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The expansion of hospice care worldwide has been received differently by medical communities in different societies. Nonetheless, existing efforts to explain how culture affects the reception of hospice care are inadequate. On the basis of fieldwork conducted in Chinese medical institutions and care facilities between 2017 and 2022, this paper draws on a theoretical framework that distinguishes between declarative culture and nondeclarative culture at the personal level to explain the discrepancies between healthcare professionals' beliefs regarding the value of hospice care and their daily healthcare practice. Moreover, this paper uses the concept of cultural scaffolding to demonstrate that the culture of hospice care and the culture of medical institutions are not separate, independent entities but rather evolve together to produce new and local forms of hospice care in the Chinese context. This analysis helps clarify the obstacles and opportunities associated with hospice care in China and contributes to existing research on the reception of hospice care worldwide. • Explains discrepancies between healthcare professionals' beliefs about hospice and daily practice. • Theoretical framework that distinguishes between declarative and nondeclarative culture. • Localized hospice care emerges as culture of hospice care and culture of medical institutions interact. • Clarifies the obstacles and opportunities faced by hospice care in China. • Contributes to existing research on the reception of hospice care worldwide. [ABSTRACT FROM AUTHOR]

Recent commentaries have proposed 'all-world ageing' as a new perspective for social scientific ageing research. It is based on the theoretical observation that the ageing process involves all forms of entities co-ageing relationally with each other, and with their surrounds. Its disciplinary implications hence being that what we categorize as ageing in social scientific ageing research should not be limited to human bodies, and that ageing non-humans should be brought under its purview. To empirically illustrate these theoretical and disciplinary assertions, and explore their implications, the current paper reports a study of how people co-age with non-humans they interact with in their daily lives. Sixteen people aged 66–90 were interviewed, ten of them also being observed at those times. The findings show some intricate and diverse relations that involve their co-ageing with varied biological entities and nature surrounds (such as plants, domestic animals and green spaces) and varied non-biological entities and non-nature surrounds (such as materials, technologies, accommodations, organizations and infrastructures). Meanwhile, important crosscutting themes – including lifespan, function and aesthetics – emerge as objectives of care, valued and exercised in broad terms. This empirical reconnaissance shows the potential for an all-world ageing perspective to engage diverse societal challenges and inform diverse areas of practice as part of a wider ethics of care. From it, a number of important considerations and undertakings arise for future scholarship. • The paper empirically road tests an all-world ageing perspective. • The paper posits that ageing research should not be limited to ageing human bodies. • Older people are found to co-age with biological and nonbiological entities/surrounds. • Lifespan, function and aesthetics are care objectives, valued and exercised broadly. • Theoretical and empirical considerations are highlighted for future scholarship. [ABSTRACT FROM AUTHOR]

This paper utilizes Benford's law, the distribution that the first significant digit of numbers in certain datasets should follow, to assess the accuracy of self-reported health expenditure data known for measurement errors. We provide both simulation and real data evidence supporting the validity assumption that genuine health expenditure data conform to Benford's law. We then conduct a Benford analysis of health expenditure variables from two widely utilized public datasets, the China Health and Nutrition Survey and the China Family Panel Studies. Our findings show that health expenditure data in both datasets exhibit inconsistencies with Benford's law, with the former dataset tending to be less prone to reporting errors. These results remain robust while accounting for variations in survey design, recall periods, and sample sizes. Moreover, we demonstrate that data accuracy improves with a shorter time interval between hospitalization and interviews, when the data is self-reported as opposed to proxy responses, and at the household level. We find no compelling evidence that enumerators' assessments of respondents' credibility or urgency to end interviews are indicative of data accuracy. This paper contributes to literature by introducing an easy-to-implement analytical framework for scrutinizing and comparing the reporting accuracy of health expenditure data. • Applied Benford's Law to assess health expenditure data accuracy. • Detected inconsistencies with Benford's Law in two widely used datasets. • Found inpatient expenditure data to be more accurate than total expenditure. • Emphasized caution against relying on enumerators' opinions to indicate data accuracy. [ABSTRACT FROM AUTHOR]

