Reduced handgrip and inspiratory muscle strength are associated with lower lung function and physical capacity in children and adolescents born preterm with very low birth weight.

Increasing research capacity and capability in a mental health and community trust in England

Objectives This study clarified the practical activities undertaken by municipal public health nurses (PHNs) during the coronavirus disease 2019 (COVID-19) pandemic and ethical and emotional conflicts they experienced to derive implications for strengthening community health responses and capacity building during future health crises.Methods This qualitative descriptive study was conducted using focus group interviews with eight municipal PHNs, with an average of 23.88 years of experience. Interview transcripts were transcribed verbatim and analyzed using inductive content analysis to extract themes regarding participants' activities and emotional experiences during the pandemic.Results Under crisis conditions, six categories describing PHNs' activities included (1) coping with rapidly increasing responsibilities under uncertain conditions, (2) supporting vulnerable populations and their caregivers, (3) restoring maternal and child health services, (4) initiating organizational and interagency collaborations to mitigate social deterioration, (5) collecting and sharing information to minimize the negative impacts of restrictions, and (6) working with community leaders and professionals to sustain residents' well-being.Seven categories emerged regarding ethical and psychological conflicts; (1) confusion from expanded roles, (2) frustration at being unable to support those in need, (3) self-doubt about service effectiveness, (4) barriers to collaboration with health centers and other institutions, (5) discrepancies between organizational policies and community realities, (6) re-examination of the meaning of public health nursing during pandemics, and (7) challenges due to insufficient infection control knowledge and systems. A key competency theme was the need to reacknowledge the PHNs' role during health crises.Conclusion During the COVID-19 pandemic, municipal PHNs have experienced limitations in providing individual support and changes in their professional roles. However, they continued to support residents via trust-based relationships with the community and the foundation of public health services, which has been built during normal times. Furthermore, they frequently face ethical dilemmas if prioritizing tasks and responding to residents, which often entails emotional burdens.

Introduction The 2015 Zika outbreak crises in Brazil, exposed major challenges in access to contraception services. This report examines outcomes of project aimed at strengthening and studying family planning services in Balsas, Maranhão, an area severely affected by ZIKV. Methods The project was guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. It followed a structured, four-phase process to systematically design, implement, and sustain evidence-based interventions aimed at enhancing contraceptive service delivery. Key activities included stakeholder engagement, health system assessments, capacity building, cascade training and task sharing from specialists to general practitioners and nurses. Results The intervention led to significant improvements in utilization of family planning services. The transformation of the Women's Health Program, based at the Dr. Rosy Kury Municipal Hospital in Balsas, into a center of excellence, enabled the introduction and scale-up of previously unavailable services such as IUD insertion and removal. This resulted in approximately 1,468 voluntary IUD insertions within 1 year, a dramatic increase from only eight in the previous 5 years. Task sharing IUD procedures with general practitioners and nurses significantly expanded service coverage. Comprehensive training and mentoring were extended to all 26 primary care facilities in Balsas and to providers in four neighboring municipalities, with a total of 80 providers trained, contributing to increased contraceptive uptake across the region. Conclusion The structured implementation approach effectively addressed systemic barriers to contraceptive access in a resource-limited setting. By empowering general practitioners and nurses to deliver a broader range of contraceptive methods, the intervention significantly enhanced service delivery. The success of this model highlights its potential for replication in similar contexts and underscores the importance of ongoing capacity building and strengthened health information systems to sustain long-term improvements.

Relationship between anticipatory grief and dyadic coping in advanced cancer patients and their spouses: An examination based on the actor-partner interdependence model.

