To assess the implementation of infection prevention and control (IPC) measures and associated factors in healthcare in low-resource settings during the COVID-19 pandemic.

Multinational cross-sectional study.

The study was conducted from February to November 2022 in Côte d’Ivoire, Democratic Republic of Congo, Madagascar and Nigeria.

A total of 6749 healthcare workers (HCWs) at 324 healthcare facilities (HCFs) were enrolled from different levels of care and types.

Standardised HCW and HCF questionnaires assessed COVID-19-related exposures and IPC measures and descriptive analyses were conducted overall and by country and HCF. Partial proportional odds models were used to assess factors associated with HCW compliance to hand hygiene and mask wearing.

Among 324 HCFs, the reported presence of IPC programmes ranged from 51.4% (n=111) at primary non-hospitals to 83.3% (n=18) at tertiary HCFs. More than half reported no patient or HCW screening (57.4%, n=186). Only 19.8% (n=64) reported handrub at point of care in every room. Among 6749 enrolled HCWs, 54.0% were working in high-risk patient care. More HCWs reported sufficient availability of masks (62.7%, n=4231) compared with respirators (28.5%, n=1926). HCW compliance with hand hygiene and mask wearing, respectively, was improved by presence of an IPC programme (OR: 1.3, 95% CI 1.2 to 1.5; OR: 1.4, 95% CI 1.2 to 1.6), IPC training received by the HCW (OR: 1.5, 95% CI 1.3 to 1.7; OR: 1.3, 95% CI 1.2 to 1.5) and availability of handrub and masks, respectively (OR: 5.9, 95% CI 4.1 to 8.4; OR: 2.3, 95% CI 2.0 to 2.7).

We conducted a large survey including HCFs across levels of care and type in urban and rural regions in sub-Saharan Africa. Critical gaps in IPC programmes and access to IPC equipment during the COVID-19 pandemic hindered HCW compliance with recommended IPC practices. To improve general infection control and pandemic preparedness in low-resource settings, continued focus on strengthening IPC programmes and ensuring access to materials/equipment is essential.

In 2024, 30.4% of the German population had a migration background. People with migration-related language barriers face numerous challenges within the healthcare system, which can negatively impact their health outcomes. While language barriers affect healthcare in general, oncology represents a complex field in which effective communication is crucial. For people with cancer in particular, difficulties in understanding information, treatment options, and the healthcare system itself may hinder access to services. This increases the risk of complications, prolonged hospitalisations and readmissions. At the same time, there is little information about this group, and evaluations of structured services are lacking. This study assesses a nurse-led complex intervention focusing on structured information and ongoing support for people with cancer and migration-related language barriers.

The intervention is designed for people with cancer and migration-related language barriers and comprises three key elements: (a) continuous guidance provided by already existing roles of oncology nurse specialists, (b) a telephone interpreting service and (c) multilingual informational materials. We will assess the intervention’s effectiveness with a controlled before-and-after study. Assuming an effect size of d=0.5 and using a 2:1 allocation ratio with 80% power, we aim to recruit 126 people with cancer and migration-related language barriers (84 intervention; 42 control) for participation. We will assess the primary outcome psychosocial support needs assessed with the Psychosocial Risk Questionnaire (PSR) at admission, discharge, and 3-month post-discharge using paper-based or digital questionnaires. The secondary outcomes, such as knowledge, quality of life, anxiety and satisfaction, are measured alongside the primary outcomes and compare the distribution of items and scores using Student’s t-test (total scores) or the Wilcoxon rank sum test (individual items) at a one-sided significance level of 5%. We will use an embedded process and economic evaluation to examine the feasibility, acceptability and implementation of the intervention in line with the Medical Research Council guidance for process evaluations of complex interventions.

The Ethics Committee of the Faculty of Medicine, University of Cologne (No. 23–1303 and 24–1266), approved the protocol, and the study was registered in the German Clinical Trials Register. We will disseminate the results of the study through peer-reviewed publications and at academic conferences.

German Clinical Trials Register (DRKS00034749).

After the loss of a parent, families with minor children face psychosocial stressors. The bereaved parent has to deal with their own grief and at the same time support the children. Providing professional support to the parents can improve well-being of parents, children and the family as a whole. However, such manualised interventions are missing for the German context. This study aims to translate and culturally adapt the parent group ‘Resilient Parenting for Bereaved Families’ (RPBF) of the Family Bereavement Program for the German context specifically for loss due to cancer, and to pilot evaluate its feasibility and potential effects.

In this mixed-methods pilot study, six to eight group leaders, who are experienced in working in bereavement support, will be trained to conduct the parent group and afterwards lead parent groups. We aim to conduct three to four parent groups with 6–8 parents each (total target sample size n=24–32). Parents participate in 10 biweekly parent group sessions on-site or online. We will assess feasibility, acceptability, satisfaction and preliminary effects on parental well-being, family coping and communication (baseline (t₀), post-intervention (t₁) and 12-week post-intervention follow-up (t₂)). Semistructured interviews with 10–12 parents will further explore experience and suggestions for refinement. Quantitative data will be analysed using descriptive and exploratory analyses and qualitative data will be analysed using qualitative content analysis.

The study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-0919). Upon completion, a German version of the Resilient Parenting for Bereaved Families (RPBF) parent group and the group leader training will be available. Findings will be disseminated through peer-reviewed publications and conference presentations. To make the results available to affected families, a lay summary will be written and disseminated in several ways.

