Precision public health in the era of genomics and big data

Abstract

Precision public health (PPH) considers the interplay between genetics, lifestyle and the environment to improve disease prevention, diagnosis and treatment on a population level—thereby delivering the right interventions to the right populations at the right time. In this Review, we explore the concept of PPH as the next generation of public health. We discuss the historical context of using individual-level data in public health interventions and examine recent advancements in how data from human and pathogen genomics and social, behavioral and environmental research, as well as artificial intelligence, have transformed public health. Real-world examples of PPH are discussed, emphasizing how these approaches are becoming a mainstay in public health, as well as outstanding challenges in their development, implementation and sustainability. Data sciences, ethical, legal and social implications research, capacity building, equity research and implementation science will have a crucial role in realizing the potential for ‘precision’ to enhance traditional public health approaches.

Mental Health Stigma in the Workplace and its Association with Possible Actions of Managers to Prevent Sickness Absence of Employees with Mental Health Problems in the Swedish Private Sector: a Video Vignette Study

Abstract

Purpose

Mental health problems (MHPs) are subjected to workplace stigma and can deteriorate into common mental disorders (CMDs) and sickness absence (SA). Research has shown that personal stigmatizing attitudes limit managers’ efforts towards employees with MHPs, but knowledge is lacking regarding stigma in social contexts (contextual stigma) and different types of possible preventive actions. This study investigates personal stigmatizing attitudes and three contextual stigma layers (employee, collegial, organizational) and different types of possible actions to prevent SA of employees with MHPs.

Method

Survey data of 2769 Swedish managers working in the private sector were analysed. Personal stigmatizing attitudes were measured with the managerial stigma towards employee depression scale and supplemented with four additional items capturing contextual stigma. Managers watched video vignettes and assessed which preventive actions (n  = 20) were possible to use in their organization. A sum score was calculated reflecting the ‘number of actions’. Principal component analysis revealed three action types: adapt tasks and setting, involve experts, and social support. A score reflecting the ‘possibilities to implement actions’ was calculated for each type. Multiple linear regression analyses were conducted with the four stigma layers as independent variables for each of the three action variables.

Results

Personal stigmatizing attitudes and contextual stigma were significantly associated with both ‘number of actions’ and ‘possibilities for implementing actions’ relating to all action types. Patterns of associations with contextual stigma were significant but varied between the different action types.

Conclusion

This study substantiated the role of personal stigmatizing attitudes and contextual stigma in relation to possible actions of managers to prevent SA of employees with MHPs. The results emphasize the role of contextual stigma. Implications for practice and research are discussed.

“This was never about a virus”: Perceptions of Vaccination Hazards and Pandemic Risk in #Covid19NZ Tweets

Abstract

In this paper, we draw on qualitative methods from the medical humanities and quantitative approaches from corpus linguistics to assess the different mappings of pandemic risks by Twitter (X) users employing the #Covid19nz hashtag. We look specifically at their responses to government measures around vaccines between August and November 2021. Risk, we reveal, was a major discursive thread in tweets during this period, but within our tweets, it was the vaccine rather than the virus around which hazard perception and response were grouped. We find that the discursive stance of those opposed to the vaccine evoked entangled medical and political hazards, untrustworthy experts, obscure information, restrictions on sovereignty, threats to children, and uncertain future dangers, all of which positioned them within what Ulrich Beck termed the world risk society. We also found that these narratives of risk manifested in specific Twitter styles, which employed a consistently larger number of hashtags. The lack of conjunctions between the hashtags, we argue, encouraged a disordered reading of doubt and precaution, as the hashtags presented triggering phrases whose interconnections were hinted at rather than specified. By contrast, those who tweeted in support of government measures were rhetorically led by solutions rather than risks, with one exception: their perception of those who were vaccine opposed. We use scholarship on risk and precautionary logic to map out the contrasting positions in tweets addressing Aotearoa New Zealand’s pandemic experience during the closing months of 2021.

The Associations Between Discrete Emotions and Political Learning: A Cross-Disciplinary Systematic Review and Meta-Analysis

Abstract

In recent decades, researchers’ interest in the role of emotions in individual political learning has grown. However, it is still unclear whether and how discrete emotions are associated with political learning. Through a cross-disciplinary systematic review and multilevel meta-analysis, we reviewed which discrete emotions have been analyzed in the context of political learning so far and meta-analytically synthesized how these emotions relate to political learning. We addressed this question by synthesizing associations between discrete emotions and various aspects of learning about political matters, such as political attention, information seeking, discussions, knowledge, and knowledge gain. The final dataset included 66 publications with 486 effect sizes, involving more than 100,000 participants. Most of the effect sizes were based on negative-activating emotions (65%; mainly anxiety, 32%, and anger, 19%) and positive-activating emotions (32%; mainly enthusiasm, 15%), while studies on positive-deactivating emotions (e.g., contentment) and negative-deactivating emotions (e.g., sadness) are largely lacking. We uncovered small positive associations (r = .05 to .13) for activating emotions, of both negative (especially anger) and positive valence (e.g., enthusiasm, only in cross-sectional designs), but no associations for negative-deactivating emotions. We discuss theoretical implications and recommend future research to include previously unconsidered emotions in order to extend existing findings.

