Background: Interprofessional education (IPE) and interprofessional collaboration (IPC) are globally recognized as strategies for strengthening health systems and improving patient outcomes. Although frameworks and evidence have been well established in high-income countries, insights from low- and middle-income contexts remain limited. In the Philippines, studies on IPE and IPC are emerging but remain fragmented across disciplines and institutions. Objectives: This review aimed to synthesize international and Philippine literature on IPE and IPC, identify key frameworks, experiences, and challenges, and discuss implications for education, practice, and policy development in the Philippine context. Materials and methods: A narrative review approach was used to integrate diverse forms of evidence on IPE and IPC. Sources were identified through PubMed, Scopus, Google Scholar, and relevant organizational reports using the keywords “interprofessional education,” “interprofessional collaboration,” “health professions,” and “Philippines.” Articles published in English between 2000 and 2024 were included if they discussed definitions, frameworks, implementation strategies, challenges, or outcomes. Extracted data were synthesized thematically to operationalize the review objectives, focusing on conceptual and policy foundations of IPE and IPC, evidence of effectiveness, international experiences, the Philippine context and local evidence, and challenges, barriers, and sustainability. Results: Global literature shows that IPE enhances teamwork, communication, and, in some cases, patient outcomes, though findings are often constrained by methodological heterogeneity. International frameworks from Australia, Canada, the United Kingdom, and the United States establish shared competency domains but highlight challenges in assessment and curriculum integration. Philippine studies demonstrate readiness among students and professionals, pilot initiatives in community and institutional settings, and recurring barriers such as faculty shortages, professional hierarchies, and limited policy support. Sustainability emerged as a major concern in both global and local contexts. Conclusion: IPE and IPC hold significant potential to advance collaborative health professions education in the Philippines and similar low- and middleincome countries. To strengthen sustainability, contextual adaptation of global frameworks, investment in faculty development, alignment of accreditation and policy standards, and longitudinal research are essential to building enduring models that enhance interprofessional collaboration and health system outcomes.

A Tale of Two Cerebral Palsies.

Disparities in diagnosis, treatment, and outcomes of early-onset breast cancer: A global perspective.

Digital Health is currently showing promising results in reducing patient and caregiver suffering that arise from misconceptions. To synthesize existing evidence on Perceived Usefulness, interest in use and willingness to use towards Epilepsy Digital Health Interventions. Databases were searched for studies reporting on the outcomes of interest by using a comprehensive search strategy. Studies published in English from January 2015 to September 2025 were included. The Newcastle-Ottawa Quality Assessment Scale was employed to evaluate the quality of included studies. Stata version 19 was used to compute a pooled proportion using a random-effects model. Heterogeneity was assessed using the Cochrane chi-square and the index of heterogeneity test. Sensitivity tests and subgroup analyses were performed. Publication bias was examined by funnel plots and Egger's test. Overall, 6041 studies were found from databases. After a step-by-step screening, 23 studies were included in this review. The total number of participants was 6703 with a sample size ranges from 12 to 1168. The pooled proportions of Perceived Usefulness, interest to use, and willingness to use Digital Health were 0.66 (0.58, 0.75), 0.69 (0.50, 0.88), and 0.75 (0.66, 0.83), respectively. In this review, Sensitivity tests indicated that none of the included studies exerted extreme influence on the pooled prevalence; and Funnel plots and Egger's test (p≤0.772) showed no evidence of publication bias. In this review, 66% of respondents perceive Digital Health as useful; 69% were interested in using Digital Health, and 75% were willing to engage with Digital Health. Most of the studies were from high-income countries, with no studies found from developing countries. This review emphasizes the importance of focusing on the user's perceptions, their interest and willingness to use Digital Health Interventions. It also stresses the need for further studies in low-income countries.

