The influence of the far right is growing globally. This calls for a critical examination of its potential public health implications. Characterized by authoritarianism, injustice, racism, misogyny, homophobia, transphobia, divisive rhetoric, and a propensity for violence, the far right often employs denialist arguments against scientific evidence, including opposition to environmental protection policies. We conducted a narrative review of existing evidence to assess the impact of these elements on public health. The findings suggest that the rise of the far right could have significant negative effects on population health. As a consequence, we advocate that the public health field and society at large must take a deliberate stance in response to this emerging reality. (Am J Public Health. 2025;115(6):873-882. https://doi.org/10.2105/AJPH.2025.308016).

The burgeoning rise in social media use has revolutionized information dissemination, rendering social media a vital tool for promoting health campaigns and enhancing 2-way health communication between senders and users. Health planners and policy makers consider social media platforms (SMPs) vital for transferring useful health information to the public. However, there are important concerns about the decision makers' perceptions of the evolving role of social media in health promotion and education campaigns.

This qualitative study explored how decision makers perceive the role of social media in health promotion and education. We aimed to shed light on strategic efficacy, real-world challenges, and valuable prospects of using social media for health communication.

We adopted a qualitative research method involving in-depth, semistructured, face-to-face interviews. We included 13 participants from government and private health care sectors in the Al-Qassim region of Saudi Arabia, who were key players and decision makers in health care programs and reforms. Data were recorded, transcribed verbatim, and analyzed using thematic analysis to identify key themes and patterns.

Five main themes were identified: (1) use of social media (frequency, type of content, target audience, purpose of communication), (2) perceptions of decision makers (how social media influences public health behavior), (3) benefits, (4) challenges, and (5) implications for future use. Participants recognized the positive role of SMPs in spreading health information, particularly in health promotion and awareness campaigns. Communication emerged as a key concept, and WhatsApp, X (Twitter), and Facebook were recognized as major platforms for digital health literacy. The participants used these applications extensively for communication with colleagues, patients, and the public, intending discussion, information exchange, and health promotion campaigns. Content inaccuracy and reliability were identified as major challenges. Furthermore, misinformation and social inequalities were identified as barriers to effective communication. Participants suggested that social media influencers play a more effective role in information dissemination than the health care staff. Far-reaching audiences, visually appealing and engaging content using videos and graphics, and assessing campaign effectiveness using metrics, such as views, shares, likes, and comments, were recognized as major benefits of social media. Participants stressed the promising role of social media in the future as technological advancements in eHealth could revolutionize health care.

SMPs play a vital role in sharing information about health-related initiatives. This research highlights the complexities and potential challenges of using social media for health promotion in Saudi Arabia. It emphasizes the need to develop strategies to combat misinformation, address privacy and confidentiality concerns, and ensure compliance with legal and ethical standards. Encouraging communication among key stakeholders, including health promotion experts, government organizations, social media companies, and the general public, can help establish effective guidelines and protocols to overcome the challenges.

Disinformation on social media can seriously affect mental health by spreading false information, increasing anxiety, stress, and confusion in vulnerable individuals as well as perpetuating stigma. This flood of misleading content can undermine trust in reliable sources and heighten feelings of isolation and helplessness among users.

This study aimed to explore the phenomenon of disinformation about mental health on social media and provide recommendations to mental health professionals that would use social media platforms to create educational videos about mental health topics.

A comprehensive analysis conducted on 1000 TikTok videos from over 16 countries, available in English, French, and Spanish, covering 26 mental health topics. The data collection was conducted using a framework on disinformation and social media. A multilayered perceptron algorithm was used to identify factors predicting disinformation. Recommendations to health professionals about the creation of informative mental health videos were designed as per the data collected.

Disinformation was predominantly found in videos about neurodevelopment, mental health, personality disorders, suicide, psychotic disorders, and treatment. A machine learning model identified weak predictors of disinformation, such as an initial perceived intent to disinform and content aimed at the general public rather than a specific audience. Other factors, including content presented by licensed professionals like a counseling resident, an ear-nose-throat surgeon, or a therapist, and country-specific variables from Ireland, Colombia, and the Philippines, as well as topics like adjustment disorder, addiction, eating disorders, and impulse control disorders, showed a weak negative association with disinformation. In terms of engagement, only the number of favorites was significantly associated with a reduction in disinformation. Five recommendations were made to enhance the quality of educational videos about mental health on social media platforms.

This study is the first to provide specific, data-driven recommendations to mental health providers globally, addressing the current state of disinformation on social media. Further research is needed to assess the implementation of these recommendations by health professionals, their impact on patient health, and the quality of mental health information on social networks.

South Africa, like most developing countries, made some efforts to attain the Sustainable Development Goals by endeavoring to reduce individuals' susceptibility to socio-economic hardships. However, the COVID-19 pandemic eroded most of those efforts. In this seemingly helpless situation, it is apparent that the coronavirus has compromised the commendable strides made toward achieving some of the efforts toward attaining some of these Sustainable Development Goals. This article, therefore, analyses the socioeconomic conditions exacerbated by COVID-19 on the East Coast of South Africa.

The study adopted a quantitative research-method approach to quantify this socio-economic disparities and applied, descriptive statistics, chi-squared test of independence, and regression to analyse the data collected using a semi-structured questionnaire survey at a rural community in the Eastern Cape of South Africa. Simple random sampling was adopted for this study and Statistical Package for Social Scientists was used to analyse the data collected.

There was no significant relationship when the question of whether the municipality has adequately implemented measures to ensure the socio-economic protection of communities was regressed with other 3 Likert scale questions (χ2 = 95.98; df = 77; P = 0.07; R 2 = 38.0%). A series of Chi-square tests did not reveal any statistically significant difference in five demographic variables and the variables they were correlated with (P > 0.05). However, there was a statistically significant difference between most questions relating to the effectiveness of the COVID-19 response strategies the municipality employed and participants' response to unmet community social needs (X2 = 35.754; df = 14; P = 0.001).

This study, therefore, revealed that social significance does not necessarily mean statistically significant following the results of the insignificant chi-squared test for the socio-economic and demographic variables. This study also sheds light on the profound impact of the COVID-19 pandemic on the socioeconomic landscape of the East Coast of South Africa. Despite commendable strides toward achieving Sustainable Development Goals aimed at reducing vulnerabilities to socio-economic hardships, the pandemic has presented daunting challenges, disrupting progress and exacerbating existing inequalities coupled with efforts of the study Municipalities strategies.

Public health threats (PHTs) influence how and in what ways managers communicate with employees. Employee resources and information during uncertain times has been noted as a reoccurring gap, especially as it relates to personal protective equipment (PPE). This study explored general and PPE-specific communication practices with 22 healthcare and emergency medical service (EMS) managers to support workers, particularly in the context of preparedness and response.

Data collection occurred in two phases that involved interviews and small group discussions to identify, examine, and better frame and execute communication practices. Qualitative analysis was informed by the 4i FACT framework and the social ecological model (SEM) to identify relevant communication practices and intervention points within health delivery settings.

Results elucidated perceived, effective leadership practices and interpersonal influences in the workplace. Tangible leadership communication practices were identified as important intervention points within the SEM, with a focus on proactive behaviors to procure necessary PPE and disseminate information. Participants emphasized one-on-one interactions with employees, and the use of trusted messengers to share health-related messages. They also highlighted the challenges of PPE shortages and the importance of access to resources across different job roles, organizations, and work settings.

