Background: With the continuous advancement of science and technology, the demand for health knowledge about pediatric orthopedics is also gradually growing. The traditional paper-based and multimedia health education models can no longer fully meet the needs of society. Fortunately, the emergence of social media has mitigated the problem of insufficient medical education resources. However, there is currently relatively little published evidence on the use of social media in pediatric orthopedics. Objective: This study aimed to examine the current applications of social media in pediatric orthopedics and to evaluate the quality and readability of related online health information. Its purpose is to provide relevant evidence to promote the understanding and development of the field. Methods: This review followed the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute reviewer manual. First, a literature search was performed in the PubMed, Embase, CINAHL, Web of Science, and Cochrane databases. The search time range was from the establishment of the databases to September 21, 2023. We endeavored to include research articles related to social media and involving pediatric orthopedics in the review. The literature was reviewed at the title, abstract, and full-text levels. Results: We included 35 of 3400 (1.03%) studies retrieved. Most of the articles used social media to help with medical staff and patient education and training (23/35, 66%) and to disseminate information (21/35, 60%), followed by helping medical staff collect data (8/35, 23%). Medical institutions and staff also used social media to increase attention (6/35, 17%), enhance social support (5/35, 14%), facilitate the recruitment of research participants (3/35, 9%), support professional development (3/35, 9%) and implement health intervention (2/35, 6%). Five general quality of information (QOI) tools, 7 specific QOI tools, and 6 readability tools were used in 12 studies analyzed for quality and readability, with overall quality being fair and readability exceeding the recommended level. According to the research data, people are increasingly interested in pediatric orthopedics on social media platforms and eager to obtain and learn relevant knowledge. Conclusions: This scoping review found that social media has a growing body of literature on pediatric orthopedic conditions and is playing an increasingly important role in knowledge dissemination and education. A variety of tools are being used for assessing the QOI, but little attention has been paid to the readability of the information. The QOI was largely fair, with readability above the recommended level. Future research should further explore the role of social media in pediatric orthopedics and continue to optimize QOI and information readability.

Human Noroviruses (HuNoVs) are the leading etiologic agents responsible for viral gastroenteritis. Drinking water (DW) serves as a significant vehicle for the transmission of HuNoVs. This study aimed to assess the occurrence of HuNoVs in drinking water sources (DWS) and DW. A systematic search spanning Web of Science, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials was executed up to July 15, 2024. Following rigorous screening, 76 eligible studies underwent meta-analysis with heterogeneity assessment via Stata 14.0 using a random-effects model. The results indicated that the pooled occurrence of HuNoVs was 11 % (95 % CI: 8-14), with occurrence of 15 % (95 % CI: 10-21) in DWS and 6 % (95 % CI: 3-9) in DW. Subgroup meta-analysis demonstrated that genogroup II (GII) of HuNoVs exhibited the highest contamination occurrence of 7 % (95 % CI: 4-10), with GII.4 and GII.17 being the predominant genotypes. The two continents with the highest number of studies were Asia (n = 27) and Europe (n = 19), with HuNoVs occurrence of 14 % (95 % CI: 8-22) and 15 % (95 % CI: 7-26), respectively. Furthermore, the occurrence showed no significant differences across the four seasons: in spring, the occurrence was 11 % (95 % CI: 3-23); in summer, 15 % (95 % CI: 7-25); in autumn, 11 % (95 % CI: 2-24); and in winter, 18 % (95 % CI: 10-27). These findings provided valuable epidemiological insight into the global occurrence, seasonal variation, and genotypic distribution of HuNoVs in DWS and DW, aiding policy development and public health strategies.

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.

Abstract 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.