Background: Cardiometabolic diseases are a leading cause of premature mortality globally, yet longitudinal national mortality patterns remain insufficiently characterised in Gulf Cooperation Council settings. This study examines national trends in cardiometabolic mortality alongside health system financing, capacity, and utilization in Kuwait between 2010 and 2022. Methods: A national ecological time-series analysis used Ministry of Health administrative data covering mortality, cardiac care unit (CCU) capacity and discharges, cardiovascular procedural volumes, and MOH expenditure. Cause-specific outcomes included circulatory disease, ischaemic heart disease (IHD), cerebrovascular disease, hypertensive disease, and diabetes mellitus. Ordinary least squares regression estimated annual trends; pre-COVID restricted models (2010-2019) separated secular from pandemic-period effects. Results: All-cause deaths rose significantly from 5448 (2010) to 8041 (2022; β = +373.5/year; p = 0.001), peaking at 10,938 in 2021. Circulatory disease mortality rates increased over the full series but not pre-COVID, indicating pandemic-era acceleration. IHD death counts rose significantly in both models (β = +68.4 and +67.0/year; p < 0.01); IHD rates showed no significant trend, implicating demographic growth. Diabetes demonstrated the strongest signal: significant increases in death counts (β = +36.5/year; p < 0.001) and mortality rates (β = +0.689/100,000/year; p = 0.002), rising progressively across all time blocks. Hypertensive mortality declined significantly (β = -0.113/year; p = 0.002). MOH expenditure, CCU capacity, and CCU discharges increased significantly, demonstrating sustained structural expansion of cardiovascular services. Conclusions: Rising cardiometabolic mortality-driven prominently by diabetes-occurred alongside sustained health system expansion in Kuwait, indicating that tertiary capacity growth alone is insufficient to offset underlying epidemiological pressures. These findings underscore the urgency of strengthening upstream cardiometabolic prevention, integrated diabetes surveillance, and long-term metabolic risk control as central pillars of sustainable NCD policy.

Pertussis (whooping cough), a vaccine-preventable disease that affects people of any age, has resurged globally after the COVID-19 pandemic. Key reasons for recent pertussis outbreaks include suboptimal pertussis vaccination coverage (particularly for vaccination during pregnancy) and growing vaccination hesitancy. During the 2023-2024 pertussis outbreaks in Europe, adolescents aged 10-14years and 15-19years had the first and third highest incidence rates, respectively. To reduce pertussis burden, it is essential to strengthen vaccination programs in the indicated target groups. This requires increased awareness among healthcare professionals about the local epidemiology of pertussis and its clinical presentation, alongside reinforcement of the benefits of vaccination for disease prevention. In parallel, robust surveillance systems and strong public health capacity for early disease detection and response are crucial to effectively manage outbreaks and build resilience against future outbreaks. Infants remain at high risk for pertussis, with complications, hospitalisation, and death being more common than in other age groups. Immunisation programmes combining vaccination during pregnancy, to protect newborn infants until their primary immunisation series has induced immunity, and infant immunisation are key to reducing morbidity and mortality. Strategies to improve pertussis vaccination uptake among adolescents and adults, especially those with high-risk medical conditions, are also essential. Strengthening global collaborations to invest in and build surveillance systems capable of identifying and responding to future outbreaks, to align national policies, to scale up immunisation during pregnancy, and to adopt a life-long immunisation approach are needed to better control endemic pertussis and manage future outbreaks.

We describe a novel curriculum designed to build capacity for public health and primary care collaboration. Since the Northwest Public Health & Primary Care Leadership Institute began in 2020, 119 participants have completed the seven-month hybrid curriculum. Application of knowledge and skills learned to workplace or community projects was reported by 84% of participants. Case-based learning and the critical friends group were valued learning methodologies. A cross-sectoral leadership curriculum can promote public health and primary care integration. (Am J Public Health. 2026;116(4):443-446. https://doi.org/10.2105/AJPH.2025.308377).

Based on the WHO's concept of health, the Guidelines for the Diagnosis and Treatment of Obesity according to Decision No. 2892/QD-BYT and Decision No. 53 of the Ministry of Education and Training, and the results of expert interviews, the study selected two standards (Physical Health, Mental and Social Health), four criteria (Body Morphology and Structure, Body Function, Motor Capacity, DASS-21 Scale) with 13 indicators to assess the health status of female vocational school students. The survey and assessment of the current situation on a sample of 166 female vocational school students from Hanoi University of Education showed that the physical health and motor capacity of this group were limited, with many indicators such as BMI, waist-to-hip ratio, body fat percentage, blood pressure, and static heart rate all higher than the standards. Furthermore, most TCBP students reported having psychosocial health problems, with depression ranging from 15.3-40%, anxiety from 19.4-33.3%, and stress being the most prev

