Background Despite Australia’s universal health insurance scheme, Medicare, out-of-pocket costs (OOPC) for health care comprises 14 % of total health expenditure. People with chronic conditions spend a greater proportion of their incomes on health care than people without a chronic condition. Objective To review the qualitative literature examining experiences of OOPC of out-of-hospital care by people with chronic conditions and to discuss this in relation to current Australian health policy. Methods Systematic review and narrative synthesis of the qualitative literature examining OOPC for people with chronic conditions in Australia. Search: Pubmed, CINAHL Complete, Cochrane Library, PsycINFO and EconLit databases from 1999 to 10th April 2025. Results 37 studies met the inclusion criteria. Reduced or lost employment due to ill-health led to income loss, aggravating the financial burden of health management. While many people were able to access bulk-billing general practitioners, challenges in affording upfront and copayments for medical and allied health consultations, and medication costs were reported. Cost was the greatest barrier to accessing dental care. Trade-offs were described between health management and meeting basic living needs, particularly for people who earned too much to qualify for government welfare payments. Conclusion While Australian health policies effectively reduce the financial burden of health care for many people, distinct challenges exist for groups ineligible for concessional thresholds. Future research to identify the priorities and preferences of people with chronic conditions can further inform policy to improve the equity of health financing in Australia.

Objective: This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Data sources: We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature. Eligibility criteria for study selection: We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention. Methods: Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention. Conclusion: Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well. Prospero registration number: PROSPERO (CRD42021296618).

Objective: This study evaluated the effectiveness of health literacy interventions aimed at reducing sugar and sugar-sweetened beverage (SSB) intake among Asian populations and identified the common characteristics of effective interventions through a systematic review of randomised and non-randomised studies. Study design: Systematic review of randomised and non-randomised trials. Methods: A systematic search of five databases identified randomised and non-randomised studies on health literacy interventions aimed at reducing sugar and SSB intake among Asian populations. Screening followed predefined criteria, and data extraction captured the intervention type, delivery, duration, and outcomes. Quality was assessed using the Cochrane Risk of Bias-2 and ROBINS-I tools for bias, and the findings were synthesised to identify effective intervention traits and research gaps. Results: Of the eight included studies, three were face-to-face educational, one behavioural, one online, one mobile text messaging, and two front-of-pack (FOP) labelling interventions. Six out of eight studies measured sugar intake, with four assessing SSB intake. Seven studies reported significant dietary improvements. Overall, bias risk was present, with three rated high. Significant inconsistencies in the two studies were further explored. Conclusion: The effectiveness of health literacy interventions in reducing sugar or sugar-sweetened beverage intake was positive, particularly for face-to-face interventions and FOP labels. Available evidence may inform policymaking for the implementation of health promotion for disease prevention and complement standards of care practices for disease management.

Low birth weight (LBW) is one of the major causes of neonatal mortality and morbidity in low and middle-income countries (LMICs). Despite the goal of reducing newborn morbidity and mortality by 2030, low-income countries, including Ethiopia, still confront major challenges. Although various systematic reviews and meta-analyses (SRMA) have been conducted on LBW in Ethiopia, there is notable variation among their findings. This umbrella review aimed to consolidate inconsistent findings into a single summary estimate, providing a robust synthesis of evidence from systematic reviews and meta-analyses to bolster health policy development and planning in Ethiopia.Articles were retrieved on PubMed/Medline, Science Direct, Web of Science, HINARI, and Google Scholar. Assessments of Multiple Systematic Reviews checklist scores were used to assess the quality of the included SRMA studies. A random-effects model was used to estimate the overall effect size.A total of eleven SRMA studies (5 prevalence and 6 predictors) involving 190,492 neonates with an outcome of interest were included in the analysis. The summary estimate for the prevalence of LBW was 16% (95% CI: 13, 18%). Being prematurity [POR: 7.86; 95% CI: 5.79, 10.67], not attending antenatal care (ANC) [POR: 2.4, 95% CI: 1.49, 3.88], having pregnancy-induced hypertension (PIH) [POR: 4.2; 95% CI: 2.78, 6.36], being a rural resident [POR: 2.14, 95% CI: 1.56, 2.94], having a pregnancy interval < 24 months [POR: 2.96; 95% CI: 1.79, 4.9], not having iron-folic acid supplementation (IFAS) [POR: 0.38; 95% CI: 0.29, 0.5], and being a maternal age < 20 [POR: 2.02, 95% CI: 1.41, 2.9] were significantly associated with LBW. This umbrella review revealed more than three out of twenty neonates experienced LBW in Ethiopia. Being premature, not attending antenatal care, having pregnancy-induced hypertension, being a rural resident, having a pregnancy interval < 24 months, not having iron-folic acid supplementation and being a maternal age < 20 were significant predictors of LBW. Therefore, timely diagnosis, proper treatment, and follow-up of women at risk might combat the incidence of LBW in Ethiopia.

