Europe is currently facing novel security threats in many different areas, reinforcing the need for a well prepared and protected health and care workforce to ensure health system resilience and service provision for the population under conditions of a poly-crisis. However, the health and care workforce is weakened by persisting shortages, competency gaps and mismatches, and poor working and mental health conditions. Health and care workers are not prepared for yet another crisis and a systematic strategy is lacking. This policy commentary argues for health and care workforce preparedness and protection as a structural pillar and integral part of an emerging EU health and security landscape, calling for a coherent European Union strategy and highlighting capacities for implementation and co-benefits for democratic societies and economies. Key policy recommendations include: developing a coordinated EU strategy that is capable to protect, prepare and retain health and care workers; closing the competencies gaps to align preparedness for military aggression, cyberattacks, climate change, and new infectious diseases; investing in research and data spaces to strengthen evidence-based information and policy; creating governance structures and building on existing EU programs and budgets to freeing resources for the health and care workforce.

Artificial intelligence innovations in substance use prevention on social media: A scoping review.

The global prevalence of obesity and diabetes continues to rise, with metabolic-bariatric surgery recognised as an effective intervention for obesity and type 2 diabetes, offering potential for type 2 diabetes remission and improved glycaemic control. This guideline, developed by the Joint British Diabetes Societies for Inpatient Care (JBDS-IP), provides recommendations for the management of diabetes in individuals undergoing metabolic-bariatric surgery. It emphasises the importance of multidisciplinary care and individualised treatment plans to optimise outcomes. Key recommendations include pre-operative glycaemic optimisation, targeting HbA1c <69 mmol/mol (<8.5%) where safe to do so, prevention of hypoglycaemia throughout all phases of care and providing a framework for medication adjustments during the liver reduction diet (LRD), peri-operative and post-operative phases. For type 2 diabetes, oral and non-insulin therapies such as metformin, DPP4 inhibitors and GLP-1 based therapies may be continued during LRD, while sulfonylureas, meglitinides and SGLT2 inhibitors should be discontinued to reduce the risk of hypoglycaemia. For those with type 2 diabetes on insulin, doses should be reduced by 35%-50% during LRD and adjusted post-operatively based on individual glycaemic control. To prevent diabetic ketoacidosis (DKA) in those with type 1 diabetes, insulin must never be stopped and careful planning with diabetes teams is essential. Post-operatively, regular glucose monitoring, hypoglycaemia surveillance, medication adjustments, and follow-up with diabetes specialists are recommended. This document serves as a guide for clinicians and service commissioners, aiming to improve inpatient diabetes care and outcomes for individuals undergoing metabolic-bariatric surgery.

Improving cholera vaccination impact through advances in gut mucosal immunology: outcomes of a 2025 expert consultation.

Hip displacement management in spinal muscular atrophy in the era of disease modifying therapies: a Delphi consensus study in the UK.

Food waste in European Households: A Meta-Analysis of behavioural drivers and quantitative trends.

Adolescent siblings of children with cancer are at elevated risk for psychosocial problems. Unfortunately, various barriers such as limited family time and resources, conflicting schedules, and psychosocial staffing constraints at cancer centers hinder sibling access to support. Digital, self-guided, single-session interventions (SSIs)-brief, low-cost, scalable mental health tools-have shown promise for surmounting such barriers and providing support to adolescents. This qualitative study aimed to gather perspectives from adolescent siblings, parents, and professionals to inform the development of a digital, self-guided Sibling SSI tailored to siblings' needs. Semi-structured interviews were conducted with adolescent siblings (n = 22), parents (n = 21), and psychosocial providers and community leaders (n = 14). Drawing on existing evidence-based SSIs that use a solution-focused brief therapy framework, interviews explored content, language, timing, and delivery preferences for a Sibling SSI. Content analysis was used to summarize key recommendations. Participants viewed a digital Sibling SSI as a promising approach to promote coping. Content suggestions included acknowledging common cancer-related and adolescent struggles, highlighting siblings' existing coping strategies, and offering personalized action plans. Participants emphasized the importance of sibling-centric language and creating a space exclusively for siblings. Early dissemination within 3months of diagnosis via psycho-oncology teams and community channels was recommended. Findings provide community-informed guidance to inform the development of a digital Sibling SSI aimed at surmounting barriers to care and enhancing psychosocial support for adolescent siblings of children with cancer.

