Introduction Youth with Neurodevelopmental Disabilities (NDD) who are transitioning to adulthood often struggle with accessing services. This limited access can result in poorer health, reduced ability to perform daily activities and engage in independent living and decreased levels of participation in society. Despite Canada’s commitment to the UN Convention on the Rights of Persons with Disabilities, British Columbia (BC) youth with NDD face additional barriers. Methods This study investigated service providers’ and decision-makers’ perspectives on barriers, facilitators and policy recommendations for accessing BC’s health, education and disability services for youth with NDD. We conducted a qualitative descriptive study with 15 semi-structured interviews. We conducted inductive thematic coding to generate themes, which we then organized and interpreted using Bronfenbrenner’s ecological model. Results Findings revealed that fragmented organizational structures, eligibility criteria, limited and unstable funding and enduring stigma impede service access, while coordinated inter-agency collaboration, clear transition planning and early, family-centered interventions may improve outcomes. Discussion Targeted policy reforms across multiple ecological levels are essential to reduce inequities in service access and strengthen the continuum of support for youth with NDD as they transition to adulthood.

Introduction Our objective was to understand how social scientific research could best address the needs and concerns of patients, families, carers, healthcare professionals, academics, private and public sector professionals, and volunteers from Long Covid charities and support groups and people with lived experience of Long Covid. We worked with different stakeholders to develop a list of research priorities that particularly focused on social science as this is where our collective expertise lies, but similar methods could also be used to set research priorities in the natural sciences, medicine or the humanities. Methods We used purposive sampling and conducted two online surveys. The first online survey ( N = 57) asked participants to identify their top five questions of concern, which resulted in a list of 253 questions. These questions were then consolidated, refined and edited down to 55 questions, categorized by topic. In the second survey ( N = 66), we asked participants to select and rank their top 10 questions from this refined list. The final output was a ranked list of nine questions based on those prioritized by at least 50% of the respondents. Results Nine research questions were developed concerning (i) treatments, therapies, and strategies; (ii) financial support; (iii) repeated reinfections; (iv) training of healthcare professionals; (v) mental health impact; (vi) future of research funding; (vii) airborne transmissions of COVID-19; (viii) developing therapeutics informed by patients’ experiences; and (ix) socioeconomic impacts of Long Covid. Many of the issues raised mirror those discussed in previous work in the UK and internationally, but additional novel themes emerged, underscoring the value of this collaborative approach. Conclusion Our survey revealed the value of including the voices of diverse individuals affected by Long Covid and those working in this area and highlighted priorities for social science in the field of Long Covid research.

The decline in physical activity (PA) from childhood through adolescence is an escalating global concern with far-reaching implications for health and wellbeing. While prior research has examined general PA trends, critical gaps remain regarding the precise onset of decline, contributing factors, and the most effective intervention strategies. This systematic review synthesizes evidence on: (a) the age or developmental stage at which PA levels significantly decline, (b) key factors influencing this decline, and (c) interventions shown to be effective in slowing or preventing it. A comprehensive search was conducted across four electronic databases: Scopus, Web of Science, Google Scholar, and CORE guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. From an initial pool of 14,621 records, 34 studies met the inclusion criteria. Findings reveal that PA levels begin to decline as early as age 7, with the most substantial drop occurring around age 9. Modifiable factors such as self-efficacy, motivation, screen time, and academic workload emerged as key contributors to this trend. Among intervention strategies, school-based, multicomponent, and theory-driven approaches, particularly those incorporating autonomy-supportive teaching, addressing both PA and sedentary behaviors, and engaging multiple stakeholders, demonstrated the strongest effectiveness. These results underscore the urgent need for early, multidimensional interventions to sustain PA engagement across developmental stages. Stakeholders including schools, policymakers, and researchers should prioritize integrated PA promotion strategies to reverse early inactivity trends. Future research should focus on the long-term sustainability of these interventions beyond the school context to ensure enduring behavioral change.

