General statements that vaccinations are among the most important preventive measures in medicine are common in public health guidance. While the efficacy of individual vaccines is well established through randomised controlled trials and observational studies, ecological studies at the population level can provide complementary insights into the relative historical contributions of different childhood vaccinations to reductions in morbidity and mortality. To date, there has been a lack of systematic reviews of such comparative studies, especially with a focus on Germany. The aim of this scoping review is to map the state of research on ecological studies that compare the relative contribution of different childhood vaccinations to reducing morbidity and mortality, with a focus on reported data from Germany in an international comparison. A more precise scientific and public communication about vaccinations strengthens confidence in evidence-based vaccination recommendations.

This scoping review follows the Joanna Briggs Institute methodology for scoping reviews. Reporting will be in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search will be conducted in MEDLINE via PubMed, Embase via Elsevier, Web of Science, Scopus via Elsevier and Google Scholar, supplemented by grey literature sources. Studies will be selected and data charted by at least two independent reviewers using the Population/Concept/Context (PCC) framework. Results will be synthesised descriptively and presented thematically.

No ethical approval is required as this is a secondary analysis of published data. The findings will be disseminated through publication in a peer-reviewed journal and as part of the first author’s doctoral thesis. The protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/4FH3X).

This study assessed the feasibility of both the delivery and evaluation of ‘enhanced’ (behaviourally informed) text message reminders containing links to existing co-designed resources supporting decision-making for people with severe mental illness (SMI) regarding attendance of cervical screening.

A pilot randomised controlled trial (RCT).

13 General Practice (GP) practices in London were recruited.

GP practices identified people with SMI aged 24–64 years who were overdue cervical screening. Target sample size was 120 participants (60 per arm) based on existing guidance for pilot trials.

In March 2025, participants were randomised (1:1) to receive either the enhanced (intervention) or the standard (control) SMS reminder.

18 weeks later, feasibility outcomes were collected (primary outcomes) and data analysis for a definitive RCT was rehearsed (secondary outcome).

Of the 150 participants across 13 GP practices that were randomised (n=75 per arm), 132 (88%) texts delivered (intervention n=64/75 (85%), control n=68/75 (91%)). 10 practices (76.9%) provided follow-up data for 102 participants (intervention n=50, control n=52). Five participants (intervention n=4, control n=1) attended screening within the trial period. Participant survey response rate was low (9/132 (7%), intervention n=5, control n=4). Both SMS messages were low cost, with the intervention SMS a 50% higher cost to deliver (7.5p vs 5p per SMS). Primary feasibility measures of recruitment rate of GP practices (27%), retention of GP practices (77%) and participants (100%), SMS delivery (88%) and data completeness (64%) indicated viability, although survey response rate (7%) did not.

Achieving adequate recruitment and retention, data completeness and comparable groups is viable with some amendments, although an alternative method is required to assess fidelity. Behaviourally informed SMS reminders are feasible to deliver to people with SMI, although it is uncertain if the extra resources are accessed and used. With changes to data collection, a definitive trial could be feasible. Given the low observed cervical screening attendance, additional intervention is needed for this group.

ISRCTN12558681.

To map empirical evidence on sexual victimisation among higher education students, focusing on disclosure pathways, coping strategies and the extent and nature of family-related evidence.

Scoping review.

Scopus, Web of Science Core Collection, MEDLINE via EBSCOhost, ERIC via EBSCOhost, ProQuest Dissertations & Theses Citation Index, Google Scholar and citation tracking. The most recent search was conducted in June 2026.

Primary empirical quantitative, qualitative and mixed-methods studies published between 1 January 2015 and 31 December 2025 were eligible if they included higher education students and/or family members and reported on at least one focal domain: disclosure, reporting, help-seeking, coping, recovery, social support or family involvement after sexual victimisation.

Two reviewers screened records and extracted data using a standardised form. Quantitative findings were summarised descriptively; qualitative and mixed-methods findings were charted by focal domain and integrated narratively. Equity-relevant characteristics were mapped using PROGRESS-Plus.

