Little research has been done on post-COVID symptoms at 24 months postinfection and on the association these may have on health-related quality of life (HRQOL).

We assessed the prevalence and severity of post-COVID symptoms and quantified EuroQol 5 Dimension 5 Level (EQ-5D-5L), self-perceived health question (EuroQol Visual Analogue Scale (EQ-VAS)) and health utility scores (HUS) up to 24 months follow-up.

The longitudinal multiple cohort CORona Follow-Up (CORFU) study combines seven COVID-19 patient cohorts and a survey among the general public. The participants received questionnaires on several time points. Participants were stratified by: without a known SARS-CoV-2 infection (control group), proven SARS-CoV-2 infection but non-hospitalised, proven SARS-CoV-2 infection hospitalised to the ward, and proven SARS-CoV-2 infection hospitalised to the intensive care unit (ICU).

In this study, data of seven COVID-19 patient cohorts and a survey among the general public are included.

Former COVID-19 patients and controls participated in this cohort study.

Former COVID-19 patients and non-COVID-19 controls were sent questionnaires on symptoms associated with post-COVID condition. The CORFU questionnaire included 14 symptom questions on post-COVID condition using a five-level Likert-scale format. Furthermore, HRQOL was quantified using the EuroQol EQ-5D-5L questionnaire: EQ-VAS and the EQ-5D-5L utility score. The EQ-5D-5L questionnaire includes five domains that are scored on a five-point Likert scale: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.

A total of 901 participants (and 434 controls) responded at 24 months follow-up. In all former COVID-19 patients, the presence of post-COVID condition at 24 months was observed in 62 (42.5%, 95% CI 34.3% to 50.9%) of the non-hospitalised patients, 333 (65.0%, 95% CI 60.7% to 69.2%) of the hospitalised ward patients and 156 (63.2%, 95% CI 56.8% to 69.2%) of the ICU patients, respectively (p

Many former COVID-19 patients experience post-COVID symptoms at 24 months follow-up, with the highest prevalence in hospitalised participants. Also, former patients reported a lower HRQOL.

The CORFU study was registered at clinicaltrials.gov (registration number NCT05240742).

To compare the quality and time efficiency of physician-written summaries with customised large language model (LLM)-generated medical summaries integrated into the electronic health record (EHR) in a non-English clinical environment.

Cross-sectional non-inferiority validation study.

Tertiary academic hospital.

52 physicians from 8 specialties at a large Dutch academic hospital participated, either in writing summaries (n=42) or evaluating them (n=10).

Physician writers wrote summaries of 50 patient records. LLM-generated summaries were created for the same records using an EHR-integrated LLM. An independent, blinded panel of physician evaluators compared physician-written summaries to LLM-generated summaries.

Primary outcome measures were completeness, correctness and conciseness (on a 5-point Likert scale). Secondary outcomes were preference and trust, and time to generate either the physician-written or LLM-generated summary.

The completeness and correctness of LLM-generated summaries did not differ significantly from physician-written summaries. However, LLM summaries were less concise (3.0 vs 3.5, p=0.001). Overall evaluation scores were similar (3.4 vs 3.3, p=0.373), with 57% of evaluators preferring LLM-generated summaries. Trust in both summary types was comparable, and interobserver variability showed excellent reliability (intraclass correlation coefficient 0.975). Physicians took an average of 7 min per summary, while LLMs completed the same task in just 15.7 s.

LLM-generated summaries are comparable to physician-written summaries in completeness and correctness, although slightly less concise. With a clear time-saving benefit, LLMs could help reduce clinicians’ administrative burden without compromising summary quality.

Cohort studies of ageing and cognitive decline typically do not begin fielding comprehensive cognitive assessments until older adulthood. However, for identifying preventable dementia risk factors, there is strong value in beginning at earlier ages. The case is especially compelling in sub-Saharan Africa, where the number of older individuals is expected to triple in the next three decades, and where risk factors may operate more intensively at earlier ages. This study reports on the adaptation and validity of the Harmonised Cognitive Assessment Protocol (HCAP) approach in the Kenya Life Panel Survey (KLPS), collected among middle-aged respondents.

To evaluate the validity of the HCAP approach in Kenya, this study assesses model fit statistics from confirmatory factor analyses (CFA) and tests measurement invariance by respondent characteristics.

Both rural and urban areas in Kenya.

