Search Results (471)

Introduction: Refusal to undergo treatment, including one of its manifestations, discharge against medical advice, must be informed, just as consent is, which is considered a core ethical principle in contemporary medical ethics. The aim of this study was to explore physicians’ attitudes and intended behaviour toward patients’ refusal of necessary treatment and to identify factors associated with their clinical decisions in such situations. Methods: A cross-sectional anonymous online survey of 393 physicians working in Lithuanian public hospitals was conducted between November 2020 and March 2021 using the secure national platform manoapklausa.lt. A convenience sampling strategy ensured representation of both large university and smaller regional hospitals, and all responses were complete due to mandatory fields in the questionnaire. Results: Most physicians (85%; 95% CI 81.2 to 88.5) have encountered situations of refusal to undergo treatment. Women (p < 0.05) and senior physicians (aged 51 years and over) (p < 0.05) tend to apply treatment without patients’ consent more often in all clinical cases, especially in surgical ones (VN1 and VN2). Difficulty in the decision-making process was associated with chronic conditions and the influence of individual religious beliefs. Insufficient patient information on the intervention was indicated as the main cause of refusal to undergo treatment (62.9%; 95% CI 58.0 to 67.4). Refusal to undergo treatment was associated with physicians’ concern about the patient (57.5%; 95% CI 52.7 to 62.3) and anxiety (38.9%; 95% CI 34.1 to 43.8). Physicians’ attitudes towards patients’ refusal to undergo treatment reflect paternalistic patterns and are mainly associated with the physician’s older age, gender, and duration of professional experience. Insufficient patient information on the intervention was indicated as the most important factor determining patients’ refusal to undergo treatment. Under Lithuanian law, patients have a clear legal right to refuse treatment, and physicians who proceed without consent may face criminal liability. Conclusions: Our findings show that, despite the legal restrictions, many physicians would still choose to treat against a patient’s will, reflecting a persistent paternalistic attitude even in the presence of clear legal prohibitions. Full article

In recent years, the sexual and reproductive health of adolescents and young adults (ages 10–24) in Africa has improved through national and international initiatives. However, major challenges remain in enabling young people to exercise their sexual and reproductive health rights (SRHRs), especially in Côte d’Ivoire. This study aimed to explore the perspectives of stakeholders on the freedom of choice of adolescents and young adults with regard to SRHRs in Haut-Sassandra, Côte d’Ivoire. We conducted this qualitative descriptive study between September and October 2023. Participants were selected using a purposive sampling method. Overall, 137 stakeholders participated in the study: 57 teachers and administrators, 17 community leaders, and 63 parents. Data were collected through interviews and focus groups, using an interview guide. Through a deductive thematic approach, we identified three forms of freedom of choice: conditional, absent, and absolute. The average age of the study participants was 46.1 years. The findings reveal that several factors influence the freedom of choice among adolescents and young adults regarding their SRHRs. These include age, gender, parental involvement, prior education, autonomy, and perceived maturity. Limited freedom was commonly associated with younger age (10–18 years), perceived immaturity, and a lack of autonomy. In contrast, greater freedom was linked to older age (18–24 years) and higher levels of perceived maturity. Stakeholders’ perspectives were shaped by cultural and religious norms, a protective attitude toward youth, and a sense of disengagement from adolescent concerns. This study underscores the importance of interventions aimed at increasing stakeholders’ knowledge and awareness of adolescents’ sexual and reproductive rights. Full article

Adolescent sexual and reproductive health and rights (SRHR) challenges, including gender inequality, child marriage, female genital mutilation/cutting and sexual and gender-based violence remain pervasive globally, particularly in Ethiopia. The Power to You(th) programme was designed to address these issues by centering youth voices and fostering transformative community change. This evaluation applied Outcome Harvesting, drawing on mixed quantitative and qualitative data, and employed a participatory approach that engages youth and stakeholders in identifying and verifying programme outcomes between 2021 and 2023. The findings revealed substantial improvements in youth participation in decision-making platforms, advocacy capacity, and awareness of SRH rights. Community attitudes shifted positively, particularly among religious and traditional leaders, who increasingly advocate against harmful practices. Youth-led networks emerged as powerful agents of change, contributing to policy shifts such as increased youth representation in health governance bodies. The evaluation also captured unexpected yet influential changes in community dynamics and institutional responsiveness. These findings highlight the value of participatory approaches in capturing complex social transformations and underscore the role of youth as active agents in reshaping SRHR outcomes. Outcome Harvesting proved effective in documenting both intended and emergent changes, offering valuable insights for scaling inclusive, youth-driven interventions. Full article