After screening and eligibility verification, 86 studies met the Population-Concept-Context criteria. These comprised 70 journal articles, 11 theses/dissertations and 5 conference proceedings papers. Most studies were conducted in North America and employed cross-sectional survey designs. Definitions and measures of sexual victimisation varied widely. When disclosure occurred, it was most often directed to peers and other informal supporters, whereas formal reporting to campus, legal or healthcare systems was less common. Coping responses ranged from social support, counselling, safety planning and advocacy to avoidance, self-blame, substance use and academic withdrawal. Family members were rarely sampled directly; family-related evidence was usually indirect, derived from students’ accounts of disclosure recipients or perceived reactions.

The evidence indicates persistent gaps in non-US contexts, distance-learning settings, research on male and gender-diverse students’ experiences and direct family-level research. Campus responses should be trauma-informed and equity-informed, while recognising that evidence for family-inclusive interventions remains preliminary and requires further empirical development.

To assess HIV knowledge, stigma and perceived adequacy of HIV curricular coverage among medical students in Egypt and to identify factors associated with HIV stigma.

An online-based cross-sectional study.

Medical schools across Egypt. Data were collected in August 2025 using a bilingual (Arabic/English) online questionnaire using convenience sampling.

First- through fifth-year students enrolled in Egyptian medical schools.

HIV knowledge was assessed using the Brief HIV Knowledge Questionnaire (HIV-KQ-18); HIV-related stigma was assessed using the Healthcare Providers HIV/AIDS Stigma Scale (HPASS) and perceived adequacy of HIV curricular coverage.

A total of 1503 students participated (mean age 20.6 years; 57.4% female), half of whom (48.9%) rated curricular coverage of stigma and psychosocial aspects of HIV as inadequate. The mean HIV-KQ-18 score was 8.96/18 (SD 4.26). Only 39.9% recognised that HIV cannot be transmitted through kissing, 47% believed washing after sex is protective and just 41.3% knew that not all infants born to mothers with HIV will have AIDS. The mean HPASS score was 60.1/108 (SD 17.6). Most students (76.8%) worried about contracting HIV from patients, 52% believed patients acquired HIV through risky behaviours and 43.6% endorsed a right to refuse providing care. Knowledge and stigma were inversely but weakly correlated (r = –0.17, p<0.001), and higher knowledge was independently associated with lower stigma on multivariable regression (B=–0.16, p<0.001). Despite higher knowledge, males reported significantly higher stigma (B=0.25, p<0.001) compared with their female counterparts. Similarly, participants who completed the Arabic form had significantly lower knowledge and higher stigma (B=0.24, p<0.001).

HIV stigma is prevalent among medical students in Egypt, with significant variations observed across gender, survey language and levels of HIV knowledge. These findings call for multifaceted interventions and curriculum reform to reduce stigma among future clinicians.

The transition into fatherhood is considered a profound life stage, involving personal development, lifestyle and emotional adjustments. Fathers’ mental health can be adversely impacted by this transition. Fathers express isolation, exclusion and limited support within perinatal services. Restricted emotional support for fathers presents negative consequences for the whole family dynamic. Limited research has explored father and professional input associated with paternal perinatal support and how healthcare services and child and family services can respond to engaging fathers and their mental and emotional support needs. This qualitative study aims to explore fathers’ mental health and well-being experiences (referring to emotional or/and social well-being) and support needs within the perinatal period, as well as current viewpoints of perinatal services (maternity, healthcare and social care services) from both fathers’ and professionals’ perspectives.

In-depth semistructured interviews and focus groups were carried out as part of a qualitative study.

Fathers’ resident within the North East and North Cumbria (NENC) and services and organisations from the voluntary, community and social enterprise (VCSE) sector and social care services across the NENC, who associate with supporting families and children, and perinatal mental health.

Fathers (n=21) and professionals (VCSE and social care services) (n=9).

Reflexive thematic analysis of 30 participants’ accounts identified two main themes and five subthemes: (1) ‘The Pregnant and Postnatal Man’ and (2) Removing the cloak of fatherhood invisibility. These themes centred around the isolation of fathers and limited emotional and mental support within the parenting transition.

The findings suggest that greater father inclusion within perinatal services, policies and antenatal education may help fathers feel more recognised and supported throughout the perinatal journey. Recognition of fathers’ emotional well-being and mental health, by adopting a ‘whole family’ emotional support approach within perinatal services was considered important to support fathers and the family dynamic in facilitating a positive transition for the whole family.

