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The article reveals the legal positions of the Constitutional Court of Ukraine regarding everyone’s right to information. Attention is focused on information that is collected by state authorities, local self-government bodies, institutions and organizations, and which is not a state or other secret protected by the Law of Ukraine «On Information» and which every person has the right to familiarize himself with. Separate attention is focused on confidential information (information with limited access). One of the types of confidential information is medical information, which, on the one hand, in special cases provided for by the Fundamentals of the Health Care Legislation of Ukraine, can be disclosed to family members or a legal representative of the patient, and on the other hand, in accordance with the decision of the European Court of Human Rights person in the case of «M.K. against Ukraine» confirmation by a doctor of a patient’s illness to a member of his family, even if he learned about it from the patient himself, is an interference by the state in a person’s right to private life, and in the case of infectious diseases, it is qualified as not carried out «in accordance with the law». Attention is focused on the fact that such situations arise more and more when military personnel undergo medical examinations and that there are prohibitive norms of a special law that forbid the disclosure of medical information regarding a certain list of diseases of a military personnel to his employer (military unit), commander, family members of the military personnel. Regarding the confidentiality of information and about a person who holds a position related to the performance of the functions of the state, local self-government bodies, and about members of his family, the legal positions of the Constitutional Court of Ukraine are established: absolutely in each specific case it is determined whether information about a person belongs to confidential; there are guarantees of protection of the rights of the above-mentioned persons, and additional legal burdens, and therefore the state is called upon to ensure a balance of public and private interest. The article also draws attention to the fact that even under martial law conditions, control (direct; indirect) by institutions of public power is prohibited both in terms of content and dissemination of information, even if the state pursues such a goal as protecting the information space from what is considered harmful by the state information that is not necessary for society. The practice of the Constitutional Court of Ukraine on this issue is established. Attention is focused on the fact that censorship cannot be used in Ukraine to protect the information field of the state even in war conditions - it is prohibited in part 3 of Art. 15 of the Constitution of Ukraine. [ABSTRACT FROM AUTHOR]

In China, HIV transmission increasingly affected men who have sex with men (MSM) and those in heterosexual marriages. This study addressed a critical gap in understanding HIV and sexual orientation disclosure within conventional heterosexual marriages, framed within a family-oriented cultural context. Heterosexually married MSM living with HIV (HIV+ MMSM) faced complex identity dynamics and interactions between "gay circles" and marital life. Such disclosure was fraught with potential repercussions, including accusations of "marriage fraud", HIV-related stigma, and divorce. This descriptive qualitative study, conducted in 2022, aimed to explore the common factors influencing HIV status disclosure to wives among Chinese HIV+ MMSM. Sixteen semi-structured interviews were conducted to analyze the factors related to the disclosure process model. Four key themes emerged: (a) concern for wives' well-being, (b) perceived marriage strength, (c) the degree of social support they had, and (d) a desire to maintain their status in a heterosexual society. The decision to (non)disclose was shaped by both approach-focused and avoidant-focused goals related to these four themes. The findings underscored the need for culturally sensitive strategies that balance family dynamics, stigma reduction, and HIV care management, emphasizing tailored approaches to effectively support this population. [ABSTRACT FROM AUTHOR]

Introduction The reality of pilot health care avoidance behavior is often common knowledge to both pilots and aeromedical physicians, but the underlying factors leading to this behavior are less understood. In the current study, we conducted a qualitative assessment of a sample of U.S. Air Force (USAF) pilots to gather firsthand perceptions of the factors that encourage and discourage disclosure during aeromedical screening and use of mental and physical health care services, as well as recommendations to improve the USAF aeromedical health care system. Materials and Methods We conducted interviews with 21 USAF pilots on their perceptions of seeking medical care to identify factors that uniquely discourage or encourage disclosure and health care utilization to understand factors that aid the aeromedical provider/aviator relationship and to elicit interventions that could be prospectively researched. This work was reviewed by the Air Force Research Laboratory Institutional Review Board at Wright-Patterson Air Force Base and designated as exempt research, FWR20220103E. Results The most reported factors that discourage military pilot health care disclosure and health care utilization overall were medical revocation, stigma, and lack of trust in providers. Unit-embedded services, ease of access, and severity of condition were the most reported factors encouraging disclosure and utilization. Factor descriptions and exemplary quotes from pilots and pilot recommendations to encourage health care utilization and disclosure are provided. Conclusions Results from firsthand interviews with pilots provide valuable information for flight surgeons to focus on building trust with their pilots to reduce health care avoidance. [ABSTRACT FROM AUTHOR]

Medical providers have an ethical duty to disclose clinically significant errors involving gametes and embryos. Although not mandatory, disclosure of errors causing no harm or near misses is recommended. In addition, clinics should have written policies in place for reducing and disclosing errors. [ABSTRACT FROM AUTHOR]

Although literature suggests that sexual assault narratives in media may encourage others to disclose their own sexual assault stories, research has yet to theorize the relationship between viewing mediated sexual assault narratives and disclosing sexual assaults. In response, I propose a theoretical model of the influence of mediated sexual assault narratives on sexual assault disclosure efficacy for adolescent girls and women. I also identify three mechanisms—survivor identity appeals, identification with the vlogger, and self-efficacy appeals—that may enhance the persuasiveness of mediated sexual assault narratives and work within the proposed model. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Truth-telling in health care is about providing patients with accurate information about their diagnoses and prognoses to enable them to make decisions that can benefit their overall health. Physicians worldwide, especially in the United Kingdom (U.K.) and the United States (U.S.), openly share such medical information. Bangladesh, however, is a Muslim-majority society with different social norms than Western societies. Therefore, we examined whether Muslim culture supports truth disclosure for patients, particularly how and to what extent medical information about life-threatening diseases is provided to patients in Bangladesh. Methods: This was a phenomenological qualitative study. We conducted thirty in-depth interviews with clinicians, nurses, patients and their relatives at Shaheed Suhrawardy Medical College Hospital in Dhaka, Bangladesh. We also used observations to explore interactions between patients, families and healthcare professionals regarding their involvement in medical decisions and truth disclosure issues. NVivo software was used to identify common themes, and a thematic analysis method was utilised to analyse the datasets. Results: This study identified three recurring themes relevant to the ethics and practice of truth disclosure: best interest rather than autonomy, the ambivalent value of deception and who understands what. The participants revealed that physicians often withhold fatal medical prognoses from terminally ill patients to ensure the best healthcare outcomes. The results indicate that deception towards patients is commonly accepted as a means of reducing burden and providing comfort. The participants opined that true medical information should be withheld from some patients, assuming that such disclosures may create a severe burden on them. Whether or to what extent medical information is disclosed primarily depends on a family's wishes and preferences. Conclusions: While truth disclosure to patients is considered an ethical norm in many cultures, such as in the U.K. and the U.S., the practice of concealing or partially revealing severe medical prognoses to patients is an actual medical practice in Bangladeshi society. This study emphasises the importance of recognising a patient's active involvement and respecting the cultural values that shape family involvement in medical decision-making. These findings may have significant policy and practical implications for promoting patient autonomy within Bangladeshi family dynamics and religious-based cultural values. [ABSTRACT FROM AUTHOR]

