In many healthcare contexts globally, where the languages of care providers and patients do not match, miscommunication or non-communication can lead to inaccurate diagnoses and subpar treatment outcomes. In order to bridge these language barriers, a range of informal practices are used, such as family members or staff acting as interpreters, ‘receptive multilingualism’ or machine translation. The development and use of technological tools are increasing, but factors such as translation quality for complex health-related texts vary widely between languages. The objective of this scoping review is to (1) identify and describe the technological tools used in direct patient-provider communication to overcome a language barrier in a healthcare setting, (2) identify how the usability of these tools was evaluated and (3) assess the usability of the technological tools.

The scoping review will follow the Joanna Briggs Institute methodology. A search strategy using variations of the keywords ‘technological tools’, ‘language barrier’ and ‘healthcare’ will be applied in the following databases and research platforms: PubMed, PsycArticle, Scopus, EBSCOhost, ProQuest and Web of Science. All literature where individuals use a technological tool to overcome a language barrier in a healthcare context will be included and exported into the screening assistant software Rayyan. The search will be limited to articles written in German or English. Two independent reviewers will screen the articles, and all relevant extracted data will be presented in a descriptive summary.

This scoping review does not require ethical approval, as the study’s methodology consists of collecting data from publicly available sources. The findings will be disseminated through publication in an open-access, peer-reviewed journal and presentations at scientific conferences. The scoping review results will also guide future research in a multinational project investigating multilingualism in providing (mental) healthcare to migrants.

The COVID-19 pandemic has had both direct and indirect impacts on the health of populations worldwide. While racial/ethnic health inequities in COVID-19 infection are now well known (and ongoing), knowledge about the impact of COVID-19 pandemic management on non-COVID-19-related outcomes for Indigenous peoples is less well understood. This article presents the study protocol for the Health Research Council of New Zealand funded project ‘Mā te Mōhio ka Mārama: Impact of COVID-19 on Māori:non-Māori inequities’. The study aims to explore changes in access to healthcare, quality of healthcare and health outcomes for Māori, the Indigenous peoples of Aotearoa New Zealand (NZ) and non-Māori during the COVID-19 outbreak period across NZ.

This observational study is framed within a Kaupapa Māori research positioning that includes Kaupapa Māori epidemiology. National datasets will be used to report on access to healthcare, quality of healthcare and health outcomes between Māori and non-Māori during the COVID-19 pandemic in NZ. Study periods are defined as (a) prepandemic period (2015–2019), (b) first pandemic year without COVID-19 vaccines (2020) and (c) pandemic period with COVID-19 vaccines (2021 onwards). Regional and national differences between Māori and non-Māori will be explored in two phases focused on identified health priority areas for NZ including (1) mortality, cancer, long-term conditions, first 1000 days, mental health and (2) rheumatic fever.

This study has ethical approval from the Auckland Health Research Ethics Committee (AHREC AH26253). An advisory group will work with the project team to disseminate the findings of this project via project-specific meetings, peer-reviewed publications and a project-specific website. The overall intention of the project is to highlight areas requiring health policy and practice interventions to address Indigenous inequities in health resulting from COVID-19 pandemic management (both historical and in the future).

To estimate the impacts of demographic factors and income disparities on the case fatality rate (CFR) of COVID-19 in Hong Kong, taking into account the influence of reporting delays (ie, the duration between symptom onset and case confirmation).

Retrospective observational longitudinal study.

A total of 7406 symptomatic patients with residence information reported between 23 January 2020 and 2 October 2021.

The study examined the disparity in COVID-19 deaths associated with the factors such as age (≥65 vs 0–64 years old groups), gender and the income level of districts (low income vs non-low income). The severe reporting delay (>10 days) was considered as the mediator for mediation analysis. A Cox proportional hazards regression model was constructed.

We found that CFR was 3.07% in the low-income region, twofold higher than 1.34% in the other regions. Although the severe reporting delay was associated with a hazard ratio (HR) of about 1.9, its mediation effect was only weakly present for age, but not for gender or income level. Hence, high CFR in Hong Kong was largely attributed to the direct effects of the elderly (HR 25.967; 95% CI 14.254 to 47.306) and low income (HR 1.558; 95% CI 1.122 to 2.164).

The disparity in COVID-19 deaths between income regions is not due to reporting delays, but rather to health inequities in Hong Kong. These risks may persist after the discontinuation of test-and-trace measures and extend to other high-threat respiratory pathogens. Urgent actions are required to identify vulnerable groups in low-income regions and understand the underlying causes of health inequities.