Background: The oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success. Aim: The aim of this systematic review is to analyse the health promotion strategies used in oral health promotion interventions in RACF settings and map the behaviour change techniques (BCTs) used in interventions to the Behaviour Change Techniques Taxonomy Version 1 (BCTTV1). This will help us identify the BCTs that are used and how effective they are in improving oral health outcomes for residents and the knowledge, attitudes and skills of caregivers in providing mouth care assistance to residents of RACFs. Methods: A database search was conducted in MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), EMBASE, PsycINFO, CINAHL and Web of Sciences databases to screen for articles relevant to the topic of the review; after full-text review a total of 31 articles comprising both randomised controlled trials and non-randomised intervention studies were included in this review. Risks of bias in randomised studies were assessed using the ROB2 tool and ROBINS-I was used to evaluate non-randomised studies. The description of intervention content in each study was coded for the presence of BCTs by two independent review authors trained in coding BCTs according to BCTTv1. Results: The most commonly used BCTs were 'demonstration of behaviour', 'instruction on how to perform behaviour' and 'credible source'. These BCTs were effective in improving oral health outcomes and knowledge of caregivers on short-term follow-up. A higher number of BCTs were coded in studies that showed significant improvement in oral health outcomes of residents on long-term follow-up with rarely used BCTs related to 'monitoring and feedback' being coded in majority of studies that showed consistent improvement in oral health outcomes of residents. Conclusion: This review identified the most commonly used BCTs used in health promotion interventions to improve oral health among older people in RACFs and found that majority of interventions were targeted towards 'knowledge transfer' and were inconsistent in improving oral health outcomes for residents over long-term. Well conducted studies with use of theoretical behaviour change frameworks to develop oral health promotion interventions are needed as majority of strategies used currently do not demonstrate consistent effectiveness in improving oral health outcomes for residents of RACFs.

Individuals born with Trisomy 21 may be more susceptible to experiencing nutrition-related conditions and diseases throughout their lifespan. Seven studies conducted outside of Canada that investigated the impact of nutrition interventions in individuals of different ages (mostly children and youth) born with Trisomy 21 reported mixed results. Furthermore, Canadian clinical nutrition practice guidelines for the provision of care to individuals born with Trisomy 21 tend to be general in nature and may be based on a body of evidence that was not representative of this population. There is a need for well-designed inclusive nutrition research studies to determine the nutritional needs of individuals born with Trisomy 21 and to better understand how to provide person-centred nutrition and healthcare services that achieve nutrition and health equity for these individuals and improve their overall nutritional status and health.

