Background: Post-traumatic stress disorder (PTSD) affects mental health in the long term and is often associated with past psychological trauma. This systematic review was conducted with a purpose to investigate the correlation between adverse childhood experiences (ACE), experiences of child maltreatment, and the occurrence of PTSD in adults over 18 years to optimize treatment guidelines accordingly. Method: The review utilized articles searched on PubMed, Google Scholar, Scopus, and Cochrane. Inclusion criteria include original studies (RCTs, cross-sectional, and cohorts) involving adults over 18 years with PTSD with a history of ACE published during the last decade (2014 and 2025). This study was conducted according to preferred reported items in systematic reviews and meta-analysis (PRISMA) guidelines. A quality assessment of the included studies was conducted using Newcastle Ottawa scale for cohort studies and the axis scale for cross-sectional studies. Results: Out of 356 articles, 169 were screened, of which 26 studies were included in this review. These studies discussed various forms of childhood maltreatment, including sexual abuse, physical abuse, traumatic events, and neglect from parents. Most of these studies indicate a direct correlation between childhood maltreatment and Adulthood PTSD. Conclusion: A robust association exists between ACE and childhood maltreatment and the development of PTSD in adulthood. There is a need for more literature to study the effects of maltreatment and comorbid mental health conditions for policymaking to protect child mental health.

Background There is a growing body of evidence from discrete choice experiments related to telehealth. Discrete choice experiments offer valuable insights in informing the design and evaluation of telehealth services and supporting the telehealth implementation and policy. Objective This review aims to examine studies assessing consumer preferences for telehealth using discrete choice experiments. Methods A systematic review was conducted, searching five health and multidisciplinary databases from inception until 4 April 2024. Grey literature searches, hand-searching, and reference list checks were also performed. Results Of 2,832 studies screened, 52 met the inclusion criteria. Most studies were conducted from the patient perspective (n=47/52, 90%) and covered a wide range of populations and settings. Of the included studies eligible for quality assessment, 68% (n=23/34) received high-quality ratings, while others were assessed as moderate. Studies comparing face-to-face consultations with telehealth generally found a preference for face-to-face appointments. Telehealth is viewed more favourably if it can be offered at a lower cost, reduces wait times, and is part of a comprehensive care plan. Telehealth tends to be preferred by younger patients and clinicians, those digitally literate, and those with less severe or more private and stigmatised health conditions. Conclusion While face-to-face consultations are generally preferred, telehealth is viewed as advantageous if it reduces costs, shortens wait times, and is integrated into comprehensive care. The findings highlight the importance of considering these attributes when designing telehealth preference studies and informing the adoption and design of telehealth services.

Background: Guidelines recommend that adults with peripheral artery disease (PAD) take antiplatelets, statins, and antihypertensives. However, it is unclear how frequently clinicians do not prescribe these medications (ie, underprescription), how often patients fail to fill/refill their prescriptions (ie, nonadherence), which factors increase underprescription/nonadherence risk, and whether underprescription/nonadherence are associated with outcomes. Methods: We searched MEDLINE, EMBASE, CENTRAL, and Evidence-Based Medicine Reviews (January 1, 2006-to-February 18th, 2025) for studies reporting cumulative incidences/point prevalences of clinician underprescription and/or patient nonadherence to antiplatelets, statins, and/or antihypertensives; adjusted-risk factors for underprescription/nonadherence; and adjusted-outcomes associated with underprescription/nonadherence among adults with PAD. Two investigators independently screened citations, extracted data, and assessed risk of bias. Data were pooled using random-effects models. Estimate certainty was communicated using GRADE. The study was registered on PROSPERO (CRD42022362801). Findings: Among 4206 citations identified, 125 studies (n = 14,681,801 participants; 37% female) were included. The pooled cumulative incidence of antiplatelet, statin, and antihypertensive (among those with PAD and hypertension) underprescription was 28% (95% confidence interval [CI] = 21-36%; moderate-certainty), 34% (95% CI = 31-38%; high-certainty), and 43% (95% CI = 33-53%; moderate-certainty), respectively. The cumulative incidence of antiplatelet, statin, and antihypertensive nonadherence was 27% (95% CI = 20-35%; moderate-certainty), 28% (95% CI = 24-33%; high-certainty), and 23% (95% CI = 22-24%; low-certainty), respectively. Underprescription was more common in population-based studies and those enrolling more females and past/current smokers while nonadherence was more common in studies enrolling more patients with diabetes. Underprescription risk factors included female sex, advanced age, malignancy history, and chronic limb-threatening ischemia (all moderate-certainty). Nonadherence risk factors included advanced age, comorbidity burden, and receiving specialist mental health care (all moderate-certainty). Underprescription was associated with increased major adverse cardiac events, all-cause mortality, and decreased amputation-free time (all moderate-certainty). Interpretation: One-quarter-to-one-half of adults with PAD are not prescribed antiplatelets, statins, and antihypertensives. Further, approximately one-quarter of these patients do not adhere to these medications after prescription. Funding: This research was supported by a 2024 Vanier Canada Graduate Scholarship (awarded to AMK and supervised by DJR), a Graham Farquharson Physician Services Incorporated Knowledge Translation Fellowship (awarded to DJR), and a Research Program Award, University of OttawaDepartment of Surgery Annual Competition (awarded to DJR).

