In home-care for older adults, several vulnerable groups come together: the older adult with care needs, family relatives who look after the older adults and, increasingly, migrant live-in careworkers who live with the older adult. Community engagement is recommended in order to reach and protect people in vulnerable situations, especially for crisis preparedness and prevention activities. This article aims at showing how a participatory approach and community involvement can lead to defining challenges and finding solutions for improving home-care for older adults in Austria. A network meeting was organized that brought family caregivers as well as live-in carers and Community Nurses together. The network meeting showed that it was possible to bring almost all affected and vulnerable groups in home-care together. The presence of Community Nurses and researchers also made it clear to the affected groups that their matters were of wider public importance.

Background: Wars and displacement impose severe psychological and emotional burdens, especially on women who are already grappling with societal pressures and caregiving roles. In Gaza, the ongoing 2023/2024 conflict has displaced hundreds of thousands of women, leaving the majority in overcrowded shelters, temporary tents, and substandard living conditions. Aims: This study aims to explore the prevalence of depression among internally displaced women (IDW) and examine the factors that contribute to their mental health challenges. Methods: A cross-sectional study was conducted in June 2024, involving 385 IDW aged 18 and above located in the south and middle of Gaza Strip. Data were collected using a self-administered, structured questionnaire. Results: Depression was found to be widespread, with 88.3% of participants showing symptoms, and 68.8% classified as having moderate to severe depression. The mean (±SD) score for depression was 17.3 ± 5.9). Experiencing the loss of a family member and sustaining an injury were associated with a significantly higher likelihood of depression, with β = 1.62 (95% CI: 0.182 to 2.54) and β = 1.43 (95% CI: 0.253 to2.61), respectively. The main barriers to access to mental health services were lack of information related the availability of health services (40.5%), services not available (22.6%), remote of health facility and long distance (15.6%), stigma from receive mental health service (8.6), and high cost (7.3%). Furthermore, 5.5% believed that they don’t need mental health services. Conclusion: Depression among IDW in Gaza Strip is alarmingly high, in particular among vulnerable group such as families lost their relatives and injured persons during the war. Immediate interventions, are essential to alleviate their psychological suffering.

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines (2017-2025: An update) - endorsed by the European Society for Brain Stimulation (ESBS) and by the International Federation for Clinical Neurophysiology (IFCN).

Flooding and the risk of PTSD, depression, and anxiety: A systematic review and meta-analysis.

Demographic and regional trends in all-cause mortality among adults with coexisting multiple myeloma and cardiovascular disease in the United States, 1999-2023: A CDC WONDER analysis.

Joint trajectories of sleep disturbance and psychotic-like experiences in adolescents: patterns, influential factors, and their associations with mental health problems.

Adolescents are a developmentally vulnerable group in mental health care, yet their experiences of informal coercion remain underexplored. Most existing research reflects adult perspectives, leaving a gap in understanding how adolescents experience such practices. This review synthesises qualitative evidence on the forms and consequences of informal coercion experienced by adolescents in mental health settings. The review followed the PRISMA guidelines and was registered in PROSPERO. A systematic search was conducted across seven databases in February 2025 (PubMed, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science, Cochrane Library). Screening and inclusion were performed using Covidence supplemented by manual reference searches. Qualitative content analysis was applied, using a framework informed by previously identified forms of informal coercion. Across 12 studies, informal coercion shaped adolescents' involvement in mental health care. Predominant forms included treatment pressure, silencing and exclusion and appealing to rules and routines, accompanied by threats or disciplinary control. These practices were experienced as undermining autonomy and trust. The adolescents responded through adaptive and resistant coping strategies, such as compliance, concealment, or overt opposition. The experiences were commonly associated with emotional distress, relational mistrust and hindered recovery, although some adolescents interpreted structured pressure as supportive or protective. Informal coercion is present and consequential in adolescent mental health care. Existing adult-based conceptualisations may overlook its relational and subtle nature. Further research is needed to explain how informal coercion is constructed in interactions and how it is justified in adolescent mental health care. Such knowledge is essential for developing ethically sound, rights-respecting nursing practices. Trial Registration: PROSPERO: CRD42025644678.

Hypovitaminosis D (HD) is a relevant deficit. This vitamin has implications in bone health, as well as immunological and metabolic functions, and in the pathophysiology of cancer. Pediatric oncology patients are at increased risk for this deficiency. A cross-sectional, retrospective study was conducted to determine the prevalence of HD in pediatric oncology patients in a high-complexity hospital between January 2019 and August 2023. Eighty-nine patients were included. The overall median vitamin D levels were 18.3 ng/mL (IQR: 11.1-26.7). The prevalence of HD was 52.8% (95%CI: 41.9-63.5). These results indicate that, in this sample, more than half of pediatric oncology patients present HD. We emphasize the importance of determining the levels of this vitamin at diagnosis and during treatment of the disease in this highly vulnerable group.