To investigate if the Jenkins Sleep Scale (JSS) demonstrates sex-related differential item functioning (DIF).

Cross-sectional study.

Survey data from the Finnish Public Sector study (2015–2017).

77 967 employees in the Finnish public sector, with a mean age of 51.9 (SD 13.1) years and 82% women.

Item response theory estimates: difficulty and discrimination parameters of the JSS and differences in these parameters between men and women.

The mean JSS total score was 6.4 (4.8) points. For all four items of the JSS, the difficulty parameter demonstrated a slight shift towards underestimation of the severity of sleep difficulties. The discrimination ability of all four items was moderate to high. For the JSS composite score, overall discrimination ability was moderate (0.98, 95% CI 0.97 to 0.99). Mild uniform DIF (p

The JSS showed overall good psychometric properties among this healthy population of employees in the Finnish public sector. The JSS was able to discriminate people with different severities of sleep disturbances. However, when using the JSS, the respondents might slightly underestimate the severity of these disturbances. While the JSS may produce slightly different results when answered by men and women, these sex-related differences are probably negligible when applied to clinical situations.

The aim of this study was to assess the prevalence of not testing for HIV and its determinants among young adult women aged 15–29 years in Papua New Guinea (PNG).

The study used secondary data from the 2016 to 2018 PNG Demographic and Health Survey (PNGDHS), a nationally representative cross-sectional survey that used a two-stage stratified sampling.

A total weighed sample of 5164 young adult women aged 15–29 years were included in the analysis.

Ever been tested for HIV was the primary outcome of the study. All analyses were adjusted using survey weights to account for unequal sampling probabilities.

The prevalence of not testing for HIV was 58.8% (95% CI: 57.4% to 60.1%). The mean age was 21.65 years (SD = 4.23). Of the women who were not tested for HIV, the majority were never married (79.4%), without formal education (63%), not working (60.2%), and from rural areas (62.9%). In the multivariable analysis, those who were never married (adjusted OR (AOR) 4.9, 95% CI 3.6 to 6.6), had poor wealth index (AOR 1.8, 95% CI 1.3 to 2.5), were from rural areas (AOR 2.0, 95% CI 1.5 to 2.6), were from the Momase region (AOR 1.3, 95% CI 1.0 to 1.7), did not read newspapers or magazines (AOR 1.7, 95% CI 1.3 to 2.1), did not listen to the radio (AOR 1.5, 95% CI 1.1 to 2.0), experienced early sexual debut (AOR 1.5, 95% CI 1.1 to 1.9), had one sexual partner (AOR 1.5, 95% CI 1.2 to 2.0) and reported no sexually transmitted infection (STI) in the past 12 months (AOR 1.8, 95% CI 1.1 to 3.1) had higher odds of not testing for HIV.

Our study found a very high unmet need for HIV testing among young adult women in PNG. Health promotion programmes should be designed to increase HIV knowledge and access to testing services, particularly targeting young women who are disadvantaged and from rural areas.

This study aimed to assess the coutilisation of oral rehydration solution (ORS) and zinc for treating diarrhoea and its associated factors among under-5 children in East Africa.

Cross-sectional study design. Multilevel Poisson regression analysis with robust variance was fitted to identify predictors of zinc and ORS coutilisation. An adjusted prevalence ratio (aPR) with a 95% CI was reported to declare the statistical significance.

Twelve East African countries.

16 850 under-5 children who had diarrhoea were included in the study.

In East African nations, the coutilisation of ORS and zinc for the treatment of diarrhoea in children under 5 was 53.27% with a 95% CI (52.54% to 54.01%). Children of mothers with primary education (aPR 1.15, 95% CI 1.09 to 1.20), secondary education (aPR 1.08, 95% CI 1.02 to 1.14), higer education (aPR 1.19, 95% CI 1.10 to 1.29), those from maternal age category of 20–24 (aPR 1.14, 95% CI 1.07 to 1.21), age category of 25–29 (aPR 1.13, 95% CI 1.06 to 1.21), age category of 30–34 (aPR 1.09, 95% CI 1.02 to 1.16), those from wealthy households (aPR 1.04, 95% CI 1.01 to 1.09) and those who have a media exposure (aPR 1.04, 95% CI 1.01 to 1.08) were more likely to receive combination.

Only half of the under-5 children with diarrhoea in East Africa were treated with a combination of ORS and zinc. To increase the use of the suggested combination therapy of ORS with zinc, it is important to empower women through education and prevent teen pregnancy.