Background: Children with complex communication needs (CCN), particularly those with autism spectrum disorder (ASD), experience significant communication challenges. This scoping review analyses the existing literature on clinical interventions designed to enhance communication in these children. The aim was to describe which intervention models are being evaluated in studies, which treatments have shown positive effects and what the clinical profile of children and adolescents who benefit from these interventions is. Method: The scoping review was conducted following the methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Results: The search strategy identified 797 records; eight records met all eligibility criteria and were included for review. The review found that multimodal interventions combining augmentative and alternative communication (AAC), naturalistic strategies and parent training were the most effective in improving both expressive and receptive communication. Conclusions: Despite the limited existing research, studies suggest that multimodal interventions can effectively enhance communication in children with CCN. This review highlights significant gaps in the literature, including the scarcity of studies with appropriate methodological rigour and the lack of standardised protocols for CCN interventions. There is a critical need for evidence-based guidelines, professional training and policy development to ensure equitable access to effective interventions.

Background The paucity of actionable data on the epidemiological profile of dental caries among adolescents in Nigeria poses significant challenges to policy formulation and implementation. This study aimed to estimate the prevalence of dental caries among adolescents in Nigeria and identify dental caries preventive behaviours associated with dental caries experience among adolescents in Nigeria over 10 years. Methods A systematic review and meta-analysis of studies on dental caries among adolescents was undertaken in September 2023. Literature searches were conducted across Academic Info, Cochrane Library, Refseek, and PubMed databases and Google Scholar, to identify studies on dental caries prevalence and dental caries preventive behaviour among adolescents in Nigeria that were published between January 2013 and December 2022. Eligible studies included cross-sectional, cohort, and case-control studies. Studies were also included if they presented data for at least one of the primary outcomes. Excluded were studies without information on the sample size, those with incomplete or overlapping samples, case reports, case series, editorials, or reviews without primary data. Heterogeneity was assessed using I2 percentages, and a funnel plot evaluated publication bias. A random effects model was used to determine the prevalence of dental caries with subgroup analysis by sex. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist to assess the quality and integrity of the included studies. The systematic review was registered on PROSPERO (CRD42024458849). Results Sixteen studies met the eligibility criteria. The pooled prevalence of dental caries among adolescents in Nigeria was 23.0% (95% CI: 16–30). The pooled prevalence for males was 16.0% (95% CI: 9–23) and that for females was 22.0% (95% CI: 11–32). The commonest dental caries preventive practices reported were daily tooth brushing, use of fluoride-containing toothpastes, and dental service utilization. Factors associated with dental caries included a history of dental service utilization, poor oral hygiene practices, and consumption of refined carbohydrates in-between-meals. Conclusion The high prevalence of dental caries among adolescents in Nigeria warrants programmatic attention with an emphasis on improving oral hygiene practices and controlling the consumption of refined carbohydrates in-between-meals. Dental service utilization for dental caries preventive needs to be encouraged.

