Conectar
Numerous studies focus on women’s experiences of intimate partner violence (IPV), but there is a lack of qualitative studies focusing on women who, as victims, become perpetrators. The study explored the lived experiences and perceptions of incarcerated women convicted of IPV against their partner in Maputo, Mozambique.
A qualitative approach was utilised with females purposively sampled for one-on-one semi-structured interviews in the Maputo female prison setting. Data were analysed using Interpretive Phenomenological Analysis (IPA).
Nine females over the age of 18 convicted and incarcerated for perpetrating IPV against their violent partners.
The analysis revealed three themes: Theme 1: Childhood exposure to violence, with subthemes: direct violence in childhood, witnessing violence in the family and the role of alcohol consumption in violence within the family. Theme 2: Living in a violent intimate relationship with subthemes: psychological violence, coping strategies as victims of IPV and use of self-defence during violent episodes. Theme 3: Consequences of IPV perpetration, with subthemes incarceration experience, mistrust of prison psychology services, disintegration of their families and plans for the future.
Mozambican women incarcerated for IPV described their lived experiences marked by family violence growing up and IPV in their relationships and how this may have shaped their coping strategies, risk appraisal and responses to threat. These factors were central to understanding the circumstances that preceded their offence. The women identified a current need for psychosocial services independent of prison staff. Sustained investment in IPV prevention and victim protection services is warranted to potentially reduce both prolonged victimisation and the risk of subsequent lethal violence.
To examine the prevalence and sociodemographic factors associated with tobacco smoking, smokeless tobacco and dual use among adults in Ghana using the 2022 Demographic and Health Survey (GDHS).
Ghana, nationwide sample of males and females aged ≥15 years.
This was a cross-sectional secondary analysis of the 2022 GDHS.
A representative sample of 22 058 individuals (females, 15 014 aged 15–49; males, 7044 aged 15–59)
Current tobacco smoking, smokeless tobacco use and dual use.
Prevalence for smoking, smokeless tobacco and dual use was 4.7 (4.1–5.4), 1.6 (1.3–2.0) and 0.6 (0.4–0.9) among males and 1.0 (0.8–1.3), 0.08 (0.05–0.1) and 0.1 (0.05–0.1) among females, respectively. Among males, smoking was associated with higher age (30–44 years: AOR: 2.3, 95% CI 1.7 to 3.1; 45–59 years: AOR: 2.6, 95% CI 1.8 to 3.7). Higher education was protective for both sexes [(males: AOR: 0.4, 95% CI 0.2 to 0.8) and (females: AOR: 0.4, 95% CI 0.2 to 0.8)] compared with their counterparts who had no education. Males in the Coastal zone had higher odds of use (AOR: 1.8, 95% CI 1.3 to 2.3) compared with males in the Middle zone, while females in the Northern/Savanna zone had lower odds of tobacco use (AOR: 0.5, 95% CI 0.3 to 0.8) compared with the Middle zone. Being Christian was associated with lower odds of smoking among males (AOR: 0.3, 95% CI 0.2 to 0.5) compared with others, while being Mole-Dagbani ethnic is associated with higher odds of smoking among females (AOR: 3.0, 95% CI 1.7 to 5.4).
The study provides the first national analysis across Ghana’s 16 regions and investigates patterns of smoking, smokeless tobacco and dual tobacco use. While tobacco use in Ghana remains predominantly smoked and male-driven, the divergent patterns of use across educational, regional and ethnic groups, especially the emerging risk among females, represent a significant public health shift that demands focused gender-sensitive tobacco control interventions.
Health insurance coverage in sub-Saharan Africa (SSA) remains low and digital premium payment systems have been suggested as a potential solution to increase enrolment and retention. This systematic review will collate and distill empirical evidence on the impact of digital premium payment in scaling health insurance coverage and retention and access to health service delivery in SSA.