Surgical Implications of the 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease: Key Recommendations Bridging Guidelines and Clinical Practice.

Secure land tenure is a critical asset for agency, livelihoods, and resilience, yet a persistent gender gap in land ownership undermines development and equality in sub-Saharan Africa (SSA). Despite a proliferation of gender-sensitive land policies, the disparity between legislative intent and on-the-ground reality remains a formidable challenge. This study employs a systematic review methodology, following a PRISMA-inspired protocol. From an initial pool of 2,446 studies identified across major academic databases, 56 met the inclusion criteria based on relevance, methodological rigour, and thematic focus, forming the basis for a thematic synthesis. The review identifies a triad of influencing factors: (1) Policy Mechanisms: including national land reforms, constitutional guarantees, and international frameworks; (2) Implementation Bottlenecks: such as weak enforcement, limited legal awareness, and lack of political will; and (3) Structural Barriers: primarily patriarchal customary tenure systems, discriminatory inheritance norms, and deeply embedded socio-cultural practices that privilege male lineage. The analysis reveals a fundamental tension of legal pluralism, where statutory laws coexist and often conflict with customary systems. The principal impediment is not a lack of policy but a governance disjuncture, a failure to align formal institutions with informal, socially entrenched norms that govern resource allocation at the community level. This review synthesises and advances theoretical frameworks at the intersection of political economy and property rights, demonstrating how patriarchal bargaining and institutional bricolage shape women’s land access within plural legal environments. It consolidates a fragmented evidence base to provide a comprehensive, region-wide analysis of the multi-scalar obstacles (from household to state) to women’s land tenure security, offering a coherent evidence map for researchers and practitioners. Transforming women's land rights in SSA requires moving beyond technical legal reforms to address the socio-institutional roots of exclusion. Key recommendations include: (1) implementing gender-responsive land governance that integrates customary and statutory systems; (2) investing in grassroots legal empowerment and awareness campaigns; (3) strengthening accountability mechanisms for policy enforcement; and (4) promoting systemic research on gendered outcomes of land tenure interventions.

The shift toward regional autonomy in Indonesia aims to bring public services closer to the community, with the expectation of improving service quality and ensuring that the benefits are felt by all stakeholders. However, local governments continue to face significant challenges in meeting the growing demand for high-quality public services, especially in crucial sectors such as clean water, health, population management, and licensing. This research evaluates the bureaucratic capacity of Makassar City, South Sulawesi, from 2020 to 2024, using a qualitative approach and descriptive analysis. Data was gathered through interviews with 12 key informants and secondary sources, including official documentation. The analysis reveals that the public service performance in Makassar does not meet community expectations, mainly due to limitations in the local government's bureaucratic capacity. These limitations include insufficient personal, organizational, and system capacities, weak political will, and low community engagement. The study concludes that improving bureaucratic capacity is essential for enhancing public service delivery. To address these challenges, the study proposes four key policy recommendations: 1) Developing a strategic plan for bureaucratic capacity building, 2) Innovating government policies to better meet community needs, 3) Implementing participatory reforms, and 4) Investing in information technology to enhance governance. The main contribution of this research is providing a deeper understanding of the role of bureaucratic capacity in improving quality of public service and developing policies that are more responsive to the needs of the community.