Life expectancy and rates of premature death are fundamental markers of health and social equity globally, and measures on which people experiencing homelessness face enormous disparities. However, unlike for other population groups with similar disparities, concerted government action to reduce homeless mortality is rare, partly due to a lack of reliable, timely data. Contemporaneous tracking of homeless deaths is required to render such deaths less invisible and measure trends over time. Drawing on multiple data sources as recommended by the US National Health Care for the Homeless Council’s seminal Homeless Mortality Data Toolkit, we routinely and contemporaneously capture, verify and report on deaths occurring among people who have experienced homelessness in the Australian city of Perth.

Dynamic cohort study.

Perth, Western Australia, Australia, between 2016 and 2022, with deaths examined between 2020 and 2022.

For this study, the cohort comprised 8753 people who experienced homelessness in Perth, with ‘recruitment’ into the cohort governed by engagement with one or more local homelessness services and programmes over the period.

Number and median age-at-death statistics.

There were 360 deaths over the 3-year period, which is likely an undercount. The median age at death was 50 years, >3 decades below the current Australian median age at death of 82 years. Aboriginal people accounted for 30% of the deaths.

The ongoing poor health and premature death of people who have experienced homeless are indictments on our society. Triangulation of multiple data sources is required to identify and monitor deaths among homeless populations. Timely, verified data on homeless mortality are important for galvanising action and accountability, and targets should be set to reduce the observed three-decade life expectancy chasm.

This study sought to examine the relationship between Toxoplasma gondii seropositivity and cognitive function in older adults.

An observational cross-sectional study.

The National Health and Nutrition Examination Survey (NHANES) study took place at participants’ homes and mobile examination centres.

A total of 2956 older adults aged 60 and above from the NHANES from 2011 to 2014 were included in the study. Exposure of interest: participants had serum Toxoplasma gondii antibody analysed in the laboratory. A value>33 IU/mL was categorised as seropositive for Toxoplasma gondii infection; Toxoplasma gondii infection.

Cognitive tests included the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest (CERAD-WL) for immediate and delayed memory, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST).

About half of the 2956 participants (mean age 70.0) were female (51.0%), non-Hispanic White (48.3%), and completed some college or above (48.3%). A total of 703 participants were positive for Toxoplasma gondii infection (23.8%). Adjusted linear regression showed that compared with participants with negative Toxoplasma gondii infection, those with positive Toxoplasma gondii infection had lower CERAD-WL immediate memory (beta (β) –0.16, 95% CI –0.25 to –0.07), CERAD-WL delayed memory (β –0.15, 95% CI –0.24 to –0.06), AFT (β –0.15, 95% CI –0.24 to –0.06), DSST (β –0.34, 95% CI –0.43 to –0.26), and global cognition (β –0.24, 95% CI –0.32 to –0.16) z-scores after controlling for the covariates.

Toxoplasma gondii seropositivity is associated with worse immediate and delayed verbal learning, language proficiency, executive functioning, processing speed, sustained attention, working memory, as well as global cognition in older adults. Public health measures aiming at preventing Toxoplasma gondii infection may help preserve cognitive functioning in older adults.

Lockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies in Ethiopia.

Comparative cross-sectional study.

The availability of essential, generic medicines for chronic diseases was assessed at two public pharmaceutical supply agency hubs.

The current study included public supply agency hub managers, warehouse managers and forecasting officers at the study setting.

The assessment encompassed the availability of chronic medicines on the day of data collection, as well as records spanning 8 months before the outbreak and 1 year during the pandemic. A total of 22 medicines were selected based on their inclusion in the national essential drug list for public health facilities, including 17 medicines for cardiovascular disease and 5 for diabetes mellitus.

The results of the study indicate that the mean availability of the selected basket medicines was 43.3% (95% CI: 37.1 to 49.5) during COVID-19, which was significantly lower than the availability of 67.4% (95% CI: 62.2 to 72.6) before the outbreak (p

The COVID-19 pandemic worsened the availability of essential chronic medicines, including higher rates of stockouts and unit price hikes for some products in the study setting. The study’s findings imply that the COVID-19 pandemic has aggravated already-existing medicine availability issues. Efforts should be made to develop contingency plans and establish mechanisms to monitor medicine availability and pricing during such crises.