This systematic review protocol has been prepared following robust methods, and it is reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will conduct searches through relevant databases, including PubMed, CINAHL, LILACS, HINARI, African Journals Online, Google Scholar, Scopus, Web of Science, Trip Pro and TOXNET from 2007 to 30 June 2026, without language restriction for studies that evaluated digital premium payment systems and reported health insurance enrolment or retention rates. The search terms and concepts include: ‘national health insurance’, ‘health insurance coverage’, ‘insurance enrolment’, ‘digital premium’, ‘e-payment’, ‘online payment’, ‘electronic payment’, ‘mobile payment’, ‘telepayment’ and ‘cashless payment’, together with their alternate terms and synonyms, singular and plural forms as well as British and American spelling. The names of the countries in SSA will be included as search terms. Grey literature including dissertation repositories, national health insurance databases and conference proceedings will be searched. Reference list of retrieved articles will be reviewed, and where necessary, experts working in the field of national health insurance will be contacted for knowledge about completed studies not captured by our searches. Two reviewers will independently screen studies, extract data (using pretested data extraction form developed from Microsoft Excel) and assess risk of bias in the included studies using the quality assessment tool for Risk Of Bias In Non-randomized Studies - of Exposures. Any disagreements will be resolved through discussion between the reviewers. Heterogeneity will be explored graphically for overlapping CIs and statistically using the
This systematic review will collate empirical data on publicly available published and unpublished primary studies and no ethical approval is required. However, an eligible study with serious ethical issues will be excluded from the analysis and the reasons for exclusion documented. The review findings will be shared with key stakeholders and health authorities, agencies involved in digital premium health insurance and policymakers. The review results will be presented at scientific conferences and symposia, and a manuscript will be submitted for publication in a high impact factor journal.
CRD42024576134.
The increasing global burden of long-term illnesses necessitates high-quality data to inform effective interventions, particularly in low-resource settings. Despite the critical role of data collectors in health research, their lived experiences and challenges remain understudied, especially in low- and middle-income countries (LMICs) like Nigeria. This study explored the experiences, barriers and facilitators encountered by field researchers working with individuals living with long-term illnesses.
A qualitative, descriptive phenomenological design was employed, involving in-depth interviews with 12 research coordinators across 12 healthcare facilities in Nigeria. Participants were purposively selected from the Nigeria Implementation Science Alliance–Model Innovation and Research Centres. Data were analysed using Colaizzi’s phenomenological method, with thematic analysis to identify key patterns.
Field researchers described both rewarding experiences and significant obstacles. While they found value in contributing to impactful research, they faced emotional strain from engaging with sensitive narratives. Key barriers included low health literacy, cultural and religious constraints, hesitation to engage in the study and logistical constraints such as unreliable infrastructure. Facilitators included prefield training, trust-building and support systems. Recommendations emphasised ethical adherence, continuous skill development, context-appropriate incentives and streamlined data collection tools.
The study underscores the need for systemic support for data collectors, including mental health resources, adaptive methodologies and institutional policies that address logistical and emotional issues. These findings advocate for participant-centred, ethically sound research practices to enhance data quality and collector well-being in long-term illness studies.
Future research needs to evaluate interventions to optimise data collection processes in LMICs.
To identify early cardiovascular changes in normotensive obstetricians, a high-stress group, using non-invasive haemodynamic monitoring, and to examine the association between burnout and haemodynamic parameters.
Cross-sectional study.
A single tertiary hospital in China.
A total of 120 healthy Han Chinese adults (aged 25–45 years, both sexes) were enrolled using stratified random sampling by age and categorised into three groups: obstetricians, clinical support staff and administrative personnel. Of these, 105 (87.5%) completed the study and entered the final analysis (obstetricians n=40; clinical support staff n=33; administrative personnel n=32); 15 were excluded due to incomplete questionnaire data. Key exclusion criteria were chronic medical conditions, medication use, acute illness, a clinical shift within 24 hours before measurement, pregnancy or lactation, body mass index extremes (≤18.5 or ≥ 28 kg/m2) and major life events within the past 6 months. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey; workload, lifestyle and family history were collected via questionnaire.