The STAR Compass to Guide Future Pharmacovigilance Based on a 10-Year Review of the Strengthened EU System

Abstract

This article reflects on the 2010 pharmacovigilance legislation of the European Union (EU). Its legislative aim of better patient and public health protection through new responsibilities for pharmaceutical companies and regulatory bodies is considered to have been achieved and is well supported by the good pharmacovigilance practices ‘EU-GVP’. For future progress, we set out a vision for high-quality pharmacovigilance in a world of ongoing medical, technological and social changes. To deliver this vision, four principles are proposed to guide actions for further progressing the EU pharmacovigilance system: synergistic interactions with healthcare systems; trustworthy evidence for regulatory decisions; adaptive process efficiency; and readiness for emergency situations (the ‘STAR principles’). Like a compass, these principles should guide actions for building capacity, technology and methods; improving regulatory processes; and expanding policies, frameworks and research agendas. Fit for the future, the EU system should achieve further improved outputs in terms of safe, effective and trusted use of medicines and positive health outcomes within patient-centred healthcare.

Refugee voices vs. humanitarian choices: how much can refugee-led organizations redefine power and agency in post-2019 Lebanon?

Abstract

In the humanitarian landscape, especially post-COVID-19, there has been a notable pivot towards inclusivity and participatory methodologies, emphasizing the pivotal role of refugee-led organizations (RLOs). In Lebanon, amidst persistent economic and political turmoil, RLOs serve as crucial support systems for Syrian and Palestinian refugees within an environment plagued by inconsistent refugee policies and heightened vulnerabilities. Academic discourse underscores the increasing significance of RLOs in humanitarian assistance, yet systemic hurdles such as power differentials and tokenistic inclusion have emerged, constraining their effectiveness and integration within the humanitarian sphere. This study critically examines the application of inclusivity within humanitarian operations, aligned with the principles outlined in the Agenda for Humanity, specifically scrutinizing how prevailing narratives and operational dynamics may marginalize RLOs in Lebanon, thereby impeding their efficacy. It endeavors to evaluate how RLOs can assert themselves as principal stakeholders in humanitarian endeavors, striving for a more equitable and pragmatic approach to power dynamics and strategic planning for refugee communities. Utilizing a qualitative and participatory methodology, this research engages with diverse RLOs in Lebanon, conducting interviews to realistically and practically frame their experiences, obstacles, and contributions within the humanitarian landscape across entrenched and often rigid hierarchies, power dynamics, and tokenism within Lebanon’s broader humanitarian landscape.

Literacy and Financial Education: Private Providers, Public Certification and Political Preferences

Abstract

Financial education can influence the level of financial literacy. In many countries public authorities implement financial education policy by means of ex ante certification of both private and public providers of education activities. This article uses political economy, educational marketing and text analysis as complementary tools to offer a positive analysis of such setting. Being financial education a credence good and given the key assumption that financial literacy is a country state–contingent endowment that deteriorates, as a consequence of innovation, the third-party certification can be considered as a strategic governance solution. Yet, when a public agency acts as third-party certifier, political and bureaucratic incentives shape its action. In particular, political activism in financial education can be motivated by financial instability worries. Such theoretical relationship is empirically confirmed applying text analyses, and using financial education narrative as a proxy for activism both for the politicians of the European Parliament and the bureaucrats of the ECB in the period 1997–2024.

Biden’s Executive Order on AI: strengths, weaknesses, and possible reform steps

Abstract

In recent years, numerous AI ethics and government initiatives have emerged globally. The E.U.’s AI Act and the Biden Administration’s Executive Order on AI are the most notable legislations. While many articles have assessed the strengths and weaknesses of the AI Act and suggested reform measures to enhance it, only a few have done the same for the Executive Order. This article addresses this research gap by offering a comprehensive analysis of the Executive Order. Specifically, it provides a critical computer-ethical (i.e., Kantian-ordoliberal) evaluation of the Executive Order’s advantages and disadvantages and explores potential ways to strengthen it.