Common mental health outcomes among children in conflict with the law in correctional facilities in Africa are an under-researched area with significant public health implications. This review will synthesise available and accessible evidence on the prevalence and associated factors of common mental health outcomes among children in conflict with the law in Africa.

Comprehensive electronic searches will date from 01 January 2015 to 31 December 2025 and will be conducted in PubMed, Sabinet, Scopus, EBSCOhost, Web of Science and PsycINFO. Articles will be screened using defined inclusion and exclusion criteria and assessed for eligibility by three independent reviewers. Discrepancies will be reviewed by a ninth reviewer. The selection process of included articles will be reported by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses will be used. The Mixed Methods Appraisal Tool will assess study quality, and data will be synthesised using meta-analysis or a narrative synthesis approach, depending on heterogeneity levels.

This study will not require ethical approval from an institutional review board, as it does not entail the direct collection of data from children in conflict with the law, nor does it pose any risk to their privacy. Once finalised, the full review report will be submitted for publication in a peer-reviewed journal. The key findings will also be shared at both local and international conferences, highlighting common mental health outcomes among children in conflict with the law.

CRD420251011484.

The study evaluated the feasibility and efficacy of a non-immersive virtual reality (VR) system on upper extremity (UE) recovery in ischaemic stroke patients in comparison to a conventional physiotherapy.

An open-label, parallel-group, randomised controlled trial randomly assigned the participants to two groups, VR intervention or conventional physiotherapy.

Two tertiary stroke care centres in South India participated in the study.

Sixty first-ever ischaemic stroke patients (1–6 months of stroke onset) having spasticity grades of 1 or 1+ as per Modified Ashworth scale and Brunnstrom recovery stages of 3, 4 or 5 in the UE were included in the intention-to-treat analysis.

High-intensity non-immersive VR-based comprehensive rehabilitation gaming system with a duration of 12 weeks (3 days/week) was compared with equally intensive conventional physiotherapy.

The feasibility outcome was the compliance with the treatment. The primary efficacy outcome was the improvement in the motor function assessed by the Fugl-Meyer assessment (FMA) and Wolf motor function test (WMFT). The secondary outcomes included the performance in activities of daily living by the Barthel index (BI) and the quality of life by the 36-item short form health survey (SF-36).

The treatment compliance was similar in two groups (p=0.19). Both groups improved in motor performance, activities of daily living and quality of life. However, there were no significant differences in the FMA (p=0.58), WMFT (functional ability scale, p=0.33; performance time, p=0.44), BI (p=0.84) and SF-36 (physical, p=0.87; mental, p=0.99) scores between the groups.

The non-immersive VR system was feasible, effective and safe; however, it was not found to be superior to conventional physiotherapy. The trial was stopped early and did not reach its proposed sample size and hence, the findings are to be interpreted cautiously.

Clinical trial registry India: CTRI/2021/11/038339 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NTc1OTI=&Enc=&userName=CTRI/2021/11/038339).

The predictive value of carotid-femoral pulse wave velocity (cfPWV) for cardiovascular (CV) events in individuals with blood pressure (BP) 120–159/80–99 mm Hg, where more accurate risk stratification has the greatest clinical effect, is unknown. This study aims to determine whether cfPWV improves the prediction of CV events beyond traditional risk factors in individuals with moderate BP.

A systematic review and meta-analysis.

PubMed and EMBASE were searched through April 2023.

We included prospective, population-based cohort studies with ≥1 year follow-up that directly measured cfPWV as an index of arterial stiffness and reported incident CV disease (CVD), atherosclerotic CVD (ASCVD), coronary heart disease, stroke or all-cause mortality outcomes.

Individual participant data from 11 cohorts (n=15 987) were harmonised and analysed using two-stage random-effects meta-analysis. Incremental predictive and clinical utility analyses compared 10-year risk models with and without cfPWV.

There were 1279 first atherosclerotic CV events over a median follow-up of 9.9 years. A 1-SD increase in log_e(cfPWV) was associated with a 1.21-fold (95% CI 1.08 to 1.36) increase in risk of ASCVD. Adding cfPWV to traditional risk factors improved ASCVD prediction: change in discrimination (C-index): 0.0048 (95% CI 0.0002 to 0.0094), p=0.041. In hypothetical populations of 100 000 individuals with moderate BP, cfPWV-guided treatment could reduce event rates by 2.7% and 3.1% under European and US guidelines, respectively.

Adding cfPWV to traditional CV risk factors may improve the prediction and classification of first CV events in individuals with moderate BP. Additional screening with cfPWV could enhance risk stratification for antihypertensive treatment initiations.

The prevalence of HIV in adolescents is a major global health concern, and research into the influence of HIV on mental health outcomes in this demographic is ongoing. We will conduct a comprehensive systematic review of common mental health outcomes in adolescents with HIV infection (aged 10–24 years). Recognising the specific psychosocial issues that adolescents living with HIV infection are confronted with, this review aims to integrate existing research on the prevalence, risk factors and protective factors related to both positive and negative mental health outcomes in this population.

