Introduction Despite progress in primary care, access to oral health remains limited in India. Integrating oral health into primary care can improve oral health outcomes for communities, especially in rural areas. This study aims to develop an implementation model for integrating dental healthcare into primary healthcare systems in Chamarajanagar and Mysuru districts of Karnataka. Methods and analysis A mixed-methods implementation research approach will be adopted for this study, comprising three phases: formative, pilot and implementation and evaluation. A mixed-methods study at the district…
This cohort study examines emergency department visits and hospitalizations for cold-related illness among older adults experiencing homelessness compared with socioeconomically disadvantaged adults with housing in Ontario, Canada.
This secondary analysis of the 4 Intelligent Stewardship Prompts to Improve Real-Time Empiric Antibiotic Selection (INSPRE) cluster randomized clinical trials evaluates the association of computerized provider order entry prompts with clinicians’ antibiotic prescribing for patients with cancer who were hospitalized for infection.
This analysis of secondary outcomes of a randomized clinical trial investigates whether the provision of mass administration of azithromycin for infants aged 1 to 11 months improves growth outcomes.
This case-control study evaluates the association between current season influenza vaccination and laboratory-confirmed influenza virus infection and, among persons with laboratory-confirmed influenza, the association with influenza-associated death.
by Luigi Russo, Erika Giacobini, Nicolò Lentini, Tommaso Osti, Maud Kamal, Stefania Boccia, Roberta Pastorino Background Molecular Tumor Boards (MTBs) bring together multidisciplinary experts to translate genomic data into clinical decisions in oncology, however, their overall clinical impact remains unclear. The aim of this systematic review is to assess the clinical impact of MTB-recommended therapies on patients with cancer outcomes. Methods and findings In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and CENTRAL up to July 2025. We included studies of any…
by Patrick Staunton, Mohammad Adib Makrooni, Master Chisale, Billy Nyambolo, Joseph Wu, Damien McCarthy, Mark Ledwidge, Yasir Bin Nisar, Chris Watson, Balwani Mbakaya, Cathal Seoighe, Joe Gallagher Background Globally, pneumonia remains the single biggest cause of mortality in children under 5 years of age. This study sought to train and test a prediction model for hospitalisation within 7 days after initial presentation in 2- to 59-month-old Malawian children with WHO-defined pneumonia in primary care and compare its performance to existing risk prediction models. Methods and findings BIOTOPE…
Background and aim This observational study aims to provide an overview of consultation-liaison psychiatry (CLP) activity within the high-intensity, complex hospital setting of the ‘Azienda Ospedaliera Universitaria Città della Salute e della Scienza’ in Turin. The study is mainly focused on delirium-related features and predictive factors of clinical outcome. Method A retrospective analysis was conducted on 500 psychiatric consultations provided by the University Facility of Psychiatry. Additional analysis was performed in a subgroup of patients with a diagnosis of delirium (143 subjects)…
Introduction School-aged children frequently experience psychological distress due to academic pressures, a challenge that is often more severe for those from underserved and minority communities. This study aims to evaluate the effectiveness of mental health interventions implemented in school and community settings for children aged 5 to 19. It also seeks to compare the outcomes between children from minority and underserved populations and their peers. Methods and analysis This systematic review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)…
Introduction Approximately 40% of women stop endocrine therapy for hormone-receptor-positive breast cancer within the first 5 years of prescribed treatment because of side effects. Musculoskeletal complaints are among the most frequently reported side effects. The Cancer Of the BReast Asanas (COBRA) study examines the effect of an 18-week yoga programme on endocrine therapy-associated musculoskeletal complaints in women with breast cancer. Methods and analysis In total, 140 women will be randomised in a 1:1 ratio to the intervention or waitlist control group. The intervention programme…
Introduction Treatment options remain limited for patients with advanced hepatocellular carcinoma (HCC) who experience oligoprogression during first-line systemic therapy (FLST), especially given the modest efficacy and restricted availability of second-line systemic therapy (SLST). This trial aims to evaluate whether continuing FLST combined with radiotherapy (RT) to oligoprogressive lesions can improve progression-free survival (PFS) compared with an early switch to SLST in patients with oligoprogressive HCC while maintaining an acceptable safety profile. Methods and analysis The…
