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Unequal harvests: AI-assisted evidence map of trends and gaps in global farmer health research along SDG 3 priorities

Por: Jäggi · L. · Falgas Bague · I. · Wey · H. · Rüfli · D. · Viglietti · P. G. · Fuhrimann · S.
Introduction

Ensuring the health of agricultural workers, the world’s largest labour force, is key for sustainable food production and progress towards the Sustainable Development Goals (SDGs).

Methods

We conducted an artificial intelligence (AI)-assisted evidence map of research records on global farmer health published from 2015 to 2024. We searched bibliographic databases and screened titles/abstracts using SWIFT-Active Screener, a collaborative review platform that uses machine-learning prioritisation to rank records for human review. We retrieved 32 006 records. After manually screening 8533 records and stopping when the tool estimated ≥94% recall of relevant records, we included 1684 studies. We mapped research output by health topic category (non-communicable diseases (NCDs), communicable diseases, injuries and mental health) country income groups and alignment with SDG 3 targets.

Results

Despite 98% of the agricultural workforce living in low- and middle-income countries (LMICs), 52% of studies originate from high-income countries (HICs). Research focuses on NCDs (29%) and injuries (26%), with LMICs focusing on pesticide poisoning and HIC on accidents. Mental health emerges as a key topic in HICs, with the proportion of publications nearly doubling from 2021 to 2024 but remains underexplored in LMICs. Key gaps with high relevance to farming populations and climate change, such as heat-related illnesses, occupational injuries and musculoskeletal conditions, are not well represented in SDG 3 indicators.

Conclusion

Our findings highlight urgent needs for a more equitable and comprehensive global research agenda that integrates agricultural worker health into sustainability frameworks beyond the SDG era, ensuring the resilience and well-being of food producers worldwide.

Feasibility and acceptability of therapist-guided, asynchronous, internet-delivered trauma-focused CBT for adolescents with PTSD: a single-group feasibility trial in Sweden

Por: Mattelin · E. · Weyler · H. · Andersson · R. · Paulsen · J. · Tielman · S. · Vikgren · A. · Bondjers · K. · Serlachius · E. · Mataix-Cols · D. · Bragesjö · M.
Objectives

Trauma-focused cognitive behavioural therapy (TF-CBT) is the established first-line treatment for paediatric post-traumatic stress disorder (PTSD), but access to evidence-based care remains limited. This study aimed to evaluate the feasibility and acceptability of a therapist-guided, 12 week, internet-delivered TF-CBT (iTF-CBT) programme for adolescents with PTSD and to explore preliminary changes in PTSD symptoms.

Design

Single-group feasibility trial.

Setting

Save the Children, Sweden.

Participants

Twenty-two adolescents (13–17 years, 82% female) with primary PTSD.

Interventions

A 12 week, therapist-guided, asynchronous, internet-delivered TF-CBT comprising eight modules and parallel caregiver modules with joint adolescent–caregiver activities.

Outcomes

Feasibility measures included recruitment pace, participant retention, treatment adherence (module completion) and therapist time. Acceptability was evaluated through satisfaction, credibility, negative effects and reported adverse events. Within-group changes in PTSD severity using independent evaluator-rated Clinician-Administered PTSD Scale (CAPS-CA-5) and the self-reported Child and Adolescent Trauma Screen 2 (CATS-2) were used as indicators of potential clinical change. Assessments occurred at baseline, during treatment, post-treatment and at 1 month follow-up (primary endpoint).

Results

Recruitment was completed after 7 months of active enrolment. Retention and adherence were high, satisfaction and credibility ratings were favourable, and no intervention-related serious adverse events occurred. Within-group improvements were observed at the primary endpoint, with large reductions on CAPS-CA-5 (Cohen’s d=1.27) and CATS-2 (Cohen’s d=1.51). At follow-up, 47.6% of participants no longer met criteria for PTSD.

Conclusions

Therapist-guided iTF-CBT for adolescents with PTSD was safe, feasible, acceptable and associated with potentially meaningful symptom improvements. These findings support further evaluation in larger, controlled trials to determine efficacy, cost-effectiveness and long-term outcomes.

Trial registration number

NCT06185244.