The following electronic databases will be searched for publications from 1959 up to December 2025: PubMed, PsycINFO, Global Health, Embase, African Journals OnLine and African Index Medicus. The review will focus on both positive and negative mental health outcomes: positive outcomes include resilience, subjective happiness and post-traumatic growth, whereas the negative outcomes include depression, anxiety, post-traumatic stress disorder, substance use disorder and suicidality. Peer-reviewed primary observational studies that report prevalence rates for common mental health outcomes outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and the International Classification of Diseases, 11th Edition, their associated factors, as well as barriers to and facilitators of use of mental health support services among this population, will be included in the review. Google Scholar and ProQuest Dissertations & Theses Global as well as Electronic Theses and Dissertations from Ghana, South Africa, Uganda and Kenya, will also be searched for grey literature. The review will be limited to publications in English or French. To assess the methodological rigour of the selected studies, the Joanna Briggs Critical Appraisal Tools will be used. The synthesis will include a narrative summary and, if applicable, a meta-analysis of quantitative data depending on the extent of heterogeneity observed in the included studies. Subgroup analyses will be conducted to investigate differences in mental health outcomes by age, sex and socioeconomic position, where applicable. This systematic review will be reported in accordance with the PRISMA statement.

This review will use secondary data and does not require ethical approval. The findings will be shared through peer-reviewed publications and conference presentations. The emphasis will be on translating research findings into practical mental health interventions and HIV-specific support services for adolescents.

CRD42024568512.

Air pollution is a significant global health concern, with studies from the USA and Europe linking long-term exposure to respiratory issues and poor school attendance in children. While Indian cities experience much higher pollution levels, the impact on lung development in Indian children remains unclear. This study aims to assess the burden of impaired lung function in Indian children and identify key factors contributing to pollution-induced lung injury.

This longitudinal, prospective cohort study is conducted in four cities categorised by particulate matter 2.5 (PM_2.5) levels: ‘very high’ (Delhi), ‘high’ (Mumbai, Bangalore) and ‘moderate’ (Mysore). A total of 4000 participants (1000 from each city) will be included in the study. Participants will complete a structured questionnaire covering sociodemographics, asthma and allergy history (International Study of Asthma and Allergies in Childhood core questionnaire), dietary intake (24-hour recall and Food Frequency Questionnaire), Physical Activity-C Questionnaire and air pollution exposure. Spirometry and Forced Oscillation Technique will be used to assess lung function. Blood samples will be collected for identification of biomarkers to predict lung impairment. After quality checks, data will be compiled, summarising pulmonary function parameters alongside covariates and confounders. Analysis of Variance (ANOVA) will assess between-city and within-city differences in lung function.

We anticipate a higher prevalence of reduced lung function in children residing in cities with very high and high PM_2.5 levels compared with the moderately polluted city. Findings from this study could establish normal age-appropriate lung function reference values for Indian urban children, aiding in clinical diagnosis.If a reliable biomarker for identifying children at risk of lung impairment is available, it could serve as an early predictor of poor lung health in asymptomatic children.

The approval from individual site institutional review board (IRB) is obtained prior to initiation of the study from institutional ethics committee, St. John’s Medical College and Hospital, Bangalore; institutional ethics committee, JSS Medical College, Mysore; institute ethics committee, Indian Institute of Technology Bombay and institute ethics committee, All India Institute of Medical Sciences. Findings from this study will be disseminated through conference presentations, peer-reviewed publications and establishment of normal age-appropriate lung function reference values for children living in urban India.

Individuals are diagnosed with terminal/chronic conditions on a daily basis globally. Unfortunately, a substantial proportion of the global disease burden of chronic illnesses is recorded within sub-Saharan Africa. Providing or receiving such news can be devastating and may be influenced by cultural preferences and contextual differences. Identifying existing trends and how such news is broken in sub-Saharan Africa will be relevant to identify and inform practice and future research.

This systematic review protocol was developed by following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P), and findings will be reported by following the guidelines and recommendations of PRISMA-2020. CINAHL, Global Health, MEDLINE, PubMed, Scopus, AJOL and APA PsycINFO will be searched for articles. Additional records will be gathered through reference harvesting in Google Scholar search. QualSyst will be used to assess the methodological quality of studies included. Thematic synthesis will be used to analyse and synthesise the findings from the eligible studies.

Due to the fact that systematic reviews focus on accessible and available literature without the direct involvement of human participants, ethical approval will not be sought. The completed review will be submitted to a peer-reviewed journal and may be presented at health conferences. The important findings would be shared with stakeholders and those involved in developing and conducting training for health practitioners, all of whom are involved in breaking bad news.

CRD42025642707.