To examine the effects of 12 weeks group-based peer-led aquatic high-intensity interval training (AHIIT) compared with aquatic moderate continuous training (AMICT) on patient-reported outcome measures (PROMs) and quality-adjusted life-years (QALYs).

A single-blind, parallel-group, randomised trial with a 1:1 allocation ratio.

Community-based setting.

89 participants (mean age 62 (SD 13) years) with rheumatic and musculoskeletal diseases, including hip and knee osteoarthritis, fibromyalgia, rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, were randomly allocated to an AHIIT (n=44) or an AMICT (n=45) group.

The intervention consisted of AHIIT (four intervals of 4 min at high intensity, Borg scale 14–18) or AMICT (Borg scale 12–13), conducted twice weekly for 12 weeks.

Outcomes included disease activity (measured by the Patient Global Assessment), fatigue, pain and health-related quality of life (HRQoL), measured by the EQ-5D utility index (five-dimensional health status measure) and EQ VAS (self-rated overall health scale) for overall health, physical and social activities. All outcomes were assessed at baseline, 3 months and 6 months. To compare the overall benefit of these interventions, QALYs were estimated based on HRQoL. Linear mixed models for repeated measures were used to estimate the mean difference (95% CI) in outcomes.

No statistically significant differences between the groups were found in any outcomes at either three or 6 months (p>0.05).

No difference between the groups was found on PROMs and QALYs. Future research should include larger sample sizes and a non-exercising control group to better determine the efficacy of AHIIT and clarify the role of exercise intensity in symptom management.

NCT05209802.

Vitamin D deficiency during pregnancy is a global health concern, contributing to adverse maternal and fetal outcomes. Despite its importance, limited data exist on vitamin D status and its determinants among pregnant women in Ethiopia. This study aimed to assess the prevalence and determinants of vitamin D deficiency among pregnant women in their first and second trimesters in Gondar Town, Ethiopia, 2024.

A facility-based cross-sectional study was conducted at the antenatal care unit of University of Gondar Comprehensive Specialized Hospital from January to March 2024.

Eligible participants were selected using a simple random sampling technique. Sociodemographic, behavioural and clinical data were collected through structured questionnaires and medical record reviews. Serum levels of vitamin D, calcium and alkaline phosphatase were analysed using the Beckman Coulter clinical chemistry analyser. Statistical comparisons between pregnant women in the first and second trimesters were performed using the independent t-test. Determinants of vitamin D deficiency were identified using multivariate logistic regression analysis.

384 pregnant women in their first or second trimester.

The prevalence of vitamin D deficiency (90 mm Hg) (AOR 0.28, 95% CI 0.11 to 0.70), lower dietary diversity (AOR 3.17, 95% CI 1.13 to 8.89), lower fish and fish oil consumption habit (AOR 3.01, 95% CI 1.03 to 8.77; AOR 12.27, 95% CI 1.50 to 100.42) were the key predictors associated with serum vitamin D defiency.

Nearly half of the pregnant women in Gondar Town exhibit vitamin D deficiency, showing a challenging public health concern. Thus, targeted interventions, such as dietary supplementation and lifestyle modifications, are urgently needed to address the problem and improve maternal and neonatal health outcomes.

To explore the opportunities, challenges and perceived strategies for the uptake of OraQuick HIV self-testing (HIVST) among female sex workers in Ethiopia.

A phenomenological study design, with the Integrated Behavioural Model used as a framework for analysis and interpretation.

Woldia, North Wollo, Ethiopia, 13–30 February 2024.

Twenty female sex workers and 18 key informants in Woldia participated in in-depth interviews, key informant interviews and focus group discussions.

The advantages related to OraQuick HIVST include its privacy, ease of use, reduced waiting time, lowered transportation costs, usability for immobile individuals, application in screening for index case testing programmes, providing confidence and reliability and the elimination of the need for healthcare providers during testing. Perceived possible challenges for the uptake of OraQuick HIVST included kit shortage, absence of policies or guidelines for HIVST, lack of post-test counselling and immediate treatment for positive individuals, potential psychological trauma such as suicidal ideation or attempts, lack of linkage to care for those with reactive results, inaccurate reporting of positive results or result concealment and doubts about reliability before education. Strategies perceived for enhancing the uptake of OraQuick HIVST included making the HIVST kit accessible to higher education communities, addressing HIVST-related doubts by including phone or email contact information, advocating and creating awareness about OraQuick HIVST and ensuring the availability of kits in easily accessible locations.

The study findings highlight many positive opportunities related to the uptake of OraQuick HIVST. Policymakers should prioritise addressing the challenges identified and implementing the proposed strategies to enhance the uptake of OraQuick HIVST, potentially leading to improved HIV testing rates and outcomes.

Traditional peoples and communities (TPCs), such as indigenous peoples and quilombolas (communities descended from escaped African slaves), face challenges related to food security and the impact of the food environment on their health. Changes in food systems, urbanisation and loss of territorial rights have contributed to less healthy eating patterns, with increased consumption of ultra-processed foods and a higher prevalence of chronic non-communicable diseases. Despite this, there are gaps in knowledge about how the food environments of these communities are investigated, especially in relation to the physical, economic, political and sociocultural dimensions.

This scoping review will be conducted following the methodological framework developed by the Joanna Briggs Institute for scoping reviews, and its reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews checklist. A systematic search will be carried out in the following databases: PubMed, SciELO, Web of Science, Embase and EBSCO, using terms related to traditional populations and food environments. The studies to be included will be selected according to the inclusion and exclusion criteria defined based on the population, concept and context technique. The study population will include TPCs, such as indigenous peoples and quilombolas; the concept will address the food environment in its physical, economic, political and sociocultural dimensions; and the context will encompass studies conducted at a global level, without any restrictions on geographic location. The study type will include original articles and grey literature. The screening of studies will involve independent reviewers and predefined inclusion and exclusion criteria. Data synthesis will be presented in tables, including information on focus, geographic scope and methodology of the selected studies. The risk of bias will be assessed using the Risk of Bias in Non-randomised Studies of Exposure tool.