Chronic pain is a public health priority that affects 18% of Dutch and 16% of German adults, representing a major societal burden. The Ems Dollart Region (EDR), which forms the northern part of the Dutch–German border area, is particularly characterised by lower incomes, more physically demanding jobs and lower health literacy, which are associated with higher pain prevalence. Individuals with lower socioeconomic status face greater pain-related disability and reduced quality of life. Public health campaigns underpinned by pain science education provide a strategy to improve understanding of pain among the wider public by addressing common misconceptions about its causes and management. However, large-scale population-level interventions and evaluations of such campaigns remain limited.

This protocol describes the design and implementation of a cross-border public health campaign in the EDR, aimed at improving public understanding of pain, changing attitudes and beliefs and promoting healthy behaviours. We will conduct a quasi-experimental before–after study in the EDR with a control group in Flanders (Belgium). The intervention is guided by behaviour change and biopsychosocial models. The campaign will deliver tailored content via social media, broadcast, print and online advertisements over a 24-month period. Two independent cross-sectional samples will be surveyed at baseline and at 2-year follow-up, comprising 3200 participants per measurement wave from three regions: the Netherlands and Germany as intervention regions, and Flanders, Belgium, as the control region. The primary outcome is the prespecified Pain Concepts Questionnaire ratio score, assessing pain-related knowledge, attitudes and beliefs. The primary analysis will use an adjusted difference-in-differences framework to estimate whether change in the primary outcome differs between the combined intervention regions and the control region. Secondary analyses will examine the Netherlands and Germany separately and will evaluate healthcare utilisation, medication use, health-related quality of life and work absenteeism.

This study protocol was reviewed by the Medical Ethics Review Board of the University Medical Center Groningen and the University of Oldenburg. The study was considered not subject to the Medical Research Involving Human Subjects Act (non-WMO declaration; reference number M24.345555, issued on 31 December 2024) and was approved by the University of Oldenburg Ethics Committee (reference number 2025–056, issued on 07 March 2025). Informed consent was obtained electronically by the research agency at the time of participants’ registration with the research panel. Study findings, regardless of outcome, will be disseminated through peer-reviewed publications and presentations at national and international conferences.

Older Chinese adults in the UK face unique needs when engaging in physical activity (PA), yet culturally appropriate strategies to promote PA remain limited.

To develop culturally appropriate PA promotion strategies for older Chinese adults living in the UK.

The intervention development comprised two stages: design and optimisation. It was informed by previous research findings and input from public and community involvement and engagement. Stage 1 combined the person-based approach (PBA), which involved developing guiding principles, an intervention planning table and a logic model, with seven steps of the Behaviour Change Wheel (BCW) to identify intervention functions, behaviour change techniques (BCTs) and delivery modes to enhance older Chinese adults’ capability, opportunity and motivation for PA. Stage 2 used think-aloud interviews with 10 older Chinese adults to optimise the intervention.

Six intervention functions (education, persuasion, incentivisation, training, modelling and enablement), 27 BCTs and multiple delivery modes were identified in stage 1. In stage 2, based on think-aloud interviews with 10 participants, three prototypes were retained in their original form, one new element was added and three were removed. The remaining components were retained with either minor or major modifications. The final strategies included culturally tailored PA booklets, monthly workshops and social media support groups.

By integrating evidence, theory and stakeholder perspectives, and by combining the PBA with the BCW, this study developed the first culturally appropriate PA promotion strategies for older Chinese adults in the UK. Further research is needed to evaluate their feasibility, acceptability and effectiveness.

The hepatitis C virus (HCV) is a significant healthcare burden across the globe and is a major cause of liver malignancies. However, patients with serious mental illness (SMI) living with HCV are disproportionately affected and underserved within the current care framework. A previous meta-analysis on this topic yielded a prevalence of 8%, which is considerably higher than that observed in the broader population. Since the original review was published in early 2022, an update is required to incorporate data published during and after the COVID-19 pandemic and to evaluate its effect on overall prevalence and care.

