This study aimed to determine the associations between adherence to the 24-hour movement guidelines and symptoms of anxiety and depression among Colombian university students.

Cross-sectional study.

1125 individuals (mean age 20.2±2.5 years; 56.7% female).

Students sampled from a single public university.

Participants completed validated self-report instruments: the International Physical Activity Questionnaire-Short Form to assess physical activity (PA), sedentary behaviour (SB) and the Pittsburgh Sleep Quality Index to assess sleep duration. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale, with a score of ≥11 used to classify elevated symptoms. Binary logistic regression models were used to estimate associations between adherence to the 24-hour movement guidelines (meeting all three, two, one or none) and mental health outcomes, adjusting for potential confounders.

Only 15.5% of students met all three components of the 24-hour movement guidelines. Meeting a greater number of components was significantly associated with lower odds of depressive and anxiety symptoms. In fully adjusted analyses, students who met all three guidelines were less likely to report anxiety symptoms (OR=0.26; 95%CI 0.13 to 0.54) and depressive symptoms (OR=0.42; 95%CI 0.22 to 0.79) compared with those who met none. Among individual behaviours, sufficient PA and adequate sleep were independently associated with lower odds of both outcomes, whereas high SB was associated with higher odds of elevated symptoms.

In this cross-sectional study, adherence to a greater number of 24-hour movement guideline components was associated with lower levels of anxiety and depressive symptoms in a graded manner. However, the cross-sectional design precludes inference regarding directionality or causality, and bidirectional associations or residual confounding remain possible. Longitudinal and interventional studies are needed to determine whether integrated daily movement behaviours influence mental health outcomes in young adults, particularly in Latin American populations.

Pregnancy in women with pre-existing type 1 or type 2 diabetes (T1D, T2D) is associated with increased risk of complications, largely driven by maternal glucose control. Hormonal changes during pregnancy make glucose management more challenging. Physical activity (PA) may improve glucose control and reduce complications; however, little is known about PA patterns in this population and no pregnancy-specific PA guidance exists for women with pre-existing diabetes. Understanding the behaviours and experiences of both pregnant women and the healthcare professionals (HCPs) who support them is needed to inform evidence-based guidance.

This mixed-methods study comprises three sub-studies. The first will recruit 175 pregnant women (75 with T1D and 100 with T2D) who will complete three 7-day monitoring periods, one per trimester. PA will be assessed using wrist-worn accelerometers and exercise diaries, dietary intake via remote food photography, and corresponding continuous glucose monitor and diabetes-related well-being data will be collected.

The second involves a subsample of ~16 women participating in focus groups to explore experiences of being physically active during pregnancy.

The third invites ~100 HCPs involved in diabetes in pregnancy care to complete an online survey, ~10 HCPS will take part in an optional interview about their experiences of providing PA guidance.

The primary outcome is the change in PA across pregnancy. Secondary outcomes include associations between PA, glucose metrics, diet and diabetes-related well-being, and qualitative themes relating to experiences of women and HCP. Quantitative data will be analysed using multilevel modelling and regression analysis, and qualitative data using reflexive thematic analysis.

Ethical approval was granted by the East Midlands Nottingham 1 Research Ethics Committee (25/EM/0190) and University of Exeter Public Health and Sport Sciences ethics committee. Findings will be disseminated through peer-reviewed publications and conference presentations.

To determine the prevalence, patterns and correlates of medicinal herb use in a rural Iranian population and to evaluate demographic and clinical predictors using adjusted regression models.

Cross-sectional analysis of baseline data from the Fasa Prospective Epidemiological Research Studies in Iran Cohort Study.

Sheshdeh, a rural district in southern Iran.

10 143 adults aged 35–70 years enrolled between 2017 and 2019.

Prevalence of self-reported medicinal herb use during the past year and its associations with demographic variables and non-communicable diseases (NCDs).

Overall, 84.7% of participants (95% CI 83.9% to 85.5%) reported herb use. In multivariable logistic regression, higher educational attainment was positively associated with herb use (university education vs. illiterate: adjusted OR 1.41, 95% CI 1.11 to 1.88). No significant adjusted associations were observed between herb use and major NCDs including diabetes, hypertension, ischaemic heart disease or depression. The most frequently used herbs were Zataria multiflora, Echium amoenum and Matricaria chamomilla, most commonly for anxiety/neurasthenia (81.6%), gastric pain (59.6%) and common cold (49.8%).

