Background Diabetes complicated by cardiovascular diseases and chronic kidney diseases poses a growing global burden. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly recommended, yet their availability, treatment costs and affordability across countries of different income levels remain poorly understood. Objectives To evaluate the regulatory availability, treatment costs and affordability of all marketed SGLT-2 inhibitors and GLP-1 RAs across 10 countries, including Nepal, Pakistan, Bangladesh, Sri Lanka, South…
Objective To determine the level and predictors of micronutrient intake inadequacy among pregnant women attending antenatal public health facilities in Bahir Dar City, Northwest Ethiopia. Design A multicentre, cross-sectional study. Setting The study was conducted in public health facilities in Bahir Dar City, Northwest Ethiopia from January to March 2024. Participants About 420 pregnant women aged 18 years and older attending antenatal care at public health facilities in Bahir Dar. Pregnant women diagnosed with chronic diseases, sick and unable to communicate, and who had attended weddings…
Introduction Inappropriate antibiotic prescribing in primary care remains a major driver of antimicrobial resistance, despite national guidelines and audit-and-feedback systems. Digital antimicrobial stewardship tools may support clinicians in making evidence-based prescribing decisions. The Prescription Search Support (PSS) tool translates guideline recommendations into an interactive decision tree integrated into electronic health records (EHR). This project aims to evaluate the impact of implementing the tool on antibiotic prescribing behaviour in Belgian general practice and to understand…
Introduction Glaucoma is an increasing global health problem and the leading cause of irreversible blindness which affects millions of people worldwide. Multiple studies on the cost-effectiveness of glaucoma screening conducted at community, clinic or hospital in developed and developing countries have been conducted, but evidence from systematic reviews is lacking. Therefore, this systematic review aims to assess the cost-effectiveness of glaucoma screening among adult populations across various countries and healthcare settings. Methods and analysis A systematic search will be conducted in…
Introduction The prevalence of pre-diabetes mellitus (pre-diabetes, pre-DM) is increasing globally, with 5%–10% of adults with pre-DM progressing to type 2 DM (T2DM) annually. Despite the availability of national screening programmes and lifestyle interventions, uptake remains suboptimal and the lived experiences of individuals navigating pre-DM diagnosis and care in Singapore remain poorly understood. Understanding these experiences is critical, as patient perspectives can reveal gaps in care delivery, particularly in a multiethnic population where cultural, social and systemic factors…
Introduction Very preterm infants (<32 weeks gestation) have an undeveloped primary endogenous circadian rhythm and are deprived abruptly of vital maternal circadian inputs after delivery. Postnatal care in neonatal intensive care units is characterised by constant levels of lighting and noise. Stress arising from disrupted cues for circadian rhythmicity likely disrupts development of coordinated circadian rhythms critical for neurogenesis, organ growth and development. We hypothesise that cycled environmental light and noise commenced soon after birth and continued until discharge home will…
Objectives To examine the link between urinary incontinence (UI) and physical activity participation in women. Little research has explored this relationship, despite the long-term effects of reduced physical activity on women’s health and well-being. Design A cross-sectional survey was conducted using self-reported data collected through social media and university channels. Participants Adults aged 18 years or older identifying as women, including transgender women who had undergone gender-affirming vaginoplasty and people assigned female at birth. In total, 413 individuals completed the…
Introduction Healthcare systems increasingly screen for social needs, yet referrals often fail to connect patients with services—particularly in emergency department (ED) settings where unmet social needs are common. Our research highlights critical barriers to service connection, including unstable access to cellphones, limited internet and low digital literacy. These challenges disproportionately affect socio-economically disadvantaged groups and are associated with poorer health outcomes and more frequent ED visits. With the recognition of information and communication technology (ICT)…
Introduction Approximately 15 million people in the UK live with obesity and at least 5 million of these are people with severe obesity (PWSO). Severe obesity significantly compromises health, well-being and quality of life and reduces life expectancy. These adverse outcomes are prevented or ameliorated by weight loss, for which sustained behavioural change is the cornerstone of treatment. Several studies suggest the potential of group-based intervention in Specialist Weight Management Services (SWMS), but PWSO remain underrepresented in research, and evidence on optimal design and outcomes is…
This cross-sectional study uses electronic health record data to assess the association of documented postpartum in-hospital breastfeeding care with exclusive breastfeeding and to test differences in care by feeding intention and demographic and clinical characteristics.