Impact of redeployment on healthcare staff well-being and retention: a survey of staff in the UK National Health Service

Por: Weyman · A. · Glendinning · R. · OHara · R.
Background

The redeployment of healthcare staff from their normal place of work and duties to alternative activities is not a new phenomenon and has typically been used as a temporary measure to address capacity gaps. While redeployment supports the mobilisation of a flexible healthcare workforce, it also presents as a source of tension in relation to staff well-being and retention. This paper reports findings from a survey of staff in the UK National Health Service (NHS), exploring the impact of redeployment.

Method

An online survey was administered by YouGov (2023), addressing contemporary evidence on variables impacting staff health, well-being and disposition to remain in NHS employment. The sample comprised NHS employees representing the principal healthcare job families and grades across acute hospitals, mental health, community and ambulance services. Statistical analysis (SPSS V.29.0.2.0) compared (independent samples t-test, z-test and 2 test for trend) redeployed and non-redeployed staff response profiles.

Results

The staff who had experienced redeployment in the 6 months prior to spring 2023 showed higher rates of submitting applications for non-NHS jobs (22%; non-redeployed staff 12%). Redeployed staff reported higher stress, lower morale and less ability to switch off from work than non-redeployed staff (p

Conclusions

The findings highlight the negative impacts associated with staff redeployment and challenges to staff health, well-being and disposition to remain employed in healthcare. Despite a growing consensus regarding the need to support the redeployed, evidence regarding ‘what works’ remains under-researched. Such insight is particularly pertinent given the growing interest in technological solutions for a more agile workforce, where deployment flexibility is a key feature.

Climate change, transactional sex, HIV/AIDS and sustainable livelihoods among fishing communities around Lake Victoria: a scoping review protocol

Por: Were · L. P. O. · Kachingwe · O. N. · Goldman · T. · Ma · Y. · Awuor · F. J. · Nyamweya · C. · Okechi · J. · Kaufman · L. · Gopal · S.
Background

The objective of this scoping review is to map out what has been published in the scientific literature on the relationship between climate change-related events and how these overlap with associated changes in resource availability, transactional sex and HIV incidence and prevalence, within fishing communities in the Lake Victoria basin. This objective is informed by the fact that climate change and the associated natural resource strains in the Lake Victoria region have exacerbated existing inequities within fishing communities. Vulnerable populations, especially women, engage in strategies such as transactional sex to cope with the uncertainty of natural resource-dependent livelihoods. This practice greatly increases women’s risk of contracting HIV in this region, with prevalence rates four to five times the national averages. This scoping review will thus show how the existing empirical literature reports on climate change, transformation in natural resources and livelihoods, and transactional sex and HIV in the Lake Victoria region.

Methods

Studies that meet the following inclusion criteria will be included: align with at least two of the major concepts of interest, including climate change, transactional sex, HIV/AIDS, Lake Victoria Basin and/or empirical studies; are published in English and after 2012; and focus on the Lake Victoria basin. The scoping review will be guided by the JBI Manual for Evidence Synthesis: Scoping Reviews, supported by the standard principles of Arksey and O’Malley. The specific search strategies to be implemented were developed with guidance from an experienced research librarian to align with the inclusion criteria. The search will be conducted in relevant global databases, with two reviewers screening the results and extracting relevant data points. Finally, results will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews flow diagram, and summarised in figures, tables and text.

Discussion

The scoping review is designed to comprehensively scope the existing literature and document the coverage of linkages between transactional sex, HIV/AIDS and sustainable livelihoods in the context of climate change with a view to informing health systems responses to human health specific to the HIV epidemic.

Scoping review registration

The proposed scoping review is registered with the Open Science Foundation (OSF), registration number:https://doi.org/10.17605/OSF.IO/9DTW4.

Effect of non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) on non-motor symptoms in multiple sclerosis: study protocol for a randomised, controlled trial

Por: Herr · T. · Gamain · J. · Strauss · S. · Szeska · C. · Flöel · A. · Penner · I.-K. · Weymar · M. · Grothe · M.
Introduction

Research in people with relapsing remitting multiple sclerosis (PwRRMS) is increasingly focusing on non-motor symptoms like cognitive impairment, fatigue and depression. Due to the high negative impact on quality of life and high socioeconomic costs based on these symptoms, more specific research to improve non-motor symptoms is needed. Transcutaneous auricular vagus nerve stimulation (taVNS) has been found to be a cognitive enhancer in preclinical research and was successfully used for the treatment of psychiatric and neurological disorders to combat dysfunctional cognitive and affective processes. However, the capacity of taVNS to improve cognitive and other non-motor symptoms in PwRRMS has not been tested yet. The aim of this study is to evaluate the therapeutic potential of taVNS on cognitive processing speed. Based on ample evidence demonstrating that taVNS promotes adaptive cognitive and affective processes, we hypothesised that taVNS would alleviate cognitive processing speed in PwRRMS.

