Health equity, consensual care and the work that survivors of violence do to navigate healthcare services.

Pregnancy options counseling in medical education and professionalism development.

Emergency department encounters' impacts on First Nations members, families and communities: Results of a thematic analysis of sharing circles in three treaty areas.

Strategies to Engage Diverse Population in Home-Based Palliative Care: A Qualitative Study in Hawaii.

Diarrheal diseases remain a leading cause of morbidity and mortality among children under five in Africa, despite the availability of cost-effective preventive and therapeutic interventions. This review examines the role of policy development and government-led interventions in diarrhea control, highlighting successes, persistent gaps, and emerging opportunities. Key strategies, including oral rehydration therapy, zinc supplementation, rotavirus vaccination, and water, sanitation, and hygiene (WASH) initiatives, have proven effective but are often undermined by inequitable access, weak health systems, and inconsistent implementation. The review emphasizes the evolving role of public health authorities in coordinating multisectoral strategies, strengthening surveillance, ensuring sustainable financing, integrating digital health innovations, and promoting equity-focused interventions. Research and monitoring priorities, including pathogen surveillance, sustainable WASH financing, and evaluation of digital IMCI and community health worker models, are essential to inform evidence-based policymaking. The study underscores that well-coordinated, adequately resourced, and context-specific government interventions are critical to reducing diarrheal morbidity and mortality and achieving child health equity in Africa. Keywords: Diarrheal diseases; Public health policy; Government interventions; Africa; Child health.

Understanding HPV vaccine preferences among sexual minority men living with HIV in Abuja, Nigeria using a discrete choice experiment.

Gender Equity in Women's Health and Sexual and Reproductive Health Services in Canada: Perspectives from Providers and Patients.

Results of the American Venous Forum research retreat on C2 disease confirms that the biology of varicose veins including etiology, progression, and novel therapeutics, as well as disparities, are top research priorities.

Culturally and linguistically diverse (CALD) communities have unique strengths, needs, and health seeking behaviours reflecting their cultural background. Therefore, top-down population-level health promotion initiatives with externally imposed performance indicators are frequently ineffective in CALD contexts. Accordingly, the Healthy New Communities (HNC) program implements an equity-based bottom-up commissioning model aimed at addressing socio-cultural factors impacting health seeking behaviours with people from refugee and migrant backgrounds. In the first phase of a comprehensive evaluation of the HNC program commissioning model, stakeholders involved in the implementation of commissioned activities and programs shared their experiences with this innovative funding model pioneered by the Queensland Health Metro South Hospital and Health Services, Health Equity and Access Team. Their perspectives were gathered in focus groups and interviews and analysed using an inductive approach to thematic analysis. The findings demonstrate the effectiveness of the HNC program commissioning model in engaging CALD communities in health promotion initiatives. Flexibility, responsiveness, trust, relationships, shared commitments, and cultural representation facilitated community members' participation in the commissioned activities. The impacts of the HNC program commissioning approach extend beyond the adoption of healthy lifestyles and include positive social, emotional, cultural, and physical impacts across a range of life domains and the creation of employment, training, and career pathways. The HNC program demonstrates how socio-cultural determinants of health can be influenced by commissioning models that prioritise community engagement, relationships, co-design, and the culturally shaped health-seeking behaviours of CALD individuals, families, and communities in the funding, design, and implementation of health promotion initiatives. SO WHAT?: Phase one results are promising and lay the foundation for an in-depth investigation of the potential of equity-based commissioning models for improving health and wellbeing outcomes for CALD communities across Queensland and beyond.

Health technology assessment (HTA) processes are becoming increasingly established and embedded in healthcare decision making around the world. Yet, there is limited evidence on whether HTA processes at the system level offer value for money to those presiding over their creation, such as governments and ministries of health. That is, whether the value of improvements in the health system exceed the costs. To address this issue, we outline the approaches adopted in a sample of recent evaluations of HTA systems and propose a set of considerations for measuring and valuing HTAprocesses. The scale and remit of the process can help identify the relevant system-level impacts of HTA such as those on productive efficiency and population health, health equity, guiding innovation and care pathways, and broader impacts. We further describe the methodological challenges and potential approaches to evaluating HTA including the appropriateness of approaches. The considerations discussed can reveal the potential for ill-designed HTA processes to generate less social value than intended.

