Globalization and Health最新文献

Background: Imported malaria cases from endemic regions pose significant challenges for malaria-free countries, leading to diagnostic delays, high treatment costs, and the potential for secondary local transmissions. There is a lack of understanding regarding the cognitive decision-making processes that influence travelers' intentions to engage in protective behaviors against malaria. This study aims to fill this gap by examining the factors that impact the willingness of travelers from China to adopt protective measures against malaria.

Methods: In a cross-sectional study conducted between March and October 2023, we utilized an online survey based on the malaria knowledge and Protection Motivation Theory (PMT) scales in Nanjing and Suzhou of Jiangsu Province, China. The survey was distributed by staff from the Centers for Disease Control and Prevention to Chinese international travelers after their returning from abroad. We analyzed the intentions to engage in malaria protective behaviors by multiple linear regression and structural equation modeling.

Results: In total, 252 international travelers from Jiangsu Province provided valid responses. Approximately 127 (50.4%) reported that their destination was a malaria-endemic area when they had traveled abroad. All seven PMT subconstructs were significantly affected by the malaria knowledge (all P < 0.05). Of all seven PMT subconstructs, two (severity and vulnerability) were strongly associated with intentions to engage in protective behavior. Notably, the level of malaria knowledge was insufficient for motivating protective behavior intention.

Conclusions: The intention to engage in antimalarial behaviors is closely linked to travelers' evaluation of malaria-related risks and their perceived ability to manage these threats. It is essential to enhance general knowledge on the risk of malaria and to provide robust pre- and post-travel healthcare for international travelers heading to malaria-endemic regions. This approach will empower travelers to adopt protective measures and reduce the incidence of imported malaria cases.

Background: Despite increased scholarly attention to sexual violence, victimization among migrant men and boys remains under researched. This study aims to explore 1) migrant men's views on and understandings of sexual victimization, 2) their own experiences with surviving and witnessing sexual violence during their past and ongoing migration journeys and 3) the consequences of such victimization and their coping behaviors.

Results: Participant observation in Brussels (Belgium) and Calais (France) preceded in-depth interviews with 39 migrant men between 16 and 47. Participants varied in age, nationality, educational level and aspired migration projects yet all of them were undocumented. They held varying, yet consistently gendered understandings of sexual violence, depicting women as victims and men as perpetrators. Although they did not explicitly label their own experiences as sexual violence, both direct and indirect forms of it were part of their past and ongoing migration trajectories. Sexual violence had a profound impact on men, inducing shame and challenging their masculine identity. Coping and prevention strategies ranged from normalizing or minimizing the violence and avoidantly forgetting, to protecting one another against future threats.

Conclusions: The results advocate for safe legal migration routes, increased awareness of migrant men's vulnerabilities to sexual violence, and enhanced training and screening of professionals and volunteers working in the field.

Background: Contemporary conditions require detailed study of internationalisation. This article offers a novel perspective on processes of internationalisation in healthcare, adapting an approach from higher education studies and enhancing it with insights from sociological scholarship on moral economies. The article asks how institutions and individuals respond to the globalising healthcare environment, and what this reveals about normative questions that govern healthcare provisioning in national contexts. This is pursued using qualitative data from a study on international commercial services in the English National Health Service (NHS).

Results: The findings of the research demonstrate how the UK government has sought to build political consensus around specific (commodified) forms of internationalisation in a context of fiscal austerity and xenophobia surrounding the provision of public services. The English NHS has been politically re-imagined as world-leading and of interest as an export industry. Study findings show this stance is premised normatively on processes of subsidy between two apparently distinct spheres - from international (private) to national (public) - but that in practice the distinction is hazy and subsidy at times indirect, routed to individual staff members or to commercial teams. The ascendancy of this as a prevailing, politically legitimate form of internationalisation for the English NHS contrasts sharply with non-commodified alternatives decried as 'health tourism'.

Conclusions: The internationalisation framework presented in this article offers a platform for future research that can shed light on the contexts, visions, policies and contestations the emerge as healthcare institutions respond to processes of globalisation. It will be important to avoid uncritical approaches to research and policy by examining not just what forms of internationalisation find favour, and their basis in geographical and racialised hierarchies, but also how approaches to healthcare internationalisation impact inequalities within and between nations.

Background: Artificial intelligence (AI) will have a lasting and drastic impact on medical research and healthcare. In addition to the benefits, the associated risks are also the subject of controversial debate and there are fears of serious consequences. There is an urgent need for action, which must be underpinned by scientific information.

