To evaluate the performance of Ghana’s environmental surveillance (ES) system for poliovirus (PV) detection from 2018 to 2022 using standardised indicators developed by the WHO and the US Centers for Disease Control and Prevention.

A retrospective performance evaluation using 10 key indicators benchmarked against global targets for PV surveillance.

Seven regions across Ghana, participating in the national ES programme implemented under the Global Polio Eradication Initiative.

Wastewater sampling was conducted at designated ES sites, supported by field collection teams and laboratory personnel responsible for sample acquisition, processing and reporting of PV detection results.

Detection rates of PV and non-polio enteroviruses (NPEVs), timeliness of sample collection and reporting, data quality and system stability.

A total of 738 wastewater samples were collected. The system demonstrated high sensitivity, detecting circulating vaccine-derived PV type 2 in 51 (6.9%) of samples, Sabin PV types 1 and 3 in 61 (9.5%) and 114 (17.8%), respectively, and NPEVs in 491 (66.5%) of samples. Over 80% of samples met the recommended 21-day collection-to-reporting time frame. Data quality exceeded the ≥80% threshold, and workflows remained stable throughout the evaluation period.

Ghana’s ES system for PV was found to be flexible, stable and effective in generating high-quality data for early detection and public health response. These findings underscore the system’s critical role in supporting polio eradication efforts and highlight its potential as a model for surveillance in similar settings.

Strengthening research capacity in Africa is vital for tackling pressing health, educational and socioeconomic challenges facing the continent. At the core of this effort is the cultivation of innovative research leaders through postgraduate training programmes that incorporate mentorship-infused supervision. Such models have demonstrated potential in improving research skills, boosting academic productivity and fostering leadership development among emerging scholars. This systematic review and meta-synthesis protocol aims to examine existing mentorship-infused supervision practices across African higher education institutions. The review seeks to identify effective models, uncover common challenges and barriers, and generate evidence-based recommendations to develop sustainable, contextually relevant strategies. Insights from this work will inform policies and practices to enhance postgraduate research training, advance research leadership and contribute to the broader goal of strengthening research ecosystems across Africa.

A systematic review and thematic meta-synthesis will be undertaken, focusing on qualitative research studies as well as the qualitative components of mixed-methods studies. Relevant studies published in English will be identified through a comprehensive search strategy. The electronic databases, including Medline/PubMed, Scopus, Web of Science, African Journals Online, EMBASE and CINAHL, will be searched to capture a wide range of peer-reviewed articles and grey literature. Databases will be searched from March 2026. Two reviewers will independently perform study selection, data extraction, quality assessment and evaluation of risk of bias, using the Critical Appraisal Skills Programme checklist.

This systematic review and meta-synthesis will analyse publicly available literature and does not require ethical approval, as it involves no primary data collection. It will adhere to established ethical and methodological standards, including proper citation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The findings will be widely disseminated through open-access journal publication, conference presentations and targeted reports for universities, research institutions and policymakers to inform and support mentorship-based postgraduate research supervision across Africa.

CDR420251049878. Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD420251049878.

To determine the prevalence of internet addiction and examine its association with psychological factors specifically depression, anxiety and loneliness among Malaysian public university students.

Cross-sectional study.

All public universities in Malaysia, 20 universities.

The study included 7278 students from 20 public universities in Malaysia.

Statistical analyses were performed usingSTATA V.17 software. Descriptive statistics summarised participants’ demographic characteristics, prevalence of internet addiction and psychological distress (depression, anxiety and loneliness). Pearson’s correlation was used to assess bivariate relationships between internet addiction and psychological variables, while multiple logistic regression identified independent factors associated with internet addiction after adjusting for significant confounders.

The study found that 38.6% of the students showed signs of internet addiction, along with a high level of psychological distress; 24.8% had depressive symptoms, 32.4% experienced anxiety and 35.5% reported loneliness. Moderate positive correlations were observed between internet addiction and depression, anxiety and loneliness (p

The findings indicate significant associations between internet addiction and psychological factors such as depression, anxiety and loneliness. A comprehensive, multifaceted approach is essential to address psychological distress among university students and reduce the risk of internet addiction.

Interstitial lung diseases (ILD) associated with an underlying connective tissue disease (CTD), also known as a systemic autoimmune rheumatic disease or SARD, are chronic conditions with a tendency to progress. CTD-ILDs are increasingly diagnosed and pose an important global health challenge. This systematic review aims to provide an overarching evaluation of their epidemiology and disease burden in Asia. In this review, the term CTD-ILD will be used to denote all major forms of ILD arising in the context of a SARD.

