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Purpose

A status quo situation has occurred among actors, policymakers, producers, retailers and consumers where no one takes the lead on the antimicrobial resistance (AMR) fight. Common theoretical approaches to behaviour including awareness, understanding and use are insufficient in the AMR context. In this paper, the authors suggest the application of accountability literature to fully understand the status quo situation with AMR.

Design/methodology/approach

AMR in food has become an alarming problem in the past decade and is an increasing threat to global health. The knowledge about AMR often comes from a medical context where the perspective is completely different. Therefore, it is difficult for consumers to apply this to a grocery store context purchasing food.

Findings

This paper uses the concept of accountability and the significant other within the accountability field and discusses how this could help overcome the non-action state of mind of consumers and other actors.

Practical implications

Enhanced accountability could significantly improve One-Health solutions for combating AMR. By fostering a culture of shared responsibility and transparent communication among stakeholders, the silo effect may be mitigated, promoting collaborative efforts. Accountability mechanisms should ensure that roles and responsibilities are clearly defined and communicated across sectors, such as health care, agriculture and policymaking. Educational initiatives can increase AMR awareness, enabling stakeholders to make informed decisions. Integrating perspectives from various domains will facilitate the development of holistic strategies, thus improving the overall effectiveness of efforts to address AMR and ensuring a sustainable approach to public health.

Social implications

Enhanced accountability in AMR management can lead to significant social benefits. By promoting transparency and collective responsibility, communities can foster greater trust and cooperation among various stakeholders, including health-care providers, policymakers and consumers. Increased awareness of AMR can empower individuals to make informed decisions, thereby promoting public health and safety. Socially, this could lead to more sustainable practices in antibiotic use and a reduction in the spread of resistant infections. In addition, fostering a culture of accountability ensures that efforts to combat AMR are more inclusive, equitable and effective, ultimately benefiting society as a whole.

Originality/value

The proposal to create strategies according to a basis of accountability can be applied at all levels of the AMR problem and for all actors. This therefore provides important knowledge about how AMR can be approached in a more long-term way where initiatives to prevent the spread of AMR do not take place in parallel or become difficult to access.

Background

Antimicrobial resistance (AMR) is a global health threat, disproportionately affecting Africa South of the Sahara, where young people have been identified as key stakeholders in AMR prevention and awareness; however, effective engagement beyond symbolic participation remains challenging, limiting the impact of youth-led initiatives in addressing AMR in the region.ObjectivesTo examine how youth-led actors in Africa South of the Sahara engage in AMR awareness, education and advocacy; the challenges they encounter; and the institutional conditions needed to move beyond symbolic participation.

Methods

A qualitative study design was employed, involving semi-structured interviews with young professionals engaged in AMR efforts across Africa South of the Sahara. Participants were recruited through convenience and snowball sampling. Online interviews were conducted between March and September 2023. Data were analysed using reflexive thematic analysis.

Results

Seventeen participants (age range 22–34) from 15 countries shared insights on AMR awareness, community engagement, and barriers in their work. Major findings included the perception of AMR as an invisible threat, generational and structural challenges in community outreach, and the need for financial and institutional support. Despite these obstacles, participants demonstrated innovative approaches, including adapting AMR outreach methods to specific social groups and a strong commitment to AMR education and policy advocacy.

Conclusions

Findings underscore the essential role of youth in AMR efforts in Africa South of the Sahara and the need for greater institutional support and capacity-building. Enhancing youth involvement beyond symbolic roles is crucial to advancing AMR initiatives, particularly through tailored communication strategies and collaborative policymaking.

Background: Antimicrobial resistance (AMR) is a major global health issue heavily influenced by human behavior. Effective communication and awareness-raising are crucial in curbing AMR, with social network sites (SNSs) significantly shaping health behaviors. Despite their potential, current analyses of AMR on SNSs have focused mainly on top-down communication initiatives.

Objective: This study aims to examine AMR on Instagram (Meta Platforms), identifying key actors, content themes, and the nature of the communication to understand how AMR is portrayed and perceived.

