In deprived urban areas of South America, young people face heightened risks of mental disorders. Research suggests an association exists between social media engagement (SME), depression and anxiety.

This study explored the associations of SME with symptoms of depression, anxiety and subjective quality of life among young people from South American deprived urban areas.

Our cross-sectional survey study used an adapted version of the Multidimensional Facebook Intensity Scale to categorise 2399 participants into four SME groups: low, moderate, high and very high. Symptoms of depression (Patient Health Questionnaire-8), anxiety (Generalised Anxiety Disorder-7) and quality of life (Manchester Short Assessment) were assessed and compared using F and Tukey tests.

Each step of increased SME was associated with more symptoms of depression and anxiety and poorer quality of life. Statistically significant differences were observed across all groups (p

The findings suggest an association exists between SME, increased mental distress and lower quality of life in young people from deprived South American urban areas. This influence seems to apply across the spectrum of engagement levels, not only to extremes. However, due to the cross-sectional nature of the study, causal relationships cannot be established.

SME should be explored in clinical settings, as lower levels are associated with lower symptom levels and better quality of life. Policies addressing youth SME should be developed and evaluated in the challenging contexts of deprived urban areas.

Simulation is well established in medical education. However, with rising numbers of medical students globally, provision of high-quality, equitable simulation teaching on a large, multisite scale is increasingly challenging. We sought to explore whether a centrally designed, multisite simulation programme could enhance student confidence equitably across multiple clinical sites with differing resources.

An evaluative study on the changes in medical student confidence on defined intended learning outcomes (ILOs) in 3 undergraduate year groups across 11 simulation sessions delivered at eight different clinical sites with variable resources and facilitators.

Eight hospitals affiliated with Imperial College School of Medicine.

Students’ self-reported confidence in achieving the ILOs via a questionnaire at the end of each session. Changes in confidence following each session were analysed and compared across sites.

522 students responded to the survey over 3 academic years. Students’ mean confidence in achieving ILOs increased in all sessions. Nine out of 10 sessions showed no statistically significant difference in the confidence increases between sites.

Our study suggests it is possible to deliver an equitable, centrally designed, large-scale simulation teaching programme to medical students across multiple clinical sites with different facilitator teams. The programme is sustainable, easily facilitated by new teaching fellows each year and is likely adaptable to other healthcare professions and settings.

Childhood cancer accounts for a significant proportion of global childhood mortality, especially in low-income and middle-income countries (LMICs). Unlike many adult malignancies, primary prevention of childhood cancers is not possible. Improving survival requires a two-pronged strategy: earlier diagnosis and effective treatment. Our study aims to establish the feasibility, clinical and implementation effectiveness of an adapted early warning signs and symptoms (EWSS) intervention in Cameroon and Kenya. It will equip healthcare workers, Ministry of Health (MOH) representatives and National Cancer Institute leaders with evidence-informed guidance on implementing context-adapted interventions to improve the early detection and referral of childhood cancers in these countries.

The study is a quasi-experimental, hybrid type 2 implementation effectiveness study based on a Ghanaian adaptation of the ‘Saint Siluan’ EWSS campaign. Our protocol proposes context-specific adaptation and evidence-based implementation of the EWSS intervention through iterative engagement with country-level implementation teams to train healthcare workers and improve referral pathways for earlier childhood cancer diagnoses in each study country. Training effectiveness will be measured through pretraining and post-training tests of knowledge and application, as well as training satisfaction surveys. Clinical effectiveness will be assessed by using a REDCap database to track the number of newly diagnosed childhood cancer cases in the study regions and counties, healthcare timelines and paths to diagnosis, and the stage and proportion of metastatic disease at diagnosis. Implementation effectiveness will be evaluated through interviews with senior and mid-level health system partners and clinicians, tracking fidelity to the implementation process as laid out in The Implementation Roadmap Workbook, and analysis of meeting minutes from monthly local implementation team meetings.

This study has received ethical approval from The Hospital for Sick Children (REB # 1000080092) and all participating sites. We have received National Ethical Clearance from the Cameroon Ethical Board (#1699) and Regional Administrative Authorizations from our piloting regions (Centre and West). We have also received ethical clearance from Kenyatta National Hospital (KNH) (ERB# KNH-ERC/RR/955) and our National Commission for Science, Technology and Innovation in Kenya licence from the counties we are piloting in Kenya. As clinical data will be collected from existing health registries and patient charts, patient consent will not be required; however, we will obtain consent from all members of the leadership implementation teams and operational implementation teams for their participation in the implementation meetings and from all individuals participating in the semistructured interviews. We will disseminate findings to build awareness and share findings among various target audiences: (1) key county and regional parties (eg, clinical societies, advocacy groups, country MOHs and regional bodies such as the East African Community, Economic Community of West African States); (2) international bodies such as the WHO; and (3) the academic community.

While group, task-oriented, community-based exercise programs (CBEPs) delivered in-person can increase exercise and social participation in people with mobility limitations, challenges with transportation, cost and human resources, threaten sustainability. A virtual delivery model may help overcome challenges with accessing and delivering in-person CBEPs. The study objective is to estimate the short-term effect of an 8-week, virtual, group, task-oriented CBEP called TIME™ (Together in Movement and Exercise) at Home compared with a waitlist control on improving everyday function in community-dwelling adults with mobility limitations.

A randomised controlled trial incorporating a type 1 effectiveness-implementation hybrid design is being conducted in four Canadian metropolitan centres. We aim to stratify 200 adults with self-reported mobility limitations by site, participation alone or with a partner, and functional mobility level, and randomise them using REDCap software to either TIME™ at Home or a waitlist control group. During TIME™ at Home classes (2 classes/week, 1.5 hours/class), two trained facilitators stream a 1-hour exercise video and facilitate social interaction prevideo and postvideo using Zoom. A registered healthcare professional at each site completes three e-visits to monitor and support implementation. Masked evaluators with physical therapy training evaluate participants and their caregivers at 0, 2 and 5 months using Zoom. The primary outcome is the change in everyday function from 0 to 2 months, measured using the physical scale of the Subjective Index of Physical and Social Outcome. The study is powered to detect an effect size of 0.4, given α=0.05, power=80% and a 15% attrition rate. Secondary outcomes are mobility, well-being, reliance on walking aids, caregiver assistance, caregiver mood, caregiver confidence in care-recipient balance and cost-effectiveness. A multimethod process evaluation is proposed to increase understanding of implementation fidelity, mechanisms of effect and contextual factors influencing the complex intervention. Qualitative data collection immediately postintervention involves interviewing approximately 16 participants and 4 caregivers from the experimental group, and 8 participants and 4 caregivers from the waitlist control group, and all healthcare professionals, and conducting focus groups with all facilitators to explore experiences during the intervention period. A directed content analysis will be undertaken to help explain the quantitative results.

TIME™ at Home has received ethics approval at all sites. Participants provide verbal informed consent. A data safety monitoring board is monitoring adverse events. We will disseminate findings through lay summaries, conference presentations, reports and journal articles.

NCT06245135.