Conectar
Anxiety disorders, obsessive–compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are common in children and adolescents and can lead to significant impairment. Cognitive behavioural therapy (CBT) with exposure is the first-line treatment, yet approximately half of treated youth do not achieve full remission. Dysfunctional cognitions—negative automatic thoughts, maladaptive beliefs and distorted interpretations—are considered key targets of CBT, but evidence in youth is mixed and underpowered. This study will examine whether change in dysfunctional cognitions mediates treatment outcome in anxiety, OCD and PTSD symptoms and whether this association varies across individual characteristics.
An individual participant data meta-analysis (IPDMA) of randomised controlled trials of CBT for youth aged 5–18 years with anxiety disorders, OCD or PTSD will be conducted. The search strategy includes the databases APA PsycINFO, MEDLINE and Web of Science Core Collection from inception to 8 September 2025. It is supplemented by screening reference lists, trial registries, grey literature and outreach to relevant research groups. Eligible trials must include at least one validated measure of dysfunctional cognitions administered at minimum pre- and post-treatment, and clinical outcomes assessed at post-treatment and follow-up. The two primary outcomes are (1) child-reported symptom severity and (2) clinician-rated clinical severity. Data will be harmonised for dysfunctional cognition scores, moderators (age, gender, socioeconomic status, comorbidity), and primary outcomes. One-stage Bayesian mixed-effects models will examine whether changes in dysfunctional cognitions predict improvements in primary outcomes and whether these effects are moderated by individual characteristics. Missing data will be addressed using multiple imputation within the Bayesian framework, and study-level heterogeneity will be modelled using random intercepts and slopes.
All datasets will be de-identified and managed under General Data Protection Regulation standards. Each included trial will have ethical approval permitting data sharing and reuse, and the secondary analysis of the shared datasets has been approved by the University of Amsterdam. Findings will be disseminated via a peer-reviewed publication, scientific conferences and open sharing of analysis scripts and harmonisation procedures.
CRD420251139130.
The main objective of the Health Survey of São Paulo or Inquérito de Saúde de São Paulo (ISA) in Portuguese, is to generate health indicators to support research and policy planning. The ISA-Physical Activity and Environment Longitudinal Study has the primary objective of examining built and social environmental determinants of leisure-time physical activity and active transportation.
The baseline (2014–2015) study included 4042 participants aged 12 years and older, men and women, living across the five regions of São Paulo city. Data were collected through household interviews. The second wave (2020–2021) used telephone interviews and included 1434 participants aged 18 or older, 58.6% female and representing 35% of the baseline sample. The third wave (2023–2024) included 1583 participants through household or telephone interviews, 58.6% of female and represented 39% of the original cohort.
The study has collected extensive individual-level data, including physical activity behaviours, health status and related behaviours, self-report of diseases and sociodemographic characteristics; built environment features such as public open spaces, transport infrastructure, schools and healthcare facilities, walkability index, sidewalks, traffic control and social environment features, such as crime occurrence and socioeconomic index. Analyses have identified changes in the built environment and their associations with physical activity and obesity. Infrastructure improvements, such as the increase of bike paths and outdoor gyms, have been more frequent in wealthier areas, reinforcing spatial inequalities. Increased availability of public open spaces has been associated with increased leisure-time walking. Obesity has shown a growing trend, particularly among specific sociodemographic groups, while physical activity has demonstrated protective effects against obesity. Cycling for transportation has remained stable over time, with disparities by gender and physical activity status.
The plan is to conduct the fourth wave in 2026 and 2027 and the fifth wave in 2029 and 2030.
This study aimed to describe the epidemiology, outcomes and costs of four immune-mediated inflammatory rheumatic diseases (IMIRDs)—systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS)—in Brazil’s public and private healthcare systems from 2018 to 2022.
Retrospective observational study.
The study was conducted across hospital and outpatient levels of care in Brazil, based on nationwide data representing the public (Department of Informatics of the Unified Health System—DATASUS) and private (National Supplementary Health Agency—ANS) healthcare sectors.
The study analysed data from four distinct systems: 609 427 patients from the public Outpatient Information System (SIA), 32 119 patients from the public Hospital Information System (SIH), 19 083 deaths from the public Mortality Information System (SIM) and 11 846 hospitalisations from the private healthcare system (ANS).
RA had the highest incidence, ranging from 19.9 to 24.9 per 100 000, while SLE remained stable (6.3–6.7 per 100 000). Prevalence increased for all diseases: RA rose from 95.7 to 136.8, SLE from 23.4 to 38.9, AS from 15.0 to 23.6 and PsA from 10.8 to 17.4 per 100 000. SLE had the highest hospitalisation (7.2%) and lethality rates (8.7%), along with the highest average outpatient cost (US$440.9 per patient). In the private system, RA and SLE accounted for the most hospitalisations (36.3% each). SLE had the highest proportion of emergency hospitalisations (70.5%), while PsA had the highest proportion of elective hospitalisations (61.8%).