A sample of n=5878 individuals from the KLPS, who have been surveyed regularly since they were schoolchildren in the 1990s. The HCAP assessment was administered in 2023 at an average age of 37 years (10–90 range 34 to 41).

For each individual, the CFA generates a general cognitive performance score, and cognitive performance scores for five distinct domains, including memory, executive functioning, language, orientation to time and place, and visuospatial functioning.

Fit of the models to the data was adequate for general cognitive performance (root mean squared error of approximation (RMSEA)=0.03; comparative fit index (CFI)=0.94; standardised root mean residual (SRMR)=0.05), language (RMSEA=0.02; CFI=0.95; SRMR=0.05) and good for memory (RMSEA=0.05; CFI=0.99; SRMR=0.02) and executive functioning (RMSEA=0.03; CFI=0.98; SRMR=0.03). The CFA indicate that the factor structure is consistent with findings from other countries and that reliability for the general cognitive performance score was high. Statistical models also suggest invariance at the scalar level for leading demographic (gender, age) and socioeconomic (education, occupational complexity) characteristics.

This study demonstrates that the cognitive functioning of mid-age Kenyans appears to be well captured by the adapted protocol. While there is a moderate decline in cognitive performance among older individuals, this relationship appears to be mediated by education, indicating that this KLPS HCAP provides a valuable baseline for studying future cognitive decline.

Tuberculosis (TB) remains a major public health challenge in Sub-Saharan Africa, exacerbated by the high prevalence of drug-resistant TB (DR-TB) and its strong association with HIV. Bedaquiline (BDQ), approved by the WHO in 2013, offers a promising treatment for DR-TB, including multidrug-resistant TB (MDR-TB) and extensively DR-TB (XDR-TB). However, BDQ has been associated with QT interval prolongation, a condition that can lead to serious cardiac arrhythmias such as torsades de pointes. This systematic review and meta-analysis aims to quantify the incidence of QT interval prolongation in patients receiving BDQ for DR-TB in Sub-Saharan Africa and identify predictors of this adverse effect.

We will conduct a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science and African Journals Online using medical subject headings and keywords related to ‘BDQ’, ‘DR-TB’, ‘QT interval prolongation’ and ‘Sub-Saharan Africa’. Eligible studies will include randomised controlled trials, cohort studies, case-control studies and observational studies conducted in Sub-Saharan Africa. Study titles and abstracts will be initially screened, and full texts will be retrieved and reviewed against eligibility criteria. Relevant data will be extracted from the selected articles and assessed for risk of bias. The primary outcome will be the pooled incidence of QT interval prolongation. Data will be synthesised using a random-effects model meta-analysis if significant heterogeneity is present; otherwise, a fixed-effects model will be applied.

This study will use published data, requiring no ethical approval. Findings will be disseminated through peer-reviewed publications and conference presentations to inform clinical guidelines and DR-TB treatment policies in Sub-Saharan Africa.

CRD42024560368.

To assess predictors of timely transition to adult diabetes care among individuals diagnosed with type 1 diabetes during childhood and adolescence. We hypothesised that older age at the last paediatric visit and urban residency would be predictors of timely transition.

Retrospective cohort study using healthcare administrative data in a jurisdiction with a universal healthcare system.

2045 adolescents and young adults diagnosed with type 1 diabetes between the ages of 0.5 and 18 years.

We ascertained age at the last paediatric diabetes visit (LPDV), age at the first adult diabetes visit (FADV) and transition duration, defined as the time between LPDV and FADV. Timely transition was defined as a transition duration of

Only 31.3% of individuals saw an adult provider within 1 year of their LPDV. Each 1-year increase in the age at LPDV was associated with increased odds of timely transition (adjusted OR 1.82, 95% CI 1.71 to 1.93, p0.05).

Older age at the LPDV and urban residency are associated with increased odds of timely transition. Interventions should be developed to help keep adolescents engaged in paediatric care until an older age before referring them to adult diabetes care. Limitations of this study include unmeasured confounding and limited generalisability to non-universal healthcare systems.

The COVID-19 pandemic amplified the need for robust multisectoral coordination; yet the specific mechanisms, benefits and challenges of such collaboration particularly in low- and middle-income countries (LMICs) remain poorly synthesised. This review aims to delineate the key elements, benefits, challenges and improvement strategies of multisectoral coordination during COVID-19 and to compare patterns between LMICs and high-income countries (HICs).