INTRODUCTIONLabor dance is an emerging non-pharmacological intervention for labor support, though current evidence remains limited, especially among pregnant women with term premature rupture of membranes (TPROM). This study aims to evaluate the effect of labor dance on the duration of labor induction and the first stage of labor, as well as on maternal and neonatal outcomes and maternal anxiety.METHODSA randomized controlled trial was conducted at a tertiary maternal and child healthcare hospital in southern China from 20 November 2023 to 31 October 2024. A total of 102 eligible full-term pregnant women with premature rupture of membranes (PROM), aged 18–35 years, and primiparous with adequate health literacy and capacity for informed consent, were randomly allocated in a 1:1 ratio to either the intervention or control group. The control group received oxytocin-induction management with routine care, ambulation encouragement. The intervention group received the same care plus labor-dance sessions (8–10 minutes per sequence, at least every 30 minutes) from 0 to 5–6 cm cervical dilation. The primary outcomes measured were the duration of labor induction. Secondary outcomes included the length of the first stage of labor, maternal anxiety levels, postpartum hemorrhage within 24 hours, delivery mode, and the incidence of maternal and neonatal infections.RESULTSCompared with the control group, the intervention group had a shorter induction time (406.20 ± 177.53 vs 495.98 ± 188.22 min), with a mean difference of 89.78 minutes (95% CI: 13.99–165.57, p=0.021). Among participants who delivered vaginally, there was a shorter first stage (429.14 ± 141.39 vs 509.28 ± 167.54 min), with a mean difference of 80.14 min (95% CI: 12.59–147.68, p=0.021). Post-intervention anxiety scores were lower in the intervention group (median: 4 vs 5; p<0.05). Chorioamnionitis occurred less frequently (13.0% vs 30.4%; p<0.05). Total labor duration, 24-h postpartum hemorrhage, overall delivery mode, and neonatal complications (asphyxia/pneumonia) did not differ significantly between groups (all p>0.05).CONCLUSIONSIn pregnant women with TPROM undergoing oxytocin induction, labor dance – a low-risk adjunct – was associated with shorter induction and first-stage labor, lower anxiety, and maybe reduced chorioamnionitis, without increases in postpartum hemorrhage or neonatal complications.CLINICAL TRIAL REGISTRATIONThe study is registered on the official website of the Chinese Clinical Trails RegistryIDENTIFIERChiCTR2300073552

This research will focus on the development of innovation capacity in future health and social care professionals, with specific attention to the role of boundary crossing in person-centered care. The health and social care sector faces fundamental transitions that demand professionals capable of innovation and boundary crossing. Demographic shifts, technological developments, and changing societal expectations create challenges that cannot be addressed through traditional approaches alone. This comparative study between the Netherlands and Norway will provide strategic insights due to their contrasting educational approaches. The Netherlands operates a market-driven healthcare system with separate educational tracks for healthcare and social work, while Norway maintains an integrated 'vernepleier' program that combines health and social care education. The main research question is: "How does the interaction between educators, students, and practice supervisors influence the development of innovation capacity in future health and social care professionals to deliver person-centered care and support across traditional boundaries?" The analytical framework will combine three complementary perspectives: 1. Person-Centered Care (PCC) as a lens for understanding holistic care approaches 2. Boundary Crossing Theory for analyzing learning processes across professional domains 3. The educational triangle of student-educator-practice supervisor as an innovation incubator Innovation capacity will be operationalized along three dimensions: - "Action Space": The scope professionals have to deviate from established protocols - "Change Strength": The ability to initiate and sustain changes - "Competence to Act": The practical skills for effective implementation of innovative approaches The research will follow a qualitative approach with document analysis, focus groups, and in-depth interviews with participants from both Dutch and Norwegian contexts, focusing on professionals in preventive and primary care settings. The four-year research plan includes: - Year 1: Exploration of context and theoretical framework - Year 2: Identity and boundary crossing - Year 3: The educational triangle - Year 4: Integration and completion The expected contributions include: - Theoretical: Enhanced understanding of innovation development, integration of theoretical frameworks, and insights into professional identity - Practical: Guidelines for educational development, integration of practice and education, and improved professional preparation This research will not only enrich academic knowledge about innovation development in professional education but also provide concrete tools for educational institutions and practice organizations to better prepare future professionals for the complex challenges in the integrated health and social care sector.