Stakeholder voices advance client-centered, culturally responsive occupational therapy research. To describe how engagement of culturally diverse, multilingual, and multidisciplinary stakeholders shaped a project aimed at culturally adapting an evidence-based autism intervention. A mixed-methods design was used to evaluate stakeholder engagement. Quantitative data were used to measure engagement frequency and quality, and qualitative data captured stakeholders' experiences. Engagement activities conducted online and in person at a local community setting. Twenty-five stakeholders-7 parents or caregivers of autistic children, 3 autistic adults, 4 occupational therapy practitioners, 2 psychologists, 3 medical doctors, 3 cultural experts, and 3 teachers-were recruited through snowball sampling. Stakeholders engaged in activities designed to support a project that evaluates two methods of engagement and completes the cultural adaptation of an evidence-based intervention. Activities were guided by the foundational expectations for partnerships as outlined by the Patient-Centered Outcomes Research Institute. The Stakeholder-Centric Engagement Evaluation measured engagement on a Likert scale ranging from 1 (never/poor) to 5 (always/excellent) for how often and how well engagement occurred. Qualitative data were collected using open questions in the survey. Engagement frequency (M = 4.45, SD = 0.24) and quality (M = 4.29, SD = 0.23) were highly rated. Open-ended responses indicated that stakeholders were satisfied with their engagement and interested in additional capacity-building; their feedback shaped the main project in areas including recruitment, retention, data monitoring, and dissemination. Stakeholders rated their research experiences highly. Engagement is vital to integrating lived experiences and cultural context into occupational therapy, advancing health equity through culturally responsive, client-centered care. Plain-Language Summary: The main project aimed to culturally adapt an evidence-based occupational therapy intervention for Hispanic and Latino autistic children and compare two methods of engagement. Hispanic and Latino families often face barriers accessing culturally and linguistically appropriate services and being included in research. This work was needed to ensure interventions are relevant, equitable, and supportive of their needs. The voices of those impacted by this work were included to guide the research process. We engaged 25 people-including parents, autistic adults, occupational therapy practitioners, psychologists, teachers, and cultural experts-to work closely with the research team. They supported the team through advisory boards and helped shape the project in important ways, such as improving how families are invited to join and how information is shared. Meetings were held mostly on Zoom, with some held in person. We measured how often and how meaningfully stakeholders were involved, and both were rated very highly. This shows that strong partnerships are possible and valuable. Listening to community voices can help ensure that research is more relevant, respectful, and effective. Projects such as this can make occupational therapy more accessible for children and families from different cultural and language backgrounds, ultimately improving health equity and quality of care. Positionality Statement: We use the terms Hispanic and Latino throughout this article to support inclusivity. The term Hispanic typically refers to people with Spanish ancestry or Spanish as a primary language; however, it is sometimes viewed as problematic because of its association with Spanish colonization. In contrast, Latino refers to people from Latin America, including the Caribbean. Given the variation in individual and community preferences, we acknowledge the complexity of these identities (Martínez & Gonzalez, 2021). Furthermore, we implement the identity-first terminology for autistic persons on the basis of their preference for using such language (Taboas etal., 2023). The first author, Lady Rios-Vega, identifies as a Latina. She is an occupational therapy practitioner and researcher who has served minoritized families. We acknowledge that her perspectives may influence how data are presented. In addition, the diverse backgrounds and experiences of all contributing authors shape our work, guiding us to pursue our objectives with a strong focus on equity and inclusivity. The senior author, Roseann Schaaf, identifies as a White woman from a middle-class background. She is an occupational therapy practitioner and an experienced autism researcher. She acknowledges the potential impact of her privileged positionality in studying the experiences of marginalized communities, and she is committed to mitigating any biases that may arise from her own perspective.

Telehealth in pediatric physiotherapy presents both opportunities and challenges, particularly in lower-resource settings where health service access and equity remain concerns. Focus of attention (FOA) for instructions and feedback, which influences motor learning outcomes, may be crucial in this context. While earlier studies have relied mainly on self-reports, direct observation can identify physiotherapists' actual use of FOA in practice. This study used an exploratory observational design to examine pediatric physiotherapists' use of FOA when delivering instructions and feedback during telehealth. The study involved two therapy centers in the capital region. Six physiotherapists each selected two clients with neurodevelopmental disorders who received weekly telehealth physiotherapy. Three sessions per client were recorded via Zoom (n = 36). Physiotherapists completed the Developmental Profile-4th Edition forms assessing clients' physical and cognitive development. Transcriptions were coded as instructions, feedback, or general chatter and classified by focus, modality, and recipient. Frequencies were calculated to derive relative focus scores, indicating physiotherapists' FOA preference. Paired t tests revealed significant differences (p < .001) in physiotherapists' relative focus scores for instructions (mean 42.62 SD 25.03) and feedback (mean 58.98 SD 23.8). Pearson's correlations revealed that overall relative focus scores were significantly associated with clients' age (r = 0.396, p = .017), cognitive development (r = 0.552, p < .001), and physical development (r = 0.552, p < .001). Physiotherapists prefer an external FOA during instructions and an internal FOA during feedback. Relative focus scores were associated with clients' age and development levels. Given the heightened reliance on verbal instructions during telehealth, these findings offer baseline evidence to inform knowledge translation and context-specific application of FOA principles in pediatric physiotherapy practice.

