Background: Oral health is a crucial component of overall well-being, particularly in childhood and adolescence when lifetime habits are established. Health education and theory-Based health promotion interventions can enhance oral health outcomes more effectively than traditional knowledge-transfer methods. Objective: The present systematic review and meta-analysis were performed with the objective of assessing the effectiveness of theory-Based health education and promotion interventions in impacting oral health outcomes among children and adolescents. Methods: Based on PRISMA and PROSPERO registration, the systematic search in seven databases was performed up to March 2025. Only RCTs involving participants aged 5 to 18 years old and with use of theoretical models like the Health Belief Model, Theory of Planned Behavior, or Social Cognitive Theory were taken into account. Primary outcomes included oral health behavior, knowledge, attitudes, self-efficacy, and clinical indicators like dental plaque, periodontal status, and DMFT. The data were combined through random-effects meta-analysis, and risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Nineteen RCTs were included. Interventions had a significant boost in self-efficacy (SMD = 1.49, 95% CI: 0.99,2.00), oral health-related quality of life (SMD = 7.38, 95% CI: 5.57,9.19), knowledge (SMD = 1.09, 95% CI: 0.80,1.39), attitudes (SMD = 9.32, 95% CI: 7.08,11.55), and behavior (SMD = 2.58, 95% CI: 2.03,3.12). Significant declines in dental plaque (SMD = -1.92, 95% CI: -2.42,-1.42) and periodontal health (SMD = -1.18, 95% CI: -1.83,-0.53) but not in DMFT scores (SMD = -0.11, 95% CI: -0.27,0.04) also occurred. High heterogeneity and small sample of evidence of publication bias were detected. Conclusions: Theory-Based health education and promotion interventions are effective in enhancing oral health outcomes across a wide range of outcomes in children and adolescents. Future research should have long-term follow-up, standardization of outcomes measures, fidelity of intervention, economic evaluations, and equitable provision across diverse populations. Clinical trial number: Not applicable. Trial registration: This systematic review has been registered prospectively in PROSPERO (International Prospective Register of Systematic Reviews) with registration number CRD420251026862.

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.

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.

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.

INTRODUCTION: Over the last years, videoconference-delivered psychotherapy (VCP) has found its way into clinical practice. This meta-analysis is the first to evaluate the effectiveness of VCP for children and adolescents with a mental disorder and their parents. METHODS: A systematic literature search was performed to identify randomized controlled trials (RCTs) that compared the effectiveness of VCP for youths with a mental disorder to a control condition. Twelve studies were included. Two reviewers independently extracted data and rated study quality. RESULTS: Effect size estimates for measures of children's symptoms of mental disorders were large for comparison between VCP and waitlist (posttreatment: Hedges's g = -1.26, k = 5) and negligible for comparisons between VCP and in-person treatment (posttreatment: g = 0.00, k = 6; follow-up: g = -0.05, k = 3). Similarly, effect size estimates for measures of children's functional impairments were large for comparison between VCP and waitlist (posttreatment: g = -1.10, k = 3) and negligible for comparisons between VCP and in-person treatment (posttreatment: g = -0.23, k = 3; follow-up: g = 0.04, k = 2). VCP more effectively reduced symptoms in children with an internalizing disorder (g = -0.88, k = 5) compared to externalizing disorders (g = 0.25, k = 2) or tic disorders (g = -0.08, k = 3). DISCUSSION: The results provide preliminary evidence that VCP is an effective treatment for youths with a mental disorder and their parents. VCP was equally effective as in-person treatment in reducing children's symptoms and functional impairments. Limitations include the limited number of RCTs and incomplete reporting of methodological features.

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.

