 automation vehicle for a 6-8 week period. RESULTS: Participants reported that the automated systems reduced the stress of driving and made traveling more enjoyable and relaxing. They also reported that the automation did not make traveling boring and take the fun out of driving. Participants indicated that their minds tended to wander when the automation was operating. The stressfulness of the automated driving experience decreased over time. Participants also reported feeling increasingly comfortable driving with the automation without monitoring it closely. The enjoyment and stress of automated driving is important because it shapes the willingness to use the automation and, hence, the safeness of driving. As expected, intentions to use and purchase automated systems were strongly predicted by the perceived favorableness of driving with the automation. Participants' pre-driving beliefs about automated systems, rather than their trust, appears to have shaped their experiences with the automation. PRACTICAL APPLICATIONS: Although some of the findings suggest that automated systems increase unsafe behavior by novice users, other facets of the surveys suggest that motorists are cognizant of the risks of automated driving and discreet in their usage of the automation.

Exploring the influence of Chinese online patient trust on telemedicine behavior: insights into perceived risk and behavior intention.

As a supplement to medical services, telemedicine is of great significance to alleviate the shortage of health resources in China. Based on the traditional consumer behavior measurement model the Technology Acceptance Mode/Theory of Planned Behavior (TAM/TPB), this paper divides online patient trust into six dimensions: perceived risk, personal trust tendency, doctors' credibility, hospitals' credibility, websites' credibility, and system guarantee. On this basis, a structural equation model (SEM) was used to explore the influence of each dimension of online patient trust on online patient intention, behavior choice, and pre-factors. A total of 582 valid questionnaires were distributed to selected patients with experience in using mobile healthcare services in the vicinity of hospitals and communities, as well as to users who shared their experiences in the discussion forums of mobile healthcare websites. The results show that online patient trust has a significant positive impact on telemedicine behavior intention selection, with a standardized path coefficient being as high as 0.866. Doctors' credibility, system guarantee, and website credibility have significant positive effects on online patient trust, with standardized path coefficients of 0.401, 0.260, and 0.226, respectively. Hospital trustworthiness and personal trust propensity have no significant effect on online patient trust. Perceived risk has a significant negative effect on online patient trust, with a standardized path coefficient of -0.118. The research findings suggest that health departments and mobile healthcare providers can enhance mobile healthcare services by considering the patients' perspectives, elevate their online trust levels, and foster a deeper understanding, safety consciousness, and confidence in telehealth services. On this basis, it can be concluded that only the participation of government, medical subjects, and online patients can effectively reduce perceived risks, improve perceived characteristics of online patients, enhance online patient trust, and promote the real willingness and behavior choice for online medical services, effectively improving the positive role of telemedicine in increasing health benefits to people.

The impact of brand image on customer satisfaction and brand loyalty: A systematic literature review.

This literature review examines the impact of brand image on customer satisfaction and brand loyalty in the context of foreign tourism. Following a review of relevant literature, 13,302 articles were found for this study, including the keywords "brand image (BI)", "customer satisfaction (CS)", and "brand loyalty (BL)". Considering the required inclusion and the quality of studies, we employed the rigorous PRISMA technique for comprehensive data synthesis and evaluated 79 articles for the final review. Our findings underscore the significant impact of brand image on shaping customer satisfaction and fostering brand loyalty within the foreign tourism sector. The study enriches the literature by incorporating self-congruity theory. In addition, factors like product quality, pricing, and advertising are identified as key determinants significantly influencing the proposed relationship.

Exploring dynamic public trust in mega infrastructure projects during online public opinion crises of extreme climate emergencies: Users' behaviors, trust dimensions, and effectiveness of strategies.

The vulnerability of mega infrastructure projects (MIPs) has generated online public opinion crises, leading to public trust damage. However, few studies focused on the online dynamic trust of MIPs in such crises from the perspective of multiple users. Based on situational crisis communication theory, this study aims to explore the dynamic public trust in MIPs during online public opinion crises of extreme climate emergencies. The extreme heavy rainstorm event in Zhengzhou City, China, was selected as the case. Content analysis, the curve fitting method, and sentiment analysis were conducted to process the collected data from multiple users. The results indicated that the opinions of trust damage were set by "media practitioners" and led by "elites," whereas the opinions of trust repair were directed by "elites," led by "media practitioners," and defended by "individuals." Besides, trust dimensions would change over time; integrity-based and competence-based trust diffused alternatively. "Diminish," "deny," and "rebuild" strategies were proved to be the most effective strategies in integrity-based, competence-based, and competence and integrity-based trust repair, respectively. The findings can contribute to the authorities monitoring online public opinions in extreme climate emergencies and repairing trustworthy images.

Trustworthy and ethical AI-enabled cardiovascular care: a rapid review.