Adolescence and early adulthood are marked by major life transitions, including leaving the parental home, which may influence dietary behaviours and related health risks. This study examined diet quality trajectories from adolescence into early adulthood and the influence of leaving home. Data were drawn from 1135 participants aged 14 to 27 years in the Raine Study (Australia), who completed food frequency questionnaires at five follow-ups. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) diet score and proportion of energy from discretionary foods and beverages. Multilevel regression models examined diet quality trajectories, investigating interactions with leaving the parental home and subsequent living arrangements (partner, friends or alone). Diet quality was generally poor and followed a quadratic trajectory. Leaving the parental home was associated with a decline in diet quality, reflected in a lower DASH diet score: β = -1.11 [95% CI: 1.80, -0.41]; and increased discretionary food intake: β = 1.28 [95% CI: 0.30, 2.26]. The decline persisted over time for DASH diet score and diminished for discretionary food intake. Moving in with a partner was associated with the greatest decrease in DASH diet score: β = -1.18 [95% CI: 2.08, -0.28]. Leaving home, particularly to live with a partner, is associated with a small decrease in diet quality in a population with already sub-optimal diets. Public health strategies targeting life transitions may help support healthier dietary behaviours in adolescents and young adults in Australia and other high-income countries.

Perinatal depression is more prevalent in low- and middle-income countries (LMICs) than in high-income countries, reflecting greater exposure to physical, psychosocial, and environmental adversities. It can have lasting consequences for the woman, her child, and wider family. Despite its high burden, access to appropriate mental health care for perinatal depression remains extremely limited in most LMICs. In this narrative review, we conducted a search of PubMed and Google Scholar from 2015 to 2024 (with the addition of other key articles based on authorship team consensus) for recent and policy-relevant systematic reviews, meta-analyses, key individual studies, and practice guidelines to provide an overview of identification, treatment, and prevention of perinatal depression in LMICs. Regarding identification, brief screening measures have been adapted and validated in LMICs, but there have been few studies testing the feasibility and effectiveness of screening programs. Cognitive behavioral therapy and interpersonal therapy have demonstrated effectiveness for perinatal depression in meta-analyses that include LMIC studies, particularly when adapted into brief, structured formats and delivered by nonspecialist providers through task-sharing models. Regarding prevention, evidence from a range of studies supports universal delivery of low-intensity psychosocial interventions during routine perinatal care and psychological interventions for women with elevated symptoms or known risk factors. Multiple barriers to implementation of effective perinatal depression interventions at scale in LMICs remain, including financial and human resource constraints, high service user to provider ratios, and underdeveloped referral pathways. Responses include delivery of interventions by peers rather than health workers and use of digital technologies.

Studies indicate that incidence of certain childhood cancers is lower in low-compared to high-income countries. By examining incidence in migrant populations in Sweden, we aimed to disentangle whether this is due to methodological factors, such as underreporting, or to genetic or environmental aetiology. In this nationwide, population-based cohort study, we grouped all children born in Sweden (1990-2019) as: Swedish background, 2nd generation, 2.5 generation (one foreign-born, one Swedish-born parent), or 3rd generation. Age-standardized incidence rates (ASR) for first childhood cancer identified in the National Cancer Register (ages 1-19) were calculated using the 2013 European standard population and are reported per 100,000 person-years [95% confidence intervals]. Incidence rate ratios (IRR) were calculated using Poisson regression adjusted for year of birth and sex. Using the same methods, we examined childhood cancer incidence by parental lineages separately, parental length of stay before birth, and World Bank income classification of parental country of birth. During 39,862,393 person-years of follow-up, 6797 children were diagnosed with cancer. The ASR of childhood cancer in Swedish background children was 17.18 [16.63-17.74], this was slightly higher in boys (18.20 [17.42-19.01]) than girls (16.09 [15.34-16.88]). The overall results were largely similar across migrant generations and parental length of stay. Lymphoma incidence was higher in 2nd generation (ASR 3.09 [2.53-3.78]) compared to Swedish background children (2.22 [2.02-2.44]). Children with migrant mothers from high-income countries had a higher incidence of leukaemia (ASR 5.88 [4.78-7.24]) compared to Swedish background children (4.31 [4.09-4.55]), whereas central nervous system tumour and leukaemia incidence was lower in children with mothers from low-income countries (2.64 [1.79-3.88], 3.66 [2.76-4.85], respectively) compared to Swedish background children (4.49 [4.24-4.75], (4.31 [4.09-4.55]). The pattern was similar for fathers from low-income countries and for IRRs. Finding lower incidence of CNS tumours and leukaemia among children born in Sweden to mothers from low-income countries challenges the hypothesis that low incidence of some childhood cancers in low-income countries is solely due to underreporting, but rather suggest that genetic or environmental factors may underlie these observations. Barncancerfonden (PR2023-0060).

