This study aimed to investigate the association between food insecurity and dietary intake with anxiety and depression among residents of underserved urban settlements in Bangladesh.

This cross-sectional study was used to collect data from participants through face-to-face interviews using structured questionnaires. Food security status was assessed using the Household Food Insecurity Access Scale, while anxiety and depression levels were measured using the Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. Dietary intake was evaluated through a 24-hour dietary recall and Food Frequency Questionnaire method.

Five districts located within the Khulna Division of Bangladesh.

Residents of underserved urban areas in Bangladesh (n=749), aged ≥18 years old.

Results indicated that 22.1%, 74.6% and 44.5% of participants experienced severe food insecurity, mild to moderate food insecurity and low Household Dietary Diversity Score, with a significant portion also showing symptoms of anxiety (57.1%) and depression (57.9%). Food insecurity and Household Dietary Diversity Score were found to be positively associated with both anxiety (p

These findings highlight that food insecurity not only affects dietary habits but also exacerbates mental health outcomes. Addressing food insecurity and balanced dietary intake could therefore contribute to better mental health outcomes and overall well-being in underserved communities. Policymakers should prioritise comprehensive strategies that ensure access to nutritious foods and provide mental health support to vulnerable groups.

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.

Knee osteoarthritis (OA) is a serious public health problem since it is linked to loss of muscular function and independence, especially in older adults. In this study, the researchers have proposed a randomised controlled trial with a three-arm study strategy to explore the effectiveness of an oral nutritional supplementation containing hydroxymethylbutyrate and undenatured type-II collagen combined with exercise training (ET) on the OA-related symptoms and biomarkers among adults with knee OA.

Adults with knee OA aged between 50 years and 75 years will be invited to participate in the study and thereafter will be randomly assigned to either one of three groups: oral nutrition supplementation+ET, ET or usual care. The primary outcomes include changes in OA-related symptoms and biomarkers. The secondary outcomes include changes in body composition, blood profiles, physical fitness, quality of life, dietary intake, disability, psychology status and morphological changes of the knee.

Ethics approval was granted by the Medical Research Ethics Committee of the National University of Malaysia (reference number JEP-2024–264). Findings of this study will be disseminated via peer-reviewed presentations at scientific conferences as well as open access publications.

ISRCTN14284561.

‘Caring’ is a critical concept in nursing discourse and many theories about care in nursing have been developed and applied to a variety of settings. One example is Swanson’s caring theory, an empirically derived middle-range nursing theory that situates caring as a relational way of attending to others to whom we have a sense of commitment and responsibility, through the five specific...

Type 1 diabetes is a chronic autoimmune disease that often presents with diabetic ketoacidosis at diagnosis. Since detection of type 1 diabetes risk is possible using genetic risk scores and autoantibody assays, prevention of diabetic ketoacidosis or delayed onset of type 1 diabetes may be possible and may improve outcomes. Several pilot screening programmes for type 1 diabetes risk have emerged worldwide but outcomes measured in these screening programmes are heterogeneous, making it difficult to compare and synthesise findings across studies. To improve the standardisation of outcome reporting and measurement, we aim to develop a patient-oriented core outcome set for studies of type 1 diabetes risk screening.

This five-step protocol was developed in alignment with the COS-STAndardised Protocol Statement and the Core Outcome Measures in Effectiveness Trials framework. The five steps will include: (1a) conducting a rapid literature review, (1b) gathering input on candidate outcomes from members of the public, (2) combining literature and public input to prepare a preliminary list of outcomes, (3) conducting Delphi surveys with a range of stakeholders to begin to establish consensus on outcomes, (4) holding a final consensus meeting to establish consensus on outcomes and (5) establishing the outcome measurement instruments for the core outcome set.

Ethics approval has been provided by The Hospital for Sick Children Research Ethics Board. The core outcome set will be distributed to researchers and clinicians involved in diabetes screening and clinical care, patient and family networks, research funders, journal editors, public health experts, and policymakers. Disseminated materials will be tailored to the various end users in the form of publication through academic journals, policy briefs, conferences, educational webinars, websites and social media.

To evaluate the completeness of reporting of simulation studies on responder analysis methods and simulation performance.

Systematic methodological survey.

We searched Embase, MEDLINE (via Ovid), PubMed and Web of Science Core Collection from inception to 9 October 2023.

We included simulation studies comparing responder analysis methods and assessing simulation performance (bias, accuracy, precision or variance, power, type I and II errors and coverage).

Two independent reviewers extracted data and assessed simulation performance. We used descriptive analyses to summarise reporting quality and simulation performance.

We identified seven simulation studies exploring augmented binary methods, distributional methods and model-based methods. No studies reported the starting seed, occurrence of failures during simulations, the random number generator used and the number of simulations. No studies reported simulation accuracy. Responder analysis results were not significantly influenced by covariate adjustment. Distributional methods remained adaptable even with skewed data. Compared with standard binary methods, augmented binary methods generated increased power and precision. When the threshold is in the tail of the distribution, a simple asymptotic Bayesian (SAB) distributional approach may not reduce uncertainty but can improve precision.