Background: Population-wide newborn blood spot screening programmes are a successful public health intervention used to detect whether the baby is at risk of certain rare conditions, with the aim of earlier diagnosis and provision of optimal care and treatment. Evaluating candidate conditions to include in newborn blood spot and genetic sequencing raises questions regarding acceptability to parents/carers. Methods: In the context of the possible expansion of the newborn blood spot screening programme in the United Kingdom, this review aimed to systematically review research on the acceptability to parents of newborn blood spot screening and genetic sequencing. A protocol was developed prior to commencing the review and was registered on the PROSPERO database. A team of researchers carried out the review, with checking at all stages carried out by at least two individuals. We included research published after 2013 with participants who were pregnant or a recent parent of a newborn and were resident in a high-income country. We included quantitative and qualitative studies that investigated the acceptability to parents/carers of newborn blood spot screening or genetic sequencing. Quantitative studies were narratively synthesised, and theories/frameworks identified and evaluated. Qualitative studies were analysed for recurring themes, and a meta-synthesis was carried out to compare and contrast these two types of data. We quality appraised included articles using tools appropriate for their study design. Results: Searches were carried out in September to November 2023 and screening identified 25 relevant research articles. Just over half were from North America, with four existing reviews and nine qualitative studies. Domains of acceptability described in the literature were: support for screening; level of anxiety, information and knowledge; consent; views of the procedure; and support after screening. The research indicated consensus support for blood spot screening, and for expanding to some other conditions, although some parental anxiety was reported. Parents/carers mostly perceived that they had received sufficient information, but the timing of this could be improved. While parents indicated interest in genomic screening, studies highlighted the need for clearer consent procedures and greater support for parents following genomic screening than for blood spot screening. Only three included studies reported using any kind of theoretical framework. Discussion: Most parents/carers found newborn blood spot screening programmes to be acceptable and favoured their large-scale implementation. A minority of parents/carers expressed concerns regarding the acceptability of processes underpinning newborn blood spot screening, such as consent, the timing of receiving information and support available after testing. More research is needed regarding the acceptability of newborn genomic sequencing screening programmes, which are less established compared with newborn blood spot screening programmes. Limitations: The over-representation of studies conducted in the United States has implications for the applicability of findings to other countries where testing is not typically mandatory and health systems differ considerably. Most studies were of cross-sectional design and there was limited representation of people from lower incomes and non-white ethnicity. While the inclusion of studies only in populations of future or very recent parents provided coherence to the findings, unclear reporting of participants may have resulted in under- or overinclusion of some studies. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159927.

Hysterectomy, removal of the uterus, is a commonly performed surgery for gynaecological morbidities. Emerging evidence indicates that hysterectomy performed before age 45 (early hysterectomy), is associated with considerable risks to women's health. While most evidence on hysterectomy is from high-income settings, national surveys from India report high prevalence of early hysterectomy in specific regions, as well as higher prevalence amongst women in rural areas and with less education. The median age at hysterectomy in India is close to ten years before the onset of natural menopause. India has recently introduced national guidelines to address early hysterectomy, but large evidence gaps on the causes and consequences remain - which in turn limits the potential effectiveness of interventions at the clinical, health system and community level. Methods: SAHELI is a Team Science study that will examine: (i) individual, social and health system determinants of early hysterectomy; (ii) women's treatment pathways to hysterectomy and for gynaecological morbidity in general; and (iii) the consequences of undergoing hysterectomy on women's physical, mental, economic and social well-being across the life course. This mixed-methods study includes population surveys amongst women in ages 25-49 in three high-prevalence states; qualitative health systems research to trace treatment journeys with women, health care providers and other stakeholders; evidence syntheses; and knowledge translation activities to ensure findings inform co-produced strategies and interventions. The study is grounded in a feminist epidemiology approach, aiming to examine individual and structural causes of vulnerability and prioritising the views of women, particularly in knowledge translation. Conclusions: SAHELI, implemented by an all-women, multi-disciplinary team, is the first study in India to examine the causes and consequences of hysterectomy in a life course approach. We aim to influence interventions, policy and future research on women's health, particularly access to quality gynaecological care and comprehensive health services through the life course.

