BACKGROUND: Aged care staff and doctors frequently highlight consumers\' role in antibiotic treatment decisions. However, few studies include consumers. This study aimed to investigate consumer perspectives on antibiotic use in residential aged care.
METHODS: A search across 6 online databases yielded 3,373 studies, with 5 meeting inclusion criteria. Participant quotes, themes, statistical analyses, and authors\' interpretive summaries in the included studies were inductively coded and refined to generate themes.
RESULTS: Three themes emerged: perception of benefits and risks of antibiotics, perceived role in antibiotic treatment decision-making, and information-communication needs. Consumers held positive attitudes toward antibiotics, did not associate antibiotics with the exclusive treatment of bacterial infections, and had limited awareness of potential risks, such as antibiotic resistance. Studies showed diverse perceptions regarding residents\' and their families\' involvement in antibiotic treatment decision-making with some residents actively seeking antibiotics and others trusting doctors to decide. Studies also described consumer need for effective provider-consumer communication and information sharing that was affected by contextual barriers such as motivation, preferences, available information resources, and provider attitudes.
CONCLUSIONS: Limited literature is available on consumer perspectives on antibiotic use in aged care. The review highlights that consumer needs are more complex than simply wanting an antibiotic. Antimicrobial stewardship programs should target consumer awareness, beliefs, and provider-consumer communication to enhance antibiotic use in aged care.

Low consumer acceptance of edible insects and insect-based products is one of the main barriers to the successful implementation of entomophagy in Western countries. This rejection is mainly caused by consumers\' negative emotional responses, psychological/personality traits, and attitudes toward food choices. However, as the role of intrinsic product characteristics on such food choices has not been adequately studied, a systematic review was conducted following the PRISMA method, to analyze studies that have assessed hedonic evaluations, sensory profiling, or emotional responses to edible insects or insect-based products. The majority of studies performed with whole insects and insect flour highlight that insect-based products are more negatively evaluated than control products. Although the sensory properties of insects are affected by species and processing conditions, they are generally negative across sensory dimensions. In particular, insects and insect-based products are generally associated with odor and flavor/taste attributes that are related to old/spoiled food. These negative attributes can be linked to the fat fraction of edible insects, with insect oils being very negatively evaluated by consumers. On the other hand, defatted fractions and deodorized oils are not associated with these negative attributes, further supporting the hypothesis that the fat fraction is responsible for the negative odor and flavor/taste attributes. However, there is still a lack of studies assessing the sensory profile of edible insects and insect-based products, as well as consumers\' emotional responses to their consumption. Future studies should focus on the effects of different processing conditions, products incorporating insect fractions (namely protein concentrates/isolates and defatted fractions), and evaluation by target consumer groups.

Direct-to-consumer (DTC) health care artificial intelligence (AI) apps hold the potential to bridge the spatial and temporal disparities in health care resources, but they also come with individual and societal risks due to AI errors. Furthermore, the manner in which consumers interact directly with health care AI is reshaping traditional physician-patient relationships. However, the academic community lacks a systematic comprehension of the research overview for such apps.
This paper systematically delineated and analyzed the characteristics of included studies, identified existing barriers and design recommendations for DTC health care AI apps mentioned in the literature and also provided a reference for future design and development.
This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines and was conducted according to Arksey and O\'Malley\'s 5-stage framework. Peer-reviewed papers on DTC health care AI apps published until March 27, 2023, in Web of Science, Scopus, the ACM Digital Library, IEEE Xplore, PubMed, and Google Scholar were included. The papers were analyzed using Braun and Clarke\'s reflective thematic analysis approach.
Of the 2898 papers retrieved, 32 (1.1%) covering this emerging field were included. The included papers were recently published (2018-2023), and most (23/32, 72%) were from developed countries. The medical field was mostly general practice (8/32, 25%). In terms of users and functionalities, some apps were designed solely for single-consumer groups (24/32, 75%), offering disease diagnosis (14/32, 44%), health self-management (8/32, 25%), and health care information inquiry (4/32, 13%). Other apps connected to physicians (5/32, 16%), family members (1/32, 3%), nursing staff (1/32, 3%), and health care departments (2/32, 6%), generally to alert these groups to abnormal conditions of consumer users. In addition, 8 barriers and 6 design recommendations related to DTC health care AI apps were identified. Some more subtle obstacles that are particularly worth noting and corresponding design recommendations in consumer-facing health care AI systems, including enhancing human-centered explainability, establishing calibrated trust and addressing overtrust, demonstrating empathy in AI, improving the specialization of consumer-grade products, and expanding the diversity of the test population, were further discussed.
The booming DTC health care AI apps present both risks and opportunities, which highlights the need to explore their current status. This paper systematically summarized and sorted the characteristics of the included studies, identified existing barriers faced by, and made future design recommendations for such apps. To the best of our knowledge, this is the first study to systematically summarize and categorize academic research on these apps. Future studies conducting the design and development of such systems could refer to the results of this study, which is crucial to improve the health care services provided by DTC health care AI apps.