Diagnostic errors in emergency departments (ED) are a significant concern and exacerbated by cognitive biases during patient handoffs. The timing and accuracy of disclosing working diagnoses during these handoffs potentially influence diagnostic decisions, yet empirical evidence remains limited.This parallel, quasi-experimental study involved 40 interns from Japanese teaching hospitals, randomly assigned to control or intervention groups. Each group reviewed eight audio-recorded patient handoff scenarios where working diagnoses were disclosed at the start (control) or end (intervention). Four cases presented correct diagnoses, while four featured incorrect ones. The main measure was diagnostic error rate, calculated as the proportion of incorrect post-handoff responses to total questions asked.No significant difference in diagnostic error rates emerged between the control (39.4 %, 63/160) and intervention (38.8 %, 62/160) groups (point estimate −0.6 %; 95 % CI: −11.3–10.1 %, p=0.91). However, a substantial difference was evident between diagnostic errors after correct (20.6 %, 33/160) and incorrect (57.5 %, 92/160) working diagnoses presented (point estimate: 36.9 %; 95 % CI: 27.0–46.8 %, p<0.001). Diagnostic momentum accounted for 52 % (48/92) of errors under incorrect diagnoses.While the timing of working diagnosis disclosure did not significantly alter diagnostic accuracy during ED handoffs, exposure to incorrect diagnoses markedly increased error rates. These findings underscore the imperative to refine diagnostic skills and reconsider ED handoff protocols to mitigate cognitive biases and optimize patient care outcomes. [ABSTRACT FROM AUTHOR]

Background: Opportunistic infections (OIs) pose a significant threat to children infected with HIV. Despite advancements in antiretroviral therapy (ART), these infections continue to be a public health concern. However, there is limited evidence regarding the incidence and predictors of OIs among HIV-infected children in Ethiopia, particularly in the study area. Therefore, the objective of this study was to assess the incidence and predictors of OIs among HIV-infected children on ART at public health facilities of Southwest Ethiopia People Regional State. Methods: The study employed an institution-based retrospective cohort design, conducted from July 1, 2018 to July 31, 2023, among HIV-infected children aged less than 15 years. Data were extracted using the national ART intake and follow-up forms. KoboCollect version 2023.2.4 and STATA version 14.0 were used for data collection and analysis, respectively. The Kaplan-Meier survival curve was used to estimate the probability of OI-free survival time. Variables with P-value < 0.25 in the bivariable Cox proportional hazard model were selected as candidates. In multivariable analysis, P-value < 0.05 and adjusted hazard ratio (AHR) with 95% confidence interval (CI) were used to declare statistically significant predictors. Results: Of the total 409 HIV infected children, 122(29.8%) developed at least one OI, contributing to 954.95 person-years of risk. The overall incidence rate was 12.8 (95% CI: 10.7, 15.2) per 100 person-years. The OI-free survival probability at the end of the follow-up period was 0.277(95% CI: 0.139, 0.434). The commonest OI was pulmonary tuberculosis, 30.33% (95% CI: 22.7, 39.2). Non-disclosing HIV status (AHR: 2.56, 95% CI: 1.42, 4.63), children aged 10–14 years (AHR: 2.34, 95% CI: 1.10, 4.95), no history of prevention of mother-to-child transmission of HIV (AHR: 2.33, 95% CI: 1.48, 3.66), hemoglobin level < 10 mg/dL (AHR: 2.26, 95% CI: 1.37, 3.75), fair or poor adherence to ART (AHR: 1.74, 95% CI: 1.09, 2.79), and having past history of OIs (AHR: 1.61, 95% CI: 1.03, 2.55) were statistically significant predictors of OIs. Conclusion and recommendations: The incidence of OIs was high in the study area. Hence, health facilities need to regularly monitor hemoglobin, enhance ART adherence, provide OI prophylaxis for at-risk children, reinforce PMTCT programs for early OI detection and management, and encourage timely and age-appropriate HIV status disclosure. Caregivers of HIV-infected children are also required to oversee and assist their children in adhering to the ART. [ABSTRACT FROM AUTHOR]

Background Healthcare professionals (HCPs) are expected to identify and respond to domestic abuse (DA) among their patients. Although research suggests that a high proportion of HCPs are affected by DA, the impact of their experiences has been under-researched. Aims To assess UK HCPs' experiences of DA and develop a broad understanding of its impact on work and HCPs' support needs. Methods An online cross-sectional survey was promoted via multiple professional channels (October to December 2022). We adopted convenience sampling and analysed data descriptively. Results Among the 192 HCP survivors who responded, all abuse subtypes—psychological, sexual, economic and physical—were common. Ninety per cent of abusers were male (ex)partners. Eighty-five per cent reported abusers directly interfered with their work and 92% reported their work and career were affected. Almost all reported physical and mental health consequences. Eighty-nine per cent reported their own experiences shaped their responses to patient survivors. On average, per year, HCP survivors reported they had 13 sick days, 5 days' leave, 10 days' lateness and 6 days' early departure due to DA. Only 20% reported their workplace had a staff DA policy, and over 50% were unsure what workplace support mechanisms were available. Just over half disclosed at work; concerns that others would question their fitness to practice were common. Twenty-two per cent reported aspects of work, for example, long hours, stopped them from seeking support outside work. Conclusions HCPs face unique barriers to DA disclosure and support-seeking and may benefit from tailored support from specialists who understand both DA and the healthcare context. [ABSTRACT FROM AUTHOR]

This study explores the influence of risk disclosure levels and types on the readability of annual reports of non-financial firms in the UK during the COVID-19 outbreak. It further investigates how the disclosure of COVID-19-related information moderates the relationship between risk disclosure and readability. The study uses a content analysis approach and CFIE software to measure the level of risk disclosure and readability in the annual reports of non-financial firms listed on the FTSE all-share from 2019 to 2021. The results show a positive and significant effect of risk disclosure level on readability, which is stronger for firms that disclosed COVID-19 information. Different types of risk disclosure have varying effects on readability, with COVID-19 risk, credit risk, and strategic risk positively affecting readability, while operational risk negatively affects it. The study contributes to the literature on information asymmetry and institutional theory by demonstrating how risk disclosure and readability are influenced by external factors like the COVID-19 outbreak and internal factors such as firm characteristics and types of risks. It introduces a new risk definition and category specific to the COVID-19 pandemic and develops new measurements for risk disclosure, including credit, liquidity, market, operational, business, strategic, and COVID-19 risks. The study provides valuable insights for managers, investors, regulators, and standard setters on the relationship between risk disclosure and readability in annual reports. It highlights the importance of disclosing COVID-19-related information to enhance the readability and understandability of financial communication. The paper contributes to the literature and practice on risk disclosure, readability, and financial communication during crises. [ABSTRACT FROM AUTHOR]