Technologies such as health and fitness applications (apps) and wearable activity trackers have recently gained popularity and may play a key role in promoting physical activity and reducing sedentary behaviours. Although several systematic reviews have investigated their efficacy in physical activity and sedentary behaviours, few studies have focused on their impact on work-related outcomes among workers. Here, to explore the effects of mHealth interventions designed to encourage physical activity and decrease sedentary behaviours on work-related outcomes, including absenteeism, presenteeism, productivity, work performance and workability among workers, we will conduct a systematic review based on recent articles and an extensive literature search.

The literature search will be performed using PubMed, Web of Science, the Cochrane Library and the Japan Medical Abstracts Society from inception to 23 September 2023. We will select studies that (1) investigated the impact of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related outcomes such as absenteeism, presenteeism, productivity, work performance and workability; (2) were designed as a randomised controlled trial (RCT) or non-randomised study of interventions (NRSI); (3) were conducted among workers and (4) were published as full-text original articles in Japanese or English. We will assess the review quality with the AMSTAR 2 tool. The risk of bias will be assessed with the RoB tool 2.0 and ROBINS-I.

Ethical approval is unnecessary as the study will rely solely on previously published articles. The research results will be submitted for publication in a peer-reviewed scientific journal.

The study protocol has been registered with the UMIN Clinical Trials Registry (ID=UMIN000052290).

Many rural communities bear a disproportionate share of drug-related harms. Innovative harm reduction service models, such as vending machines or kiosks, can expand access to services that reduce drug-related harms. However, few kiosks operate in the USA, and their implementation, impact and cost-effectiveness have not been adequately evaluated in rural settings. This paper describes the Kentucky Outreach Service Kiosk (KyOSK) Study protocol to test the effectiveness, implementation outcomes and cost-effectiveness of a community-tailored, harm reduction kiosk in reducing HIV, hepatitis C and overdose risk in rural Appalachia.

KyOSK is a community-level, controlled quasi-experimental, non-randomised trial. KyOSK involves two cohorts of people who use drugs, one in an intervention county (n=425) and one in a control county (n=325). People who are 18 years or older, are community-dwelling residents in the target counties and have used drugs to get high in the past 6 months are eligible. The trial compares the effectiveness of a fixed-site, staffed syringe service programme (standard of care) with the standard of care supplemented with a kiosk. The kiosk will contain various harm reduction supplies accessible to participants upon valid code entry, allowing dispensing data to be linked to participant survey data. The kiosk will include a call-back feature that allows participants to select needed services and receive linkage-to-care services from a peer recovery coach. The cohorts complete follow-up surveys every 6 months for 36 months (three preceding kiosk implementation and four post-implementation). The study will test the effectiveness of the kiosk on reducing risk behaviours associated with overdose, HIV and hepatitis C, as well as implementation outcomes and cost-effectiveness.

The University of Kentucky Institutional Review Board approved the protocol. Results will be disseminated in academic conferences and peer-reviewed journals, online and print media, and community meetings.

NCT05657106.

Despite climate change being described as a code red for humanity, health systems have been particularly slow in both climate mitigation and adaptation responses. The effects of climate change on health and health systems will not be felt equally, with underserved and marginalised communities disproportionately impacted. The circumpolar region is warming at 3–4 times the global rate, amplifying already existing socioeconomic barriers and health inequities, with particular amplified effects for the substantial Indigenous population in the area.

We therefore sought to explore perspectives of physicians around patient-planetary health (P-PH) co-benefit prescribing in a circumpolar region in the Northwest Territories (NWT), Canada, known to be one of the ground zero levels for climate change.

Thirteen semi-structured physician interviews were carried out in the NWT region between May 2022 and March 2023 using purposive sampling. Interviews were transcribed verbatim and reflexive thematic analysis was carried out to identify key themes.

There were three main themes identified including (1) current healthcare system does not support planetary health, (2) supporting patient-planetary health is currently difficult for clinicians and (3) considering change in the NWT to support patient-planetary health. Participants noted key opportunities to move planetary health forward, with the NWT having the potential to be an innovative model for planetary health-informed change for other health systems.

The NWT health system has unique features due to its rural and remote nature and smaller population base. Despite this, our study identified some key opportunities for advancing P-PH co-benefit efforts. The identified opportunities may be considered in future intervention, organisational change and policy-making efforts with potential relevance in other settings.

Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy indicators and QALE.

361/363 LAs in GB (lower tier/district level) within the period 2018–2020.

