To examine how menstruation, contraceptive use and gender-based violence intersect to shape the sexual and reproductive health and autonomy of girls and young women in Kenya.

Qualitative study exploring girls and young women’s experiences with contraceptive use and menstrual management, using in-depth interviews and focus group discussions analysed through a reflexive thematic approach.

Four county-run family planning clinics in Uasin Gishu County, Kenya.

77 girls and young women aged 15–19 years (via 35 in-depth interviews and 7 focus group discussions) and 27 family planning clinic providers (via 5 focus group discussions).

Interviewees’ contributions suggest that covert contraceptive use, when discovered through menstrual monitoring, provoked intimate partner violence. Heavy menstrual bleeding, whether related to contraceptive use or not, was viewed as a sexual restriction and also fuelled intimate partner violence. Furthermore, the inability to afford sanitary pads, combined with the stigma surrounding menstruation, drove some girls and young women into exploitative sexual relationships, often resulting in unwanted or unintended pregnancies.

Menstrual bleeding and contraceptive use, both independently and in combination, affect girls and young women’s reproductive autonomy and overall health and well-being, particularly in relation to gender-based violence. Improving menstrual hygiene management, challenging the stigma and harmful norms tied to menstruation and contraception and ensuring safe contraceptive use are integral to improving sexual and reproductive health and autonomy and are requisite for preventing and eradicating gender-based violence.

Anxiety disorders, obsessive–compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are common in children and adolescents and can lead to significant impairment. Cognitive behavioural therapy (CBT) with exposure is the first-line treatment, yet approximately half of treated youth do not achieve full remission. Dysfunctional cognitions—negative automatic thoughts, maladaptive beliefs and distorted interpretations—are considered key targets of CBT, but evidence in youth is mixed and underpowered. This study will examine whether change in dysfunctional cognitions mediates treatment outcome in anxiety, OCD and PTSD symptoms and whether this association varies across individual characteristics.

An individual participant data meta-analysis (IPDMA) of randomised controlled trials of CBT for youth aged 5–18 years with anxiety disorders, OCD or PTSD will be conducted. The search strategy includes the databases APA PsycINFO, MEDLINE and Web of Science Core Collection from inception to 8 September 2025. It is supplemented by screening reference lists, trial registries, grey literature and outreach to relevant research groups. Eligible trials must include at least one validated measure of dysfunctional cognitions administered at minimum pre- and post-treatment, and clinical outcomes assessed at post-treatment and follow-up. The two primary outcomes are (1) child-reported symptom severity and (2) clinician-rated clinical severity. Data will be harmonised for dysfunctional cognition scores, moderators (age, gender, socioeconomic status, comorbidity), and primary outcomes. One-stage Bayesian mixed-effects models will examine whether changes in dysfunctional cognitions predict improvements in primary outcomes and whether these effects are moderated by individual characteristics. Missing data will be addressed using multiple imputation within the Bayesian framework, and study-level heterogeneity will be modelled using random intercepts and slopes.

All datasets will be de-identified and managed under General Data Protection Regulation standards. Each included trial will have ethical approval permitting data sharing and reuse, and the secondary analysis of the shared datasets has been approved by the University of Amsterdam. Findings will be disseminated via a peer-reviewed publication, scientific conferences and open sharing of analysis scripts and harmonisation procedures.

CRD420251139130.

Current pharmacological treatment options for painful diabetic neuropathy (PDN) often fail to provide adequate pain relief. However, in the recent SENZA-PDN study, high-frequency 10 kHz spinal cord stimulation (SCS) demonstrated significant long-term improvements in lower limb pain and health-related quality of life (HRQoL) in a PDN population. Furthermore, more than half of 10 kHz SCS recipients showed improved sensory function based on non-blinded clinical assessments in post hoc analysis. We report the design of the PDN-Sensory study, which aims to evaluate changes in pain and neurological function with 10 kHz SCS in the treatment of PDN. The study will include objective measures of neurological function, including the modified Toronto Clinical Neuropathy Score (mTCNS) and intraepidermal nerve fibre density (IENFD).

