Quality collaboratives improve quality of care at the hospital and collaborative levels, but less is understood about how such efforts affect patient-level disparities. This study evaluated how a quality improvement (QI) effort (increasing multiarterial grafting during coronary artery bypass grafting (CABG)) translated into populations which historically receive lower-quality care (females and patients of low socioeconomic status).

Retrospective cohort study.

All non-federal hospitals in the state of Michigan that perform cardiac surgery and participate in a statewide collaborative database (n=33).

Patients undergoing first-time, isolated CABG receiving at least two bypass grafts from 2011 to 2022 were identified.

Association of sex and socioeconomic status with multiarterial grafting was evaluated across the study period. The distressed community index (DCI), a socioeconomic ranking (0—not distressed, 100—severely distressed), was matched to the patient’s zip code. Hierarchical regression modelling was performed to associate DCI and sex with multiarterial grafting, incorporating patient factors and hospital and surgeon effects. A sex-surgery year and DCI-surgery year interaction term was performed to assess the change in the rate of multiarterial grafting.

A total of 40 322 patients underwent CABG at 33 centres with a median age of 66 years and 24% were female. The rate of multiarterial grafting was 15%, although lower among females (10% vs 17%) and the highest (vs lowest) DCI quartile (14% vs 18%). After risk adjustment, females were less likely to receive multiarterial grafting (OR_adj 0.51 (95% CI 0.45 to 0.58), padj 0.35 per 10-point increase (95% CI 0.24 to 0.51), p0.05).

Despite a large overall increase in multiarterial grafting due to QI efforts, females and patients with low socioeconomic status had lower rates of multiarterial grafting. QI efforts should be evaluated both overall and among patients who historically receive lower quality care to improve quality and equity.

Although obstetrics and gynaecology (O&G) is a predominantly female specialty, previous studies have suggested that women remain under-represented in academic authorship. This study evaluates trends in female and male first and last authorship in six leading O&G journals (Human Reproduction Update, American Journal of Obstetrics and Gynecology, British Journal of Obstetrics and Gynaecology, Obstetrics and Gynecology, Gynecologic Oncology and Best Practice & Research Clinical Obstetrics & Gynaecology) between January 2013 and December 2023.

A bibliometric analysis was conducted using the Web of Science database. The gender of the first and last authors was determined using Genderize.io, with a probability threshold of ≥75% for classification. Binary logistic regression was performed to model the probability of authorship by gender across journals.

Among 57 310 publications, 38 455 first (43.8% male and 56.2% female) and 38 950 last authors (58.6% male and 41.4% female) were identified and analysed. Over the past decade, female authorship has shown a clear upward trend, with first authorship increasing from 43% (1141/2636) in 2013 to 69% (2769/4036) in 2023, and last authorship increasing from 29% (770/2700) to 54% (2180/4047). First authorship was statistically more likely to be held by women in Human Reproduction Update (1.23, 95% CI 1.02 to 1.48), American Journal of Obstetrics & Gynecology (1.63, 95% CI 1.58 to 1.70) and Obstetrics & Gynecology (2.33, 95% CI 2.22 to 2.45). However, female last authorship was significantly more likely only in Obstetrics & Gynecology (1.21, 95% CI 1.16 to 1.27).

Despite an increasing trend in female representation in first and last authorships over the past decade, a significant gender disparity persists. While women now constitute the majority of first authors, last authorship remains disproportionately male, reflecting ongoing barriers to female leadership in O&G research. These findings highlight the need for targeted institutional efforts to promote gender equity in academic medicine.

To estimate the sociodemographic and geographical variation in prescribing selective serotonin reuptake inhibitors (SSRIs) and medications for attention-deficit/hyperactivity disorder (ADHD) to children and young people (CYP) in North West London, UK.

Cross-sectional population-based study.

General practices in North West London, UK, with data for the period 2020–2022 obtained from the Discover Now platform, which covers approximately 95% of the local population.

762 390 CYP aged 5–24 years in the year 2022.

Primary outcome: Prescription rates of SSRIs and ADHD medications. Secondary outcomes: Associations between prescription rates and sociodemographic factors, including age, gender, geographical area (local authority), ethnicity and socioeconomic deprivation (measured using the Index of Multiple Deprivation).

The total sample comprised 762 390 CYP. 2.20% of the sample were prescribed an SSRI (95% CI 2.17% to 2.24%) and 0.50% an ADHD medication (95% CI 0.49% to 0.52%) in years 2020–2022. High deprivation was associated with the highest rates of an SSRI prescription (2.5%). In contrast, low deprivation was associated with the highest rates of an ADHD medication prescription (0.70%). This divergent pattern was evident in some London boroughs and not in others. The relationship between level of area deprivation and prescription rates also differed by borough. Overall, the sociodemographic factors could not explain most of the variation in prescription rates (Pseudo R² 0.18 for SSRI and 0.06 for an ADHD medication).

Prescriptions for common mental disorders and ADHD for CYP from North West London varied by sociodemographic characteristics and London borough of residence, potentially exacerbating mental health inequalities. To monitor and address these inequalities, more extensive use of linked electronic health records should be undertaken; for example, data on mental health diagnosis and service utilisation are needed to investigate the relationship between diagnosis and treatment over time.

The demand for home care services has increased with the growth of the older population. Currently, home care workers (HCWs) are experiencing challenges such as poor working conditions, high turnover, fragmented services and dissatisfied clients, which are indicative of limitations on HCWs’ ability to provide quality integrated home care to older people. Therefore, we conducted a scoping review to identify the key elements that affect the capabilities of the HCWs in providing quality integrated care to older people in their homes.

Scoping review.