Simulation studies comparing responder analysis methods exhibit suboptimal reporting quality. Compared with standard binary methods, augmented binary methods, distributional methods and model-based methods may be better choices, but there is no best one.

The coronary artery calcium (CAC) scan serves as a crucial tool in assessing the risk of coronary atherosclerosis in patients with hyperlipidaemia, particularly when there is ambiguity surrounding pharmacotherapy decisions. In addition to CAC, advanced glycation end products (AGEs), glycated proteins and lipids involved in ageing are emerging as markers for atherosclerosis. However, the relationship between AGEs score and CAC scores has not been evaluated to date. Our primary objective is to evaluate abnormal CAC scores in patients with low and borderline ASCVD risk and normal low-density lipoprotein cholesterol (LDL-C) levels ≤100 mg/dL. The secondary objective is to explore potential associations between CAC and AGEs scores.

We will retrospectively review health records of adult patients seen at the General Internal Medicine Executive Health Program (Mayo Clinic; Rochester, Minnesota) between 1 September 2023 and 31 March 2024, where all patients were offered the option of a baseline CAC scan. For our primary aim, we will determine the percentage of patients with low and borderline 10-year Atherosclerotic Cardiovascular Disease (ASCVD) risk, not receiving pharmacotherapy for hyperlipidaemia, who have LDL-C levels ≤100 mg/dL and have an abnormal CAC score. For our secondary aim, we will examine potential associations between CAC and AGEs scores.

This study was determined to be exempt from institutional review board approval (ID 24–0 03 921; 45 CFR 46.104d, category/subcategory 4(iii)) at the Mayo Clinic, Rochester. The findings of this study will be published in a peer-reviewed journal.

Gender-based violence (GBV) is a pervasive global issue that transcends cultural, economic and educational boundaries, with an exceptionally high prevalence among refugees. Despite extensive research on GBV in Ethiopia, evidence of its occurrence in refugee settings remains limited.

To examine the prevalence and contributing factors of GBV among reproductive-age women in the Okugu Refugee Camp, Gambella, Ethiopia.

A facility-based cross-sectional study.

This study analysed 416 reproductive-age women living in Okugu Refugee Camp.

The study was conducted in the Okugu Refugee Camp from 15 March to 30 May 2023.

The study’s primary outcome was gender-based violence, while the secondary outcome focused on the factors influencing it.

A total of 422 reproductive-age women participated in the study, with a response rate of 98.6%. The prevalence of gender-based violence was 64.4% (95% CI: 59% to 69%). Among the participants, 51.9% experienced physical violence, while 34.9% had a history of sexual violence. Factors, illiterate women (AOR=2.73, 95% CI: 1.509 to 4.942), those who had lived in the camp for more than 4 years (AOR=3.24, 95% CI: 1.964 to 5.372), women who did not discuss sexual intercourse with their family or intimate partner (AOR=4.7, 95% CI: 2.83 to 7.80) and women who consumed alcohol (AOR=2.19, 95% CI: 1.30 to 3.69) were at significantly higher risk of experiencing gender-based violence.

Gender-based violence in the study area was highly prevalent. Key determinants included illiteracy, alcohol consumption, lack of discussion and prolonged stay in the camp. Stakeholders should prioritise interventions such as promoting female education, fostering open discussions and addressing substance use to mitigate gender-based violence in the refugee camp.

This study aimed to investigate the association between the type and severity of disabilities and depression among adolescents aged 15–17 years living in underdeveloped areas of Indonesia.

Cross-sectional study.

Data were derived from the 2018 Indonesia Basic Health Research, a nationally representative data of Indonesia.

We used information collected from 4811 adolescents aged 15–17 living in underdeveloped areas of Indonesia.

The primary outcome was depression, based on the conditions experienced by respondents during the last 2 weeks.

The analysis showed that 5.65% of adolescents aged 15–17 years living in underdeveloped areas of Indonesia had depressive symptoms. Adolescents with severe physical and psychological disabilities were most at risk, exhibiting significantly higher odds of developing depression (aOR=12.09, 95% CI: 5.41 to 27.03, p0.001). Other significant predictors included female adolescents (aOR=2.18, 95% CI: 1.51 to 3.14, p0.001) and those who had a non-communicable disease (aOR=3.50, 95% CI: 1.00 to 12.18, p=0.049).

These findings highlight the critical need for targeted depression interventions and collaborative efforts to support vulnerable adolescents in underdeveloped areas of Indonesia, particularly those with disabilities, girls and those with non-communicable diseases. Efforts to engage healthcare providers, educators and policymakers to improve access to mental health resources will enhance the overall well-being of vulnerable populations.