To address the lack of accurate and accessible mental health medicines-information resources for children, young people and their parents/guardians using design thinking to co-design free-to-use, video resources tailored to this audience.

A multiphase qualitative case study using the Double Diamond model of Design Thinking: Discover, Define, Develop and Deliver. This included iterative prototyping, thematic analysis and public and patient involvement throughout.

Dublin, Ireland with online distribution of the final resources internationally through a free, open-access platform.

A multidisciplinary co-design team including two specialist mental health pharmacists, two academic pharmacists, five consultant psychiatrists, a psychiatric nurse, a youth content specialist, three youth activists and a parent representative.

26 co-designed, medicines-information videos were created, including versions for children (voiced by children), parents/guardians and young people. Videos feature storytelling formats with Bitmoji characters. Feedback from youth and parent collaborators guided design and content. Since launch, www.youthmed.info has had over 25 000 website views and more than 30 000 video views, with engagement from over 91 countries. The resources are also linked on national and international clinical and charity platforms.

Youth Med.Info addresses a gap in accessible, accurate mental health medicines-information by placing users – children, young people, parents/guardians and clinicians—at the centre of its design.

Tuberculosis (TB) remains a major public health challenge in Sub-Saharan Africa, exacerbated by the high prevalence of drug-resistant TB (DR-TB) and its strong association with HIV. Bedaquiline (BDQ), approved by the WHO in 2013, offers a promising treatment for DR-TB, including multidrug-resistant TB (MDR-TB) and extensively DR-TB (XDR-TB). However, BDQ has been associated with QT interval prolongation, a condition that can lead to serious cardiac arrhythmias such as torsades de pointes. This systematic review and meta-analysis aims to quantify the incidence of QT interval prolongation in patients receiving BDQ for DR-TB in Sub-Saharan Africa and identify predictors of this adverse effect.

We will conduct a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science and African Journals Online using medical subject headings and keywords related to ‘BDQ’, ‘DR-TB’, ‘QT interval prolongation’ and ‘Sub-Saharan Africa’. Eligible studies will include randomised controlled trials, cohort studies, case-control studies and observational studies conducted in Sub-Saharan Africa. Study titles and abstracts will be initially screened, and full texts will be retrieved and reviewed against eligibility criteria. Relevant data will be extracted from the selected articles and assessed for risk of bias. The primary outcome will be the pooled incidence of QT interval prolongation. Data will be synthesised using a random-effects model meta-analysis if significant heterogeneity is present; otherwise, a fixed-effects model will be applied.

This study will use published data, requiring no ethical approval. Findings will be disseminated through peer-reviewed publications and conference presentations to inform clinical guidelines and DR-TB treatment policies in Sub-Saharan Africa.

CRD42024560368.

The AMBulatoRy blOod preSsure In older Adults (AMBROSIA) study cohort was designed to determine whether ambulatory blood pressure (BP) monitoring (ABPM) is useful for identifying older adults with hypertension taking antihypertensive medication who are at increased risk for falls. The association of home BP monitoring (HBPM) with falls was assessed in an ancillary study (AMBROSIA-HOME).

AMBROSIA was a prospective observational study of adults aged 65 years and older taking antihypertensive medication for hypertension. Participants were recruited from Kaiser Permanente Southern California (KPSC), an integrated healthcare delivery system, and enrolled from May 2019 to November 2022. Demographic and clinical characteristics and geriatric assessments were collected over the course of two consecutive study visits. Participants completed a 24-hour ABPM and 1 week of HBPM. Over the following year, falls were assessed using a monthly falls calendar, and serious fall injuries were assessed from the KPSC electronic health record (EHR).

We enrolled 670 participants; 656 completed 24-hour ABPM and 536 also completed HBPM. The mean (SD) age of the AMBROSIA cohort was 75 (6) years, 16% were over 80 years of age and 56% were female. There were 13% non-Hispanic Asian or Pacific Islander, 22% non-Hispanic Black, 18% Hispanic and 44% non-Hispanic White participants. Nearly 72% had mild cognitive impairment, 50% were pre-frail and 4% were frail. Overall, 87% of participants returned all monthly calendars during follow-up.

The AMBROSIA cohort can be updated with longitudinal data from the EHR including antihypertensive medication to explore the relationship of fall risk and white coat effect, defined as the difference between clinic BP and out-of-clinic BP, BP variability over 24 hours and postprandial BP decline with antihypertensive medication intensification during follow-up. Additionally, the cohort can be updated to include outcomes data from the EHR such as cardiovascular events to examine BP phenotypes as potential predictors of cardiovascular events.