RA had the highest prevalence and incidence rates among the studied IMIRDs, while SLE was associated with the highest lethality, outpatient costs and emergency hospitalisations. The rising prevalence of these diseases highlights their growing burden on Brazil’s healthcare systems.
To investigate the occurrence of depression and mental health disorders other than depression among Brazilian people with intellectual disabilities, analysing data from a national household survey.
Cross-sectional epidemiological study using data from the 2019 National Health Survey (PNS).
Brazil, nationwide data collection in urban and rural private households.
272 499 individuals, among whom 1.2% (n=3198) reported intellectual disabilities.
Self-reported depression and mental health disorders other than depression (anxiety, panic, schizophrenia, bipolar disorder, psychosis or obsessive–compulsive disorder (OCD)), either isolated or comorbid.
Among people with intellectual disabilities, 43.2% reported at least one mental health disorder versus 13.7% without disabilities. In adults aged 0–59 years, intellectual disability was associated with higher odds of depression (adjusted OR (aOR) 3.25, 95% CI 1.76 to 6.00), mental health disorders other than depression (aOR 12.23, 95% CI 7.52 to 19.90) and depression associated with other mental health disorders (aOR 14.34, 95% CI 7.92 to 25.96). In older adults (≥60 years), risks also remained elevated: depression (aOR 1.71, 95% CI 1.04 to 2.79), mental health disorders other than depression (aOR 4.33, 95% CI 2.09 to 8.94) and depression associated with other mental health disorders (aOR 2.98, 95% CI 1.49 to 5.95). Women with intellectual disabilities were more likely to report depression and multimorbidity, while men more often reported non-depressive disorders. Poorer self-perceived health was consistently linked to worse outcomes across age groups.
Mental health disorders and their comorbidities are significantly more prevalent among people with intellectual disabilities in Brazil. These findings highlight the urgent need for inclusive, equitable and specialised mental healthcare policies.
Equitable access to healthcare technology is a major public health issue. For adults with type 2 diabetes (T2D), continuous glucose monitoring (CGM) technology can improve diabetes self-management and clinical outcomes. Even though CGM is now recommended by professional guidelines for all patients with diabetes on insulin therapy, evidence suggests that CGM is underutilised and inequitably prescribed across health systems. As CGM is an emergent technology, it is vital to understand what approaches have been studied to overcome inequities in CGM access for adults with T2D, what aspects of equitable access have yet to be addressed and what are facilitators and barriers to CGM access at the individual, facility and health system levels.
We will use the Joanna Briggs Institute’s revised scoping review framework to conduct our analysis. The protocol is registered with Open Science Framework (https://osf.io/z2exn). We will search for peer-reviewed literature containing empirical evidence for the facilitators and barriers to equitable access to CGM technology for patients with T2D. Findings will be organised according to research objectives and the Framework for Digital Health Equity, and summarised using narrative synthesis of descriptive statistics for quantitative findings, and themes for qualitative findings. This review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.
The findings from this review will provide valuable information and support for future research into the equitable implementation and use of CGM for patients with T2D. We will disseminate findings at conferences and publish in a peer-reviewed journal.
To evaluate temporal trends in the epidemiology of hip osteoarthritis (OA) in the USA from 1990 to 2019, with stratification by sex and geographic region.
Cross-sectional time-series analysis using secondary data from the Global Burden of Disease (GBD) study.
US population-based analysis, stratified by the four US Census Bureau regions: Northeast, Midwest, South and West.
De-identified, aggregate population-level data representing all adults in the USA from 1990 to 2019, drawn from the GBD database.
Age-standardised rates per 100 000 population for years lived with disability (YLDs), prevalence and incidence of hip OA. Outcomes were stratified by sex and region. Statistical significance was defined as p
Between 1990 and 2019, hip OA in the USA increased by 23.91% in YLDs, 24.67% in prevalence and 25.22% in incidence. In 2019, the mean YLDs were 28.30 in women versus 25.48 in men; prevalence was 49.55 versus 41.08; and incidence was 919.29 versus 818.10 (all p
There has been a substantial rise in the burden of hip OA in the USA over the past three decades. Women and residents of the Northeastern USA are disproportionately affected. These findings underscore the need for targeted public health strategies that account for geographic and sex-based disparities in hip OA burden.
Mobile diagnostic imaging services provided at home increase accessibility and convenience, particularly for older adults, people with disabilities and other vulnerable groups. These services can reduce the need for patient travel and support the routine monitoring of chronic conditions. However, current guidelines often overlook user acceptance and environmental considerations within the home setting.
To map studies that identify the models, barriers and facilitators for performing home-based diagnostic imaging/graph according to end users.