On May 31, 2021, Naomi Osaka, one of the top-ranked female tennis players, and one of the highest-paid female athletes in the world, announced her withdrawal from the French Open on her social media (Twitter) account, citing mental health issues. There exists a stigma around mental health; and people suffering from mental health conditions often experience "discrimination and stigma" (World Health Organization, 2019). Such disclosures by a noted sportsperson provide an opportunity to help combat the stigma. The present study uses unsupervised machine learning and qualitative thematic analysis to analyze 11,800 English language responses to her tweet. Results indicate that Osaka's tweet mostly garnered a lot of support and encouragement. However, there also existed some negative comments. Additionally, 40% of the negative comments were disseminated by bot-like automated accounts. Practical implications for sports communication are also discussed. [ABSTRACT FROM AUTHOR]

Background: The principal route of HIV infection in children is vertical transmission. Thus, this study aimed to assess the incidence of mother-to-child transmission of HIV and predictors of positivity among HIV-exposed infants. Method: Institutions-based retrospective follow-up study was conducted in South Gondar Public hospitals, Northwest Ethiopia from December 2019 to November 2021. The data were taken from PMTCT logbooks and patient medical records, with death being the competing event. Data were entered in to Epi info version 7 and exported to STATA version 14 for final analysis. Both bivariable and multiple variable proportional subdistribution hazard analysis were conducted to identify predictors. P-value < 0.05 was level of significance. Result: A total of 469 exposed infant mother pairs records were included. The cumulative incidence rate at the end of the study period was 5.2 per 1000 person months (5.2; 95% CI: 3.4-8.0).Infants' absence of ARV prophylaxis at birth (aSHR = 3.7; 95% CI: 1.33–10.48), Mothers with no PMTCT intervention (aSHR = 5.1; 95% CI: 1.83–14.03), home delivery (aSHR = 4.1; 95%CI: 1.46–11.63) and maternal disclosure of HIV status to partner/families (aSHR = 2.9; 95% CI: 1.06–7.78) were predictors of HIV positivity. Conclusion: The study found that Infants' absence of ARV prophylaxis at birth, mothers without PMTCT intervention, home delivery and mothers who were not disclosing their HIV status to families were predictors of HIV positivity. [ABSTRACT FROM AUTHOR]

There is a legal duty of confidentiality on the part of nurses working in mental health care. Nonetheless, it may be necessary to release some information if a patient is assessed as posing a potential credible risk, to protect the patient or others from harm. However, contemporary research literature reveals gaps in nurses’ knowledge and practice, with respect to sharing patients’ confidential information. The aim of this study was to understand potential causal factors for these knowledge and practice gaps, so they can be addressed. A theoretical thematic analysis of focus-group data was undertaken. Findings indicated nurses had limited knowledge of confidentiality. Additionally, participants described a paucity of support networks nurses could approach for information. Participants also emphasised their perception that health services unrealistically expected them to always identify and manage patient risk. In summarising these findings, recommendations for interventions to address these knowledge and practice gaps are outlined. [ABSTRACT FROM AUTHOR]

Disclosures of lived experience with mental health conditions by faculty and students in social work education programs have the potential to increase knowledge about mental health conditions, dispel myths, and possibly improve future practice with individuals living with these conditions. There is minimal research about programs’ practices regarding student disclosure or about faculty disclosure decisions. Informed by an antioppression framework, this exploratory study used an online survey of deans and directors, Bachelor of Social Work and Master of Social Work coordinators, and field education coordinators of Counsel on Social Work Education–accredited programs (N = 320). We asked: (a) under what circumstances respondents recommend to students that they disclose and not disclose their conditions to class or field instructors, and (b) for those with mental health conditions, what factors influence their workplace disclosure decisions. Findings include that some respondents prioritize student preferences and recognize multiple benefits of disclosure, but many place constraints on student disclosure, consider disclosure unprofessional, or accept myths about people with mental health conditions. Faculty make personal workplace disclosure decisions based on trust and relevance. Implications for welcoming students and faculty with mental health conditions include recognizing potential benefits of disclosure and addressing mental illness discrimination in academia and field. [ABSTRACT FROM AUTHOR]

Background: Young people with depression are met with stigma related to their mental health, which exacerbates loneliness, social isolation, and depression symptoms. While disclosing depression could improve one's mental health, stigma can also make social interactions more challenging and reduce the likelihood of receiving treatment. This research explored young people's experiences with stigma and recommendations for addressing it. Methods: Semi‐structured interviews conducted with N = 35 young people aged 18–25 years (Mage = 20.09) were analyzed with thematic analysis. Participants met the criteria for clinical depression using the Mood and Feelings Questionnaire (score >27) or had recently obtained a medical diagnosis (N = 18) of depression by a medical professional. Results: Participants faced stigma when deciding to disclose their depression, which fed into a vicious cycle influencing feelings of loneliness, social isolation, and withdrawal. Their recommendations for others to avoid this cycle can be summarized under three main themes: (1) Social affirmation: identify allies and build meaningful connections; (2) Self‐affirmation: build a constructive relationship with the self; and (3) Societal affirmation: structural changes are needed. Conclusions: The current research indicates that social, self‐, and societal affirmation are considered important for reducing the detrimental impacts of stigma. Policies and programs are needed that provide mental health support to young people, and public awareness campaigns that guide young people to appropriate resources (i.e., support and intervention) via governmental public health bodies. [ABSTRACT FROM AUTHOR]