The devolution of health systems development to local governments in the Philippines in 1991 brought with it unintended consequences as local chief executives found themselves with new responsibilities for which they were not prepared. These unintended consequences were exacerbated with the implementation of the country's Universal Health Care Act in 2019. To address this problem, the Foundation, a non-profit and non-government organization based in the Philippines with the aim of improving health outcomes, has designed a health governance capacity building intervention: the Bayang Malusog (literally Healthy Communities) Municipal Leadership Development Program (BM-MLDP). The BM-MLDP is a 12-month capacity building intervention for local chief executives and local health officials consisting of deep dive immersions, change management and leadership sessions, sustainability of health reform sessions, and co-design sessions to improve population health outcomes. Its implementation on the municipalities of Balete and New Washington in 2022-2023 contributed to improving and sustaining optimal population health outcomes despite resource constraints. This highlights the potential of health governance and capacity building interventions like the BM-MLDP in improving population health outcomes and advancing the implementation of universal health coverage in resource-constrained, devolved healthcare settings.

Se-enriched functional eggs are prevalent nowadays, which may help improve body health and anti-oxidant capacities. However, the modulatory effects on cecal microbiota are still limited. This study aims to investigate the underlying mechanism of Se-enriched egg powder in modulating the cecal microbiota of Kunming mice. A total of 72 mice were randomly assigned to a control treatment (CON), a conventional egg powder treatment (EP), and four gradient Se-enriched egg powder treatments (EPS1-EPS4, with the Se content ranging from 0.01 to 0.04% of total dietary content) for a 35-day feeding procedure. Parameters included growth performance, tissue Se content distribution, serum anti-oxidant capacities (GSH-Px, SOD, MDA), and immune cytokines (IgG, TNF-α), and cecal microbiota composition was further measured. Results showed dietary 0.02% (EPS2) significantly improved growth performance, physiological anti-oxidant defenses, and cytokine TNF-α (p < 0.05), while significantly reducing feed conversion ratio and malondialdehyde (MDA) compared with CON (p < 0.05). Metagenomic results revealed that Se-enriched egg powder significantly increased bacterial α-diversity and the abundance of Akkermansia, Bacteroides, and Bifidobacterium (p < 0.05), while significantly decreasing Desulfovibrio and Escherichia-Shigella (p < 0.05). In conclusion, dietary supplementation with Se-enriched egg powder effectively enhances growth performance, anti-oxidant capacity, and immunity, mainly through the promotion of beneficial bacteria diversity and suppression of pathogens.

This study aimed to evaluate a dietary phytogenic preparation (PT) comprising Ginkgo biloba L. leaves and mangosteen extract in broilers challenged with pathogenic Eimeria tenella. One-day-old Arbor Acres broilers (n = 600) were randomly assigned to a treatment group (six replicate floor pens/treatment, 20 chicks/replicate): non-challenged and control diet-fed negative control group (NC); E. tenella challenged and control diet-fed positive control group (PC); and PC + PT (50, 100, or 200 mg PT/kg of diet). On day 14, all groups except NC were gavaged with 1.0 × 10⁴ oocysts of E. tenella. The Eimeria challenge impaired (P < 0.05) body weight, which was mitigated by dietary PT on days 21 and 28. Furthermore, E. tenella challenge increased cecal lesion scores; however, dietary PT preparations reduced (P < 0.001) these lesions. Moreover, Eimeria challenge impaired ileal morphology; however, dietary PT alleviated these changes. All E. tenella-challenged broilers exhibited lower total short-chain fatty acid content in their cecal digesta and partially lowered (P = 0.055) ileal digestibility of crude fat being the latter linearly improved by dietary PT preparations (P < 0.05). Nitric oxide concentrations in the serum and cecal mucosa were elevated after Eimeria challenge; however, they were relieved by dietary PT in a concentration-dependent manner. Serum total cholesterol and high-density lipoprotein cholesterol concentrations in the Eimeria-challenged groups were lower than those in the NC group. Eimeria challenge also decreased catalase activity in the liver and superoxide dismutase activity in the cecal mucosa, but increased glutathione peroxidase activity in the cecal mucosa compared with that in the NC group. Increasing dietary PT concentrations increased serum (linear effect, P = 0.031) and liver (linear effect, P = 0.034) glutathione peroxidase levels and superoxide peroxidase activity in the cecal mucosa (quadratic effect, P = 0.015). Collectively, dietary PT shows promising potential as a nutritional solution to reduce avian coccidiosis via the modulation of innate and antioxidant markers and the alleviation of Eimeria-specific cecal lesions.