This bibliometric study examines the scholarly landscape of migration and women's health, analyzing 1314 Scopus-indexed articles from 462 journals published between 2000 and 2023. Findings indicate a consistent increase in research output, reflecting growing global interest in this interdisciplinary field. Geographically, high-income countries (HICs), including the United States, Canada, the United Kingdom, and Australia, dominate contributions, while low- and middle-income countries (LMICs) remain underrepresented despite hosting significant migrant populations. International collaborations play a crucial role, with key institutions such as the University of California and the London School of Hygiene and Tropical Medicine shaping research efforts. The keyword co-occurrence analysis highlights migration, gender dynamics, mental health, and reproductive health as dominant themes. Persistent gaps in mental and reproductive healthcare access for migrant women emphasize the need for trauma-informed care (TIC), mobile bilingual healthcare services, and inclusive health policies. Disparities in research funding further exacerbate global health inequities, underscoring the necessity of equitable redistribution of resources, including redirecting at least 10 % of HIC research grants to LMIC-led studies. The COVID-19 pandemic magnified pre-existing vulnerabilities, stressing the importance of multilateral collaborations and sustainable policy interventions to enhance migrant healthcare access. This study provides valuable insights into research trends, collaboration networks, and thematic focus areas, offering a foundation for future interdisciplinary research and evidence-based policymaking aimed at promoting health equity for migrant women globally.

Background: The World Health Organization (WHO) defines perinatal mortality (PNM) as the "death of a baby between 28 weeks of gestation onwards till the first 7 days of life." PNM is a key indicator of the quality of care for newborns and directly reflects the category of prenatal, intrapartum, and postpartum care given to a newborn. According to a report published by the WHO, 2.3 million children died within their first 20 days of life in 2022. Approximately 6500 newborn deaths occur every day, accounting for 47% of all child deaths under the age of five years. PNM is a public health concern in low and middle-income countries. According to the Pakistan Health and Demographic Survey 2017-18, the PNM rate has remained consistently high in Pakistan (75 per 1000 births) during the last decade. Aims: To observe the frequency of PNM and early neonatal mortality (ENM) among the Pakistani population within the last decade and to identify additional risk factors for PNM and ENM. Methods: Published studies were searched using keywords comprising PNM, ENM, stillbirths, risk rate, perinatal period, and their combinations with search engines such as Science Direct, SCOPUS, PubMed, and Google Scholar. We followed Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines to filter articles and selected 18 relevant articles for systematic review. All studies reported either the PNM, ENM, stillbirth, or live birth rate. Results: Systematic review showed that the PNM rate in Pakistan remained high from 2013 to 2022. Hypertensive disorders, antepartum hemorrhage, and neonatal infections increased the overall risk of PNM and ENM. Other factors that contributed to the high PNM rate were advanced maternal age, low birth weight, congenital abnormalities, multigravida, poor socioeconomic conditions, and other medical problems such as gestational diabetes. Conclusion: The PNM rate in Pakistan was found to be high according to the systematic review, but discrepancies were observed when compared with the WHO figures for PNM. We recommend conducting more original research to accurately assess the PNM rate in Pakistan, which is essential for informed and effective policy making.

