Global birth rates have been in steady decline and are projected to continue this trajectory in the coming decades. While existing literature provides important insights into the demographic and socioeconomic dimensions of this trend, there remains a critical gap in theoretical frameworks that engage with the broader implications of declining fertility. Current family planning programs often concentrate on pregnancy and postnatal care but tend to overlook the preconception period, particularly the need to equip women with the resources and autonomy required to make informed decisions about reproduction. Such omissions may have unintended consequences for women’s reproductive choices and broader fertility patterns. Meanwhile, rather than centering policy efforts solely on increasing birth rates, it is imperative to shift the focus toward improving the quality of births which emphasizes the long-term comprehensive benefits to individuals, families and society. This approach necessitates the provision of comprehensive support covering the entire reproductive cycle for women, supported by robust engagement from the global health community. This study seeks to explore the multifaceted factors that shape women’s capacity and inclination to bear children under conditions conducive to positive maternal and infant outcomes. It introduces a holistic framework designed to inform the policies and practices of health and governmental institutions, with the aim of promoting women’s overall well-being and effective and sustainable fertility outcomes.

Wars erode human dignity and global solidarity. Take famine—the worst form of death by starvation en masse—for example. Famine is particularly telling and chilling, as in the modern era, the (almost) famine in Gaza and Sudan is predominantly human-made. In addition to acute consequences like deaths, famine also causes long-term damage to people’s physical health and psychological well-being, from their susceptibility to cardiovascular diseases, trauma, and suicidality. A growing body of research also indicates that, largely due to high-definition and high-fidelity media coverage of wars with high definition and fidelity, people living in non-war zones can also face prolonged, yet often overlooked, mental health challenges. While the global health community shoulders the majority of the short- and long-term burden of care and cure in armed conflicts, we often have little power to hold warring parties responsible, not least because politicians’ careers are often term-based if not short-lived. Using the famine in Gaza and Sudan as examples, this paper sheds light on the imperative of holding warring parties accountable—in care and cash—for the damage they exert on lives and livelihoods worldwide. Wars might be inevitable (almost), famine, and disregard for human dignity and despair are not. Key messages What is already known on this topic? War drives famine, disease outbreaks, psychological trauma, and health system collapse, disproportionately affecting women and children. Starvation has been used as a weapon of war, despite its prohibition under international humanitarian law. What this study adds Emphasizes the need to quantify the full health and economic costs of war, particularly in settings such as Gaza and Sudan experiencing famine and health system collapse. Proposes a Global Conflict Accountability Mechanism to hold warring parties financially responsible for health impacts. Advocates for the formal inclusion of global health professionals in diplomacy and peacebuilding. How this study might affect research, practice, or policy Encourages research on the long-term health and economic consequences of war, including mental health and chronic disease. Supports integrating global health actors into conflict-sensitive humanitarian planning and peace processes to improve equitable access to care.

Climate change is an existential threat, and it is often difficult to translate the urgency and immediacy of climate catastrophes into common parlance. One way to effectively engage the public in climate change conversations is through effective communication practices, such as persuasive communication. Persuasive communication uses tailored messages to elicit desirable behavioural outcomes in the audience and has great potential to promote positive attitudinal and behavioural changes in the target audience. However, while persuasive communication has potential, recurring evidence suggests that using fear appeals in climate change communication can create unintentional mental health challenges for the audience. In light of the scale and scope of climate crises, positive, personal, and people‐centred persuasive communications may be more suitable for long‐term and sustainable deployment. However, there is a shortage of research in the literature. Bridging this research gap, this paper aims to explore how fear‐based climate communications impact public mental health and how alternative positive messaging frameworks can serve as sustainable interventions. This study seeks to enhance public mental health and cultivate a sense of engagement and responsibility among individuals, thereby facilitating collective action and influencing policymakers to implement more constructive climate‐response strategies. Ultimately, we aspire to offer inclusive and sustainable solutions that empower the public to actively participate in protecting our shared environment while mitigating climate change.