Scrutinizing the Mortality from Cerebrovascular Disease with Underlying Metabolic Syndrome in the United States from 2000 to 2019 - A Comprehensive Analysis of CDC WONDER Database.

Introduction: This article discusses social inclusion as a very important factor in public health that affects well-being and health equity. Objective: Analyze the role of social inclusion in public health and its relationship with social determinants and living conditions. Methodology: A literature review was conducted using the terms “social integration AND public health” and “social inclusion AND public health.” Results: Low social integration increases health inequalities by up to three times, while community participation improves well-being by 26%. Vulnerable groups experience more than 60% exclusion, confirming its impact as a critical determinant in public health. Conclusion; This study shows that social inclusion allows us to understand and address health inequalities, promoting more equitable systems. Further research is recommended to ensure inclusion and justice in healthcare. KEY WORDS: Social adjustment, social change, public health, health equity.

Trends and predictors of malnutrition during chemotherapy among adults with cancer in Ethiopia: A prospective longitudinal study.

Advancing climate justice for vulnerable groups: Optimizing spatial configuration of urban blue–green infrastructure to mitigate heat risks leveraging explainable machine learning

ABSTRACT Air pollution is widely recognized as a major public health concern, and emerging evidence suggests an association with dementia. Establishing a causal relationship, however, is difficult. Economic cycles affect both dementia prevalence and pollution levels: during economic booms, financial resources for treatment rise, but so do air pollution and work-related stress. In South Korea, air quality has generally improved, even as Alzheimer’s cases have increased with population aging, indicating a time-series relationship that biases regression results. Air pollution and vascular dementia also temporarily declined during COVID-19, reflecting omitted variable bias. To address these endogeneity concerns, we use wind speed and direction as instruments for air pollution in South Korea. Our estimates show that higher concentrations of PM10, PM2.5, and NO2 significantly increase dementia cases, with instrumental variable results substantially larger than ordinary least squares, underscoring the importance of correcting for bias. These findings carry important policy implications. Because air pollution is a negative externality, its health consequences—including dementia—extend beyond individual responsibility and represent broader social costs. Reducing pollution could therefore not only improve health outcomes but also ease the considerable economic burden of dementia care. As air pollution disproportionately affects vulnerable groups—individuals with dementia who are unable to sustain employment or income—targeted social support is also essential to address their combined medical and financial challenges. Implications: We underscore the importance of addressing endogeneity issues when evaluating the relationship between air pollution and dementia. Conventional approaches may produce biased estimates due to spurious time-series-correlations and omitted variables. By using wind speed and direction as instruments, we identify LATE-based causal effects of air pollution on the number of dementia patients. Our findings suggest important policy implications: reducing air pollution can lower the substantial social and economic costs associated with dementia. Improved administrative data linking clinical records with environmental exposures would support effective monitoring and policy evaluation. Furthermore, international cooperation is needed to address transboundary nature of air pollution.

To systematically map Irish national health datasets and policy frameworks relevant to children and young people (0-24years) and appraise their readiness for quality improvement, equity monitoring, and interoperable reuse. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI)-guided scoping review will synthesise peer-reviewed and grey literature. Datasets will be benchmarked using World Health Organization Data Quality Review (DQR) domains, Findable, Accessible, Interoperable, Reusable (FAIR) principles, European Medicines Agency registry guidance and PROGRESS-Plus equity stratifiers. Outputs will be synthesised into structured matrices (national catalogue, key quality indicators and availability-variability layer) and an equity heat map. The review will characterise heterogeneity in coverage, coding, governance, equity stratification and linkage-readiness across perinatal, hospital, registry, surveillance and community datasets, identifying priority gaps for standardisation. Within the context of healthcare quality assurance, the synthesis will enable evidence-informed benchmarking across clinical domains, from perinatal outcomes to chronic disease management. The integration of DQR and FAIR appraisals will allow Irish health agencies to identify datasets that meet international standards of reliability, completeness and accessibility. Simultaneously, mapping PROGRESS-Plus variables will reveal where data gaps perpetuate inequities, informing targeted data-collection reforms. The resultant framework will provide a replicable model for how nations can align data governance with the continuous quality-improvement cycle central to the International Journal of Pharmaceutical Quality Assurance's mission - linking structure (data quality), process (data use) and outcomes (policy and patient benefit). This review will generate a decision-ready catalogue of Irish paediatric and young people's health datasets, highlighting strengths, gaps and opportunities for improvement. By appraising data quality, equity stratifiers and linkage readiness, it will provide actionable recommendations for standardisation and governance. Policymakers can use the outputs to align datasets with international best practice, clinicians can advocate for inclusion of outcome and patient-reported measures and researchers can identify priority areas for secondary analysis and linkage studies - supporting safer, fairer, and more effective child health services in Ireland. Strengthening child health data systems has direct societal benefits by enabling more equitable, transparent and evidence-based policy. By mapping available datasets and assessing equity stratifiers, this review will highlight gaps in capturing determinants such as ethnicity, deprivation and disability. Addressing these gaps will allow more accurate monitoring of health inequalities and ensure that vulnerable groups are not overlooked in service planning. The outputs will support a culture of accountability, inform public debate on data use and contribute to building a learning health system that promotes fairness, inclusivity and trust in healthcare for children and young people. This protocol delivers the first integrated, decision-ready framework to benchmark paediatric data ecosystems against international quality, equity and stewardship standards, enabling learning health systems and policy-relevant data governance in Ireland and comparable Organisation for Economic Co-operation and Development settings.