This systematic review will adhere to the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including a flow diagram to depict the process by four independent reviewers that will assess titles and abstracts against the following predetermined criteria. A systematic review of the literature search published from 2000 to 2024 will be conducted using five electronic databases including PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library and Web of Science. Publications that meet the inclusion criteria of this review will be subjected to a full-text review to extract relevant data. Collated data will be analysed and organised into categories based on the expected outcome and objectives. The quality of published evidence, including heterogeneity across studies, will be checked against PRISMA checklists and assessed by Newcastle-Ottawa Scale.

Ethics approval is not applicable for this study since no original data will be collected. The findings of this review will be disseminated through a peer-reviewed publication in a scientific journal and conference communications, with the aim of contributing insights to the field by identifying research gaps and informing clinical practice.

The protocol of this systematic review is registered with the National Medical & Research Register (ID-24–03600-GUB) and International Prospective Register of Systematic Reviews PROSPERO (CRD420251037095).

There is a global rise in the burden of childhood obesity, increasing the risk of early onset adult obesity. Most developing countries face the double burden of malnutrition; overnutrition as overweight/obesity and undernutrition.

To determine the current burden and determinants of childhood thinness, overweight and obesity using national survey data.

Data from a cross-sectional survey conducted in 2022 were used.

Data from the seventh Demographic Health Survey conducted in Ghana were used.

The participants included 4417 children ≤59 months.

The seventh Ghana Demographic Health Survey in 2022 employed a two-stage stratified cluster sampling design, selecting 618 clusters to create a nationally representative sample. Weight and height were measured using the SECA 874U scale and Shorrboard, respectively. Children’s heights were measured recumbent (24 months). Multivariate logistic regression was used to assess the relationship between thinness and obesity, as well as the independent factors.

The outcome variable was obesity, determined by a WHZ of >+2SD.

The weighted prevalence of overweight/obesity and thinness in children under 5 years is 9.9% and 5.2%, respectively. Children who were overweight or obese had a mean age of 23.11 months, those who were thin or severely thin had a lower mean age of 21.02 months, and those with normal nutritional status were relatively older, with a mean age of 28.41 months. The Upper West, Northeast and Northern regions had the lowest densities of obesity. In the multivariate logistic regression model, children residing in Ashanti, Oti, Northern, North East and Upper East regions had significantly reduced odds of being obese compared with those in the Ahafo region. The average haemoglobin for those overweight/obese was 10.8 g/dL, and 10.7 g/dL for those who were normal and marginally reduced, 10.5 g/dL for those who were thin.

Regional disparities, maternal nutritional status, socioeconomic conditions and unsafe water sources were significant determinants of child nutrition outcomes. These findings call for targeted, multipronged interventions that integrate maternal-child nutrition, safe water, sanitation and regional context.

Exercise-based interventions are well-established in reducing falls and fall-related injuries, but adherence and accessibility remain key challenges, particularly in rural areas. While conventional in-person training is widely used, digital interventions may offer scalable solutions to enhance engagement and reach. However, pragmatic trials evaluating the real-world effectiveness of conventional and digitally supported fall prevention interventions are lacking, limiting the evidence base for their implementation in routine healthcare settings. The SURE-Footed into the Future Fall Intervention Trial (SURE-FIT) aims to compare the effectiveness of two structured fall prevention interventions—a conventional centre-based exercise programme and a hybrid telemedical programme combining in-person and tablet-supported training—against a wait-list control group in reducing falls and fall-related injuries among community-dwelling older adults.

This study is a pragmatic three-arm, parallel-group, randomised controlled superiority trial with a 1:1:1 allocation ratio. Participants (≥65 years, community-dwelling, planned n=2778) will be randomly assigned to (1) conventional centre-based training supplemented with printed materials for home-based continuation (conventional group), (2) a hybrid model integrating centre-based and tablet-supported training for continuation (tablet group) or (3) a wait-list control group. The intervention includes a 9-week supervised phase followed by 43 weeks of independent home-based training. The primary outcomes are the incidence rate of falls and fall-related injuries over 12 months. Secondary outcomes include physical functioning, physical activity, concerns about falling, loneliness and the risk of low protein intake. A process evaluation will assess intervention feasibility and implementation. Additionally, qualitative interviews will be conducted with participants, course instructors and municipal stakeholders to explore experiences, facilitators and challenges related to programme participation and implementation. A health-economic evaluation will be conducted to assess the cost-effectiveness of the structured fall prevention interventions. Data collection will take place at baseline and every 3 months via standardised questionnaires, with a subgroup undergoing physical performance testing and sensor-based activity monitoring. Analyses will follow an intention-to-treat approach.