This study focuses on the knowledge and attitudes of Orthodox clergy in Greece regarding religious psychopathology, which refers to the complex phenomena where religious experiences or beliefs intersect with mental disorders. The sample included 125 clergy members with varying levels of education and pastoral experience. The findings reveal significant gaps in the understanding of basic concepts of religious psychopathology, despite recognition of the need for collaboration with mental health professionals. Formal education proved to be a decisive factor in understanding religious psychopathology, as clergy with higher educational levels demonstrated significantly better knowledge. In contrast, clergy opinions towards mental health issues appeared to be shaped by multiple factors beyond education alone. Experience in collaboration with psychologists or psychiatrists was positively associated with higher knowledge levels and more realistic, positive attitudes toward managing religious psychopathology. Additionally, clergy who had direct experience with cases of religious psychopathology showed greater sensitivity and differentiated perspectives. The study highlights the urgent need to incorporate knowledge of religious psychopathology into theological education in Greece and to strengthen cooperation between the Church and mental health services. Such initiatives can improve pastoral care, reduce the stigma surrounding mental illness, and holistically support members of religious communities Full article

Contemporary religiosity is undergoing profound transformation, shaped by postsecular and postmodern dynamics. Amid global declines in institutional affiliation, religious and spiritual tourism has emerged as a salient expression of evolving faith. Poland exemplifies this paradox: witnessing one of the world’s steepest declines in youth religiosity, even as Catholicism retains symbolic centrality. Drawing on survey data from 510 Polish young adults (Generation Z), this study examines how religiosity, faith-based travel, and social attitudes intersect within a postsecular framework. Findings reveal a dual trajectory: while religious tourism reinforces institutional belonging and traditional values, spiritual tourism aligns with individualized, fluid religiosity and looser ties to religious institutions. The study introduces a novel conceptual model mapping the interdependencies between religiosity, mobility, and identity among youth in postsecular societies. This framework demonstrates how faith-based travel actively mediates social attitudes and reconfigures religious engagement, positioning mobility as a generative force in shaping contemporary belief. Rather than following a linear path of secularization, Generation Z selectively blends inherited Catholic traditions with personalized, experience-driven spirituality. These findings advance sociological debates on secularization, postsecularism, and the transformation of religious identity through mobility. Full article

This study examines the influence of religious socialization on the crises of faith among Turkish youth in Türkiye. Drawing on qualitative interviews with 20 participants, it adopts a process-oriented approach, conceptualizing a crisis of faith not merely as an abrupt disruption but as a gradual process shaped by the complex and sometimes conflicting dynamics within religious socialization. Young individuals are not simply passive agents in the traditionally one-way transmission of faith; instead, they become more autonomous and dynamic as they encounter negative attitudes and behaviors, often leading to a crisis of faith. The analysis highlights the roles of authoritarian parenting, perceived inconsistencies in religious teachings, peer and social media influence, and gender inequalities within patriarchal contexts. The findings suggest that while religious socialization provides an initial framework for faith, it also poses challenges that prompt Turkish youth to re-evaluate or distance themselves critically from traditional religion. Full article

The article is focused on the recent exegetical trend of “contextual” readings of the Bible, or context-sensitive exegesis in global Biblical scholarship. It is written by three authors from different ethnic and cultural contexts (German, Korean, Ethiopian) in order to emphasize the diversity to be considered. In the first part, the aims, history and relevant factors of contextual reading are described. The second part makes clear that also the traditional historical-critical exegesis is strongly contextual, drawing on Enlightenment thought and Western views of life. Therefore, any claims of “objectivity” or universality are problematic. In the third and fourth section of the article, two different contexts from global Christianity or the Majority World are introduced. first the African, especially Ethiopian context under the label of “vulnerability”, and then an Asian, precisely South Korean context with regard to the understanding of spirits and demons. The Ethiopian author describes how vulnerability has generally shaped the African cultural experience and specifically common language in Ethiopia, including religious attitudes which are characterized by a general openness for the divine. She also shows, that in such a culture, with the danger of naivete and acceptance of many problematic interpretations critical discernment is needed, as has already been stated by an Ethiopian philosopher of the 17th century. The part on Korean interpretation discusses the various views on spirits and demons in Korean Bible translations and the influence of Confucian thought and Shamanism on readings of the Bible. Using the example of the Gerasene demoniac, the author shows readers aware of shamanic ritual including pigs and intended to pacify the restless souls can impact the reading of this particular Biblical text even among modern Koreans. A brief concluding section draws some conclusions. Both examples demonstrate the diversity of contexts and their resonances with the Biblical texts when they are read in these different contexts. It is also obvious that there is not a single clear-cut dualism between Western and “postcolonial” readings. Neither the historical readings nor the contextual are “right” as such. Rather, there should be an open dialogue, on equal footing, that considers the context and also allows for critical interaction in order to prevent abuse of biblical texts, not only in colonial relations, but also within a given context by traditionalists, political powers, and spiritual authorities, so that the liberating power of the gospel can come into effect, for the benefit its readers. Full article