Background: Mobile health (mHealth) interventions promoting healthy lifestyle changes offer an adaptable and inexpensive method for accessing health information but require cultural appropriateness and suitability for acceptance and effectiveness in Indigenous populations. No systematic review on effective mHealth interventions for Indigenous women during pregnancy and the early childhood years has been conducted. Objective: This review evaluated the effectiveness of mHealth interventions promoting healthy behaviors for Indigenous mothers and children from conception to 5 years post partum. It also aimed to explore the observed effectiveness differences based on participant engagement, intervention design, and provision of context. Further, the review explored if the interventions were co-designed. Methods: A systematic search of 5 databases was conducted: SCOPUS, MEDLINE, CINAHL, PsycINFO, and ProQuest (Dissertation or Thesis). Studies were included if they were either a randomized controlled trial, pre-post comparison, or a cohort study using mHealth with Indigenous women for maternal and child health following a preregistered PROSPERO protocol (CRD42023395710). HealthInfoNet was searched for gray literature and the reference lists of included studies were hand searched. The initial title and abstract screen for eligibility were performed by 1 reviewer. A full-text screen of eligible studies and a quality appraisal of included studies was performed by 2 reviewers independently. The appraisal tools used were the Mixed Methods Quality Appraisal Tool and the Centre of Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE). A descriptive synthesis of the extracted data was performed. Results: Of the 663 articles screened, only 3 met the eligibility criteria. Each paper evaluated a different mHealth intervention: Remote Prenatal Education; the SMS Parent Action Intervention (two-way text messaging); and the Screening, Brief Intervention and Referral to Treatment (SBIRT) eCHECKUP To Go (web-based screening and intervention). Statistically significant changes were reported in some outcomes, including an increase in the parental participation rate in face-to-face prenatal education; increased rate of breastfeeding initiation and exclusive breastfeeding (2-12 months); improved overall children's behavior related to sleep, diet, physical activity, screen time, and intake of sugary beverages; improved individual children's behavior related to physical activity and sleep; and decrease in alcohol drinks per week and binge drinking episodes per 2 weeks due to time effect. However, no study provided a sample size calculation for the reported significant outcomes. Also, due to the small number of included studies and each study evaluating a different intervention, it was not possible to combine results to ascertain if the participant engagement, intervention design, or community context had any impact on the effectiveness. Conclusions: Due to the lack of sample size calculation, it was not possible to establish whether differences in the effectiveness were due to the interventions or a type I statistical error. Therefore, caution is required in the interpretation of these findings. Trial registration: PROSPERO CRD42023395710; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023395710.

Objective: The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges. Methods: A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated. Results: Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205-1.595, I2 = 58.9%, p = 0.002). The subgroup analysis showed that "emergency department type" (p = 0.004) and "mean age of the sample" were the sources of the RR values' heterogeneity (p = 0.026). Conclusions: Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations. The prospero registration: This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.

Objective: The objective of this review is to assess and synthesize the available qualitative evidence on health professionals' experiences in screening for postpartum depression (PPD). Introduction: PPD is a significant public health problem. Clinical screening is essential to develop appropriate interventions to meet the needs of women and their families. The findings of this review have important implications for decision-making and policy development for continuous professional development programs that promote evidence-based PPD screening. Inclusion criteria: This review considered studies that explore the experiences of health professionals who screen for PPD in any geographic location at any health care facility, scenario, or setting. The review focused on qualitative data, including methods such as phenomenology, grounded theory, ethnography, action research, and feminist research. Methods: The review followed a 3-step search strategy in line with JBI methodology for systematic reviews of qualitative evidence. The databases searched included PubMed, CINAHL (EBSCOhost), Embase (Elsevier), Scopus, LILACS (BVS), ScienceDirect (Elsevier), PsycINFO (Ovid), Index Psi Journals (BVS-PSI), and PePsic (IPUSP). Unpublished studies were searched for in Google Scholar, Cybertesis, Dart-E, EthOS, and Open Access Theses and Dissertations (OATD). Two independent reviewers evaluated the included studies for methodological quality and extracted data using the JBI data extraction and synthesis tools. Studies published in English, Portuguese, and Spanish from database inception until October 2023 were included. Results: Twenty-four qualitative studies from 14 countries across 5 continents involving 392 health professionals were included. A total of 113 findings were extracted and grouped into 5 categories: i) education and training; ii) responsibility of PPD screening, referral, and follow-up: role of the job and work overload; iii) screening, referral, and follow-up; iv) disclosure, judgment, culture; v) and health system structure. Two synthesized findings evolved from these categories: i) The need for training and ongoing education, professional role, professional practice, and ways of caring in screening postpartum women for depressive symptoms; ii) External barriers, facilitating factors, and health system issues. Conclusions: Health professionals' experiences caring for women and families concerning PPD are influenced by their culture, practices, training, and worldview. Regular workshops and practical training sessions that emphasize the development of PPD-screening skills, particularly in recognizing subtle signs of depression and conducting culturally sensitive assessments, could be highly effective for health professionals. Policymakers should collaborate with health care professionals to develop and implement policies tailored to different contexts and cultures. Providing educational subsidies and ensuring monitoring and follow-up after PPD screening are fundamental for the sustainability of PPD screening and management.

