Despite a global decline in tobacco use,smoking remains a leading cause of preventable death,with rising vaping rates among adolescents and young adults further complicating nicotine cessation efforts.Digital interventions,particularly chatbots,have gained attention for their potential to support tobacco and vaping cessation by sim-ulating human-like conversations and providing instant feedback.However,evidence of their effectiveness is limited.The emergence of generative artificial intelligence(AI)chatbots,such as ChatGPT,offers a promising av-enue for more personalised and effective cessation support.This article reviews existing literature on traditional chatbot interventions for cessation services,explores the potential of AI chatbots,namely ChatGPT,in continuing to support tobacco and vaping cessation efforts,and identifies areas for future research.It highlights the need to further monitor the reliability and accuracy of AI-generated content and to develop frameworks ensuring health-care professionals receive adequate training in using these new tools effectively to support patients in quitting smoking and/or vaping.

Background:Low awareness of common pediatric eye conditions,such as amblyopia,conjunctivitis,and myopia in rural Chiang Rai,Thailand,prompted the development of a specialized curriculum.This curriculum aimed to provide individuals serving these areas with resources to educate and disseminate information within their communities.Methods:A one-hour curriculum covering the causes,signs,diagnosis,treatment,and prevention of amblyopia,conjunctivitis,and myopia was delivered virtually to public health students at a Thai university and in-person to students at this university and rural community members.The in-person seminar included hands-on activities and simulations of these eye conditions.Knowledge acquisition and retention were assessed using pre-tests,immediate post-tests,and one-month post-tests.Results:The seminar was attended by 87 virtual public health students,111 in-person public health students,and 40 in-person rural community members.All groups showed significant improvement in test scores from pre-test to immediate post-test(P＜0.001).In-person students had 1.57 times the odds of answering correctly on the immediate post-test compared to virtual students,despite no significant difference in baseline knowledge.However,the subset of in-person students who did not receive bilingual materials showed no significant difference in immediate post-test performance compared to virtual students(P＞0.05).Although public health students had more than twice the odds of answering correctly at pre-test compared to rural community members,there were no significant differences between groups on the immediate post-test(P＞0.05).Conclusion:A brief seminar significantly improved understanding and retention of pediatric eye conditions,achieving similar levels of understanding among public health students and rural community members,regard-less of initial knowledge on this topic.In-person,hands-on seminars with educational materials in participants'preferred language proved more effective than virtual ones in achieving these improvements.

Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard devi-ation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5％.This result,although on par with the global IPV average(27％),is 1.5％higher than the national rate(26％).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.

Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucial for comprehensive health outcomes.This oversight contributes to a significant mental health burden,with up to 40％of rehabilitating patients experiencing depression or anxiety.This perspective article reviews evidence from social and affective neuroscience to highlight the urgent need to integrate well-being as a central component of rehabilitation.We propose a holistic rehabilitation model that includes psychological,affective,and social interventions alongside physical therapies.This model draws on existing studies demonstrating that emotional resilience and social support are key predictors of successful rehabilitation outcomes.Patients with strong social and affective well-being are more likely to adhere to treatment protocols and achieve better physical recovery.Conversely,neglecting these dimensions can exacerbate mental health conditions,leading to what we identify as a"second wave"of health crises—mental health conditions triggered by chronic physical ailments.By adopting this holistic approach,healthcare systems can improve immediate rehabilitation outcomes,prevent the long-term escalation of mental health issues,and reduce the overall burden on global mental health services,ultimately enhancing the quality of life for patients worldwide.

Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EM-BASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insuf-ficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.

Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is to iden-tify the key factors influencing irrational medicine consumption and devise a strategic framework to encourage responsible medicine use.Method:A cross-sectional qualitative descriptive design was used.Study data were collected using semi-structured interviews and analysed using thematic analysis to identify the key factors contributing to irrational medicine consumption.Results:Various factors like cyberchondria coupled with health misinformation,inaccessible healthcare,limited product choices,misleading online pharmacies,and infeasible pharmaceutical regulations act as key drivers of irresponsible medicine consumption.The participants recommended enhancing healthcare access,utilizing technology,promoting health literacy,and updating regulations as strategies to improve responsible medicine use.Against this backdrop,the study proposes a double helix model for responsible consumption of medicines through bilateral efforts from both consumers and the health system.Conclusion:Highlighting the importance of responsible consumption,this paper calls health system actors to action to accelerate the efforts to foster responsible consumption of medicines.