This systematic review and meta-analysis will replicate the methodology of the original review. To ensure a thorough investigation, a systematic search strategy will be implemented across PubMed, Google Scholar, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science to include studies published from 2 July 2020 to 22 June 2026. The review will include prospective observational and retrospective cross-sectional studies conducted among adults aged over 18 years with a verified SMI diagnosis and laboratory-confirmed HCV status. A dual-reviewer protocol will be employed to evaluate all retrieved titles, abstracts and full-text manuscripts to ensure unbiased selection. Any disagreements will be adjudicated by a third senior investigator. Methodological rigour will be assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Prevalence Studies Quality Assessment Tool for Systematic Reviews of Observational Studies. This validated instrument will ensure transparency and standardised quality assessment and will be supplemented by a customised 3-point global assessment. A Generalised Linear Mixed Model (GLMM) with a logit transformation will be used for the meta-analytical synthesis to effectively account for expected heterogeneity and extreme proportions, while the degree of inconsistency across studies will be quantified using the I² statistic.

Formal ethical clearance is not required for this study, as it relies entirely on the synthesis of secondary data from published articles.

CRD420261331799.

This study explored perspectives of practitioners providing weight management support for urban-dwelling young adults (18–35 years) with obesity in Sri Lanka, addressing an important evidence gap in understanding obesity management from a provider perspective.

This descriptive qualitative study employed face-to-face semi-structured interviews, and the data were analysed using a framework approach within thematic analysis.

Eight purposively selected practitioners involved in weight management in the Colombo District, Sri Lanka, were interviewed. Participants represented key domains of comprehensive obesity management, including dietary, physical activity, behaviour and medical management. Recruitment continued until thematic saturation was achieved.

Two key themes emerged from the data: (1) Barriers to effective weight management and (2) Strategies to improve weight management. Within the first theme, five subthemes emerged, including limited knowledge and confidence among practitioners, provider attitudes towards clients, resource and service limitations, client motivation and adherence challenges and cultural and religious influences and myths. The second theme comprised four subthemes: early detection with a proper referral system, comprehensive and individualised care approach, continuous follow-up and self-monitoring and supportive social environment.

The findings indicate that obesity management is hindered by fragmented care, with provider, client and system-level factors constraining practitioners’ weight management efforts and limiting opportunities for improved care. These findings suggest the potential value of strengthening interdisciplinary referral pathways and targeted training to support more coordinated care.

The transition from chronic homelessness to being housed is a period of increased mortality risk. Examining the post-housing period is important for improving our understanding of this increased risk.

To investigate, in a retrospective cohort study, the mortality rate of people who had been chronically homeless and who moved into supported housing and to identify risk factors associated with mortality.

Retrospective cohort study with eligible records reviewed from 1 October 2017 until 14 June 2024.

Three supported housing units in Ottawa, Ontario, Canada.

Participants were any individual, alive or deceased, who moved into one of the eligible supported housing units within 6 months of their opening date. 123 participants were included in the study. The mean age was 41.3 (SD 11.9) years, and 76 (62%) were male.

The primary outcome was all-cause and cause-specific mortality following transition to supported housing. Differences in demographics and morbidity were also compared between people who were alive as of 14 June 2024 and those who were deceased as of 14 June 2024.

During a mean follow-up of 2.6 years, there were 27 deaths recorded (22% of those who moved into supported housing). Most, 11 (40%), died from ‘other causes’, where the cause of death was unclear or unknown and where they were found dead in their room, seven (26%) died of ‘natural causes’ usually in hospital after a medical event, seven (26%) of an opioid overdose and two (8%) where we have suppressed cause of death for privacy. There were no statistically significant differences in psychiatric diagnoses, substance use, medical diagnoses or opioid agonist therapy between those who died and those still alive at the end of the study period. Survival differed significantly across age groups (log-rank ²=11.05, p=0.011), with residents aged 31–45 years demonstrating better survival than older age groups. No significant differences in survival were observed by sex.

There is a high mortality rate in people who are chronically homeless who move into supported housing. As our findings do not identify any clear baseline risk factor, it supports the idea that the transition into housing must be complemented with comprehensive health and well-being services that can meet this population’s complex needs to reduce the mortality risk.