ABSTRACT Persuasive system design (PSD) that guides individuals’ decision-making in a digital environment can be a powerful tool that needs to be handled with responsibility. Vulnerable user groups, such as teenagers and young adults, are proving more likely to be influenced by PSD. In light of that, we conducted a case study with 273 fourteen-year-old girls in Scandinavia to understand the recognition of teenage girls towards the two sides of PSD, namely digital nudging and dark patterns. Our findings show that the teenage girls had a hard time recognising specific features of PSD. Based on our findings, we offer two main contributions. Firstly, we offer in-depth insights into the way teenage girls recognise PSDs. Secondly, we contribute with design guidelines for designers and educators for ethical nudge design.

Short-video platforms, characterized by algorithmic curation and passive consumption, have emerged as dominant components of digital life. However, the associations between short-video platform use and health across different groups and usage behaviors remain understudied. This study investigates associations between short-video platform use and health, examining whether these relationships vary across health status, usage behaviors, and socioeconomic status. A cross-sectional study was conducted using multistage stratified sampling across eastern, central, and western China from July to September 2024. The inclusion criteria were age 18 years or older, ability to communicate effectively, and no cognitive disorders or mental disturbance. Of 7725 participants enrolled, 46.96% (n=3628) were male, and the average age was 65.49 (SD 8.39) years. The data were collected via face-to-face interviews using a structured questionnaire. Self-rated health and relative health deprivation (Kakwani index) were used to measure health. Quantile regression explored associations between whether using short-video platform and health varies across the health distribution, while linear regression examined associations of years, frequency, daily duration, and purpose diversity of short-video platform use with health. Moderating effect analysis explored the role of socioeconomic status in the relationship between the daily duration of use and health. Coefficients were tested using 2-tailed t tests, and statistical significance was defined as a 2-sided P value less than .05. Quantile regression revealed heterogeneous associations. Compared to nonusers, short-video platform users had better self-rated health at the 70th to 90th quantiles and lower relative health deprivation at the 10th to 30th quantiles. However, the users at the 10th quantile of self-rated health had worse self-rated health (β=-2.224, 95% CI -3.835 to -0.613). Longer engagement (≥3 y) correlated with lower relative health deprivation (β=1.970, 95% CI 0.308-3.632), while daily use of 1-4 hours was associated with poorer self-rated health (β=-3.385, 95% CI -4.872 to -1.898; β=-3.038, 95% CI -5.054 to -1.022) and higher relative health deprivation (β=0.035, 95% CI 0.021-0.050; P<.001; β=0.034, 95% CI 0.014-0.054). Compared to no purposeful use, using with 2 purposes was associated with better self-rated health (β=6.082, 95% CI 0.250-11.914) and lower relative health deprivation (β=-0.063, 95% CI -0.120 to -0.005). The association was stronger for use with 3 or more purposes. Socioeconomic status moderated the relationship between daily duration of use and health. This study provides a more specific investigation of how these associations vary across health strata and usage patterns. The findings reveal patterns of benefit and risk across population subgroups, underscoring that how and why individuals engage with platforms matter more than mere access or frequency. These insights necessitate targeted digital well-being policies that protect vulnerable groups, particularly those in poor health or with lower socioeconomic status. Furthermore, policies should actively encourage intentional, functionally grounded use to reduce health inequities and advance equitable digital inclusion.