Tobacco smoking remains a critical public health concern in Indonesia, particularly in Aceh Province, where male smoking prevalence reaches 56.12%. Cultural permissiveness and weak enforcement of tobacco control regulations have contributed to this high prevalence. Women, especially wives, are central figures in family health and may play an essential role in influencing household smoking behavior. However, their roles and strategies remain underexplored, especially in conservative cultural settings. This qualitative study employed a Participatory Action Research (PAR) approach to examine the roles of women in controlling the smoking behavior of family members in Aceh. A total of 75 research subjects were selected from three districts (Aceh Singkil, Gayo Lues, and Pidie Jaya) using a combination of purposive sampling and snowball sampling methods. Data were collected through semi-structured in-depth interviews and were analyzed thematically using NVivo 15 software. The analysis framework was based on Lawrence Green’s PRECEDE model, which includes predisposing, enabling, and reinforcing factors. This study found that women demonstrated progressive attitudes toward smoking, evolving from passive acceptance to active responsibility. They employed both persuasive strategies (health education, emotional appeals, and motivation) and coercive actions (household smoking bans, threats, and withdrawal of privileges). Women also positioned themselves as health monitors and guardians within the household. Despite cultural limitations and gender hierarchy, many participants reported partial or complete success in encouraging their husbands to quit smoking, particularly when supported by religious norms and health awareness. Women play a pivotal role in shaping smoking-related behavior in the family. Empowering women through participatory frameworks and culturally tailored interventions can enhance their effectiveness as health advocates. This study underscores the need to integrate gender-sensitive strategies into national tobacco control policies, especially in culturally conservative regions. Full article

Introduction: With global protein demand rising, edible insects offer a nutrient-rich and environmentally sustainable alternative protein source that could help address both dietary and ecological challenges. This study investigates the attitudes, perceptions, and willingness of Saudi university students to consume edible insects (entomophagy) as an alternative protein source, with implications for public health, nutrition, and food security across the Arab region. Methods: A cross-sectional survey was conducted among 1711 students (34.4% men, 65.6% women) from multiple Saudi universities. The Eating Attitudes Questionnaire (EAQ) assessed disgust, interest, and attitudes toward using insect-based feed for animals, as well as measures of environmental concern, health risk beliefs, and social influences. Results: Significant gender differences were observed in willingness: men reported higher willingness to consume edible insects (21.1%) compared with women (8.5%). They also reported lower disgust scores, higher interest, greater environmental concern, and lower health risk beliefs. Regression analysis showed that positive attitudes toward using insects as animal feed, interest, environmental concern, and social influences were strong predictors of willingness, whereas disgust and health risk beliefs were negative predictors. Previous experience, familiarity, and religious beliefs were not significant predictors. Conclusions: These findings highlight the importance of targeted interventions that reduce psychological barriers and promote willingness to try edible insects, thereby contributing to Saudi Arabia’s efforts to strengthen food security and advance sustainable nutrition strategies within the kingdom and the broader Arab region. Full article

Background: Therapeutic abortion is a controversial topic since people throughout the world have different views on it. Methods: In this qualitative study, 12 adults (ages 19–36 years) from Irbid, in the Northern region of Jordan, were selected from a variety of public locations (markets, mosques) in April and May 2025 to participate in semi-structured interviews with the goal of exploring attitudes toward therapeutic abortion. The interviews, which lasted an average of 30 min, focused on two primary topics: attitudes about therapeutic abortion and determining who has the authority to make abortion decisions. An audio recorder was used to capture the responses, which were then preserved in their original, unaltered state. Following verbatim transcription, the responses were subjected to thematic analysis in order to determine the main themes. The original code was made manually. Results: Three themes were identified under the first topic: “unconditional rejection”, “conditional acceptance”, and “empathetic and woman-centered attitudes”. Medical and religious experts’ decision-making arose by the theme of “abortion decision” that emerged in relation to the second topic. Conclusions: Jordanians have conflicting views on therapeutic abortion and are adamantly opposed to making their own decisions on the matter. Full article

