Suicide is a leading cause of death in the USA, and its incidence has increased substantially in recent years. Observational studies have used large, linked databases to investigate risk factors for suicide, but data generally originate from a small number of similar sources. Prevention efforts may be strengthened by linking data from diverse sources across multiple sectors. The New Opportunities for Health and Resilience Measures for Suicide Prevention project aims to develop a resource for characterising key risk and protective factors for suicide outcomes by linking state-level death records with county-level data from 12 administrative sources, including medical, legal and social service records, among others.

Administrative records of death, emergency medical services, emergency department syndromic surveillance, homelessness services, psychiatric crisis services, jail stays, domestic violence referrals and Medicaid/Medicare claims will be obtained through partnerships with source agencies. Death records are available for Washington State, while all other records are available for residents of King County, Washington. Temporal availability varies, but records generally cover the years 2014 to 2023. An iterative machine learning paradigm will be used to link individuals across different records, and events will be harmonised and deduplicated.

This study has been approved by the Washington State Institutional Review Board, and data sharing agreements have been established with each contributing data source. Descriptive information will be disseminated via public data dashboards of suicide and non-fatal suicide behaviours. Analytic studies will be disseminated in peer-reviewed scientific journal publications.

To assess the impact of opening a large community-based asynchronous review ophthalmic clinic on attendance delays among patients with stable chronic eye disease attending a London teaching eye hospital network.

Interrupted time-series analysis of routine electronic health records of appointment attendances.

A large eye hospital network with facilities across London, UK, between June 2018 and April 2023.

We analysed 69 257 attendances from 39 357 patients, with glaucoma and medical retina accounting for 62% (n=42 982) and 38% (n=26 275) of visits, respectively. Patients over 65 made up 54% (n=37 824) of attendances, while 53% (n=37 014) were from the more deprived half of the population, and 51% (n=35 048) were males.

An asynchronous review clinic opened in a shopping centre in London, in autumn 2021, following the COVID-19 lockdown in spring 2020.

Average attendance delays (days), calculated as the difference between follow-up attendance date and the latest clinically appropriate date determined at the preceding attendance.

Pre-COVID-19, attendance delays for chronic eye disease monitoring were increasing by 0.9 days per week (95% CI, 0.8 to 0.9) on average, worsening to 2.0 days per week (95% CI, 2.0 to 2.0) after the first COVID-19 national lockdown, mid-March 2020. Opening the asynchronous review clinic increased appointment capacity, with delays decreasing on average by 8.1 days per week (95% CI, 8.1 to 8.2) shortly after opening. The rate of decrease slowed to 0.3 days per week (95% CI, 0.3 to 0.3) after 5 months. We found no significant differences in average attendance delays by age, gender or level of deprivation.

The asynchronous review clinic significantly reduced attendance delays across the hospital network, addressing pre-existing backlog for stable chronic eye diseases. The reduction appeared to be maintained after the initial backlog had been cleared.

Variations in mental health and sexual and reproductive health (SRH) outcomes of girls/women (cisgender and transgender) and gender-diverse (nonbinary, Two-Spirit, gender fluid, agender, queer, gender neutral) youth with intersectional identities exist and have largely been ignored in the literature. There is a lack of information on how these health services meet the health needs of girls/women and gender-diverse youth with intersectional identities and the quality of such services. The objective of this global realist review is to identify how, why, for whom, in what contexts and to what extent mental health and SRH services meet the health needs of girls/women (cisgender and transgender) and gender-diverse youth (10–25 years) with intersectional identities.

The protocol has been registered with PROSPERO and will follow Realist and Meta-narrative Evidence Syntheses Quality Standards for Realist Reviews. We will identify the programme theory and implementation determinants of mental health and SRH services for girls/women (cisgender and transgender) and gender-diverse (nonbinary, Two-Spirit, fluid, agender, queer, gender neutral) youth (10–25 years). The scope of the review will be defined in the first stage and will include consultations with youth Advisory Group members and initial programme theory development. An iterative search of scholarly bibliographic databases (MEDLINE, Embase, APA PsycInfo, CINAHL, Web of Science, IBSS) in addition to a grey literature search will take place in the second stage. The third stage will include evidence extraction and synthesis. In the final stage, the narrative will be developed and refined in consultation with Youth Advisory Group members, and findings will be disseminated.

The study was approved by the Research Ethics Board at the Centre for Addiction and Mental Health (2023/153). Findings will be disseminated through peer-reviewed publications, youth-friendly materials and webinars and national and international conferences.

CRD42024532422.

For several decades, mortality has decreased more rapidly among individuals with a higher socioeconomic position than among those with a lower position. This widening social inequality gap has increasingly been recognised as an important aspect of public health research and policies. The objective of this study was to examine trends in educational inequality in healthy life expectancy (HLE) in Denmark between 2010 and 2021 at the age of 30 years.

The study is a population-based study based on register data on longest attained education, standard life tables and self-reported health information from nationwide health surveys.

The study is conducted among the general adult population in Denmark.