PubMed, PsycINFO, Scopus, CINAHL, Cochrane, Analysis & Policy Observatory, Australian Association of Gerontology (Australia), WHO, Trove (Australia), Social Care Online (UK) and Google between January 2014 and August 2025.

Studies were included if they focused on the analysis of HCWs’ experience in providing care to older people within home settings and were published in the English language between January 2014 and August 2025.

19 studies met the inclusion criteria out of 2844 retrieved articles. Most studies were conducted in North America (n=8). Qualitative studies were the most commonly reported (n=16). The findings of the studies were combined and categorised into four themes using a narrative synthesis approach. The four themes identified were HCWs’ capability through (1) collaborative practice, (2) education and training, (3) structural conditions at work and (4) personal attributes.

This scoping review on home care for older people highlights four interconnected pillars that shape HCWs’ capabilities. This review provides valuable insights to inform the standards and policies to strengthen HCWs’ capabilities across these domains. Future study is needed to explore the measures taken by agencies to understand and address key elements of HCWs’ capability.

Care (Education) and Treatment Reviews (C(E)TRs) are intended to reduce unnecessary psychiatric hospital admission and length of stay for people with intellectual disability and autistic people. The use and impact of C(E)TRs have not been systematically evaluated since their introduction in England in 2015. The aims of this study are to describe the demographic and clinical profiles of people who receive a community C(E)TR and to investigate their effects on admission, length of hospital stay and clinical and functional change.

We will conduct a retrospective cohort study using de-identified data from electronic health records derived from two large National Health Service mental health providers in London, England, including one replication site. Data will be extracted using the Clinical Record Interactive Search (CRIS) tool for all people with recorded intellectual disability and/or autism who received mental healthcare from 2015. We will identify community C(E)TR events using keyword searches. Community C(E)TRs will be examined in two ways: (1) In a community cohort, we will capture data in the 6-month periods before and after a community C(E)TR and compare this to a matched control group and (2) In a hospital cohort, we will compare groups who did and did not receive a community C(E)TR prior to their admission. We will describe the socio-demographic and clinical profiles of each group and their health service use, and compare C(E)TR and no C(E)TR groups using t-tests (or a non-parametric equivalent). The primary outcomes are admission to a psychiatric hospital (community cohort) and length of psychiatric hospital admission and clinical change (hospital cohort). Admission to psychiatric hospital will be estimated using propensity score weighting and difference-in-differences methods. Cox’s proportional hazard model will be used for length of hospital admission and repeated-measures analysis of variance (ANOVA) will be used to assess clinical change.

Use of CRIS to examine de-identified clinical data for research purposes has overarching ethical approval. This study has been granted local approval by the South London and Maudsley CRIS Oversight Committee. Findings will be disseminated in an open-access peer-reviewed academic publication, at conference presentations, and to service users and carers in accessible formats.

Atopic dermatitis (AD) is a chronic, relapsing, heterogeneous skin disease affecting 2%–7% of adults, with roughly 30% having moderate-to-severe disease. AD symptoms, like intense itching and skin pain, carry a substantial disease burden that negatively impacts patients’ quality of life (QoL) and psychosocial well-being. Lebrikizumab is a novel, high-affinity monoclonal antibody that selectively binds to and neutralises interleukin-13 with high potency. Three clinical trials with lebrikizumab (ADvocate 1 and 2; ADhere) demonstrated significant clinical benefit in patients with AD, while the 3-year long-term extension study of lebrikizumab (ADjoin) further demonstrated long-term efficacy and safety in patients with AD. The ADTrust study will evaluate patient well-being, their relationship with their skin, long-term effectiveness, and safety of lebrikizumab, treatment satisfaction, and long-term effect of lebrikizumab treatment on different aspects of patients’ lives, including itch, pain, sleep, fatigue, work impairment and overall QoL among adult patients with moderate-to-severe AD in a real-world setting.

This non-interventional, prospective, observational, real-world evidence study will involve approximately 150 sites across Europe and approximately 1200 adults with moderate-to-severe AD treated with lebrikizumab for 2 years. The primary endpoint is patient well-being assessed by the 5-item WHO Well-Being Index (WHO-5) questionnaire. Key secondary endpoints include clinical effectiveness (Eczema Area and Severity Index and Investigator’s Global Assessment Scale), disease symptomatology and control (Patient-Oriented Eczema Measure, 24-hour peak pruritus, skin pain, fatigue and sleep quality Numerical Rating Scale, and safety and tolerability. Other validated endpoints will evaluate physician-reported and patient-reported QoL and treatment satisfaction (Dermatology Life Quality Index, Treatment Satisfaction Questionnaire-9), patients’ work productivity and impairment (Work Productivity and Activity Impairment (WPAI)-AD) and disease control (AD Control Tool). Novel experimental endpoints will also be evaluated with the aim to assess patients’ relationship with their skin (SkinLove questionnaire), disease control (intensity and frequency of flares) and an Effectiveness Diary^+© (a brief monthly survey on a voluntary basis with the aim to assess the long-term impact of lebrikizumab on three fundamental aspects of the patients’ life: the well-being (WHO-5), the itch intensity (24 hours peak pruritus) and the frequency and intensity of flares). Statistical analyses will be descriptive and explorative and based on observed cases. Missing data imputation may be used to handle missing data for primary endpoints and secondary effectiveness endpoints.

This study will be conducted according to the protocol, which has ethics committee approval (Hamburg Ethic Committee in Germany: 2024-101358-BO-ff), and all applicable laws and regulatory requirements for each participating country. The results will be disseminated through scientific publications and congress presentations.

NCT06815380 (Pre-results).