Methods: Based on the sender-message-channel-receiver model, this study used content analysis to review publicly accessible posts on Instagram. The data refer to 24 months, focusing on the hashtag “#antibioticresistance.” After cleaning the data, 610 posts (10% of the total 6105) were analyzed.

Results: Content creators were predominantly information drivers or professionals in science and health. Posts frequently featured text-dominated visuals or images of bacteria and laboratory tests. However, the AMR posts were found to be siloed, with limited engagement beyond specific interest groups. The study highlighted the neutrality and accuracy of the content but noted the challenge of reaching a broader audience.

Conclusions: While Instagram serves as a platform for accurate and informative AMR communication, the post of it remains confined to niche groups, limiting its broader impact. To enhance engagement, AMR discussions should be integrated into more general interest content, use visually compelling formats, and encourage institutional participation and interactive user engagement.

Background

Precision medicine and artificial intelligence (AI) are increasingly integrated into colorectal cancer (CRC) care, offering personalised treatment strategies and data-driven decision support. While these technologies promise improved outcomes, they also raise challenges concerning clinical decision-making, the doctor-patient relationship, and ethics. This study explores physicians’ perspectives on integrating precision medicine and AI in CRC care.

Methods

A qualitative study was conducted using semi-structured interviews with ten CRC physicians from six European countries. Participants were recruited through purposive and snowball sampling. Interviews were analysed using thematic analysis.

Results

Three key themes emerged from the analysis. First, physicians described precision medicine as a logical extension of existing tailoring practices, offering new opportunities while introducing complexity. Many expressed concerns about the blurred boundary between experimental and standard treatments, noting potential implications for equity and ethical decision-making. Second, AI was viewed as a future partner in care, with the potential to enhance efficiency and assist in synthesising complex data. However, participants voiced concerns about trust, clinical responsibility, and the lack of regulatory clarity, particularly due to AI’s “black box” nature. Finally, doctors reported challenges in communicating both precision medicine and AI-based recommendations to patients. They emphasised the importance of adapting communication strategies to individual patients and highlighted the need for structured approaches to ensure patient understanding and prevent miscommunication, especially when dealing with uncertain outcomes or emerging technologies.

Conclusions

The findings highlight both the opportunities and challenges of integrating precision medicine and AI in CRC care. Addressing concerns related to communication, ethics, and regulation requires clear guidance and improved support for clinicians. Precision medicine and AI enhance CRC care but demand robust communication, regulation, and ethical safeguards to ensure transparency, trust, and physician autonomy.

Excessive or improper lighting can affect human health and well-being. However,lighting is seldom considered within frameworks analyzing the interrelationsbetween the urban environment and the health and well-being of communities.Lighting-related concerns are often conceptualized and discussed in environmentalterms through the light pollution frame. Positively, this frame emphasizes humanresponsibility for the environmental detriment and animal harm caused by lightingand promotes the discussion of aesthetics and existential dimensions connected tonocturnal darkness. Negatively, it is flawed with epistemological shortcomings andnormativity; it is prone to the risk of ideological and political polarisation and tendsto underemphasize the health implications of excessive and improper lighting. Thisstudy addresses this gap by arguing for the advantages of a public health framing oflighting-related concerns. In particular, it highlights how this perspective can bettercapture the health implications of lighting and inform urban policies. Placing lightconcerns within a public health framework entails presenting a relatively knownlandscape that resonates with the value systems of virtually everyone. This approachsupports the creation of a common, multi-stakeholder space in discussions onlighting policies, balancing considerations of urban security, safety, inclusivity, andaccessibility as different dimensions of diverse populations’ health and well-being.By emphasizing the public health dimension, this study contributes to the discourseon lighting as a determinant of health and well-being. Such a holistic frameworkaligns with the United Nations Sustainable Development Goal 3 on good health andwell-being by fostering conditions that advance health for all, addressing lighting notmerely as an environmental issue but as a critical public health priority.

Background

In this study, we examined the ethical implications of Egypt’s new clinical trial law, employing the ethical framework proposed by Emanuel et al. and comparing it to various national and supranational laws. This analysis is crucial as Egypt, considered a high-growth pharmaceutical market, has become an attractive location for clinical trials, offering insights into the ethical implementation of bioethical regulations in a large population country with a robust healthcare infrastructure and predominantly treatment-naïve patients.