Background: Women with a history of hypertensive disorders of pregnancy are at an increased risk of cardiovascular disease. Although clinical practice guidelines for management of hypertensive disorders of pregnancy recommend involvement of a general practitioner for ongoing cardiovascular disease preventative care, there are no intervention strategies embedded within primary care aimed at improving risk assessment or management for women after hypertensive disorders of pregnancy. The study aim was to co-design an intervention to improve implementation of cardiovascular disease risk assessment and management following hypertensive disorders of pregnancy for primary care settings in a local health district in New South Wales, Australia. Method: Using the Integrated Knowledge Translation framework, a series of five co-design meetings with the investigative team and end users were conducted online. Meetings were informed by the Behaviour Change Wheel framework for intervention development and incorporated research findings from a systematic review and meta-analysis, surveys and an online discussion. Data from activities and audio recordings following each meeting were analysed thematically using inductive-deductive thematic analysis. Results were summarized after each meeting, and findings used to inform ongoing intervention development. Results: The 18 end users included women with lived experience of hypertensive disorders of pregnancy (n = 8), obstetricians (n = 2), midwives (n = 5) and general practitioners (n = 3). Target priorities were to improve communication between hospital staff and general practitioners following the occurrence of hypertensive disorders of pregnancy and increase the knowledge of general practitioners and women regarding cardiovascular disease prevention after cardiometabolic pregnancy complications. Part 1 of the intervention is set within the hospital setting and delivered via physical resources to address the communication gap between hospital and primary care providers about the occurrence of hypertensive disorders of pregnancy. Part 2 is delivered via an update to an existing general practice education platform and through resources for use within consultations to provide education for women and general practitioners about cardiovascular disease prevention after hypertensive disorders of pregnancy. Conclusion: The Integrated Knowledge Translation and Behaviour Change Wheel frameworks aided in the development of a targeted intervention to improve implementation of cardiovascular risk assessment and management for women after hypertensive disorders of pregnancy, based on gaps identified in current primary care practice.

Background: Evidence shows that twin pregnancy is associated with increased adverse outcomes, including stillbirth. The present study aimed to investigate the global prevalence of stillbirth among fetuses resulting from twin pregnancies through a systematic review and meta-analysis. Methods: To identify relevant studies, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched databases including PubMed, Web of Science, Google Scholar, Scopus, Embase, and Science Direct using keywords such as "stillbirth," "twin pregnancy," "fetus," and "prevalence" without applying any time constraints to the search. The quality of the articles was evaluated using the STROBE checklist. To ensure the reliability of our findings, we employed a random-effects model for analysis, and the heterogeneity of the studies was assessed using the I2 index. Data analysis was conducted using Version 2 of Comprehensive Meta-Analysis software. Results: In a review of 10 studies with a sample size of 627,797 people, our meta-analysis revealed a global prevalence of stillbirth among fetuses resulting from twin pregnancies, reported to be 1.4% (95% CI 0.9-2.1). Our study also showed that with increasing sample size and years of study, the global prevalence of stillbirth among fetuses resulting from twin pregnancies decreased (p < 0.05). The highest prevalence of stillbirth, 3.5 (95% CI 2.2-5.4), was reported in the monochorionic type. Conclusion: The occurrence of stillbirth in twin pregnancies is a significant health concern for countries worldwide. Identifying its prevalence and contributing factors can aid health planning and policy development.

目的 整合阴道分娩产妇产后会阴疼痛管理的最佳证据，为临床开展有效会阴疼痛管理提供依据。方法 系统检索临床支持决策系统、国内外指南网站、专业学会或协会网站及相关数据库等，获取阴道分娩产妇产后会阴疼痛管理的相关文献，包括临床决策、证据总结、最佳实践、指南、专家共识、系统评价，检索时限为建库至2023年11月。由2名研究者对文献独立进行质量评价，4名研究者按照标准化提取表格进行证据提取并整合，小组讨论确定最终的最佳证据。结果 纳入20篇文献，其中临床决策3篇，证据总结4篇，指南4篇，专家共识4篇，系统评价5篇。最终从会阴创伤的预防、会阴伤口的缝合、疼痛评估、非药物干预、药物干预、产后健康教育及人员培训7个方面总结了26条证据。结论 总结的阴道分娩产妇产后会阴疼痛的最佳证据较为科学、全面，临床医护人员可结合实际临床情景和患者需求选择证据，制订相关疼痛管理措施，以降低产妇会阴疼痛程度。