Cardiovascular disease has historically been the most common cause of death (COD) among people with and without diabetes. However, substantial progress has been made in the management of cardiovascular disease. We conducted a multinational analysis to establish whether this trend is still the case. In this multinational, population-based study, we assembled aggregated annual mortality data collected during routine clinical care from nationally or regionally representative administrative datasets in high-income jurisdictions between 2000 and 2023. For inclusion, datasets must have ongoing enrolment of new patients with diabetes, cause-specific death counts in people with and without diabetes, and sex-specific and age-specific data. We collected population size, counts of prevalent diabetes (type 1 and type 2), death counts, and person-years of follow-up in people with and without diagnosed diabetes by sex and 10-year age group. We estimated cause-specific trends in mortality rates, proportional mortality, and mortality rate ratios (MRR) for people with versus those without diabetes (type 1 and type 2) using Poisson models standardised for age and sex. Using data from 11 jurisdictions, we identified 2·7 million deaths in people with diabetes and 11·0 million deaths in people without diabetes during a total of 1·7 billion person-years of follow-up. Cardiovascular disease mortality decreased in all jurisdictions in populations with and without diabetes. Mean 5-year declines in cardiovascular disease mortality among people with diabetes ranged from 8·3% (95% CI 5·9 to 10·7) to 25·4% (22·8 to 28·0). Mortality due to diabetes declined in most jurisdictions. Dementia mortality increased in people with and without diabetes in six (86%) of seven jurisdictions. Cancer mortality declined in people with diabetes in three (33%) of nine jurisdictions and in people without diabetes in six (67%). At the end of the observation period, cancer was the leading COD in people with diabetes in four (36%) of 11 jurisdictions. MRRs were generally stable for all CODs. Exceptions include Lithuania, where the mean 5-year change in MRR for cardiovascular disease was -7·6% (-10·1 to -5·1), indicating a more rapid fall in cardiovascular disease mortality in people with diabetes than in people without. For dementia, the MRR increased in Denmark (5-year change 8·0% [5·0 to 11·1]) and Scotland (11·4% [8·5 to 14·3]). Mortality from cardiovascular disease and diabetes has declined among people with diabetes in most jurisdictions, whereas mortality from dementia has increased markedly, independent of age. Cardiovascular disease is no longer universally the most common COD among people with diabetes in high-income countries. US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.

Synthesised evidence on the formal recognition of advanced community pharmacists (ACPs) and their practice is limited. This review aims to explore global evidence on the practice of formally recognised ACPs. This scoping review followed the JBI Manual for Evidence Synthesis and PRISMA guidelines. Advanced practice was determined using the International Pharmaceutical Federation framework encompassing four pillars: professional practice, leadership, research, and education. Formal recognition referred to post-registration acknowledgement by authorised bodies. Twelve databases and Google Scholar were searched between 2004 and 2024, without country or language restrictions. Findings were thematically analysed using NVivo 14. Sixty-three studies from six high-income countries were included, predominantly from Canada (n=18) and the United States (n=16). Formally recognised ACPs provided clinical services including prescribing (n=27), vaccination (n=22), and medication review (n=20). Few studies reported ACPs practice within the research and education pillars. There was variation in the definition and formal recognition mechanisms of ACPs between studies. In addition, many studies reported practice corresponding to advanced services but did not describe prerequisite training or formal recognition. Reported challenges included inadequate remuneration, limited access to patient records, and low stakeholder awareness. Key facilitators were availability of formal recognition, interprofessional relationships, and appropriate training. ACPs have expanded public access to clinical services. However, formal recognition and practice of ACPs from low-middle-income-countries are underrepresented in the literature. More work is needed to recognise ACPs' practice in education and research. Future research should clearly operationalise advanced practice within existing frameworks, explicitly report recognition mechanisms, and engage broader stakeholders in the implementation, evaluation, and role development of ACPs.