The global rise in pharmaceutical production and consumption has led to an increase in pharmaceutical waste, posing significant risks to both public health and the environment. Improper disposal methods contribute to environmental degradation, including disruptions to aquatic ecosystems and the spread of antimicrobial resistance. Despite these growing concerns, a comprehensive review of pharmaceutical waste management and disposal practices is still lacking. To address this gap, a scoping review was conducted, analyzing 4269 records from three databases (Medline OVID, Web of Science, and Embase) and grey literature, with 67 studies ultimately included. The initial records were identified through a comprehensive search across the aforementioned databases using a structured strategy based on three core concepts: medication waste, disposal methods, and environmental or human health impacts. This was followed by a two-stage screening process guided by the PCC framework and predefined inclusion criteria. The review aims to assess disposal practices and their impacts, identify research gaps, and guide future research toward effective strategies for managing pharmaceutical waste while protecting ecological balance and public health. The publications timeline shows increasing interest in the topic, particularly with a surge in studies during 2022 and 2023. The findings reveal a significant regulatory gap, especially in the Global South, where limited infrastructure and public awareness lead to reliance on household waste disposal. In contrast, medication take-back programs are more common in the Global North. This disparity underscores the urgent need for policy development. Addressing pharmaceutical waste effectively requires coordinated efforts from the pharmaceutical industry, healthcare providers, regulatory bodies, and local communities. Key strategies should include regulatory action, public education, technological innovation, and addressing issues like drug misuse and overconsumption, particularly of antibiotics, which contribute to antimicrobial resistance. A holistic approach is essential to mitigate both environmental and public health risks.

Background: Cancer is a growing public health concern in Africa and Asia, where access to effective healthcare and resources is often limited. There is an urgent need for evidence-based cancer control policies in Africa and Asia, along with systems for prevention, early detection, diagnosis and treatment, and palliative care. This emerging issue has garnered growing interest from international institutions but there has been little visible action, and the existing knowledge remains scattered and fragmented. This scoping review aims to explore the breadth and scope of evidence regarding knowledge transfer interventions to enhance cancer care in Africa and Asia. Methods: We conducted a systematic search of Embase, Emcare, ERIC, APA PsycInfo, Medline, and Google Scholar, supplemented by expert bibliographies and references. Peer-reviewed empirical studies in English or French from January 1978 to September 2024 were included. Data were organised using the AIMD (Aims, Ingredients, Mechanism & Delivery) framework. Study quality was presented using the Mixed Methods Appraisal Tool. Results: The scoping review examined seven articles providing evidence on five unique interventions. The interventions included target both decision-makers and health professionals and aim to strengthen evidence-based cancer control policies and implementation strategies. The interventions documented have all been initiated by external actors, mainly international institutions or researchers from high-income countries, in collaboration with African and Asian stakeholders. In addition, some researchers have been involved in participatory research projects designed to enable decision-makers to implement evidence-based cancer control policies and programmes. Conclusions: This scoping review highlights a critical lack of evidence on knowledge transfer interventions in cancer care across Africa and Asia, partly due to limited funding for non-communicable diseases. It calls for the integration of knowledge transfer components into all cancer research and interventions, supported by robust evaluation strategies, to develop evidence-based, economically feasible, and culturally appropriate policies, guidelines and interventions that can be used in nations with limited healthcare resources to improve cancer outcomes.