This multicentre, prospective, randomised controlled trial will compare conventional medical management (CMM) with 10 kHz SCS+CMM in individuals with diabetes and chronic, intractable lower limb pain due to PDN. Participants will be randomised 1:1 to CMM alone or 10 kHz SCS+CMM, with optional crossover at 6 months. The primary outcome is the proportion of participants at 6 months achieving ≥50% pain relief from baseline. The key secondary endpoint is the proportion of participants at 6 months with a reduction in mTCNS of ≥3 points from baseline (excluding changes in foot pain). Additional endpoints at 6 and 12 months include changes from baseline in mTCNS, IENFD, 7-day averaged pain score, pain-related interference, HRQoL, sleep, psychological outcomes, functional status and metabolic parameters.

The study protocol received central approval from the Western Institutional Review Board (IRB #20230954). Local IRB approval will be required before initiation of the study at each participating clinical site. The study complies with Good Clinical Practice guidelines (ISO 14155), the Declaration of Helsinki, and all applicable national, federal and local regulatory requirements. Dissemination plans include presentations at national and international conferences and publication in a peer-reviewed journal with open access.

NCT05777317.

Haemophilia is a rare inherited bleeding disorder with complex support and costly treatment. Comprehensive care for people with haemophilia (PwH) must take place in structured and continuously evaluated treatment centres. The aim of the Public Assistance for People with Haemophilia in Brazil Project (PATCH Project) is to assess the infrastructure, human resources and healthcare delivery processes of Brazilian Blood Centres (BC) involved in the provision of haemophilia care.

This is a nationwide cross-sectional study involving 98 BC across Brazil’s 26 states and the Federal District, focusing on the care provided to PwH. A self-administered structured questionnaire was prepared, based on national and international recommendations for management, treatment and outcomes assessment in PwH. The criteria of the World Federation of Haemophilia and the European Association for Haemophilia and Allied Disorders will be used to define standards of quality.

Ethical approval for this study was granted by the Human Research Ethics Committee of the Federal University of Goiás, the coordinating centre (protocol CAAE 53863221.8.0000.5078), and subsequently by all participating institutions. Written informed consent is obtained from all participants prior to enrolment. Study findings will be disseminated through publication in peer-reviewed journals and presentation at international scientific conferences. Research data will be managed in accordance with ethical and legal standards and will be made available on reasonable request to support future investigations.

Not applicable

To develop and validate a polycystic ovary syndrome (PCOS) case definition using administrative health data sources.

A validation study.

Secondary care centre outpatient gynaecology clinic in Calgary, Alberta, Canada.

3951 electronic health records of women aged 18–45 years who presented to a gynaecology clinic in Calgary, Canada, between January 2014 and December 2019 were reviewed. We identified 180 patients with PCOS using the Rotterdam criteria. Participants were excluded if they were biologically male, pregnant at the time of the consultation, did not meet the date criteria or if their consultation note was missing. The chart data were connected to the Practitioner Claims and the Discharge Abstract Database by personal health number.

Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 68 case definitions for PCOS were estimated. Case definition performance was graded.

Of the 68 case definitions tested, none had high validity. The best performing case definitions were: (1) ≥3 instances of International Classification of Diseases-9 code 256.4 (polycystic ovaries) with exclusion codes (sensitivity 23.89%, specificity 99.59%, PPV 74.14%, NPV 96.35%) and (2) 626.X (irregular menstruation), 704.1 (hirsutism) and ≥3 instances of code 256.4 with exclusion codes (sensitivity 2.78%, specificity 99.97%, PPV 83.33%, NPV 95.40%).

We identified several case definitions for PCOS of moderate validity with high PPV (>70%) for case ascertainment in PCOS research in jurisdictions with similar administrative health data. These case definitions are limited by low sensitivity, which should be considered when interpreting research findings.