Since the depathologisation movement in 2007 to challenge the pathologisation of trans identities in Western psychiatry, significant developments have occurred, including revisions to Standards of Care and diagnostic criteria such as ICD-11's gender incongruence and DSM-5's gender dysphoria, acknowledging gender diversity as an expected part of human development. This paper argues that Japanese medical models reflect global issues but also have unique aspects shaped by cultural and linguistic nuances. Using critical discourse analysis, this paper examines how depathologisation discourses are perceived in the Japanese medical community, focusing on the term seidouitsusei-syōgai (gender identity disorder), presenting three ways in which seidouitsusei-syōgai is used: psychiatric disorder, syōgai / sikkan (impairment/disability/disorder), and diagnostic category. These uses are influenced by legal and social reforms, healthcare access and alignment with international classifications, while the medical profession's authority remains unexamined. Reflecting the structural challenges of diagnostic models in trans medicine, the interpretation of seidouitsusei-syōgai differs from the English phrase 'gender identity disorder' due to the specific connotations of syōgai in the Japanese context. By examining Japan's approach to depathologisation and medicalisation, this paper enriches the understanding of trans medicine and the impact of depathologisation discourse in Japan. • Japanese medical views on trans depathologisation through critical discourse analysis. • Focusing interpretations of seidouitsusei-syōgai(=gender identity disorder). • 3 usages, psychiatric, syōgai/sikkan and diagnostic, are influenced by social factors. • The authoritative role of the medical profession remains unexamined. • Japan sharing structural problems of diagnostic model but has specific connotations. [ABSTRACT FROM AUTHOR]

Medicalization represents an increasingly significant form of social control. Emergent evidence suggests that workplace managers take up medicalized practices and discourses to produce a compliant labor force, but this phenomenon has received limited sociological attention. This paper extends prior theories of medicalization to investigate therapeutic management in the low-wage workplace. I draw upon eight months of ethnographic fieldwork in Disability Works, a nonprofit job training program for people with mental illnesses, and interviews with other providers and advocates within this field. Disability Works harnesses therapy, psychiatry, and "softer" therapeutic practices such as mindfulness meditation, sleep hygiene, and positive affirmations to produce its workforce. This paper identifies two dimensions of therapeutic management: (1) it aims to inculcate work norms at the level of client-workers' embodied dispositions, and (2) it aims to transform structural problems into individual ones. Findings illuminate therapeutic management as an emergent workplace regime and may guide future research on its effects. • "Therapeutic management" is an emergent managerial style. • Ethnographic fieldwork and interviews illustrate practices of therapeutic management. • This style draws on therapy, psychiatry, and pseudo-therapeutic practices. • Therapeutic management aims to inculcate work norms at the dispositional level. • Therapeutic management aims to transform structural problems into individual ones. [ABSTRACT FROM AUTHOR]

A perception at the core of studies that consider the link between social rank and stress (typically measured by the so-called stress hormone cortisol) is that the link is direct. Examples of such studies are Bartolomucci (2007) , Beery and Kaufer (2015) , and Koolhaas et al. (2017). A recent and stark representation of this body of work is a study by Smith-Osborne et al. (2023) , who state that "social hierarchies directly influence stress status" (Smith-Osborne et al. p. 1537, italics added). In the present paper, we reflect on this "direct" perspective. We conjecture that the link between social rank and stress involves an intervening variable: an indirect relationship arises when the loss of rank triggers a behavioral response in the form of risk taking aimed at regaining rank, and it is the engagement in risk-taking behavior that is the cause of an elevated level of cortisol. Smith-Osborne et al., as well as others whose papers are cited by Smith-Osborne et al. and who, like Creel (2001) and Avitsur et al. (2006) , conducted comprehensive research on the association between rank (social standing) and stress, do not refer to risk taking at all. We present four strands of research that lend support to our conjecture: evidence that in response to losing rank, individuals are stressed; evidence that in response to losing rank, individuals resort to risk-taking behavior aimed at regaining their lost rank; evidence that there exists a link between engagement in risky activities or exposure to risk and elevated levels of cortisol; and an analytical perspective on incidence and intensity, namely a perspective that shows how the willingness to take risks responds to a change in rank, specifically, how a loss of rank triggers a greater willingness to take risks and how this trigger is stronger for individuals whose rank is higher. • The link between social rank and stress involves an intervening variable. • Loss of rank triggers a behavioral response in the form of risk taking. • This response is aimed at regaining rank. • Risk-taking behavior is the cause of an elevated level of cortisol. [ABSTRACT FROM AUTHOR]