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: Artificial intelligence (AI) is increasingly integrated into health care, including psychiatry and psychology. In educational contexts, AI offers new possibilities for enhancing clinical reasoning, personalizing content delivery, and supporting professional development. Despite this emerging interest, a comprehensive understanding of how AI is currently used in mental health education, and the challenges associated with its adoption, remains limited. Objective: This scoping review aimed to identify and characterize current applications of AI in the teaching and learning of psychiatry and psychology. It also sought to document reported facilitators of and barriers to the integration of AI within educational contexts. Methods: A systematic search was conducted across 6 electronic databases (MEDLINE, PubMed, Embase, PsycINFO, EBM Reviews, and Google Scholar) from inception to October 2024. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies were included if they focused on psychiatry or psychology, described the use of an AI tool, and discussed at least 1 facilitator of or barrier to its use in education. Data were extracted on study characteristics, population, AI application, educational outcomes, facilitators, and barriers. Study quality was appraised using several design-appropriate tools. Results: From 6219 records, 10 (0.2%) studies met the inclusion criteria. Eight categories of AI applications were identified: clinical decision support, educational content creation, therapeutic tools and mental health monitoring, administrative and research assistance, natural language processing (NLP), program/policy development, students' study aid, and professional development. Key facilitators included the availability of AI tools, positive learner attitudes, digital infrastructure, and time-saving features. Barriers included limited AI training, ethical concerns, lack of digital literacy, algorithmic opacity, and insufficient curricular integration. The overall methodological quality of included studies was moderate to high. Conclusions: AI is being used across a range of educational functions in psychiatry and psychology, from clinical training to assessment and administrative support. Although the potential for enhancing learning outcomes is clear, its successful integration requires addressing ethical, technical, and pedagogical barriers. Future efforts should focus on AI literacy, faculty development, and institutional policies to guide responsible and effective use. This review underscores the importance of interdisciplinary collaboration to ensure the safe, equitable, and meaningful adoption of AI in mental health education.

This systematic review examined trends in the prevalence of type 2 diabetes mellitus (T2DM) and identified its risk factors among adults in Vietnam. PubMed, Web of Science, Wiley Online Library, and Scopus databases were searched to identify relevant literature. The search yielded 10 studies, including 2 national surveys and 8 regional investigations. National prevalence estimates of T2DM were 2.7% in 2002 and 5.4% in 2012. The estimates for the northern region were 1.4% in 1994 and 3.7% in 2012 and those for the southern region were 3.8% in 2004, 7.0% in 2008, and 12.4% in 2010. The major determinants of T2DM included older age, urban residence, high levels of body and abdominal fat, physical inactivity, sedentary lifestyle, genetic factors, and hypertension. The prevalence rate by gender was variable in both national and regional studies. There was insufficient information available on some potentially important risk factors such as smoking, dietary intake, income, and educational level. Our review signifies a rapidly growing prevalence of T2DM in Vietnam and suggests that extra effort is required to prevent and control this disease

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.

Purpose: Low- and middle-income countries (LMICs) experience the highest rates of injury-related deaths globally, exacerbated by a lack of robust emergency medical services (EMS). Though fractures contribute substantially to global injury, little is known about prehospital management of extremity fractures in LMICs. Methods: This review included literature published between January 2000 and January 2024. Inclusion criteria pertained to prehospital settings, defined as care rendered prior to hospital presentation, including care provided by lay first responders (LFRs), professional EMS personnel, and traditional bonesetters (TBS). Multiple authors used the Newcastle-Ottawa scale to assess texts meeting inclusion criteria, extracting relevant details for analysis. Results: Of 1251 articles identified, 25 met inclusion criteria. Studies spanned 9 countries across 4 continents, with 14 articles studying care by TBS, 9 by LFRs, and 2 by other prehospital providers. LFR training courses report a combined weighted average pre-/post-course difference of 29.16 percentage points. A total of 67% of included studies report adverse outcomes associated with TBS-managed fractures in the prehospital setting. TBS care is often sought prior to hospital presentation due to sociocultural beliefs, accessibility, and cheaper costs. Few training courses for TBS have been performed, though one course reports a 20.4% increase in fracture management knowledge. Conclusion: In certain resource-limited settings, TBS provide most initial fracture management, which may adversely impact outcomes. Knowledge transfer has been demonstrated during prehospital fracture management courses for LFRs and TBS. Early evidence suggests TBS training and integration into healthcare systems may reduce complication rates, improving long-term outcomes.

