UNASSIGNED: In Singapore, the healthcare system strongly encourages mothers to breastfeed and breastfeeding initiation is near-universal. However, sustained breastfeeding rates remain low. Little is currently known about how breastfeeding information disseminated in the healthcare setting influences women\'s breastfeeding experiences. This study explored breastfeeding promotion and educational resources from the perspective of Singaporean mothers and healthcare workers.
UNASSIGNED: Semi-structured interviews with 14 mothers of infants aged 1-5 months and who had used obstetric, maternity, and/or paediatric services in Singapore, and 20 health workers with experience in general, obstetric, maternal, or paediatric care recruited using purposive sampling methods. Interview transcripts were coded using an inductive method.
UNASSIGNED: Breastfeeding communications were viewed as too moralized and too focused on nudging women to breastfeed, with relatively little emphasis on timely, practical information or solutions for mothers unable to latch. Hence mothers tended to rely on alternative resources such as blogs. They lacked in-depth knowledge of the benefits of breastfeeding and viewed it as detrimental to maternal mental wellbeing due to the perceived stress and guilt when experiencing difficulties, notably with milk supply and latching, and from the inability to meet breastfeeding expectations. Husbands, older family members, confinement nannies, and employers were considered influential individuals to encourage breastfeeding, but they commonly discouraged breastfeeding due to social and cultural factors which led to supplementation with formula.
UNASSIGNED: For better breastfeeding outcomes, future informational sources on breastfeeding should be morally neutral, practical, set realistic expectations for the demands of breastfeeding, and target influential individuals such as family members, confinement nannies and employers.

The acronym CALL TO ECLS has been proposed as a potential tool to support decision-making in critical communication moments when qualifying a patient for the ECPR procedure. The aim of this study is to assess the accuracy of the acronym and validate its content. Validation is crucial to ensure that the acronym is theoretically correct and includes the necessary information that must be conveyed by EMS during the qualification of a patient with out-of-hospital cardiac arrest for ECMO. A survey was conducted using the LimeSurvey platform through the Survey Research System of the Jagiellonian University Medical College over a 6-month period (from December 2022 to May 2023). Usefulness, importance, clarity, and unambiguity were rated on a 4-point Likert scale, from 1 (not useful, not important, unclear, ambiguous) to 4 (useful, important, clear, unambiguous). On the 4-point scale, the Content Validity Index (I-CVI) was calculated as the percentage of subject matter experts who rated the criterion as having a level of importance/clarity/validity/uniqueness of 3 or 4. The Scale-level Content Validity Index (S-CVI) based on the average method was computed as the average of I-CVI scores (S-CVI-AVE) for all considered criteria (protocol). The number of fully completed surveys by experts was 35, and partial completion was obtained in 63 cases. All criteria were deemed significant/useful, with I-CVI coefficients ranging from 0.87 to 0.97. Similarly, the importance of all criteria was confirmed, as all I-CVI coefficients were greater than 0.78 (ranging from 0.83 to 0.97). The average I-CVI score for the ten considered criteria in terms of usefulness/significance and importance exceeded 0.9, indicating high validity of the tool/protocol/acronym. Based on the survey results and analysis of responses provided by experts, a second version was created, incorporating additional explanations. In Criterion 10, an explanation was added-\"Signs of life\"-during conventional cardiopulmonary resuscitation (ROSC, motor response during CPR). It has been shown that the acronym CALL TO ECLS, according to experts, is accurate and contains the necessary content, and can serve as a system to facilitate communication between the pre-hospital environment and specialized units responsible for qualifying patients for the ECPR.