To ascertain the clinical impact, prevalence and associated determinants of delayed treatment intensification, defined as delaying the escalation of treatment plans for individuals with type 2 diabetes mellitus who fail to attain ideal glycaemic control, at the University of Gondar Comprehensive Specialised Hospital in Northwest Ethiopia.

A mixed-methods study.

University of Gondar Comprehensive Specialised Hospital.

420 patients with type 2 diabetes mellitus with poor glycaemic control after the index date were included in this study. A simple random sampling technique was employed to select the required sample size. Data were collected retrospectively and entered into EpiData V.4.6 and exported to Stata V.14.2 for analysis.

Multivariable logistic regression was used to identify factors associated with delayed treatment intensification. A p value of 0.05 in the multivariable analysis was considered statistically significant. Qualitative data were collected through in-depth interviews with eight selected healthcare providers, and thematic analysis was undertaken to identify the underlying barriers to timely treatment intensification.

Delayed treatment intensification.

The prevalence of delayed treatment intensification was 51.4% (95% CI 46.6% to 56.2%), with a median delay of 14 months (IQR: 7.5–42 months) from the index date. Among those experiencing delayed treatment intensification, 43.1% developed new chronic diabetic complications, including retinopathy (18.1%), neuropathy (14.4%) and nephropathy (6.0%). Other complications (hypertension, stroke, heart failure and diabetic foot ulcer) accounted for 4.64% of the cases. Significant predictors of delayed treatment intensification included longer duration of diabetes (adjusted ORs (AOR) 1.68; 95% CI 1.13 to 2.5), presence of comorbidities (AOR 1.83; 95% CI 1.04 to 3.2) and use of cardioprotective medications (AOR 1.59; 95% CI: 1.04 to 2.43). The qualitative findings revealed additional barriers contributing to delayed treatment intensification, including financial limitations, insufficient patient awareness and non-adherence among patients. Additionally, healthcare provider-related factors, including professional fatigue and knowledge gaps, as well as health institution-related factors such as inadequate healthcare infrastructure.

This study found a high prevalence of delayed treatment intensification (51.4%), associated with comorbidities, longer disease duration, low patient awareness, cardioprotective drug use and barriers related to the system and providers. To address these gaps, priorities should include strengthening patient education, scheduling regular reviews for high-risk patients and improving clinical decision support tools for timely treatment intensification. Enhancing healthcare infrastructure, such as medication supply and diagnostic services, and offering refresher training to reduce provider fatigue, are also crucial for improving the delivery of diabetes care.

Temporomandibular disorders (TMDs) are a prevalent group of musculoskeletal conditions affecting the temporomandibular joint, associated structures and masticatory muscles. The internet has become a primary source of health information for many patients; however, the readability, reliability, content and quality of online information on TMDs vary widely. A comprehensive synthesis of the characteristics and evaluation methods of such content is currently lacking.

This scoping review will follow the Joanna Briggs Institute methodology and be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed primary and secondary studies assessing online information on TMDs will be included if they report on readability, reliability, content or quality. Eligible information sources include publicly available websites, videos and social media; discussion forums and printed materials will be excluded. No language, date or geographical restrictions will be applied. A three-step search strategy will be implemented across PubMed, Web of Science, Embase, PsycINFO and CINAHL, followed by citation tracking. Screening will be conducted independently by two reviewers using Rayyan. Data will be extracted with a pilot-tested charting tool and synthesised narratively and descriptively in tabular and graphical formats.

As this study will only use data from publicly available sources, ethical approval is not required. Findings will be disseminated through publication in a peer-reviewed journal, conference presentations and professional networks, with the aim of guiding the development of accessible and reliable digital resources for individuals seeking information on TMDs.

This protocol has been prospectively registered on the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/TAH7K.

The aim of this study was to prioritise a set of indicators to measure World Health Organization (WHO) quality-of-care standards for small and/or sick newborns (SSNB) in health facilities. The hypothesis is that monitoring prioritised indicators can support accountability mechanisms, assess and drive progress, and compare performance in quality-of-care (QoC) at subnational levels.