Advanced haemodynamics were assessed via Ultrasonic Cardiac Output Monitor. The primary outcome was cardiac power output (CPO). Secondary outcomes included other non-invasive haemodynamic parameters, such as cardiac index (CI), systemic vascular resistance index, Smith–Madigan inotropy index and corrected flow time.
Severe burnout was associated with reduced CPO and CI (–0.152 W and –0.403 L/min/m2, respectively; both p2, respectively; both p
In high-stress populations, advanced haemodynamic patterns may serve as an early-warning biomarker for burnout, guiding personalised exercise advice. Longitudinal studies are needed to confirm their predictive value.
The United Nations (UN) Sustainable Development Goal 6 seeks to ensure universal access to safe drinking water by 2030, but vast inequities in access exist, especially among vulnerable communities including limited resource, rural, disaster-affected areas. Flood disasters, exacerbated by the climate crisis, hinder the ability of individuals and families to meet essential drinking water needs and increase their susceptibility to waterborne illnesses. Point-of-use (POU) water treatment is an effective solution for water-insecure populations during and immediately following flood emergencies. However, an initial literature search identified knowledge gaps surrounding implementation of POU water systems. This scoping review aims to synthesise published evidence between January 2015 and July 2025 on barriers and facilitators to utilisation of POU water treatment systems during and immediately following flood-related disasters. The findings will inform efforts to promote resilience and agency among water insecure communities, specifically by equipping them with actionable knowledge on sustainable access to safe drinking water.
This scoping review will be guided by the work of Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Search terms will be identified through an iterative process using the PICOT method and Boolean logic. Four databases—Scopus, PubMed, Web of Science and Google Scholar—with the addition of grey literature from UN agencies and non-governmental organisations focused on water-related issues will be searched. Two independent reviewers will apply a priori eligibility criteria to select studies. Conflicts will be resolved through discussion and a third independent reviewer absent agreement between the first two reviewers. Cohen’s kappa statistic will be calculated to assess inter-rater reliability. Data extraction will be guided by predefined data points, and the Consolidated Framework for Implementation Research will guide evidence synthesis through a solution-based approach.
Institutional research ethics review is not required because no human subjects are involved. Findings will be disseminated through a peer-reviewed publication, a policy brief, conference presentations and infographics for use by organisations serving flood disaster impacted communities.
In 2017, Lifeline Nehemiah Projects in Sierra Leone launched 2YoungLives, a mentoring initiative for vulnerable pregnant adolescents, including those living with disabilities. Drawing from the social model of disability, we aimed to investigate the exacerbated disabling barriers which prevent these girls and their babies from accessing available healthcare and develop comprehensive solutions to improve their access.
Qualitative methods were used in this study.
Participants were invited to participate in face-to-face interviews in one district in Sierra Leone.
Six pregnant or postnatal adolescents living with disability, alongside four caregivers and five stakeholders from various organisations participated in semi-structured interviews employing thematic analysis.
We identified four key themes: (1) discrimination and financial barriers within the healthcare system, despite laws ensuring free healthcare for persons living with disabilities, (2) societal stigma manifested through abandonment by families and inadequate support, (3) lack of understanding of disability issues, particularly of those with intellectual impairments, leading to stigmatisation and exclusion, and (4) infrastructural limitations which hinder accessibility to essential services, with many facilities remaining non-compliant with disability regulations.
Adolescent girls living with disability during pregnancy and after birth in Sierra Leone face barriers to accessing healthcare, including caregiver ignorance, lack of autonomy, disabling services, social stigma and ineffective policy implementation, despite existing supportive laws. These findings keep those women who are arguably the most vulnerable, adolescent and living with a disability, from accessing perinatal healthcare, exacerbating their risk and that of their babies. Solutions include the need to enforce disability-inclusive policies and infrastructure adaptations, awareness and training for healthcare providers and community advocacy to break down social stigma.
To examine the impact of the COVID-19 pandemic on body mass index (BMI) and obesity status among Canadian residents and explore how this association varied by sociodemographic and health status.
Prospective cohort study.
Canada.
41 302 adults, aged 45–85 at baseline, participating in the Canadian Longitudinal Study on Aging.