To show how sugar-sweetened beverage (SSB) taxes were framed in posts on Twitter (now known as X) through text and images, we conducted a content analysis on a sample of Tweets from California users posted between January 1, 2015 and December 31, 2018 about SSB taxes in Berkeley, San Francisco, Oakland, and/or Albany, California. We evaluated posts for information sources, arguments for or against SSB tax policies, and images used. We found that posts presented a mix of messages through text and images. The majority of posts (64%) included arguments supporting SSB taxes, 28% presented a neutral position (e.g., factual information) or a mix of both pro-and anti-tax arguments, and 8% opposed. One-third of posts included an image, almost half of which appeared to be stock photos from SSB advertisements: many of these were shared by medical and public health users. Some tax supporters also reposted messages and images from opposition campaigns and added their own criticisms. By reposting opponents\' anti-tax messages and images of SSBs, tax supporters may have inadvertently promoted SSBs, reinforced opposition to SSB taxes, and normalized SSBs. While advocates effectively shared pro-tax arguments, they should also ensure that accompanying images reflect the solutions they seek, not just the problem they are trying to combat.

Submarine control rooms are characterised by dedicated individual roles for information types (e.g. Sonar operator processes sound energy), with individuals verbally reporting the information that they receive to other team members to help resolve uncertainty in the operational environment (low information integration). We compared this work design with one that ensured critical information was more readily available to all team members (high information integration). We used the Event Analysis of Systemic Teamwork (EAST) method to analyse task, information, and social networks for novice teams operating within a simulated submarine control room under low versus high information integration. Integration impacted team member centrality (importance relative to other operators) and the nature of information shared. Team members with greater centrality reported higher workload. Higher integration across consoles altered how team members interacted and their relative status, the information shared, and how workload was distributed. However, overall network structures remained intact.
Wider integration (distribution) of information within teams in a simulated submarine control room altered the content of the information shared between team members and the centrality and workload of team members. Practitioners must consider how to integrate information in sociotechnical systems such that information traditionally held by specialist positions can be distributed within teams to benefit team performance and other outcomes.

High-quality medical care and effective public health are impossible without adequate staffing. Modern medicine is subject to the trends of globalization and internationalization, like many other industries and spheres of the national economy, and today both doctors and nurses often provide medical care to foreign-speaking citizens: tourists, migrants, refugees, foreign students, etc. The article provides an overview of publications reflecting the importance of linguistic training and knowledge of foreign languages for medical professionals.

Introduction: Kidney stones are common and morbid conditions in the general population with a rising incidence globally. Previous studies show substantial limitations of online sources of information regarding prevention and treatment. The objective of this study was to examine the quality of information on kidney stones from artificial intelligence (AI) chatbots. Methods: The most common online searches about kidney stones from Google Trends and headers from the National Institute of Diabetes and Digestive and Kidney Diseases website were used as inputs to four AI chatbots (ChatGPT version 3.5, Perplexity, Chat Sonic, and Bing AI). Validated instruments were used to assess the quality (DISCERN instrument from 1 low to 5 high), understandability, and actionability (PEMAT, from 0% to 100%) of the chatbot outputs. In addition, we examined the reading level of the information and whether there was misinformation compared with guidelines (5 point Likert scale). Results: AI chatbots generally provided high-quality consumer health information (median DISCERN 4 out of 5) and did not include misinformation (median 1 out of 5). The median understandability was moderate (median 69.6%), and actionability was moderate to poor (median 40%). Responses were presented at an advanced reading level (11th grade; median Flesch-Kincaid score 11.3). Conclusions: AI chatbots provide generally accurate information on kidney stones and lack misinformation; however, it is not easily actionable and is presented above the recommended reading level for consumer health information.

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Background. Wildfire smoke events are increasing in frequency and intensity due to climate change. Children are especially vulnerable to health effects even at moderate smoke levels. However, it is unclear how parents respond to Air Quality Indices (AQIs) frequently used by agencies to communicate air pollution health risks. Methods. In an experiment (3 × 2 × 2 factorial design), 2,100 parents were randomly assigned to view one of twelve adapted AQI infographics that varied by visual (table, line, gauge), index type (AQI [0-500], AQHI [1-11+]), and risk level (moderate, high). Participants were told to imagine encountering the infographic in a short-term exposure scenario. They reported worry about wildfire smoke, intentions to take risk-mitigating actions (e.g., air purifier use), and support for various exposure reduction policies. Subsequently, participants were told to imagine encountering the same infographic daily during a school week in a long-term exposure scenario and again reported worry, action intentions, and policy support. Results. Parents\' responses significantly differentiated between risk levels that both pose a threat to children\'s health; worry and action intentions were much higher in the high-risk group than the moderate-risk group in both short-exposure (F = 748.68 p<.001; F = 411.59, p<.001) and long-exposure scenarios (F = 470.51, p<.001; F = 212.01, p<.001). However, in the short-exposure scenario, when shown the AQHI [1-11+] with either the line or gauge visuals, parents\' action intentions were more similar between moderate- and high-risk level groups (3-way interaction, F = 6.03, p = .002). Conclusions. These results suggest some index formats such as the AQHI-rather than the AQI-may better attune parents to moderate levels of wildfire smoke being dangerous to children\'s health. Our research offers insights for agencies and officials seeking to improve current public education efforts during wildfire smoke events and speaks to the critical need to educate parents and help them act short-term and long-term to protect children\'s health.