This study contributes insights into communication practices during a public health emergency, offering a nuanced understanding of managerial approaches, PPE-related communication, and the broader contextual factors influencing information dissemination. Further, the integration of frameworks like 4i FACT and SEM provides a structured perspective for future communication strategies, supporting tailored approaches across organizations.

People with chronic illnesses such as Human Immunodeficiency Virus (HIV), hypertension, and Diabetes Mellitus (DM) are a priority for Coronavirus disease (COVID-19) vaccination due to elevated risk of severe disease. We explored the perspectives and experiences of COVID-19 vaccination among these priority populations in Southwestern and Southcentral Uganda.

Between January and April 2023, we conducted in-depth interviews with adult (≥18 years) persons living with HIV (PLWH), hypertension and/or DM (n = 30) and key informant interviews with healthcare providers and managers (n = 12) at Mbarara and Masaka Regional Referral Hospitals. We used the Behavioral and Social Drivers model to explore the factors that influenced COVID-19 vaccination. We coded the data using Dedoose software and analyzed them using thematic deductive analysis.

Motivations to take the COVID-19 vaccine included fear of COVID-19, observing the effect of COVID-19 or the vaccine on others, vulnerability from underlying illnesses, family and social support, health worker recommendation, vaccine benefits and trust in the vaccine. Fear of side effects and vaccine interactions with antiretroviral, antihypertensive or antidiabetic medications, misinformation, rapid vaccine development and rollout, inadequate sensitization, and healthcare providers' hesitancy hindered uptake. Furthermore, health system challenges like stockouts and long queues hindered uptake or dose completion.

Fear of COVID-19, trust in the vaccine, family and social support facilitated COVID-19 vaccination uptake. Conversely, fear of side effects, vaccine and medication interaction, misinformation and inadequate sensitization hindered vaccine uptake. Effective communication strategies involving health workers and community leaders and sustained vaccine supply are crucial to improve COVID-19 vaccine uptake.

The online version contains supplementary material available at 10.1007/s44155-025-00199-0.

In light of the dynamic COVID-19 pandemic, the exposure to pandemic-related media coverage may change over time and may be particularly relevant due to associations with psychopathological symptoms. The aims of the present study were to examine changes in media consumption over time and to analyze its prospective associations with psychological strain.

The study uses a longitudinal observational design with ten periods of online data collection from March 2020 to April 2022 in an adult convenience sample (N = 8337) of the general population in Germany.

Our data revealed that the frequency and duration of pandemic-related media exposure as well as their subjective critical evaluation showed the highest levels at the beginning of the pandemic and peaked again in autumn 2020 and spring 2021. The primarily used media formats changed only slightly over time. The amount of media exposure at baseline was associated with more impairing pandemic-related anxiety 1 month, 1 year, and 2 years later.

Our results hint to potentially problematical and long-lasting associations of pandemic-related media consumption with mental strain. Our findings could serve as an orientation for recommendations, further research, and adequate interventions for a responsible dealing with media coverage.

The authors have pre-registered this research at clinicaltrials.gov without an analysis plan; retrievable at: https://clinicaltrials.gov/ct2/show/NCT04331106 .

The COVID-19 pandemic profoundly affected nurses globally. As frontline workers, nurses faced increased responsibilities amid challenges such as isolation, infection risks, family obligations and disrupted social support systems. Coping with these challenges was associated with adverse mental health outcomes.

This perspective paper examines a collaboration between two schools of nursing in the United States and India to address these mental health challenges.

Faculty from both institutions identified key mental health topics, leading to five webinars that delved into topics such as acute and long-term impacts of COVID-19 on nurse mental health, coping mechanisms, caregiving responsibilities and children's needs during the pandemic.

Impressively, over 11,000 nurses from 60 countries engaged, fostering a global platform for sharing evidence-based knowledge, experiences and strategies.

This partnership exemplifies the value of international collaboration. By pooling resources and expertise across cultural contexts, the initiative not only disseminated crucial knowledge but also cultivated a sense of global community among nurses. The success of this collaboration underscores the potential of such global partnerships for healthcare institutions worldwide, offering avenues to share best practices and enhance support systems for nurses confronting similar crises globally.

While the Internet can be a valuable resource for learning about health issues, for those without adequate e-health literacy skills, it can have adverse effects on unwanted anxiety and cyberchondria risk. Improving e-health literacy is essential to manage health and death anxiety and help reduce the risk of cyberchondria. The aim of this study is to determine the e-health literacy, health anxiety, cyberchondria and death anxiety levels of university students, evaluate them in terms of independent variables and examine the relationship between the scales.

The study was completed with 568 students receiving education in the health department of a university. Data were obtained using the e-Health Literacy Scale, Health Anxiety Inventory, Cyberchondria Severity Scale, and Death Anxiety Scale. The chi-square, Mann-Whitney U, Kruskal-Wallis, Tamhane's T2 post hoc tests, and Spearman correlation were used to analyze the data.

The mean score of e-health literacy was 28.63±4.65; health anxiety was 19.11±8.37, cyberchondria was 86.30±18.28 and death anxiety was 7.34±2.14. Cyberchondria is low in women and those who do not conduct online research on health. E-health literacy was higher in those earning above the minimum wage. Health and death anxiety was low in men and in those who did not conduct online health-related research. Health anxiety was positively correlated with cyberchondria and death anxiety and negatively correlated with e-health literacy. There was a positive relationship between cyberchondria and E-health literacy and death anxiety. This study highlights the complex relationship between eHealth literacy, health anxiety, cyberchondria and death anxiety. It shows that low e-health literacy can increase health anxiety, which in turn can worsen cyberchondria and death anxiety. By emphasising the importance of e-health literacy in health education, the findings may help students manage their anxiety, make informed health decisions, and increase their professional competence.

The coronavirus pandemic shaped challenges for marginalized groups. Specifically, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) people experienced community-building constraints, notably in predominantly rural regions. People are also navigating digital geographies, or online social environments, in novel ways to develop virtual communities in the face of prejudice, discrimination, and potential trauma. Through a minority coping approach, the present study explored LGBTQ+ people's experiences navigating the dynamics of digital geographies during the pandemic while residing in socially conservative, highly rural physical spaces where they may be exposed to vicarious trauma. Using qualitative semi-structured interviews, data were gathered from 43 LGBTQ+ identifying individuals between 19 and 59 years old (M/SD = 27.7/9.2) between October 2020 and January 2021. Nearly 14% identified as transgender, nonbinary, or queer individuals, 35% as bisexual individuals, and 21% as people of color including Hispanic/Latina/o. Thematic analysis of the narratives described participants' exposures to online discrimination and stigmatization of minority groups (racial and/or sexual/gender minority groups) during the COVID-19 pandemic, institutional constraints to identity expression, utilizing social technologies to manage their identities, and negotiating digital strategies to promote social ties. Findings emphasize improving marginalized people's experiences with digital geographies through identity affirmation and community relationship-building to offset potentially traumatic experiences. Furthermore, service providers can utilize the findings to tailor effective virtual LGBTQ+ community programming to support underserved, marginalized populations.