As the study does not involve the collection of primary data or human participants, it does not require ethical approval. The results will be submitted to peer-reviewed journals and presented at public health and nutrition conferences, contributing to the advancement of knowledge on food environments of TPCs.

Suicidal thoughts and behaviours are linked to a wide range of mental health conditions. New interest in the psychiatric benefits of nitrous oxide (N₂O) has only recently emerged. The broad pharmacological effects of N₂O are thought to be due in large part to N-methyl-d-aspartate antagonism and opioid effects. The purpose of this study protocol is to test whether inhalational N₂O exerts rapid antisuicidal effects as a transdiagnostic treatment for suicidal ideation.

This is the protocol of a single-centre pilot study of N₂O inhalation in 85 psychiatric inpatients. The initial 45-min double-blind, randomised, placebo-controlled inhalation session either consists of 50% N₂O and 50% oxygen (‘active treatment’) or 50% oxygen plus air. The primary outcome is the change in Beck Scale for Suicidal Ideation scores between the day before and the day after inhalation. A second inhalation containing N₂O will be administered 1 week after the first inhalation to ensure that all study participants receive the active treatment at least once. For the mechanism of action and prediction, a nested biomarker substudy will employ multimodal techniques, including analysis of hair and blood samples and electroencephalography.

This study was approved by the local ethics committee (‘Kantonale Ethikkommission—Kanton Zürich’) and by the Swiss Agency for Therapeutic Products (Swissmedic). Study results will be disseminated primarily by peer-reviewed scientific journals and also by conference presentations, patient and public events and social media.

ClinicalTrials.gov ID NCT06636357.

Pre-eclampsia causes significant maternal and perinatal morbidity and mortality. It also causes changes in the cardiovascular, endothelial and metabolic systems, from which women may not fully recover after delivery. This study examined the association between the time of onset of pre-eclampsia and the risk for cardiovascular disease (using glucose tolerance, lipid profile and blood pressure) and renal function at 6 weeks post partum.

A prospective cohort study.

Lagos University Teaching Hospital, Idi-Araba, Mother and Child Centre, Gbaja, Surulere and Lagos Island Maternity Hospital, Lagos, Nigeria.

44 women with pre-eclampsia were studied and data on their sociodemographic characteristics, gestational age at diagnosis and blood pressure were collected on admission. They were followed up through delivery till 6 weeks post partum, when blood pressure check, 75 g oral glucose tolerance test, fasting lipid profile and serum creatinine were done.

The exposure was pre-eclampsia. The outcomes were cardiovascular disease risk markers, viz persistent hypertension, glucose intolerance and dyslipidaemia, and renal function at 6 weeks post partum in women who had pre-eclampsia.

Data were analysed using Stata V.16.1. Mann Whitney-U test was used to compare medians and Fisher's exact test was used to compare the categorical variables.

Of the women studied, 13 (29.5%) had early onset pre-eclampsia and 31 (70.5%) had late onset pre-eclampsia. Mean gestational age at diagnosis was 30.8±1.57 weeks in women with early-onset pre-eclampsia and 35.6±1.26 weeks in women with late-onset pre-eclampsia (p

The prevalence of persistent hypertension at 6 weeks post partum is high in women with pre-eclampsia. Serum triglyceride concentration was significantly higher in early onset compared with late onset pre-eclampsia; subsequent studies powered to determine the full cardiovascular risk and how long to follow postnatal women up will be beneficial.

Despite growing evidence to characterise cancer-associated cognitive decline (CACD) in women with breast cancer, interventions to mitigate CACD are limited. Emerging evidence suggests aerobic exercise may enhance cognition after breast cancer diagnosis and treatment; yet, CACD remains an understudied outcome of exercise, and few high-quality studies have been conducted. In addition to knowledge gaps in effectiveness, the translation of exercise interventions to community settings remains challenging. The Breast cancer Reasoning and Activity INtervention (BRAIN) investigates the effectiveness of aerobic exercise training, delivered in a community-based setting, for improving cognitive function in women with breast cancer and gathers information on the implementation success of the intervention.

This Hybrid Type I effectiveness–implementation study is conducted at an academic medical centre in the southwestern United States in partnership with a non-profit, community health and wellness organisation. The study enrols 160 women diagnosed with stage I–IIIa breast cancer and within 3–36 months of treatment completion into a 1:1 randomised controlled trial. Individuals randomised to the exercise group receive a 6-month, individually tailored aerobic exercise programme delivered by exercise trainers employed at local community fitness centres. The programme is progressive in nature and designed to help participants achieve aerobic exercise levels consistent with guidelines for cancer survivors. Individuals randomise to the control group receive a 6-month health education control intervention delivered virtually by hospital-based health educators. Cognitive performance (primary), self-reported cognition, patient-reported outcomes, physical activity and cardiorespiratory fitness are measured at baseline, 6 months (postintervention) and 12 months (follow-up). Brain structure and function are measured via magnetic resonance imaging (MRI) at baseline and 6 months. Implementation outcomes are defined by the RE-AIM framework, which includes reach, effectiveness, adoption, implementation and maintenance. RE-AIM outcomes are measured at baseline, 6 months, 12 months and ongoing during the study.

This study was approved by the Mayo Clinic Institutional Review Board (#23-000020). All participants provide informed consent prior to participation. Findings will be disseminated to scientific, clinical and community audiences through manuscripts, presentations and newsletters.

NCT04816006.