Direct-to-consumer genetic tests (DTC-GT) offer a variety of genetic health risk information. Understanding evidence of impacts is required for effective policy to protect consumers and healthcare services. We undertook a systematic review according to PRISMA guidelines, searching five literature databases for articles assessing analytic or clinical validity, or reporting consumer or healthcare professional experience with health risk information derived from DTC-GT, published between November 2014 and July 2020. We performed a thematic synthesis to identify descriptive and analytical themes. Forty-three papers met inclusion criteria. Many consumers submit raw DTC-GT data for third-party interpretation (TPI). DTC-GT sometimes report \'false positive\' or incorrectly interpreted rare variants, or that such information can result from TPI. Consumers have high expectations of DTC-GT and TPI, and are broadly satisfied, although many do not act on results. A minority of consumers experience adverse psychological impacts. Healthcare consultations can be complex, and professionals have reservations about the validity and utility of DTC-GT-derived information. The contrast between consumer and health professional perceptions can result in mutual dissatisfaction with consultations. Health risk information from DTC-GT and TPI is broadly valued by consumers but presents complex challenges for healthcare services and some consumers.

Effective and sustainable interventions are necessary for long-term improvement of food safety. This review provides a summary of food safety interventions evaluated in selected low- and middle-income countries in Asia between 2000 and 2020. A systematic screening of published articles from PubMed and CabDirect databases was carried out with the aid of Rayyan QCRI software. A total of 25 studies were considered in the review. A \'before and after\' study design was the most frequently used design (64%), while five studies (20%) used a randomized control trial (RCT) design. Interventions applied focused on training to improve knowledge, attitudes, and practices (KAP) towards safe food (60%) or on specific technologies (40%). Nine of the 25 studies were specific on the value chain considered: cattle (1), poultry (1), pigs (4) and fish value chains (3). Except for one study, all interventions reported some level of success; 17 were rated as having a high level of success, defined differently across studies. However, there is a clear evidence gap for the efficacy and cost-effectiveness of food safety interventions in market settings, both consumer- and vendor-facing. A rigorous and standardized assessment of intervention effectiveness and sustainability is recommended, to not only identify areas of improvement, but also to ensure scaling of interventions with demonstrated evidence of success and sustainability.

Understanding the unmet needs of healthcare consumers with attention-deficit/hyperactivity disorder (ADHD) (individuals with ADHD and their caregivers) provides critical insight into gaps in services, education and research that require focus and funding to improve outcomes. This review examines the unmet needs of ADHD consumers from a consumer perspective.
A standardised search protocol identified peer-reviewed studies published between December 2011 and December 2021 focusing on consumer-identified needs relating to ADHD clinical care or research priorities.
1,624 articles were screened with 23 studies that reviewed examining the needs of ADHD consumers from Europe, the U.K., Hong Kong, Iran, Australia, the U.S.A. and Canada. Consumer-identified needs related to: treatment that goes beyond medication (12 studies); improved ADHD-related education/training (17 studies); improved access to clinical services, carer support and financial assistance (14 studies); school accommodations/support (6 studies); and ongoing treatment efficacy research (1 study).
ADHD consumers have substantial unmet needs in clinical, psychosocial and research contexts. Recommendations to address these needs include: improving access to and quality of multimodal care provision; incorporating recovery principles into care provision; fostering ADHD health literacy; and increasing consumer participation in research, service development and ADHD-related training/education.