Background: The SARS-CoV-2 pandemic had a major impact on nursing and healthcare as well as on research. The aim of this study was to analyse the characteristics of nursing- and SARS-CoV-2-related research in Germany. Methods: A scoping review was conducted. We systematically searched (06/2023) Medline, CINAHL, the German Register of Clinical Trials, abstract books of conferences and conducted a manual literature search. We included empirical studies addressing aspects of nursing and the pandemic and involving German researchers. Study selection and data extraction were conducted independently by two reviewers. Results were analysed descriptively. Results: We included 131 publications (85 quantitative, 27 qualitative, 6 mixed-/multi-methods studies, 12 systematic reviews, 1 discussion paper); 49 % of the studies were published in 2021. First authors were mostly from medicine, psychology and nursing science, last authors from medicine. Most studies were explorative. Most of the quantitative studies used observational designs, only four were experimental. Nurses and other healthcare professionals were the most common target group; people with care needs or relatives were rarely addressed. The most common topics included health, perceived burden, working conditions, and characteristics of care during the pandemic. A quarter of the studies were not externally funded, 32 % did not provide information on funding. The Federal Ministry of Education and Research (21 %) was the most common funding body. Conclusion: Pandemic-related nursing research was published to a limited extent by nursing scientists; clinical nursing research was particularly underrepresented. Dependable funding and the development of a research infrastructure for nursing research are necessary to ensure evidence-based nursing in times of crisis and to generate findings that are relevant to clinical practice and health policy decision-makers.

Background: Both Health Technology Assessment (HTA) and Performance Management (PM) are clinical governance disciplines that aim to improve the quality, equity, and financial sustainability of health organizations and systems. Although HTA and PM share many features, to the authors' knowledge, few studies have investigated their interplay. This study attempts to fill this gap by analysing how the literature has explored and developed the integration between HTA and PM concepts and tolls within healthcare sector. Methods: To address this gap, this study examines 33 papers selected through a scoping review that explores the inter of HTA and PM within the healthcare sector. In particular, the paper adopted the preferred reporting items for systematic reviews and meta-analysis (PRISMA) methodology to select and analyse articles. Results: The review highlights the dynamic convergence of HTA and PM, emphasizing how combining these frameworks and functions can enhance decision-making in healthcare. This integration ensures that technologies are adopted on the basis of proven effectiveness in pursuing healthcare systems goals and that performance metrics align with evidence-based practices, leading to better resource allocation and improved patient outcomes. The literature review underscores the need for further research to understand the integration between HTA and PM and their combined impact on organizational performance, sustainability, and resilience in the healthcare sector. Conclusion: This study contributes to the literature by providing a comprehensive overview of the current state of research on HTA and PM, offering insights for future studies, and practical recommendations for integrating these disciplines to improve healthcare management and policymaking.

This study provides a comprehensive overview of wastewater surveillance studies on pathogens, identifies key characteristics of studies that are associated with public health actions, and highlights the actions resulting from these studies. Many studies refer to the value of wastewater surveillance in public health decision-making, but it remains unclear how many studies support public health action and whether this is incorporated into study designs. Therefore, we conducted a scoping review following PRISMA guidelines and used the machine learning tool ASReview to identify wastewater surveillance studies monitoring pathogen circulation in human populations, followed by correlational analyses. A total of 974 studies were included, of which only 84 described public health action. Merely 28 of these incorporated strategies to facilitate action within their study designs. Studies leading to public health action primarily monitored viruses, e.g., SARS-CoV-2 and poliovirus, and since 2024 also influenza A and B virus, respiratory syncytial virus, hepatitis A virus and mpox virus. Furthermore, studies conducted by public health institutes or targeting non-standard locations are more likely to result in action, whereas those with larger population sizes or focusing on residential areas are less likely to result in action. The most common public health actions included informing health authorities and identifying cases. Our findings highlight the value of learning from existing use cases. While wastewater surveillance can support public health actions, evidence of its use is limited. Future studies should improve study designs by, e.g., incorporating strategies for public health actions to maximize their effectiveness and impact on decision-making.

Purpose of review: Early Gestational Diabetes Mellitus (eGDM) is an emerging public health issue in India, characterised by varying prevalence estimates, healthcare access disparities, and inconsistent screening practices. This scoping review aims to map the existing literature on eGDM screening in India, identify evidence gaps, and inform future research, policy formulation, and resource allocation. Recent findings: The review, guided by the Arksey and O'Malley framework, includes studies published between 2000 and 2024 that highlight significant eGDM screening and management disparities across public and private healthcare settings, rural-urban locations, and socioeconomic groups. Several screening initiatives have been introduced, but challenges persist, including a lack of standardised diagnostic criteria, low healthcare provider awareness, limited accessibility of screening, and sociocultural barriers. Economic evaluations suggest that eGDM screening can be cost-effective, yet India-specific assessments remain scarce. The integration of eGDM screening within India's national healthcare programs, including NPCDCS, remains minimal. There is a significant gap in knowledge translation, with limited efforts in adapting research findings into policy and practice. Addressing these challenges requires robust policy and programmatic responses, including standardised diagnostic guidelines, improved healthcare provider training, equitable service access, and culturally sensitive community engagement. Strengthening research-to-policy pathways is critical to improving eGDM screening and outcomes across India.