BACKGROUND Older women face disproportionate health challenges, exacerbated by multiple unprecedented challenges such as global aging, disease outbreaks, and geopolitical as well as technological upheavals. This study examines technology-based mental health interventions for this demographic, aiming to inform policy. METHODS A systematic review of randomized controlled trials (RCTs) targeting older women's mental health post-COVID-19 was conducted using databases like Web of Science and PubMed, adhering to PRISMA guidelines and registered with PROSPERO (CRD42020194003). RESULTS A total of 3463 articles were screened for eligibility, among which, 17 RCTs met the inclusion criteria. The review results show that 17 RCTs were conducted in middle-income and high-income countries. Fifteen RCTs generated statistically significant outcomes and reported specific aspects of their interventions to improve the mental health of older women. CONCLUSION Technology-based interventions show promise for improving older women's mental health. Policy recommendations include establishing comprehensive mental health centers, implementing universal healthcare, promoting digital literacy, and strengthening public awareness campaigns.

AIM Due to increasing use of mitochondrial DNA (mtDNA) sequencing in both forensic practice and clinical disease research, this study explores the optimization of the next-generation sequencing (NGS) method for whole mitochondrial genome analysis on the Illumina MiSeq platform. METHODS Initial attempts using pre-made commercial primers were unsuccessful, leading to the design of novel custom-designed primers in our laboratory and optimization of sequencing chemistry and protocols. A comprehensive protocol was developed, involving long-range amplification, enzymatic fragmentation, and the use of IDT® for Illumina DNA/RNA UD Indexes and MiSeq Reagent Nano Kit v2 (300 cycles), whereby DNA extraction, quantification, and library preparation were all performed according to optimized protocols. RESULTS Successful amplification was confirmed using gel electrophoresis and Agilent Bioanalyzer, with optimized conditions yielding clear, specific amplicons 9.8 and 8.5 kb in length. Sequencing results demonstrated high-quality reads with an average coverage depth of 742x and a GC content of 43-45%. The study highlights the efficiency of custom primers and individual library normalization for reliable mtDNA sequencing. CONCLUSION These findings advance the application of NGS in forensic and clinical settings by enhancing the detection of rare mutations and mitochondrial heteroplasmy, paving the way for routine mtDNA analysis using NGS technology.

AimCOVID-19 pandemic, caused by SARS-CoV-2, has had a profound impact on global health, including in Bosnia and Herzegovina, which faced unique challenges due to limited testing and high mortality rates. This analysis aimed to identify mutations and detect different SARS-CoV-2 lineages across four pandemic waves.MethodologyA total of 127 SARS-CoV-2 samples were collected and sequenced from patients from the Federation of Bosnia and Herzegovina, providing a comprehensive overview of the viral genetic diversity in this region. Two sequencing platforms, Ion Torrent and Illumina, were used, whereby 37 samples were sequenced on the Ion Torrent platform, while others were sequenced on the Illumina platform.ResultsThis study presents a genomic analysis of SARS-CoV-2 variants circulating in the Federation of Bosnia and Herzegovina over four distinct pandemic waves, spanning from March 2020 to April 2023. Examination of genomic variations across these waves revealed key mutations associated with transmission and potential virulence.ConclusionThese genomic insights into SARS-CoV-2 evolution in Federation of Bosnia and Herzegovina emphasizes the importance of continuous surveillance to understand viral evolution and strengthen public health responses to future pandemics.

The language we speak shapes our reality. In this paper, we shed light on the fact that by inventing and normalizing phrases such as the "U.K. variant", "Chinese virus", or the "Spanish flu", we are not only endorsing discriminative narratives that could deepen divisions within society, harming people's mental health, but also distracting the public's attention from the most important issue amid the pandemic-how to stall or stem COVID-19 in a timely matter. Furthermore, we also make a call to actions for media professionals, health experts, and government officials to stop creating and popularizing discriminative COVID-19 terms, so that we can reduce the divisions between societies and better focus on controlling the pandemic.

Abstract Mental health is deteriorating quickly and significantly globally post-COVID. Though there were already over 1 billion people living with mental disorders pre-pandemic, in the first year of COVID-19 alone, the prevalence of anxiety and depression soared by 25% worldwide. In light of the chronic shortages of mental health provider and resources, along with disruptions of available health services caused by the pandemic and COVID-related restrictions, technology is widely believed to hold the key to addressing rising mental health crises. However, hurdles such as fragmented and often suboptimal patient protection measures substantially undermine technology’s potential to address the global mental health crises effectively, reliably, and at scale. To shed light on these issues, this paper aims to discuss the post-pandemic challenges and opportunities the global community could leverage to improve society’s mental health en masse.