Methods: By analyzing temporal and geographic patterns, including national readiness for access to AI, we therefore identified incentives and barriers to global research under socioeconomic conditions.

Results: The explosive increase in annual publications started in 2017. The main players in AI_med research were the USA, China, the UK, Germany, and South Korea. There was a significant correlation between the publication output on AI in medicine (AI_med) and the metrics for economy and innovation. Additionally, citation patterns show the disadvantage of the Global South compared to the North American and European countries. In several weaker economies: Jordan, Pakistan, Egypt, Bangladesh, and Ethiopia, a more positive position was found in relation to the number of articles suggesting a better ranking in AI_med research in the future.

Conclusion: The results show the need for advanced global networking to ensure all relevant aspects for equitable development and the beneficial use of AI_med without promoting racial or regional inequities and to enforce this not only in the AI systems of economically strong countries but also for the participation of economically weaker countries.

Background: Building on the success of tobacco health warning labels, EU Member States and institutions are increasingly considering similar requirements for alcohol products. While industry responses to pricing and availability policies have been widely studied, their framing of Alcohol Health Warning Labels (AHWLs) as a policy solution remains comparatively underexplored. This paper examines how alcohol industry stakeholders responded to the EU notification process for Ireland's proposed alcohol labelling regulations, introduced under Ireland's Public Health (Alcohol) Act 2018.

Methods: This paper analyses 16 submissions from alcohol industry actors to the European Commission regarding Ireland's proposed alcohol warning label regulations. Qualitative methods, specifically thematic analysis, were used to examine industry arguments. The research team first reviewed five submissions to inductively develop a codebook, which was then applied to the remaining submissions, with new codes added as necessary. Two team members independently coded each submission, and thematic content was refined through team discussion.

Results: Alcohol industry arguments against AHWLs fall into four main themes: lack of evidence supporting the content of health warning labels and their broader use, negative trade and economic impacts of AHWLs, potential risks to EU governance posed by Ireland's labels, and the industry's self-positioning as responsible actors committed to public health. In addition, we identify novel industry strategies related to the intricacies of AHWLs, including a heightened focus on wording and language, coordination of activities across multiple governance levels, and tailored framing to suit the institutional context.

Conclusions: Alcohol industry actors employ arguments similar to those seen in other policy debates, which continue to pose a significant barrier to evidence-based alcohol policymaking. The analysis suggests that industry actors can strategically adapt their arguments to varying institutional settings and policy instruments, demonstrating their political dexterity and reinforcing the barriers to policy progress. These findings highlight the need for further research into the alcohol industry's influence and provide insights for jurisdictions considering labelling legislation.

Digital activism around Long Covid has reverberated around the globe, as patients, researchers, and clinicians worked together to understand the chronic condition. However, Long Covid networks, much like other social networks, have hierarchies and barriers that can impede equitable access. In this article, we examine how the global digital center and periphery shape how people with Long Covid connect to networks to learn about their illness symptoms, diagnoses, treatments, and experiences. We introduce case narratives of two Kenyan women-one elite Nairobian who was connected to the digital center and another middle class woman who connected with her through a peripheral digital community-to describe how elite patients were engaged at the digital center, and non-elite patients were engaged in the periphery with digital and non-digital connections through which they cultivated other social networks to communicate, share, and experience their illness experiences. The Kenyan case study introduces a context where people have sophisticated digital lives and are engaged in global information networks. Yet, we argue that some Long Covid patients' experiences are impossible to divorce from the digital activism that has drawn together a remarkable global patient community, causing a ripple effect on how people define and experience the self and illness throughout the world. We conclude that many Kenyans may be engaging with digital networks differently and from different places of geographic, cultural, linguistic, and technological power, possibly cultivating divergent idioms, interpretations, and experiences of the post-viral condition. This demonstrates not only how social networks function at the digital periphery but also the complexities situated within the periphery itself, which is at important social nodes, connected to the digital center.

Background: The World Health Organization recommends initiating breastfeeding in the first hour of life, exclusive breastfeeding for six months, and continued breastfeeding for at least two years. Aggressive marketing of breast milk substitutes (BMS) undermines breastfeeding and is linked to adverse child and maternal health outcomes. This is particularly problematic in the Global South, where socioeconomic conditions often amplify the risks associated with BMS. The adoption of national BMS legislation in line with the 1981 International Code of Marketing of Breast-milk Substitutes is therefore crucial but difficult due to strong opposition from the transnational formula milk industry. Breastfeeding advocates in Kenya were able to overcome this powerful opposition when the country adopted a strict BMS Act in 2012, which has since facilitated and protected remarkable improvements in breastfeeding rates. We conduct a qualitative case study to identify the political enablers of the successful adoption of this important law.

