Prevalence estimates of sibling bullying indicate it occurs more frequently and with more negative consequences than peer bullying, yet many countries do not track or investigate the phenomenon. University students from Argentina, Estonia, and the United States were surveyed to investigate their retrospective experiences involving sibling bullying, how often it occurred, the roles held, and the forms communicated. In the aggregated data, roughly 50 % of the sampled emerging adults (N = 3477) reported experience with sibling bullying, with the dual role of bully-victim being the most frequently reported role held by males and females, with the second role being bully for males and victim for females. Verbal forms of bullying were most frequently reported by males and females, with physical, relational, and technological forms occurring less frequently, indicating the importance of studying the messages conveyed during bullying incidents. Variations between biological sex, bullying role and form were detected that indicate siblings experience bullying in ways that are unique from peer bullying. Country comparisons revealed bullying frequencies varied among males and females, suggesting sibling bullying experiences are likely to be culturally influenced. More research is warranted to examine the negative impact bullying has on sibling psycho-social development and the potential transfer to non-familial relationships and contexts. Discussion of these findings and the implications for academics and practitioners alike is provided.

BACKGROUND: Asia consists of diverse nations with extremely variable health care systems. Integrated real-world data (RWD) research warehouses provide vast interconnected data sets that uphold statistical rigor. Yet, their intricate details remain underexplored, restricting their broader applications.
OBJECTIVE: Building on our previous research that analyzed integrated RWD warehouses in India, Thailand, and Taiwan, this study extends the research to 7 distinct health care systems: Hong Kong, Indonesia, Malaysia, Pakistan, the Philippines, Singapore, and Vietnam. We aimed to map the evolving landscape of RWD, preferences for methodologies, and database use and archetype the health systems based on existing intrinsic capability for RWD generation.
METHODS: A systematic scoping review methodology was used, centering on contemporary English literature on PubMed (search date: May 9, 2023). Rigorous screening as defined by eligibility criteria identified RWD studies from multiple health care facilities in at least 1 of the 7 target Asian nations. Point estimates and their associated errors were determined for the data collected from eligible studies.
RESULTS: Of the 1483 real-world evidence citations identified on May 9, 2023, a total of 369 (24.9%) fulfilled the requirements for data extraction and subsequent analysis. Singapore, Hong Kong, and Malaysia contributed to ≥100 publications, with each country marked by a higher proportion of single-country studies at 51% (80/157), 66.2% (86/130), and 50% (50/100), respectively, and were classified as solo scholars. Indonesia, Pakistan, Vietnam, and the Philippines had fewer publications and a higher proportion of cross-country collaboration studies (CCCSs) at 79% (26/33), 58% (18/31), 74% (20/27), and 86% (19/22), respectively, and were classified as global collaborators. Collaboration with countries outside the 7 target nations appeared in 84.2% to 97.7% of the CCCSs of each nation. Among target nations, Singapore and Malaysia emerged as preferred research partners for other nations. From 2018 to 2023, most nations showed an increasing trend in study numbers, with Vietnam (24.5%) and Pakistan (21.2%) leading the growth; the only exception was the Philippines, which declined by -14.5%. Clinical registry databases were predominant across all CCCSs from every target nation. For single-country studies, Indonesia, Malaysia, and the Philippines favored clinical registries; Singapore had a balanced use of clinical registries and electronic medical or health records, whereas Hong Kong, Pakistan, and Vietnam leaned toward electronic medical or health records. Overall, 89.9% (310/345) of the studies took >2 years from completion to publication.
CONCLUSIONS: The observed variations in contemporary RWD publications across the 7 nations in Asia exemplify distinct research landscapes across nations that are partially explained by their diverse economic, clinical, and research settings. Nevertheless, recognizing these variations is pivotal for fostering tailored, synergistic strategies that amplify RWD\'s potential in guiding future health care research and policy decisions.
UNASSIGNED: RR2-10.2196/43741.

We examined the implications of exposure to misinformation about COVID-19 in the United States, South Korea, and Singapore in the early stages of the global pandemic. The online survey results showed that misinformation exposure reduced information insufficiency, which subsequently led to greater information avoidance and heuristic processing, as well as less systematic processing of COVID-19 information. Indirect effects differ by country and were stronger in the U.S. sample than in the Singapore sample. This study highlights negative consequences of misinformation during a global pandemic and addresses possible cultural and situational differences in how people interpret and respond to misinformation.

