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Perinatal challenges for mothers of Haitian origin and their newborns in French Guiana: a historical cohort from 2013 to 2021

Por: Laumonnier · J. · Alcouffe · L. · Vendittelli · F. · Covis · S. · Bernard · S. · Nacher · M. · Elenga · N. · Osei · L.
Objectives

To describe the sociodemographic characteristics of mothers of Haitian origin and the obstetric and neonatal outcomes of their newborns born in French Guiana between 2013 and 2021 in order to identify specific vulnerabilities within this population.

Design

A descriptive, population-based study using data from a comprehensive birth cohort including all deliveries in French Guiana from 2013 to 2021.

Setting

All maternity units in French Guiana, a French overseas territory located in South America.

Participants

A total of 66 485 live births were recorded during the study period, including 14 065 (21.2%) births to mothers of Haitian origin.

Primary and secondary outcome measures

Sociodemographic characteristics, antenatal care indicators and neonatal outcomes were compared between mothers of Haitian origin and mothers of other origins. Adjusted odds ratios (aOR) and 95% CI were calculated for key outcomes.

Results

Compared with mothers of other origins, Haitian mothers had higher odds of delivering a newborn small for gestational age (aOR=1.41, 95% CI 1.32 to 1.50), neonatal hospitalisation at birth (aOR=1.19, 95% CI 1.11 to 1.28), having an insufficient number of antenatal visits (aOR=1.32, 95% CI 1.26 to 1.38) and lacking health insurance coverage (aOR=2.83, 95% CI 2.52 to 3.17). Conversely, they had a lower risk of adolescent pregnancy (

Conclusion

Mothers of Haitian origin in French Guiana experience distinct social and perinatal vulnerabilities. Strengthening equitable access to healthcare and implementing targeted community-based interventions are essential to improve maternal and neonatal health outcomes in this population.

Effects of breathing exercise and thoracic techniques on pain and disability in low back pain: A systematic review and meta-analysis

by Tahere Seyedhoseinpoor, Ramin Jafari, Zohreh Shafizadegan, Maryam Abbaszadeh-Amirdehi

Purpose

The objective of this study was to systematically review the effectiveness of thoracic-focused interventions, including breathing exercises and thoracic manual techniques (mobilization, high-velocity low-amplitude manipulation, and release techniques), on pain and disability in patients with low back pain (LBP).

Methods

PubMed, Scopus, Web of Sciences, ProQuest, Ovid, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Clinical Trials (CENTRAL), and Google Scholar were searched without language restrictions. Clinical trials with control groups on pain and disability in low back pain patients focusing on the efficacy of breathing exercises or thoracic technique were included. In total, 31 studies contributed to the meta-analysis for pain and 24 for disability.

Results

Pooled analyses using Morris’ dppc demonstrated a statistically significant, small effect for pain reduction (dppc = −0.35, 95% CI = −0.46 to −0.23) and a large effect for disability improvement (dppc = −0.71, 95% CI = −0.86 to −0.57) when compared with control groups. Thoracic manual techniques showed larger effects on both pain and disability compare to breathing exercises. However, substantial statistical heterogeneity (I² > 85%) persisted in most analyses.

Conclusion

Breathing and thoracic manual techniques may be effective in reducing disability and, to a lesser extent, pain in patients with LBP, but the overall certainty of evidence is low. However, the quality of the evidence is low. Variability in treatment protocols, study quality, blinding, and outcome measures likely contributed to inconsistencies. Further high-quality trials with standardized protocols are needed to confirm these findings and inform clinical practice.