This paper explores news media discourse about care.data: an NHS England programme of work for amalgamating and sharing patient data from primary care for planning and research. It was scrapped in 2016 after three years of public outcry, delays and around 1.5 million opt-outs. I examine UK news media coverage of this programme through the 'fire object' metaphor, focusing upon the visions of purpose and value it inspired, the abrupt discontinuities, juxtapositions and transformations it performed, and the matters of concern that went unheeded. Findings suggest that, in care.data's pursuit of a societal consensus on NHS patient data exploitations, various visions for new and fluid data flows brought to presence narratives of transforming the NHS, saving lives, and growing the economy. Other realities and concerns that mattered for certain stakeholders, such as data ownership and commercialisation, public engagement and informed consent, commitment and leadership, operational capabilities, and NHS privatisation agendas, remained absent or unsettled. False dichotomies kept the controversy alive, sealing its fate. I conclude by arguing that such failed programmes can turn into phantom-like objects , haunting future patient data schemes of similar aspirations. The paper highlights the role news media can have in understanding such energetic public controversies. • Care.data was an NHS England's programme for extracting and analysing primary care data. • Care.data was scrapped in 2016 after public outcries and more than 1.5 million opt-outs. • I analyse UK news media to examine discourses around care.data's discontinuities and shifts. • Ethical concerns and design flaws empowered multiple visions to develop and compete. • Care.data arrived at an inevitable antagonistic deadlock that was hard to resolve. [ABSTRACT FROM AUTHOR]

Stigma and discrimination are increasingly understood as shaping health, and in turn conceptualised as social processes shaped by power and structural inequities. A challenge to analysis and implementing interventions is developing theory that can integrate analysis of structure, agency and power. One theoretical framework already promoted by prominent scholars as supporting this need is Bourdieu's social practice theory. This paper explores the application to date of Bourdieu's theory on stigma, discrimination and health. The paper describes how existing health literature has used concepts of symbolic violence, fields, capitals and habitus to develop insight into stigma power. The discussion explores how this theoretical framework is though underutilised and there has been little consideration of new programmatic approaches based on this theory. Directions for future research include the need for integrated approaches to analysis, especially using habitus to explore stigma power, and addressing processes of change. Directions for conceptualising interventions address how a mismatch of field and habitus could foster change and then the role for prophets in fostering symbolic revolutions. All these potential directions must in turn be integrated within the vast scholarship on stigma. In conclusion, further application and development of Bourdieu's social practice theory could help address the theoretical challenges facing the field of stigma, discrimination and health research. • Bourdieu's theory has been widely promoted to support stigma, discrimination and health research. • Exploration of existing literature shows wide application and development. • Aspects of the theory, notably habitus, are little used. • The theory is little used in interventions; directions for future development are described. [ABSTRACT FROM AUTHOR]

