Health最新文献

{"title":"The role of primary care providers in supporting more sustainable lifestyles: Experiences and expectations of vegan parents.","authors":"Kadri Aavik, Marta Velgan","doi":"10.1177/13634593251387566","DOIUrl":"10.1177/13634593251387566","url":null,"abstract":"<p><p>There is growing evidence of the harms caused by the mass production and consumption of animal products and the benefits of plant-based diets - ethically, environmentally, and for human health. While human and planetary health are increasingly viewed as interconnected, the healthcare system remains largely anthropocentric and disengaged from sustainability goals. Given its influential role, the healthcare system can either support or hinder the acceptance of plant-based diets as part of addressing ecological and public health crises. This article explores the experiences of vegan parents in their interactions with primary care providers (PCPs) based on qualitative interviews with 25 vegan parents. Our findings indicate that while some parents reported neutral or supportive experiences, negative and unsupportive interactions with PCPs were more typical. Fear of stigma led some to avoid disclosing their family's veganism altogether. These findings highlight important concerns about the quality and equity of healthcare, patient autonomy, and the healthcare system's potential role in supporting and promoting plant-based diets and sustainable food practices more broadly. As powerful institutional authorities, the healthcare system and its key actors, such as PCPs, can and should support moving towards more sustainable and ethical food and health futures.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"538-557"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making 'safer injecting' matter for people who inject image and performance enhancing drugs.","authors":"Timothy Piatkowski, Emma Kill, Sonya Weith, Steph Reeve, Luke Cox, Ross Coomber, Cheneal Puljevic, Thomas O'Connor, Jason Ferris","doi":"10.1177/13634593251388294","DOIUrl":"10.1177/13634593251388294","url":null,"abstract":"<p><p>Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"516-537"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspended responsibility: The trouble with integrating researchers into shared-responsibility models for machine learning-supported decisions.","authors":"Theresa Willem, Alena Buyx, Ruth Müller","doi":"10.1177/13634593251377105","DOIUrl":"10.1177/13634593251377105","url":null,"abstract":"<p><p>With the rise of machine learning-based decision support systems, the responsibility for potential errors is regularly questioned. Scholarly work regarding this issue has criticized a \"responsibility gap,\" that is, unattributable responsibility for the effects of machine learning-supported decisions. One proposition to close the responsibility gap is to include scientists, who lay the basis for the functioning of machine learning models in distributed responsibility models, assigning them a share of responsibility for potential errors. However, to date, responsibility models that include scientists have not gained a foothold in regulation. To provide an empirical basis for the discussion around novel responsibility models, this study provides a social scientific analysis of an interdisciplinary machine-learning consortium that works on machine learning-based decision support systems for healthcare - an area where errors have particularly fundamental consequences for individuals. We investigate researchers' speculations about their responsibility for the downstream effects of their ML research results after translation to clinical practice. We find that researchers point to tensions in the scientific sector as well as to agential, local, and temporal shifts of their research outputs during translation to clinical practice as a major source of what we call \"suspension of responsibility.\" Our insights contribute to debates about novel responsibility models that are fair to patients, doctors, and scientists and can inform similar debates beyond healthcare.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"476-496"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Equal footing, equal voice': Recognition of self and other in Shared Reading for people with lived experience of mental distress.","authors":"Sara James, Juliane Römhild, Melinda Turner, Anne-Maree Sawyer, Chris Maylea","doi":"10.1177/13634593251381809","DOIUrl":"10.1177/13634593251381809","url":null,"abstract":"<p><p>Over the last two decades evidence has been mounting for the effectiveness of arts interventions as public health measures. With mental health services under-resourced and overwhelmed by need, support is growing for a diversity of non-clinical approaches to support individuals in community settings. In their declaration of the organisation's collective vision, the Victorian Mental Illness Awareness Council (VMIAC) emphasises the need for diverse forms of support beyond traditional biomedical services. This paper reports on findings from a pilot Shared Reading intervention, conducted in partnership with VMIAC in 2023, for people who have lived experience of mental distress in Victoria, Australia. Shared Reading is a form of interactive, creative bibliotherapy that combines the benefits of engaging with literature with those of taking part in a communal activity. In-depth interviews with participants revealed that multiple levels of recognition made this non-clinical activity therapeutic for participants. Utilising Honneth's theory of recognition, these findings expand conceptual understandings of the therapeutic effects of Shared Reading as a psychosocial intervention for people with experiences of mental distress.