Prospective, iterative, deductive, stepwise process to prioritise a list of QoC indicators organised around the WHO Standards for improving the QoC for small and sick newborns in health facilities. A technical working group (TWG) used an iterative four-step deductive process: (1) articulation of conceptual framework and method for indicator development; (2) comprehensive review of existing global SSNB-relevant indicators; (3) development of indicator selection criteria; and (4) selection of indicators through consultations with a wide range of stakeholders at country, regional and global levels.

The indicators are prioritised for inpatient newborn care (typically called level 2 and 3 care) in high mortality/morbidity settings, where most preventable poor neonatal outcomes occur.

The TWG included 24 technical experts and leaders in SSNB QoC programming selected by WHO. Global perspectives were synthesised from an online survey of 172 respondents who represented different countries and levels of the health system, and a wide range of perspectives, including ministries of health, research institutions, technical and implementing partners, health workers and independent experts.

The 30 prioritised SSNB QoC indicators include 27 with metadata and 3 requiring further development; together, they cover all eight standard domains of the WHO quality framework. Among the established indicators, 10 were adopted from existing indicators and 17 adapted. The list contains a balance of indicators measuring inputs (n=6), processes (n=12) and outcome/impact (n=9).

The prioritised SSNB QoC indicators can be used at health facility, subnational and national levels, depending on the maturity of a country’s health information system. Their use in implementation, research and evaluation across diverse contexts has the potential to help drive action to improve quality of SSNB care. WHO and others could use this list for further prioritisation of a core set.

The study aimed to assess the trends and factors associated with modern contraceptive use among female youths (15–24 years) in Tanzania from 2004 to 2022.

We performed secondary analysis of cross-sectional data from four consecutive Demographic and Health Surveys (DHS) in Tanzania: 2004, 2010, 2015/2016 and 2022.

Tanzania.

Sexually active female youths (n=8659).

The use of any modern contraceptive method, coded as Yes or No.

The sample had a median age of 21 (IQR 18–22 years), with 63.7% aged 20–24 years. Modern contraceptive use among female youths increased from 24.6% in 2004 to 32.1% in 2022. Consistent across surveys, modern contraceptive use was positively associated with secondary or higher education level, having one or more live births and engaging in sexual activity within the month preceding the survey. Additionally, adolescents (15–19 years) demonstrated a weak protective association, indicating a reduced likelihood of modern contraceptive use compared with young women (20–24 years). In 2015/2016 and 2022 surveys, primiparous, multiparous and married/cohabiting women were more likely to use modern contraceptives than nulliparous women.

Modern contraceptive use among female youths increased gradually in Tanzania between 2004 and 2022 Tanzania DHS. To sustain these upward trends and reduce the risk of unwanted pregnancies and sexually transmitted infections, public health policies should consider the factors positively associated with modern contraceptive use, particularly among young women aged 20–24 years, married/cohabiting, who have initiated childbearing and those with high education levels.

To evaluate the associations between depressive symptoms, HIV vulnerability factors and oral pre-exposure prophylaxis (PrEP) use and adherence among adolescent girls and young women (AGYW) in Kenya.

Cross-sectional observational study.

Research site in Kisumu, Kenya.

300 AGYW aged 19–24 years (median age 21 years, IQR 20–22), attending follow-up visits in a randomised controlled trial of the efficacy of a single-dose HPV vaccine.

Participants responded to questionnaires assessing their depressive symptoms (Patient Health Questionnaire-9), HIV vulnerability and PrEP use and adherence.

Moderate to severe depressive symptoms were reported by 14.3% (95% CI 10.5% to 18.8%). Factors associated with increased prevalence of depressive symptoms included medium HIV risk perception (adjusted prevalence ratio (aPR) 2.25; 95% CI 1.20 to 4.26) and engaging in transactional sex (aPR 2.51; 95% CI 1.15 to 5.48). The rate of oral PrEP use was 19.3% (n=58, 95% CI 15.0% to 24.0%), with 43.0% reporting adherence (≥5 doses in the past week). Depressive symptoms were not significantly associated with PrEP use (aPR 0.94; 95% CI 0.52 to 1.70).