Health inequalities are a perennial concern for policymakers and in service delivery to ensure fair and equitable access and outcomes. As health inequalities are socially influenced by employment, income, and education, this impacts healthcare services among socio-economically disadvantaged groups, making it a pertinent area for investigation in seeking to promote equitable access. Researchers widely acknowledge that health equity is a multi-faceted problem requiring approaches to understand the complexity and interconnections in hospital planning as a precursor to healthcare delivery. Operations research offers the potential to develop analytical models and frameworks to aid in complex decision-making that has both a strategic and operational function in problem-solving. This paper develops a simulation-based modelling framework (SimulEQUITY) to model the complexities in addressing health inequalities at a hospital level. The model encompasses an entire hospital operation (including inpatient, outpatient, and emergency department services) using the discrete-event simulation method to simulate the behaviour and performance of real-world systems, processes, or organisations. The paper makes a sustained contribution to knowledge by challenging the existing population-level planning approaches in healthcare that often overlook individual patient needs, especially within disadvantaged groups. By holistically modelling an entire hospital, socio-economic variations in patients' pathways are developed by incorporating individual patient attributes and variables. This innovative framework facilitates the exploration of diverse scenarios, from processes to resources and environmental factors, enabling key decision-makers to evaluate what intervention strategies to adopt as well as the likely scenarios for future patterns of healthcare inequality. The paper outlines the decision-support toolkit developed and the practical application of the SimulEQUITY model through to implementation within a hospital in the UK. This moves hospital management and strategic planning to a more dynamic position where a software-based approach, incorporating complexity, is implicit in the modelling rather than simplification and generalisation arising from the use of population-based models. [ABSTRACT FROM AUTHOR]

Medical travel and transnational healthcare involve various difficulties such as the distance and disconnect between patients and healthcare providers, language barriers or logistical challenges of moving ill bodies across space. Medical travel facilitation steps in with some sort of brokerage service that contributes to overcoming or managing these difficulties and, as this paper suggests, acts to create a quality of 'smoothness'. By unpacking three salient facilitation practices, namely connecting, communicating, and coordinating, this paper conceptualises the empirically derived category of 'smoothness'. This as a disposition, outcome, and spatio-temporal manoeuvre of medical travel facilitation. Based on the way in which such practices of mediation act to create smoothness, namely in an attentive, persistent, and collective tinkering manner, this paper suggests that some practices of medical travel facilitation are productively thought not just about setting up the possibility of care transnationally, but that they are key forms of care in itself. Based on these findings, smoothness is considered to be a central but also contested quality of medical travel facilitation and brokerage in a broader sense, but as proposed here, also for care. This conclusion potentially has implications not just for the study of transnational healthcare and mediation activities, but also that of care and transnational mobilities more generally. • Medical travel facilitation creates smoothness in mediating transnational healthcare. • Conceptualising smoothness as a disposition, outcome and spatio-temporal manoeuvre. • Brokerage and an STS-take on medical travel facilitation and care. • Smoothness as a quality of medical travel facilitation, brokerage and possibly care. • Medical travel facilitation between Oman and India. [ABSTRACT FROM AUTHOR]

Despite overwhelming evidence to the contrary, the concept of 'race' as a biological unit continues to persist in various scientific disciplines, notably in the field of medicine. This paper explores the persistence of 'race as biology' in medical research via examining select citational practices that have perpetuated this problematic concept. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. By analyzing citation threads and historical patterns, we aim to shed light on the creation and perpetuation of false scientific truths and their impact on medical research, training, and practice. We focus on two prominent examples, eGFR and Spirometry, and trace key articles' citational histories, highlighting the flawed evidence in support of racial corrections in medical assessments. The eGFR equation incorporates 'race' as a factor based on the erroneous belief that Black individuals have higher muscle mass than white individuals. Our analysis reveals that key cited sources for this belief lack robust and well-developed datasets. Similarly, Spirometry measurements incorporate racial correction factors, relying on questionable evidence dating back to the Civil War era. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. They play a crucial role in shaping theoretical positions and validating data and assumed knowledge. Evaluating citation threads and key articles consistently referenced over time can reveal how falsehoods and erroneous assertions are constructed and maintained in scientific fields. This study underscores the need for critical examination of citational practices in medical research and urges a shift toward a more cautious approach when citing sources that support 'race as biology.' The paper calls for a reevaluation of pedagogical approaches and assigned readings in medical education to prioritize an anti-racist perspective in future research endeavors. • Algorithms in contemporary medicine often involve "race" as a biological variable. • We offer a review of the citation threads in eGFR and Spirometry algorithms. • Support for race as variable relies on faulty, weak, and unsupportive citations. • Medical training must attend to and use caution around "truths" about racialized bodies. [ABSTRACT FROM AUTHOR]