Misinformation has been identified as a major threat to society and public health. Social media significantly contributes to the spread of misinformation and has a global reach. Health misinformation has a range of adverse outcomes, including influencing individuals' decisions (e.g. choosing not to vaccinate), and the erosion of trust in authoritative institutions. There are many interrelated causes of the misinformation problem, including the ability of non-experts to rapidly post information, the influence of bots and social media algorithms. Equally, the global nature of social media, limited commitment for action from social media giants, and rapid technological advancements hamper progress for improving information quality and accuracy in this setting. In short, it is a problem that requires a constellation of synergistic actions aimed at social media users, content creators, companies, and governments. A public health approach to social media-based misinformation that includes tertiary, secondary, and primary prevention may help address immediate impacts, long-term consequences, and root causes of misinformation. Tertiary prevention to 'treat' this problem involves increased monitoring, misinformation debunking, and warning labels on social media posts that are at a high risk of containing misinformation. Secondary prevention strategies include nudging interventions (e.g. prompts about preventing misinformation that appear when sharing content) and education to build media and information literacy. Finally, there is an urgent need for primary prevention, including systems-level changes to address key mechanisms of misinformation and international law to regulate the social media industry. Anything less means misinformation-and its societal consequences-will continue to spread.

With the current rapid increase in digital technology adoption, understanding the relationship between technological proficiency and self-esteem is crucial to older adults. This study explores the mechanisms through which technological proficiency influences self-esteem, particularly considering its associations with technological engagement, self-efficacy, social participation, and autonomy. By using a narrative review approach, this study synthesizes recent findings from gerontology and psychology to examine these relationships. The analysis shows that higher technological proficiency enhances self-esteem by boosting self-efficacy, fostering social participation, and promoting greater autonomy. Older adults who are skilled in using digital tools exhibit greater confidence in managing daily activities and maintaining their social networks, contributing to their psychological resilience. Conversely, lower technological proficiency is linked to frustration, social exclusion, and diminished self-esteem, exacerbated by the digital divide. However, despite these insights, much remains unexplored; for example, no longitudinal study has been conducted to capture the dynamic relations between technological proficiency and self-esteem. These findings suggest that further research is needed to learn more about how technological proficiency influences self-esteem and recommend clinical ways of supporting older adults in their current stage.

Antimicrobial resistance (AMR) is a growing global health threat, partly driven by inappropriate antibiotic use. Healthcare students, as future practitioners, must have a good understanding of AMR to contribute to antimicrobial stewardship. This study aimed to evaluate the impact of an educational intervention on healthcare students' knowledge of AMR and to assess patterns of antibiotic use prior to the intervention.

A quasi-experimental pre-and-post study design was conducted with unpaired groups of healthcare students. An educational intervention was carried out comprising of two 20-minute PowerPoint lectures, as well as question and answer sessions focused on understanding the spread, impact, and prevention of AMR. A self-administered questionnaire was given as a pre-test and repeated as a post-test immediately after the training. Students' knowledge of AMR and patterns of antibiotic use was assessed pre-intervention while knowledge of AMR was assessed post-intervention. The knowledge was categorised into domains (Understanding Antibiotic and Antimicrobial Resistance; Spread and Impact of Antibiotic/Antimicrobial Resistance; Prevention of Antibiotic/Antimicrobial Resistance). The total score for each domain of knowledge tested was categorized into good knowledge (≥ 80%) and poor knowledge (< 50%).

The number of participants in the pre- and post-intervention were 185 and 157 students with average age of 17.7 years and 17.8 years respectively. Post-intervention, there was a significant increase in students' AMR knowledge, with correct responses regarding spread and impact of AMR increasing from 40.5% pre-intervention to 62.4% post-intervention (p < 0.001; φ (effect size = 0.218). The proportion of students demonstrating good overall knowledge increased from 28.1 to 44.6% (p = 0.001; φ (effect size = 0.171). Misconceptions, such as misunderstanding that antibiotic resistance does not result from the body becoming resistant to antibiotics, persisted but not statistically significant (24.9-17.2%, p = 0.055). Pre-intervention also revealed varied antibiotic use patterns, including the inappropriate use of antibiotics for malaria (51.7%, (n = 76)), and common cold (25.2% (n = 37)).

The study findings indicate that educational interventions can effectively improve healthcare students' knowledge of AMR, though persistent misconceptions underscore the need for more targeted educational efforts. Incorporating structured AMR content into healthcare curricula could help the students contribute to antimicrobial stewardship. Future research should evaluate knowledge retention and behaviour changes to optimize the long-term impact of AMR education.

Effective science communication is crucial in informing citizens in times of crisis. The ICT-driven metamorphosis of the media industry (media-morphosis) has facilitated the shift from a rather one-directional information deficit model in science communication to a more bidirectional communication corresponding to a dialogue model. Little is known about the preferences for social media communication from the supply side of institutional and scholarly communication. Analyzing survey data from nearly 8,700 scientists, we compared their preferences for press media and social media, proxies of traditional centralized communication channels and modern decentralized channels, respectively. Our empirical results show that trust in governments and prioritizing access to all perspectives on the crisis are important factors that influence scientists' preferences regarding forms of communication. Trust favors centralized systems, while social media serves as an alternative in contexts lacking trust in politics. Prioritizing the diffusion of different perspectives drives a shift to stated preferences for decentralized communication systems. We also show that scientists' stated preferences for communication systems depend on the socio-political context.

Microorganisms are fundamental to life on Earth, influencing biogeochemical processes, soil fertility, and the health of humans, animals and plants. Human activities have left a remarkable footprint on the environment, including global microbiomes. Enhancing awareness and improving education about microbiome functions can contribute to a sustainable economy and resilient systems. However, public understanding of microbiome science is hindered by misinformation and limited accessible educational resources. To address this, we developed the massive open online course (MOOC) 'Microbiome & Health', available on iMooX.at and YouTube. The course, structured into six units, covers microbiome concepts, methodologies, human and plant microbiomes, antibiotic resistance, and environmental impacts, aligning with the One Health concept and the Sustainable Development Goals of the United Nations. Initial results show that the MOOC provides the means to increase microbiology literacy, with 73.2% external participation and above-average completion rates. Integration as a mandatory component in university courses has improved student performance, halting declining grades and pass rates. This highlights the MOOC's potential to enhance public and academic understanding of microbiome science, fostering informed decisions for sustainable health and environmental stewardship as well as paving the way for new microbiome-based solutions in biotechnology.

Medical misinformation (false health or medical-related information) has seen a rapid increase in volume recently, with the global surge in social media usage and further exacerbation by the COVID-19 pandemic. This may put more lives at stake, as misinformation is an often-cited reason that people make dangerous health choices, engage in harmful practices and reject beneficial health treatments. In this article, we explore the drivers and consequences, as well as suggest several strategies at the personal, educational and systemic level, for physicians to guide and communicate with patients who subscribe to medical misinformation.

As identified in 1936 by Hans Selye, stress is shaping diseases through the induction of inflammation. But inflammation display some yin yang properties. On one hand inflammation is merging with the innate immune response aimed to fight infectious or sterile insults, on the other hand inflammation favors chronic physical or psychological disorders. Nature has equipped the cells, the organs, and the individuals with mediators and mechanisms that allow them to deal with stress, and even a good stress (eustress) has been associated with homeostasis. Likewise, societies and the planet are exposed to stressful settings, but wars and global warming suggest that the regulatory mechanisms are poorly efficient. In this review we list some inducers of the physiological stress, psychologic stress, societal stress, and planetary stress, and mention some of the great number of parameters which affect and modulate the response to stress and render it different from an individual to another, from the cellular level to the societal one. The cell, the organ, the individual, the society, and the planet share many stressors of which the consequences are extremely interconnected ending in the domino effect and the butterfly effect.

Online health-related misinformation poses a serious threat to public health. As the coronavirus disease 2019 (COVID-19) pandemic aggravated the spread of misinformation regarding COVID-19, relevant research has surged.

To systematically summarize Chinese and English articles regarding health-related misinformation about COVID-19 on social media and quantitatively describe research progress.