Medicinal herb use is highly prevalent among adults in southern Iran. Educational level, but not chronic disease status, was associated with herb use. These findings highlight the need for integrated public health strategies regarding safe and evidence-based use of medicinal herbs.

This systematic review and meta-analysis aimed to determine the prevalence, patterns and associated factors of complementary and alternative medicine (CAM) use among pregnant women in Iran.

A systematic review and meta-analysis of observational studies.

A comprehensive search was conducted in PubMed/MEDLINE, Web of Science, Scopus, ScienceDirect and major Iranian databases from inception to 30 November 2024.

We included observational studies published in peer-reviewed journals that assessed CAM use among pregnant women in Iran and reported prevalence estimates or relevant associated factors.

Data extraction and quality assessment were performed independently by two reviewers using a standardised form and the Quality Assessment Tool. Meta-analyses of proportions were performed using the DerSimonian and Laird random effects model. The between-study heterogeneity was assessed using the I-squared (I²) statistic. Subgroup analysis, 95% prediction intervals (95% PrIs) and sensitivity analysis were conducted to explore the sources of heterogeneity and to evaluate the robustness of the overall effects, respectively. This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with PROSPERO.

20 studies with a total of 8106 participants were included. The pooled prevalence of CAM use was 49% (95% CI 39% to 59%). The between-study heterogeneity was very high (I²=94.69%) with a wide 95% PrIs range of 3%–94%. The very high between-study heterogeneity and the wide range of PrI for the pooled prevalence were not explained by the quality of the studies, geographical regions of Iran or the methods of data collection. Mentha longifolia, Zataria multiflora and Boswellia thurifera were the most commonly used herbs. Across the included studies, the first trimester of pregnancy was most frequently reported as the period of CAM use, with socioeconomic factors identified as significant predictors. Family and friends were the primary sources of information regarding CAM. The most common reasons for CAM use included gastrointestinal issues, respiratory problems such as colds and coughs, and the desire to improve general health. Only 31% of participants disclosed their use of CAM to their healthcare provider.

Nearly half of pregnant women in Iran use CAM, yet disclosure to healthcare providers is low. An actionable implication is the critical need to integrate routine enquiry about CAM use into standard antenatal care to ensure safe practice. Further research is recommended to evaluate the effectiveness, safety and outcomes of CAM use among pregnant women.

CRD42024618490

Women residing in rural areas or belonging to lower socioeconomic status (SES) strata experience disproportionately low rates of breast cancer screening, contributing to delayed diagnoses and poorer prognoses. In addition, their participation in clinical trials remains markedly limited, reducing opportunities to access preventive and screening interventions. Promoting research preparedness among women before disease onset may empower them to make informed decisions regarding their health and willingness to participate in clinical research with fewer emotional and logistical barriers.

This project applies a community-based participatory research approach to develop and refine the WeCARE (Women’s Engagement for Cancer Awareness, Resources and Education) intervention for women aged 50–74 years who have either never undergone breast cancer screening or have not received screening in the past 5 years and who reside in rural areas or belong to low SES groups. The intervention consists of two components. Component 1 is a single-day, in-person community forum that includes (a) an educational seminar led by an oncologist to address breast cancer risk and screening guidelines, (b) survivor storytelling to enhance emotional engagement and cultural resonance and (c) facilitated navigation to breast cancer screening and future research participation. Component 2 involves structured post-forum follow-up through multiple touchpoints (phone calls and mailed boosters) to reinforce knowledge, address barriers and support screening completion and research enrolment. Quantitative data (eg, screening completion, satisfaction and follow-up engagement) will be summarised using descriptive statistics to assess feasibility and reach on 50 participants. Qualitative feedback from participants will undergo thematic analysis to identify barriers, facilitators and perceived cultural relevance. Integrated mixed-method interpretation will inform iterative refinement of the WeCARE intervention and guide design of subsequent larger trials.

Approved by the Mayo Clinic Institutional Review Board (IRB #25–008934). All participants will provide informed consent. Procedures ensure confidentiality, cultural sensitivity and participant safety. Data will be stored in REDCap and disseminated through publications, conferences, local town halls and community reports.

Chronic obstructive pulmonary disease (COPD) has an unpredictable clinical course, causing difficulties in short-term mortality prediction, overtreatment and delayed palliative care. Existing prediction models are limited and lack applicability to Chinese elderly patients with advanced COPD. Given the heavy disease burden and limited palliative care in China, we designed this multicentre cohort study to develop a 6-month mortality prediction model for elderly patients with advanced COPD to aid risk stratification, timely palliative care and efficient healthcare resource allocation.