Cardiovascular disease (CVD) is the leading cause of death in the USA, with significant disparities affecting racial/ethnic minority populations particularly in Philadelphia. Although effective self-management can improve outcomes for those with CVD risk factors, social and economic barriers often impede implementation of recommended health behaviours in underserved communities. This study aims to (1) determine the effectiveness of the Decision-making Education for Choices in Diabetes Everyday (DECIDE)+ intervention in improving CVD self-management skills among Philadelphia residents with CVD risk factors and unmet social needs compared with standard community health worker (CHW) engagement and (2) assess the reach, adoption, fidelity and maintenance of DECIDE+.

Using a type 1 hybrid effectiveness-implementation design, this quasi-experimental study will compare outcomes between participants who enrol in the DECIDE+ group (n=250) or receive standard CHW services (n=250). DECIDE+ combines a structured nine-session problem-solving programme for chronic disease management with ongoing CHW support addressing social needs. Both groups will be randomly assigned to either monthly or biweekly CHW follow-up to examine the impact of contact frequency on health behaviour outcomes. Primary outcomes include CVD self-management skills measured by the Self-care of Chronic Illness Inventory. Implementation outcomes will be assessed through a mixed-methods approach including structured interviews with CHWs and analysis of programme-level data.

This study was approved by the University of Pennsylvania Institutional Review Board (Protocol #856216). Written informed consent is obtained from all participants prior to enrolment. This pragmatic trial addresses cardiovascular health disparities by simultaneously enhancing problem-solving skills for chronic disease management and addressing social and environmental barriers to effective self-management. The study will provide valuable insights into the effectiveness of multilevel CHW-delivered interventions and optimal implementation strategies in real-world community settings. Findings will be disseminated through peer-reviewed publications and scientific conference presentations.

NCT06732102.

Youth with disabilities in low- and middle-income countries (LMICs) face persistent exclusion from education, employment and social participation. Those affected by leprosy often experience additional stigma, discrimination and structural barriers that further restrict empowerment, livelihood opportunities and social inclusion. Community-based approaches, including Community-Based Rehabilitation (CBR) and Community-Based Inclusive Development, aim to promote inclusion by empowering individuals and addressing barriers. However, evidence on how these approaches contribute to empowerment, livelihood development and social inclusion among youth with disabilities remains fragmented. This scoping review aims to map and synthesise evidence on community-based approaches that support empowerment, livelihood development and social inclusion among youth with disabilities including those affected by leprosy in LMICs.

This scoping review has been developed in accordance with the Joanna Briggs Institute (JBI) methodological framework for scoping reviews and is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines for review protocols. The protocol is registered on the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/QG6UD). The literature search was conducted between April and June 2026. The completed scoping review will be reported in accordance with the PRISMA-ScR guidelines.

The review is primarily informed by the WHO CBR Guidelines, which provide the conceptual and analytical framework for examining community-based disability inclusion, livelihood development, empowerment, participation and social inclusion. Critical Disability Studies will serve as a complementary interpretive lens to examine structural inequalities, power relations, stigma, discrimination and the broader social barriers influencing the experiences and participation of youth with disabilities.

Eligible studies will include youth aged 15–35 years with physical, sensory, intellectual or psychosocial disabilities in LMICs, including disability associated with leprosy where reported. Peer-reviewed and grey literature published in English between 1 January 2010 and 30 June 2026 will be searched in PubMed, Scopus, Web of Science, PsycINFO, ERIC and relevant organisational grey literature repositories.

Data will be synthesised using a hybrid deductive–inductive thematic analysis, with deductive coding guided by the CBR Guidelines and Critical Disability Studies, and inductive coding used to identify emerging themes. NVivo V.15 software will support data management and analysis.

Ethical approval is not required, as this study involves secondary analysis of publicly available literature. Findings will be disseminated through peer-reviewed publications, conference presentations, policy briefs and stakeholders’ engagement.

To identify client and provider perspectives on contraceptive counselling in Pakistan and inform the development of an effective, rights-based counselling intervention package.

A formative, multimethod qualitative study was conducted using in-depth interviews, non-participant observations of counselling encounters and thematic analysis. The study was embedded within a WHO-led multiphase complex intervention.

Primary care-level family planning facilities (public and private) in the urban and peri-urban districts of Islamabad and Rawalpindi.

The analysis reported in this paper includes 72 married family planning clients (36 women and 36 men), 15 frontline healthcare providers and 72 observed counselling sessions across three facilities. Broader stakeholder interviews with programme managers, public-sector officials and donor/development partners were collected for the wider multiphase study but are not analysed in this paper.