Populism has emerged as a central explanation employed by both media outlets and scholars for the mishandling of the COVID-19 crisis. Nonetheless, the relationship between public health and populism extends before and beyond the pandemic. This paper offers a comprehensive overview of existing evidence and theoretical conceptualisations on the intersection of populism, health emergencies, and contrarian scientific positions, drawing from a diverse range of disciplines. I conducted a scoping review of 283 original studies, analysing their analytical framework, geographic focuses, and methodological approaches. Employing quantitative text analysis, I summarised the research field into 18 common topics, organised into five coherent categories: citizen's perspective, political elites, political communication, pandemic consequences, and non-COVID-related issues. While the scholarly interest in this area has surged since the onset of the pandemic, it has predominantly concentrated on specific cases, such as Brazil and the US, often conflating different policy types. The evidence summary elucidates that populism assumes varying roles within distinct contexts, and there is no linear relationship between political populism and specific approaches to health crises and science. I further compare definitions of populism within the context of health and scientific positions. I propose that future research should employ a policy typology for health emergency responses, assessing political positions based on policy arenas. This paper contributes to the understanding of the complex interplay between political populism, contrarian scientific perspectives, and public health. • Descriptive summary of multiple disciplines and theoretical frameworks. • Research interest in this theme surged after the COVID-19 pandemic. • Geographic focus and generalisation of specific cases such as Brazil and the US. • Lack of linear and universal association between populism and health emergencies. • Adoption of a common policy typology to guide future research. [ABSTRACT FROM AUTHOR]

In recent years, there has been renewed interest in diversifying the understanding and discussion about the causes of depression to move beyond biomedical determinism—a view that biomedical factors are the ultimate cause of an individual's depression. There is increasing emphasis on diversity in how people seek to articulate the causes of depression to incorporate non-biomedical dimensions. Furthermore, the biomedical understanding of depression has been increasingly questioned due especially to emerging limitations in pharmacotherapy. These shifts encourage social analyses that explore what narratives as to the causes of depression are constructed and presented with relative plausibility in different contexts and why and how. By analysing published memoirs of individuals diagnosed with depression in Japan, this study aims to provide fresh insights into narratives around the causes of depression. It illustrates how memoirs portray depression and its perceived causes in characteristic ways in a nation that adopts Western diagnostic systems, biomedical therapeutics and other relevant technologies. I will show that 'burnout' is the dominant theme in the Japanese data, diverging from the predominantly biomedical narrative in Western societies. This burnout narrative depicts depression as the somewhat unfortunate but unsurprising result of overwork arising from individual active adaptations to structural features of the Japanese work culture. I argue that reasons, rather than causes, articulate the making of the burnout narrative by revealing the interplay between the structural and individual and ultimately enrich the understanding of depression. The paper concludes with a call for exploring the shifting relationship between illness and normalcy that the burnout narrative implies. I suggest that further studies could explore how the boundaries between normalcy and illness are enacted and re-enacted and to what avail through public discourse and through shifting diagnostic schemata in the context of different national norms and practices. • There are international differences in how depression is experienced and represented. • Biomedical explanations of depression are frequently documented in the literature. • This paper shows ways in which depression is explained in the language of burnout. • Burnout emphasises the interaction between the individual and the structural. • Distinguishing reasons from causes helps better understand burnout and depression. [ABSTRACT FROM AUTHOR]