Utilizing communication privacy management (CPM) theory as a framework, we explored the privacy boundaries that individuals with bipolar disorder have around their diagnosis information in romantic relationships. Participants' (n = 92) responses to an online survey were coded and analyzed, resulting in themes that evidenced consideration of possible individual and relational outcomes when contemplating renegotiating or fortifying boundaries around diagnosis, and the use of both core and catalyst criteria in deciding when to make romantic partners co-owners of diagnosis information. Results of this study provide empirical support for CPM theory and implications for privacy boundary management decisions for individuals diagnosed with bipolar disorder. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the effectiveness and responsiveness of differentiated Human Immunodeficiency Virus (HIV)/Acquired Immuno-Deficiency Syndrome (AIDS) service delivery models (DSDMs) implemented to enhance antiretroviral therapy (ART) access and outcomes for patients while addressing Tuberculosis (TB)-HIV integration, focusing on four of the five DSDMs currently implemented in Uganda. Methodology: A descriptive cross-sectional survey was conducted in eight districts of central Uganda using Lot Quality Assurance Sampling approach from 7th to 23rd March 2023. We randomly sampled 2668 patients who have been on ART for at least 1 year in a Facility-Based Individual Management (FBIM) model or in a non-FBIM DSDM for at least one year. Data were collected through patient interviews and review of records in ART and DSDM registers as well as ART cards. We analyzed the data in proportions, comparing the selected ART outcome and responsiveness indicators between Community Client Led ART Distribution (CCLAD), Community Drugs Distribution Point (CDDP) and Fast-Track Drug Refill (FTDR) DSDMs with the standard care (FBIM) model. The ART outcome variables include patients retained in the 1st line of the ART regimen, patients in World Health Organization clinical stage 1 during the last facility visit, patients who had no CD4 request during the past 12 months, viral load suppression, ART adherence, and patients who reported that they did not experience HIV/AIDS-related symptoms in the past 6 months. The variables on TB care include screening for TB using the intensified case finding form and patients tested positive for TB. Responsiveness variables include the perceived; travel time for ART refill, travel distance for ART refill, convenience and flexibility during ART refill, cost of travel for ART refill, fear of being seen at ART refill point, waiting time before service, adequacy of service time, crowding and risk of infections, social support, ability to address ART treatment challenges, HIV status disclosure and barriers to access. Non-overlap in 95% confidence interval in indicator proportion between non-FBIM DSDM and FBIM means a statistically significant difference in proportion, or otherwise non-significant. Results: Higher proportions of ART patients in the CCLAD and CDDP DSDMs adhered to ART, had suppressed viral load, and a lower TB prevalence than those in FBIM model. Additionally, more CCLAD and CDDP clients reported shorter travel time and distance to access ART than their counterparts in the FBIM model. Compared to FBIM model, higher proportions of those in CCLAD and CDDP also reported flexibility in ART refill scheduling, reduced transport costs, fewer privacy concerns, less HIV/AIDS-related stigma, shorter waiting times, more efficient services, decreased congestion at ART pickup sites, enhanced peer support, improved problem-solving assistance, and increased HIV status disclosure. The FTDR model outperformed FBIM in proportions with fewer requests for CD4 testing, viral load suppression, as well as proportions of clients who reported; shorter travel time, lower transportation cost, decreased privacy concerns, shorter waiting time, and efficient service provision. Compared to both CDDP and FTDR, the FBIM had a higher proportion of clients remain on the first-line ART regimen. Conclusion: Community-based DSDMs show responsiveness to clients' needs without compromising the effectiveness of ART care for patients. Although FTDR also demonstrates high effectiveness and responsiveness for clients on ART, there is potential for further improvement. Planners and implementers of ART programs should consider both demand- and supply-side innovations to sustain the continuation of DSDMs. [ABSTRACT FROM AUTHOR]

As increasing numbers of autistic students pursue postsecondary education, it is important to understand the supports and barriers inherent in various institution types. Liberal arts colleges, with small class sizes and personalized learning environments, might be appealing to autistic students and their families. This study aims to explore the potential benefits and challenges that the liberal arts context presents for neurodiverse students. Using a multiple case study approach, we conducted interviews with 13 key stakeholders (including students, faculty, & staff) across five liberal arts institutions. Our findings are organized around these five themes: the unique liberal arts context, the implications of disclosure and diagnosis, academic experiences, social supports, and dynamics of romantic relationships for autistic students. [ABSTRACT FROM AUTHOR]

Background: World Health Organization recommended community-based ART (CBART) approaches to improve access to antiretroviral treatment (ART) and treatment outcomes among key populations living with (KPLHIV). Key populations (KP) are female sex workers, men who have sex with men, persons who inject drugs, and transgender people. How CBART for KP (KP-CBART) worked and why, for whom and in what circumstances it worked within KP communities or at community sites, are yet to be described. The aim of this study is to describe the different KP-CBART approaches or models in Nigeria, identifying the context conditions and mechanisms that are likely to produce the desired outcomes. Method: Building on our previous study eliciting an initial programme theory for KP-CBART, we used a multiple case design and cross-case analysis to evaluate 3 KP-CBART approaches, namely: One Stop Shop clinic; community drop-in centre; and outreach venue. Between 2021 and 2023, we conducted a retrospective cohort study, 99 indepth interviews and 5 focused group discussions with various actors. Using realist evaluation, we synthesised context-mechanism-outcome configurations (CMOCs) and developed programme theory for each of the cases and an overall theory. Result: The analysis showed the central importance of decentralizing ART service delivery to a safe place within the community for KPLHIV. The provision of ART in a KP friendly environment triggered a feeling of safety and trust in the healthcare workers among KPLHIV, resulting in KP-CBART acceptance and improved ART uptake, medication adherence and retention on ART. KP community engagement in ART delivery, peer support through support group meetings, and linkages with KP-led organizations improved self-efficacy, fostered solidarity and a sense of belonging among KP. These resources encouraged and motivated clients to engage with the KP-CBART model. However, fear of disclosure of HIV and KP status, and lack of trust between KP groups, demotivated and discouraged KPLHIV from initiating ART and continuing their treatment in KP-CBART. Conclusion: To optimise access to ART and treatment outcomes for KPLHIV, policy makers and health practitioners should ensure the provision of a safe place for ART service delivery that can be trusted by the clients and the KP communities. [ABSTRACT FROM AUTHOR]

Receiving a diagnosis of schizophrenia can be a life-changing experience with both negative and positive consequences. Previous research has identified important aspects of diagnosis, such as disagreement with the label, diagnostic shifts, stigma, and communication of the diagnosis. There is, however, relatively little research from the lived experience perspective. In this study, we investigated the lived experiences of receiving a schizophrenia diagnosis utilising a popular Reddit discussion forum. We used inductive thematic analysis to consider posts from 105 unique usernames and identified five themes. These were (i) Denial and acceptance; (ii) Stigma of diagnosis and selective disclosure; (iii) The complicated process of diagnosis; (iv) Losing, maintaining, and finding a sense of self; and (v) Receiving, finding, and providing support. Diagnosis is a complex personal experience where the same person can simultaneously accept and reject the diagnostic label. Greater attention is required to the lived experience of this diagnostic journey. [ABSTRACT FROM AUTHOR]