Ethical approval has been granted by the Ethics Committee of Ulm University (271/23). Written informed consent will be obtained from all participants before enrolment. Study findings will be disseminated through peer-reviewed publications, scientific conferences and national fall prevention initiatives. Additionally, results will be shared with key municipal representatives, and the German National Association of Senior Citizens’ Organisations (BAGSO). A publicly accessible website will provide ongoing access to study information and findings in plain language.

DRKS00032878, German Clinical Trials Register

To assess maternal medical conditions, physical and surgical ailments, contraceptive use and barriers to its use, maternal mental health, neonatal health, breastfeeding practices and available social support in the postpartum period.

A prospective cohort study.

A large tertiary care centre.

12 245 women who delivered after 22 weeks gestation in the year 2022.

Three pre-specified exposures, namely mode of delivery, presence of significant risk factors and preterm delivery within the cohort, were used to identify potential groups of women who would need additional support.

The primary outcome was the number of unscheduled visits by the mother or child and the indications for these visits.

The secondary outcomes in mothers included unhealed wound sites, anaemia, increase in body mass index (BMI) by >3, persistent high blood pressure, pain in the abdomen or pelvis, urinary or bowel problems, musculoskeletal pain, abnormal maternal mental health, breast-related issues and barriers to breastfeeding, contraceptive use and sexual activity.

Only 2% of women and children were lost to follow-up. Nine women and 75 babies died. The majority of infant deaths were related to serious congenital diseases. Unscheduled visits to the health facility were seen in 44% of the cohort, most commonly for upper respiratory infections and fever in the mother and baby. 41 mothers and 741 infants needed admission to hospital. Hospitalisation was more common in those with risk factors or preterm delivery. High blood pressure was seen in 3 to 4% and anaemia in 4% of the cohort. Wound infection was seen in 3 to 4% and urinary incontinence in 2% of women. Wound infection was more common with instrumental delivery. Bowel incontinence was rare. A fourth of the cohort had musculoskeletal pain, especially back pain, which was more common after caesarean delivery. Only 5.5% of the cohort had unsatisfactory mental health, and these women were more likely to have abnormal mental health scores with the NICE Questionnaire at screening. The family APGAR of the cohort was 9/10, and 95% belonged to the middle-income group. 2.6% of neonates had delayed milestones, and this was more common in the group with risk factors and preterm delivery.

Healthcare utilisation was mainly for minor complaints. Re-admissions were rare, as intrapartum and immediate postpartum care were optimal. Women who delivered by caesarean section or delivered a preterm child needed additional support in the postpartum phase. NICE Questionnaire is a quick and easy screening tool to identify unsatisfactory mental health and should be used before discharge, postnatally, even in busy settings. The implementation of formal telephonic support 24 hours a day in birthing facilities should be explored in the future. Holistic postnatal care of mother and child during the immunisation of the baby would be the best opportunity to improve the quality and coverage of care in the postnatal phase.

CTRI/2022/03/041343.

Hospital patients are at an increased risk of falls, which are a significant safety concern within healthcare settings.¹ Understanding how the COVID-19 pandemic has influenced fall risks is essential for identifying key factors that could inform future fall prevention strategies.² This scoping review aims to explore the barriers and challenges associated with preventing inpatient falls in the context of the post-COVID-19 environment.

The methodology for this scoping review follows the framework established by Arksey and O’Malley. A comprehensive literature search will be conducted using specific keywords to identify relevant published studies. Searches will be performed across selected electronic databases, including PubMed/MEDLINE, CINAHL, Scopus, ProQuest and Web of Science, covering publications from 2014 to 2024. This review will focus on a global perspective. Two authors will independently screen titles and abstracts to identify potential studies for inclusion. Studies meeting the inclusion criteria will be retrieved for full-text review, and their references will be assessed for relevance using the same criteria. The PRISMA flow diagram will guide the review process. Data will be extracted, analysed and charted according to categories from the selected publications.

This scoping review will provide a comprehensive overview of the barriers and challenges in preventing inpatient falls in the post-pandemic context. The findings will be disseminated through submission for publication in a scientific journal.