Background Breast cancer has been a serious health problem worldwide. Early detection is undoubtedly effective in combating severe public health problems in developing countries. Meanwhile, primary care physicians play an important role in implementing screening programs. The objective of our study was to evaluate the determinants of primary care physicians’ intention to provide the breast cancer screening services (BCSs) for rural women. Methods We conducted a cross-sectional survey in 24 towns in Jiangsu Province. A total of 1,101 primary care physicians participated in and completed the study. The data collection tool was developed based on the theory of planned behavior (TPB), which includes attitude, subjective norms, and perceived behavioral control, as well as extended components including knowledge of BCSs and past providing-BCSs behavior. Results The results of our study showed that subjective norms ( β = 0.352, p < 0.001) had the strongest influence on primary care physicians’ intention to engage in breast cancer screening, followed by attitudes and perceived behavioral control. Both screening knowledge and past screening provision behavior had an indirect effect on behavioral intentions. Conclusion The present study demonstrated that extended TPB is an effective model for explaining primary care physicians’ intention to engage in breast cancer screening programs. Meanwhile, our findings provide a reference for governments, hospitals and policies aiming to increase primary care physicians’ intention to provide rural women with BCSs.

Public health professionals frequently engage with residents of rural Georgia to conduct needs-based initiatives, which aim to identify deficiencies and shortcomings in community health. However, this process can exacerbate existing stereotypes and lead community members to feel a sense of despair in their own communities. The Community Health Resource Project (CHRP) offers a counterbalance through a strengths-based approach by highlighting animal, plant, human, and environmental resources, or “One Health” assets, that currently exist in the community. CHRP begins by analyzing publicly available county-level data to gain an initial understanding of the health landscape before proceeding to the field. Next, the team engages in Participatory Asset Mapping (PAM) to gather community-driven qualitative insights on existing One Health assets in participating rural or underserved counties. Data gathered from community engagement strategies inform the development of comprehensive county-specific asset maps and reports. This paper describes the methods of applying a strengths-based approach to highlight community One Health-related assets. These strategies can be a valuable tool for developing targeted workforce development efforts in resource-limited counties for the benefit of all species.

Objectives To identify the discharge preparation service needs of parents of preterm infants through a qualitative systematic review and meta-synthesis. Methods A systematic search was conducted for qualitative studies examining the discharge preparation needs, experiences, and perceptions of parents of preterm infants. The search was limited to publications in English and Chinese, as these were the languages in which the research team was proficient, ensuring accurate comprehension and interpretation of the nuanced qualitative data. The inclusion criteria were as follows: (P) Parents of preterm infants hospitalized in the NICU or parents of preterm infants discharged from the NICU; (I) Needs, experiences, and difficulties encountered by parents of preterm infants in preparation for hospital discharge; (Co) Follow-up of preterm infants during hospitalization in the NICU or in the weeks following discharge from the NICU; (S) Various types of qualitative research. Two independent reviewers screened titles and abstracts, assessed the full texts of potentially eligible studies for inclusion, evaluated the methodological quality of the included studies, and extracted the data. Discrepancies were resolved through discussion or consultation with a third reviewer. Results A total of 12 studies revealed 3 descriptive themes and 9 sub-themes: (1) psychological and social support needs, (2) information and skills support needs, (3) continuity of services and resource requirements. Conclusion During the preparation for discharge of parents of preterm infants in the NICU, their needs for psychological support, knowledge, and skills in preterm infant care, as well as post-discharge support, are evident. Healthcare professionals should address their psychological needs, facilitate family role adaptation, provide individualized health education, and strengthen the post-discharge support system to enhance parents’ ability to care for preterm infants at home. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ .

Background Life satisfaction and quality of life are essential indicators of wellbeing in older adults. Social capital has been increasingly recognized as a key factor influencing these outcomes. This study systematically reviewed and synthesized existing evidence on the association between social capital and quality of life and life satisfaction among older adults through a systematic review and meta-analysis. Methods A comprehensive literature search was performed in MEDLINE (via PubMed), PsycINFO, and CINAHL (via EBSCO) from inception to January 15, 2025. Observational studies reporting quantitative associations between social capital and quality of life and life satisfaction in adults aged ≥60 years were included. Unadjusted effect sizes ( r ) were pooled using random-effects models for meta-analysis to account for variability across studies. Subgroup meta-analyses were conducted to examine differences based on publication period, geographic location, and quality of life measures. Between-study heterogeneity was tested using the I 2 index, and publication bias was investigated using funnel plots, Egger's test, and Begg's test. Results We identified 13 studies that included 5,880 older participants from seven countries. Meta-analyses revealed life satisfaction ( r = 0.25, 95% CI: 0.20–0.31) and quality of life ( r = 0.35, 95% CI: 0.19–0.49) all demonstrated significant associations with social capital. The overall pooled effect size ( r = 0.27, 95% CI: 0.22–0.32) demonstrated a consistent positive relationship. Subgroup analyses showed that cognitive social capital ( r = 0.35, 95% CI: 0.18–0.49) had a stronger association than structural social capital ( r = 0.24, 95% CI: 0.19–0.29). Regional differences were not statistically significant ( p = 0.182), although the effect sizes varied across continents: America ( r = 0.24, 95% CI: 0.16–0.32), and Asia ( r = 0.30, 95% CI: 0.23–0.37). Statistical heterogeneity was observed across meta-analyses ( I 2 = 68.9–95.5%). Publication bias was not significant based on Egger's and Begg's tests. Conclusions The findings of this meta-analysis suggest that social capital, particularly its cognitive dimension, plays an important role in enhancing quality of life and life satisfaction outcomes, with differences across time and geographic regions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42025638236 , identifier: CRD42025638236.