The high prevalence of depressive symptoms among AGYW highlights the importance of integrating mental health screening into HIV prevention services, particularly for individuals with higher HIV risk perception and those engaging in transactional sex.

Despite the benefits of regular physical activity, many nurses have low activity levels, leading to higher risks of chronic diseases and absenteeism. Over 30% of nurses are overweight or obese, often due to stressful work conditions and night shifts, increasing the risk of metabolic disorders.1 2 Nurses also have the lowest participation in workplace health programmes,...

Anxiety and depression are among the top contributors to disability in the Kingdom of Saudi Arabia (KSA), but little is known about their economic impact. This study estimates the economic burden of moderate to severe symptoms of anxiety and depression among adults in KSA.

A cross-sectional survey was administered via a web panel. Participants were asked to fill out the Patient Health Questionnaire-4 (PHQ-4) for themselves and on behalf of other household members to capture prevalence rates. Those who reported at least moderate symptoms of anxiety or depression filled out a longer survey with questions on healthcare utilisation and productivity losses due to symptoms. These responses were monetised using prevalence rates and population estimates to calculate per-person and total annual costs.

Prevalence estimates are based on responses from 1164 participants on behalf of 3202 Saudi adults. Of these, 269 individuals with symptoms completed the longer survey.

Prevalence of anxiety and depression; healthcare utilisation (medications, outpatient, inpatient) and productivity losses due to absenteeism and presenteeism.

In total, 26.2% reported at least moderate symptoms consistent with anxiety and/or depression. Among those with symptoms, direct healthcare costs due to anxiety and depression averaged Saudi riyal (SAR) 3431.95 per person annually. Indirect costs via absenteeism and presenteeism averaged SAR 9702.87 and SAR 24 577.28 per person assuming that anxiety and/or depression episodes last for 6 months. Summing up the healthcare costs and productivity losses yields a total annual economic burden of SAR 163.3 billion. Absenteeism accounts for 24.8% of this total (SAR 40.5 billion), presenteeism accounts for 62.8% (SAR 102.5 billion) and healthcare resource utilisation accounts for 12.4%(SAR 20.3 billion).

The overall prevalence of anxiety and depression in KSA is estimated at 26.2%. The economic burden associated with these symptoms amounts to SAR 163.3 billion or 4.1% of GDP. Absenteeism and presenteeism costs account for the vast majority of the total, but a large percentage (nearly 60%) also report emergency department visits and unplanned hospital admissions. Evidence-based interventions should be considered to address the health and economic burden of these conditions in KSA.

The gig economy is a promising arena to reduce unemployment and provide other benefits such as the opportunity to earn supplemental income. Like all other forms of work, the gig space also presents occupational health issues for those working in it. This proposed review is aimed at identifying and describing the common occupational health outcomes reported within this workforce; second, to examine the risk factors that contribute to the development of these health issues; and third, to assess the interventions and support systems currently in place to promote the occupational health of gig workers.

A systematic review will be undertaken according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (2009). A search from 2015 to 2025 will be conducted on four global databases (Web of Science, SCOPUS, Academic Source Complete and Business Source Complete). Only records in English, full text and peer-reviewed journal articles will be included. Book chapters, thesis, reports and systematic reviews will be excluded. The Joanna Briggs Institute Critical Appraisal Tools will be used to assess the methodological rigour of various studies prior to inclusion for the final analysis. The extracted data will be synthesised using a narrative synthesis approach, integrating findings from both quantitative and qualitative studies.

This research is exempt from ethics approval because the work will be carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.

CRD420250654059.

Low-income adults with disabilities experience disproportionately high rates of food insecurity and preventable healthcare utilisation. The Supplemental Nutrition Assistance Program (SNAP) can reduce food insecurity and improve health, but there are accessibility gaps in the SNAP enrolment process. Existing outreach and enrolment assistance programmes have been shown to boost SNAP enrolment, but their health effects are understudied. This study estimates the effects of a SNAP outreach and enrolment assistance programme on health outcomes among low-income adults with disabilities.