This scoping review protocol is registered with Open Science Framework (OSF) available at https://osf.io/.

Falls are highly prevalent among individuals with dementia, largely due to the cognitive and physical impairments associated with the condition. Understanding the barriers and challenges to fall prevention in community-dwelling individuals with dementia is essential for developing tailored strategies that address their unique risks. Despite the existing evidence on fall prevention in older adults, few reviews specifically examine the obstacles faced by persons with dementia and their caregivers in community settings. This scoping review, therefore, aims to map the barriers and challenges to preventing falls among community-dwelling individuals with dementia.

This review will follow Arksey and O’Malley’s five-stage framework and be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews checklist. Six electronic databases (PsycINFO, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Scopus and Embase) will be searched for relevant studies published between 2014 and 2024. Grey literature sources, including dissertations and conference proceedings, will also be included. Data will be charted and synthesised thematically to provide an overview of barriers and contextual factors influencing fall prevention. The study commenced in August 2025 and is expected to be completed by February 2026.

As this review involves the analysis of existing literature, ethical approval is not required. Findings will be disseminated through peer-reviewed publications, conference presentations and summaries tailored for healthcare providers and caregiver groups.

The protocol is registered with the Open Science Framework: https://osf.io/gnw47/(dataset).

This study aimed to evaluate the feasibility of delivering a vocational rehabilitation intervention (Return to Work After Trauma—ROWTATE), remotely to individuals recovering from traumatic injuries. The primary objectives were to assess therapists’ training and competence, adapt the intervention and training for remote delivery and assess the feasibility and fidelity of remote delivery to inform a definitive randomised controlled trial.

A mixed-methods feasibility study incorporating (1) telerehabilitation qualitative literature review, (2) qualitative interviews preintervention and postintervention with therapists and patients, (3) a team objective structured clinical examination to assess competency, (4) usefulness of training, attitudes towards (15-item Evidence-Based Practice Attitude Scale) and confidence in (4-item Evidence Based Practice Confidence Scale) evidence-based practice, intervention delivery confidence (8-bespoke questions) and intervention behaviour determinants (51-items Theoretical Domains Framework) and (5) single-arm intervention delivery feasibility study.

The study was conducted in two UK Major Trauma Centres. The intervention and training were adapted for remote delivery due to the COVID-19 pandemic.

Therapists: Seven occupational therapists (OTs) and clinical psychologists (CPs) were trained, and six participated in competency assessment. Seven OTs and CPs participated in preintervention interviews and surveys; six completed post-intervention interviews and four completed post-training surveys. Patients: 10 patients were enrolled in the single-arm feasibility study and 4 of these participated in postintervention qualitative interviews. Inclusion criteria included therapists involved in vocational rehabilitation delivery and patients admitted to major trauma centres. Exclusion criteria included participation in other vocational rehabilitation trials or those who had returned to work or education for at least 80% of preinjury hours. Intervention: The ROWTATE vocational rehabilitation intervention was delivered remotely by trained OTs and CPs. Training included competency assessments, mentoring and adaptation for telerehabilitation. The intervention was delivered over multiple sessions, with content tailored to individual patient needs.

Therapists found the training useful, reported positive attitudes (Evidence-Based Practice Attitude Scale mean=2.9 (SD 0.9)) and high levels of confidence in delivering evidence-based practice (range 75%–100%) and the ROWTATE intervention (range 80%–100%). Intervention barriers identified pretraining became facilitators post-training. Half the therapists needed additional support post-training through mentoring or additional training. The intervention and training were successfully adapted for remote delivery. High levels of fidelity (intervention components delivered: OTs=84.5%, CPs=92.9%) and session attendance rates were found (median: OT=97%, CP=100%). Virtually all sessions were delivered remotely (OT=98%, CP=100%). The intervention was acceptable to patients and therapists; both considered face-to-face delivery where necessary was important.

The ROWTATE intervention was delivered remotely with high fidelity and attendance and was acceptable to patients and therapists. Definitive trial key changes include modifying therapist training, competency assessment, face-to-face intervention delivery where necessary and addressing lower fidelity intervention components.

ISRCTN74668529.

Infant feeding practices in the first 2 years of life are linked to long-term weight trajectories. Despite the importance of obesity prevention interventions, there are no randomised controlled trials (RCTs) evaluating early childhood education and care (ECEC) and primary caregiver-targeted interventions on child weight and feeding outcomes.