Globally, awareness and use of pre-exposure prophylaxis (PrEP) for preventing HIV vary widely. This cross-sectional study assessed knowledge, attitudes, and experiences related to PrEP use among sexually active men in Vojvodina, Serbia. Study was conducted from July to December 2024. Data were collected by seven district public health institutes in Vojvodina and two NGO community checkpoints. Participants were adult men with perceived high-risk sexual behaviour, infection symptoms, or seeking sexual health advice, regardless of their sexual orientation. Participation was anonymous and involved a structured self-administered questionnaire. Among 597 participants (28.3% of clients counselled and/or tested across nine centres), 71.0% were aware of PrEP and 17.2% had previously used it. About 55% of participants had correct basic PrEP knowledge, 28.8% incomplete, and 18.8% insufficient. Overall, 80.2% expressed a positive attitude toward PrEP, 11.7% were undecided, and 8.1% have negative attitude. Age categories (31-40 years: OR = 1.66, 95% CI: 1.01-2.73, p = 0.047), consistent use of online apps to meet partners (OR = 1.98, 95% CI: 1.09-3.62, p = 0.026), and prior PrEP use (OR = 2.12, 95% CI:1.33-3.40, p = 0.002) were associated with higher odds of correct PrEP knowledge. Correct knowledge was the strongest predictor of a positive attitude toward PrEP (OR = 3.21, 95% CI: 1.68-6.12, p < 0.001). Despite high awareness, use of PrEP was limited, and accurate knowledge strongly predicted positive attitudes, underscoring the importance of education and counselling. Enhancing public health capacity, reducing stigma, and improving information flow are essential for effective, equitable HIV prevention in Serbia and the wider Central and Eastern Europe region.

BackgroundMaintaining a high level of functional ability, which is essential for independent living in older adults, is influenced by social participation. Oral health has been associated with higher-level functional ability; however, whether social participation is related to this association remains unclear. This study aimed to investigate the association among oral health, higher-level functional ability, and social participation.MethodsThis cross-sectional study included 154 participants aged ≥65 years (mean age: 82.6 ± 5.5 years) in an underpopulated area. Higher-level functional ability was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Oral health was evaluated based on the number of teeth present, occlusal status, and swallowing function. Social participation was measured by the number of participants in social groups, such as sports groups, neighborhood groups, senior citizen clubs, hobby groups, learning and culture clubs, and other types of groups.ResultsAfter adjusting for age, sex, nutritional status, comorbidities, drug use, cognitive decline, mental health status, marital status, educational level, and going outside, Poisson analysis showed that the number of teeth present was positively associated with higher-level functional ability (B = 0.006, P = 0.026). Inclusion of social participation as a covariate attenuated this association (B = 0.005, P = 0.089). Occupational status and swallowing function were not associated with higher-level functional ability.ConclusionThese findings suggest that the number of teeth present is associated with higher-level functional ability and that social participation might affect this association.