Using bibliometrics, we systematically analyzed and compared the characteristics of scientific articles in English and Chinese, examining article numbers, journals, authors, countries, institutions, funding, and research topics, and compared changes in popular research topics.

This study analyzed 1,294 articles, revealing a significant increase in article numbers and citations during the COVID-19 pandemic (1.94 times and 2.95 times, respectively, compared to pre-pandemic data). However, high-impact articles were scarce and the field lacked a core group of authors and collaborative networks. China had the largest number of papers (n=266) and funds (n=292), but articles in English exceeded by far those in Chinese (1,131 vs 163, respectively). Regarding article topics, the transformation from qualitative small-data analyses to quantitative empirical big-data research has been realized.

With the maturity of natural language processing technology, in-depth mining of massive user-generated content has become a hot spot. The outbreak of the COVID-19 pandemic has prompted the research focus to shift from misinformation-related health problems to social problems involving the sources, content, channels, audiences, and effects of communication networks. Using artificial intelligence technology like machine learning to deeply mine large amounts of user-generated content on social media will be a future research hot spot.

Numerous studies have demonstrated that minority groups had a higher level of medical mistrust than non-minority groups, and minority communities were criticized for noncompliance with the public health guidelines during the COVID-19 pandemic. This study explores racial minorities' attitudes and actual behavioral responses to the COVID-19 pandemic public health guidelines. A total of 221 adults responded to an online survey (mean age = 41.5; 48.0% female; 24.4% non-White). Study results indicate that racial minorities have lower trust in public health guidelines compared to non-minority groups but have taken more actions according to the public health guidelines. Analysis also uncovers the mediating roles of perceived pandemic severity and perceived public health action benefits, on the relation between minority status and public health compliance. This study contextualizes how racial minorities respond to public health crises in action, and the dissonance between that and their historical mistrust of medical authorities. This work highlights the importance of recognizing the minority's historical burden and fostering trust in government and professionals during public health crisis.

No studies describe what patients search for online in relation to retrograde cricopharyngeal dysfunction (RCPD). Our objectives were to describe the Google search volume for RCPD, identify the most common queries related to RCPD, and evaluate the available online resources.

Observational.

Google Database.

Using Ahrefs and Search Response, Google search volume for RCPD and "People Also Ask" (PAA) questions were documented. PAA questions were categorized based on intent, and the websites were categorized on source. The quality and readability of the sources were determined using the Journal of the American Medical Association (JAMA) benchmark criteria, Flesch Reading Ease score, and Flesch-Kincaid Grade Level.

Search volume for RCPD-related content has continually increased since 2021, with a combined average volume of 6287 searches per month. Most PAA questions were related to technical details (61.07%) and treatments (32.06%) for RCPD. Websites provided to answer these questions were most often from academic (25.95%) and commercial (22.14%) sources. None of the sources met the criteria for universal readability, and only 15% met all quality metrics set forth by JAMA.

Interest in RCPD is at an all-time high, with information related to its diagnosis and treatment most popular among Google users. Significantly, none of the resources provided by Google met the criteria for universal readability, preventing many patients from fully comprehending the information presented. Future work should aim to address questions related to RCPD in a suitable way for all patient demographics.

During the COVID-19 pandemic, many advocacy groups and individuals criticized governments on social media for doing either too much or too little to mitigate the pandemic. In this article, we review advocacy for COVID-19 elimination or "zero-covid" on the social media platform X (Twitter). We present a thematic analysis of tweets by 20 influential co-signatories of the World Health Network letter on ten themes, covering six topics of science and mitigation (zero-covid, epidemiological data on variants, long-term post-acute sequelae (Long COVID), vaccines, schools and children, views on monkeypox/Mpox) and four advocacy methods (personal advice and promoting remedies, use of anecdotes, criticism of other scientists, and of authorities). The advocacy, although timely and informative, often appealed to emotions and values using anecdotes and strong criticism of authorities and other scientists. Many tweets received hundreds or thousands of likes. Risks were emphasized about children's vulnerability, Long COVID, variant severity, and Mpox, and via comparisons with human immunodeficiency viruses (HIV). Far-reaching policies and promotion of remedies were advocated without systematic evidence review, or sometimes, core field expertise. We identified potential conflicts of interest connected to private companies. Our study documents a need for public health debates to be less polarizing and judgmental, and more factual. In order to protect public trust in science during a crisis, we suggest the development of mechanisms to ensure ethical guidelines for engagement in "science-based" advocacy, and consideration of cost-benefit analysis of recommendations for public health decision-making.

The proliferation of fake news on social media platforms has become a significant concern, influencing public opinion, political decisions, and societal trust. While much research has focused on the technological and algorithmic factors behind the spread of misinformation, less attention has been given to the psychological drivers that contribute to the creation and dissemination of fake news. Cognitive biases, emotional appeals, and social identity motivations are believed to play a crucial role in shaping user behaviour on social media, yet there is limited systematic understanding of how these psychological factors intersect with online information sharing. Existing studies tend to focus on individual aspects of fake news consumption, such as susceptibility to misinformation or partisan biases, leaving a gap in understanding the broader psychological mechanisms behind both the creation and dissemination of fake news. This systematic review aims to fill this gap by synthesizing current research on the psychological factors that influence social media users' involvement in dissemination and creation of fake news. Twenty-three studies were identified from 2014 to 2024 following the PRISMA guidelines. We have identified five themes through critical review and synthesis of the literature which are personal factors, ignorance, social factors, biological process, and cognitive process. These themes help to explain the psychological factors contributing to the creation and dissemination of fake news among social media users. Based on the findings, it is evident that diverse psychological factors influence the dissemination and creation of fake news, which must be studied to design better strategies to minimize this issue.

This study investigated the experiences of communication officials at local health departments (LHD) in the US Midwest regarding the correction of health misinformation on Facebook during the COVID-19 pandemic. Through interviews with communication officials, this study examined how and why they corrected health misinformation, the challenges they encountered during the correction process, and the importance of having fact-checkers within LHDs. The analysis of the data revealed four major themes: factors influencing misinformation correction on Facebook, perceived effectiveness of health misinformation correction, the intersection of the First Amendment and health misinformation, and the role of fact-checking in LHDs. The LHD communication officials often faced conflicts and public rebuttals when directly correcting misinformation leading them to adopt the strategy of addressing misinformation through future posts instead of direct correction. These findings provide significant insights for communication officials to identify and correct health misinformation and emphasize the need for healthcare organizations to provide essential resources to information and communication professionals during times of crises.

Vaccine hesitancy, a pressing global challenge in vaccination programs, was significantly amplified during the COVID-19 pandemic. The proliferation of misinformation, including false claims and rumours, and the influence of anti-vaccine movements fuelled hesitancy. This study aims to explore the socio-economic determinants that influenced vaccine hesitancy and the impact of public health information sharing in Sri Lanka during the pandemic. The study employed a comprehensive mixed-method approach for data collection, administrating a household survey (n = 3330) and 206 semi-structured interviews. The survey results indicated that 37.8% (n = 3113) of respondents delayed or rejected vaccines for various reasons, the leading cause being the fear of side effects of the vaccine. Although fear of side effects was the prime reason for rejection (n = 1176, 46.29%), respondents demonstrated an extremely poor understanding of the potential side effects of vaccines, which was 55.39% (n = 3113). Notably, 84.60% (n = 3113) were unaware of the vaccine development process. Multivariate logistic regression analysis showed that middle-income people (AOR-0.42) and females (0.65) were less likely not to make decisions based on scientific information compared to underprivileged people and males. The survey also revealed that strong belief in the use of traditional medicines and remedies and religious beliefs (n = 1176, 3.95%) were among the main reasons for hesitancy. The findings illustrate that misinformation, lack of health knowledge, and lack of understanding to seek scientific information have fuelled vaccine hesitancy in Sri Lanka.