Three overarching themes were identified: (1) counselling was often understood as basic method-related information rather than a structured, rights-based decision-making process; (2) public and private facilities differed in counselling depth, method choice, privacy and use of visual/couple-centred approaches; and (3) system constraints, including time pressure, commodity limitations, limited follow-up mechanisms, weak privacy arrangements and inconsistent training, shaped the quality of counselling. Observation data supported interview findings by showing variation in privacy, side-effect discussion, client engagement and follow-up advice across facilities.

Findings from participating facilities suggest that the current counselling model in these settings inadequately supports informed, autonomous reproductive choices. A redesigned, context-sensitive counselling package is needed to address these gaps. This should be supported by improved training, supportive supervision, inclusive tools, systemic reforms and enhanced follow-up mechanisms that are essential to increase decision-making autonomy and contraceptive continuation.

NCT06081842.

Chronic diseases driven by modifiable risk factors (MRFs), such as poor diet, physical inactivity, tobacco use and harmful alcohol consumption, disproportionately affect ethnic minority groups worldwide and within multi-ethnic societies such as Singapore. Although culturally tailored interventions and implementation strategies exist, there is limited synthesis of what has been used, for whom and under which contextual conditions these approaches produce equitable reductions in MRFs. EQUATOR aims to identify and synthesise policies, programmes and implementation strategies that have been tailored for ethnic and cultural minority populations and to develop explanatory mid-range programme theories describing how, why and under what circumstances such tailoring produces equitable outcomes.

We will conduct a scoping review with a realist synthesis as the analytical approach. Searches will be run in PubMed and Scopus for studies published from January 2010 onwards, restricted to English. Eligible studies include experimental, quasi-experimental, qualitative, mixed-methods studies and reviews that evaluate or report outcomes for tailored strategies addressing MRFs in ethnic minority populations and explicitly examine equity-focused outcomes or mechanisms. A piloted data extraction form will capture study characteristics, contextual details, intervention/strategy descriptions, theoretical underpinnings and outcomes using a RE-AIM lens (reach, effectiveness, adoption, implementation, maintenance) and equity indicators. Extracted data will support (1) an inductive typology of strategies/interventions for each MRF and (2) realist S/ICMO (Strategy/Intervention–Context–Mechanism–Outcome) configurations to generate mid-range programme theories explaining how tailoring works (or fails) across contexts.

Ethical approval is not required for this literature synthesis. Findings will be disseminated through peer-reviewed publications, presentations to policymakers and practitioners and stakeholder briefings to emphasise actionable recommendations for culturally tailored strategies to reduce MRFs and promote health equity in multi-ethnic settings.

To develop an algorithm to identify pelvic inflammatory disease (PID) episodes based on diagnostic codes, estimate their frequency and determine the proportion related to Chlamydia trachomatis infection.

Hospital visits by women aged 18–45 years presenting with one of 31 diagnostic codes potentially associated with PID between July 2017 and December 2019 were extracted from the electronic medical record (EMR) warehouse of 39 public hospitals in the Paris area, France (EDS-APHP).

1956 patients totalling 2191 visits were included.

Natural language processing (NLP) methods were developed and validated against expert reading to identify PID episodes from textual medical reports. The resulting classification served as a reference to select relevant diagnostic codes for constructing a PID identification algorithm.

The final algorithm included 10 diagnostic codes, with 3 codes searched in principal or associated diagnoses and 7 codes in principal diagnosis only. The algorithm’s performance on 1732 NLP-classified visits was a 0.80 recall, a 0.74 precision and a 0.77 F1-score. On a set of 93 expert-classified visits, these performance metrics were 0.76, 0.82 and 0.79, respectively. The algorithm identified 901 PID episodes in 880 patients during the study period. C. trachomatis infection was detected in 9.9% of them.

Exploiting EMR data enabled the development of an algorithm with satisfactory performance for detecting PID episodes based solely on diagnostic codes. This algorithm will be useful to identify PIDs among hospitalisations from large-scale healthcare claims databases lacking medical reports, which will contribute to assess the burden of C. trachomatis infections and their complications.