Background: Tension-type headache (TTH) is a prevalent primary headache disorder significantly impacting quality of life and healthcare resource utilization, with females typically bearing a higher disease burden. However, comprehensive analyses and predictive studies on the global TTH burden stratified by gender are currently lacking. Aim: This study utilized data from the Global Burden of Disease (GBD) Study to analyze the global burden of tension - type headache by sex from 1990 to 2021 and conducted a 15 - year projection (up to 2036). Methods: We conducted a systematic review of GBD 2021 data, employing Joinpoint regression analysis and decomposition analysis to assess TTH incidence, prevalence, YLDs, and DALYs. Additionally, we used the ARIMA model for a 15-year predictive analysis of TTH burden trends. Results: From 1990 to 2021, global female TTH cases rose from 669.54 million (95% UI: 586.2-751.8 million) to 1.04 billion (95% UI: 923.0-1.1 billion), with incidence increasing from 242.9 million (95% UI: 218.8-267.0 million) to 369.86 million (95% UI: 332.5-407.2 million). Male cases grew from 616.82 million (95% UI: 537.2-696.4 million) to 970 million (95% UI: 851.0-1.0 billion). Decomposition analysis indicated population growth was the primary driver of the increase in female TTH prevalence. Projections suggest that by 2036, the incidence will reach 9,174.84 per 100,000 females (95% UI: 8,854.8-9,494.9), prevalence will be 25,135.1 per 100,000 females (95% UI: 23,977.2-26,283.0), YLD rate will be 62.76 per 100,000 females (95% UI: 58.8-66.7), and DALY rate will be 60.97 per 100,000 females (95% UI: 56.7-65.2). Conclusion: This study highlights the significance of gender in TTH burden, particularly the heightened risk for females. Through temporal trend analysis and predictive modeling, we provide insights into future TTH disease trajectories, aiding global public health policy formulation and healthcare resource allocation.

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: Health inequalities are differences in health status or in the distribution of resources and opportunities between different population groups. Bayesian models are well-suited to address the special features and uncertainties in inequality analyses, making them useful for informing policymaking. This research reviewed the use of Bayesian models in racial health equity studies focused on non-communicable diseases. Methodology: A systematic review was conducted to assess the applications and utility of Bayesian inference in racial health equity studies for non-communicable diseases (PROSPERO Registry No. CRD42024568708). A total of 2274 articles were identified through electronic databases, and 46 studies met inclusion criteria. All but three articles were from high-income countries, and all were published between 2008 and 2024. We summarized the information qualitatively, and each document included was assessed using the Bennett-Manuel checklist tool. Findings: Studies on cancer and cardiovascular diseases were the most frequent. The most frequently used models were Poisson, spatial, and logistic regressions, with Markov-chain Monte Carlo and Integrated nested Laplace approximations being the dominant sampling strategies. The studies found that Black individuals, followed by those of Hispanic ethnicity, are the racial/ethnic groups most affected by health inequities. Data on other racial groups (e.g., Indigenous populations, people of Asian heritage) was insufficient for drawing definitive conclusions. The main factor contributing to these disparities lies within the health system, particularly in terms of access and quality, which can be understood in the context of each disease. Interpretation: The integration of Bayesian modeling into health equity studies holds promise for developing methodologies that lead to insights and foster meaningful change.

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.

Gastrointestinal (GI) cancers are among the leading causes of cancer-related morbidity and mortality worldwide, presenting a significant public health challenge. Even with medical research advancements, their incidence remains rising due to modifiable and non-modifiable risk factors across lifestyle, environmental, genetic, and socioeconomic factors. This narrative review identifies and synthesizes key risk factors contributing to GI cancers, including unhealthy diets (high consumption of processed foods, red meat, and added sugars), physical inactivity, obesity, smoking, alcohol use, infections (e.g., Helicobacter pylori), environmental pollution, chronic stress, and socioeconomic disparities. The review emphasizes the interaction among these factors and how this interplay is responsible for the development and progression of GI cancer. It emphasizes the importance of early detection, lifestyle modifications, and public health interventions tailored to specific populations. Understanding these interconnected risk factors provides critical insights for guiding prevention strategies, policymaking, and health education. Addressing modifiable risk factors through a comprehensive, multi-sectoral approach may significantly reduce the global burden of GI cancers and improve long-term health outcomes.