Objectives To investigate the stage-specific prevalence and progression mechanisms of sarcopenia in aging patients undergoing maintenance hemodialysis (MHD), and to identify modifiable risk and protective factors relevant to early public health interventions. Methods This multicenter cross-sectional study enrolled 448 eligible older adults (aged ≧ 60 years) undergoing maintenance hemodialysis (MHD) from three tertiary hospitals in Bengbu, China, between January and April 2025, using convenience sampling. Sarcopenia was classified according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Data on demographics, body composition, nutrition, self-efficacy, physical activity, and inflammation were collected. Logistic regression analyses identified factors associated with sarcopenia onset and progression. Results Sarcopenia prevalence was 54.0%, with 25.0% at the possible stage, 19.6% confirmed, and 9.4% severe. Key protective factors for sarcopenia onset included female sex, higher basal metabolic rate (BMR), higher Body Mass Index (BMI) and greater self-efficacy (SES6). Risk factors included low physical activity, diabetes, longer dialysis vintage, and malnutrition (MQSGA). Progression to confirmed/severe stages was independently associated with reduced BMI, protein mass, and self-efficacy, along with elevated BMR and physical inactivity. These findings highlight the importance of early screening and personalized preventive strategies in aging MHD populations. Conclusion Sarcopenia is highly prevalent among older adults receiving MHD, with distinct stage-specific progression patterns. This study identified key modifiable risk and protective factors related to both the onset and progression of sarcopenia. Early detection of possible sarcopenia and timely interventions targeting nutrition, physical activity, and self-efficacy may delay progression and promote healthy aging in this population.

Background Frailty is a public health concern linked to falls, disability, and mortality. Early screening and tailored interventions can mitigate adverse outcomes, but community settings require tools that are accurate and explainable. Korea is entering a super-aged phase, yet few approaches have used nationally representative survey data. Objective This study aimed to identify key predictors of frailty risk using the K-FRAIL scale using explainable machine learning (ML), based on data from the 2023 National Survey of Older Koreans (NSOK). It also sought to develop and internally validate prediction models. To demonstrate the potential applicability of these models in community public health and clinical practice, a web-based application was implemented. Methods Data from 10,078 older adults were analyzed, with frailty defined by the K-FRAIL scale (robust = 0, pre-frail = 1–2, and frail = 3–5). A total of 132 candidate variables were constructed through selection and derivation. Using CatBoost with out-of-fold (OOF) SHapley Additive exPlanations (SHAP, a game-theoretic approach to quantify feature contributions), 15 key predictors were identified and applied across 10 algorithms under nested cross-validation (CV). Model performance was evaluated using receiver operating characteristic–area under the curve (ROC-AUC), precision–recall area under the curve (PR-AUC), F1-score, balanced accuracy, and the Brier score. To assess feasibility, a single-page bilingual web application was developed, integrating the CatBoost inference pipeline for offline use. Results SHAP analysis identified depression score, age, instrumental activities of daily living (IADL) count, sleep quality, and cognition as the leading predictors, followed by smartphone use, number of medications, province, driving status, hospital use, physical activity, osteoporosis, eating alone, digital adaptation difficulty, and sex, yielding 15 key predictors across the mental, functional, lifestyle, social, and digital domains. Using these predictors, boosting models outperformed other algorithms, with CatBoost achieving the best performance (ROC-AUC = 0.813 ± 0.014; PR-AUC = 0.748 ± 0.019). Conclusion An explainable machine learning model with strong discrimination performance and adequate calibration was developed, accompanied by a lightweight web application for potential use in community and clinical settings. However, external validation, recalibration, and subgroup fairness assessments are needed to ensure generalizability and clinical adoption.