Results: BMS legislation was first politically debated in Kenya in the 1980s following mobilization of women-led civil society organizations, namely the Breastfeeding Information Group and the Maendeleo ya Wanawake Organization. The issue re-emerged on the political agenda in the 2000s but faced opposition from the transnational formula milk industry. Kenya's BMS Act was ultimately adopted during a policy window opened by a constitutional reform. Support for the adoption of this landmark law was led by effective female political leaders, including public health minister Beth Mugo, the ministry's nutrition division head Terrie Wefwafwa, and members of the Kenya Women's Parliamentary Association. In the formulation and adoption of the law, these female leaders received important support from international organizations, such as the United Nations Children's Fund, as well as from powerful male allies, including president Mwai Kibaki.

Conclusions: The Kenyan case illustrates how women's political leadership can counteract the power of the transnational formula milk industry and help achieve strict BMS legislation. Effective female leadership for BMS legislation can occur in various political offices and positions, including those of ministers, legislators and bureaucrats. Female leaders can leverage their own influence by strategically exploiting policy windows and recruiting male allies.

Background: Telemedicine is mentioned as a technological solution in various fields of medicine and nowadays using telemedicine in the field of mental health in the refugee population, has attracted special attention in the world. This research was conducted with the aim of investigating the usage of telemedicine in the refugee populations mental health.

Methods: This study, conducted in 2024, involved a comprehensive search of databases including Web of Science, Cochrane, ProQuest, Ovid, EBSCO, PubMed, and Scopus, up until April 2023. Based on predefined inclusion and exclusion criteria, 12 relevant articles were identified. The quality and methodology of the selected articles were evaluated using the Mixed Methods Appraisal Tool (MMAT) checklist.

Results: A total of 12 articles were included in the review. Feasibility and investigation of telemedicine challenges (5 articles) and its evaluation and effectiveness investigation (7 articles) were used. Most of the studies were quantitative (8 cases) and mostly dealt with socio-economic-cultural application issues (5 cases) and screening (2 cases). Most of the studies were purely focused on refugees (5 cases).

Conclusions: Results have shown that paying attention to the challenges, disadvantages, and telemedicine required Infrastructure in the field of mental health, will lead to effectiveness, screening, and treatment. This causes positive social, economic, and cultural effects on refugees. However, the need for future studies with more attention to technical and governmental challenges and their issues (security and reimbursement), the refugee population with various ethnicities, and different health fields (prevention, treatment, follow-up, rehabilitation, etc.) seems to be necessary.

Background: Alcohol use disorder (AUD) imposes a significant burden on individuals and society. With globalization, transnational alcohol corporations influence policy enforcement and consumer behavior, hindering cost-effective and evidence-based interventions such as reducing alcohol availability and restricting alcohol advertising, as recommended in the World Health Organization (WHO) Best Buys for the prevention and control of noncommunicable diseases (NCDs).This study utilizes the Global Burden of Disease Study 2021 dataset to examine global and regional disparities, offering key insights into the global trends of AUD and addressing critical research gaps.

Results: The global age-standardised prevalence of alcohol use disorders among individuals aged 15 years and older decreased from 1,698 per 100,000 in 1990 to 1,335 per 100,000 in 2021, with an average annual percent change of -0.78%. Similarly, the average annual percent change for mortality and disability-adjusted life years were - 0.82% and - 0.83%, respectively. Importantly, the age-standardised decline in alcohol use disorders was more pronounced in females compared to males (prevalence: -0.82% versus - 0.75%; mortality: -1.22% versus - 0.73%; disability-adjusted life years: -0.95% versus - 0.79%). The age-standardised prevalence of alcohol use disorders may remain higher among males until the year 2040. For the older adult groups aged 55 to 74, there was no statistically significant decline in alcohol use disorders mortality rates (Ps ≥ 0.17). Furthermore, countries characterized by a high sociodemographic index did not exhibit a significant reduction in mortality (average annual percent change: 0.02%). Between 1990 and 2021, high levels of alcohol consumption and experiences of childhood sexual abuse were identified as major risk factors for alcohol use disorders.

Conclusion: Understanding the trends of AUD in the context of globalization is crucial. Given that certain populations continue to experience persistent alcohol-related issues, protecting these groups from the influence of transnational alcohol corporations through effective policy measures such as strengthening regulations on alcohol advertising targeting older adults, and establishing independent regulatory agencies may be a key strategy for reducing the global health burden of AUD.