To assess the efficacy of an 18-month digital health intervention (Tiny Bites) delivered to ECEC services and primary caregivers of children aged 4 to ≤12 months on child age-adjusted and sex-adjusted body mass index-for-age z-score (zBMI) relative to usual care control in the Hunter New England (HNE) region of New South Wales, Australia.

This type 1 hybrid cluster RCT will include up to 60 ECEC services and 540 children/caregiver dyads. The intervention supports ECEC services and caregivers to deliver recommended responsive feeding practices to infants. ECEC services will receive access to an online assessment platform, training and resources, and implementation support. Primary caregivers will receive text messages, monthly e-newsletters, online links and direct communication from ECEC services. We will assess the impact on child zBMI at 18-month follow-up. Secondary outcomes include duration of consuming any breastmilk, child diet and caregiver responsive feeding practices. We will also assess ECEC policy and practice implementation related to targeted feeding practices, programme cost effectiveness, adverse effects and engagement with the programme (ECECs and caregivers). For the primary outcome, between-group differences will be assessed for paired data using two-level hierarchical linear regression models.

Ethics approval has been provided by HNE Human Research Ethics Committee (HREC) (2023/ETH01158), Deakin University (2024-202) and University of Newcastle HREC (R-2024-0039). Trial results will be submitted for publication in peer-reviewed journals, presented at scientific conferences locally and internationally and to relevant practice stakeholders.

ACTRN12624000576527.

To develop an updated core dataset for acute stroke care in Ireland, informed by international audit benchmarking and national stakeholder consensus, for integration into the Irish National Audit of Stroke (INAS).

Scoping review and three-round Delphi process.

Medline Ovid, Embase, CINAHL EBSCOhost, Google Scholar, audit websites and grey literature (2010–2024). Additional audit documentation was obtained via direct author contact.

National stroke audits or registries with a country-wide scope, ≥1 year of continuous data collection and active in 2021 were eligible. Only audits covering acute stroke care were included in this study phase. All records were screened for inclusion.

Audit documentation (data dictionaries, item definitions and contextual metadata) was retrieved from eligible audits. Acute stroke care items were extracted, charted and benchmarked against existing INAS items and each other to identify commonalities and gaps. Frequently collected international items (appearing in ≥4 audits/registries) were shortlisted. A three-round Delphi process with 24 national stakeholders (clinicians, nurses, allied health professionals, researchers, policymakers and patient representatives) was conducted to audit and refine the dataset through structured, anonymised item rating, iterative feedback and consensus-building discussions.

Twenty-one eligible international stroke audits/registries were identified, yielding ~4500 audit items. Benchmarking against existing INAS items (n=103), frequently collected international items (n=97) and expert-suggested items (n=22) informed the Delphi consultation. The final dataset expanded INAS by 18 items, totalling 86 acute care and 35 thrombectomy-specific items. New additions included stroke-related complications and risk factor documentation.

This structured, consensus-led process resulted in an internationally benchmarked, stakeholder-informed core dataset to enhance standardised stroke auditing in Ireland. The expanded dataset supports enhanced clinical monitoring, quality improvement and health system planning. This approach may inform audit development and research efforts in other contexts.

To examine the association between maternal and neonatal biochemical variables in babies born to mothers with hypertensive disorders of pregnancy (HDP) and admitted to the neonatal unit within 24 hours of delivery.

Retrospective chart review study.

Specialised antenatal hypertension clinic and neonatal unit in a tertiary unit referral hospital.

Pregnancies complicated with HDP (N=282) and their neonates if admitted to the neonatal unit within 24 hours of delivery.

We examined the association between maternal and neonatal biochemical variables, after controlling for maternal, neonatal and pregnancy characteristics.

There were strong associations and independent prediction of neonatal levels by maternal levels for urea, creatinine, sodium and calcium. The highest associations were between neonatal and maternal urea and creatinine, where the only predictor was the respective maternal variable (model R²= 0.61 and 0.60, respectively). Similarly, maternal sodium and calcium were the strongest predictors for neonatal sodium and calcium (model R²= 0.36 and 0.22, respectively). On the contrary, the strongest predictor for neonatal total protein, albumin and globulin was the gestational age (model R²= 0.43, 0.35 and 0.48, respectively) with no maternal contribution for total protein and albumin.

Maternal levels of urea, creatinine, sodium and calcium, in a pregnancy complicated by HDP, should be taken into consideration by both the obstetric and neonatal teams when deciding on timing of delivery and providing intensive monitoring.

