The 2014 genocide perpetrated by Islamic State in Iraq and Syria (ISIS) against the Yazidi community resulted in widespread psychological trauma, mass displacement and targeted destruction of cultural heritage. This exploratory study examined a therapeutic arts and photography intervention with formerly captured Yazidi women, alongside the participatory development of a cultural archive, as an integrated approach to supporting mental health, cultural resilience and survivor authorship in a postconflict setting.

Mixed-methods exploratory study using a pre–post quantitative design integrated with qualitative semistructured interviews and participatory focus groups.

Humanitarian, camp-based and community settings in northern Iraq within a Yazidi-led psychosocial support programme in a postconflict context.

Twelve formerly captured Yazidi women initially enrolled, with 10 completing the intervention and quantitative assessments; all were adult women who had survived captivity by ISIS and were engaged with local psychosocial services.

Primary quantitative outcomes were psychological distress, flourishing and coping, assessed using a modified Refugee Health Screener (RHS-15); qualitative outcomes focused on participants’ experiences of wellbeing, coping and meaning-making through arts engagement and cultural archiving.

Quantitative analyses indicated statistically significant reductions in psychological distress (p=0.015) and increases in flourishing (p=0.046); corresponding effect sizes suggested large but imprecise changes consistent with the small sample and exploratory nature of the study. Qualitative analyses identified outcomes related to enhanced social–emotional well-being, occupational justice and renewed future orientation, alongside therapeutic mechanisms including emotional expression, social connection, skill development, positive distraction and artistic medium-specific processes. The participatory archive development process yielded four primary functions: cultural and religious preservation, community well-being and resilience, education and understanding and participant-defined purpose and preferred forms of artistic expression. Mixed-methods integration demonstrated convergence between improvements in well-being and qualitative accounts of agency, identity reconstruction and cultural continuity.

This study provides preliminary evidence that therapeutic arts and photography, integrated with participant-led cultural archiving, may support reductions in distress and increases in flourishing among formerly captured Yazidi women. Positioning cultural archiving as a psychosocial and community-based practice highlights its potential to support collective resilience, survivor authorship and occupational justice alongside individual healing. Further research is needed to examine long-term outcomes, scalability and comparative effectiveness across contexts and to develop accessible, culturally grounded models for integrating such interventions into clinical and community services.

To examine COVID-19 vaccine uptake among people diagnosed with sexually transmitted and bloodborne infections (STBBIs), people with healthcare-documented methamphetamine use and those experiencing both exposures in Manitoba, Canada.

Population-based retrospective matched cohort study using linked administrative healthcare, laboratory and vaccination data.

Manitoba, Canada, from 1 March 2020 to 31 March 2022.

Manitoba residents aged ≥16 years with laboratory-confirmed chlamydia or gonorrhoea, syphilis or HIV and/or healthcare-documented methamphetamine use during the 4 years before 1 March 2020 were classified into eight mutually exclusive exposure cohorts. Individuals were matched with comparators without the corresponding exposure based on age, sex, geographical region and area-level income quintile.

Receipt of ≥2 COVID-19 vaccine doses. Poisson regression models incorporating person-time were used to estimate adjusted rate ratios (aRRs) and 95% CIs.

Compared with matched comparators, vaccine uptake was lower in the Syphilis Only (aRR 0.83, 95% CI 0.80 to 0.86), Syphilis Plus (aRR 0.77, 95% CI 0.74 to 0.79), Chlamydia/Gonorrhoea Only (aRR 0.91, 95% CI 0.90 to 0.92), Chlamydia/Gonorrhoea Plus (aRR 0.74, 95% CI 0.72 to 0.77), Methamphetamine Only (aRR 0.71, 95% CI 0.68 to 0.73) and Methamphetamine plus STBBI cohorts (aRR 0.64, 95% CI 0.62 to 0.67). Uptake in the HIV Only cohort was similar to that among matched comparators (aRR 0.97, 95% CI 0.93 to 1.00). Lower uptake was concentrated among individuals living in lower-income areas.

COVID-19 vaccine uptake was lower among several populations affected by STBBIs, methamphetamine use or both, with the greatest disparity among people experiencing intersecting STBBI and methamphetamine-related exposures. Integrating vaccination with HIV, STBBI, harm-reduction and addiction services may improve vaccine equity during future public health emergencies.

Regular physical activity and limiting sedentary behaviour are important aspects in managing multiple sclerosis (MS). Fatigue is a common and disabling symptom in MS, contributing to impairments in activities of daily living and poorer quality of life. This study aims to determine the effectiveness of a physical activity and sedentary behaviour intervention, called iStep-MS, for reducing fatigue in people with MS when delivered across the MS care pathway.