Background: Although trauma exposure is universally prevalent, the ways in which individuals respond to potentially traumatic events vary. Between-country differences have been identified as affecting the development and manifestation of transdiagnostic psychological symptoms, but it remains unclear how stress and trauma-related transdiagnostic symptoms and risk patterns differ based on geographic region.Objective: To explore whether there are distinct classes of stress and trauma-related transdiagnostic symptoms and to determine predictors of class membership in a global sample.Method: Participants (N = 8675) from 115 different countries were recruited online between 2020-2022 and completed the Global Psychotrauma Screen, which assesses stress and trauma exposure, related symptoms, and risk factors. A latent class analysis (LCA) was used to identify classes of stress and trauma-related symptoms per world region (African States, Asia-Pacific States, Eastern European States, Latin American and Caribbean States, Western European and Other States, and North America) and the total sample. Likelihood of class membership was assessed based on demographics, characteristics of the potentially traumatic event, and potential risk factors across the world regions.Results: Similar class compositions were observed across regions. A joint latent class analysis identified three classes that differed by symptom severity (i.e. high, moderate, low). Multinomial logistic regression analyses revealed several factors that conferred greater risk for experiencing higher levels of symptoms, including geographic region, gender, and lack of social support, among others.Conclusions: Stress and trauma-related symptoms seem to be similarly transdiagnostic across the world, supporting the value of a transdiagnostic assessment.
A latent class analysis of transdiagnostic stress and trauma-related symptoms in a global sample showed high, medium, and low symptom classes.Class compositions were similar across global geographic regions.Several factors were associated with high symptom class membership globally, including gender, geographic region, and lack of social support.

UNASSIGNED: Verbal and written medicine information are available to the public but the quality, ease of access, ease of understanding and use of these resources varies greatly between countries. Timely access to quality medicine information is essential to support patient safety.
UNASSIGNED: This international cross-sectional survey, conducted in low-to high-income countries, aimed to compare experiences of and preferences for medicine information sources among respondents with recent medicine use.
UNASSIGNED: The survey was originally developed in England (Kent), then adapted and translated for use in southern Thailand (Songkhla), Malaysia (Klang Valley), and central Uganda (Kampala). Data were analysed using simple descriptive statistics and Chi-squared tests.
UNASSIGNED: A total 1588 respondents were involved in the study. Community pharmacies were the primary source of medicines in all four countries (40.7 to 65.3%). Most respondents (1460; 92%) had received at least one form of information with their medicine, but provision of written medicine information (WMI) varied between countries. A manufacturer\'s leaflet was the most frequent information source for patients in England, while verbal information was common in Thailand, Malaysia and Uganda. There was commonality across countries in the desire for verbal information with or without WMI (1330; 84.8%); aspects of medicine information wanted most frequently were instructions on medicine use (98.3%), indication (98.2%), name (94.4%) and possible side effects (94.3%); and the importance of providing leaflets with all medicines (87.5%). Fewer than 10% in Uganda would use internet based WMI, compared to between 20% and 55% elsewhere.
UNASSIGNED: Preferences for medicine information are similar across countries: verbal information is seen as most desirable, and the most wanted aspects of information are common internationally. Accessibility and understandability are key influences on preferred information sources. In-country regulations and practices should ensure that all medicine users can access the information necessary to maximise safe medicine use.

UNASSIGNED: Older adults in the United States (US) have worse health and wider socioeconomic inequalities in health compared to Britain. Less is known about how health in the two countries compares in midlife, a time of emerging health decline, including inequalities in health.
UNASSIGNED: We compare measures of smoking status, alcohol consumption, obesity, self-rated health, cholesterol, blood pressure, and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N= 9,665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the US (N=12,297), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position.
UNASSIGNED: US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health, heavy drinking, and smoking was worse in Britain. We found smaller socioeconomic inequalities in midlife health in Britain compared to the US. For some outcomes (e.g., smoking), the most socioeconomically advantaged group in the US was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain.
UNASSIGNED: US adults have worse cardiometabolic health than British counterparts, even in early midlife. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems, or other environmental risk factors.
UNASSIGNED: ESRC, UKRI, MRC, NIH, European Research Council, Leverhulme Trust.