Abstract This scoping review provides a broad overview of the existing literature on economic evaluations of preventive, screening, and treatment programmes for peripartum depression (PPD). PPD is one of the leading causes of disease-related disability among women. However, PPD often goes undiagnosed and untreated, with as many as half of cases not being identified. We followed the PICO-P (publication type) structure. Databases were searched from inception until 30 June 2023. The intervention stage in the studies was classified as prevention, screening, treatment, screening and treatment, and prevention and treatment. The health economics methods of the studies were divided into cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, cost-minimisation analysis, return of investment, and multiple. Ultimately, 38 studies were included for extraction and evaluation. Several interventions for PPD may be cost effective, including peer support, psychological therapies, and screening strategies using tools like the Edinburgh Postnatal Depression Scale (EPDS). However, study limitations include heterogeneity across studies, methodological limitations, and limited generalisability to diverse populations. The cost-effectiveness results of PPD interventions may differ across different health systems, partly due to differences in the amount and distribution of resources available. By implementing suggested policy recommendations, policymakers can significantly improve the identification, treatment, and prevention of PPD, ultimately improving the health and well-being of mothers, children, and families.

目的 对乳腺癌患者性功能障碍发生率及其影响因素进行系统评价。方法 计算机检索国内外关于乳腺癌患者性功能障碍发生率及其影响因素的研究，检索时段为建库到2023年7月31日，由2名研究员独立进行文献筛选和信息提取，并进行质量评估，采用Stata 18.0软件进行Meta分析。结果 总计纳入17项研究，样本量为3 818例。乳腺癌患者的性功能障碍发生率为63.0%[95%CI(54.0%,72.0%)]。亚组分析结果显示，国内外乳腺癌患者的性功能障碍发生率分别为75%和48%,且差异有统计学意义。Meta分析结果显示：年龄(OR=1.12,95%CI:1.04～1.19,P=0.001)、月平均收入(OR=1.87,95%CI:1.23～2.87,P=0.004)、围绝经期(OR=4.32,95%CI:1.90～9.80,P<0.001)、手术方式(OR=2.61,95%CI:1.73～3.94,P<0.001)、化疗(OR=2.29,95%CI:1.38～3.78,P=0.001)、性健康教育(OR=4.68,95%CI:2.95～7.43,P<0.001)、术后时间(O...

Spinal muscular atrophy (SMA) is a rare inherited autosomal recessive progressive disease of a varying phenotype, with varying clinical symptoms, and as a result the patients suffering from it require multiple types of care. It was deemed useful to conduct a systematic literature review on the pharmacoeconomic evaluations of all currently registered disease-modifying therapies in order to inform policy and highlight research gaps. Pharmacoeconomic analyses written in English and published after 2016 were considered for inclusion. PubMed/Medline, Global Health and Embase were systematically and separately searched between 16 October and 23 October 2023. Hand-searching was also conducted on PubMed based on reference lists of published literature. After the exclusion criteria were applied, 14 studies were included. BMJ checklist was used for quality assessment and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess the quality of reporting of all included studies. Data extraction was performed manually. Regarding evidence synthesis, data were heterogeneous and are thus presented based on comparison. This study confirms the need for pharmacoeconomic analyses (cost-effectiveness or cost-utility) also in cases when the cost of treatment is very high and the incremental cost-effectiveness ratio values exceed the usual, acceptable values for standard therapy. Specific willingness to pay thresholds for orphan medicines are of the utmost importance, to allow patients with SMA to have access to safe and effective treatments. With such economic evaluations, it is possible to compare the value of medications with the same indication, but it should be emphasized that in the interpretation of data and in making decisions about the use of medicines, the impact of new knowledge should be considered.

Introduction: Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM. Methods: Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics. Results: Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years. Conclusion: Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings. Prospero registration: CRD42024529497.