Introduction South African women are vulnerable to HIV acquisition during the postpartum period which can result in perinatal transmission via breastfeeding; many male partners do not know their HIV status. Biomedical approaches to preventing HIV for postpartum women include pre-exposure prophylaxis (PrEP) and antiretroviral treatment for male partners with HIV. Gaps in implementation include low uptake of PrEP among postpartum women and infrequent testing of men who may be motivated to test for HIV to protect the health of their infant. Methods and analysis We will conduct a randomised pilot…
Objectives To quantify sex- and age-related differences in hypercholesterolaemia diagnosis and associated comorbidities around the menopausal transition, using a population-based real-world dataset. Design Retrospective, multicentre, non-interventional observational cohort study. Setting Region-wide public healthcare system data (primary and secondary care) from Andalusia (Spain), 2016–2022. Participants All adult patients meeting inclusion criteria with a recorded diagnosis of hypercholesterolaemia between 1 January 2016 and 31 December 2022 (n=557 034; 227 834 men and 329 200 women)…
Introduction Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects around 35%–50% of men during their lifetime. The efficacy of current oral medication for CP/CPPS remains limited. Recent studies demonstrated that vagus nerve stimulation may improve chronic pelvic and abdominal pain. Accordingly, transcutaneous auricular vagus nerve stimulation (taVNS) might represent a promising, non-invasive therapeutic approach for the clinical management of CP/CPPS. Methods and analysis The trial of Transcutaneous Auricular vagus nerve Stimulation for moderate to severe Chronic…
Objective Referrals to speech and language pathology are infrequent for people with Parkinson’s disease (PD), despite speech and communication being often affected and greatly impacting their quality of life. This study investigated the knowledge, self-competence and challenges faced by speech and language pathologists (SLPs) in Malaysia when managing PD cases. Design Participants self-administered an online-survey in a cross-sectional study design. The survey consisted of 14 questions on current practices of SLPs with their patients with PD, self-perceived competence when assessing and…
Purpose Intimate partner violence (IPV) is a major public health concern in Bangladesh, where approximately two-thirds of women report experiencing partner violence and over half of young men admit to perpetrating it. While adverse childhood experiences (ACEs) are among the strongest predictors of IPV, existing research has relied on cumulative ACE scores, overlooking how distinct dimensions of childhood adversity may differentially predict violence. This study examines the relationship between two dimensions of ACEs, threat (eg, exposure to violence) and deprivation (eg, lack of emotional or…
Background Hepatitis, a disease characterised by inflammation of the liver, is a leading global health challenge that contributes to over 1.3 million deaths annually, with hepatitis B and C accounting for many of these fatalities. Intensive care unit (ICU) management of patients is particularly challenging due to the complex clinical care and resource demands. Despite advancements in ICU predictive analytics, limited research has specifically addressed hepatitis patients, creating a gap in optimising care for this population. Methods This study focuses on predicting ICU length of stay (LoS)…
Introduction Hypertension is the leading global risk factor for mortality, causing over 10 million deaths annually. In sub-Saharan Africa, hypertension prevalence is high, particularly in rural areas, where it is less likely to be diagnosed, treated or controlled effectively. This results in a high burden of complications, including heart failure, stroke and kidney disease. Community-centred approaches using community health workers (CHWs), risk-based approaches and simplified treatment regimens have shown promise in improving hypertension management. However, there is limited evidence on the…
Objectives The study aims to estimate the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in the Greater Kasai region of the Democratic Republic of the Congo (DRC) and to examine how demographic and socio-economic factors, such as displacement status and livelihood conditions, are associated with these mental health outcomes. Design A cross-sectional two-stage multi-cluster sampling survey. Setting In 2016–2019, a violent conflict in the Greater Kasai region of the DRC led to widespread atrocities and massive displacement. The population not only has to cope with…
Objectives This study aimed to describe the factors influencing mental health and wellbeing from the perspective of Moroccan youth. Design This is a descriptive cross-sectional survey. Setting All 12 regions in Morocco. Main outcome measures Perceived priority drivers of mental health and well-being among youth. Results A total of 1182 participants were included (mean age 20.5 years, 68.2% female, 85.7% from urban settings). Regarding health and nutrition, 46.3% valued sleep, 59.7% emphasised physical health, 53.1% highlighted access to quality healthcare and 56.5% prioritised clean air. In…