Discrimination, which arose during the coronavirus disease 2019 outbreak, is a global public health issue. This study aimed to provide fundamental knowledge in proposing control measures to mitigate discrimination. We focused on two psychological variables: belief in just deserts (BJD, i.e., the belief that the infected individual deserves to be infected), a psychological factor that potentially promotes discrimination and prejudice, and human rights restrictions (HRR; i.e., the degree of individuals\' agreement with government restrictions on citizens\' behavior during emergencies). Differences in these items, as well as their annual trends from 2020 to 2022, were examined in Japan, the United States (US), the United Kingdom (UK), Italy, and China. In addition, the associations between BJD and HRR by country and year and the direction of the associations between them in Japan and Italy were analyzed. Online surveys were conducted annually, with 392-518 participants per country and year. The BJD was higher in Japan and lower in the UK. BJD increased significantly from 2020 to 2021 in all countries, except in China. Meanwhile, HRR was higher in China and lower in Japan. The HRR decreased from 2020 to 2021 in Japan and decreased from 2020 to 2022 in the US, the UK, and Italy. There were significant positive associations between BJD and HRR in Japan and Italy. Cross-lagged panel models revealed positive bidirectional associations between BJD and HRR in Japan and Italy, respectively, indicating that the HRR declined among those with weak BJD and that the BJD increased among those with high HRR. In Japan and Italy, the dissemination of public messages targeting those with a high HRR in the early stages of an infectious disease outbreak could potentially mitigate the adverse impact of the BJD, eventually reducing discrimination, especially when the infection is not attributed to the fault of the infected individuals.

BACKGROUND: A key task for countries around the world facing the COVID-19 pandemic was to achieve high vaccination coverage of the population. To overcome \"vaccination inertia,\" governments adopted a variety of policy instruments. These instruments can be placed along a \"ladder of intrusiveness\" based on their degree of constraint of individual freedoms. The aim of this study is to investigate how the governments of three European countries moved along the ladder of intrusiveness and how the choice of policy instruments was influenced by contextual factors.
METHODS: The study draws on secondary data sources, including academic and gray literature, policy documents, and opinion polls, over an observation period from December 2020 to summer 2022. The study employs inductive logic to analyze data and identify the factors explaining similarities and differences across England, Germany, and Italy.
RESULTS: The study identifies similarities and differences in how the three countries advanced along the ladder of intrusiveness. Contextual factors such as policy legacy, social acceptability, and ideological orientation contribute to explain the observations.
CONCLUSIONS: Country-specific contextual factors play an important role in understanding the choice of policy instruments adopted by the three countries. Policy makers should carefully consider these factors when planning immunization strategies.

UNASSIGNED: Psychological wellbeing is an essential indicator of early care and education (ECE) teachers\' positive practices across countries. Moreover, previous studies suggest that teachers\' wellbeing and practice may be indirectly associated via emotion regulation. However, teachers in various contexts demonstrate different patterns of psychological wellbeing, emotion regulation, and emotional responsiveness, and the ways these factors associate with each other also vary.
UNASSIGNED: The current study investigates whether the indirect associations between ECE teachers\' psychological wellbeing (i.e., emotional exhaustion, job-related competence, and personal stress) and their responsiveness toward children\'s emotions via emotion regulation (i.e., reappraisal and suppression) appear differently in two national contexts, the United States (US) and South Korea (SK). Multi-group path analysis was conducted to compare the mediation models between US teachers (n = 1,129) and SK teachers (n = 322).
UNASSIGNED: We found significant indirect associations among wellbeing, emotion regulation, and responsiveness in both countries. However, significant associations were more prominent among SK teachers, and the patterns of indirect associations had substantial cross-country differences. Furthermore, the roles of reappraisal and suppression emotion regulation found to be different among ECE teachers in SK and US.
UNASSIGNED: The cross-country variations in the associations among wellbeing, emotion regulation, and responsiveness suggest that differential policy efforts and intervention strategies are needed for ECE teachers in the US and SK.

Air pollution is an important anthropogenic hazard due to its effect on human health and the environment. Understanding how the population perceives the risk associated with air pollution is a crucial aspect to inform future policies and communication strategies. The aim of this study is to examine the association between air pollution concentrations and public risk perception of air pollution, also exploring socio-demographic patterns in the general population of Italy and Sweden. To this end, we derived 3-year PM10 average concentrations from ground monitoring stations and integrated with a population-based survey carried out in August 2021 in both countries. Relative perceived likelihood and impact on the individual were considered as domains of risk perception. In addition this, information on direct experience and socio-demographic factors were included as possible determinants of risk perception. Linear regression models were performed to examine the association of PM10 average concentrations at regional level and individual level factors with risk perception domains. In both countries, respondents who live in the most densely populated regions report a higher perceived likelihood of air pollution. Direct experience is the main driver of risk perception in both countries. Being male and smokers in Italy, older age and having left/centre-left political orientation in both countries are associated with a higher perceived likelihood and impact of air pollution. These findings will inform future health and environmental studies regarding the public risk perception of air pollution highlighting individual\'s awareness and the socio-demographic patterns.