We estimated life tables for LAs using official statistics and utility scores from an area-level linkage of the Understanding Society survey. Using the Sullivan method, we estimated QALE at birth in years with corresponding 80% CIs. To examine the association between inclusive economy indicators and QALE, we used an open access data set operationalising the inclusive economy, created by the System Science in Public Health and Health Economics Research consortium.

Population-weighted QALE estimates across LAs in GB were lowest in Scotland (females/males: 65.1 years/64.9 years) and Wales (65.0 years/65.2 years), while they were highest in England (67.5 years/67.6 years). The range across LAs for females was from 56.3 years (80% CI 45.6 to 67.1) in Mansfield to 77.7 years (80% CI 65.11 to 90.2) in Runnymede. QALE for males ranged from 57.5 years (80% CI 40.2 to 74.7) in Merthyr Tydfil to 77.2 years (80% CI 65.4 to 89.1) in Runnymede. Indicators of the inclusive economy accounted for more than half of the variation in QALE at the LA level (adjusted R² females/males: 50%/57%). Although more inclusivity was generally associated with higher levels of QALE at the LA level, this association was not consistent across all 13 inclusive economy indicators.

QALE can be estimated for LAs in GB, enabling further research into area-level health inequalities. The associations we identified between inclusive economy indicators and QALE highlight potential policy priorities for improving population health and reducing health inequalities.

No whole-school interventions which seek to reduce physical, sexual and emotional violence from peers, intimate partners and teachers have been trialled with adolescents. Here, we report a protocol for a pilot trial of the Good School Toolkit-Secondary Schools intervention, to be tested in Ugandan secondary schools. Our main objectives are to (1) refine the intervention, (2) to understand feasibility of delivery of the intervention and (3) to explore design parameters for a subsequent phase III trial.

We will conduct a pilot cluster randomised controlled trial, with two arms and parallel assignment. Eight schools will be randomly selected from a stratified list of all eligible schools in Kampala and Wakiso Districts. We will conduct a baseline survey and endline survey 18 months after the baseline, with 960 adolescents and 200 teachers. Qualitative data and mixed methods process data collection will be conducted throughout the intervention. Proportion of staff and students reporting acceptability, understanding and implementing with fidelity will be tabulated at endline for intervention schools. Proportions of schools consenting to participation, randomisation and proportions of schools and individual participants completing the baseline and endline surveys will be described in a Consolidated Standards of Reporting Trials diagram.

The ethical requirements of our project are complex. Full approvals have been received from the Mildmay Ethics Committee (0407-2019), the Uganda National Council for Science and Technology (SS 6020) and the London School of Hygiene & Tropical Medicine (16212). Results of this study will be published in peer-reviewed academic journals, and shared with public bodies, policy makers, study participants and the general public in Uganda.

PACTR202009826515511.

Despite to high burden of road traffic injuries (RTIs), the RTI epidemiology has received less attention with rare investments on robust population cohorts. The PERSIAN Traffic Safety and Health Cohort (PTSHC) was designed to assess the potential causal relationships between human factors and RTI mortality, injuries, severity of the injury, hospitalised injury, violation of traffic law as well as offer the strongest scientific evidence.

The precrash cohort study is carried out in four cities of Tabriz, Jolfa, Shabestar and Osku in East Azerbaijan province located in northwest Iran. The participants were people who sampled among the general population. The cluster sampling method was used to enrol the households in this study. The PTSHC encompasses a wide and comprehensive range and types of data. These include not only the common cohort data collections such as medical examination measures, previous medical history, bio assays and behavioural assessments but also includes data obtained using advanced novel technologies, for example, electronic travel monitoring, driving simulation and neuro-psycho-physiologic laboratory assessments specifically developed for traffic health field.

A total of 7200 participants aged 14 years and above were enrolled at baseline, nearly half of them being men. The mean age of participants was 39.2 (SD=19.9) years. The majority of participants (55.4%) belonged to the age group of 30–56 years. Currently, approximately 1 200 000 person-measurements have been collected.

PSTHC will be used to determine the human-related risk factors by adjusting for the vehicle and land-use-related factors. Therefore, a lot of crashes can be prevented using effective interventions. Although this cohort provides valuable data, it is planned to increase its size to achieve the highest level of evidence with higher generalisability. Also, according to the national agreement this cohort is going to be extended to several geographical regions in second decade.

To determine the community’s perception on the magnitude of Xeroderma pigmentosum (XP) disease and healthcare-seeking practices in Micheweni, Pemba in response to the public widespread information on the increased burden of the disease.

Mixed-methods cross-sectional study.