The study pragmatically evaluates a programme that provided outreach and SNAP enrolment assistance for low-income households. The study leverages a random process that selected households for one of two types of outreach, including an information-only arm and an information plus enrolment assistance arm, which formed a control group by default. The study will estimate the effect of this programme among low-income adults with disabilities using Medicaid and SNAP administrative data. Study outcomes include emergency department, hospital and long-term nursing home utilisation. SNAP enrolment and benefit amounts are secondary study outcomes and will be tested as a mediating mechanism of action. The study will test effect heterogeneity based on race, ethnicity, age and chronic conditions.

The study, which relies on deidentified data, was determined to be exempt as human subjects research by the Institutional Review Boards at Johns Hopkins Medicine and the Michigan Department of Health and Human Services. The study is being conducted in ongoing consultation with an Advisory Group of experts in food advocacy and disability advocacy. In addition to disseminating findings in peer-reviewed publications, findings will be disseminated to state decision-makers and the community in partnership with an advisory group.

Current diets which are commonly high in meat and ultra-processed foods are unhealthy and unsustainable and contribute significantly to climate change, environmental degradation and poor health outcomes. Transitioning to healthy and sustainable diets that are rich in plant-based foods and low in animal products could reduce environmental impacts and improve population health. Young Australian adults are a critical target group for dietary intervention as they are motivated towards climate action and have the lowest diet quality out of all adult age groups. As such, this study proposes a digital nutrition intervention to promote healthy and sustainable diets in this population group.

A 4-week pilot pre-post intervention will be conducted on the Deakin Wellbeing mobile application between July and August 2025. 32 young adults (18–25 years old; current student and/or staff at Deakin University; consume less than 260 g/week of legumes or 175 g/week nuts, living in Australia) will receive 4 weeks of the intervention to improve their adherence to a healthy and sustainable diet. Primary outcomes include feasibility (retention rate) and acceptability (engagement and user experience). Secondary outcomes include sustainable food literacy, legume and nut intakes, and adherence to a healthy and sustainable diet. Primary outcomes will be reported with descriptive statistics, while changes in secondary outcomes at each study time point will be measured using repeated measures Analysis of Variance, Friedman tests and McNemar’s tests.

Ethics approval to conduct the study was granted by the Deakin University Human Research Ethics Committee (2024/HE000163). A summary of findings will be disseminated to key stakeholders, for example, Deakin University Student Engagement groups, and will also be presented to the wider research community at conferences and via peer-reviewed publications. A summary of the results will be sent to all participants via email.

Australian New Zealand Clinical Trials Registry Registration ID: ACTRN12625000335493p, prospectively registered on 22 April 2025. Universal Trial Number: U1111-1319-0745.

Cohort studies of ageing and cognitive decline typically do not begin fielding comprehensive cognitive assessments until older adulthood. However, for identifying preventable dementia risk factors, there is strong value in beginning at earlier ages. The case is especially compelling in sub-Saharan Africa, where the number of older individuals is expected to triple in the next three decades, and where risk factors may operate more intensively at earlier ages. This study reports on the adaptation and validity of the Harmonised Cognitive Assessment Protocol (HCAP) approach in the Kenya Life Panel Survey (KLPS), collected among middle-aged respondents.

To evaluate the validity of the HCAP approach in Kenya, this study assesses model fit statistics from confirmatory factor analyses (CFA) and tests measurement invariance by respondent characteristics.

Both rural and urban areas in Kenya.

A sample of n=5878 individuals from the KLPS, who have been surveyed regularly since they were schoolchildren in the 1990s. The HCAP assessment was administered in 2023 at an average age of 37 years (10–90 range 34 to 41).

For each individual, the CFA generates a general cognitive performance score, and cognitive performance scores for five distinct domains, including memory, executive functioning, language, orientation to time and place, and visuospatial functioning.