Research on the impact of smoking behaviour across generations has primarily focused on grandmaternal smoking during pregnancy. However, the broader multigenerational effects of smoking behaviour, notably through environmental and behavioural pathways, remain underexplored. This study evaluated previous studies on the possibility of transgenerational transmission, rather than in utero transmission, regarding the effects of grandparental smoking behaviour on offspring’s development outcomes.

This study is a systematic review with qualitative evidence synthesis.

A comprehensive search was conducted across multiple online databases, including PubMed, EBSCOhost, Web of Science and Scopus. To ensure a broad scope of relevant studies, publication dates, study locations and language were restricted to English only.

After duplicates were removed, 3916 articles remained from the 4133 identified articles. Based on the predefined eligibility criteria, 38 articles were selected for full-text assessment. The selection process involved multiple reviewers, with disagreements resolved through consensus.

Multiple reviewers independently extracted data using a standardised protocol. The Joanna Briggs Institute critical appraisal tool was used to assess the quality of the included studies, with inter-rater reliability tests indicating moderate-to-high agreement. Extracted data included study design, participant demographics, exposure details and measured outcomes.

This systematic review included seven studies because of heterogeneity in reported outcomes and effect measures. Three independent reviewers extracted data using a standardised coding sheet. The synthesis compared methodologies, identified gaps, key findings and conclusions across studies.

Seven included articles examined grandchildren’s behaviour, such as hyperactivity disorder, oppositional defiant disorder and conduct problems, body composition and IQ concerning grandparents’ smoking habits. Most studies used robust statistical methods; two included parental factors as mediators. The synthesis of results indicated that the associations were primarily indirect. Key findings revealed that grandparents’ smoking status was significantly associated with their grandchildren’s physical and cognitive outcomes. Furthermore, the reviewed studies demonstrated sex-specific transgenerational effects of ancestral smoking on grandchildren’s health, with stronger effects often observed in male descendants.

This review highlights the methods and findings of previous studies on the potential transgenerational transmissions through which grandparents’ smoking behaviour may influence grandchildren’s behavioural, physical and cognitive development. Although the findings emphasise the importance of environmental and behavioural factors, further research is needed to address existing gaps and clarify mechanisms.

This systematic review protocol was registered in the PROSPERO database under registration number CRD42024571725.

This study aimed to describe the experiences of chemotherapy-induced oral mucositis among patients with breast cancer. Its primary focus is on how chemotherapy-induced oral mucositis affects day-to-day functioning, psychological wellness and overall quality of life.

12 Jordanian women who had been diagnosed with breast cancer and had presented with chemotherapy-induced oral mucositis were the purposive sample for this qualitative study, which employed in-depth, semistructured interviews. The verbatim transcriptions of the interviews were subjected to thematic analysis.

The thematic analysis of the 12 participants’ reviews revealed five main themes: distressing physical manifestations, eating and nutritional struggles, mouth care difficulties, psychological strain, social and emotional consequences, and coping and adaptation strategies.

Breast cancer patients’ daily routines, mental health and quality of life are all significantly impacted by chemotherapy-induced oral mucositis. According to the study, individuals with breast cancer who experience chemotherapy-induced oral mucositis should get patient-centred care and address their emotional, psychological, social and physical discomfort to maximise their outcomes.

Oral health research provides evidence for policy and practice, yet no study has comprehensively mapped the scope of oral health research in Malaysia. The COVID-19 pandemic has also created a great impact on oral healthcare in Malaysia, including the dental care delivery. Additionally, there is a notable lack of research focusing on oral health during and after the COVID-19 pandemic. Therefore, this scoping review will aim to map the landscape of oral health research conducted in Malaysia and identify key topics, study designs, populations studied and gaps in the literature, in order to inform future research priorities and policy, particularly in the post-COVID-19 era.

The methodology draws on Arksey and O’Malleys’ seminal framework for the scoping review and will be reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines. We will search five major electronic databases—PubMed, Scopus, ProQuest, Cochrane and Web of Science—as well as selected grey literature sources (eg, theses, dissertations and conference proceedings) for studies published in English from January 2014 to December 2024. Studies of any design related to oral health in Malaysia will be included. Two reviewers will be performing title and abstract screening, in which they will be working independently. The included publication will undergo a full-text review, and references cited in these studies will be examined following the inclusion criteria. The PRISMA-ScR flow diagram will be used as a guide throughout the process. Data will be extracted, analysed and charted according to key categories identified in the included publications. A narrative synthesis and descriptive statistics will be presented.