Per- and polyfluoroalkyl substances (PFAS) are highly persistent contaminants frequently detected in foods of animal origin, raising concern for human health. Eggs and egg products are recognized by the European Food Safety Authority (EFSA) as one of the major dietary sources of PFAS exposure in Europe. This study applied the relative potency factors (RPFs), based on hepatic toxicity, to estimate cumulative dietary exposure to PFAS from eggs across different population groups. The 95th percentile occurrence data were combined with food consumption patterns to express exposure in perfluorooctanoic acid equivalents, providing a biologically relevant metric. Perfluorooctanesulfonic acid emerged as the dominant contributor to cumulative exposure. Toddlers exhibited the highest estimated weekly intake, reaching 1.63 ng/kg bw per week, while adolescents, adults, and elderly populations showed progressively lower values. These findings highlight children as a particularly vulnerable group due to higher intake per body weight. Consistent with previous studies, commercial eggs generally contained PFAS only at trace levels, whereas home-produced eggs often showed elevated contamination, in some cases exceeding the European Union maximum levels and EFSA's tolerable weekly intake. Overall, this work demonstrates the potential of the RPF approach for mixture-based risk assessment, underscores the need for refined exposure evaluation, and reinforces the importance of continuous monitoring of PFAS in eggs.

With China's rapidly aging population, the oral health of older adults living alone has become a growing concern due to their limited social support and potential health disparities. This study aimed to compare oral health status between Chinese adults aged 65-74 living alone versus those cohabiting with others and identify factors associated with oral health disparities. A cross-sectional analysis utilized data from China's 4th National Oral Health Survey, including 4,406 participants (312 living alone; 4,094 cohabiting). Oral examinations assessed caries, periodontal status, and tooth loss; structured questionnaires captured demographics, socioeconomic status, behaviors, and self-perceived oral health. The survey was conducted according to the basic methods proposed by the World Health Organization (WHO). Older adults living alone (7.1%) showed worse oral health: higher caries prevalence (83.01% vs. 76.26%), more tooth loss (8.26 vs. 6.76), less occluding pairs (6.85 vs. 8.14), lower oral health knowledge scores (5.88 ± 2.51 vs. 6.32 ± 2.31), and worse self-perceived oral health (P < 0.05). Regression confirmed living situation, age, gender, education, income, area, smoking and drinking alcohol as key predictors of oral health outcomes (P < 0.05). Oral health is significantly poorer among Chinese seniors living alone and is significantly associated with socioeconomic and behavioral factors. Targeted interventions-including enhanced social support, financial aid, and oral health education-are urgently needed for this vulnerable group.

Civic technologies are increasingly promoted as tools to enhance democratic participation, decision-making, collective action, and digitally enabled governance. This study examines the emergence of AI-enabled multilingual civic platforms and their potential to support inclusive participation and social innovation in linguistically diverse democracies. The study adopts a conceptual and exploratory research design, supported by qualitative analysis, to enhance the theoretical clarity of contested concepts such as digital empowerment and social innovation. A systematic review of 158 civic technology platforms was also conducted to examine the role and limitations of major public resource repositories in promoting multilingual democratic processes through three dimensions: social innovation, digital democracy, and civic technology. The findings show that instrumentalist approaches to social innovation – prioritising efficiency, performance, and scalability of civic tools implementation – predominate over approaches that emphasising empowerment, deliberation, and changes in social and governance relations. Most platforms are technology-driven rather than human-centered, with limited attention to inclusion, linguistic diversity, and meaningful participation. Consequently, their capacity to enable transformative forms of social innovation remains constrained. The study concludes that while AI-enabled multilingual platforms may reduce language barriers and facilitate the participation of minority and vulnerable groups, their democratic and socially innovative potential depends on the alignment between technological and user design, governance arrangements, and the extent to which they enable inclusive participation and knowledge co-creation.

This paper presents a conceptual framework for developing a geographic information system (GIS) designed to monitor agricultural and rural development in Ukraine with integrated human rights assessment components. The proposed system addresses critical challenges facing Ukraine’s rural territories in the context of post-war reconstruction, including food security degradation, land resource management, infrastructure destruction, and protection of vulnerable population groups. The study outlines a comprehensive monitoring framework structured around six indicator blocks: security situation, food security, land resources and land use, agro-food system infrastructure, socio-economic conditions of rural territories, and human rights observance. The system architecture incorporates modular design principles, spatial database technologies, and advanced analytical capabilities to support evidence-based policy development and decision-making at multiple governance levels. Integration of geospatial analysis and socio-economic assessment methods aims to provide a tool for a human rights-based approach implementation into rural development management during Ukraine’s post-war reconstruction.