Since 2007, the number of HIV diagnoses in Turkey has increased more than 600% and the AIDS-related deaths have more than doubled. Despite trans community being severely impacted by the growing epidemic, there exists a conspicuous absence of epidemiological data regarding the HIV burden of trans people. This paper examines the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of health providers. The paper emphasizes the urgent need for comprehensive interventions to address the intersecting issues of HIV risk, structural violence, and discrimination faced by HIV-positive trans sex workers, one of the most marginalized communities worldwide. To interpret better how transphobia and HIVphobia become deeply entangled in Turkish medical settings, the paper draws from the concepts of iatrogenesis , necropolitics, and immunity. By bringing together these conceptual tools with long-term ethnographic data and in-depth interviews, this paper demonstrates that trans women are treated by healthcare providers as though they are always-already infectious. The paper contends that aggressive immunitarian boundaries, erected between healthcare personnel and individuals deemed "contagious others," are central to doctors' denial of medical care and reluctance to touch, examine, or even admit trans patients, particularly when they are HIV-positive. • Social immunization lies at the core of doctors' refusal of care for trans patients. • Social immunization is central to the operation of necropolitics and iatrogenesis. • Doctors establish violent boundaries in an attempt to "protect" themselves. • Trans women are assumed to be inherently contagious by healthcare providers. • Trans communities are slowly debilitated through denial of healthcare services. [ABSTRACT FROM AUTHOR]

In their 2010 book, Lorna Weir and Eric Mykhalovskiy conceptualised the role of vigilance in unknown and emerging infectious disease threats. Theirs is a macro-level account which draws on empirical data to describe vigilance as a set of technical and political arrangements that govern collection, analysis, interpretation and communication of data as it pertains to unknown threats. In this paper we expand their work to detail a conceptual analysis of the role of vigilance at the micro-level during periods of high infectious disease threat. Our data are daily press conferences and associated non-discursive tools in New South Wales (NSW), Australia during times of heightened COVID-19 risk. This paper is a conceptual analysis that draws on theories of vigilance and related concepts to show how a key aspect of vigilance is making previously unseen threats visible or present. Communications formulated and encouraged three types of vigilance as a set of governing relations: institutional or authority-based; individual outward-facing; and individual inward-facing. We also describe the relationship between vigilance and related concepts that are used in response to anticipated public threats. Authority based vigilance involved contact tracing and policing of movement and behaviours. In individual outward facing vigilance people were asked to be alert to, analyse, and react to risk in their immediate environment. Inward facing vigilance required people to gather and react to information about their own behaviours and within their own bodies. There was a relationship between different types of vigilance; as risk increased and authority-based vigilance was less successful in containing the spread of infection, individual vigilance had a stronger role to play. This extension of vigilance at the micro-level sees some of the same unintended consequences as Weir and Mykhalovskiy describe at the global level, particularly in how burdens are inequitably distributed and experienced. • Citizens became an arm of vigilance apparatus during COVID-19 pandemic in Australia. • Vigilance was authority-based; individual outward facing; individual inward facing. • Disadvantaged populations carried higher vigilance burden. • Earlier conceptions of vigilance in infectious disease emergencies are extended. [ABSTRACT FROM AUTHOR]

This paper begins with the common phrase 'good girl' as a lens through which to explore the insidious nature of patronising and paternalistic language on women's agency in obstetric care. Here we see how misogynistic language is both violence against women in its own right, and serves to create a context in which more extreme obstetric violence can be precipitated. Based on thematic analysis of discussion on Mumsnet, and on contributions to a research-focused Facebook group, this paper illustrates the complexity of recognising and refuting misogyny as a female patient as well as the damage that can occur from a cultural context in which this language is normalised. Here, words both boast a materiality through the environments they reify, and become transient and slippery, with semiotic uncertainty. • Use of misogynistic language in obstetric and fertility care is widespread. • This language may be difficult to identify and address. • Language that positions women as incompetent creates a context in which violence may occur during childbirth. • Experiences of obstetric violence are common even in the UK, amongst well-educated women. [ABSTRACT FROM AUTHOR]

Previous studies of service reconfiguration in healthcare have explored the influence of power on processes and outcomes. However, in these accounts the moral agency of managers is often underemphasised. This paper draws on the theoretical tools provided by the sociology of morality to help deepen understanding of the interaction between power and moral agency in service reconfiguration in healthcare. It presents results from a qualitative study of a pan-organisational service reconfiguration in the NHS in England, involving nineteen in-depth interviews with those leading the change and the analysis of twelve programme documents. We combine concepts of the moral background and epistemic governance to interpret participants' conviction that the service change was 'the right thing to do'. The paper shows how epistemic work carried out by service change regulations shaped the moral background within which participants worked. This, in turn, channelled their moral agency – specifically their commitment to patient care – in a way that also reflected central priorities. The paper adds to sociological understandings of service reconfiguration through considering the interaction of structure, agency and power, while also developing the concept of the moral background to show how power relations can influence moral beliefs. • Managers can show strong faith in uncertain evidence for healthcare service change. • The moral background explains this in a way which considers power and moral agency. • Confidence in evidence depends on background assumption of future as predictable. • Confidence also depends on premise that finances are not open to moral evaluation. • Service change regulations carry out epistemic work on background assumptions. [ABSTRACT FROM AUTHOR]