Global HIV prevention, treatment, and care interventions and strategies for key populations: Protocol for a scoping review

by Emmanuel Kumah, Dorothy Serwaa Boakye, Eunice Agyei, Richard Boateng, Veronica Penaman Asamoah, Emmanuel Osei Tutu

Introduction

Since its emergence, HIV/AIDS has remained one of the most significant global health challenges, with key populations—such as sex workers, men who have sex with men (MSM), transgender people, people who inject drugs (PWID), and individuals in prisons or other closed settings—disproportionately bearing the burden of the epidemic. These groups, often at heightened risk due to social, legal, and structural vulnerabilities, face persistent barriers to accessing prevention, treatment, and care services. Despite progress in reducing new infections and improving treatment outcomes, these disparities, exacerbated by stigma, structural inequalities, and insufficient political commitment, continue to limit the effectiveness of global HIV responses.

Aim

This scoping review protocol aims to systematically map the range of HIV prevention, treatment, and care interventions and strategies targeting key populations worldwide. Rather than formally evaluating effectiveness, the review will describe the nature, extent, and types of interventions implemented, identify barriers to implementation, and highlight gaps in research and practice.

Methods

Following the Joanna Briggs Institute (JBI) guidelines for scoping reviews, the study will systematically identify and analyze evidence from multiple databases, including PubMed, Embase, CINAHL, Scopus, and PsycINFO, alongside regional and grey literature sources. The review will include studies focusing on key populations and evidence-based interventions, such as prevention tools, treatment strategies, and policy or structural interventions. Data will be extracted and synthesized using quantitative and qualitative approaches, with results presented through descriptive statistics and thematic analysis. Findings will inform the development of a comprehensive, evidence-based framework tailored to the unique needs of key populations.

Conclusion

By mapping available interventions and strategies for HIV prevention, treatment, and care among key populations, this review will provide a comprehensive overview of existing approaches, barriers, and gaps. The findings will inform future research, policy, and practice, supporting more targeted, inclusive, and sustainable HIV responses that contribute to global efforts to end AIDS as a public health threat by 2030.

Effect of a strength-based empowerment programme, using teach-back method, on caregiver burden and resilience among family caregivers of patients undergoing haemodialysis: a protocol for a clinical trial study

Por: Reyhani · N. · Kameli · A. · Hoseini Azizi · T. · Haresabadi · M. · Hejazi · S.
Introduction

Family caregivers of patients undergoing haemodialysis experience significant psychological, social and physical challenges that contribute to caregiver burden and reduced resilience. Strengths-based empowerment programmes, combined with the teach-back method, may help reduce burden and enhance resilience. This protocol describes a randomised controlled trial designed to evaluate the effect of such an intervention among family caregivers of haemodialysis patients.

Methods and analysis

This parallel-group randomised controlled trial will enrol 78 family caregivers of haemodialysis patients in Bojnurd, Iran, using a convenience sampling method. Participants will be randomised into intervention and control groups through block randomisation with a block size of four. The 10-week intervention will include 60 Short Message Service messages, five fortnightly teach-back phone calls and four structured inperson reinforcement sessions. The control group will receive the standard educational support provided by the dialysis unit. Outcomes will be measured at baseline, immediately post intervention and at the end of 8 weeks follow-up using the Caregiver Burden Questionnaire for Hemodialysis Caregivers and the Connor-Davidson Resilience Scale. A blinded statistician will perform repeated measures Analysis of Variance (ANOVA) for the analysis.

Ethics and dissemination

The participants will be assured that their data will remain confidential. Written informed consent will be obtained from the participants. The research proposal has been prospectively registered in the Iranian Clinical Trial Registration Centre (IRCT20250109064329N1; Date of full registration: 18 February 2025) and approved by the Ethics Committee of North Khorasan University of Medical Sciences (code: IR.NKUMS.REC.1403.128). All methods will be carried out in accordance with relevant guidelines and regulations. Findings will be disseminated to participants via a lay summary, to healthcare providers, policymakers and stakeholders through reports and presentations and submitted for publication in peer-reviewed journals. Deidentified participant data will be available from the corresponding author on reasonable request, in accordance with institutional policies and ethical approval.

Trial registration number

IRCT20250109064329N1.

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