BMI and BMI-defined obesity were measured at baseline, follow-up 1 and follow-up 2 (FUP2), with 33% of FUP2 data (n=13 444) gathered after 16 March 2020, when COVID-19 restrictions began. Correction factors were applied for self-reported BMI and weighted generalised estimating equations assessed BMI changes before and during the pandemic.
We found a significant interaction between follow-up time and timing of FUP2 data collection (before or during the pandemic). Participants measured during the pandemic had an excess BMI increase of 0.21 kg/m² (95% CI 0.15 to 0.28) and 1.06 times higher odds of obesity (95% CI 1.03 to 1.09) compared with prepandemic trends. Increases were more pronounced among females, middle-aged adults and those without diabetes.
The COVID-19 pandemic was associated with a modest increase in BMI and obesity among Canadian adults. Ongoing research is needed to assess long-term trends.
Loneliness and social isolation are increasingly recognised as determinants of cardiovascular and brain health, particularly among older adults. Evidence from high-income settings links social disconnection to higher risk of coronary heart disease, stroke, cognitive decline and mortality, yet few interventions have been adapted for rural, resource-limited environments. In rural coastal Ecuador, demographic stability, low migration and strong community engagement provide a unique context to evaluate a culturally grounded intervention. This study aims to determine whether a multi-component social connection intervention programme (SCIP), informed by the Social Cognitive Theory, can reduce loneliness and social isolation and improve cardiovascular, cognitive and psychosocial outcomes among older adults living in three rural villages participating in a population-based cohort.
This quasi-experimental matched-control study will be conducted in Atahualpa (intervention site) and the neighbouring villages of El Tambo and Prosperidad (control sites). Eligible participants are adults aged ≥60 years without disability, dementia or major psychiatric illness. Intervention participants will be matched to controls using variable-ratio propensity score methods. The 12-month SCIP includes monthly community educational activities, peer-support group sessions and individualised coaching (two times per month) focused on skill-building, goal-setting and cognitive-behavioural strategies. Participants in the control villages will receive usual community and primary care services without exposure to SCIP activities. Baseline and 12-month assessments will measure social isolation, loneliness, cardiovascular health, sleep quality, cognitive performance, depressive symptoms and quality of life. Incident stroke, cardiovascular disease and mortality will be monitored quarterly. Analyses will use mixed-effects models for continuous and categorical outcomes and Cox proportional hazards models for incident events, adjusting for relevant confounders.
The protocol was approved by the Ethics Committee of Hospital-Clinica Kennedy, Guayaquil. All participants will provide written informed consent. Findings will be disseminated through peer-reviewed publications, conference presentations and community reports. Results may inform scalable strategies to enhance psychosocial well-being and reduce cardiovascular and cognitive risk in underserved rural populations.
The transition from hospital to home is a vulnerable stage in the patient pathway. Patients and carers often report unmet information needs regarding diagnoses, medication changes, follow-up arrangements and escalation pathways during the post-hospital discharge period. Digital information interventions—such as electronic health records, patient portals or remote communication systems—have been proposed to improve discharge pathways. However, evidence on their impact is unproven. The aim of this review is to understand what works for whom, how, why and in what circumstances in relation to digital information interventions during the hospital-to-home journey.
Pawson’s realist review approach will be used. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and Realist and Meta-narrative Evidence Syntheses: Evolving Standards quality and reporting standards will also be followed. The review will follow five steps: (1) Development of the initial programme theory; (2) evidence search; (3) selection and appraisal of data; (4) extraction and organisation of data and (5) data synthesis and analysis. The search will be conducted in MEDLINE (Ovid); Embase; PsycINFO; Web of Science and Cochrane Library and supplemented with citation tracking, grey literature, relevant organisational websites, programme evaluation reports and through consultation with stakeholders. The realist review will be an iterative process, and the initial realist programme theory will be tested (confirmed, refuted or refined) in response to the data searches and stakeholder discussions. Patient and public involvement and engagement will be embedded throughout the review. Patients, carers and health and care stakeholders will contribute to refining the initial programme theory, interpreting emerging programme theory and co-developing dissemination outputs to ensure findings remain grounded in lived realities.