This research focuses on the legal rules related to the financial independence of a company from that of its partners, in order to avoid the commingling of financial liabilities and the overlapping of claims between the company's creditors and the company itself, and between the company's creditors and its partners. This has led to the development of the principle of company independence and its separate legal personality, the adequacy of capital, sound company management and governance, controls preventing the malicious transfer of funds from the company for the purpose of liquidation, the prevention of fraudulent and deceptive practices intended to harm third parties (creditors), and the prohibition of unfair competition by managers with the company, among other modern rules in this field. Since the principle of company independence is a judicial principle, first appearing in the English case of Salmon v. Salmon, it was subsequently codified in the company laws of most Commonwealth countries and later adopted by other nations. Furthermore, many courts have recently issued rulings providing protection for individual creditors of companies undergoing audit, inspection, or liquidation. The rules mentioned above were referenced in the body of this research and reviewed and analyzed in accordance with the rulings of various courts. The research concluded with several key findings and recommendations, the most important of which are: Conclusion: The emergence of the principle of lifting the veil on the institutional independence of commercial companies is considered an exception to the application of the principle of independence and resulted from negative practices by companies not covered by the law. Recommendation: Legal advisors to companies should exercise due diligence, caution, and care when drafting company articles of incorporation and when issuing legal opinions to founding partners or company directors during incorporation or while managing the company's affairs, in order to avoid situations that lead to the commingling of the partners' financial liabilities with those of the company.

Antibiotic prophylaxis in urodynamics: A systematic review of secondary studies.

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ), characterized by persistent neuropathic pain that significantly impairs quality of life. Despite the availability of multiple treatment options, PHN remains under-recognized and undertreated, with wide variation in management practices across Europe. This Delphi consensus aimed to: (1) identify key challenges and unmet needs in PHN diagnosis and management; (2) determine the optimal use and positioning of topical treatments, such as lidocaine-medicated plasters; and (3) develop best-practice recommendations to support clinical decision-making and improve patient outcomes. A modified Delphi methodology was followed. An international steering group (SG) comprising seven healthcare professionals (HCPs) experienced in PHN management met online and developed 42 consensus statements for inclusion in an HCP survey; 16 statements were adapted for inclusion in a patient survey. Each statement was presented with a four-point Likert scale to assess agreement, and the surveys were distributed online by a third party to 640 HCPs and 205 patients located in France, Germany, Ireland, Italy, and the UK. Consensus was defined a priori as ≥ 75% agreement. The SG reviewed the results at a second meeting, identified key findings, and formulated best-practice recommendations. A total of 205 HCPs experienced in managing PHN and 26 patients with PHN completed the surveys. Consensus was achieved on 41 of 42 statements in the HCP survey and on all 16 statements in the patient survey. The SG reviewed and discussed the consensus results and formulated eight key recommendations addressing HZ prevention, PHN diagnosis, and optimization of management, including the appropriate positioning of topical therapies and multidisciplinary care. The results of this consensus highlight the unmet needs in PHN care. Implementation of the recommendations into clinical practice is hoped to support more consistent, patient-centered management and improved outcomes for individuals with PHN across Europe.