Increasing Colorectal Cancer Screening: A Systematic Economic Review of Patient Navigation Services.

Tuberculosis (TB) commonly presents in the pulmonary form, but extrapulmonary TB may also be seen in any part of the body. This report presents a case of extrapulmonary TB in a 21-year-old male patient who immigrated from Africa. He presented with a painful chest wall swelling that appeared suddenly and had no other symptoms. CT of the chest, abdomen, and pelvis showed fluid collections of the chest wall and mesentery that were drained and biopsied. PCR of the drainage detected Mycobacterium tuberculosis (Mtb) DNA, and AFB culture with smear grew Mtb. This patient’s sudden onset of chest wall swelling in the absence of other symptoms presents as an unusual presentation of TB not generally seen in high-income countries where TB prevalence is low. This case exemplifies the importance of maintaining a high suspicion for extrapulmonary TB, especially in patients from endemic countries.

To assess the global burden, trends, and inequalities of diabetes prevalence and treatment coverage among adults aged ≥45years from 1990 to 2040. Diabetes prevalence and treatment coverage data were obtained from the NCD-RisC database. Average annual percentage changes (AAPC) were estimated using join point regression, and a Bayesian age-period-cohort model was used to project diabetes prevalence and treatment coverage from 2023 to 2040. Cross-national health inequalities were measured using the slope index of inequality (SII) and the relative concentration index (RCI). Globally, diabetes prevalence rose from 12.85% in 1990 to 23.57% in 2022 (AAPC=1.90%), and is projected to reach 37.44% by 2040 (AAPC=2.59%). Treatment coverage grew from 33.22% to 45.88% (AAPC=1.02%) and is projected to surge to 51.64% by 2040 (AAPC=0.65%). Diabetes prevalence grew fastest in middle-income countries, whereas treatment coverage improved most in higher-income countries. The SII for prevalence burden decreased from -0.25% in 1990 to -14.86% in 2022, and is projected to further decline to -18.32% by 2040. For treatment coverage, the SII increased from 24.57% in 1990 to 43.91% in 2022, with a projected rise to 54.22% by 2040. The relative inequality measured by the RCI showed a similar pattern. Between 1990 and 2040, diabetes prevalence is projected to increase significantly, while treatment coverage shows only limited improvement. Over the same period, the diabetes prevalence burden is increasingly concentrated in resource-limited regions, while treatment accessibility is becoming progressively more concentrated in economically developed areas.

Attitudes toward people with epilepsy (PWE) have improved over recent decades, especially in high-income countries including Germany. However, this trend is less pronounced in low-income countries. This study aims to assess and compare attitudes toward PWE in two large ethnocultural minority groups in Berlin: Arabic and Vietnamese residents. Residents of Berlin aged 18years or older, born and raised in selected Arabic countries or Vietnam were invited to participate in a survey. We used a preliminary version of the standardized "Scales of Attitudes toward People with Epilepsy" (SAPE) questionnaire with scales on Social Distance, Stereotypes, Personal Concerns, and Emotional Reactions to PWE differentiated by Fear, Anger, and Pity/Compassion. In addition, the Caveness Questions (CQ) about personal experience with epilepsy and knowledge about epilepsy were assessed. Limiting comparability with previous literature and overall validity of findings was the use of a preliminary version of SAPE and the lack of formal validation of Vietnamese and Arabic translations of SAPE. A total of 297 participants were interviewed; 15 of those had never heard of epilepsy and were excluded from the analysis. Eventually, questionnaires of 133 Arabic and 149 Vietnamese interviewees (female sex, 43 vs. 68%; mean age, 34.8±9.7 vs. 34.0±12.4years; duration of stay in Germany, 6.0±5.1 vs. 7.9±9.4years) were considered. Multivariable Generalized Linear Model (GLM) analyses showed that Arabic compared to Vietnamese participants had higher objections to having one's own children play with PWE, but less likely deemed epilepsy as a mental disease; furthermore, they had lower objections to employment of PWE. In the SAPE scales, Arabic interviewees scored significantly lower for the 'Social Distance' and the 'Emotional Reactions: Fear' scale. A strong predictor for more positive attitudes across almost all SAPE subscales in both groups was higher education. Arabic and Vietnamese residents of Berlin differed in some specific facets of the attitude toward PWE. Attitudes were generally more positive than in surveys done in several Arabic countries and Vietnam. Higher levels of education predicted more positive attitudes in both groups calling for specific knowledge transfer to the general population on epilepsy and persons affected.