A scoping review was conducted following the methodological framework of the Joanna Briggs Institute and reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist.
Studies that addressed mobile or portable diagnostic imaging or graph examinations conducted in the home for individuals of any age or health status were included. Studies were eligible if they reported on barriers, facilitators or user experiences. Studies that focused on wearable technologies were excluded.
The search strategy was developed using terms related to home-based diagnostic imaging/graph, portability, home setting and user perceptions. Searches were conducted in PubMed, Web of Science, Scopus, Embase, The ACM Guide to Computing Literature and LILACS, without restrictions on publication date or language. Additional grey literature was identified through Google Scholar.
Two reviewers independently extracted data using a standardised form that captured study characteristics, types of procedures, target populations and reported barriers and facilitators. Quantitative data were summarised using absolute and relative frequencies. Qualitative findings were synthesised through basic content analysis to identify and categorise recurring themes.
Data were charted in tables to organise and visually map study contexts, methodological features and thematic patterns related to implementation and user experience.
Twenty-six studies published between 1998 and 2023 across 15 countries were included. The diagnostic examinations included mostly polysomnography, X-ray imaging and ultrasonography. Seven categories of barriers were identified, such as physical discomfort, equipment-related challenges and procedural limitations. Seven facilitators were also reported, including perceived comfort, patient satisfaction and equipment usability.
This review identifies key factors affecting the delivery and user experience of mobile diagnostic imaging at home, including logistical, technical and environmental aspects. It reveals gaps in the literature and provides a basis for future research to inform more inclusive and effective public health policies and service design.
Open Science Framework (DOI 10.17605/OSF.IO/7UV5D).
Maternal and child health remains a critical public health challenge in developing countries. Annually, an estimated 250 000–280 000 maternal deaths occur, with up to 95% attributed to inadequate access to timely, effective and quality healthcare. While digital health interventions have demonstrated significant potential in improving maternal health services, education and support in high-income settings, their effectiveness, feasibility and broader impact in resource-limited contexts remain understudied.
This systematic review will assess the effectiveness, feasibility and impact of digital health interventions for pregnant women and new mothers in resource-limited settings across developing countries. We will conduct a comprehensive search of MEDLINE (via PubMed), Embase, Scopus, Google Scholar and grey literature sources to identify randomised controlled trials, quasi-experimental studies and observational studies published in any language. The quality of included studies will be assessed using the Cochrane‘s risk of bias tools, RoB 2 for randomised trials and the ROBINS-I tool for non-randomised studies. A standardised data extraction form will be developed, piloted and used to systematically collect study data. We will employ the web-based CADIMA platform to facilitate screening, data extraction and evidence synthesis while minimising bias. Data will be synthesised narratively by summarising study characteristics and, where appropriate, through meta-analysis using random-effects models to calculate pooled effect sizes. Finally, we will evaluate the strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation approach to assess confidence in the findings.
No ethical approval was required for this systematic review, as it uses only previously published data. The findings will be submitted for publication in a peer-reviewed journal and presented at relevant international conferences to disseminate them to the broader academic community. To ensure practical application of our results, we will develop a policy brief summarising key findings and recommendations.
This protocol is registered to PROSPERO, and the registration number is CRD42025631164.
The prevalence of women with primary dysmenorrhoea is high and negatively impacts physical and mental health. The intense cyclic episodes of pain generate central nervous system dysfunctional processing. In this sense, strategies focused on the central nervous system are important to re-establish normal functioning. Home-based self-administered transcranial direct current stimulation (tDCS) emerges as a strategy to modulate dysfunctional brain areas and improve the symptoms. This protocol aims to evaluate the effects of home-based self-administered tDCS for pain, premenstrual symptoms, physical performance, quality of life, electroencephalography and patient global impression in women affected by primary dysmenorrhoea.
This is a single-centre, parallel, randomised, double-blinded clinical trial protocol. 40 women affected by primary dysmenorrhoea will be randomised into two groups (active-tDCS or sham-tDCS). Then, 20 consecutive sessions of home-based self-administered tDCS will be performed. The assessments will occur at five time points: baseline, after the 20th sessions, at the first, second and third cycles after tDCS interventions (follow-ups). Primary outcome will be pain according to visual analogue scale. Quality of life, premenstrual symptoms screening, depression, anxiety, physical performance, electroencephalography and participants’ satisfaction will be the secondary outcomes. A mixed analysis of variance will calculate the effect of stimulation.
The study was approved by the ethics committee of the Federal University of Rio Grande do Norte (No. 6.037.756) and registered in the Brazilian Clinical Trials Registry (n° RBR-747k8vb). Participants may withdraw at any time without penalty. Free support will be available from the lead researcher if needed. All procedures will follow Good Clinical Practice and international ethical standards.
FreshRSS 