Objective:Studies on the occupational health risks and experiences of healthcare waste handlers since the decline in coronavirus disease 2019(COVID-19)incidence are scarce in Nigeria.The current study aimed to examine what seemed as the"hidden"and rarely researched area of practice from the standpoint of different stakeholders in a Nigerian Lassa fever treatment hospital.The primary objective was to understand the nature of waste handlers'practices and experiences and identify areas for improvement centred on supporting the development of best practices,in accordance with the World Health Organisation(WHO)guidelines.Methods:This study employed a qualitative case study design,gathering data from healthcare waste handlers(n=34)through four focus groups.Additionally,four in-depth interviews were conducted with ward managers and the infection control team to gain insight into the organisational framing of waste handling practice,the perceived challenges faced by waste handlers from their perspectives,and the provision of training and support.The qualitative data were audio-recorded and transcribed verbatim through manual processes and subjected to a reflexive thematic analysis conducted manually.Results:The findings revealed that waste handlers were subjected to various occupational health risks,including back pain,needlestick injuries,psychological distress,fatigue,anxiety,and prolonged exposure to sunlight.Con-cerns were raised regarding the inadequate supply of personal protective equipment and other essential tools,which suggests a need for organisational commitment to ensure the continual availability of these resources to protect the health and safety of these employees.A critical issue identified was the lack of comprehensive training for waste handlers,highlighting a form of organisational negligence.The consensual views expressed by the waste handlers indicated a sense of dissatisfaction with their working environment,largely attributable to organisational and societal stigmatisation.Furthermore,the study underscored that the hospital management faced significant financial constraints and advocated for increased funding to effectively implement best practice standards.Conclusion:To effectively manage healthcare waste and reduce hazards to waste handlers,the organisational leadership should prioritise training and support.This initiative will not only benefit the waste handlers but also the patients,other healthcare workers,and the general public.Although the findings focus on the case context of a Nigerian Lassa fever treatment hospital,the wider implications of this study are linked to the role of in-stitutional support for waste handling practice.Moreover,it extends to the potential positions of institutions as displaying a form of"benign anomie"in not ensuring the wellbeing of waste handlers through sufficient regula-tion and governance focused on prioritisation,processes,and procedures.The study highlights the relevance of embedding WHO guidelines in other similar contexts as part of implementation across institutions involved with waste handling.

The Global Health Network Conference 2022 addressed the critical need for expanded health research capabilities in low-and middle-income countries and low-resource settings,particularly in light of global health threats such as pandemics and climate change.This deficit often results in insufficient research to inform effective health inter-ventions.Held in Cape Town,South Africa,the conference brought together a diverse group of health researchers,practitioners,and policymakers from over 50 countries to explore how health research can be embedded into every healthcare setting.The conference emphasized fostering leadership,integrating research findings into pol-icy and practice,enabling research in all healthcare settings,and engaging communities through the research process.This article collates and considers the key findings and recommendations from the eight sessions.These sessions were designed to follow the research cycle,from setting the question to taking the findings into practice,with a focus on capacity building,data-driven decision-making,and tackling gender and societal disparities.Our aim is that by reporting these outputs we can share valuable experience and insights that can help research teams in their studies and through doing so,spark a shift in global health research through this remarkable collabora-tive effort in knowledge and methods sharing that continues through the Global Health Network community.The recommendations derived from this conference align with the World Health Organization's strategies for rein-forcing health research systems and showcase the importance of empowering low-and middle-income countries to conduct research that addresses their unique health challenges.By advancing global health research through collaboration,innovation,and community involvement,the conference laid the groundwork for a comprehensive framework that supports the Sustainable Development Goals and promotes equitable healthcare for all.

Objective:This study has the objective to offer a thorough overview of the current state and future research possibilities regarding the social stigma of tuberculosis(TB).Given the growing volume and variety of research in this field,a quantitative approach is essential for mapping existing themes and pinpointing potential areas for further investigation.To accomplish this,a bibliometric and content analysis was performed to explore the current literature and emphasize key themes and future directions.Methods:The study examines 770 bibliographic records from Scopus and visualizes the results of the biblio-metric analysis using co-occurrence and thematic map analyses with VOSviewer and Tableau Public software.Additionally,a content analysis was conducted based on the findings from the co-occurrence analysis.Results:The findings indicate a notable rise in publications and citations related to the social stigma of TB,with prominent research topics including healthcare workers,social support,mobile health technology(mHealth),nursing,and attitudes.Emerging areas of research encompass epidemiology,public health,patient delays,multidrug-resistant TB(MDR-TB),corona virus disease 2019,and mHealth.Future studies might concentrate on the factors leading to patient delays,as well as the development of diagnostic tools and effective treatment regimens for MDR-TB cases.Conclusion:This study offers important insights into the current state of social stigma in TB research and iden-tifies promising areas for future investigation.By addressing these research gaps and refining methodological approaches,researchers can strengthen initiatives to combat TB stigma,ultimately resulting in more effective treatments and improved adherence among TB patients.

Background:Long-term exposure to toxic substances increases the risk of their accumulation and triggering endocrine disruption.The ill-planned irrigation systems in Uzbekistan led to severe environmental disasters,resulting in aridization and the spread of organochlorine pesticides and toxic metals across the region.Objective:We investigate the influence of negative environmental factors on hormonal activities such as sex steroids,gonadotropic hormones,and growth factors,in addition to potential disruptions in growth rate and anthropometric indicators in prepubertal adolescents living in this region.Methods:This study included 405 prepubertal boys aged 11 to 13 years,residing in the cities of Muynak(un-favorable region)and Nukus(favorable region)of Uzbekistan.We measured 20 anthropometric parameters and assessed somatotype by the Heath-Carter method,peak height velocity(PHV),and maturity offset based on Mir-wald's equation.In addition,the endocrine profile of 8 hormonal parameters was assessed,which includes growth factors,gonadotropins,sex steroids,and thyroid status.Results:We observed a positive dependence of physique,rate of maturation,and level of androgens,stimulated by gonadotropin hormones.Children living in unfavorable environmental regions show a decrease in follicle-stimulating hormone,luteinizing hormone,total testosterone(the best predictor),and anthropometric signs of androgen deficiency.These resulted in an increase in maturity offset and PHV,combined with lower skeletal density and ectomorphic somatotype compared to their peers living in favorable environmental regions.Conclusion:Regional differences in stature,body weight,and anthropometric parameters of adipose tissue,growth factor axis,and thyroid hormones are the influencing indices in the regulation of growth in prepubertal children.We hypothesize that the inhibition of the gonadotropin-testosterone axis may result from endocrine disruption due to higher levels of toxic metals and pesticide exposure.