Telemedicine in Africa has evolved from small-scale pilots to an essential tool for enhancing healthcare access, efficiency, and equity. Early efforts faced challenges due to limited infrastructure, high costs, and weak policies. The COVID-19 pandemic accelerated telemedicine adoption, exposing the need for stronger digital health strategies. Despite interest, many countries still struggle with regulation, coordination, and scaling sustainable implementations. This review examines the development and policy adoption of telemedicine across Africa before and after the pandemic, identifying key innovations, ongoing challenges, and lessons to guide future digital health planning. A narrative review was conducted, with study selection guided by PRISMA transparency standards. A structured search was conducted across PubMed, Google Scholar, Web of Science, Cochrane Library, Scopus, and policy databases from the WHO, the African Union, and UNECA. The search included publications from 2000 to 2025, focusing on English-language studies addressing telemedicine policies or implementation in African countries. The COVID-19 pandemic accelerated adoption, driving rapid innovation and policy shifts. In Nigeria, platforms such as MobiHealth, Tremendoc, and Dokilink expanded access via phone and WhatsApp, maintaining care during lockdowns. In South Africa, regulatory reforms enabled consultations without prior doctor-patient relationships, allowing 97% of patients to be managed virtually and reducing hospital burden. Nurse-led teleconsultations improved access, while a remote diabetes program reduced mortality by 20% among high-risk patients. Telepsychiatry expanded mental health services, and SMS-based interventions remained the most widely used due to affordability and accessibility. Despite progress, policy responses were uneven. South Africa's rapid reforms contrasted with Nigeria's fragmented frameworks, which lacked enforceable telemedicine provisions. Persistent challenges include weak data governance, limited interoperability, inadequate funding, and "pilotitis," where projects fail to scale. Telemedicine adoption in Africa has grown markedly since COVID-19 but remains constrained by infrastructural and regulatory weaknesses, and variable acceptance. Strengthening legal frameworks, improving infrastructure, and increasing awareness among providers and communities are vital to sustain progress, integrate telehealth into routine care, foster innovation, and enhance equitable healthcare across the continent.

Whole-body MRI: social media perspectives and opportunities for radiologist engagement.

Invisible signals, visible dilemmas: The ethical frontiers of liquid biopsy in precision oncology.

Consideration of social and environmental determinants of maternal and perinatal health in the geographic information systems era: a primer.

Population health equity provisions in impact assessment: Legal mapping of federal, provincial, and territorial frameworks in Canada

Early detection is an essential component in averting preventable higher-stage pressure injuries (PI). However, decades of clinical practice have not yielded the elimination of preventable hospital-acquired PIs, especially in patients with dark skin tones. Late detection of PIs in dark skin tones is a health equity issue. As an equity-informed initiative, an interprofessional team in a large hospital complex developed an enabler for practice to address overreliance on simple visual inspection for detecting early skin and tissue damage. The 4Ts practice enabler provides a nontechnological and practical approach for the early identification of stage 1 PIs in all skin tones by examining skin tone, temperature, texture, and twinge (pain). This equity-informed comprehensive approach will impact early detection of PI, thereby triggering expedited measures for effective prevention.

Health technology assessment (HTA) informs evidence-based decision-making for resource allocation in healthcare; however, the topic selection phase that determines which technologies proceed to full assessment is underexplored and often lacks fairness and transparency, particularly disadvantaging orphan medicinal products (OMPs) for rare diseases. We drew on selectively identified literature and illustrative HTA experiences to advance an opinion-driven argument about equity in topic selection for OMPs, grouping insights into three domains: structural challenges, conceptual frameworks and policy strategies. Structural barriers in topic selection include a lack of institutionalised, participatory processes, overreliance on prioritisation criteria implicitly aligned with population-wide impact and minimal engagement with stakeholders representing the rare disease community, resulting in the systematic under-prioritisation of OMPs. Procedural and value frameworks, including multi-criteria decision analysis (MCDA), evidence-informed deliberative processes (EDPs), accountability for reasonableness (A4R), equity weighting and Health Equity Impact Assessment (HEIA), can help agencies incorporate social value and fairness before formal appraisal, but remain unevenly operationalised. Policy strategies such as equity-oriented horizon scanning, open nomination systems, and special pathways for OMPs are highlighted as feasible approaches to promote fairness. Achieving equity in HTA topic selection for OMPs requires both policy and cultural change, and embedding pluralistic value frameworks, engaging stakeholders and adopting specific policy tools are essential steps towards ensuring that rarity is met with heightened ethical attention rather than exclusion.

Severe maternal morbidity and hypertensive disorders of pregnancy among women with intellectual disabilities: Identifying potential intervention targets.