Background: Despite advances in precision medicine, the translation of genetic and genomic technologies into routine practice is hampered by a heterogeneous and limited evidence base and the absence of standardized evaluation methodologies. Health Technology Assessment (HTA) plays a critical role in bridging this gap, yet assessment approaches and comprehensiveness vary widely. This systematic review aims to map the landscape of the assessment reports on genetic and genomics applications, analyze their methodological aspects and identify gaps. Methods: PubMed, Scopus, Web of Science, and the international HTA database, were searched for assessment reports of genetic/genomic technologies. Information on reports general characteristics, assessment domains and their components, consulted sources of evidence and reported gaps was extracted. Findings were synthesized narratively. Results: Out of 27,331 screened records, 41 reports were included, predominantly from Canada, the United Kingdom, and Australia, mainly aimed at informing policy making for single or multiple gene tests for cancer patients. Most reports used a generic HTA methodology and assessment domains varied across reports. Key clinical aspects, such as clinical accuracy and safety, suffered from evidence gaps (39.0% and 22.0%), while personal and societal aspects were the least investigated assessment domain (48.8-78.0%). Overall, lack of evidence and limited generalizability of findings were the most commonly reported gaps across multiple domains. Conclusions: The review highlighted significant fragmentation in current evaluation methodologies of genetic and genomic applications, with underassessment of analytical/clinical accuracy, safety, and non-health outcomes, alongside evidence gaps and limited generalizability. These issues compromise both evaluation and decision-making process, underscoring the urgent need for alternative study designs and standardized, comprehensive assessment frameworks to facilitate the successful implementation of emerging genetic and genomic technologies.

The Integrated Disease Surveillance and Response (IDSR) framework, introduced by the WHO in 1998, aimed to unify disease surveillance across West Africa, replacing fragmented systems. However, challenges such as limited real-time reporting, inadequate data collection and workforce shortages continue to impede disease control and outbreak response. The resurgence of infectious diseases like Ebola, cholera, COVID-19 and monkeypox highlights the need to strengthen IDSR systems for effective public health management. This article reviews IDSR implementation in West Africa, identifying persistent gaps, including delayed outbreak detection, limited laboratory capacity and weak surveillance infrastructure. It emphasises the importance of policy development, capacity building and stakeholder engagement to secure political support and resources. Integrating technological innovations-such as mobile health (mHealth), geographic information systems (GIS), electronic health records and big data analytics-can enhance real-time data sharing and response coordination. Strengthening laboratories, workforce training and monitoring frameworks is essential to improve IDSR performance. Strategic investments are crucial to bolster public health capacities, accelerate response times and mitigate future epidemics in West Africa.

The prevalence of early childhood caries (ECC) tends to increase in the first 5 years of life as children grow, and those affected by ECC are likely to experience caries throughout their lives. ECC negatively impacts the oral health-related quality of life of both children and their families. Although controlling sugar intake and the use of fluoride are well-known methods for managing dental caries, preventive and therapeutic interventions alone have not been sufficient to prevent the development of new caries lesions. This review aims to explore why ECC continues to occur despite the oral health team having the necessary knowledge to prevent it. Based on current scientific evidence, this article highlights the need for the oral health team to consider additional factors, such as implementing oral health prevention programs in the first 450 days of life, enhancing caregivers' oral health literacy, creating a supportive environment, and engaging in upstream actions (teledentistry, implementation science, health policies development etc.) to effectively manage and prevent dental caries. Otherwise we would be educating and treating children and sending them back to the conditions that made them sick. By addressing these factors, it might be possible to improve long-term oral health outcomes for children and reduce the burden of ECC on children and their families.

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.