The results of this scoping review will illustrate an overview and provide a better understanding regarding the oral health research in the Malaysian context; whether research has already been conducted, is currently ongoing and is still needed; and which areas should be prioritised for future investigation. As this review will use publicly available literature, formal ethics approval will not be required. The findings will be submitted for publication in an open-access peer-reviewed journal, presented at national and regional conferences and shared with Malaysian dental professional bodies and relevant stakeholders.

The protocol of this scoping review is registered with the Open Science Framework and is available at osf.io/hjq6m.

The primary objective was to determine whether a behaviour change intervention delivered to hospital staff would (1) improve the proportion of Aboriginal and/or Torres Strait Islander (Aboriginal) babies being registered and (2) reduce hospital admissions and emergency presentations for babies

Quasi-experimental design and cohort study.

Five tertiary birthing hospitals in WA.

The intervention was delivered to health service providers who were in the five tertiary birthing hospitals. Outcome data were collected on Aboriginal babies born between 1 January 2016 and 30 June 2018 who were delivered within these hospitals. Babies in the control group (n=226) were born 6 months before the intervention and intervention babies (n=232) were born 6 months following the intervention. For the secondary objective, there were 4573 babies included in the analysis.

A behaviour change intervention delivered to hospital staff in five hospitals.

The primary outcomes were the proportion of babies who were registered and whether a baby had been admitted to hospital or an emergency department by 3 and 6 months old. The secondary outcome was to determine factors that might influence the proportion of registered Aboriginal births in WA (cohort study).

There was evidence of a 38% reduction in emergency presentations within 6 months for babies born to hospitals 6 months following the staff training (OR 0.62, 95% CI 0.42 to 0.91), and little evidence of improvements in birth registrations, hospital admissions within 3 or 6 months of birth or emergency department presentations within 3 months of birth. Of the 4573 babies included in the cohort study, 3769 (82.4%) babies had their births registered and 804 (17.6%) babies did not. Factors that were associated with not having a birth registered included low birth weight babies with a 34% decrease in odds of having a registered birth compared with those with a normal birth weight (adjusted OR (aOR) 0.66, 95% CI 0.51 to 0.86). Timing of first antenatal visit was associated with reduced odds of having a birth registered if this occurred in the second (aOR 0.77, 95% CI 0.64 to 0.93) or third trimester (aOR 0.59, 95% CI 0.45 to 0.77) compared with the first trimester.

Our study identifies the complexities surrounding birth registrations and improved hospital utilisation for Aboriginal babies, the importance of targeted interventions and ongoing efforts needed to address this issue comprehensively.

ACTRN12615000976583.

Peripheral arterial disease (PAD) affects approximately one in five people over 60 in the UK. In severe cases, revascularisation, such as surgical bypass or endovascular methods, is often required to restore limb perfusion. Between 2000 and 2019, 527 131 revascularisation procedures were carried out in the UK. Postprocedural surveillance is essential to detect restenosis and maintain vessel patency. However, standard surveillance using duplex ultrasound (DUS) is resource intensive. Ankle Doppler waveform assessment is quick, inexpensive and accurate for PAD diagnosis, yet its role in postrevascularisation surveillance remains unexplored. This study aims to evaluate the diagnostic accuracy of ankle handheld Doppler waveform assessment (ankle HHD) for detecting restenosis after lower limb revascularisation, as compared with formal DUS.

This is a prospective diagnostic accuracy study (ClinicalTrials.gov Identifier NCT06619223). We aim to recruit 121 people with PAD undergoing planned lower limb revascularisation at Imperial College Healthcare NHS Trust. Follow-up assessments will take place at 3 months, 6 months and 12 months post revascularisation. At each visit, a vascular scientist will perform the index test (Ankle HHD) followed by DUS as the reference standard. A subset of participants will undergo repeat testing to assess interobserver and intraobserver reliability. Restenosis will be defined as one or more arterial lesions of ≥50% stenosis or tandem lesions with a combined value of ≥50%. The primary outcome is the sensitivity of ankle Doppler waveform assessment for detecting restenosis, compared with DUS.

The study has received approval from Health Research Authority (HRA) and Health and Care Research Wales (REC reference 24/LO/0462). Results will be disseminated through research presentations and papers.