The study was registered with the German Clinical Trials Register (DRKS00039060 (date of registration: 19 February 2026))

Cardiac arrest (CA) remains a major health burden with poor survival and poor neurological outcomes despite decades of advances in resuscitation science. Although high-quality cardiopulmonary resuscitation is essential, it provides only limited cerebral and coronary perfusion, and current strategies relying on high-dose epinephrine may adversely affect cerebral microcirculation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a potential adjunct to improve coronary and cerebral perfusion without compromising microvascular blood flow. Although animal studies and small human case series suggest physiological and clinical benefits of REBOA in CA, randomised clinical trials are lacking.

This prospective, randomised controlled, single-centre clinical trial investigates the effect of REBOA during the treatment of CA. The planned study duration is 36 months, with a total of 98 patients to be randomised to either standard advanced life support (ALS) or ALS plus REBOA. Adult patients with an in-hospital CA, successful placement of a femoral artery introducer sheath and any electrical cardiac activity in the initial rhythm analysis are eligible for inclusion. Exclusion criteria comprise traumatic CA, asystole as the initial rhythm, pregnancy and CA occurring on intensive care units, in the operating room or in cardiac catheter laboratory. The primary outcome is sustained return of spontaneous circulation lasting for at least 20 min. Secondary and exploratory outcomes include survival, neurological outcome, changes in aortic blood pressure, end-tidal CO₂ and near-infrared spectroscopy values as well as causes of death and vascular complications related to the intervention. Statistical analyses will be performed on a modified intention-to-treat basis.

The study protocol (Version 2.1, 11.02.2026) was approved by the Cantonal Ethics Committee of Cantone Bern (2025-D0108). Study results will be disseminated through peer-reviewed journals.

NCT07434726.

To investigate whether the Happy Healthy Active Children (HHAC) initiative increased children’s time spent in different physical activity (PA) intensities in kindergartens located in disadvantaged neighbourhoods.

A within-subject design, nested within the HHAC initiative, with children acting as their own controls.

Seven kindergartens in the adjacent disadvantaged neighbourhoods of Tingbjerg and Husum located in Copenhagen, Denmark.

Children aged 3–5 years attending participating kindergartens. A total of n=51 children provided valid accelerometer data from at least one HHAC activity day and one regular kindergarten day.

HHAC is a partnership-based initiative promoting active outdoor living through co-created activities centred around play, nature and cooking. In the kindergarten setting, activities were implemented one day per week over 10 weeks from the second half of 2023 to the first half of 2024.

PA was measured using thigh-worn Axivity AX3 accelerometers over two 10-day periods during the initiative. Time spent in moderate-to-vigorous PA (MVPA), light PA and sedentary behaviour (SB) was compared between HHAC activity days and regular kindergarten days.

Compared with regular days, children spent significantly more time in MVPA (8.6 min, p=0.002) and significantly less time in SB (9.2 min, p=0.007) on HHAC activity days. Play activity days showed the largest effects, with increased time spent in MVPA (13.2 min, p=0.002) and significantly less time spent in SB (19.2 min, p

The HHAC initiative, particularly its play-based activities, increased MVPA and reduced SB among children in kindergartens located in disadvantaged neighbourhoods.

As fatigue is among the most frequent manifestations of post-COVID syndrome (PCS), this study aimed to assess the prevalence and severity of cognitive and physical fatigue after occupational SARS-CoV-2 infection and to identify sociodemographic, clinical and occupational predictors of fatigue severity.

Cross-sectional analysis of a multicentre prospective registry.

Six German Social Accident Insurance hospitals distributed across Germany, providing standardised post-COVID assessments for individuals with persistent symptoms following occupational SARS-CoV-2 infection.

Workers with confirmed SARS-CoV-2 infection recognised as an occupational disease or work-related accident who presented with persistent symptoms and were enrolled in a multicentre post-COVID registry.

Cognitive and physical fatigue severity assessed using validated self-administered questionnaires (Fatigue Scale for Motor and Cognitive Functions, Modified Fatigue Impact Scale and Würzburg Fatigue Inventory for Multiple Sclerosis). Clinical relevance was determined based on established cut-offs reported in the literature. Fatigue severity was operationalised using median splits of the respective subscales to identify factors associated with higher fatigue levels.

Among 1511 registry cases, 628 participants had complete fatigue data. Median age was 54 years, 77% were female and most worked in nursing (43%) or educational/care professions (19%). Clinically relevant fatigue was highly prevalent: cognitive fatigue affected 78%–93% and physical fatigue 87%–98%. Both fatigue dimensions were positively correlated with older age, work incapacity and persistent symptom burden. In multivariate analyses, a higher number of acute symptoms was associated with lower odds of cognitive fatigue (adjusted OR 0.39, 95% CI 0.19 to 0.81), while physical fatigue remained associated with profession (adjusted OR 2.04, 95% CI 1.17 to 3.59). Sex, pre-existing conditions, hospitalisation and variant wave were not significant predictors in either model.

Fatigue is a prevalent and disabling PCS-symptom among occupationally exposed workers. Distinct determinants of cognitive and physical fatigue emphasise the need for early recognition, targeted management and rehabilitation strategies to support recovery and work reintegration.