BACKGROUND: Earlier detection of children at risk for neurodevelopmental disorders is critical and has longstanding repercussions if not addressed early enough. OBJECTIVES: To explore the supporting or facilitating characteristics of paediatric primary care models of care for early detection in infants and toddlers at risk for neurodevelopmental disorders, identify practitioners involved, and describe how they align with occupational therapy's scope of practice. METHODS: A scoping review following the Joanna Briggs Institute framework was used. PubMed Central, Cumulative Index to Nursing & Allied Health Literature, and Scopus databases were searched. The search was conducted between January and February 2022. Inclusion criteria were: children aged 0-3 years old; neurodevelopmental disorders including cerebral palsy (CP) and autism spectrum disorder (ASD); models of care used in the paediatric primary care setting and addressing concepts of timing and plasticity; peer-reviewed literature written in English; published between 2010 and 2022. Study protocol registered at https://doi.org/10.17605/OSF.IO/MD4K5. RESULTS: We identified 1,434 publications, yielding 22 studies that met inclusion criteria. Models of care characteristics included the use of technology, education to parents and staff, funding to utilize innovative models of care, assessment variability, organizational management changes, increased visit length, earlier timeline for neurodevelopmental screening, and collaboration with current office staff or nonphysician practitioners. The top 4 providers were paediatricians, general or family practitioners, nurse/nurse practitioners, and office staff. All studies aligned with occupational therapy health promotion scope of practice and intervention approach yet did not include occupational therapy within the paediatric primary care setting. CONCLUSIONS: No studies included occupational therapy as a healthcare provider that could be used within the paediatric primary care setting. However, all studies demonstrated models of care facilitating characteristics aligning with occupational therapy practice. Models of care facilitating characteristics identified interdisciplinary staff as a major contributor, which can include occupational therapy, to improve early detection within paediatric primary care.

Preterm birth, defined as delivery before 37 weeks of gestation, is a significant contributor to neonatal morbidity and mortality worldwide. Understanding the prevalence of preterm birth is critical to improving neonatal care, informing public health strategies, and supporting health care planning. The objective of this study was to explore the problem of preterm birth in Saudi Arabia by estimating the prevalence of preterm birth over a defined period of time. CINAHL, Cochrane Pregnancy and Childbirth Database, Embase, and Medline were searched, limiting the search to the human Saudi population, with no date or language restriction. Titles, abstracts, and full texts were screened to determine eligibility for inclusion. Included studies were assessed for risk of bias utilizing the Let Evidence Guide Every New Decision (LEGEND) tool. Then, data were extracted in a customized data collection form. Among the 14 full texts reviewed, 10 studies met the eligibility criteria and were included in the final review, with a total of 50,514 participants for singletons and 336 sets of twins or/and high-order gestation in different regions of Saudi Arabia. Six studies have been entered into the meta-analysis and resulted in a pooled prevalence of preterm birth of 7.89 per 100 live births (95% confidence interval: 6.94 to 8.97). For multiple pregnancies, the average prevalence of preterm birth was 91.3 per 100 live births (95% confidence interval: 88.3 to 94.3). The overall preterm birth rate in Saudi Arabia can be utilized in national health planning and public health policy development. By knowing the prevalence of preterm birth, healthcare practitioners and policymakers can effectively plan for capacity building and healthcare services to provide efficient and proactive care for preterm infants, ultimately improving patient outcomes by reducing neonatal morbidity and mortality.

Stunting is a chronic malnutrition problem caused by a lack of nutrients over a long period. This leads to problems later in life, resulting in difficulty in achieving optimal physical and cognitive development. This study analyzes policies, interventions, and addresses of child stunting in Asian, African, and American countries through a systematic review. The design used is a systematic review, articles are collected using electronic databases such as ScienceDirect, SpringerLink, ProQuest, PubMed, and SAGE from 2019-2023 using the keywords policy, management, and stunting. As the results of the literature review to reduce stunting rates, stunting policies and programs focus on food security, decentralization of the health system, availability of health services and access to health services, maternal education, access to water, hygiene, sanitation, maternal nutrition, and poverty alleviation- appropriate policy implementation results of holistic and comprehensive policy formulation. Stunting prevention requires cross-program and cross-sector collaboration and is carried out comprehensively.