Introduction: The presence of hypertension could reduce the health-related quality of life (HRQoL) of people with HIV (PWH). Yet, literature describing the HRQoL of PWH who have hypertension in Uganda is scarce making the design of locally adapted interventions cumbersome. In our study, we compared HRQoL scores of people with HIV with and without hypertension on long term antiretroviral therapy (ART) in Uganda. Methods: We recruited 149 PWH with hypertension and 159 PWH without hypertension in the long-term ART cohort at an urban clinic in Kampala, Uganda. Data on socio-demographics were collected using an interviewer designed questionnaire while data on the World Health Organisation clinical stage viral load and CD4 count as well as ART duration were extracted from clinic electronic database and a generic EuroQol -5D- 5L (EQ-5D- 5L) and Medical Outcome Study (MOS-HIV) questionnaire used to collect HRQoL data. Data were summarized using descriptive statistics while inferential statistics were used to determine associations between key variables and HRQoL. Mann-Whitney U tests were used to compare HRQoL between groups of interest. Results: One hundred ninety (61.7%) participants were female. PWH who had hypertension were older (Mean ± SD: 53.7 ± 8.3 vs 49.9 ± 8.6, p value <0.001) than those without hypertension. Participants with hypertension had lower overall median health utility scores (0.71 (0.33–0.80) vs 0.80 (0.44–0.80), p value = 0.029) and mean physical health score (48.44 ± 10.17 vs 51.44 ± 9.65, p value < 0.001) as opposed to those without hypertension. Hypertension (p value = 0.023), high income status, >70,000 UGX, (p value = 0.044), disclosure of the HIV status of the participants to their partner (p value = 0.026), and current history of smoking (p value = 0.029) were associated with low HRQoL scores. Conclusion: Among people with HIV, those with hypertension had lower HRQoL compared to those without. This calls for inclusion of quality-of-life assessment in the management of PWH who have been diagnosed with hypertension to identify those at risk and plan early interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary What Is Known on the Subject What the Paper Adds to Existing Knowledge Implications for Practice Introduction Aim Methods Results Discussion Limitations Implications Recommendations Pre‐registration nursing students report high rates of stigma, leading to low help‐seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre‐registration nursing students. There are nil recorded clinical placement interventions that have decreased self‐stigma for pre‐registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self‐stigma. The knowledge around the mental health struggles experienced by pre‐registration nursing students, and the effect of a non‐traditional mental health placement in decreasing self‐stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help‐seeking behaviours. Traditional mental health clinical placements can improve pre‐registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self‐stigma, which affects mental health disclosure and help‐seeking behaviour.The present study investigates nursing students' stigma following a non‐traditional mental health placement immersed alongside people living with mental illness.Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help‐seeking.Pre‐registration nurses (N = 848) completed the instrument pre‐ and post‐placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001, ηp2$$ {\eta}_p^2 $$= .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non‐traditional placement (Attitudes: p < .001, ηp2$$ {\eta}_p^2 $$= 0.09, Social Distance: p < .001, ηp2$$ {\eta}_p^2 $$= 0.07, Disclosure/Help‐seeking: p < .001, ηp2$$ {\eta}_p^2 $$= 0.04).These findings emphasize that attending a non‐traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma.Further research in this area could focus on which attributes of the clinical placement setting foster positive help‐seeking.These results are noteworthy for stigma surrounding disclosure/help‐seeking, as traditional (i.e. hospital‐based) mental‐health clinical placements have been found ineffective in reducing nursing student stigma in this domain.Further research into the effectiveness of non‐traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help‐seeking, is required. [ABSTRACT FROM AUTHOR]

This study analyzes the life stories of eight young people living with vertically transmitted HIV in order to understand their perceptions marked by secrecy and silence regarding their experiences with the virus. Conducted at a specialized outpatient clinic in Rio de Janeiro, the study adopted circle dance, a Complementary and Integrative Health Practice, as a care tool. Using a qualitative approach and Life History as a data collection method, the focus was to understand the youth’s experiences related to the disease and the crucial aspects of their lives. Three girls and five boys participated in the study, all aware of their diagnosis. The principal emerging themes included family dynamics, school environment connection, challenges in treatment adherence, age at the time of diagnosis disclosure, and time elapsed since then. Analyzing these young people’s narratives allowed us to explore individual and social aspects of their experiences, revealing their similarities and differences. The circle dance workshops provided a playful space for expressing emotions and feelings through body movements, expanding young people’s perspectives on the future. [ABSTRACT FROM AUTHOR]

Workplace mental health challenges have emerged as a significant concern post-pandemic. Despite this, the pervasive stigma surrounding mental illness leads to the concealment of symptoms and reluctance to seek professional help among employees. This study aims to explore the perception of different stakeholders towards the 'Detection and disclosure' of workplace mental health challenges in the Indian context. Fifteen semi-structured interviews were conducted with human resource professionals, counselors, and employees who had previously experienced mental health challenge(s). Thematic analysis was done to identify recurring themes and sub-themes. Three critical pathways were identified: minimizing the inhibitory factors, including lack of awareness, denial, low self-efficacy, stigma, and underestimating organizational capability; maximizing the encouraging factors, including psychological safety, perceived social support, and communicating success stories; and implementing supportive organizational practices, including generating awareness and literacy, build the organizational capability, strengthen the role of managers, leadership advocacy, policies, and processes. By fostering a culture of support and prioritizing employee well-being, organizations in India can create healthier and more resilient work environments, benefiting both individuals and the larger society. [ABSTRACT FROM AUTHOR]

Background: Second-line HIV treatment failure has become increasing worldwide, mainly in sub-Sahara Africa including Ethiopia. Even though the problem becomes increasing, inadequate information was available about its magnitude and associated factors in the current study area. Objective: To assess the factors of second-line Anti-Retroviral Treatment virological failure among second-line ART users. Method and materials: Institutional-based unmatched case-control study design was conducted from September to December 2021 at Felege Hiowt and University of Gondar Comprehensive Specialized Hospitals; Amhara region, Northwest Ethiopia. A total of 216 patients (60 cases and 156 controls) were recruited by a simple random sampling technique with a 1:3 cases-to-controls ratio. Patients who had two viral load results >1000 copies/ml within a 3-month interval after taking ART drugs for at least 6 months were cases and those who had ≤1,000 copies/ mL were controls. The sample size was calculated by using Epi-Info version 7.2.4. Structured questionnaires were used to gather the required information. SPSS version 26 was used to summarize the findings. In bivariate logistic regression model, Variables with two-tailed P-value ≤ 0.25 at 95% confidence interval were transferred into multivariate binary logistic regression model and P value at ≤ 0.05 was set as statistically significant. Results: Out of 216 patients recruited, 212 have participated with a response rate of 98.2%. From these participants, 117(55.2%) were males and 187(88.2%) were urban dwellers. Among the total respondents, 208(98.1%) had age > 24 years, 200(94.3) were at HIV clinical stage I, 72(34%) had poor ART adherence and 112(52.8) did not disclose their HIV status. Likewise, most of the patients 147(69.37) didn't use condoms. The associated factors were not disclosing HIV status (AOR = 3.4, 95% CI: 1.52–7.79), medium adherence (AOR = 3.7, 95% CI = 1.3–10.7), poor adherence level (AOR = 5.27, 95% CI: 2.2–12.5), not using condoms (AOR = 4.47, 95% CI: 1.63–12.2) and Viral load (>150 copies/ml) when switched to second-line ART (AOR = 3.56, 95% CI: 1.5–8). Conclusion and recommendations: Non-disclosure, poor or medium adherence, not using condoms and high Viral load (>150 copes/ml) when switched to second-line ART were the main factors for second-line Anti-Retroviral Treatment virological failure. Disclosure about HIV status, using condoms and improving treatment adherence level are crucial to reduce second-line virological failure. [ABSTRACT FROM AUTHOR]