Fit of the models to the data was adequate for general cognitive performance (root mean squared error of approximation (RMSEA)=0.03; comparative fit index (CFI)=0.94; standardised root mean residual (SRMR)=0.05), language (RMSEA=0.02; CFI=0.95; SRMR=0.05) and good for memory (RMSEA=0.05; CFI=0.99; SRMR=0.02) and executive functioning (RMSEA=0.03; CFI=0.98; SRMR=0.03). The CFA indicate that the factor structure is consistent with findings from other countries and that reliability for the general cognitive performance score was high. Statistical models also suggest invariance at the scalar level for leading demographic (gender, age) and socioeconomic (education, occupational complexity) characteristics.

This study demonstrates that the cognitive functioning of mid-age Kenyans appears to be well captured by the adapted protocol. While there is a moderate decline in cognitive performance among older individuals, this relationship appears to be mediated by education, indicating that this KLPS HCAP provides a valuable baseline for studying future cognitive decline.

Adolescent idiopathic scoliosis (AIS) often imposes a significant psychological burden on teenagers. Cognitive and behavioural strategies have demonstrated the potential to alleviate these challenges. Chatbots, with their real-time interaction capabilities, provide a promising and accessible approach to delivering psychological interventions for young people.

This pilot trial will evaluate a chatbot-delivered, structured psychological intervention (SPI-Bot) incorporating cognitive and behavioural strategies for teenagers with AIS. Conducted as a single-centre, parallel-group randomised controlled trial, the study aims to assess the feasibility, acceptability and preliminary effectiveness of SPI-Bot. Fifty-two teenagers with AIS and mild to moderate psychological symptoms will be block-randomised into two groups. The intervention group will complete an 8-week, evidence-based SPI-Bot programme, while the control group will engage in casual conversations with another chatbot that does not include specific psychological health content. Assessments will be conducted at baseline, postintervention (8 weeks) and follow-up (12 weeks). Primary outcomes include feasibility and acceptability, measured through recruitment rates, adherence rates, attrition rates, engagement, working alliance, usability, user experience and adverse events. Secondary outcomes focus on effectiveness, including psychological distress, psychological well-being, perceived social support and quality of life. Participants in the intervention group will be purposively sampled for semistructured interviews to explore their perceptions of the intervention process.

This study has been approved by the Institutional Review Board of the Hong Kong Polytechnic University (Reference: HSEARS20240919007). The results of this pilot study will be disseminated through peer-reviewed journals and conference presentations.

NCT06698952

The purpose of this study was to analyse the speech-language pathology (SLP) literature from 2012 to 2022 and evaluate authorship trends and factors associated with gender disparities.

Authorship across journals published by the American Speech-Language-Hearing Association (ASHA) was evaluated. Outcomes collected from each article included the gender of the first and senior authors, author department affiliations, study type, reported funding source and the country of origin. Three sets of linear regression models were explored to determine the probability of male first authorship, of male senior authorship, and of a study being funded.

A total of 2754 articles were identified for inclusion. The majority of the literature was authored by females, with 77% of first authors and 68% of senior authors being female. Studies with a male senior author were shown to be 4.05–4.67 times more likely to have a male first author than with a female senior author. Male senior authors were over-represented relative to their proportion of ASHA membership compared with female senior authors. Male authorship was associated with certain subtopics, including voice, stuttering and motor speech. Funding probability decreased for all authors regardless of gender between 2012 and 2022.

Implicit gender bias and societal gender stereotypes lead to a greater number of women in the field of SLP; the same biases and stereotypes often limit the research productivity and academic leadership potential of women in the field. Addressing these biases and stereotypes is vital to move towards gender equity in the field.

Clinical practice training introduces stress to student nurses due to potential conflicts with patients, families and supervisors.1 Grounded in work stress models, the study recognises the significance of contextual (social supports) and personal resources (eg, optimism, resilience, self-efficacy and emotional intelligence (EI)) for stress reduction among student nurses in adapting to work demands.