BACKGROUND: Artificial intelligence (AI) is increasingly used for prevention, diagnosis, monitoring, and treatment of cardiovascular diseases. Despite the potential for AI to improve care, ethical concerns and mistrust in AI-enabled healthcare exist among the public and medical community. Given the rapid and transformative recent growth of AI in cardiovascular care, to inform practice guidelines and regulatory policies that facilitate ethical and trustworthy use of AI in medicine, we conducted a literature review to identify key ethical and trust barriers and facilitators from patients' and healthcare providers' perspectives when using AI in cardiovascular care. METHODS: In this rapid literature review, we searched six bibliographic databases to identify publications discussing transparency, trust, or ethical concerns (outcomes of interest) associated with AI-based medical devices (interventions of interest) in the context of cardiovascular care from patients', caregivers', or healthcare providers' perspectives. The search was completed on May 24, 2022 and was not limited by date or study design. RESULTS: After reviewing 7,925 papers from six databases and 3,603 papers identified through citation chasing, 145 articles were included. Key ethical concerns included privacy, security, or confidentiality issues (n = 59, 40.7%); risk of healthcare inequity or disparity (n = 36, 24.8%); risk of patient harm (n = 24, 16.6%); accountability and responsibility concerns (n = 19, 13.1%); problematic informed consent and potential loss of patient autonomy (n = 17, 11.7%); and issues related to data ownership (n = 11, 7.6%). Major trust barriers included data privacy and security concerns, potential risk of patient harm, perceived lack of transparency about AI-enabled medical devices, concerns about AI replacing human aspects of care, concerns about prioritizing profits over patients' interests, and lack of robust evidence related to the accuracy and limitations of AI-based medical devices. Ethical and trust facilitators included ensuring data privacy and data validation, conducting clinical trials in diverse cohorts, providing appropriate training and resources to patients and healthcare providers and improving their engagement in different phases of AI implementation, and establishing further regulatory oversights. CONCLUSION: This review revealed key ethical concerns and barriers and facilitators of trust in AI-enabled medical devices from patients' and healthcare providers' perspectives. Successful integration of AI into cardiovascular care necessitates implementation of mitigation strategies. These strategies should focus on enhanced regulatory oversight on the use of patient data and promoting transparency around the use of AI in patient care.

Sociopolitical context and COVID-19 fatality rates in OECD countries: a configurational approach.

BACKGROUND: The effectiveness of crisis response can be influenced by various structural, cultural, and functional aspects within a social system. This study uses a configurational approach to identify combinations of sociopolitical conditions that lead to a high case fatality rate (CFR) of COVID-19 in OECD countries. METHODS: A Fuzzy set qualitative comparative analysis (QCA) is conducted on a sample of 38 OECD countries. The outcome to be explained is high COVID-19 CFR. The five potentially causal conditions are level of democracy, state capacity, trust in government, health expenditure per capita, and the median age of population. A comprehensive QCA robustness test protocol is applied, which includes sensitivity ranges, fit-oriented robustness, and case-oriented robustness tests. RESULTS: None of the causal conditions in both the presence and negation form were found to be necessary for high or low levels of COVID-19 CFR. Two different combinations of sociopolitical conditions were usually sufficient for the occurrence of a high CFR of COVID-19 in OECD countries. Low state capacity and low trust in government are part of both recipes. The entire solution formula covers 84 percent of the outcome.  Some countries have been identified as contradictory cases. The explanations for their COVID-19 CFR require more in-depth case studies. CONCLUSIONS: From a governance perspective, the weakness of government in effectively implementing policies, and the citizens' lack of confidence in their government, combined with other structural conditions, serve as barriers to mounting an effective response to COVID-19. These findings can support the idea that the effects of social determinants of COVID-19 outcomes are interconnected and reinforcing.

Building and Sustaining Flu Vaccine Acceptance and Trust in the Black Community through Partnerships with Churches, Salons, and Barbershops.

Despite the benefits of flu vaccines, Black adults continue to experience lower vaccination rates in the United States. Contributing factors include lack of access to health care and trusted information about vaccines. The National Minority Quality Forum's Center for Sustainable Health Care Quality and Equity collaborated with church pastors, barbers, and hair stylists to disseminate a survey to their communities to assess barriers/facilitators to flu vaccine uptake. The population (n = 262) was mostly Black (93%), female (77%), between the age of 50-64 (39%) and vaccinated (73%). The most common reasons cited by respondents for being vaccinated were personal health, a habit of getting the shot, and a desire not to spread it to others. Among the unvaccinated (27%), the most common reasons for not vaccinating were lack of perceived need, concern the shot would make them sick, and that they do not normally get vaccinated. Vaccine knowledge and trust in health care providers' recommendations was higher amongst vaccinated individuals. Amongst the unvaccinated, trust was lower and there was a stronger belief that the vaccine would not prevent illness. Age was also associated with the likelihood of being vaccinated and greater vaccine knowledge and trust in provider recommendations. Unvaccinated individuals, particularly those under 54 years of age, did not hold strong distrust, attitudes were more neutral, and concern for others was moderate, suggesting an opportunity to target younger age groups. This study highlights the importance of trusted community messengers in conveying targeted messages on the safety and effectiveness of the flu vaccine.