Objectives: While numerous studies have explored the impact of gender on Health-Related Quality of Life (HRQOL), there is a lack of evidence specifically among reproductive-age women undergoing Antiretroviral Therapy (ART). Therefore, this study aims to investigate HRQOL and its associated factors among reproductive-age women receiving ART at Hiwot Fana Comprehensive Specialized Hospital in Eastern Ethiopia. Methods: A cross-sectional study included 418 women of ART. The World Health Organization quality of Life Questionnaire (WHOQOL-HIV BREF) was used to assess HRQOL. Binary logistic regression was used to determine the factors that could predict HRQOL. Results: The study found that the median age of the participants was 37 years, and the overall percentage of women with good HRQOL was 40.7%. Women who stayed on ART for more than 6 years had higher odds of overall good HRQOL (AOR 6.73, 95% CI 3.31–13.71) compared to those with a duration of 6 years or less. Besides, women having no child (AOR 25.03, 95% CI 4.93–127.06), one child (AOR 18.60, 95% CI 3.95–87.65), two children (AOR 12.89, 95% CI 3.66–45.37) and three children (AOR 3.77, 95% CI 1.06–13.34) had higher odds of overall good HRQOL compared to those with four/more children. Conclusions: The study found that the majority of women on ART had poor HRQOL. Factors such as longer duration of taking ART, higher CD4+ cell count, disclosure of HIV status, and receiving care from adherence support teams were associated with better quality of life. Thus, strengthening adherence support teams, promoting safe disclosure of HIV status, and providing comprehensive support for HIV-positive women are required to improve their overall HRQOL. [ABSTRACT FROM AUTHOR]

First responders, especially those without adequate support, are at heightened risk for experiencing adverse mental health outcomes. Workplace mental health interventions for first responders are becoming more common. However, systematic research within the field of communication has not typically informed the development of these workplace interventions. The current study conducted interviews with 26 first responders to examine the messages they receive about mental health from their organizations and how those messages affect their support-seeking decisions. Analysis of the interviews revealed that first responders receive inconsistent messages from their departments about whether to seek support for mental health-related problems, creating confusion and distrust. [ABSTRACT FROM AUTHOR]

Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients' outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey. [ABSTRACT FROM AUTHOR]

With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS' 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p < 0.001). Our results highlight the importance of multi-month ART dispensing, enhanced communication, and voluntary disclosure of one's HIV status in preventing ART interruption in times of crises in Burundi. [ABSTRACT FROM AUTHOR]

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The construction industry has been identified as a major contributor to occupational accidents that can lead to fatalities. As a result, this study aims to evaluate the effectiveness of new safety and health regulations and revised guidelines in improving safety and health disclosures and performance within the construction industry. We retrieved safety and health disclosure reports from 25 Taiwanese construction companies between 2013 and 2020 using the Market Observation Post System website. We analyzed the data using the Kaplan–Meier method to assess the timing of disclosures and differences between larger (≥300 employees) and smaller (<300 employees) companies. We found that construction companies reported safety indicators more promptly than health indicators and that larger companies disclosed earlier compared to smaller ones. Only 45% of companies provide detailed reviews and preventative measures in their sustainability reports despite 64% disclosing occupational accidents. We found that from 2013 to 2020, more companies improved their occupational safety and health (OSH) reporting. This improvement coincided significantly with the adoption of international standards and Taiwan's government regulations. In summary, the study found that larger companies were more likely to disclose OSH data compared to smaller ones. This suggests that company size and available resources could have an impact on reporting practices. While some progress was made, companies still struggle to provide detailed reports on major accidents, balancing transparency with competitiveness. [ABSTRACT FROM AUTHOR]

Disclosure of near-miss medical error (ME) and how to disclose ME to patients remain controversial. Furthermore, available guidelines on the disclosure of ME have primarily emerged in developing countries; however, their suitability for Central Asian states is unknown. The objective of this study was to determine the proportion of healthcare professionals (HCPs) intending to disclose MEs and their perceptions pertaining to MEs. We conducted a cross-sectional survey in Kazakhstan using a structured questionnaire to collect data from 109 HCPs about the causes of disclosure MEs and the consequences in their practice. The majority of participants believed that they would be sued if they disclosed errors and near misses. There was a positive relationship between the threat of censure (p = 0.03) and the threat of dismissal (p = 0.01) in HCPs. There was also a significant difference between the distributions of liable for malpractice after disclosing an error to a patient or family member and experience of reporting a ME to administration. In this study, most HCPs reported MEs to a hospital administration, although about half perceived that disclosing MEs to a patient is ethically unnecessary. Poor disclosure could be due to the fear of litigation and dismissal. [ABSTRACT FROM AUTHOR]

This article discusses the topic of clinical trial transparency and disclosure from the perspective of medical writing. It highlights the changes and developments in regulations and policies governing the public disclosure of clinical trial data and documents, including the implementation of the EU Clinical Trials Regulation and the impact of the COVID-19 pandemic. The article emphasizes the importance of staying up to date with these changes and provides resources for updates and insights. It also covers various aspects of clinical trial transparency and disclosure, such as the protection of personal data, transitioning trials to new regulations, plain language summaries of trial results, and the challenges of regional differences in transparency requirements. The article concludes by mentioning upcoming articles that will further explore different aspects of clinical trial transparency and disclosure. [Extracted from the article]

Background: Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure. Purpose: This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong. Methodology: A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention. Results: Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables. Conclusion: Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context. [ABSTRACT FROM AUTHOR]

This article explores the experiences of two neurodivergent researchers who have established peer support networks at their universities. Christina Elliott, a lecturer at Newcastle University, shares her personal journey of self-disclosure and the positive impact it had on her work and the support she received. Patrick Brundell, a research fellow at the University of Nottingham, discusses the creation of a neurodiversity staff network and the importance of providing a safe space for neurodivergent individuals to share their experiences. The article offers guidance on supporting neurodivergent students and emphasizes the need for understanding and inclusivity in academia. The authors, Christina Elliott and Patrick Brundell, have provided their contact information and affiliations, and they have no competing interests. The article was published in the journal eLife. [Extracted from the article]