Ethical approval is not required for this review as it involves secondary analysis of published literature. The review will be conducted in accordance with principles of research integrity, transparency and responsible stakeholder involvement. Findings will inform the co-design of future digital discharge interventions and contribute to national priorities around digital transformation, safety and equity in transitional care. Dissemination will include conference presentations, a peer-reviewed journal article and accessible summaries co-developed with stakeholders to support equitable implementation and impact.
To assess the status of women’s empowerment and its associated factors using multidimensional empowerment index in Tigray, Ethiopia.
Community-based cross-sectional study.
Tigray regional state, Ethiopia.
A sample of married pregnant women (n=1477) whose gestational age was at least 8 weeks were the study participants.
The primary outcome of the study was women’s empowerment status, assessed using 24 indicators across five key domains: decision-making power, social independence, attitudes towards violence against women, social networking and household asset ownership. Equal weight was assigned to all domains and the weight assigned to each domain was distributed equally to the indicators within the corresponding domain. Women who scored at least 80% (ie, met 4 out of 5 domains) were considered as empowered.
In total, only 8.2% (95% CI 6.9 to 9.78) of women were empowered. Intrafamilial factors: husband’s education with primary (adjusted OR (AOR): 2.66 (1.30 to 5.43), secondary AOR: 4.69 (2.23 to 9.84) and tertiary AOR: 3.60 (1.20 to 10.83)) levels, being from model households (AOR: 4.38 (1.33 to 14.47)), households with middle (AOR: 3.50 (1.13 to 8.37)) or high (AOR: 3.10 (1.25 to 7.67)) wealth index, enrolment in productive safety net programmes (AOR: 2.37 (1.25 to 4.50)) and age at first pregnancy (AOR: 1.16 (1.08 to 1.24)) were positively associated with women’s empowerment. From the community-level characteristics, dowry (AOR: 1.82 (1.10 to 5.30)) and perceived good availability of justice for women and girls (AOR: 3.00 (1.05 to 8.60)) were positively associated with women’s empowerment. Conversely, the history of an adverse pregnancy outcome was negatively associated with women’s empowerment (AOR: 0.51 (0.26 to 0.99)).
The overall status of women’s empowerment in Tigray was very low. Husband’s education, being model household, wealth index, enrolment in productive safety net programmes, dowry practice, perceived good availability of justice for women and girls and age at first pregnancy were found to be significant factors associated with women’s empowerment. In view of these empirical insights, several policy recommendations are proposed. First, interventions should focus on the identified associated factors, particularly in areas with lower empowerment scores such as partner’s education, improving access to justice for women, addressing harmful community practices such as dowry and strengthening household economic status through social protection and livelihood programmes. Second, the promotion of gender-balanced household dynamics through awareness campaigns and policy incentives could make a substantial contribution to women’s empowerment in the study area.
Epic MyChart, used as a patient portal or within Epic Healthy Planet programmes, is integrated with the Epic electronic health record system, enabling secure access to health information, communication with clinicians and self-management tools. Despite increasing portal adoption in the UK and internationally, there is fragmented and unclear evidence demonstrating impact on clinical outcomes, engagement, safety, experience, efficiency and equity. This scoping review will map existing research on Epic MyChart, identify barriers and facilitators to uptake, and explore technical and operational determinants influencing implementation.
We will conduct a scoping review guided by Arksey and O’Malley’s framework, refined by Levac et al, and report according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and PRISMA-Equity guidelines. Eligible studies will include original research evaluating Epic MyChart or Epic Healthy Planet programmes, reporting outcomes related to patient-reported measures, clinical effectiveness, engagement, safety, efficiency or equity. Searches will cover MEDLINE, CINAHL, PsycINFO, EMBASE, Cochrane CENTRAL, Scopus, trial registries and grey literature. Two reviewers will independently screen records and extract data on study characteristics, outcomes, equity factors and implementation determinants. Quantitative findings will be synthesised narratively using synthesis without meta-analysis guidance; qualitative data will undergo thematic synthesis. Stakeholder consultations with health informatics experts, clinicians, data scientists and health system managers, alongside a patient and public involvement workshop, will support interpretation of findings. A logic model will illustrate relationships between portal features, implementation factors and outcomes. Although focused on Epic MyChart, the review will offer insights relevant to other patient portals, as many implementation and equity considerations are shared across digital health systems.
