Conectar
Police are frequently dispatched to a wide range of 911 calls, including mental and behavioural health crises, despite lacking the training, resources and time to respond effectively. In particular, people with serious mental illness are at elevated risk of experiencing excessive use of force, arrest and continued criminal legal involvement following police contact. Following the murder of George Floyd and other highly publicised police killings, Community Safety Response (CSR) programmes, staffed by unarmed peers, mental health professionals and other trained responders, have proliferated to provide non-police responses to mental and behavioural health and other quality-of-life concerns. CSR programmes have expanded rapidly, yet the evidence base remains fragmented and largely outside the peer-reviewed literature.
This scoping review will synthesise peer-reviewed and grey literature from 2020 to present on CSR programmes operating in North America. Guided by Joanna Briggs Institute methodology and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards, we will search multiple databases (Medline, PsycINFO, Embase, SocIndex, Web of Science, Policy Commons) and employ complementary grey literature search strategies, including targeted website searches, reference tracking and review of internal and external reports and evaluations. Inclusion criteria require that programmes provide non-police first response to calls traditionally served by law enforcement and include information on programme operations or outcomes. Two reviewers will independently screen and extract data on process metrics including operational characteristics, dispatch, funding, services provided and outcomes such as populations served, diversion from police, service linkage and use of force.
No ethical review for this study is required as it will not include human subjects or any identifiable information. Findings will provide the first national synthesis of CSR programme models, operations and outcomes. Results will inform policy-makers, practitioners, researchers and community members. Findings will be disseminated through peer-reviewed publications and public-facing products to support implementation, scale-up and sustainability of CSR programmes.
In the last 60 years, newborn bloodspot screening (NBS) has expanded as a public health intervention from a single severe childhood genetic disease (SCGD) to up to as many as 80 SCGD and testing of ~40 million newborns/year worldwide. However, the gap between current NBS and its potential to increase the efficiency, effectiveness and global equity of healthcare delivery for SCGD is large and rapidly growing. There are now effective therapeutic interventions—drugs, diets, devices and surgeries—for up to 2000 SCGD. Since almost all SCGD can be identified by bloodspot genome sequencing, it has been a longstanding goal to supplement current NBS with genome sequencing-based NBS (gNBS) for all eligible SCGD. We recently described a novel gNBS platform (named Begin Newborn Genome Sequencing (BeginNGS)) with the potential to overcome several major challenges to gNBS (cost, scalability, false positives and an unprepared healthcare workforce). A pilot clinical trial of BeginNGS for 412 SCGD in a level IV neonatal intensive care unit (NICU) had a true positive rate of 4.2%, sensitivity of 83%, positive predictive value of 100% and clinical utility rate of 4.2%, indicating readiness of the platform for use in a powered, multicentre study.
The BeginNGS study is a single group, international, multicentre, adaptive clinical trial to compare utility, acceptability, feasibility and cost-effectiveness of BeginNGS gNBS (experimental intervention) with standard NBS (control). A minimum of 10 000 neonates (aged 50 000 US children per year.
This study was approved by the WCG Clinical institutional review board on 14 February 2024, and the most recent amendment approved on 7 October 2025 (approval number 20235517). Study findings will be shared through research consortium workshops, national and international conferences, community presentations and peer-reviewed journals.
by Samantha Hertz, Finnegan Klein, Todd L. Bredbenner, Miranda Cosman, Karl J. Jepsen
Developing a strong skeleton during growth is critical for minimizing fractures later in life. Prior work showed that bone mass varied with external bone size, a measure of the outer bone width. We tested how this association affected the identification of children with low bone mass. Radiographs of the nondominant hand of 45 White females and 54 White males, all ~ 8 years old, were assessed and second metacarpal length (Le) and the midshaft outer and inner widths were measured at the 40, 50, and 60% midshaft sites. The average total area (Tt.Ar), a measure of the area enclosed by the periosteal surface, and cortical area (Ct.Ar), a measure of bone mass, were calculated assuming a circular cross-section. Individuals were sorted into tertiles using robustness (Tt.Ar/Le). Z-scores were calculated for Ct.Ar first using the cohort mean and standard deviation and second using each robustness tertile mean and standard deviation. Females and males with Z-scores in the lower 33% range were identified for the group-average and tertile-specific average comparisons. Agreement between the two reference group approaches was determined using Cohen’s kappa statistic for each sex. The percentage of individuals identified with low Ct.Ar depended on whether Z-scores were compared to the group average or tertile-specific averages. When compared to the group average, 67% of females and 56% of males identified with lower Ct.Ar were from the narrowest tertile, whereas 0% of females and 22% of males were from the widest tertile. For females and males, Cohen’s kappa coefficient showed almost perfect agreement for the intermediate tertile (kappa coefficient > 0.84), but agreement was only poor to moderate (kappa coefficientThe study aimed to assess the trends and factors associated with modern contraceptive use among female youths (15–24 years) in Tanzania from 2004 to 2022.
We performed secondary analysis of cross-sectional data from four consecutive Demographic and Health Surveys (DHS) in Tanzania: 2004, 2010, 2015/2016 and 2022.
Tanzania.
Sexually active female youths (n=8659).
The use of any modern contraceptive method, coded as Yes or No.
The sample had a median age of 21 (IQR 18–22 years), with 63.7% aged 20–24 years. Modern contraceptive use among female youths increased from 24.6% in 2004 to 32.1% in 2022. Consistent across surveys, modern contraceptive use was positively associated with secondary or higher education level, having one or more live births and engaging in sexual activity within the month preceding the survey. Additionally, adolescents (15–19 years) demonstrated a weak protective association, indicating a reduced likelihood of modern contraceptive use compared with young women (20–24 years). In 2015/2016 and 2022 surveys, primiparous, multiparous and married/cohabiting women were more likely to use modern contraceptives than nulliparous women.
Modern contraceptive use among female youths increased gradually in Tanzania between 2004 and 2022 Tanzania DHS. To sustain these upward trends and reduce the risk of unwanted pregnancies and sexually transmitted infections, public health policies should consider the factors positively associated with modern contraceptive use, particularly among young women aged 20–24 years, married/cohabiting, who have initiated childbearing and those with high education levels.
To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention.
Ethnographic study.
Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi-structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach.
Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses.
Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient-facing staff.
Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non-nursing staff, with potential to reduce pressures on busy nurses and improve patient safety.
The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research.
Patient/public contributors were involved in study design, evaluation and data analysis. They co-authored this manuscript.
FreshRSS 