Background: Despite policy initiatives and strategic measures highly focused on preventing mother-to-child transmission through the implementation of the Option B+ program, adherence to the treatment is still challenging. The level of adherence and determinants of Option B+ program utilization reported by different studies were highly inconsistent in Ethiopia. Hence, this systematic review and meta-analysis aimed to estimate the pooled prevalence of adherence to the Option B+ program and its predictors among HIV-positive women in Ethiopia. Methods: PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were searched for published articles from March 2010 to March 2022. The pooled prevalence of adherence was estimated using a weighted DerSimonian-Laird random effect model. The I2 statistics was used to identify the degree of heterogeneity. Publication bias was also assessed using the funnel plot and Egger's regression test. Results: A total of 15 studies were included. The pooled estimate of the option B+ program among HIV-positive women in Ethiopia was 81.58% (95% CI: 77.33–85.84). Getting social and financial support (AOR = 3.73, 95% CI: 2.12, 6.58), disclosure of HIV status to partners (AOR = 2.05, 95% CI: 1.75, 2.41), time to reach a health facility (AOR = 0.33, 95% CI: 0.16, 0.67), receiving counseling on drug side effects (AOR = 4.09, 95% CI: 2.74, 6.11), experience of drug side effects (AOR = 0.17, 95% CI: 0.08, 0.36), and knowledge (AOR = 4.73, 95% CI: 2.62, 8.51) were significantly associated with adherence to the Option B+ program. Conclusion: This meta-analysis showed that the level of adherence to the Option B+ program in Ethiopia is lower than the 95% level of adherence planned to be achieved in 2020. Social and financial support, disclosure of HIV status, time to reach the health facility, counseling, drug side effects, and knowledge of PMTCT were significantly associated with option B+ adherence. The findings of this meta-analysis highlight that governmental, non-governmental, and other stakeholders need to design an effective strategy to scale up the level of disclosing one's own HIV status, access health facilities, improve knowledge of PMTCT, and counsel the potential side effects of Option B+ drugs, and advocate the program to reduce the multidimensional burden of HIV/AIDS. Trial registration: Prospero registration:CRD42022320947. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320947. [ABSTRACT FROM AUTHOR]

Background Information: Over 1.6 million Nigerians have succumbed to the ravaging scourge of the acquired immunodeficiency syndrome (AIDS) epidemic since its discovery. Viral suppression (VS) then becomes a critical cost-effective human immunodeficiency virus (HIV) prevention strategy. We assessed the prevalence and predictors of VS. Materials and Methods: This retrospective case file review was conducted among adults (aged ≥18 years) living with HIV/AIDS who accessed care at a tertiary health facility in Northwestern Nigeria between January and December 2021. Results: One thousand one hundred and twenty HIV/AIDS-eligible patients accessed care during the study. Their age ranged between 20 and 70 years with a mean of 43.83 ± 10.83 (95% confidence interval [CI]: 43.19--44.46). The patients were mostly female (728; 65.0), residing in urban areas (680; 60.7%), self-employed (440; 39.3%), married (712; 63.6%), receiving antiretroviral therapy (ART) for at most 14 years (916; 81.8%), on first-line ART regimen (812; 72.5%), in HIV clinical stage 1 (964; 86.1%), and with a baseline CD4 count of 199 cells/⋅l (453; 40.4%). The prevalence of VS of 64.3% (720/1120) was recorded in the study. The predictors of VS were disclosure of HIV status (odds ratio [OR] =2.4; 95% CI = 1.503--3.832), absence of opportunistic infections (OR = 2.6; 95% CI = 1.242--5.406), receiving ART for 15-29 years (OR = 2.1; 95% CI = 1.398--3.292), first-line ART regimen (OR = 3.7; 95% CI = 2.618-5.115), and adequate adherence (OR = 4.7; 95% CI = 3.324-6.766). Conclusion: VS was suboptimal among the study cohort with adequate adherence being its strongest predictor. [ABSTRACT FROM AUTHOR]

Quality disclosures regarding medical outcomes such as patient mortality are common healthcare policy instruments. Mixed evidence exists on whether quality disclosures improve outcomes for disclosed ailments. Moreover, disclosure policies can generate spillovers and impact ailments not targeted by the policy. We examine the effects of quality disclosure regulation on mortality improvements in disclosed and nondisclosed ailments. We use patient records for California hospitals for 1995–2014 and construct three groups of ailments: those that were the target of disclosure regulation, complementary ailments that were not the target of disclosure regulation but are medically related to the disclosed ailments, and medically unrelated ailments. Using a difference-in-differences design, we find that quality disclosure regulation is associated with declines in mortality risk of disclosed ailments ranging from 11.5% to 23%. Quality disclosure regulation is also associated with improvements for complementary ailments that are not the target of the disclosure policy. Such positive spillover effects yield an estimated 15.2% decline in mortality risk. Consistent with demand-side pressures driving improvements, market shares become sensitive to disclosed quality measures after disclosure regulation. Our findings of direct and spillover effects have implications for disclosure regulation. This paper was accepted by David Simchi-Levi, accounting. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4817. [ABSTRACT FROM AUTHOR]

Background: The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic. Methods: This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects. Results: Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing. Conclusion: It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies. [ABSTRACT FROM AUTHOR]

Background: Despite the increase in disclosures of medical errors, transparency remains a challenge. Recognized barriers include shame, fear of litigation, disciplinary actions, and loss of patient trust. In 2018, the Israeli Ministry of Health initiated a series of workshops about disclosure of medical errors. The workshops involved medical center executives, healthcare providers, patients, and family members of patients who had previously been harmed by a medical error. This study presents the lessons learned about perceived challenges in disclosure of errors in 15 such workshops. Methods: Data collection included participant observations in 15 workshops, full audio recordings of all of the workshops, and documentation of detailed field notes. Analysis was performed under thematic analysis guidelines. Results: We identified four main themes: "Providers agree on the value of disclosure of a medical error to the patient"; "Emotional challenges of disclosure of medical error to patients"; "The medico-legal discourse challenges transparency"; and "Providers and patients call for a change in the culture regarding disclosure of medical errors". Participant observations indicated that the presence of a patient who had experienced a tragedy in another hospital, and who was willing to share it created an intimate atmosphere that enabled an open conversation between parties. Conclusion: The study shows the moral, human, and educational values of open discourse in a protective setting after the occurrence of a medical error. We believe that workshops like these may help foster a culture of institutional disclosure following medical errors. We recommend that the Ministry of Health extend such workshops to all healthcare facilities, establish guidelines and mandate training for skills in disclosure for all providers. [ABSTRACT FROM AUTHOR]

This monograph analyzes online coverage and social media posts from five professional athletes—Simone Biles, Serena Williama, Naomi Osaka, Chloe Kim, and Gracie Gold—to sheds light on the journalistic and individual narratives around athletes, performance, goals as these intersect with mental health. Online news and entertainment media's general representation of athletes frequently emphasizes victory with a focus on outcomes, often overshadowing the athletes' well-being. Using social identity and framing theories, the study identifies narratives in social and online media, emphasizing the storytelling components related to mental health, as well as what athletes express as potential causes of the mental health issues they are experiencing, especially intense competition, physical condition, media pressure, and a general lack of mental health awareness in sports. The study's examination of how athletes use their social media platforms to help journalists craft their stories offers a deeper understanding of their mental health stories beyond the basic win-or-lose narrative. We advocate for a paradigm shift, urging recognition of athletes as individuals with vulnerabilities who deserve supportive environments. [ABSTRACT FROM AUTHOR]