Worldwide, women face a disproportionately heavy health burden than their male counterparts. Yet there is a chronic lack of research attention and investment in women's health, which may explain the absence of women-inclusive, let alone women-centred, understanding of the causes, consequences, and confounding factors that shape individuals' health and quality of life. In this manuscript, by analysing the U.S. National Health Expenditure data, we show how ingrained the issue of poor investment in women's health even in the 0-18 years age group in terms of per capita health expenditure. We hope this manuscript sheds light on how early-life poor health investment in women's health might be a potential cause for women's poor health in adulthood, and in turn, underscores the importance of investing resources into better understanding and improving women's health.

COVID-19 offers many valuable lessons, many of which could be found in unique societies like Hong Kong. The metropolis is special for its drastically varying—good and bad—COVID-19 performances. Hong Kong was widely considered a pandemic control and containment success for maintaining a remarkably low number of COVID-19 infections and deaths, until it was not. In March 2022, for instance, Hong Kong had the world’s highest COVID-19 infection rates. As Hong Kong shares many similarities with other metropolises around the world, it is important to learn the hard-earned lessons from its failure to control infections. Drawing insights from the literature and our own research, this analysis aims to identify key lessons societies could gain from Hong Kong’s COVID-19 responses to ensure better preparation for future pandemics.

Mental health is deteriorating far and fast globally post-COVID. Though there were already over one billion people living with mental disorders pre-pandemic, in the first year of COVID-19 alone, the prevalence of anxiety and depression soared by 25% worldwide. In light of the chronic shortages of mental health resources and talents, along with disruptions of available health services caused by pandemic-related restrictions, technology is widely believed to hold the key to addressing the rising mental health crises. However, hurdles such as fragmented and oftentimes suboptimal patient protection measures substantially undermine technology’s potential to address the global mental health crises reliably and at scale. To shed light on these issues, this paper aims to discuss the post-pandemic mental health challenges and opportunities, and the strategies and solutions the global mental health community could leverage to protect and elevate society’s mental health in the long run.

Abstract Avoidable disasters are both saddening and baffling. In 2022, 159 people, mostly in their 20s, and 30s were crushed to death in Itaewon’s narrow alleyway amid South Korea’s first pandemic-restrictions-free Halloween celebration. What is particularly sobering about this tragedy is that although many people called police hotlines as crowds became cramped and static, their calls went unheeded for hours. Rather than order independent investigations into the catastrophe (as of January 2024), the President of South Korea at the time focused on superficial issues such as asking the public to refer to the disaster as an “accident” (which it was not, it was an avoidable disaster) and the casualties as “the dead” (who are casualties indeed, instead of victims of a preventable tragedy). In this paper, we examine how officials’ complacency about public health and safety dangers, ineffective disaster prevention, and preparedness systems, as well as the government’s chronic lack of prioritization of public health and safety may have contributed to the disaster. Furthermore, we discuss the importance of creating integrated public health and safety protection systems to prevent similar tragedies from happening.

Abstract Background: Alcohol use and abuse remain prevalent in China, though mounting evidence shows that even drinking in moderation is detrimental to health. While many countries’ intake is on the decline, China’s alcohol consumption is rising fast and is on the path to overtaking countries like the United States, even on a per capita level. Objectives: This paper aims to analyze the danger of lax enforcement of laws and regulations against alcohol use and abuse and underscores the imperative for effective health interventions to curb problematic alcohol consumption in China. Results: Different from their Western counterparts, Chinese drinkers often consume more spirit with a high percentage of alcohol in social settings that encourage the “ganbei culture”—making toasts with alcohol filled to the brim and downed in one go to show respect—which perpetuates excessive drinking at a fast pace. Though the country has various laws and regulations in place to curb problematic alcohol consumption, like workplace drinking, their impacts are dismal. Considering that China has 1.4 billion people, the country’s uncurbed alcohol consumption trend could have a detrimental effect on national strategic objectives like “Healthy China 2030” and international ones like the Sustainable Development Goals. To further compound the situation, prevalent campaigns promoted by liquor companies—like alcohol-infused coffee, chocolate, and ice cream—may groom young people to develop alcohol consumption habits, if not addictions, for generations to come. Conclusions: We developed the Framework of 5Vs of China’s “Ganbei Culture to shed light on the issue, with the hope that it, along with the overarching insights of this paper, can assist health professionals and policymakers in better guarding and improving public health against the harms of alcohol use and abuse in China and beyond.