Extensive evidence of health disparities and systemic racism has prompted scholars to examine constructs that may account for differences in the burden of disease. One such construct is health literacy, which has been posited to have four components: print literacy, oral literacy, numeracy, and cultural and conceptual knowledge. Consistent with historical trends related to culturally based constructs, the latter component has garnered the least attention in the published literature, despite its pervasive influence on health care outcomes. We engage in a reformulation and conceptual analysis of cultural and conceptual knowledge, defined as the filter through which individuals obtain, process, and understand health information and options for diagnosis and treatment. We propose the construct of cultural schema, and operationalize the construct as having cognitive (knowledge, beliefs) and affective (attitudes, emotions) components. As we strive to achieve a more complex understanding of influences on behavioral outcomes, a greater focus on these culturally based factors is essential. In this article, we present a conceptual analysis that seeks to advance the field by: (a) providing distinct definitions for each component that can be applied across fields of study and theoretical frameworks, (b) offering measurement considerations consistent with their conceptualizations, and (c) making recommendations for future theory, research, and practice. We hope that with greater conceptual and measurement clarity of cultural schema, more consistent results will be obtained, constructs and processes that affect health outcomes will be identified, and more personalized intervention will be possible, optimizing the limited resources available for health promotion efforts.

Pundits and scholars alike suspect that Facebook plays a role in not only exposing Americans to misinformation, but also encouraging them to seek out misinformation from other sources. Whether or not Facebook is responsible for stimulating misinformation search beyond the social networking site, however, is an open question. If Facebook encourages misinformation search behavior, we might expect search volume on other websites to simultaneously decrease when web traffic to Facebook is comparatively low. Here, we exploit a naturally-occurring and exogenous interruption to Facebook's service to study the site's impact on misinformation search. Difference-in-difference analyses reveal that minute-by-minute Google searches for pandemic misinformation (e.g., unproven COVID-19 remedies, vaccine conspiracy theories) tended to increase during the outage period, in comparison to a typical day (and vs. a placebo). These findings are less consistent with views that the site stimulates misinformation search, and more consistent with a steady and transferable demand for health misinformation. Our results showcase the importance of examining not only the supply side of misinformation, but also the demand side.

Online digital networks, including social networks, have significantly impacted individuals' personal and professional lives. Aside from exchanging news and topics of interest, digital networks play an essential role in the diffusion of information, which frequently significantly impacts worldwide societies. In this paper, we present a new mathematical epidemic model for digital networks that considers the sentiment of solitary misinformation in the networks and characteristics of human intelligence that play an important role in judging and spreading misinformation inside the networks. Our mathematical analysis has proved the existence and validity of the system in a real-time environment. Considering the real-world data, our simulation predicts how the misinformation could spread among different global communities and when an intervention mechanism should have to be carried out by the policyholders. Our simulation using the model proves that effective intervention mechanisms by isolating the fake news can effectively control the spread of misinformation among larger populations. The model can analyze the emotional and social intelligence of groups frequently subjected to disinformation and disseminating fake news.

Health literacy can be defined as an individual's competence to use knowledge and information to maintain and improve health. Research has shown the crucial importance of health literacy in everyday life. Nurses play an important role in fostering patients' health literacy. But there is a lack in research on nurses' health literacy and how it influences their work. Therefore, this study aims to determine nursing students' health literacy and find out whether this group assessed that there was a change in their health literacy before and after the COVID-19 pandemic. In addition, this study aims to find out whether there is a relation between nursing students' assessments of their health literacy and their assessments of whether and how they use strategies to foster their patients' health literary in everyday work. We conducted a longitudinal study with two points of measurement, before the COVID-19 pandemic (N = 112) and after (N = 304). Nursing students filled out an online questionnaire using validated scales. To analyze the data, we used descriptive statistics, correlation analysis, and Welch's t-test. The results show that before the COVID-19 pandemic, the nursing students assessed their health literacy as quite high, and after the COVID-19 pandemic, they found it difficult to access (t = 17.881; p < 0.001; Cohen's d = 0.46), understand (t = 16.404; p < 0.001; Cohen's d = 0.56), appraise (t = 15.429; p < 0.00; Cohen's d = 0.47), and apply health-related information (t = 13.761; p < 0.001; Cohen's d = 0.54). Implications of our study concern nurses' vocational education and training in which nurses must learn about health literacy and strategies to foster their patients' health literacy.

Throughout history, armed conflicts have profoundly affected individuals and societies, with recent events in Ukraine, the Middle East, and beyond bringing into sharp focus the severe mental health and humanitarian consequences of geopolitical crises. Such situations often result in mass fatalities, destruction, displacement, forced migration, and other critical life events. Amid these scenarios, the adverse outcomes for mental health and well-being in both the short and long term must be emphasized. As a conceivable example of the latter, the proposed concept of intergenerational trauma could have far-reaching implications. In particular, in certain regions, civilians have repeatedly experienced instances of violence and may have continually been exposed to critical life events and traumatic stress. In this context, the consequences of these events for individual well-being and global mental health will likely be registered for years to come. Accordingly, urgent help and actions to address the mental health burdens within contemporary conflicts should be accentuated in humanitarian, political, and diplomatic interventions. Equally, health policies must adopt a long-term approach to support initiatives under the purview of global and public mental health objectives.

The COVID-19 pandemic had a profound global impact, affecting individuals, including those with mental illness, through early and widespread information dissemination. Although the neurobiological basis of delusions remains unclear, external stimuli and historical events are known to influence them. The pandemic provided a unique opportunity to explore this phenomenon.

To determine the prevalence of COVID-19-related delusional content, among individuals presenting for treatment of psychosis during the peak of the COVID-19 pandemic and investigate associated clinical and demographic factors.

Chris Hani Baragwanath Academic Hospital in-patient psychiatry department.

Data were extracted retrospectively from adult psychiatric admissions spanning April to September 2020 on patients whose presenting complaints included delusions. Demographic factors, symptoms, psychiatric, medical and substance use history, and a documented Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnosis by the attending psychiatrist were collected.

The prevalence of COVID-19-related delusional content was 25.5%. Significant demographic association was observed with education level of Grade 12 and above (p = 0.000338). The odds of a diagnosis of schizophrenia and related disorders were 2.72 times greater than mood and psychotic disorder due to another medical condition in those with COVID- 19-related delusional content (OR 2.19, 95% CI: [1.4-3.4]).

The presence of COVID-19-related delusional content in patients admitted to hospital with psychosis provides further evidence of the role of external stimuli in the formation of delusions.

This study underscores the influence of socio-cultural factors on delusions and advocates for interventions and expanded research to address mental health outcomes.

Community-based fact-checking is a promising approach to fact-check social media content at scale. However, an understanding of whether users trust community fact-checks is missing. Here, we presented n = 1,810 Americans with 36 misleading and nonmisleading social media posts and assessed their trust in different types of fact-checking interventions. Participants were randomly assigned to treatments where misleading content was either accompanied by simple (i.e. context-free) misinformation flags in different formats (expert flags or community flags), or by textual "community notes" explaining why the fact-checked post was misleading. Across both sides of the political spectrum, community notes were perceived as significantly more trustworthy than simple misinformation flags. Our results further suggest that the higher trustworthiness primarily stemmed from the context provided in community notes (i.e. fact-checking explanations) rather than generally higher trust towards community fact-checkers. Community notes also improved the identification of misleading posts. In sum, our work implies that context matters in fact-checking and that community notes might be an effective approach to mitigate trust issues with simple misinformation flags.