Aims: The World Health Organization (WHO) Health Emergency Programme funded three systematic reviews to inform development of guidance for emergency preparedness in health emergencies. The current review investigated the type of learning interventions that have been developed and used during health emergencies, and how they were developed. Methods: We searched PubMed, CINAHL, Communication and Mass Media Complete (EBSCO), and Web of Science. Study quality was appraised by WHO-recommended method-specific checklists. Findings were extracted using a narrative summary approach. Results: 187 studies were included. Studies were split between online, in-person, and hybrid modalities, conducted mostly by hospitals and universities, and most frequently training nurses and doctors. Studies emphasized experiential learning to develop and reinforce skills; online learning for knowledge dissemination; multi-sectoral partnerships, institutional support and carefully constructed planning task forces, rapid training development and dissemination, and use of training models. Conclusion: It Most studies evaluated only knowledge or self-confidence of trainees. Relatively few assessed skills; evaluations of long-term outcomes were rare. Little evidence is available about comparative effectiveness of different approaches, or optimum frequency and length of training programming. Based on principles induced, six recommendations for future JIT training are presented.

目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南，系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析，内容涵盖身体活动或运动干预对6～18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估，对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析，涉及24 567例儿童和青少年，其中6篇为高质量，2篇为中等质量。在身体健康方面，结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率，且能提升心肺耐力和肌肉力量。在心理健康方面，身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...

目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南，系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析，内容涵盖身体活动或运动干预对6～18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估，对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析，涉及24 567例儿童和青少年，其中6篇为高质量，2篇为中等质量。在身体健康方面，结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率，且能提升心肺耐力和肌肉力量。在心理健康方面，身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...

Background: Understanding the effects of climate change on health outcomes is crucial for effective policy formulation and intervention strategies. However, in Low- and Middle-Income Countries, like Bangladesh, the true extent of these effects remains unexplored due to data scarcity. This study aims to assess available evidence on climate change-related health outcomes in Bangladesh, to compare it with actual national occurrences, and to explore challenges related to climate change and health data. Methods: We first conducted a systematic review to summarize the climate-sensitive diseases examined in existing literature in Bangladesh. The review results were then compared with over 2.8 million samples from the government's data repository, representing reported cases of climate-sensitive diseases during 2017-2022. This comparison aimed to identify discrepancies between the diseases currently occurring in Bangladesh related to climate change and available knowledge through existing research. Additionally, we also explored the limitations of the data recorded in the government data repository. Results: The available literature in Bangladesh reports only a few specific climate-sensitive diseases, including Diarrhea, Dengue, Cholera, Malaria, Pneumonia, Cardiovascular Diseases, Hypertension, Urinary-Tract Infections, and Malnutrition, which were also considered in few studies. This represents a segment of the total 510 reported climate-sensitive diseases in Bangladesh, of which 143 diseases were responsible for 90.66% of the total occurrences. The most common forms of diseases were diarrhea and gastroenteritis of presumed infectious (28.51%), pneumonia (18.88%), anxiety disorders, panic disorders, generalized anxiety disorders (13.2%), and others (13.15%). Additionally, Urinary-Tract infections (7.87%), cholera (3.03%), and typhoid fever (3.27%) were other frequently reported climate-sensitive diseases. We also explored several challenges related to available data in the government repository, which include inadequate collection of patients' comprehensive socio-demographic information and the absence of a unique patient identifier. Conclusion: The findings underscore the urgent need to tackle data challenges in understanding climate-sensitive diseases in Bangladesh. Policies and programs are required to prioritize the digitalization of the healthcare system and implement a unique patient identification number to facilitate accurate tracking and analysis of health data. Climate Change, including rising temperature and extreme weather events like cyclone and floods, poses a significant global health threat [1]. The World Health Organization estimates climate change already causes at least 150,000 deaths annually at the global level, and that number is projected to double by 2030. Beside these other impact of climate change are far-reaching, leading to forced displacement, malnutrition and increased incidence of diseases such as dengue, diarrhea, and pneumonia [2]. Additionally, climate change has established links to mental health issues, like anxiety and depression [3]. The effects are particularly severe in Low- and Middle-Income Countries (LMICs) due to limited resources and inadequate infrastructure for coping with erratic weather and disasters [4]. We undertook a comprehensive mixed-method study, incorporating a systematic review of existing studies conducted in Bangladesh, along with an analysis of government data repository. A detailed description of each component is presented below.