The article "DSB: Drum prüfe, wer sich gegen negative Bewertungen verteidigt" is about a fine of 10,000 euros imposed by the Data Protection Authority (DSB) on a doctor. The doctor had published the medical diagnosis of a patient in response to a negative online review. The DSB decided that the publication of the diagnosis constitutes a violation of data protection law. The authority emphasized that the disclosure of the diagnosis was not necessary to respond to the negative review. It is emphasized that online reviews are important but must remain within the framework of the law. [Extracted from the article]

This article discusses the concept of posttraumatic growth (PTG) and its potential for supporting residents in the aftermath of medical errors. It highlights the emotional distress experienced by resident physicians following an error, which can lead to burnout and negatively impact their training and patient care. The article suggests strategies for supporting residents after an error, including the formalization of a peer response network, restructuring morbidity and mortality conferences, developing medicolegal curricula, and teaching error disclosure. The goal is to create a growth culture that promotes learning and resilience among residents in emergency medicine. [Extracted from the article]

The recent social media–led and –centered movement encouraging mental health awareness, disclosure, and discussion, primarily among adolescents,1 can have significant benefits, including reducing mental health stigma, providing peer and social support, and disseminating information. Conversely, mental health disclosure online provides a catalyst for spreading misinformation and cyberbullying. It may also present opportunities for monetary and other forms of secondary gain; for example, some TikTok dissociative identity disorder (DID) influencers have vast numbers of followers and include donation links to their Venmo and PayPal accounts. At the time of this writing, TikTok hashtags "#did," "#didsystem," and "#dissociativeidentitydisorder" have amassed hundreds of thousands of views. [ABSTRACT FROM AUTHOR]

Introduction We examined the impact of financial disclosures and warning labels on pro-e-cigarette Instagram posts and their association with attitudes toward the ad and product among youth and young adults. Methods During March to May 2021, we conducted a factorial experiment using an online convenience sample of youth and young adults (N = 1687, M age = 21.54). Participants were randomized to one of four conditions: pro-e-cigarette Instagram posts with only a financial disclosure, only a warning label, both a financial disclosure + warning label, or no financial disclosure or warning label. After viewing the posts, participants answered questions regarding their attitude toward the ad and the product. We used one-way ANOVA to estimate the association of condition on outcomes controlling for demographics. Results Young adults who viewed Instagram posts with only a financial disclosure reported more positive attitudes toward the ad than those who viewed posts with both a financial disclosure + warning label (p <.05). Young adults who viewed posts with only a financial disclosure reported more positive attitudes toward the product than those who viewed posts with only a warning label, both a financial disclosure + warning label, and without either (p s <.05). Differences were not statistically significant for youth. E-cigarette use status was associated with increased positive attitudes toward the ad (p <.001) and product (p <.001) for all participants. Conclusions Our results can inform policy interventions to mitigate the effects of e-cigarette social media marketing among youth and young adults. Including financial disclosures may not decrease appeal of e-cigarettes compared to posts without either. Implications Findings from the study suggest that a warning label may be more effective in reducing the effects of pro-e-cigarette social media posts than a financial disclosure among young adults. Public health officials should examine additional strategies beyond financial disclosures and warning labels (eg, social media peer mentoring program) to offset the persuasive effects of pro-e-cigarette social media marketing posts on young people. Additional policy interventional efforts are needed to limit the impact of e-cigarette social media marketing. [ABSTRACT FROM AUTHOR]

This mixed-methods study investigated if individuals in high-resource, low-stigma environments experience any benefits from disclosing their mental illness. Participants were recruited from a small Midwestern liberal arts college. Survey data were collected on attitudes toward mental illness on campus (N = 384) that showed low levels of public stigma and moderate levels of self-stigma. Class year and mental health status were predictors of public stigma and campus-specific attitudes toward mental illness, but not self-stigma; race and gender were not significant predictors of either. Screening questions yielded 50 in-depth interviews about stigma on campus, mental illness disclosure, and students' social capital. Qualitative coding revealed four findings: 1) students reported low levels of public stigma associated with mental illness; 2) white students, but not students of color, reported an inverted status hierarchy that incentivized mental illness disclosure; 3) white students garnered social capital from disclosing their mental illness; 4) mental illness was used by white students as a social buffer against shame over unearned privileges. In high-resource, low-stigma environments, privileged individuals may experience social motivation to publicly disclose mental illness. This has implications for student help-seeking behaviors and poor mental health outcomes on college campuses. [ABSTRACT FROM AUTHOR]

Adolescents and youth living with HIV (AYLHIV) experience worse health outcomes compared to adults. We aimed to understand the experiences of AYLHIV in care in the youth-focused Red-Carpet program in Kenya to assess the quality of service provision and identify programmatic areas for optimization. We conducted focus group discussions among 39 AYLHIV (15–24 years) and structured analysis into four thematic areas. Within the HIV testing theme, participants cited fear of positive results, confidentiality and stigma concerns, and suggested engaging the community and youth in HIV testing opportunities. Within the HIV treatment adherence theme, participants cited forgetfulness, stigma, adverse side effects, lack of family support, and treatment illiteracy as barriers to adherence. Most participants reported positive experiences with healthcare providers and peer support. In terms of the HIV status disclosure theme, AYLHIV cited concerns about their future capacity to conceive children and start families and discussed challenges with understanding HIV health implications and sharing their status with friends and partners. Youth voices informing service implementation are essential in strengthening our capacity to optimize the support for AYLHIV within the community, at schools and healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: Clinical depression ranks as a leading cause of disease and disability in young people worldwide, but it is widely stigmatized. The aim of this qualitative research was to gather young people's experiences of depression stigma and its impact on loneliness, social isolation, and mental health disclosure and secrecy. This novel information can then be used to guide psychosocial interventions for young people with depression. Methods: This qualitative study included N = 28 young people aged 18–25 years (Mage = 21.30). Participants were recruited from the community who had high symptoms of depression (assessed through a pre-screen using the Mood and Feelings Questionnaire (MFQ) with a benchmark score > 27) or had been recently diagnosed with depression by a medical professional. Semi-structured interviews were based on conceptual model drawings created by participants and analyzed using thematic analysis. Results: Four main themes emerged: 1) Depression secrecy: positive and negative aspects; 2) Depression disclosure: positive and negative aspects; 3) The solution is selective disclosure; and 4) Participants' recommendations do not align with personal preferences. In particular, the young people described non-disclosure as a way to be in control, but that secrecy prevented authentic engagement with others. Young people also described disclosure as eliciting more stigma but as necessary to gain help. Finally, the young people described struggling with knowing how much to disclose in relation to their mental health and with whom they could disclose. Conclusions: This study provides new evidence of how young people with depression experience stigma and its effects on disclosure and mental health secrecy. Knowing how young people struggle with these issues can allow us to develop interventions to encourage them to come forward and discuss their mental health in order to receive appropriate support and treatment. We recommend young people be signposted and have access to mental health champions or nominated teachers in their schools or universities. [ABSTRACT FROM AUTHOR]