Social media are immensely popular among adolescents. Thus, concerns have been raised about the threats adolescents encounter on social media and the possible negative health consequences, such as depressive symptoms and anxiety. This study investigated the prevalence of nine social media threats: (1) cyberbullying, (2) sexual harassment, (3) racism, (4) unauthorized distribution of sensitive material, (5) phishing attempts, (6) misinformation, (7) the sale or distribution of drugs, (8) harmful or dangerous social media challenges, (9) content causing appearance pressures. The study also investigated how individual and social factors, problematic social media use (PSMU), and online communication with strangers are associated with social media threat exposure, as well as the association between social media threats and self-rated health, depressive feelings, and anxiety symptoms.

Nationally representative Health Behaviour in School-aged Children (HBSC) data from Finland were obtained from 2288 respondents aged 11, 13, and 15 years. Fixed effects regression models were applied. The most common threat, encountered daily and weekly, was misinformation. Regression models showed that individual and social factors, PSMU, and online communication with strangers explained adolescent exposure to social media threats in differing ways. Furthermore, certain factors (e.g., emotional intelligence, family support) were associated with encountering social media threats less frequently, whereas other factors (e.g., PSMU, online communication with strangers) were associated with more frequent encounters. Daily and weekly exposure to social media threats was systematically associated with poor self-rated health, frequent depressive feelings, and anxiety symptoms.

Our study highlights the need for intervention and health promotion efforts to mitigate adolescent exposure to social media threats and ensuing negative health consequences.

This infodemiology study aimed to analyze characteristics of English-language Instagram posts on 'Biological Dentistry'.

Using CrowdTangle, we analyzed 500 'Biological Dentistry' posts published on Instagram from May 2017 to May 2022. Two researchers assessed each post for facticity, motivation, author's profile, sentiment, and interaction metrics. Statistical analysis was employed to compare interaction metrics between dichotomized categories of posts' characteristics and determine predictors of misinformation and user engagement.

Over half of the posts (58.4%) were from health-related authors, and a considerable number contained misinformation (68.2%) or were financially motivated (52%). Sentiment was mostly negative or neutral (59.8%). Misinformation was associated with financial motivation (OR = 2.12) and health-related authors (OR = 5.56), while non-health-related authors' posts associated with higher engagement (OR = 1.98). Reliable content, non-health-related authorship, and positive sentiment were associated with increased user interaction.

Misinformation about 'Biological Dentistry' on Instagram is mainly spread by financially incentivized health-related authors. Yet, non-health-related authors' posts resonate more with audiences, highlighting a nuanced relationship between content facticity, authorship, and engagement.

(1) Background: Dietary behaviour transformation is imperative for the attainment of more sustainable food systems, including an increased intake of plant-based foods and lower consumption of red meat and highly processed foods. The influence of news media coverage on public opinion regarding dietary behaviours is significant. Therefore, this study aimed to explore how sustainable/plant-based diets have been portrayed in Australian news media. (2) Methods: The Factiva global news database was used to search news articles published in Australia between 2018 and 2020. Relevant news articles were selected if they included keywords relating to sustainable diets, plant-based diets, and meat alternatives. We used a coding protocol to extract key information, such as date of publication, article topic, and any health, environmental and economic impacts. Then, we performed a framing and thematic analysis of the data. (3) Results: From 357 included articles, more than half of the articles encouraged increasing the intake of plant-based foods (53.5%) and reducing animal-derived food intake (55.2%). Several reasons for such shift from animal protein centric Australian diets were identified throughout the articles such as health benefits (15.4%), environmental impacts (11.2%), animal welfare (4.8%), seasonality and local food intake (5.3%), avoiding overconsumption (4.5%) and food wastage (4.5%). (4) Conclusions: The predominant frame in Australian news coverage about sustainable diets has been about consumption, more plant- and less animal-based products, with little nuance about the complex interplay of diet quality and environment in influencing food choices. Australian news media should broaden its coverage of sustainable diets to include health, environmental, and economic factors to improve public understanding and facilitate informed and sustainable food choices. Further research is needed to enhance comprehension of how the audience perceives media coverage on this topic, which will provide a more thorough understanding.

It has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents.

The analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed.

Cyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01-1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents.

Cyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria's effect extends beyond health anxiety.

The COVID-19 pandemic was characterized by an abundance of information, some of it reliable and some of it misinformation. Evidence-based data on the impact of misinformation on attitudes and behaviours remains limited. Studies indicate that older adults are more likely to embrace and disseminate misinformation than other population groups, making them vulnerable to misinformation. The purpose of this article is to explore the effects of misinformation and information overload on older adults, and to present the management strategies put in place to deal with such effects, in the context of COVID-19.

A qualitative exploratory approach was adopted to conduct this research. A total of 36 semi-structured interviews were conducted with older adults living in Quebec, Canada. The interviews were fully transcribed and subjected to a thematic content analysis.

Participants said they could easily spot misinformation online. Despite this, misinformation and its treatment by the media could generate fear, stress and anxiety. Moreover, the polarization induced by misinformation resulted in tensions and even friendship breakdowns. Participants also denounced the information overload produced largely by the media. To this end, the participants set up information routines targeting the sources of information and the times at which they consulted the information.

This article questions the concept of vulnerability to misinformation by highlighting older adults' agency in managing misinformation and information overload. Furthermore, this study invites us to rethink communication strategies by distinguishing between information overload and misinformation.

The aim of this study was to carry out a systematic literature review to investigate the main immune cells responsible for implantation failures. We selected papers from PubMed, Embase and Virtual Health Library databases. Eligible articles included publications between January 1, 2010 and April 24, 2022. Inclusion criteria were: observational and case-control studies; and the exclusion criteria were: review papers, letters to the editor, abstracts, animal studies and case reports. We extracted the following information: day of collection, number of patients, control group, age of patients, type of sample used, immune cells and cytokines. As main findings in our mapping, we found that in peripheral blood, CD3+, CD4+, CD8+, CD16+, CD56+, CD57+, CD69+, CD154+, CD158a+, NKp46 cells were increased and the CD4+, CD45+, Foxp3 and NKp46 markers were reduced. From the endometrial biopsies, there was an increase in CD3+, CD4+, CD5+, CD8+, CD16+, CD25+, CD45+, CD56+, CD57+, CD68+, CD127+ and a reduction in CD45+, CD56+, NKp46 and FoxP3 cells. Cytokines found increased in peripheral blood included IL-6, IL-10, IL-17, INF-γ, TGF-ß, TNF-α; while IL-4, IL-6, IL-10, IL-35, FoxP3, TGF-ß, SOCS3 were reduced. As for the biopsies, there was an increase in IL-2, IL-6, IL-17, IL-22, IL-23, INF-A1, INF-B1, INF-γ, TNF-R and a reduction in IL-6, IL-10, INF-γ, TGFß, TNF-α. We concluded that immune cells can be modulated during pregnancy failure, but further studies are needed to elucidate the modulating effect of the immune system on the endometrium of these patients.