Participants include respondents from the Danish National Health Survey and the Danish Health and Morbidity Survey in 2010, 2013, 2017 and 2021 aged ≥30 years.

Expected lifetime in good self-rated health, with no long-standing illness and with no activity limitations was estimated by Sullivan’s method, and educational inequality was expressed by the Slope Index of Inequality.

Between 2010 and 2021, educational inequality in HLE increased among both men and women for long-standing illness (5-year trend: +1.1 and +1.2 years) and activity limitations (+2.4 and +2.6 years) but remained stable among men (+0.1 year) and decreased among women (–0.3 year) for self-rated health. For the latter two indicators, the inequality gap narrowed after 2017.

Trends in educational inequality in HLE in Denmark 2010–2021 vary by health indicator. Steadily widening gaps were demonstrated for long-standing illness, while narrowing gaps were seen after 2017 for activity limitations and self-rated health. Future studies are encouraged to explore potential health risk behaviours that may explain or modify these inequality trends.

The WHO’s Integrated Management of Childhood Illness (IMCI) in young infants

We will create a dataset that integrates data from population-based studies globally with similar designs that have examined the presence of signs of PSBI identified by frontline health workers throughout the young infant period (days 0 to

All prior studies incorporated into our pooled analysis were approved by the independent local ethics committee/institutional review board (IRB) at each study site in each country, and all study participants provided informed consent. This project was approved by the Stanford University School of Medicine IRB protocol 74456. Study findings will be disseminated through publications in peer-reviewed journals, WHO documents, and presentations at maternal and child health meetings.

Adolescent girls living in low-income urban informal settlements face unique challenges that elevate their susceptibility to early childbearing. However, there has been limited research attention, especially qualitative studies, on their use or non-use of antenatal care (ANC) services. Informed by the socioecological theory, we examined the obstacles to and facilitators of ANC services use among pregnant adolescent girls in a low-income urban informal settlement in Kenya.

The study adopted a qualitative explanatory design. We purposively selected 22 adolescent girls aged 13–19 who were either pregnant or had given birth, 10 parents and three health providers to participate in individual interviews. We employed inductive and deductive thematic analyses informed by socioecological theory to explain the barriers to enablers of antenatal services use among pregnant adolescent girls in low-income informal settlements.

Most adolescent girls interviewed faced barriers at multiple socioecological levels, resulting in delayed ANC initiation and fragmented engagement with services. At the intrapersonal level, girls grappled with internalised stigma and late pregnancy recognition and acceptance, often dismissing early signs due to fear or denial. Their young age and limited knowledge of maternal health left them terrified in fear, caught between societal judgement and the daunting prospect of confronting their condition. At the interpersonal level, societal stigma and discrimination pushed many into secrecy, hindering their access to antenatal services. However, parents, other family members, and health providers played a key role in enabling access to care by offering various forms of support to pregnant girls, including offering counselling and accompanying girls to clinics. At the organisational level, user fees and condescending health providers’ attitudes hindered ANC use. Yet, good patient-provider communication, privacy and confidentiality played a key role in enabling ANC attendance.

Pregnant adolescent girls face unique challenges that prevent them from accessing ANC early and completing the recommended number of visits. These challenges range from intrapersonal factors to interpersonal and organisational factors. Programmes to improve early initiation of ANC for pregnant adolescents should include interventions that address the social stigma associated with early and unintended pregnancy, promote family support and make health facilities responsive to the needs of pregnant girls.

On 6 February 2023, two massive earthquakes occurred in Kahramanmaras province in Türkiye. In addition to direct physical damage, earthquakes can also significantly affect individuals’ respiratory health in the postdisaster period. This study aimed to investigate respiratory diseases and related mortality following earthquakes.

This is a retrospective observational study. 1 month following the earthquake, all cases that came to the emergency department between 6 February 2023 and 6 March 2023 who required a pulmonologist consultation were included (n=278). All cases requiring a pulmonologist consultation who were admitted to the emergency department within the same date period 1 year ago (6 February 2022–6 March 2022) were included in the control group (n=255).

Türkiye, Adana Province.

Respiratory diseases, mortality risks in 3 weeks and 3 months, and factors that may affect mortality were investigated in the population exposed to the earthquake.

Pneumonia had the highest rate among admissions in the postearthquake period (36.0%). The pneumonia rate and pneumonia-related deaths were significantly higher compared with those in the previous year (OR: 2.28, 95% CI: 1.05 to 4.94 and OR: 2.49, 95% CI: 1.15 to 5.39; 3-week and 3-month mortality, respectively). The disease that had the second highest admissions rate was chronic obstructive pulmonary disease exacerbation (25.9%). Earthquake exposure is associated with increased risk of 3-week (OR: 1.58, 95% CI: 1.03 to 2.43) and 3-month mortality (OR: 1.55, 95% CI: 1.03 to 2.36).

The period after the earthquake is associated with an increase in the incidence of pneumonia and a poor prognosis for patients with pneumonia. Considering all cases, earthquake exposure has a negative impact on the prognosis of respiratory diseases.