Prevalence of Medical Mistrust and Its Impact on Patient Satisfaction in Pediatric Caregivers.

Racial minorities report lower perceived quality of care received compared to non-Hispanic White Americans, resulting in racial disparities in patient satisfaction. Medical mistrust, defined as a lack of confidence in the medical establishment and the intentions of medical personnel, is more prevalent among racial minority groups and is associated with poorer health outcomes. This study examines the prevalence and racial differences of patient/caregiver medical mistrust and its relationship to patient satisfaction among the pediatric patient population at a large urban academic medical center. A cross-sectional anonymous survey was conducted for caregivers of pediatric families seen at an urban tertiary care facility, including demographic information, the Patient Satisfaction Questionnaire (PSQ), and the Group-Based Medical Mistrust Scale (GBMMS). Linear regressions and mediation analyses were performed, examining race-based medical mistrust and associations with patient satisfaction. Sixty-seven surveys (67% Black/African American, 24% White) were completed. Black/African American participants reported higher levels of medical mistrust (M = 2.29, SD = 0.88 vs. M = 1.37, SD = 0.50; p < .001), which was associated with lower patient satisfaction (p < .001). In a parallel mediation analysis, disaggregating the GBMMS into three subscales, a significant indirect relationship emerged between race and patient satisfaction via the subscale lack of support from healthcare providers (95% CI [- 1.52, - .02], p < .05). Black/African American participants were more likely to have medical mistrust, and greater medical mistrust was significantly associated with lower patient satisfaction. Black/African American participants were significantly more likely to perceive lower support from healthcare providers which, in turn, was associated with lower patient satisfaction. These findings identify potential areas for intervention to improve Black/African American patients' experience with healthcare.

Encompassing trust in medical AI from the perspective of medical students: a quantitative comparative study.

BACKGROUND: In the years to come, artificial intelligence will become an indispensable tool in medical practice. The digital transformation will undoubtedly affect today's medical students. This study focuses on trust from the perspective of three groups of medical students - students from Croatia, students from Slovakia, and international students studying in Slovakia. METHODS: A paper-pen survey was conducted using a non-probabilistic convenience sample. In the second half of 2022, 1715 students were surveyed at five faculties in Croatia and three in Slovakia. RESULTS: Specifically, 38.2% of students indicated familiarity with the concept of AI, while 44.8% believed they would use AI in the future. Patient readiness for the implementation of technologies was mostly assessed as being low. More than half of the students, 59.1%, believe that the implementation of digital technology (AI) will negatively impact the patient-physician relationship and 51,3% of students believe that patients will trust physicians less. The least agreement with the statement was observed among international students, while a higher agreement was expressed by Slovak and Croatian students 40.9% of Croatian students believe that users do not trust the healthcare system, 56.9% of Slovak students agree with this view, while only 17.3% of international students share this opinion. The ability to explain to patients how AI works if they were asked was statistically significantly different for the different student groups, international students expressed the lowest agreement, while the Slovak and Croatian students showed a higher agreement. CONCLUSION: This study provides insight into medical students' attitudes from Croatia, Slovakia, and international students regarding the role of artificial intelligence (AI) in the future healthcare system, with a particular emphasis on the concept of trust. A notable difference was observed between the three groups of students, with international students differing from their Croatian and Slovak colleagues. This study also highlights the importance of integrating AI topics into the medical curriculum, taking into account national social & cultural specificities that could negatively impact AI implementation if not carefully addressed.

The state of (mis) trust: Human-centered technology development & implementation in intensive mental health settings.

Innovative technology-based solutions in mental healthcare promise significant improvements in care quality and clinical outcomes. However, their successful implementation is profoundly influenced by the levels of trust patients hold toward their treatment providers, organizations, and the technology itself. This paper delves into the complexities of building and assessing patient trust within the intensive mental health care context, focusing on inpatient settings. We explore the multifaceted nature of trust, including interpersonal, institutional, and technological trust. We highlight the crucial role of therapeutic trust, which comprises both interpersonal trust between patients and providers, and institutional trust in treatment organizations. The manuscript identifies potential key barriers to trust, from sociocultural background to a patient's psychopathology. Furthermore, it examines the concept of technological trust, emphasizing the influence of digital literacy, socio-economic status, and user experience on patients' acceptance of digital health innovations. By emphasizing the importance of assessing and addressing the state of trust among patients, the overarching goal is to leverage digital innovations to enhance mental healthcare outcomes within intensive mental health settings.