Eligible studies will include empirical qualitative, quantitative or mixed-methods research published in English between 1 January 2020 and 15 August 2024 that examines formal coordination mechanisms (eg, task forces, public-private partnerships, inter-agency committees) within the context of COVID-19. Searches will be conducted across PubMed, EBSCOhost, Emerald Insight, Google Scholar and selected grey-literature repositories. Citation chaining will be employed to identify additional sources.

Two reviewers will independently screen all records using Covidence, applying pre-piloted eligibility criteria to 5% of citations and proceeding only if inter-rater reliability achieves ≥0.70. Data will be extracted into a Consolidated Framework for Implementation Research (CFIR)-informed template. Qualitative data will be analysed through framework synthesis, structured by the five CFIR domains. Quantitative data will be narratively summarised and, where outcomes are sufficiently similar across at least two studies, synthesised using a fixed-effect model.

Risk of bias will be assessed using Critical Appraisal Skills Programme for qualitative and Risk Of Bias In Non-randomised Studies of Interventions for non-randomised studies. Studies with serious or critical risk will be excluded from pooling. Subgroup analyses (LMIC vs HIC), sensitivity analyses (model and risk) and confidence grading using Confidence in the Evidence from Reviews of Qualitative Research and Grading of Recommendations, Assessment, Development and Evaluations will be conducted.

No primary data will be collected; thus additional Research Ethics Committee approval is unnecessary. The results will be disseminated via open-access publication, conference presentations and policy briefs for Nairobi County health stakeholders.

CRD42023466849.

The integration of dental services within the broader healthcare landscape is crucial for achieving integrated healthcare delivery. However, we lack a clear representation of the full spectrum of possible dental service integration, which is necessary for policymakers, healthcare system organisers, researchers, professionals and patients themselves to optimise organisations. Our present research aims to establish the foundation for a taxonomy of dental services that is fully integrated into the health domain, while minimising historical, cultural or epistemological biases.

This protocol outlines a scoping review that will adhere to the framework of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. It has also been registered on the Open Science Framework. The research team, including a patient representative, advocate and transdisciplinary researcher, who has been involved from the inception, describes a two-phase dynamic screening process. An initial search will be conducted in the PubMed database using a Boolean search strategy based on theoretical frameworks that view health through a biopsychosocial continuum. New taxa will be progressively identified, and in the second phase, we will develop a new search strategy based on the results obtained and will explore deeper into certain categories or subcategories of taxa. Iterative strategies may also involve using new databases and even grey literature. This process will be repeated until taxon saturation is achieved and will be updated prior to submission to capture the latest literature, ultimately resulting in a comprehensive taxonomy, at the scale of individual healthcare pathways (micro- and meso-levels of organisation).

This scoping review will analyse published secondary data and does not require ethical review. The findings will be disseminated through publication in scientific journals, presentation at conferences and sharing through professional networks.

Physical activity has important benefits for the prevention and management of chronic diseases and healthy ageing. Health professionals have valuable opportunities to promote physical activity to a large group of people across the lifespan. Promotion of Physical Activity by Health Professionals is a hybrid type 1 effectiveness-implementation cluster randomised trial designed to evaluate the impact of physical activity promotion by health professionals (n=30 clusters) on physical activity participation in their patients (n=720). To inform the future implementation of this programme, we will be conducting a within-trial and modelled economic evaluation.

We will conduct a cost-effectiveness and cost-utility analysis from the perspective of the healthcare, aged care and disability funder. The time horizon will be 6 months for the within-trial analysis and 2 years for the modelled analysis. Data on intervention costs will be collected using trial records. Data on healthcare utilisation will be collected using data linkage. Incremental cost-effectiveness ratios (ICERs) will be reported for physical activity and quality-adjusted life years outcomes. Bootstrapping will be used to explore uncertainty around the ICERs and estimate 95% CIs. Results will be presented on a cost-effectiveness plane. The probability that the intervention would be cost-effective at varying willingness-to-pay thresholds will be presented using a cost-effectiveness acceptability curve.

Ethics approval was obtained through Sydney Local Health District (RPAH zone) Ethics Review Committee (X23-0197). The findings of this study will be disseminated through peer-reviewed journal articles and conference presentations.

Australian New Zealand Clinical Trials Registry: ACTRN12623000920695.