Ethical approval is not required as the review uses published data. Findings will be disseminated through peer-reviewed publication, conferences and stakeholder engagement to inform implementation of patient portals internationally.
The protocol is registered on the Open Science Framework (https://osf.io/5azdh/overview).
High burdens of infectious and non-communicable diseases and human resource shortages strain primary healthcare systems in Southern Africa. Despite the widespread use of community health workers (CHWs) across the region, the existing literature offers no holistic exploration of the characteristics of CHWs’ work. The Job Demands-Resources model provides a framework to enable such a review, positing that two aspects of working conditions—job demands and job resources—are unique to each workplace but have universal impacts on workers’ health, motivation and the achievement of organisational aims.
The population, concept and context framework will guide the development of a comprehensive search strategy to source reports on CHWs working in large-scale programmes that explore job demands and job resources within at least one Southern African Development Community country. Searches to identify peer-reviewed articles and grey literature will be done in CHW Central, CINAHL, PubMed, Scopus and the WHO Library with citations purposively mined. Eligibility will be limited to reports published in English after the Declaration of Ouagadougou on Primary Health Care in 2008, as this ushered in the modern era of large-scale CHW programmes in Africa. Following publication of this protocol, two reviewers will independently complete screening and full-text review, with the lead author driving data extraction and coding. The results will include organising job demands and job resources into themes, documenting the types of research that articulate these themes and identifying potential knowledge gaps. The review’s methodology and the inclusion of various types of literature will support replicability and comprehensiveness.
Formal ethical approval is not required. Results will take the form of a summative article, and additional publications may be considered if the results warrant more in-depth reporting. The evidence from this review may also inform the creation or improvement of programmes.
INPLASY202580052.
The Healthy Lifestyle Index (HLI) integrates key behaviours to assess their cumulative impact on health. While higher HLI adherence is linked to lower disease and mortality risk, its long-term trajectory association remains understudied. This study aims to examine the dose-response relationship and long-term association of HLI on mortality risks.
Systematic review and dose-response meta-analysis using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
PubMed, Scopus and Web of Science were searched until June 2024.
We included observational cohort studies that assessed the relationship of HLI or its trajectories with all-cause, cardiovascular disease (CVD)-cause or cancer-cause of mortality.
Analysis of 13.7 million participants demonstrated that higher adherence to the HLI is linked to lower risk of all-cause (HR: 0.48; 95% CI 0.46 to 0.53; GRADE: moderate), CVD-cause (HR: 0.49; 95% CI 0.44 to 0.51; GRADE: moderate) and cancer-cause mortality (HR: 0.55; 95% CI 0.49 to 0.61; GRADE: low). These associations were further confirmed in a dose-response manner. Moreover, compared with maintaining an unhealthy lifestyle, a decline in HLI adherence was associated with a 14% higher risk of all-cause and a 19% higher risk of cancer-related mortality. In contrast, an improvement in HLI adherence was linked to a 20% lower risk of all-cause and a 13% lower risk of cancer-related mortality.
Adherence to HLI and its long-term patterns are associated with lower mortality risk. These findings emphasise the importance of lifestyle-based prevention and intervention strategies in reducing mortality.
CRD42024500538.
To identify psychosocial and structural barriers to prompt malaria care-seeking in Malawi by applying the Three Delays Model (delay 1: deciding to seek care; delay 2: reaching a facility; delay 3: receiving quality care).
cross-sectional study.
Nationally representative data collected from Malawi communities between 25 May 2021 and 1 July 2021.
913 female caregivers who reported a child with fever in the past 2 weeks.
Prompt care-seeking for fever (same or next day) from a qualified health provider.