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"497-515"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging little balance: How white doulas with mainstream training understand and engage with anti-oppressive practice.","authors":"Nina Zettl-Lee, Jan Gelech, Jordan Wellsch","doi":"10.1177/13634593251389640","DOIUrl":"10.1177/13634593251389640","url":null,"abstract":"<p><p>Though the benefits of doula care in reducing birth inequities and mitigating obstetric violence are well established, little is known about how White doulas from mainstream training programs (most doulas in Canada) understand and implement anti-oppressive practice (AOP) in different sociocultural contexts. Guided by interpretative phenomenological analysis, we conducted life history and semi-structured interviews with five White doulas working in Western Canada. The doulas described varying levels of engagement, confidence, and effectiveness across three distinct levels of sociopolitical interaction: relationships with birthing families (micro level), supporting clients within biomedical institutions (meso level), and advocating for enhanced maternal care within the broader structural landscape (macro level). Differences in AOP across these three sociopolitical contexts and between doulas were connected to various factors, including mainstream doula training, healthcare politics, professional structures, local histories, and individual preferences and circumstances. Implications for mainstream doula education, interprofessional collaboration, and hospital birthing practices are discussed.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"578-600"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145632478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals with chronic pain using opioids: Challenging treatment choices, shared decision-makers, or risk-makers? A critical discourse analysis of Belgian policy documents.","authors":"Lena De Bonte, Justine Vanbavinckhove, Liesbet Goubert, Fleur Baert, Peter Pype, Sam Schelfout, Sónia Bernardes, Bart Morlion, Melissa Ceuterick","doi":"10.1177/13634593251377102","DOIUrl":"10.1177/13634593251377102","url":null,"abstract":"<p><p>Chronic pain, defined as pain persisting for more than three months, affects one in four Belgian adults. Treating chronic pain comprises challenges for patients and clinicians as the term encompasses diverse conditions such as fibromyalgia, migraine, and long-term pain without a known biomedical cause. Additionally, growing evidence highlights the limited efficacy of opioids in managing chronic non-cancer pain. This has prompted critical policy changes in pain management, including shifts away from opioid use. This study explores how Belgian policy documents depict patients, healthcare providers, and therapeutic relationships within the context of opioid use in the treatment of chronic non-cancer pain. A critical discourse analysis of 32 Belgian Dutch-language policy documents was performed using Fairclough's framework. This approach examines how language in texts reflects and shapes social power dynamics and ideologies, and allows us to gain insight into the policy discourses surrounding opioid use for chronic pain. Based on our analysis, we suggest that written policy texts about the use of opioids to manage chronic pain are constructed through the deployment of three discourses: a medical authority discourse, a patient empowerment discourse, and a high-risk medication discourse. While all discourses are rooted in the biopsychosocial pain model, they prioritize different aspects of chronic pain management. Whereas the medical authority discourse emphasizes the decision-making role of physicians, the patient empowerment discourse shifts attention to patients' experiences and preferences. Lastly, the high-risk medication discourse underscores opioids' addictive potential. These discourses reflect varying perspectives on chronic pain management and have different implications for clinical practice. The findings offer valuable insights into how Belgian policy documents discursively construct or challenge therapeutic relationships and stigma.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"455-475"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prescriptive whiteness of culinary medicine: Reinforcing medical authority through epistemic erasure.","authors":"Kate G Burt","doi":"10.1177/13634593261457575","DOIUrl":"https://doi.org/10.1177/13634593261457575","url":null,"abstract":"<p><p>Culinary Medicine (CM) is positioned by physician leaders as an innovative, interdisciplinary model addressing the long-neglected role of food and nutrition in clinical healthcare. Yet its institutional rise recenters medical authority and erases the feminized and racialized expertise that had led dietary care for over 100 years. This article critiques CM as a case study in epistemic erasure and medical dominance, examining how professional and institutional hierarchies shape which knowledge is recognized as legitimate. Drawing on frameworks of racial capitalism, epistemic injustice, and feminist standpoint theory, this article finds that CM devalues and marginalizes dietetics and ignores community-based models of nutritionally tailored meals, despite decades of success. By framing CM as novel, the origins, knowledge, and expertise informing culinary-focused dietary care is recoded through male- and physician-dominated institutions. CM's implementation often reproduces structural biases, including racialized gatekeeping through biometric eligibility and the dismissal of cultural foodways. While CM holds potential for addressing diet-related health disparities, it must confront the exclusionary logics it reproduces to truly achieve health equity. CM must center the expertise of those historically excluded, particularly women, communities of color, and community-based practitioners, to build equitable, interprofessional models that prioritize professional humility and structural transformation over institutional prestige to improve population health.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261457575"},"PeriodicalIF":2.