Micheweni district, Pemba.

211 male and female adults in the household survey, three caretakers/parents of patients with XP in the case study, 20 key community leaders/influential people and health workers in in-depth interviews and 50 community members and other leaders in six focus groups.

This study has revealed that XP disease exists in few families of which some of them have more than one child affected. The record review showed that there were a total of 17 patients who were diagnosed with the disease for the past 3 years, however only 10 were alive during the time of the survey. Findings from the community members revealed that several patients were believed to have XP disease and perceived causes include inheritance, food types, beliefs and other sociocultural practices. Stigma and discrimination were reported by caretakers and religious leaders. However, some cases believed to be XP were identified as other skin conditions when clinical examination was performed by the team of our researchers. There is a great confusion about XP and other skin diseases.

The study has shown that XP affects only few families, hence termed as concentrated rather than a generalised disease. Due to the rareness of the disease, majority of people in the district are unaware of the disease, hence confusing it with other skin conditions. There is a need for the government in collaboration with other stakeholders to provide educational programme to community members about the disease to address the misconception about the magnitude of the disease.

Digital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD.

Scoping review using the framework proposed by Arksey and O’Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.

Cochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023).

Completed scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia.

Screening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping.

The literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance.

Various DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.

To investigate the prevalence of depression and anxiety symptoms among older adults in an urban district in China, as well as their associated factors.

Cross-sectional study.

General communities in Shenzhen, Guangdong, China.

A total of 5372 community-dwelling older adults aged 65 years or older were initially recruited. Ultimately, 5331 participants met the inclusion criteria and were included in this study.

Participants completed a sociodemographic questionnaire, along with assessments including the Patient Health Questionnaire-9, Generalised Anxiety Scale-7, UCLA Loneliness Simplification Scale, Insomnia Severity Index Scale (ISI), Community Dementia Brief Screening Scale and the 8-item Dementia Screening Questionnaire. Statistical analyses included the Shapiro-Wilk test, independent t-test, Wilcoxon rank test, ² test and univariate and multivariate linear regression analysis.

The prevalence of depression and anxiety symptoms among older adults in Shenzhen communities was 10.4% and 11.3%, respectively. In multivariate analysis, age (B=–0.01, p

We observed a high prevalence of depression and anxiety symptoms among older adults in this study. The existing welfare system and infrastructure should remain and targeted mental health programmes addressing the identified risk factors should be proposed.

Globally, malnutrition among women of reproductive age is on the rise and significantly contributing to non-communicable disease, deaths and disability. Even though the double burden of malnutrition (DBM) is a common problem among women in sub-Saharan Africa (SSA), there are limited studies examining the factors contributing to underweight, overweight, and obesity at the SSA level.

To determine the factors associated with the DBM, and their relative magnitude, among women of reproductive age in SSA.

Cross-sectional study design.

33 SSA countries.

240 414 women of reproductive age.

A multilevel multinomial logistic regression model was applied to identify factors associated with malnutrition. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association.

The pooled prevalence of underweight, overweight and obesity among women in SSA were 8.87%, 16.47% and 6.10%, respectively. Women who are from rural residence and smoke cigarettes were more likely to be underweight. Conversely, women between the age of 24–34 and 35–49, who have higher education, belong to a middle and rich household, are ever married, have high parity, use contraceptives, have media exposure and smoke cigarettes were more likely to be overweight and/or obese.

The findings of our study suggest that certain factors such as residence, education status, wealth, marital status, occupation, cigarette smoking, and contraceptive use have a significant assocation with malnutrition among women. Therefore, it is important for public health programs aimed at preventing the double burden of malnutrition to focus on these factors through comprehensive public awareness and cost-effective operational health interventions.

The study aimed to assess private general physicians’(GPs) healthcare practices, identifying perceived malpractices, the support they receive, and barriers they experience in providing healthcare services.

Qualitative exploratory study.

Rural district, Thatta in Province of Sindh, Pakistan.

15 GPs.

Our results include increased motivation among GPs for continued professional development, the high influence of pharmaceutical companies on providers’ prescribing practices, perceived malpractices by GPs, and the prevalence of quackery and ineffective regulatory mechanisms for private GPs in a rural district.

Our findings have implications for the capacity building of GPs by academic institutions, enforcement of regulatory measures by the authorities, and the introduction of measures to curb practices by unqualified practitioners. Finally, more research will be needed to further understand the perceptions of GPs, their needs and the service delivery interventions that will enhance the quality of care they provide.