Prompt care-seeking was primarily associated with delay 1 (adjusted OR (aOR) 0.58, 95% CI 0.43 to 0.78) and psychosocial (aOR 0.59; 95% CI 0.44 to 0.79) factors. Significant factors included incorrect knowledge of malaria symptoms, cause and diagnosis (aOR 0.71: 95% CI 0.53 to 0.97), negative attitudes towards care-seeking (aOR 0.58; 95% CI 0.41 to 0.82), incorrect knowledge of when and where to seek care (aOR 0.19: 95% CI 0.07 to 0.50) and far distance from a health facility (aOR 0.67, 95% CI 0.49 to 0.93).
Despite the availability of free malaria services, significant bottlenecks remain in the initial decision-making phase. To reduce malaria mortality, national programmes should prioritise social and behaviour change interventions that move beyond general awareness to target specific care-seeking attitudes and intra-household decision-making dynamics.
Australian studies investigating parental factors often lack meaningful inclusion of Aboriginal and Torres Strait Islander families, limiting our understanding of current influences on positive developmental trajectories within communities. There is growing recognition of the need for culturally safe and responsive longitudinal research that is co-designed and co-led by the community for the community. An Indigenous-led birth cohort study of Aboriginal and Torres Strait Islander families in Queensland, Australia, has therefore been developed to better understand health across generations.
The Strong Families Study is a co-designed prospective longitudinal birth cohort study that will follow 400 Indigenous families in Queensland from pregnancy until the child reaches 5 years of age. Eligible participants include pregnant individuals (
This study was approved by the Mater Misericordiae Ltd Human Research Ethics Committee (HREC/MML/105191) and ratified by the University of Queensland Human Research Ethics Committee (2025/HE001924). Endorsement letters were secured from partner services at each study site. Findings will be shared with partnering hospitals and funding bodies at conferences and through reports and peer-reviewed publications.
To investigate the impact of non-pharmaceutical interventions (NPIs) on COVID-19 transmission in different pandemic stages across 12 Asian countries.
This was an ecological study of publicly available data. This study used the Stringency Index from the Oxford COVID-19 Government Response Tracker (OxCGRT) as a composite measure of implementation strictness of non-pharmaceutical interventions.
Data were obtained from Our World in Data and OxCGRT (January 2021 to September 2022).
12 countries were included in the study: Azerbaijan, Turkey, Bahrain, Israel, Lebanon, Japan, South Korea, Singapore, Malaysia, Thailand, Cambodia, and Indonesia.
The instantaneous reproduction number (Rt). Rt is defined as the expected number of secondary infections occurring at time t, divided by the number of infected individuals, each scaled by their relative infectiousness at time t (an individual’s relative infectiousness is based on the generation interval and time).
Three different pandemic development patterns were identified: Cluster 1 countries (marked by distinct fluctuation), Cluster 2 countries (characterised by smaller fluctuation) and Cluster 3 countries (featuring a peak between July and September). An increase in the Stringency Index was associated with a significant decrease in Rt during warmer seasons in both Cluster 1 and 2 (both p values
This study demonstrates that the effectiveness of NPIs varies with seasonal changes and pandemic patterns. Therefore, to improve the efficiency of public health responses, policymakers should tailor NPI strategies based on seasonal variations and local socio-structural factors. The findings provide new insights for future research on the impact of NPI implementation during pandemics, which plays a critical role in pandemic management.
As populations age and climate variability intensifies, seasonal migration has emerged as a strategy among older adults to reduce exposure to climatic extremes and optimise living conditions. In China, millions of older adults migrate annually between cold northern and tropical southern regions, providing a natural setting to examine the health effects of seasonal migration. The Frigid-Tropical Migratory Population Health (ftMPH) cohort was established to assess the short- and long-term health effects of this migration and the underlying biological, behavioural and social pathways.
The ftMPH cohort is a prospective, dynamic cohort jointly conducted in Heilongjiang (a cold region) and Hainan (a tropical region) in China, with a planned sample size of approximately 26 000 participants. Adults aged ≥60 years are recruited and classified into four subcohorts: cold-origin seasonal migrants, cold-region residents, tropical-origin seasonal migrants and tropical-region residents. Baseline assessments include questionnaires, clinical examinations, biospecimen collection and environmental exposure measurements. Each migration cycle is assessed at predefined time points spanning the departure and return phases. Migration exposure will be updated longitudinally at each follow-up interval.