Patient recruitment has been ongoing since May 2024 and will be completed by December 2026, with a 12-month follow-up to be completed by December 2027. Eligible patients are being enrolled, and multidimensional baseline data including demographic characteristics, clinical indicators, laboratory results, comprehensive geriatric assessment and COPD-specific prognostic factors are being systematically collected. All participants will receive 12 months of standardised follow-up (monthly for the first 6 months and quarterly thereafter) to monitor 6-month all-cause mortality (primary outcome), as well as survival duration, end-of-life healthcare utilisation and do-not-resuscitate status (secondary outcomes). After completion of data collection, we will employ multiple machine learning algorithms to develop and internally validate a 6-month mortality prediction model with pre-specified centres reserved for external validation. Model performance will be evaluated by discrimination and calibration and head-to-head comparisons with the Body Mass Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) and Age, Dyspnoea and Airflow Obstruction (ADO) indices will be conducted to verify its clinical value. The findings will provide a China-specific prediction tool for elderly patients with advanced COPD to guide clinical intervention, palliative care referral and healthcare resource allocation.

This study was approved by the Biomedical Ethics Review Committee of West China Hospital, Sichuan University (No. 2024-2662) and registered at ChiCTR2500100351. Informed consent is being obtained from all participants. Results will be published in peer-reviewed journals and presented at academic conferences.

ChiCTR2500100351.

Dental caries is the most prevalent chronic condition among Argentine children, with distribution and severity strongly shaped by social and territorial inequalities. This study evaluated caries treatment needs and their spatial and socio-economic associations among preschool children in Buenos Aires.

An ecological population study was conducted among 54 337 6-year-old children attending public schools in Buenos Aires. Caries severity was measured using the Caries Treatment Needs Index (CTNI) by calibrated examiners.

Socio-economic indicators included individual health coverage, neighbourhood housing prices, distance to the nearest primary health centre, population density and the proportion of households with unsatisfied basic needs. Analyses comprised descriptive statistics, multivariate regression, ORs and spatial autoregressive models.

Overall, 67.9% of children had treatment needs (CTNI >2) and 17.5% had high needs (CTNI >10), with significant heterogeneity across municipalities (p

Caries treatment needs in Buenos Aires follow a clear socio-economic and spatial gradient, with both individual and neighbourhood disadvantage independently associated with increased needs and highlighting the need for targeted, territorially focused public health strategies.

Adolescent mothers are at increased risk of rapid repeat pregnancy during the postpartum period, particularly in low-and middle-income countries where unmet need for contraception remains high. Stigma, limited autonomy and inadequate youth-friendly services contribute to low uptake of postpartum contraception. Digital health interventions have been proposed as scalable approaches to improve access to contraceptive information and support. However, evidence specifically focusing on digital interventions to enhance postpartum contraception among adolescent mothers has not yet been comprehensively mapped. This scoping review aims to identify and describe the available evidence in this area.

This review will follow the Arksey and O’Malley framework, with refinements by Levac et al and guidance from the Joanna Briggs Institute. Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. MEDLINE, Embase, Scopus and Web of Science along with relevant grey literature sources will be searched. Studies involving adolescent mothers (10–19 years) within 12 months after childbirth and evaluating digital interventions for postpartum contraception will be included. Two reviewers will independently screen and extract data using a standardised charting form. Findings will be synthesised descriptively to map intervention types, outcomes and research gaps. No formal quality appraisal will be undertaken.

Ethical approval is not required. Findings will be disseminated through peer-reviewed publication, conference presentations and engagement with relevant stakeholders to inform research, policy and programme development.

Neonatal hypoglycaemia is a common metabolic disorder in newborns and may be more frequent in infants delivered by caesarean section because of altered metabolic adaptation after birth. Evidence specific to Chinese caesarean-delivered newborns remains limited.

To determine the incidence of neonatal hypoglycaemia and identify factors associated with its occurrence in Chinese newborns delivered via caesarean section.

Cross-sectional study.

Three regional obstetric care centres in East China.

A total of 1232 mother-newborn pairs, including both term and preterm singleton infants delivered via caesarean section.