Long-Term Outcomes Following Traumatic Injury in Older Adults in Pakistan: A Prospective Cohort Study.

The role of misinformation in COVID-19 vaccine hesitancy in low- & middle-income countries.

Olympic medal performance is a measure of a country’s competitive sport achievements but also largely shaped by various socioeconomic aspects. This study attempts to comprehensively investigate the spatiotemporal development of Olympic performance and to build a highly accurate hierarchical forecasting model. Firstly, using data from the 2008-2024 Olympic Games (five editions) after data cleaning and feature engineering it can be observed an extremely positive correlation between size of the games and total number of medals with correlation coefficient. The exploratory analysis suggests that GDP is the main socio-economic factor determining a nation’s medal competitiveness and its relationship with the number of medals has significant structural differences. It can be seen that for high-income countries, the conversion efficiency of economic resources into competitive advantages is best. This research devised separate forecast systems for nations on varying levels of competition; it used a share-smoothing prediction method on top-performing countries so grasp long-term trend; added up weight least-squares shares regression plus reliability shrinkage system for mid-ranking countries; and innovatively developed a two-step prediction framework integrating logistic regression and random forests models for those nations without any previous medal record. Forecast results suggest at the 2028 Los Angeles Olympics USA will get 150 medals because they are the host nation while China UK and France which are all powerhouses will stay in the lead positions. With the coupling of multiple features, this paper gives scientific evidence for people to know about the change in Olympic performance.

Central venous access devices (CVADs) are essential in paediatric care but pose significant risks. Synthesising existing evidence is needed to guide safe, effective, and equitable practice amid evolving interventions and complex management needs. To develop an evidence and gap map (EGM) to identify, categorise, and visualise paediatric evidence on interventions aimed at improving CVAD outcomes. Following Campbell Collaboration guidance, systematic searches were conducted in PubMed, CINAHL, Scopus, and CENTRAL (date limits: 2014 to 30 June 2024). Eligible studies included patients (0-18 years) evaluating an intervention to improve CVAD outcomes, including randomised and non-randomised trials, implementation studies, and systematic reviews. Two reviewers independently screened and extracted data on CVAD type, intervention, setting, outcomes, and study design. Data were descriptively analysed and visualised in Tableau. Of 952 studies in the broader EGM, 151 were paediatric-specific. Most were conducted in high-income countries (72%) and high-acuity settings, including critical care (41.9%) and oncology (38.5%). CVAD type was unspecified in 80.1% of studies. Systematic reviews (22.5%) and randomised controlled trials (28.5%) were available, though 40.4% of studies were before-and-after studies without controls. Common interventions addressed infection prevention, insertion technologies, and flushing. Clinical outcomes, particularly bloodstream infection (27.8%), dominated reporting, while patient-reported, economic, and device removal outcomes were rarely reported (< 2%). Only studies from the last 10 years and English-language databases were included. No formal quality appraisal was conducted. Significant evidence gaps exist. Future research should prioritise rigorous, paediatric-specific studies across diverse settings and outcome domains. Open Science Framework (OSF) q6gcr: https://osf.io/q6gcr/overview.