Introduction The advent of social media platforms, notably TikTok, has significantly transformed the landscape of health information dissemination, offering both opportunities and challenges for public health communication. This study focuses on TikTok's influence on sinus health information, addressing the dual challenge of widespread engagement and the risk of misinformation in otolaryngology, or ENT (ear-nose-throat), information online. We introduce the ENT Content Engagement and Quality Index (ENT-CEQI), a pioneering tool designed to assess the quality and engagement of ENT-related content on TikTok, aiming to improve public understanding of sinus health. Materials and methods Our methodology involved a systematic analysis of sinus health-related content on TikTok. We collected data on the top 100 most popular videos using the hashtag #sinus at two different points in time, analyzing engagement metrics and content quality. The ENT-CEQI was developed to evaluate content, incorporating both quantitative engagement metrics (views, likes, comments, shares, favorites) and qualitative assessments (accuracy, clarity, relevance, practicality, engagement). The study employed statistical analyses, including trend analysis, correlation analysis, principal component analysis (PCA), KMeans clustering, regression analysis, and the Kruskal-Wallis test, to understand the dynamics of content engagement and quality. Results Initial findings revealed significant disparities in engagement metrics and quality scores among different content creator categories, with physician-generated content showing the highest engagement and quality. The trend analysis indicated shifts in content popularity and quality over time, with a notable increase in views and likes for private company content. The PCA and clustering analyses identified distinct content clusters, offering insights into viewer engagement patterns. Regression analysis and the Kruskal-Wallis test, however, did not find significant predictors (p-value: 0.3916) of content quality or differences in likes across content types, suggesting complex factors influencing content engagement and quality perception. Discussion The study highlights TikTok's potential and pitfalls in disseminating sinus health information. The introduction of the ENT-CEQI represents a major step toward enhancing the evaluation of health content on social media, emphasizing the importance of accuracy, clarity, and relevance in public health communication. The analysis underscores the complexity of social media engagement and the need for robust tools to assess content quality. It also points to the critical role of healthcare professionals in engaging with the public through social media to combat misinformation. Conclusions TikTok serves as a potent platform for sinus health education, capable of reaching wide and diverse audiences. The ENT-CEQI emerges as a vital tool for assessing the quality and engagement of ENT-related content, guiding content creators toward producing more reliable and informative content. This study contributes to the understanding of social media's role in health communication, advocating for the strategic use of innovative tools such as the ENT-CEQI to enhance public health outcomes through improved online health education and misinformation management.

COVID-19 is an emergent disease with significant global concern, which might have a negative effect on quality of life. This study aimed to determine the impact of the COVID-19 pandemic on the quality of life of people (with or without COVID-19) attending primary health centers in A'Seeb Wilayat in Muscat, Oman.

This cross-sectional study was conducted in four randomly selected primary health centers in A'Seeb Wilayat from 17 July 2021 to 31 January 2022. All Omani men and women, aged ≥ 18 years, regardless of their COVID-19 infection status, who were able to read and use online questionnaire, were included. The consecutive sampling method was applied. An online self-administered and validated Arabic version of the Short Form-12 was used to determine the impact of the COVID-19 pandemic on mental and physical quality of life.

A total of 701 participants were included with a mean age of 25.3 years. Two-thirds of the participants (n = 473, 67.5%) reported being physically affected by the COVID-19 pandemic (score of ≤ 50) and more than half (n = 392, 55.9%) had been mentally affected (score of ≤ 42). Univariate analysis revealed a significant association between physical impact and educational level, low family income, chronic diseases, and alcohol consumption. Gender, young age, being single, low income, and chronic diseases were significant risk factors for mental impact.

Physical and mental impacts are very common during the COVID-19 pandemic. Several risk factors were identified. Public health programs need to be implemented to mitigate the negative impact of COVID-19 on quality of life.

The study aimed to review general and specific health literacy studies in different countries in Asia to understand the progress of health literacy researches in the region. English-published studies with quantitative measurements of health literacy were collected through a systematic search in PubMed, Cochrane Library, Embase, and Web of Science, without publication dates limitation. A total of 156 articles on general health literacy, oral, mental, disease-specific health literacy, and eHealth literacy were collected. General health literacy was the most covered topic in 89 articles, followed by eHealth Literacy. Health literacy studies have been conducted in 16 countries and have been increasingly concerned in most of the countries in Asia. China had the largest number of articles, followed by Taiwan. Four studies had participants from more than one country. Education, age, health status, incomes, and living/residential area were significantly associated with health literacy levels in 156 studies, with the prevalence of 55.8%, 28.2%, 20.5%, 17.9%, and 10.9%, respectively. Lower health literacy was related to poorer health outcomes or lower quality of life in 71 studies.

The Covid-19 pandemic has dramatically changed how information is shared and processed worldwide. The COVID-19 pandemic has profoundly affected the globalization of information, causing shifts in communication, information dissemination, and technology. This paper investigates the impact of pandemics-related uncertainty on the index of de facto informational globalization (the measure based on high-technology exports, international patents, and used internet bandwidth). The paper uses the panel dataset of 18 Central and Eastern European (CEE) countries from 1990 to 2020. The results indicate that pandemics-related uncertainty negatively affects the informational globalization level in the CEE economies. The findings are robust in utilizing different estimation techniques and considering NATO member CEE countries.

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Online health disinformation is one of the key challenges faced globally. Although there are efforts to address this issue, most of the proposed solutions were ineffective or could not address it effectively. One of the key reasons for the ineffective solutions is lack of understanding on how public deal with disinformation and the different areas that could be influenced by health disinformation.

This study aims to analyze the public perceptions towards online health information, investigate the impact of online health disinformation, and propose a framework for addressing the issue of online health disinformation.

A mixed-methods approach design is used in this study which includes a cross-sectional survey design to gather data from public; and a semi-structured interviews approach with healthcare experts to analyze the impact of online health disinformation on the society. A total of 409 Saudi residents were included for survey, and 22 health informatics experts were considered for interviews.

The results revealed low digital literacy levels and poor critical analysis skills among the public resulting in poor management of health disinformation. Age and education can influence the users' perceptions about the use of various online health information evaluation techniques. Thematic analysis of the interviews identified impact in four areas including social, economic, technical, and legal fronts; and various strategies were identified for public, governments, and healthcare institutions for managing the online health disinformation.

The occurrence of online health-related disinformation in Saudi Arabia is high, and there is a need to implement strict regulatory framework for managing disinformation.

Patients narratives are being recorded increasingly frequently and spontaneously in short user produced content (UGC) films, which may have an impact on the vlogger's health as well as the public's comprehension of the relevant health concerns. This paper addressed three research questions regarding the population characteristics of UGC video publishers, the narrative theme of the videos, and the emotional orientation of the commenters. This study aimed to deepen our understanding of COVID-19 patients' narrative intentions and emotional needs through the theoretical frameworks of theory of planned behavior (TPB) and negative dominance theory (NDT). We collected 335 videos from 28 COVID-19 patients and 572,052 comments as samples on Douyin platform, the largest short-video website in China. Using Latent Semantic Analysis, we analyzed the descriptive information of the video blogs, the narrative textual information of the videos, and the emotional orientation of the comments. Our findings revealled seven categories of narrative themes, with 52.1% of video comments exhibiting a positive emotional orientation. Within a framework integrating TPB and NDT theories, we analyzed the behavioral intentions of vloggers and viewers during COVID-19 epidemic, and interpreted the persistent posting of videos and the active posting of comments as positive actions that counteracted the multiple effects of negative messages. This study contributes to the understanding of individual narratives in macro-risk communication, both theoretically and empirically, and offers policy recommendations in relevant fields.