In 2023, Sub-Saharan Africa recorded the world’s highest teenage pregnancy rate of 4.4 per 1000 women compared with the global average of 1.5 per 1000, highlighting the need for accurate nutritional assessment during pregnancy. Current mid-upper arm circumference (MUAC) thresholds differ between non-pregnant adolescents (18.5 cm) and pregnant adolescents (23 cm) as per the Uganda Integrated Management of Acute Malnutrition guidelines. This classification can lead to inadequate treatment and mislabelling of adolescents as non-responders, despite nutritional improvements. This study will reassess MUAC thresholds for predicting nutritional status and pregnancy outcomes among pregnant adolescents in Bundibugyo District, Uganda.

This health facility-based prospective cohort study will target 241 pregnant women comprising 121 pregnant adolescents (10–19 years) and 120 adults (20–49 years) in their first trimester (≤12 weeks of gestation) receiving antenatal care (ANC) at Bundibugyo General Hospital and Bupomboli Health Centre III in Bundibugyo District, Uganda. Recruitment of study participants will commence in June 2026 and participants will be followed up for 6–9 months during routine ANC visits until delivery. Quantitative data will be collected through questionnaires and from patients’ hospital records during routine ANC visits. The study primary outcomes are maternal gestational weight gain and maternal haemoglobin status. Secondary outcomes include pregnancy outcomes (birth weight, gestational age at delivery, preterm birth, small for gestational age status, maternal pregnancy complications and mode of delivery). The main explanatory variable is MUAC assessed as baseline MUAC, repeated MUAC measurements during subsequent ANC visits and the rate of MUAC change across gestation. Receiver operating characteristic analyses and internal bootstrap validation will be used to derive and internally evaluate study-derived adolescent-specific MUAC thresholds. Qualitative data from 10 to 12 key informants will be obtained once through key informant interviews and triangulated with the quantitative findings to explain and contextualise the results.

Kyambogo University Research Ethics Committee (KyU-REC-2025-43) and the Uganda National Council for Science and Technology (HS7233ES) have approved this study protocol. Local administrative clearance has been sought from the Bundibugyo District Health Office and from Bundibugyo General Hospital and Bupomboli Health Centre III. Results will be published in peer-reviewed journals and summaries will be shared with the Bundibugyo District Health Office, participating health facility in-charges, ANC units and study participants.

This review aims to map and summarise evidence on digital health technologies (DHTs) for home-based rehabilitation in children with cerebral palsy (CP), including technology types, usage, outcomes, adoption barriers and evidence gaps.

This scoping review follows the Arksey and O’Malley framework, incorporates updates from Levac et al and is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews.

10 electronic databases were searched from inception, with individual database searches last updated between 17 September 2025 and 6 June 2026, including PubMed, Cochrane Library, EBSCOhost, Google Scholar, ScienceDirect, Scopus, PEDro, OTseeker, IEEE Xplore and ACM Digital Library.

Peer-reviewed primary studies involving children under 18 with CP receiving DHTs for home-based rehabilitation were included. Studies in clinical settings or not published in English were excluded.

Two reviewers independently extracted data with a third reviewer resolving disagreements. Quantitative results were summarised with basic statistics; qualitative results were analysed using thematic analysis per Joanna Briggs Institute methods. The review did not compare the effectiveness of different technologies.

52 studies were included covering eight technology categories. Telerehabilitation/telehealth and virtual reality/exergaming were most common. Outcomes covered six domains, with upper limb motor function most frequently assessed. The main facilitators were gamification, cost-effectiveness and caregiver capacity building; the main barriers were access and equipment constraints, methodological limitations and connectivity issues. Five evidence gaps were identified: small sample sizes, short follow-up periods, limited representation of low- and middle-income countries, inconsistent outcome measures and a lack of real-world validation.

Randomised controlled trials, standardised outcome sets and scalable, culturally appropriate digital health solutions are needed, especially for low- and middle-income countries. Future reviews should consider including specialist databases.

Long-term sickness absence represents a major public health challenge with far-reaching consequences for both individuals and society. Musculoskeletal disorders (MSDs) are among the leading causes of sickness absence. Although mobile apps show promise for supporting self-management of MSDs, high-quality evidence remains limited, and outcomes related to work participation are rarely examined. This trial aims to evaluate whether an individually tailored, app-based self-management intervention (SmaRTWork), provided in addition to usual care, improves return-to-work compared with usual care alone among individuals on sick leave due to MSDs.