Fostering biopharmaceutical R&D has been a key element of industrial and innovation policy worldwide. Typically, this requires complementary investments from the public and private sectors. However, there is little empirical evidence on the extent of public and private biopharmaceutical R&D investment in countries outside of the US and Europe. We conducted a literature review to assess the biopharmaceutical R&D environment and related public policies in seven middle- and high-income countries outside of Europe and the US, selected for geographic diversity and data availability: Australia, Brazil, India, Japan, Singapore, South Africa, and South Korea (n = 7). We researched and reported levels and shares of public and private investment in biopharmaceutical R&D via an aggregation of granular, public data from the most recent pre-Covid year available for each country, which ranged from 2017 to 2020. We contrast these figures to those estimated from supranational data sources such as the OECD and WHO. Aggregating across countries, the private sector accounted for 74% of biopharmaceutical R&D spending. Private sector spending within countries ranged from 35% to 92%, with a simple average of 58%. We contextualise differences between these estimates and those from supranational sources. Overall, the public and private sectors both have important roles in biopharmaceutical innovation across countries. The public sector often funds R&D in universities and basic science, with public funding for later stages of R&D, such as clinical trials, varying by country. There are differences in the extent to which countries invest in initiatives to bridge academia and the private sector. Aggregative biopharmaceutical R&D spending data may lead to different insights than data from supranational sources. Given the complementary nature of public and private R&D spending, countries wishing to encourage biopharmaceutical R&D should consider targeted public sector investment to spur an environment conducive to private investment. Since data are sparse and not always comparable across countries, there is a need for increased and consistent tracking of data on R&D spending. Further research is needed to connect country-specific data to policies that support R&D sector productivity.

A pediatric neurosurgeon's approach to the treatment of hydrocephalus can vary but often includes ventriculoperitoneal (VP) shunt insertion or endoscopic third ventriculostomy (ETV). However, there are several suspected barriers to accessible hydrocephalus care, particularly regarding endoscopy. The aim of this study was to characterize neurosurgical approaches and perceived barriers to pediatric hydrocephalus treatment globally. An online survey targeting a non-random sample of pediatric neurosurgeons was distributed via international neurosurgery mailing lists. Demographics including age, sex, level of training, years of practice, and country of residence were collected. Likert-scale and multiple-choice questions were used to determine surgical indications, surgeon preferences, surgeon training, and access to endoscopy. Fisher's exact test was used to compare frequencies between high- and low-income countries. Forty-five neurosurgeons from 29 countries with a mean age of 49.2 ± 10.4 (mean ± S.D.) years, all treating pediatric hydrocephalus, responded to the survey. Overall, 64.4% (n = 29/45) were from high-income countries (HICs) and 35.6% (n = 16/45) were from low- and middle-income countries (LMICs). Regarding VP shunt insertion, 41.4% of HIC respondents and 81.3% (p = 0.013) of LMIC respondents acknowledged barriers to treatment. Barriers to VP shunt insertion included equipment access, specifically hardware availability reported by 10.3% of HIC respondents and 43.8% of LMIC respondents (p = 0.021). Regarding ETV, 51.7% of HIC surgeons and 93.8% of LMIC surgeons (p = 0.007) reported a barrier. Barriers to ETV included equipment access, specifically endoscope/balloon catheter availability, reported by 34.5% of HIC respondents and 81.3% of LMIC respondents (p = 0.005). Respondents also reported surgeon/staff training problems, patient financial insecurity, and operating room (OR) access but no significant differences were found between the two economic groups for ETV or VP shunt insertion. Furthermore, 81.3% of LMIC respondents and 44.8% (p = 0.027) of HIC respondents expressed the desire to treat more patients endoscopically. LMICs face more perceived barriers to the treatment of pediatric hydrocephalus than HICs. These perceived barriers are more frequent in endoscopic treatment, in comparison to VP shunt insertion in both economic groups, largely due to improper access to endoscopic equipment. Future studies should focus on leveraging neurosurgical collaborations to improve care worldwide.

ABSTRACT There are increasing calls to take a more asset-based, decolonised approach to refugee education. However, we lack analysis of the degree to which the field of refugee education knowledge production is deficit-based or asset-based and the factors that structure those patterns. We address this gap through a systematic review and mixed-methods meta-synthesis of peer-reviewed articles on refugee education since the 1970s. We find more asset-based texts over time, within the education discipline, published by institutions in high-income countries, and by multi-author teams. Despite some promising patterns, the balance between asset-based and deficit-based discourse has only marginally improved in fifty years.