目的 系统评价基于格林模式的健康教育对脑卒中患者的干预效果。方法 计算机检索PubMed、Embase、Cochrane library、Web of Science、中国知网、维普数据库、万方数据库和中国生物医学文献数据库，检索格林模式健康教育对脑卒中患者干预效果影响的随机对照试验，时限为建库～2023年11月20日。由2名研究者独立筛选文献、资料提取和文献质量评价。采用RevMan 5.4软件进行Meta分析。结果 共纳入11篇文献，包括982例患者。Meta分析结果显示，与传统健康教育相比，格林模式的健康教育能有效改善脑卒中患者的整体健康行为水平（自我实现、健康责任、锻炼依从性、营养、人际关系、压力应对）、肢体运动功能、神经功能和自我感受负担。但在提升脑卒中患者日常生活能力方面，两组间未见显著差异。此外，根据亚组分析结果显示，干预时间≥6个月时，试验组锻炼依从性与对照组之间比较无明显差异[SMD=1.590,95%CI(-0.380,3.570),P=0.110]。结论 格林模式的健康教育有助于改善脑卒中患者整体健康行为水平，促进患者身体功能恢复和提升其生活质量。

Background: Health Impact Assessment (HIA) procedures can include the assessment of inequalities and inequities associated with the distribution of environmental health risks and benefits, aimed at attenuating the exacerbation of environmental health disparities. This systematic review, conducted as part of the Joint Action Prevent Non-Communicable Diseases initiative, explores methods for assessing health inequalities and equity within HIA frameworks, particularly in local projects affecting the distribution of environmental risks and benefits. Methods: Adhering to the PRISMA guidelines, a systematic review of the scientific literature was conducted using the MEDLINE/PubMed, Scopus, and Embase databases, searching until March 8, 2024. Furthermore, a grey literature analysis encompassed the Institutional Repository for Information Sharing (IRIS) of the World Health Organization, to identify guidelines and recommendations addressing equity considerations in HIAs. Studies were included based on predefined eligibility criteria if they explored issues related to inequalities, inequities, and vulnerabilities within the context of HIAs. Data extraction focused on methodologies that incorporated equity considerations within the HIA framework, particularly concerning local urban planning initiatives, transport infrastructure, and industrial settings. Results: A total of 33 studies met the inclusion criteria. Among these, eight documents from the grey literature, identified as guidelines and guidance, underscored the importance of prioritizing equity to ensure that health impacts are addressed fairly across diverse population groups. The remaining 25 peer-reviewed studies employed a combination of quantitative and qualitative methodologies. Quantitative approaches, including exposure-response modeling and Geographic Information System (GIS) mapping, were utilized to evaluate spatial and demographic health disparities. Qualitative methods, such as focus groups, interviews, and participatory tools, provided insights into the lived experiences of vulnerable populations affected by local interventions. Studies addressing urban and transportation planning predominantly emphasized socioeconomic stratification, whereas those focused on industrial settings highlighted occupational hazards and community vulnerabilities. Conclusion: This review highlights the diverse and fragmented approaches used to address health inequalities and equity in HIA. It underscores the need for interdisciplinary and systematic methodologies that integrate quantitative and qualitative perspectives, ensuring equity remains a central consideration in policymaking and project implementation. Finally, it proposes a practical framework for integrating equity into HIA.