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different gazes and hands: Visual representations of causes and solutions of adolescent depression on Chinese state media social platforms.","authors":"Xiang Huang, Fei Yang","doi":"10.1177/13634593261458884","DOIUrl":"https://doi.org/10.1177/13634593261458884","url":null,"abstract":"<p><p>This paper conducts a multimodal critical discourse analysis of 92 accompanying images in 22 articles related to adolescent depression published on the WeChat official accounts of major Chinese state-aligned media outlets, including <i>People's Daily</i>, <i>CCTV.com</i>, <i>China News Service</i>, and <i>Health News</i>. We pay special attention to analyze the multimodal discursive strategies employed to represent the causes and solutions of adolescent depression, as well as the implicit health ideologies embedded within these representations. Findings indicate that different gazes and hands are discursively represented as causes and solutions for adolescent depression. Specifically, a blaming gaze and judgmental hands visually construct the perceived origins of depression, while a mothering gaze and caring hands are deployed to depict pathways to recovery. In particular, the state media predominantly attribute the causes of depression to familial and socio-cultural factors-such as academic pressure and \"face\" culture-through discursive strategies including cool color palettes, spatial marginalization of adolescents, and metaphorical constructs like dominant parental figures, surveilling eyes, and encircling social judgments. In contrast, solutions are frequently visualized through warm tones, intimate compositions, and metaphors such as \"healing hugs from mothers,\" emphasizing familial emotional support while underrepresenting professional medical intervention. We argue that these discourses may reinforce familial-centric ideologies and conventional gender norms of mothers. Implications for more sensitive and constructive media discourses on adolescent depression in the Chinese context are discussed.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261458884"},"PeriodicalIF":2.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward an inclusive (crip)epistemology: Exploring the experiences of researchers with lived experience of disability in health research.","authors":"Gabrielle Leblanc-Huard, Catherine Isadora Côté, Audrey L'Éspérance, Joanie Thériault","doi":"10.1177/13634593261455074","DOIUrl":"https://doi.org/10.1177/13634593261455074","url":null,"abstract":"<p><p>This study explores the challenges, opportunities, and transformative potential of <i>researchers with</i> lived experience of disability in health research. While experiential knowledge is increasingly valued in this field, little attention has been paid to those who integrate it as principal investigators or scholars. Drawing on feminist standpoint theory and cripistemologies, this qualitative, participatory study engaged 25 researchers and allies in a design-thinking workshop and follow-up questionnaire to explore challenges, opportunities and solutions to further deploying lived experience of disability in health research. Analysis revealed that lived experience of disability is frequently devalued in academia, leaving many participants hesitant to disclose their identities, fearing of being dismissed as biased. At the same time, participants emphasized that this proximity to lived realities offers a unique advantage point for innovation: it enables the identification of gaps in literature, the formulation of new research questions, and the development of more inclusive methodologies. Also, proximity to the research topic creates a complex interplay of emotional burden and deep motivation. For many, engaging in this work was profoundly empowering, transforming personal experience into a source of knowledge production, community care, and social change. Findings underscore the need for cultural shifts to recognize lived experience of disability as having the potential to be scientifically rigorous, develop adapted methodological frameworks, and create inclusive academic environments. Integrating researchers with lived experience of disability represents not only a question of social justice, but also fosters opportunities to enrich scientific inquiry, challenge ableist productivity norms, and reimagine academic time through crip and slow scholarship.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261455074"},"PeriodicalIF":2.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148328791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disciplinary incorporation: Conditions enabling CAM's expansion and institutionalization in Europe and North America.","authors":"Ayşe Polat","doi":"10.1177/13634593261462957","DOIUrl":"https://doi.org/10.1177/13634593261462957","url":null,"abstract":"<p><p>Drawing on a critical interpretive synthesis of interdisciplinary scholarship, this article examines how complementary and alternative medicine (CAM) expanded and was institutionalized in Europe and North America from the 1970s onward amid broader transformations in medicine, society, and global governance. Contributing to Health's 30th anniversary special issue, this article identifies six intersecting conditions that collectively enabled CAM's growing visibility, recognition, and institutional incorporation: (1) intellectual, feminist, and epistemological critiques that destabilized biomedical authority and re-centered lived experience; (2) a broad social turn in public health that reframed disease causation through structural and behavioral determinants; (3) the rethinking of modernization and the emergence of medical pluralism, which challenged universalist accounts of modern medicine; (4) neoliberal restructuring and consumerism, which marketized care and expanded spaces for alternative therapeutics; (5) the scientification and professionalization of CAM through research, clinical trials, and training infrastructures; and (6) the growing influence of the World Health Organization, which promoted CAM's incorporation into health systems while standardizing practices and conditioning recognition on alignment with biomedical norms. Together, these shifts produced a heterogeneous field shaped by disciplinary incorporation: CAM practices were selectively legitimated insofar as they were rendered legible to biomedical, scientific, and regulatory frameworks, redrawing rather than simply widening the boundaries of medical legitimacy.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261462957"},"PeriodicalIF":2.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}