Abstract Introduction. Family planning is a critical catalyst for achieving Sustainable Development Goal (SDG) Target 3.7, promoting gender equality, and empowering women to participate in education and the workforce. In the Philippines, while the modern contraceptive prevalence rate (mCPR) has risen to 58%, an “unmet need” of 12% persists, largely due to high drop-out rates among women who previously used a method but discontinued it. Understanding the drivers behind this discontinuation is essential to bridging the gap between contraceptive intent and long-term use. Objectives. This study aims to determine the reasons for contraceptive drop-out among contraceptive pill and injectable acceptors at the Advanced Comprehensive Family Planning Services, Research and Training Center (CFPC) of Dr. Jose Fabella Memorial Hospital. It seeks to analyze socio-demographic profiles and identify themes leading to missed follow-ups to improve counseling, operational efficacy, and standard of reproductive care. Methods. The study utilized a qualitative cross-sectional study using a narrative inquiry approach was employed. The study targeted women registered as “acceptors” of short-term hormonal methods, such as contraceptive pills and injectables, who missed scheduled follow-ups in April 2025. Purposive sampling was used to obtain a sample of 45 participants (reaching thematic saturation) from a pool of 248 identified drop-outs. Data was collected via telephone interviews by trained facilitators and analyzed using frequency distributions for demographics and Inductive Thematic Modeling for narrative data. Results. The participant profile primarily consisted of housewives, with secondary education, Roman Catholics, women aged 30–39, living in with partner and residing within the National Capital Region. Four major themes for drop-out emerged: Health System and Personal Access Issues: The most prominent theme, with subthemes of location, time, and financial constraints. Medical Problems: Specifically adverse side effects like irregular bleeding or weight gain. Socio-cultural and Family Barriers: with subthemes of lack of partner support, having a partner working abroad (OFW), or a desire for another pregnancy. Lastly, Lack of Awareness: Resulting in missed intake or confusion regarding scheduled follow-up dates. Discussion. The dominance of access issues suggests that for working-class housewives, “financial constraints” are often tied to logistical hurdles like travel costs (“walang pamasahe”) rather than the cost of the contraceptive itself. Medical side effects remain a critical barrier, even for the majority of participants who explicitly wished to avoid future pregnancies, highlighting a need for better initial counseling to manage expectations. The complexity of short-term regimens also poses a challenge for younger acceptors or those with limited health literacy. Conclusion. Contraceptive discontinuation is a multifaceted process driven by an intersection of systemic gaps, physical burdens, and domestic circumstances. To improve continuation of family planning method, healthcare interventions must evolve beyond the provision of supplies to include integrated support strategies. Key recommendations include proactive side-effect management, decentralized care through partnerships with local health units, enhanced male engagement to foster domestic support and empowerment programs. Addressing these barriers is vital for ensuring family planning effectively promotes social equity in the Philippine health system.

Evidence-based parenting interventions (EBPIs) are among the most powerful interventions in child mental health, but they are often impacted by non-response and drop-out. Extensive research has demonstrated that measurement-based care (MBC), which involves routine collection of client-reported measures to track intervention progress and inform shared decision-making, is associated with improved outcomes in adult mental health populations, including reduced rates of deterioration and drop-out. Comparatively, there has been little research on MBC in child mental health. MBC is inherently more complex and nuanced in EBPIs for child mental health due to the need to collect and integrate data from multiple caregivers, therefore the application of MBC requires careful consideration. This paper presents key considerations and recommendations for the effective implementation of MBC in EBPIs, with a focus on the application of the Collect, Share, Act Model (Barber & Resnick, 2022). Key considerations and recommendations are provided for: (1) collecting multi-informant data, (2) selecting measures, (3) administering measures, (4) sharing and integrating multiple and discrepant perspectives, (5) examining trajectories of change in EBPIs, (6) using MBC data to optimise clinical decision making and intervention planning, (7) considering organisational factors that may affect implementation, and (8) using MBC with culturally and linguistically diverse populations. A new framework is provided, the Parenting CIRCLE of MBC, to guide how MBC data can inform clinical decision making to personalise EBPIs to the needs and preferences of families.

ESTRO clinical practice guideline on radiotherapy for adult soft tissue sarcoma of the extremities and trunk wall - Endorsed by ASTRO.

The Bridging the Gaps (BTG) in Leukemia, Lymphoma and Multiple Myeloma Consensus Conference 2025 brought together a multidisciplinary group of oncology experts to address the complexities of lymphoma management, focusing on mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and diffuse large B-cell lymphoma (DLBCL). This article presents consensus recommendationsdeveloped through a modified Delphi process, which emphasize the need for tailored therapeutic strategies in light of recent advancements in treatment options. Key recommendations include the screening for high-risk features in MCL, use of the BOVen regimen (zanubrutinib, obinutuzumab, and venetoclax) for TP53-aberrant cases, and integration of chimeric antigen receptor T-cell therapy for patients with mantle cell lymphoma that is refractory to covalent Bruton tyrosine kinase inhibitors. For CLL, recommendations include consideration of time-limited therapies for younger patients and a "watch and wait" strategy for asymptomatic patients despite the improved activity and safety of current treatment regimens. For DLBCL, this article highlights the challenges in treatment sequencing and the role of circulating tumor DNA and minimal residual disease testing in monitoring disease progression. Overall, the conference describes the importance of ongoing research to refine management strategies and improve patient outcomes in lymphoma care, addressing the gaps in clinical practice where high-level evidence is lacking.