This case-crossover study examines the association of exposure to fine particulate matter (PM2.5) from wildfires with emergency department (ED) visits for migraine and other primary headache syndromes in 2 provinces in Canada.
This cohort study estimates the rate of automated external defibrillator (AED) use prior to emergency medical service (EMS) arrival in pediatric out-of-hospital cardiac arrest (OHCA) and assesses whether AED use is associated with neurological outcomes in this population.
This survey study describes the intentions, behaviors, and preferences regarding maternal vaccination during pregnancy or respiratory syncytial virus antibody shot administration for infants after birth among pregnant women and parents of children younger than 5 years.
This cohort study examines whether the Tigray War was associated with HIV diagnosis, linkage to care, and provision of antiretroviral therapy in Mekelle City, Ethiopia.
This comparative effectiveness study evaluates the association between glucagon-like peptide-1 receptor agonist (GLP-1 RA) initiation and 3-year fragility fracture risk among adults with type 2 diabetes.
Objectives Consent processes for adolescent vaccination in Canada have been identified as potential barriers to vaccine uptake. This study examined current practices for obtaining consent for adolescent vaccines across Canadian jurisdictions to better understand the variation, complexity and opportunities for improvement. Design An environmental scan. Setting The study was conducted between 25 March 2025 and 27 February 2026, across public health systems in Canada. Data were drawn from relevant written documents and from key informants (KIs) representing public health, vaccine administration…
Introduction Liver resection is a technically demanding procedure due to the complex and highly variable anatomy of the liver. Conventional preoperative planning relies on two-dimensional imaging, which requires mental reconstruction of three-dimensional anatomical relationships and may increase cognitive workload and intraoperative decision-making time. Patient-specific three-dimensional (3D) liver mapping has been shown to improve anatomical understanding and planning accuracy; however its impact on intraoperative efficiency has not been adequately investigated. Methods and analysis This is…
Introduction Up to 40% of women with breast cancer will require a mastectomy, and breast reconstruction is routinely offered to restore symmetry. While not all women want, or are suitable for, breast reconstruction, many want to be symmetrical following breast cancer surgery. For these women, contralateral mastectomy for ‘flat symmetry’ is a good alternative, but in the UK, access to contralateral ‘symmetrising’ mastectomy (CSM) is highly variable. Many women seeking this option describe feeling frustrated, unsupported and having to ‘fight’ to access care, while clinicians express concerns…
Background Short peripheral catheters (SPCs) are the most frequently used vascular access devices in neonates but are associated with complications and limited dwell times. International guidelines recommend using the smallest appropriate catheter gauge, yet 24G SPCs remain the default choice in many neonatal intensive care units (NICUs) while 26G SPCs are less often used because of concerns about flow adequacy particularly during blood transfusions. Evidence directly comparing these gauges in neonates is limited. Methods We conducted a retrospective cohort study in a tertiary NICU and…
Objective To determine the pattern and determinants of exclusive breastfeeding (EBF) among infants visiting a tertiary care hospital of underprivileged population. Design Cross-sectional study. Study The Department of Pediatrics, Pakistan Railway Hospital, Rawalpindi, Pakistan. Methods A total of 385 infants, born with gestational age between 34–42 weeks, were analysed. Data collection was performed through a structured questionnaire designed to capture relevant demographic and clinical details. The pattern of breastfeeding (BF), including EBF, formula milk, animal milk (cow/buffalo/goat milk)…