Virtual agents (VAs) and immersive virtual reality (VR) applications broaden the opportunities for accessing healthcare by transposing certain processes from the analogue world into a virtual realm. While these innovations offer a number of advantages including improved access for individuals in diverse geographic locations and novel therapeutic options, their implementation raises significant ethical, social, and legal implications. Key considerations pertain to the doctor-patient relationship, privacy and data protection, justice, fairness, and equal access as well as to issues of accountability, liability, and safety. This paper conducts a comprehensive review of the existing literature to analyse the ethical, social, and legal ramifications of employing VAs and VR applications in healthcare. It examines the recommended strategies to mitigate potential adverse effects and addresses current research gaps in this domain. • Virtual agents (VA) and immersive virtual reality (VR) are explored in the healthcare sector. • The paper investigates their ethical, legal, and social implications (ELSI) on basis of a literature review. • Key considerations pertain to the doctor-patient relationship, data protection, equal access, liability, and safety. • The paper gives an overview of the recommendations made to mitigate risks. [ABSTRACT FROM AUTHOR]

Child and maternal health, a key marker of overall health system performance, is a policy priority area by the World Health Organization and the United Nations, including the Sustainable Development Goals. Previous realist work has linked child and maternal health outcomes to globalization, political tradition, and the welfare state. It is important to explore the role of other key policy-related factors. This paper presents a realist synthesis, categorising policy instruments according to the established NATO model, to develop an explanatory model of how policy instruments impact child and maternal health outcomes. A systematic literature search was conducted to identify studies assessing the relationships between policy instruments and child and maternal health outcomes. Data were analysed using a realist framework. The first stage of the realist analysis process was to generate micro-theoretical initial programme theories for use in the theory adjudication process. Proposed theories were then adjudicated iteratively to produce a set of final programme theories. From a total of 43,415 unique records, 632 records proceeded to full-text screening and 138 papers were included in the review. Evidence from 132 studies was available to address this research question. Studies were published from 1995 to 2021; 76% assessed a single country, and 81% analysed data at the ecological level. Eighty-eight initial candidate programme theories were generated. Following theory adjudication, five final programme theories were supported. According to the NATO model, these were related to treasure, organisation, authority-treasure, and treasure-organisation instrument types. This paper presents a realist synthesis to develop an explanatory model of how policy instruments impact child and maternal health outcomes from a large, systematically identified international body of evidence. Five final programme theories were supported, showing how policy instruments play an important yet context-dependent role in influencing child and maternal health outcomes. • A realist synthesis was conducted. • Assessed relationship between policy instruments and child and maternal health. • Synthesis informed by 132 unique studies. • Five final programme theories were supported. • Impact of policy instruments was context-dependent. [ABSTRACT FROM AUTHOR]