Methods and analysis

This study protocol describes the prospective, single-centre, SHAM-controlled, single-blinded trial with a planned sample size of 60 participants (30 PwRRMS, with a diagnosis of multiple sclerosis according to McDonald criteria and 30 healthy controls; age: 18–50 years). The Symbol Digit Modalities Test (SDMT) will be used to determine cognitive processing speed, Beck Depression Inventory-II to determine depression and Fatigue Scale for Motor and Cognitive Functions to determine fatigue. The severity of multiple sclerosis will be assessed using the Expanded Disability Status Scale. After baseline assessment, a taVNS protocol (duration: 30 min, tolerance threshold, pulse width: 250 μs, stimulation frequency: 25 Hz, 30 s on/30 s off) will be applied, followed by post-intervention assessment.

Ethics and dissemination

The study was reviewed and approved by the local ethics committee of the University Medical Centre Greifswald (study reference number: BB137/24). Clinical trial registration: www.drks.de, number: DRKS00034912. Study results will be disseminated through academic conferences as well as peer-reviewed publications.

Trial registration number

DRKS00034912.

Retinal detachment in Nigerians: a multicentre cross-sectional study on demographics, risk factors for blindness and surgical outcomes in a developing country

Por: Okonkwo · O. N. · Adenuga · O. O. · Nkanga · D. · Oyekunle · I. · Ovienria · W. · Agweye · C. T. · Akanbi · T. · Ibanga · A. A. · Udoh · M.-M. · Collaborative Retina Research Network Report 5
Objective

To compare the presenting demographic and clinical characteristics of rhegmatogenous retinal detachment (RRD) with other RD types, investigate risk factors of blinding RD and the outcome of surgical intervention.

Design

Prospective, cross-sectional and multicentre.

Setting

Four ophthalmic centres in three geographic locations of Nigeria.

Participants

264 eyes from 237 patients diagnosed with RRD, tractional retinal detachment (TRD) and exudative retinal detachment (ERD) seen between April 2019 and March 2020.

Results

264 eyes of 237 patients were diagnosed out of 35 641 patients screened. RRD was the most common RD (n=167 (70.5%), TRD 61 (25.7%) and ERD 9 (3.8%) patients). The hospital-based prevalence of all RD is 6.6 per 1000 patients (0.66%), and for RRD alone, 4.7 per 1000 patients (0.47%). The most common symptom was a sudden decline in vision, 100 patients (42.2%); floaters and flashes were uncommon, 5 (2.1%). RRD presented earliest, with a median symptom duration of 2 months, and TRD and ERD at 7.5 months each.

The 46–65-year age group had the highest representation, RRD (n=70, 41.9%), TRD (n=41, 67.3%), ERD (n=4, 44.4%). The mean age was highest in TRD (52.3±12.7 years) and lowest in RRD (44.0±17.5 years) and ERD (45.2±20.4 years). Males dominated (RRD 70.1%, TRD 62.3%, and ERD 66.7%). Ocular trauma was highest in RRD 29.3%, TRD 7.5% and ERD 10%; fellow eye RD was highest in TRD 47.5%, ERD 20%, RRD 8% and myopia was highest in RRD 27.6%.

Two-thirds of eyes were blind (Snellen best-corrected visual acuity

Shorter symptom duration is associated with better preoperative and postoperative vision. In contrast, longer durations are connected to poorer outcomes. Eyes with symptoms lasting less than a week had a 17% rate of postoperative blindness, compared with 30% in cases lasting 1–3 months, and 51% in cases exceeding 6 months.

Conclusions

Delays in diagnosing and treating RD result in high rates of preoperative blindness, which can be reversed with surgery even after several weeks of symptoms. Understanding the associations between RD and the risk of blinding RD in developing countries will benefit early diagnosis, treatment and improve treatment outcomes.

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