Background: Healthcare workers (HCWs) are at high risk of acquiring and transmitting infections, including COVID-19. Vaccination is a crucial method for preventing the spread of infectious diseases; however, vaccine non-acceptance can hinder optimal vaccine coverage. This research aims to evaluate the level of COVID-19 vaccine acceptance and the associated factors among HCWs in West Africa. Methods: A structured literature review of quantitative cross-sectional studies was conducted, searching databases including Medical Literature Analysis and Retrieval System Online (MEDLINE), African Journals Online, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Google Scholar. The review focused on studies from April 2021 to February 2023 that examined factors influencing COVID-19 vaccine acceptance among HCWs in West Africa. Data extraction and quality assessment of the included studies were conducted using Joanna Briggs Institute tools. Results: Five articles met the inclusion criteria, and they reported that the acceptance level of the COVID-19 vaccine ranged from 38.3% to 73.6%. Barriers to acceptance included concerns about vaccine safety and effectiveness, side effects, short duration of clinical trials, limited and false information, and lack of social trust. Conclusions: COVID-19 vaccine acceptance among West African HCWs is influenced by sociodemographic factors, vaccine concerns, and accurate information, necessitating health promotion strategies and multisectoral collaboration for improved acceptance.

Objective: This study aims to assess research trends in the association between schizophrenia and autoimmune diseases, systematically review their relationship, and evaluate the credibility of existing evidence. Methods: Bibliometric analysis was conducted using the bibliometrix package in R, along with VOSviewer and CiteSpace. Relevant systematic reviews and meta-analyses were retrieved from six databases: PubMed, Web of Science, Embase, CINAHL, PsycINFO, and the Cochrane Library. Summary risk estimates were recalculated using the DerSimonian and Laird method under a random-effects model, and the credibility of the evidence was assessed. Results: The bibliometric analysis found that "meta-analysis" has become a frequently used keyword and may be a focal point for future research. The umbrella review included 17 articles, containing 24 report data points from 12 quantitative reviews. Results indicated that 9 reports assessed the relationship between schizophrenia and autoimmune diseases. Schizophrenia was significantly associated with autoimmune neurological disorders (RR = 1.42; 95 % CI = 1.18-1.72), providing suggestive evidence. Seven reports evaluated the impact of schizophrenia on autoimmune diseases, showing highly suggestive evidence that schizophrenia patients had a pooled relative risk of 2.22 (95 % CI = 1.95-2.52) for psoriasis. Eight reports assessed the impact of autoimmune diseases on schizophrenia, with bullous pemphigoid patients showing significantly higher schizophrenia prevalence (OR = 2.63; 95 % CI = 2.03-3.39). Conclusions: This study synthesizes evidence of varying levels, highlighting the association between schizophrenia and autoimmune diseases. It offers new insights for future exploration, fosters interdisciplinary collaboration, and provides valuable implications for public health policy development.

Context: Organizational leadership is essential for adequate and stable financing, strong governance across jurisdictions and sectors, and a competent public health workforce for effective and resilient public health systems. While there have been some efforts to characterize leadership competencies at the individual level, more focus is needed to understand effective governance of public health organizations and systems through the lens of leadership competencies at the organizational level. Objective: To identify organizational level leadership competencies for effective and equitable public health governance. Design: This scoping review included published academic literature from Scopus, Web of Science, Medline, and ProQuest and grey literature from Google Scholar, Canadian Government websites, Trove, FedSys, and Open Grey, published between 2004 and 2023. The search strategy focused on the concepts of governance, leadership, and pub-lic health organizations. An inductive-deductive approach informed the analysis using reflexive thematic analysis and a framework outlining the six functions of public health governance. Results: A total of 35 records were included for analysis; 22 academic and 13 grey literature records. This review identified 9 themes describing organizational leadership competencies for public health governance: 1) Systems thinking 2) Public policy development, implementation and evaluation, 3) Partnership and collaboration, 4) Equity and justice 5) Organizational learning, 6) Oversight, 7) Resource stewardship, 8) Legal authority, 9) Organizational ethics. Conclusions: This scoping review contributes to our understanding of the leadership competencies needed to enact and sustain effective governance at an organizational level. These identified themes and associated competencies can facilitate the creation of organizational culture and values that align with effective governance tenets in public health. Additional research is needed to further apply and contextualize these competencies in different countries and public health settings.