OBJECTIVE: We tested abortion messaging to develop evidence-based communication recommendations for doctors who provide abortion care.
METHODS: We conducted an online survey in a nationally representative sample of 1215 people, using National Opinion Research Center\'s Amerispeak Panel. We surveyed participants before and after viewing two brief videos featuring doctors who provide abortion care speaking about their work. Doctors\' comments were grounded in strategic communications and applied psychology research, and emphasized caregiving roles, avoided political-sounding punditry, and acknowledged abortion\'s complexities. We assessed participants\' characterizations of doctors, and how these characterizations impact support for abortion restrictions and views on abortion legality. We analyzed pre-post data using descriptive statistics, t tests, and multivariable regression.
RESULTS: Postmessaging more participants endorsed positive descriptors of doctors who provide abortion care (p < 0.001, t = 8.99); fewer endorsed negative descriptors (p < 0.001, t = 10.32). Increased postmessaging endorsement of positive descriptors predicted declines in support for abortion restrictions (adjusted odds ratio = 1.69, p < 0.01); decreased endorsement of negative descriptors did not. After messaging, 37% of respondents said their views of doctors who provide abortion care made them less likely to support abortion restrictions, compared to 14% before (p < 0.001, t = -6.9). After messaging, there was more overall support for legal abortion and less for abortion being mostly illegal (46% to 48% and 24% to 22%, p < 0.001; t = -4.11).
CONCLUSIONS: When doctors who provide abortion care use messaging recommendations that include speaking about abortion\'s complexities and avoiding political-sounding punditry, they generate more support for legal abortion and less for restrictions.
CONCLUSIONS: The voices of doctors who provide abortion care shape public opinion. When doctors speak from caregiving perspectives, avoid punditry, and acknowledge abortion\'s complexities, they generate more support for legal abortion and less for restrictions. However, audiences may not be aware a priori that ideas of doctors shape their views.

OBJECTIVE: To identify perceived differences in the key domains of patient-provider communications between sexual and gender minority (SGM) and non-SGM patients.
METHODS: We reviewed data from the Health Information National Trends Survey (HINTS) to assess patient perspectives on different domains of patient-provider communications in the ideological framework by Epstein and Street (2007) [1]. Between SGM-identified (N = 491) and cisgender, heterosexual respondents (N = 7426), we assessed the proportions of responses to survey questions about the six domains of patient-provider communications and calculated odds ratios (OR) with 95 % confidence intervals (CI) (N = 7917).
RESULTS: Overall, compared to cisgender, heterosexual individuals, fewer SGM individuals reported always experiencing optimal patient-provider communications across all domains, most notably in areas of emotional support (OR=0.70, 95 % CI: (0.51, 0.97)), patient self-management (OR=0.73, 95 % CI: (0.54, 0.99)), and managing uncertainty (OR=0.68, 95 % CI: (0.49, 0.94)).
CONCLUSIONS: Further research on detailed SGM patient perceptions of their relationships with healthcare providers is needed to understand why such differences in communication exist and provide practical recommendations to improve care delivery.
CONCLUSIONS: SGM patients perceive their current provider communications to be suboptimal, so we must improve emotional management training in future provider-based SGM competency trainings and encourage patient self-management during individual provider encounters.