There is growing evidence to support the use of co-design in developing interventions across many disciplines. This scoping review aims to examine how co-design methodology has been used in the development of cardiovascular disease (CVD) secondary prevention interventions within health and community settings.
We searched four academic databases for studies that used the co-design approach to develop their intervention. Studies were included if consumers (adults with CVD) and key stakeholders (e.g. clinicians, service providers) were involved in the co-design process. The review focused on methodology rather than traditional study outcomes; therefore, co-design processes and activities were extracted and evaluated against a selected co-design framework.
Twenty-two studies were included in this review. Studies were implemented across various settings with consumers and stakeholder groups most frequently consisting of patients and healthcare professionals, respectively. Most studies specifically stated that they used a \'co-design\' approach (n = 10); others used terms such as participatory action research (n = 3), user-centred design (n = 3) and community-based participatory research (n = 2). Although there was variability in terminology, co-design processes, and participants, all studies adhered to the key principles of consumer engagement. Predominant co-design activities included semistructured interviews, focus groups, co-design/development workshops and advisory group meetings. Intervention effectiveness was assessed in eight studies showing mixed results.
This review provides an overview of how the co-design approach has previously been used in the development of CVD secondary prevention interventions. These findings provide methodological considerations that can guide researchers and healthcare services when implementing co-design to develop feasible and acceptable interventions that can improve outcomes for CVD populations.
No patients, service users, caregivers, people with lived experience or members of the public were involved in this scoping review. This review article was written by academics who have undertaken a significant amount of co-design work with consumers and stakeholders.

Information about where medicines are in stock and how much they cost facilitates consumers\' timely access to affordable medicines by enabling price comparisons and the identification of stockists. Our aims were to: (1) Review how consumer access to price and availability information is engaged within the Medicine Access discourse and (2) identify factors associated with the existence of interventions that provide consumers with medicine availability and price information. We conducted two scoping reviews. We reviewed 26 medicine access and pharmaceutical system strengthening frameworks to assess how they conceptualise information access. We then reviewed four interventions that provide consumers with availability and price information to identify the factors associated with these interventions\' existence. We found that in the medical access discourse, information is mainly cast as helpful to entities that ensure medicine access for populations. Information as an enabler of medicine procurement for consumers/households is less emphasised. We then identified the following eight factors that facilitate consumer access to reliable medicine price and availability information: the recognition of a medicine access problem that can be mitigated by consumer access to information; cross-sectoral collaboration; the willingness of medicine sellers to disclose their inventory information; having information quality control measures; appropriate incentives for intervention adoption; enabling legal environments; systems of pooling information; and access to digital information technology infrastructure. We recommend that more theoretical and implementation attention ought to be directed at how medicine price and medicine availability information can empower individual consumers to make sound purchasing decisions.

BACKGROUND: People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners.
METHODS: A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, and the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data.
RESULTS: A total of 57 citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in health systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis and BPD-related stigma surrounding health and crisis care services.
CONCLUSIONS: Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. It is anticipated that results of this review will inform future research, policy, and practice to address BPD-related stigma in health systems, as well as approaches for improving the delivery of responsive health services and care for consumers with BPD and their carers/families.
BACKGROUND: Open Science Framework ( https://osf.io/bhpg4 ).

Quince fruit (Cydonia oblonga) that belongs to the Rosaceae family and native to the Mediterranean region has been studied for decades for its unique importance in food and medicine. This fruit is packed with vitamins, minerals as well as fibers, pectin and tannins. Quince is known by its many therapeutic effects that include antioxidant, anti-inflammatory, antimicrobial, anti-ulcerative, and anticancer actions. However, this fruit is underutilized at the level of food processing due to its sensory attributes and the limited appreciation of its benefits by both farmers and consumers. Other than jellies and jams, quince could be processed into various healthy sub-products. The aims of the current review are to present botanical and nutritive value of this fruit, review the available literature on its therapeutic effects in order to increase farmers and consumers awareness about the importance of quince fruit and showing the different ways of utilizing it.