In Italy, the debate on migrants often focuses on issues such as social integration, economic conditions, and access to services. However, a little-investigated aspect concerns the double stigmatization of LGBTQ+ migrants, a reality made invisible by both the lack of research and the strict anti-LGBTQ+ laws present in many countries of origin. This study aimed to compare homonegativity levels between first- and second-generation migrants. A quantitative approach was used, with 127 participants (age 18–55, M = 30.63, SD = 11.58) completing an anonymous online questionnaire in three different languages. The instrument included a sociodemographic form and the Italian Scale for Measuring Homonegativity. A multivariate General Linear Model (GLM) analysis revealed significant effects of generation (p < 0.001, η² = 0.688) and gender (p < 0.01, η² = 0.144), with second-generation youth and women reporting lower levels of homonegativity. Religious affiliation had a minimal impact, influencing only the perception of deviance towards gay men (p < 0.05). Interactions between factors were generally non-significant, except for gender and religion. These findings underline the importance of generational and gender differences in the formation of homonegativity and highlight the need for further research to explore the cultural and social dynamics influencing these attitudes. In addition, there is a need to further explore how experiences of discrimination influence the well-being of LGBTQ+ migrants and what resilience strategies are adopted to address the challenges of homonegativity and marginalization. Full article

The individual’s willingness to pay (WTP) for environmental reduction programs is one way of gauging society’s environmental consciousness. We explore the determinants of an individual’s WTP for a product produced from carbon capture and utilization (CCU) technology in Qatar. A representative questionnaire sample was administered to 1012 respondents in Qatar on habits, perceptions, economic and religious attitudes related to environmental consciousness, and WTP. The findings reveal that environmental concern is significantly enhanced by environmental consciousness, awareness, and education, while environmental awareness also positively influences perceived social norms regarding others’ environmental awareness. Further, environmental consciousness, religiosity, and education are significantly positively associated with the WTP for an eco-friendly product. Also, those who earn high incomes have a greater WTP for eco-friendly products with premium prices of 10–75% higher. Respondents motivated by religious obligation have a significantly greater WTP for eco-friendly products with a 10–30% price premium. These findings imply the need for context-specific strategies that leverage cultural values, address income disparities, and effectively communicate the benefits of green choices to drive the adoption of green products. Full article

Hebrew and Greek versions of the Books of Kings and Chronicles present various instances of kings undergoing conversion with respect to their political and religious attitudes. In some cases, kings who were initially good become bad, while in others, bad kings repent. This paper explores the “conversion” patterns of king Ahab, focusing on their respective themes and vocabulary. The paper focuses on a comparison of the Hebrew and Greek versions, showing that the pattern of conversion changed in the late period: the Greek versions focus more on interior conversion. Full article

Religion and partisanship remain deeply intertwined in contemporary American politics, especially in public debates on religious expression in state institutions. This study examined whether religious identity and behavior continue to influence public attitudes independently of party affiliation in a highly polarized environment. Drawing on the latest 2023–2024 Pew Religious Landscape Study, the analysis examined support for teacher-led Christian prayer in public schools—a constitutionally contentious issue—through survey-weighted logistic regression models. The models included key religious predictors—tradition, born-again identity, and church attendance—alongside controls for political ideology and party identification. While Republican partisanship is the single strongest predictor of support, religious identity retains a significant and independent effect. Evangelical Protestants, as well as highly observant individuals across traditions, consistently show greater support for school prayer than their less religious or differently affiliated co-partisans. These residual effects point to the persistence of religious subcultures within each party coalition. By identifying such within-party variation, this study contributes to broader debates on the evolving boundaries of secular governance and the complex interplay between religion and partisan identity. Full article

Cultural and religious norms significantly influence reproductive decisions, including prenatal testing and pregnancy termination. We conducted a cross-sectional study among Muslim women living in mixed Jewish-Arab cities compared to those in predominantly Arab cities in Israel. Data for all co-variates were obtained through participants’ self-reports by an online questionnaire of 36 items for adequate content validity between July 2022 and June 2023. In total, 1081 Israeli Muslim women aged 18–49 years were enrolled. Religious affiliation has been shown to influence individuals’ attitudes toward abortion, with members of religious communities often holding more restrictive or negative views on the subject. Muslim women residing in mixed Jewish-Arab cities demonstrate significantly higher uptake of both non-invasive and invasive prenatal testing, as well as pregnancy terminations following abnormal diagnoses, compared to those in predominantly Arab cities (p < 0.001), which indicates that proximity to Jewish communities, greater availability of health services, and exposure to more permissive social norms in mixed cities may reduce religious and cultural barriers, thereby facilitating more informed reproductive decisions. Older women (≥35) in mixed cities had a higher tendency to birth a child with abnormalities in the past than Arab cities (80.9% vs. 70.0%, respectively), However, women who lived in mixed cities underwent more non-invasive (87.2% vs. 64.8%, respectively), invasive prenatal tests (85.1% vs. 69.7%, respectively), and pregnancy termination (88.3% vs. 64.1%, respectively) than those in Arab cities, p < 0.001. Our findings indicate the importance of gaining a deeper understanding of the relations between religious convictions, cultural standards, and medical practices that should contribute to reducing the prevalence of genetic disorders with their associated adverse impact on families, communities, and healthcare systems. Full article