The proliferation of false and misleading health claims poses a major threat to public health. This ongoing "infodemic" has prompted numerous organizations to develop tools and approaches to manage the spread of falsehoods and communicate more effectively in an environment of mistrust and misleading information. However, these tools and approaches have not been systematically characterized, limiting their utility. This analysis provides a characterization of the current ecosystem of infodemic management strategies, allowing public health practitioners, communicators, researchers, and policy makers to gain an understanding of the tools at their disposal.

A multi-pronged search strategy was used to identify tools and approaches for combatting health-related misinformation and disinformation. The search strategy included a scoping review of academic literature; a review of gray literature from organizations involved in public health communications and misinformation/disinformation management; and a review of policies and infodemic management approaches from all U.S. state health departments and select local health departments. A team of annotators labelled the main feature(s) of each tool or approach using an iteratively developed list of tags.

We identified over 350 infodemic management tools and approaches. We introduce the 4 i Framework for Advancing Communication and Trust (4 i FACT), a modified social-ecological model, to characterize different levels of infodemic intervention: informational, individual, interpersonal, and institutional. Information-level strategies included those designed to amplify factual information, fill information voids, debunk false information, track circulating information, and verify, detect, or rate the credibility of information. Individual-level strategies included those designed to enhance information literacy and prebunking/inoculation tools. Strategies at the interpersonal/community level included resources for public health communicators and community engagement approaches. Institutional and structural approaches included resources for journalists and fact checkers, tools for managing academic/scientific literature, resources for infodemic researchers/research, resources for infodemic managers, social media regulation, and policy/legislation.

The 4 i FACT provides a useful way to characterize the current ecosystem of infodemic management strategies. Recognizing the complex and multifaceted nature of the ongoing infodemic, efforts should be taken to utilize and integrate strategies across all four levels of the modified social-ecological model.

As the use of social media becomes more widespread, its impact on health cannot be ignored. However, limited research has been conducted on the relationship between social media and suicide. Little is known about individuals' vulnerable to suicide, especially when social media suicide information is extremely prevalent.

This study aims to identify the characteristics underlying individuals' vulnerability to suicide brought about by an increase in suicide-related tweets, thereby contributing to public health.

A case-only design was used to investigate vulnerability to suicide using individual data of people who died by suicide and tweet data from January 1, 2011, through December 31, 2014. Mortality data were obtained from Japanese government statistics, and tweet data were provided by a commercial service. Tweet data identified the days when suicide-related tweets surged, and the date-keyed merging was performed by considering 3 and 7 lag days. For the merged data set for analysis, the logistic regression model was fitted with one of the personal characteristics of interest as a dependent variable and the dichotomous exposure variable. This analysis was performed to estimate the interaction between the surges in suicide-related tweets and personal characteristics of the suicide victims as case-only odds ratios (ORs) with 95% CIs. For the sensitivity analysis, unexpected deaths other than suicide were considered.

During the study period, there were 159,490 suicides and 115,072 unexpected deaths, and the number of suicide-related tweets was 2,804,999. Following the 3-day lag of a highly tweeted day, there were significant interactions for those who were aged 40 years or younger (OR 1.09, 95% CI 1.03-1.15), male (OR 1.12, 95% CI 1.07-1.18), divorced (OR 1.11, 95% CI 1.03 1.19), unemployed (OR 1.12, 95% CI 1.02-1.22), and living in urban areas (OR 1.26, 95% CI 1.17 1.35). By contrast, widowed individuals had significantly lower interactions (OR 0.83, 95% CI 0.77-0.89). Except for unemployment, significant relationships were also observed for the 7-day lag. For the sensitivity analysis, no significant interactions were observed for other unexpected deaths in the 3-day lag, and only the widowed had a significantly larger interaction than those who were married (OR 1.08, 95% CI 1.02-1.15) in the 7-day lag.

This study revealed the interactions of personal characteristics associated with susceptibility to suicide-related tweets. In addition, a few significant relationships were observed in the sensitivity analysis, suggesting that such an interaction is specific to suicide deaths. In other words, individuals with these characteristics, such as being young, male, unemployed, and divorced, may be vulnerable to surges in suicide-related tweets. Thus, minimizing public health strain by identifying people who are vulnerable and susceptible to a surge in suicide-related information on the internet is necessary.

Misinformation poses a serious challenge to clinical and policy decision-making in the health field. The COVID-19 pandemic amplified interest in misinformation and related terms and witnessed a proliferation of definitions.

We aim to assess the definitions of misinformation and related terms used in health-related literature.

We conducted a scoping review of systematic reviews by searching Ovid MEDLINE, Embase, Cochrane, and Epistemonikos databases for articles published within the last 5 years up till March 2023. Eligible studies were systematic reviews that stated misinformation or related terms as part of their objectives, conducted a systematic search of at least one database, and reported at least 1 definition for misinformation or related terms. We extracted definitions for the terms misinformation, disinformation, fake news, infodemic, and malinformation. Within each definition, we identified concepts and mapped them across misinformation-related terms.

We included 41 eligible systematic reviews, out of which 32 (78%) reviews addressed the topic of public health emergencies (including the COVID-19 pandemic) and contained 75 definitions for misinformation and related terms. The definitions consisted of 20 for misinformation, 19 for disinformation, 10 for fake news, 24 for infodemic, and 2 for malinformation. "False/inaccurate/incorrect" was mentioned in 15 of 20 definitions of misinformation, 13 of 19 definitions of disinformation, 5 of 10 definitions of fake news, 6 of 24 definitions of infodemic, and 0 of 2 definitions of malinformation. Infodemic had 19 of 24 definitions addressing "information overload" and malinformation had 2 of 2 definitions with "accurate" and 1 definition "used in the wrong context." Out of all the definitions, 56 (75%) were referenced from other sources.

While the definitions of misinformation and related terms in the health field had inconstancies and variability, they were largely consistent. Inconstancies related to the intentionality in misinformation definitions (7 definitions mention "unintentional," while 5 definitions have "intentional"). They also related to the content of infodemic (9 definitions mention "valid and invalid info," while 6 definitions have "false/inaccurate/incorrect"). The inclusion of concepts such as "intentional" may be difficult to operationalize as it is difficult to ascertain one's intentions. This scoping review has the strength of using a systematic method for retrieving articles but does not cover all definitions in the extant literature outside the field of health. This scoping review of the health literature identified several definitions for misinformation and related terms, which showed variability and included concepts that are difficult to operationalize. Health practitioners need to exert caution before labeling a piece of information as misinformation or any other related term and only do so after ascertaining accurateness and sometimes intentionality. Additional efforts are needed to allow future consensus around clear and operational definitions.

As the coronavirus disease (COVID-19) pandemic ends, it is worth considering whether the ability to cope with such a pandemic has improved. The initial response to COVID-19 was hampered by the fear of new infectious diseases and spread of misinformation on the Internet. This highlights the need to enhance our ability to critically evaluate information rather than indiscriminately search for and trust information on the Internet. Therefore, this study examined how cyberchondria and eHealth literacy moderate the effect of fear of COVID-19 on the efficacy of coping behaviors for future epidemics and pandemics. The participants were 1000 adults in South Korea who were selected based on population proportionality. The results showed that fear of COVID-19 was significantly positively related to cyberchondria, and eHealth literacy was significantly positively related to the efficacy of coping behaviors. Further, the fear of COVID-19 had a significantly negative effect on the efficacy of coping behaviors, and the moderating effect of cyberchondria varied according to the level of eHealth literacy. These results emphasize the importance of eHealth literacy in enabling critical decision-making regarding misinformation.