目的 检索汇总并评价成人代谢相关脂肪性肝病（metabolic dysfunction-associated fatty liver disease,MAFLD）营养管理的相关最佳证据，为临床实践提供参考。方法 依据“6S”模型自上而下系统检索美国国家指南库，英国国家卫生与临床优化研究所网站，国际指南协作网，医脉通；美国肝病研究学会，欧洲肝病研究协会，亚太肝病学会，美国临床内分泌学会，意大利肝病协会，欧洲临床营养与代谢学会，美国肠外肠内营养学会，BMJ Best Practice,UpToDate，乔安娜·布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库，PubMed,Cochrane Library,Web of Science,Embase,CINAHL，中国知网，维普，万方，中国生物医学文献服务系统。文献包括成人MAFLD营养管理相关指南、推荐实践、专家共识、系统评价、证据总结。检索时限为建库至2024年3月1日。由2名研究者独立进行文献质量评价和资料提取，并形成最佳证据。结果 共纳入文献24篇，从评估与目标、膳食模式、饮食结构、膳食...

Background: Sexual and reproductive health (SRH) programmes and services aim to prevent complications of pregnancy and childbirth, unintended pregnancies, unsafe abortions, complications caused by sexually transmitted infections, including HIV, sexual violence and impacts from avoidable cancer. Objective: To systematically identify published economic evaluations of SRH programmes and services, assess the methods used and analyse how costs and outcomes are estimated in these studies. Settings: Low- and middle-income countries. Design: Systematic review and narrative synthesis. Methods: Eight databases were searched, including EMBASE, MEDLINE, Scopus, Health Technology Assessment, Web of Science, PsycINFO, National Health Service Economic Evaluation Database (NHS EED) and African Journals Online (AJOL) from 1998 to December 2023. The inclusion and exclusion criteria were developed using the Population, Intervention, Comparator, Outcome and Study Design framework. The review included economic evaluations alongside randomised trials and economic studies with modelling components. Study characteristics, methods and results of economic evaluations were extracted and tabulated. The quality of the studies was assessed using the Consensus Health Economic Criteria list and Philips checklists for trial-based and model-based studies, respectively. The review followed the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the results were synthesised narratively in line with Centre for Reviews and Dissemination guidance. Results: 7575 studies were screened and categorised. 20 studies were included in the review. The studies assessed the cost-effectiveness and costs of SRH programmes and services from an individual, healthcare or societal perspective. The main SRH programme considered was contraceptive services. The main outcome measures reported were disability-adjusted life years, quality-adjusted life years, couple years of protection and pregnancies averted. Most of the studies did not indicate the costing approach used, and many of the studies evaluated direct medical costs only. Most of the study designs were model-based with significant heterogeneity between the models. The review showed that many studies did not fulfil all of the requirements for a high-quality economic evaluation. 1 out of the 20 studies reviewed considered equity. Conclusions: The review revealed heterogeneity in approaches to evaluating the costs and outcomes of SRH programmes. These methodological limitations may have implications for their use by public health decision-makers to inform optimal decision-making. Prospero registration number: CRD42023435241.

目的：检索、评价并总结终末期肝病病人营养管理的最佳证据，为临床应用提供参考。方法：根据“6S”证据模型，自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价，并根据主题提取和汇总证据。结果：共纳入文献23篇，包括指南及专家共识5篇、系统评价及Meta分析6篇，随机对照试验12篇，从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论：总结了终末期肝病病人营养管理的最佳证据，建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。