Data were extracted from hospital electronic medical records. Neonatal hypoglycaemia was defined as a blood glucose level below 2.6 mmol/L within 24 hours after birth. Maternal, obstetric and neonatal characteristics were analysed. Bivariable analyses were performed to assess associations between neonatal hypoglycaemia and candidate variables, followed by multivariable logistic regression to identify independent factors. Predictive performance of the final model was evaluated using receiver operating characteristic analysis.

Neonatal hypoglycaemia occurred in 800 of 1232 newborns, giving an incidence of 64.9% (95% CI 62.3% to 67.6%). In multivariable logistic regression, higher gestational age was independently associated with lower odds of neonatal hypoglycaemia (OR 0.781, 95% CI 0.684 to 0.891; p

Neonatal hypoglycaemia was common among Chinese newborns delivered via caesarean section, but most episodes were asymptomatic and resolved with routine feeding within 24 hours. Gestational age, fetal growth classification, elective caesarean delivery, parity and amniotic fluid characteristics were associated with hypoglycaemia in the current model. Early glucose monitoring and targeted nutritional support may be particularly important for newborns at increased risk.

The Government of India launched the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) to expand access to affordable generics through private retail outlets named as Jan Aushadhi Kendras (JAKs). This study examines the association of PMBJP with out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE) and impoverishment rate (IR) attributable to medicines.

A cross-sectional observational study was conducted across nine Indian states in 2022–2023.

Outpatient (OPD) and inpatient (IPD) departments of secondary and tertiary government hospitals, private pharmacies and JAKs in 18 districts of India

A total of 10 336 patients were recruited from OPD (n=2881) and IPD (n=1009) departments of government hospitals as well as pharmacy settings (n=6446). Data on sociodemographics, disease severity, number of generic prescriptions, source of acquiring medicines and medicine-related OOPE were collected through semistructured interviews and periodic follow-ups.

Primary outcomes included mean OOPE on medicines, incidence of CHE (≥40% of non-food consumption expenditure on medicines), IR among JAK and non-JAK users were the primary outcomes of the study. Secondary outcomes comprised awareness of JAKs, generic prescribing rates in hospitals and the factors associated with OOPE, CHE and IR.

Patients procuring medicines exclusively from JAKs reported the lower mean OOPE (OPD: 172; IPD: 275; pharmacy: 307), compared with significantly higher spending at private pharmacies (OPD: 1085; IPD: 3165; pharmacy: 1031). After adjusting for covariates, OOPE among exclusive JAK users was significantly lower relative to private pharmacy users by 60.6%–89.3%. Furthermore, matched analysis confirmed 42% lower expenses, compared with private pharmacies. The likelihood of CHE was also significantly greater among private pharmacy users. However, utilisation of JAKs remained limited, mainly due to low awareness, perceived stock shortages and low rates of generic prescribing.

PMBJP is associated with significant reduction in OOPE and financial hardship, positioning it as an effective cost-containment intervention within India’s universal health coverage framework. Strengthening supply chains, promoting generic prescribing and integrating JAKs with public facilities would further maximise its impact.

Research has yielded contradictory results regarding differences in physical fitness and cardiometabolic risk between children and adolescents living in rural and urban areas.

The present study aimed to analyse the moderating role of area of residence on the association of physical fitness and anthropometric parameters in Chilean adolescents.

Cross-sectional analysis of a nationally representative school-based sample from Chile.

A total of 7,833 adolescents with an average age of 15.8±0.7 years participated in both rural (n=759) and urban (n=7,074) settings. Physical fitness tests were evaluated using the Assessing Levels of Physical Activity and Fitness (ALPHA-Fitness) battery and anthropometric variables such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Generalised linear models with Gaussian distributions were constructed to estimate moderation models, with anthropometric-related variables as dependent variables, physical fitness variables as independent variables and area of residence as a moderator. Moderation analyses were conducted to examine whether the area of residence influences the association between physical fitness and anthropometric indicators (WC, WHtR and BMI).

In all models, place of residence did not moderate the potential associations between physical fitness and anthropometric indicators; for example, cardiorespiratory fitness with WC (B=0.13, 95% CI 0.05 to 0.31; 0=0.160), WHtR (B=0.08, 95% CI –0.03 to 0.20; p=0.143) or BMI (B=0.08, 95% CI –0.03 to 0.20; p=0.207).

These findings suggest the associations between physical fitness and anthropometric outcomes do not differ significantly between rural and urban adolescents.