Bats are a known reservoir of rabies virus in 10 Caribbean nations. A cross-sectional survey of five species of native bats on U.S. Virgin Islands of St. Croix, St. John, and St. Thomas was performed during September 2019–January 2020. Serological testing was used to determine whether native bat populations have been exposed to rabies virus. Bats (n = 72) from seven sampling locations in the United States Virgin Islands (USVI) all tested negative for rabies neutralizing antibodies. The sensitivity of detection of rabies virus antibodies ranged from 49.4% to 100%, depending on geography, bat species clustering, and presumed prevalence. A previous rabies cross-sectional survey conducted during 2019–2020 led by the USVI Department of Health determined freedom-from-rabies for small Indian mongoose (Urva auropunctata) populations in U.S. Virgin Islands. These findings, along with a historical absence of rabies detections in passive surveillance of dogs, cats, and wildlife, supports an evidence base that USVI may be rabies-free. These surveillance activities built local One Health capacity and fostered federal, university, and territory collaboration in USVI. Continued surveillance will help determine a declaration of rabies freedom for USVI.

Purpose: To evaluate the impact of pelvic floor physical therapy (PFPT) on urinary incontinence by assessing PFPT dosage on patient outcomes using the Urogenital Distress Inventory-6 (UDI-6) scores. Methods: Patient data were derived from a patient outcomes registry. All patients completed an initial and final UDI-6 patient-reported outcome measure. Urogenital Distress Inventory-6 change from initial to final was calculated and used as the dependent variable in a multiple linear regression. The primary independent variables were dosage, defined as frequency of visits per week and total visit count across an episode of care. Additional predictor variables were included, encompassing demographics, initial disability levels, and mental and physical health capacity. Results: A total of 3436 women were included in the cohort, age 48 ± 17, and largely used commercial insurance (75%). The regression revealed higher initial UDI-6 scores, higher visit dosage, and better initial mental and physical health as significant predictors of improvement in urinary stress symptoms as measured by the UDI-6 ( r = .45, P &lt; .001). The regression model explained 20% of the variance in UDI-6 change ( P &lt; .001). Discussion: Greater improvements occur in patients with more severe urinary symptoms and better baseline physical and mental health status. Additionally, greater UDI-6 change was observed in patients who received higher dosage of PFPT. The results highlight the importance of individualized treatment planning and adequate visit frequency to achieve clinically meaningful outcomes. From a policy perspective, the study supports early access to care and flexible visit coverage to ensure equitable care delivery.

Protocol paper for an implementation science approach to promoting colorectal cancer screening in Federally Qualified Health Center Clinics: A stepped-wedge, multilevel intervention trial.

Summary: Mount Lewotobi Laki-Laki in East Flores District, East Nusa Tenggara Province (NTT), Indonesia, erupted on Monday, November 4, 2024. At least nine people died, dozens more were injured, and several buildings burned due to ‘material rain’ from the eruption. Referring to data from the National Disaster Management Agency (BNPB), the local government has declared a two-month emergency response status from November 4 to December 31, 2024. Earlier this year, the consultant from the Center for Health Policy and Management, University of Gadjah Mada (CHPM UGM), visited NTT Province several times to assist the NTT Provincial Health Office (PHO) in developing a health contingency/preparedness plan. The impact applied in the Eruption of Mount Lewotobi Laki-Laki disaster response operation This field report was written using an observational descriptive approach. The authors were part of a team of consultants who assisted in building health capacity for disaster management. The best practices and lessons learned are documented as part of academia’s role in assisting the Ministry of Health in building the capacity of NTT PHO, so they are ready with a health contingency plan before a disaster strikes. During the early stage of response operations, the Health Emergency Operation Centre (HEOC) was activated with a solid organizational structure established, rapid health risk assessment (RRA) conducted, and integrally involving the sub-subclusters under the health cluster. Moreover, a response map was developed in the early stage of response, as well as a health cluster coordination meeting. Due to the efficient management of the existing health capacity, an EMT-CC has not yet been established, as no non-EMT personnel are required from outside the province. Furthermore, the NTT Province is an archipelago-type province; the capacity building provided by CHPM-UGM will help them determine where to establish the EMT-CC based on the response map and RRA results.