Methods

We conducted a comparative analysis of Egyptian law with regulations from Sweden and France, including the EU Clinical Trials Regulation, considering ethical human subject research criteria, and used a directed approach to qualitative content analysis to examine the laws and regulations. This study involved extensive peer scrutiny, frequent debriefing sessions, and collaboration with legal experts with relevant international legal expertise to ensure rigorous analysis and interpretation of the laws.

Results

On the rating of the seven different principles (social and scientific values, scientific validity, fair selection of participants, risk-benefit ratio, independent review, informed consent and respect for participants) Egypt, France, and EU regulations had comparable scores. Specific principles (Social Value, Scientific Value, and Fair selection of participants) were challenging to directly identify due to certain regulations embodying 'implicit' principles more than explicitly stated ones.

Conclusion

The analysis underscores Egypt's alignment with internationally recognized ethical principles, as outlined by Emanuel et al., through its comparison with French, Swedish, and EU regulations, emphasizing the critical need for Egypt to continuously refine its ethical regulations to safeguard participant protection and research integrity. Key issues identified include the necessity to clarify and standardize the concept of social value in research, alongside concerns regarding the expertise and impartiality of ethical review boards, pointing towards a broader agenda for enhancing research ethics in Egypt and beyond.

BACKGROUND: The implementation of precision medicine is likely to have a huge impact on clinical cancer care, while the doctor-patient relationship is a crucial aspect of cancer care that needs to be preserved. This systematic review aimed to map out perceptions and concerns regarding how the implementation of precision medicine will impact the doctor-patient relationship in cancer care so that threats against the doctor-patient relationship can be addressed.

METHODS: Electronic databases (Pubmed, Scopus, Web of Science, Social Science Premium Collection) were searched for articles published from January 2010 to December 2021, including qualitative, quantitative, and theoretical methods. Two reviewers completed title and abstract screening, full-text screening, and data extraction. Findings were summarized and explained using narrative synthesis.

RESULTS: Four themes were generated from the included articles (n = 35). Providing information addresses issues of information transmission and needs, and of complex concepts such as genetics and uncertainty. Making decisions in a trustful relationship addresses opacity issues, the role of trust, and and physicians' attitude towards the role of precision medicine tools in decision-making. Managing negative reactions of non-eligible patients addresses patients' unmet expectations of precision medicine. Conflicting roles in the blurry line between clinic and research addresses issues stemming from physicians' double role as doctors and researchers.

CONCLUSIONS: Many findings have previously been addressed in doctor-patient communication and clinical genetics. However, precision medicine adds complexity to these fields and further emphasizes the importance of clear communication on specific themes like the distinction between genomic and gene expression and patients' expectations about access, eligibility, effectiveness, and side effects of targeted therapies.

Introduction

The health of a community depends on the health of its individuals; therefore, individual health behaviour can implicitly affect the health of the entire community. This is particularly evident in the case of infectious diseases. Because the level of prosociality in a community might determine the effectiveness of health programmes, prosocial behaviour may be a crucial disease-control resource. This study aimed to extend the literature on prosociality and investigate the role of altruism in antibiotic decision making.

Methods

A discrete choice experiment was conducted to assess the influence of altruism on the general public’s preferences regarding antibiotic treatment options. The survey was completed by 378 Swedes. Latent class analysis models were used to estimate antibiotic treatment characteristics and preference heterogeneity. A three-class model resulted in the best model fit, and altruism significantly impacted preference heterogeneity.

Results

Our findings suggest that people with higher altruism levels had more pronounced preferences for treatment options with lower contributions to antibiotic resistance and a lower likelihood of treatment failure. Furthermore, altruism was statistically significantly associated with sex, education, and health literacy.

Conclusions

Antibiotic awareness, trust in healthcare systems, and non-discriminatory priority setting appear to be structural elements conducive to judicious and prosocial antibiotic behaviour. This study suggests that prosocial messages could help to decrease the demand for antibiotic treatments.