Objective: This scoping review investigates the potential of 6G technology in healthcare, particularly in smart city settings, focusing on its enhanced data capabilities, AI's role in healthcare optimization, infrastructure support, interoperability, quality standards, and privacy and security concerns. Patients and methods: The scoping review followed the Arksey and O'Malley framework, with Levac et al.'s methodological advancements. The review team searched academic databases like PubMed/Medline, SCOPUS, Embase, Web of Sciences, and IEEE Xplore. They also explored grey literature sources like Google Scholar, OpenGrey, and Web of Science Conference Proceedings. A search strategy was developed, and 145 studies were selected from an initial pool of 9835 records from 2010 to 2025. The review categorized 145 studies into three phases, focusing on deploying 6G technology in healthcare, the infrastructure required, and ethical considerations related to the technology's ethical implications. Result: Phase one focused on advancements like real-time imaging, performing medical procedures remotely, using predictive tools to analyze data, and providing care tailored to individual patients. Phase two examined how the next generation of wireless technology (6G) could interact with communication systems, including techniques to handle large amounts of data (massive MIMO) and using extremely high-frequency signals (terahertz communications) to transfer information faster. Phase three explored ethical concerns about applying 6G technology, such as systems that make decisions based on user intentions (intent-driven management) and organizing information around data-based designs (data-driven architecture). The review highlights how 6G technology could revolutionize patient care and medical services by enabling faster data transfers, reducing delays, increasing system capacity, and incorporating artificial intelligence. Conclusion: The scoping review shows the capability of the transformative potential of 6G technology, particularly in healthcare and urban development, emphasizing its enhanced data transfer speeds, reduced latency, and increased capacity that can significantly improve patient care through better remote monitoring, security, and telemedicine services. It stresses the vital role of policymakers in guiding the development of 6G infrastructure, ensuring effective spectrum allocation, and implementing robust security measures while addressing health and electromagnetic exposure concerns. Policymakers are urged to adopt security-by-design principles, adhere to international standards, and foster collaboration among academia, industry, and government to drive innovation and ensure the responsible deployment of 6G technology. By stimulating research and establishing clear performance metrics, they can facilitate continuous improvement and adaptation, ultimately benefiting society as a whole. The review concludes that strategic policy formulation is essential for maximizing the advantages of 6G technology, leading to more intelligent, productive, and sustainable societal frameworks.

Background: Given trends towards greater life expectancy, there is an increasing need to promote healthy ageing and add quality and value to older adults' lives, however the evidence regarding the effects on overall health and wellbeing has not been synthesised. Active lifestyles may provide diverse health and wellbeing benefits for older adults in terms of maintaining or improving their physical, psychological, and social functions. This systematic review evaluates whether and how different types of interventions within community-based settings could benefit specific aspects of older adults' health and wellbeing. Methods: PubMed, PsycINFO, Scopus and Web of Science were systematically searched in January 2022 for experimental studies (including randomised controlled trials, non-randomised controlled trials, and quasi-experimental studies) exploring health and wellbeing benefits of community-based activities in older adults. A total of 12,707 sources were identified through database searches with 183 retained for full screening. Final inclusion was based on the following eligibility criteria: (1) participants were generally healthy and predominantly independent community-dwelling older adults aged 60 and above; (2) interventions were based in real-world settings, e.g., dance, art and technology classes, etc. held in publicly-accessible facilities; (3) pre-/post-interventions assessed at least one outcome in physical health, psychological wellbeing or social connections; (4) control groups were used, including passive and active control groups or groups that received a different type of intervention; (5) experimental studies followed a quantitative research design. Study quality was systematically assessed, and a comprehensive narrative synthesis of the findings was conducted. Results: Of the 183 studies screened, 56 were included in the final review. Among the 33 predominantly physical interventions, 31 demonstrated positive effects. Of the 16 predominantly mental interventions, 14 reported benefits. All seven predominantly social interventions reported positive effects. Discussion: The benefits of real-world interventions were reported across a range of outcomes, particularly in terms of reducing depression or anxiety, or improving physical functioning, sleep quality and social participation. However, heterogeneity in interventions, sample design, duration and dosage suggest that more research is needed to support the effects of duration and dosage of intervention exposure. As real-world interventions more closely resemble the way in which older people engage in activities, evidence of their effectiveness in promoting health and wellbeing should inform preventative healthcare provision and policymaking.

