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Evaluating the impact and cost-benefit of CAMFEDs livelihoods support on young womens economic activity, health and well-being in Tanzania and Zimbabwe: protocol for a multi-method, longitudinal study

Por: Ranganathan · M. · Neuman · M. · Shah · V. · Abramsky · T. · Montero · A. M. · Greco · G. · Shimmin · C. · Boero · L. · Mackworth-Young · C. R. S. · Bandason · T. · Buwu · N. · Chidawanyika · S. · Minja · P. · Mitti · R. D. · Alex · S. · Kajula · L. · Ngadaya · F. · Binyaruka · P. · Mboya
Background

In sub-Saharan Africa, young women face disproportionate challenges transitioning from school to employment, with high rates of those not in education, employment or training (NEET). Structural barriers—including unequal gender norms, early marriage and unpaid labour—limit their economic participation. The Campaign for Female Education (CAMFED) Livelihoods programme supports young women’s transition from school to independent adulthood through mentoring, life skills, business and agricultural training and access to financial resources.

Aim

This study will evaluate the impact, process and mechanisms of change, and cost-benefit of CAMFED Livelihoods programme in Tanzania and Zimbabwe (2024–2027), focusing on outcomes related to economic activity, empowerment, leadership, mental health, subjective well-being and sexual and reproductive health among adolescent and young women (aged 15–24 years).

Methods and analysis

We will conduct a mixed-method, longitudinal evaluation across five districts in Tanzania and three districts in Zimbabwe. The quantitative component includes a pre-post cohort with a comparison group in Tanzania (n=1520) and a single-cohort design in Zimbabwe (n=500), with data collected at baseline, midline and endline. Primary outcomes are NEET status and leadership, complemented by measures of well-being, empowerment and health. The qualitative component will explore mechanisms of change and programme delivery. A cost-benefit analysis will estimate social and economic returns using a provider perspective. Youth researchers will be engaged to enhance participatory learning.

Ethics and dissemination

We have received ethics approvals from the London School of Hygiene and Tropical Medicine (31266), the National Health Research Ethics Committee (6732) in Tanzania and the Medical Research Council of Zimbabwe (MRCZ/A/3239) in Zimbabwe. Results of this study will be published in peer-reviewed academic journals and shared with policymakers, study participants and the other stakeholders in Tanzania and Zimbabwe.

UNIversity students LIFEstyle behaviours and Mental health cohort (UNILIFE-M): study protocol of a multicentre, prospective cohort study

Por: Schuch · F. B. · Waclawoscky · A. · Tornquist · D. · Oyeyemi · A. L. · Sadarangani · K. P. · Takano · K. · Teychenne · M. · Balanza-Martinez · V. · ONeil · A. · Romain · A. J. · McGrath · A. · Alselmi · A. · Andrade-Lima · A. · Zanetti · A. C. G. · Trompetero-Gonzalez · A.-C. · Heiss
Introduction

Students enrolling in higher education often adopt lifestyles linked to worse mental health, potentially contributing to the peak age onset of mental health problems in early adulthood. However, extensive research is limited by focusing on single lifestyle behaviours, including single time points, within limited cultural contexts, and focusing on a limited set of mental health symptoms.

Methods and analysis

The UNIversity students’ LIFEstyle behaviours and Mental health cohort (UNILIFE-M) is a prospective worldwide cohort study aiming to investigate the associations between students’ lifestyle behaviours and mental health symptoms during their college years. The UNILIFE-M will gather self-reported data through an online survey on mental health symptoms (ie, depression, anxiety, mania, sleep problems, substance abuse, inattention/hyperactivity and obsessive/compulsive thoughts/behaviours) and lifestyle behaviours (ie, diet, physical activity, substance use, stress management, social support, restorative sleep, environment and sedentary behaviour) over 3.5 years. Participants of 69 universities from 28 countries (300 per site) will be assessed at university admission in the 2023 and/or the 2024 academic year and followed up for 1, 2 and 3.5 years.

Ethics and dissemination

The study was first approved at a national level in Brazil (CAE:63025822.8.1001.5346). Study sites outside Brazil obtained additional ethics approval from their institutions using the main approval. Results from the UNILIFE-M cohort will be disseminated through scientific publications, presentations at scientific meetings, press releases, the general media and social media.

Are we getting better over time? Clinical and patient-reported outcomes for reverse shoulder arthroplasty: a National Joint Registry cohort study

Por: OMalley · O. · Davies · A. · Taghavi Azar Sharabiani · M. · Rangan · A. · Sabharwal · S. · Reilly · P.
Objectives

This study aims to review whether both clinical and Patient Reported Outcome Measures (PROMs) of Reverse Shoulder Arthroplasty have improved over time using the National Joint Registry (NJR).

Design

This study is a population-based cohort study using the NJR and Hospital Episode Statistics for England.

Setting

Publicly funded hospitals and procedures in England from 1 January 2013 to 31 December 2021.

Participants

All patients that received a reverse shoulder arthroplasty (RSA) in the specified time period. Patients were excluded if they had less than 1 year of follow-up.

Main outcome measures

Primary outcome was revision at one year. Secondary outcomes were non-revision re-operation and mortality at one year, length of stay (LOS) and mean change in Oxford Shoulder Score (OSS) from pre-operatively to 6 months post-operatively.

Results

There were 24 411 RSA cases available for analysis. There was no significant improvement in revision rates over time; however, there was a significant reduction in non-revision re-operations (OR 0.93 (0.86–0.99) p=0.03) and mortality (0.96 (0.92–1.00) p=0.04). LOS over time improved with an average reduction of 0.24 days per year, ranging from a mean of 3.94 days in 2013 to 2.44 days in 2021 (p

Conclusion

Over the 9-year period recorded in the NJR, revision rates were low and remained similar. There has, however, been an improvement in other clinical outcomes such as non-revision reoperation and mortality as well as functional outcomes and reduced LOS, which demonstrates progress in the quality of care provided to shoulder replacement patients and is suggestive of advancements in surgical techniques, perioperative management and rehabilitation strategies.

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