This is a multicentre, two-arm randomised controlled superiority trial with embedded economic and process evaluations. The study will take place across South-East England in acute and community National Health Service settings and charity-funded MS and neurological therapy centres. Intervention deliverers will include a range of healthcare staff such as physiotherapists, occupational therapists, therapy assistants, nurses and exercise therapists. A target sample size of n=198 participants will be randomised 1:1 to the intervention (iStep-MS behaviour change intervention plus usual care) or control (usual care only) arms. Participants will be adults with any type of MS, experiencing MS-related fatigue, relapse-free for >3 months, with a Self-Reported Disability Status Scale category of ≤3.5 (no disability to moderate disability) or 4–6.5 (significant disability). The iStep-MS intervention includes four one-to-one consultation sessions in-person or online with an intervention deliverer over 3 months, incorporating behaviour change techniques aimed at increasing physical activity and reducing sedentary behaviour. The consultations are supported by a handbook designed to help individuals with MS set goals and achieve behavioural changes and a wearable activity tracker for self-monitoring. Outcomes (assessed at baseline, 3 months and 9 months) include self-reported fatigue, quality of life, MS-impact, walking capability, pain, self-efficacy and waist circumference. Sitting, standing and stepping will be measured over 8 days using the activPAL4 device. A process evaluation will assess intervention acceptability, adherence and fidelity, including questionnaires and focus groups with participants and deliverers. A cost-effectiveness analysis will evaluate the value for money of the intervention against usual care.

Ethical approval has been granted by the NHS London—Bloomsbury Research Ethics Committee (reference 25/LO/0272). Results will be disseminated in scientific journals, conferences and to the wider public (eg, newsletters and social media).

ISRCTN16944301.

While evidence consistently demonstrates elevated COVID-19 risks among people with intellectual and physical disabilities, less is known about how household living arrangements shape these inequalities. Residential setting and household size influence exposure, capacity to isolate and reliance on care yet have rarely been examined jointly with disability status at a population scale. This study aims to estimate disability-related inequalities in COVID-19 infection, hospitalisation and mortality in Scotland and to assess whether residential setting and household size modify these inequalities using linked, population-wide administrative data.

This population-wide retrospective cohort study will use linked administrative data in Scotland. The study will focus on individuals present in the 2011 Scottish Census with records linkable to the Scottish population spine, which encompasses all individuals registered with a general practice who received a Community Health Index number. The cohort will comprise those who were alive, resident in Scotland and aged 16 years or older on 1 March 2020. Disability status will be classified from Census records as intellectual disability, physical disability (without intellectual disability) or a comparison group without reported disability. Address information recorded by the general practice will be linked to Ordnance Survey AddressBase Premium to assign Unique Property Reference Numbers. Residential settings will be classified from Basic Land and Property Unit codes as private dwellings or communal establishments and household size will be derived from resident counts at each property. Following linkage to the Public Health Scotland COVID-19 Research Database, outcomes including infection, hospitalisation and mortality will be ascertained from 1 March 2020 to 30 April 2022. Cox proportional hazards models will estimate associations between disability status, household living arrangements and COVID-19 outcomes, adjusting for relevant covariates. Effect modification will be assessed by evaluating interactions between disability status and household living arrangements on both multiplicative and additive scales.

Ethical approval was granted by the College of Social Sciences Research Ethics Committee, University of Glasgow (reference: 400200099). Data linkage was approved by the Scottish Public Benefit and Privacy Panel for Health and Social Care and the Scottish Government & National Records of Scotland Data Access Panel (reference: 2021-0119). Findings will be disseminated through peer-reviewed open-access publications and conference presentations.

Despite limited evidence of efficacy, opioid analgesics are frequently used by patients for chronic pain while awaiting total hip or knee arthroplasty (THA or TKA). Preoperative use of opioids is problematic as it increases the likelihood of postoperative opioid-related adverse drug events and postoperative complications and is the strongest predictor of persistent opioid use post surgery. Opioid tapering prior to elective surgery has been proposed as a strategy for mitigating harms and improving postoperative outcomes. This protocol describes a randomised clinical trial, which aims to determine the effectiveness of a preoperative pharmacist-partnered opioid tapering programme compared with standard care for patients awaiting elective THA or TKA on postoperative outcomes including persistent opioid use.

Eligible participants must be aged ≥18 years; awaiting elective unilateral or bilateral THA or TKA; speak and read English; use prescription opioid analgesics at least 4 days a week and have access to internet or telephone. The participants will be excluded if they are undergoing a repeat surgery (same procedure within 6 months), are using opioids for cancer, palliative care or substance use disorder; have previously or are currently undergoing an opioid tapering programme or active medication review or have cognitive impairment. Enrolled participants will be randomised in a 1:1 ratio in permuted blocks of two and four to: (1) intervention or (2) standard care. A total of 314 participants will be recruited into the study. The intervention will include a pharmacist-partnered opioid tapering programme in which a pharmacist will work with participants to reduce their opioid dose over a 3-month period before surgery. Standard care will involve review by the hospital preadmission clinic multidisciplinary team to assess medical, physical and psychological health prior to surgery and education sessions for preoperative and postoperative care. The primary outcome assessed is persistent opioid use 3 months post surgery. The key secondary outcome is total Western Ontario and McMaster Universities Arthritis Index score. Data analysis will be performed using an estimand framework, with a generalised estimating equation model for the primary outcome from 1 day to 3 days presurgery to 3 months post surgery and a multilevel model for the main secondary outcome from baseline to 3 months after surgery. Cost-effectiveness and cost-utility analyses will be conducted to determine whether the intervention is cost-effective from the healthcare system perspective.

Ethics approval for this study was granted by a Human Research Ethics Committee (approval number: 2023/ETH01042). Results will be disseminated in peer reviewed journals, at international scientific meetings as well as meetings with key stakeholders and via the media.

ACTRN12623000685617.