The primary outcome is the incidence of major cardiovascular disease events, including non-fatal myocardial infarction, coronary revascularisation, stroke and cardiovascular mortality. Secondary outcomes include non-cardiovascular mortality, chronic disease events, healthcare utilisation and ageing-related measures. Time-to-event analyses will be performed using Cox proportional hazards models. Inverse probability of treatment weighting (IPTW) will be used to control for baseline confounding, with stabilised weights and covariate balance assessed using standardised mean differences. Longitudinal changes in repeated measures will be analysed using mixed-effects models.
Ethical approval was obtained from the Ethics Review Committee of Harbin Medical University (approval No HMUIRB2024029PRE) and the Ethics Review Committee of Hainan Medical University (approval No HYMLL-2025-102). Findings will be disseminated through peer-reviewed publications, conference presentations and policy or technical reports.
The ftMPH cohort is registered with the Chinese Clinical Trial Registry (ChiCTR2500102337; registered on 13 May 2025).
To assess the level of health system responsiveness (HSR) and its associated factors among outpatients attending primary healthcare units (PHCU) in Arba Minch, South Ethiopia.
Facility-based cross-sectional study.
Three PHCUs (one primary hospital and two health centres) in Arba Minch town, Southern Ethiopia.
A total of 379 outpatients aged 18 years and above were selected using a systematic random sampling.
Primary outcome: level of HSR, measured across seven domains (communication, confidentiality, basic amenities, dignity, choice, prompt attention and autonomy) using a 28-item tool adapted from the WHO HSR framework. Secondary outcome: factors associated with HSR, identified via bivariate and multivariable linear regression.
The overall HSR was 59.4%. The highest-performing domains were confidentiality (73.9%) and dignity (70.7%), while the choice of healthcare provider was rated lowest (34.6%). In multivariable linear regression analysis, factors significantly associated with HSR score were travel time to reach the health facility on foot (β = –0.26, 95% CI –0.37 to –0.14); out-of-pocket payment for transport (β = –6.51, 95% CI –8.33 to –4.70); patient satisfaction score (β=1.57, 95% CI 1.27 to 1.88) and perceived quality of healthcare score (β=0.32, 95% CI 0.14 to 0.49).
HSR among outpatients in PHCU was moderate, with several individual and service-related factors associated with patient experiences. These findings suggest the need for focused interventions to improve responsiveness domains, although more research is required to demonstrate causal relationships.
Atherosclerotic cardiovascular disease (ASCVD) continues to be a leading cause of preventable death globally. Polygenic risk scores (PRS) offer a way to detect individuals at higher relative risk of developing ASCVD, but they have not yet been incorporated into routine clinical practice. Pragmatic trials offer a way to evaluate the integration of PRS into cardiovascular disease prevention in primary care, allowing for a more accurate assessment of their effectiveness in everyday clinical practice.
This trial evaluates the effectiveness of preventive statin treatment on reducing the incidence of cardiovascular events and death over 5 years in women (aged 55–80) and men (aged 45–80) with a high coronary artery disease PRS. This is a pragmatic, multicentre, open-label, parallel group, randomised clinical trial with a 1:1 allocation ratio to intervention (n=1350), receiving preventive rosuvastatin 20 mg treatment or control (n=1350), receiving current standard of care. Following the intention-to-treat principle, all randomised participants are analysed according to their allocated group, with the primary outcome defined as time to first major adverse cardiovascular event, comprising ischaemic heart disease, stroke or transient ischaemia, peripheral vascular occlusion and stenosis, revascularisation or cardiovascular death.
This trial has received ethical approval from the Estonian Committee on Bioethics and Human Research (13.06.2024 nr 1.1-12/1531) and the Estonian Ethics Committee for Medicinal Products (19.12.2024 nr RKU-4/92).
FreshRSS 