Participation of citizens and service users is increasingly commonplace in research, policy and technology development. Alongside this development, social scientists have become increasingly incorporated into large-scale research and innovation projects to facilitate participatory spaces. This requires reflection on the mechanisms, outcomes and, ultimately, the accountabilities of participation. In this paper, we propose the lens of care framework for approaching such reflections. We illustrate its value by using it to account for our role in establishing participatory spaces as part of a European Horizon 2020-funded research and innovation project, entitled EmERGE. We describe the codesign processes we developed and implemented with the aim of enabling heterogeneous voices, distinct experiences and multiple ideas to be articulated to inform the development and implementation of a digital platform for HIV care. We show how the lens of care framework enables us to trouble participation along prior theoretical distinctions between patients/citizens roles, invited/uninvited spaces and inclusive/scientistic voices and provides novel lines of inquiry to capture the relational and emergent processes of participation in digital health innovation. In the EmERGE project, spaces of participation were co-created within and by the community, whose members skilfully arranged the material, social and temporal set-up. Within these spaces we were able to articulate voices, deliberate knowledge and study the potentialities of technology so that initial technological inscriptions of empowerment through information-push were challenged and were, eventually, replaced by more interactive forms of clinician-patient engagement in digital HIV care. Through the lens of care , this paper aims to provide a reflective tool for researchers and practitioners who are involved in the design, implementation, and evaluation of participatory projects. • Demonstrates how participation has been troubled along three key dimensions. • Develops the lens of care framework to reflect and evaluate participatory processes. • Elaborates the codesign process to develop a digital health platform for HIV care. • Analyses the selection of actors and knowledges within participatory spaces. • Guides researchers to take responsibility for the worlds they co-construct. [ABSTRACT FROM AUTHOR]

The first Transplant Games took place in 1978 in Portsmouth, England. Since then, numerous Olympic-style sporting 'Games' have been established, each aiming to increase public awareness of organ donation, demonstrate the benefits of transplantation, and encourage patient fitness. Despite this, there is limited research exploring the psycho-social and health impacts of the Games. Drawing on qualitative research conducted at the 2022 British Transplant Games and the 2022 European Transplant and Dialysis Games, this paper explores the Games through a therapeutic landscapes framework, a concept that examines the ways in which environments contribute to health and wellbeing. Building upon work that acknowledges the relational and contingent nature of health-in-place, I argue that the Games are a therapeutic landscape of social relations for transplant recipients in three ways: providing a landscape of belonging , a landscape of hope , and a landscape of motivation. Through this therapeutic landscapes perspective, the Transplant Games are presented as a peer-to-peer clinic – a care space where individuals are more actively involved in their health on a reciprocal level than in the traditional hospital clinic. In turn, this paper emphasises the crucial role of affective peer support in producing health-promoting environments. This research seeks to make a practical contribution to the wider transplant community by promoting the Games as an environment which may positively contribute to both physical and mental wellbeing. • The Transplant Games function as a therapeutic landscape for organ recipients. • They provide a peer-to-peer clinic where participants are active in their health. • The Games provide a landscape of belonging, acceptance, understanding and family. • In showing you can still lead a healthy life, the Games become a landscape of hope. • As a landscape of motivation, the Games improve both physical and mental health. [ABSTRACT FROM AUTHOR]

Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by ' hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context. • Understanding hesitant adoption provides insights into increasing vaccine acceptance • In remote Alaska, Elders may influence the decisions community members make • Images and conversations reinforced narratives of safety and efficacy • Agency in information-seeking increased vaccine confidence [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic provoked a large impact on tourism because of the enforcement of harsh travel restrictions and the increased global health risks caused by international mobility. This paper utilizes a longitudinal analysis to tests the impact of COVID-19 on tourists' health risk perceptions, and their relationships with destination image perception and visiting intentions. Tourists are surveyed at two different points of time, before and after the COVID-19 pandemic. Multi-group structural equation modeling is utilized for the comparison of the relationships at the two points of time. The results show that the negative influence of health risk perceptions on destination image perception and visiting intentions are significantly larger after the COVID-19 pandemic while there are no significant differences in the impact of destination image perception on visiting intentions. Thus, not only are tourists more sensitive to health risk perceptions after COVID-19, but this higher sensitivity has larger impacts both on their perceptions of destination image and on the behavioural implication. The results have useful implications in terms of the need to dedicate more efforts for the management of health conditions of destinations after COVID-19. • Presents a framework for conceptualizing and assessing health risk perceptions in tourism destinations in two scenarios, pre and post-pandemic. • Longitudinal appraisal of the impact of the pandemic on health risk perceptions. • Quantitatively testing the effects of the pandemic on health risk perception and health-related behavior. [ABSTRACT FROM AUTHOR]