Background: Home support is a critical yet under-recognized component of public health and aging policy, with economic perspectives often overlooked in workforce and system planning. This paper explores the economics of home support services in Ireland, against a backdrop of increasing demand for home care driven by aging populations and workforce supply challenges. Aims: To provide a comprehensive overview of the economic challenges faced by the home support sector in Ireland, particularly in relation to workforce sustainability, population health, and quality service delivery. To explore international best practices and case studies that can further inform the development of home support models. Methods: Utilizing both qualitative and quantitative population, labor force, and health service data, the analysis of the Irish context investigates three critical areas: (1) the rising demand and funding of home support, (2) cost comparisons with institutional care, and (3) the economic implications of workforce expansion. Systematic literature review of the international evidence used a structured search of electronic databases (Web of Science, MEDLINE, CINHAL) using key terms ("home support," "workforce development," and "economic or cost") to identify a range of recent (published 2015-2025) and relevant case studies to inform policy development. Results: Findings indicate that Ireland's market-driven approach, heavily reliant on approved private providers, exacerbates issues like low wages, job insecurity, and high staff turnover, which negatively impact service quality. Implications for healthcare workforce policy include improving wages and working conditions, establishing career pathways and professional development, and increased government investment. Recommendations for policy include making strategic investments in workforce stability and better integration of home support with informal care systems to enhance service delivery. Conclusion: Policymakers can inform themselves about the economic considerations for developing a robust home support system in the context of aging populations. Further research is needed into the assumptions and validity of financial decisions to ensure services are sustainable.

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.

Background: This research focuses on improving epidemic monitoring systems by incorporating advanced technologies to enhance the surveillance of diseases more effectively than before. Considering the drawbacks associated with surveillance methods in terms of time consumption and efficiency, issues highlighted in this study includes the integration of Artificial Intelligence (AI) in early detection, decision support and predictive modeling, big data analytics in data sharing, contact tracing and countering misinformation, Internet of Things (IoT) devices in real time disease monitoring and Geographic Information Systems (GIS) for geospatial artificial intelligence (GeoAI) applications and disease mapping. The increasing intricacy and regular occurrence of disease outbreaks underscore the pressing necessity for improvements in public health monitoring systems. This research delves into the developments and their utilization in detecting and handling infectious diseases while exploring how these progressions contribute to decision making and policy development, in public healthcare. Methodology: This review systematically analyzes how technological tools are being used in epidemic monitoring by conducting a structured search across online literature databases and applying eligibility criteria to identify relevant studies on current technological trends in public health surveillance. Results: The research reviewed 69 articles from 2019 to 2023 focusing on emerging trends in epidemic intelligence. Most of the studies emphasized the integration of artificial intelligence with technologies like big data analytics, geographic information systems, and the Internet of Things for monitoring infectious diseases. Conclusions: The expansion of publicly accessible information on the internet has opened a new pathway for epidemic intelligence. This study emphasizes the importance of integrating information technology tools such as AI, big data analytics, GIS, and the IoT in epidemic intelligence surveillance to effectively track infectious diseases. Combining these technologies helps public health agencies in detecting and responding to health threats.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background: Essential services ensure the health, safety, and well-being of individuals and their communities. However, there is currently a lack of consensus on what constitutes an essential service in Australia. This gap hinders a detailed spatial understanding of essential service provision, access, and influence on populations. This systematic review critically assessed the literature on essential services and their impact on quality of life to understand service definitions and their relative contributions to quality of life. Methods: A systematic search of ten databases was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Five criteria were established for the inclusion of studies: (i) major developed economies, (ii) defined essential service and focus on spatial access, (iii) quality of life outcome, (iv) peer-reviewed, and (v) published between 2000 and 2024. Results: From 1,473 unique records, seven studies met the inclusion criteria, with studies from Europe, Asia-Pacific, and North America. Across the studies, services were characterised based on their primary function and contributions to quality of life. Service categories included food, retail, personal services, health, education, culture and recreation, and faith-based services. Despite demographic and scale variations, services that fostered social connection and a sense of place showed the highest positive impact on quality of life. Conclusions: Findings indicate limited and inconsistent evidence on essential service measures and their relationship with quality of life. The persistent lack of justification for classifying services as essential in research hinders definitive conclusions about which services most effectively enhance quality of life. Future research should adopt standardised, validated measures, and address representation gaps across diverse populations and regions. This work is fundamental for developing a validated set of essential services, to improve national modelling of geographic access and inform policy, decision-making, and understanding of how access to services influences quality of life.