Background: Sufficient nutrition is essential for well-being, health, and development among school-aged children. Malnutrition, involving underweight and obesity. Malnutrition exhibits a worldwide public health problem. It emphasizes the vital need for successful nutritional education. Web-based modules are a favorable approach to providing nutritional education. Aim: This study aimed to evaluate the effect of implementing a web-based module on knowledge and practice regarding nutrition among school children. Method: A quasi-experimental study was conducted on 41 schoolchildren by using the convenience sampling technique. A purposive sampling technique was used to recruit 15 experts. Four online questionnaires were used for data collected to assess demographic data, knowledge, and dietary habits. A Delphi survey checklist was used to develop consensus for web-based education sessions. The intervention's effect was evaluated at pre-test, post-test, and three-month follow-up. Results: The results displayed a statistically significant increase in nutrition knowledge and practice scores across the three times of data collection (P ≤ 0.05). Students' knowledge level was poor among 95.1% in the pretest, converted to good level among 95.1% in the post-test, and continued good at follow-up among 73.2% of students. Proper total dietary practice improved from 0% pre-test to 100% at follow-up. Both experts and students provided strongly positive feedback on the module's quality, design, and usability. Conclusion: The web-based module is a reliable and highly accepted educational tool that successfully improved and sustained nutrition-related knowledge and dietary practices among school children. Recommendations: Key recommendations include immediately integrating nutritional health education into the curriculum and conducting a long-term study to measure the sustainability of improved dietary habits

The integration of technology into language education requires future teachers not only to master digital tools but to understand the relationship between technological, pedagogical, and content knowledge within the TPACK framework. Building on Mishra and Koehler’s model (2006) and Farrell’s reflective practice theory (2015), this study investigates how systematic reflection can enhance TPACK development among philology students. A mixed methods approach, including reflective journals, peer feedback, and micro lesson analysis, was used to bridge theory and classroom practice. Findings from the review of international research reveal a lack of multimodal and longitudinal studies, as well as limited representation of Russian and Uzbek contexts. The proposed TPACK reflective framework integrates the “Technology Integration Planning Cycle” into philology programs through iterative steps of design, implementation, and reflection. Key recommendations include multimodal reflection through digital portfolios, collaborative feedback, and continuous assessment across the learning stages. The study concludes that developing TPACK through reflective, design-based learning enables future language teachers to align technology use with pedagogical and disciplinary goals, fostering sustainable professional growth in the digital era.

Turmeric ( Curcuma longa Linn.), a versatile crop with culinary, medicinal, cultural, and economic significance, holds immense potential for Fiji's agricultural sector. Despite the predominance of wild harvesting, Fiji ranks as a key global exporter, supplying high‐demand markets like the USA and New Zealand. This review synthesises current knowledge on turmeric production and markets in Fiji, evaluates its socioeconomic significance, and examines key challenges. Between 2016 and 2025, production increased fivefold, rising from 607.7 Mt to 3755.5 Mt, while the export volume grew from 981.298 t in 2018 to 2970.96 t in 2023. The FAO's One Country One Priority Product (OCOP) initiative has supported the promotion of turmeric in Fiji, emphasising organic production and value‐added products to enhance livelihoods and climate resilience. The findings identify critical constraints and opportunities, providing a foundation to guide research, inform policy, and support strategies that enhance farmer livelihoods and promote sustainable agricultural practices. Key recommendations include farmer education, quality seed propagation, tailored agronomic practices, and market research to capitalise on niche opportunities in pharmaceuticals and cosmetics. Future policies should enhance sustainable wild‐harvesting and commercial cultivation. Collaborative efforts among government, academia, and the private sector will be critical to unlocking the potential of this “golden spice.”