We will conduct a randomised controlled trial with two parallel arms: 1) SmaRTWork in addition to usual care and 2) usual care alone. Individuals 20–59 years old who have been sick-listed for

The trial is approved by the Committees for Clinical Trials of Pharmaceuticals and Medical Devices (Ref. 563919). Results will be published in peer-reviewed journals and presented at national and international conferences.

NCT07034040.

To examine immigration-related inequities across the perinatal mental healthcare pathway, including differences in case detection, treatment uptake and timeliness of care, among first-time parents in Sweden.

Population-based cohort study using linked administrative register data.

The three largest Swedish regions (Stockholm, Västra Götaland and Skåne) covering approximately 55% of the national population.

All first-time parents with a live first birth between 1 January 2008 and 31 December 2018 residing in the study regions (404 043 mothers and 391 068 fathers).

Individuals’ country of birth (born outside vs inside the Nordic countries).

We examine immigration-related inequalities across the perinatal mental healthcare pathway, including case detection (issues recorded a year postpartum, with no diagnoses/treatments in the previous year), treatment uptake (antidepressants and/or psychotherapy) and timeliness of care (weeks from diagnosis to treatment).

In the 12 months postpartum, 7.2% of mothers and 4.5% of fathers had common perinatal mental health conditions requiring clinical management. Parents born outside the Nordic countries had substantially lower detection rates: –5.3 percentage points for mothers (95% CI –5.8 to –4.9; 59% below the Nordic-born baseline of 9.0%) and –2.5 percentage points for fathers (95% CI –2.8 to –2.3; 48% below the Nordic-born baseline of 5.2%). Conditional on diagnosis, immigrant mothers and fathers were 12.1 and 7.6 percentage points less likely to receive treatment, respectively. Differences in time from diagnosis to treatment were small.

Immigration-related inequalities were observed across multiple stages of the perinatal mental healthcare pathway. As previous evidence suggests similar or higher levels of perinatal mental health problems among immigrant parents, the observed differences are unlikely to reflect lower need for care. Findings instead point to inequalities in access and use of perinatal mental healthcare and highlight the need for more equitable screening, assessment and follow-up.

Child maltreatment (CM) can have significant and long-lasting consequences over the life course. These include long-term physical injuries and an increased risk for mental illness. Preventive applications are critical to reduce maltreatment, promote early detection and initiate early interventions, and prevent further harm. Social marketing (SM) strategies offer a promising approach for the prevention of CM. They use commercial marketing principles to raise awareness and/or influence behaviour of populations for social welfare purposes. To date, there is no comprehensive overview of SM strategies and applications used for prevention, early detection and reduction of harms of physical and emotional child abuse and neglect. This study aims to address this gap by means of a scoping review mapping the national and international literature and to provide an understanding of how SM strategies have been conceptualised and implemented in CM prevention. We chose a scoping review to catalogue and organise the literature, define key constructs and identify gaps, instead of pooling effects.

PubMed, Scopus, Web of Science, ERIC and PsycINFO will be searched for relevant existing literature published between 2010 and 2025 using a search string based on the Population, Concept and Context scheme. Empirical studies examining SM strategies for the prevention of physical and emotional abuse and neglect of all designs will be included.

The results will be presented in both narrative and tabular formats. These tables will report on general study characteristics (eg, country, year of publication, study design), key characteristics of SM applications (eg, prevention aims, setting, components, target audiences) and strategies used (eg, media channels, communication formats and theories used). Where reported, we will also summarise evaluations of SM strategies used (eg, study design and outcome measures, main findings).

The reporting of the review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews: Checklist and Explanation and PRISMA Statement for Reporting Literature Searches in Systematic Reviews.

Literature is used as the only data source, therefore, no ethical approval is required. The findings will be disseminated through peer-reviewed publications and conference presentations. They will identify research gaps and will inform a research agenda on integrating SM strategies in the design of preventive applications regarding child physical/emotional abuse and neglect and future evaluations. Our findings can also inform the design of population-level prevention policies and strategies that use SM strategies to raise public awareness of CM and to promote preventive behaviours in everyday settings.

A protocol outlining the scoping review has been preregistered at the Open Science Framework (osf preregistration).