ClinicalTrials.gov, NCT06619223.

To investigate the scalability of the multi-component Falls After Stroke Trial (FAST) intervention tailored to community-dwelling adults with stroke to enable post-trial implementation.

A mixed-methods formative evaluation of FAST data guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.

Community settings across three states in Australia.

Stroke participants were a subset of FAST trial participants (n=50) who were community-dwelling adults who had experienced a stroke up to 5 years prior and were at risk of falling. Therapists who delivered the intervention in the trial (interventionists) were physiotherapists and occupational therapists, trained in the FAST intervention.

The FAST intervention is an individually tailored home safety and functional exercise programme designed to reduce falls and improve community mobility. It is offered over a 6-month period using 10 home visits, two telephone calls and programme resources, for example, manual and worksheets.

Trial data, including interventionist training records and delivery data, resources and stroke participants’ adherence data were used to assess the Adoption, Implementation and Maintenance dimensions of the RE-AIM framework.

The FAST intervention was delivered by 22 interventionists. High implementation fidelity was shown with 90% of the stroke participants receiving FAST dose and content. Effective strategies supporting implementation included standardised programme resources, comprehensive pre-programme training, regular interventionist feedback and interventionist mentoring from experts. Online training and peer support networks will be required for scale up.

This study identifies how a complex intervention to prevent falls after stroke was successfully delivered. The AIM dimensions provided insights to FAST features essential for scale-up. Interventionist training, resources and mentoring/feedback were essential for adoption within the trial. Training and resources should be accessible in an online format for scale up (maintenance).

ACTRN12619001114134.

Interest in workplace bullying (WPB) has been steadily growing with a focus on understanding its consequences as well as prevalence rates in different occupations and across different countries with varying cultural contexts. Research in the Middle East remains limited, especially in Lebanon. The scarcity of data from the Lebanese healthcare sector underscores the need to better understand WPB in this unique sociocultural and organisational environment.

The primary aim of this study is to investigate the prevalence of WPB among healthcare providers and hospital staff in Greater Beirut. The secondary aim is to investigate the relationship between WPB, psychological well-being, burnout and sick leaves in the Lebanese cultural context.

A cross-sectional study design was conducted.

Seven hospitals in Greater Beirut took part in the study, including six private hospitals and one public hospital.

A total of 958 participants aged 18–64 were recruited using stratified proportionate non-random sampling. Stratification by hospital size and department aimed to ensure broad representation of nursing and support staff across institutions. The participants included nursing and supporting staff, of which 26.3% were males and 73.7% were females. Those employed for less than 6 months were excluded.

The Arabic versions of each of the Negative Acts Questionnaire-Revised (NAQ-R), the General Health Questionnaire (GHQ-12) and the Copenhagen Burnout Inventory (CBI) were administered. These instruments were selected for their established reliability and widespread use in cross-cultural occupational health research. Surveys were administered via paper-and-pencil (six hospitals) and online (one hospital). Prevalence of bullying using the NAQ-R cut-off scores was first calculated and then their respective thresholds identified using receiver operating characteristic analysis. Pearson’s correlation coefficient was used to evaluate the relationship between the NAQ-R and the GHQ-12, CBI and number of sick leaves.

Using the lower threshold as a cut-off on the NAQ-R, 35.1% of participants were classified as bullied. When applying the higher threshold as a cut-off, the percentage was slightly lower but remained comparable at 32.4%. Results showed that across the two outcomes, those who were bullied both when using a lower threshold and upper threshold were significantly more distressed and burnt out (pt(df) = –8.43, p±1.96; Upper threshold: ² (4, N=902)=9.963, p=0.019, Standardised residual for 6–10 days=2.2>±1.96).

Findings yielded lower prevalence rates of WPB among nurses and the entire sample as compared with research carried out in the Arab region. Our study further supports the impact of culture on the perpetuation of WPB and the uniqueness of Lebanon’s culture on influencing this prevalence. Results indicated that participants who were bullied were significantly more distressed, more burnt out and reported taking up more sick leaves. These findings highlight the need to consider local workplace culture when addressing bullying and reinforce the significant psychological and occupational toll bullying takes on affected individuals. Healthcare institutions are encouraged to implement and reinforce clear antibullying policies, WPB prevention strategies and confidential reporting mechanisms. Future research should explore longitudinal patterns of bullying, obtain a more nationally representative sample and examine the effectiveness of targeted interventions to create safer, more supportive work environments.