Adolescent and parental perceptions of the Fontan Udenafil Exercise Longitudinal Assessment Randomised Controlled Trial (FUEL) and its open-label extension were examined, to identify factors affecting future research participation.

A validated survey was administered at two time points to adolescents (12–19 years) and their parents to assess likes/dislikes of study participation, research team, study burden and benefits. A 5-point Likert scale (strongly disagree [−2] to strongly agree [ + 2]) was used, and scores were averaged. Regression models explored potential predictors. Open-ended questions queried the most/least appealing aspects of participation and considerations for future research.

Among 250 FUEL participants at 14 centres, 179 adolescent and 183 parent surveys were completed at T1 (6 months after randomisation). Perceptions of research participation were generally positive: 1.35 ± 0.45 for adolescents; 1.56 ± 0.38 (p < 0.001) for parents. There were no significant differences between females vs. males. Themes from open-ended responses included liking to help others and themselves, liking the study team, and disliking study burden. Adolescents liked the compensation and disliked study-related testing. At T2 (end of open-label extension study), 121 adolescents and 114 parents responded. Perception scores remained high at 1.39 ± 0.51 for adolescents and 1.58 ± 0.37 for parents (p = 0.001). There were no significant gender differences in perceptions between adolescents, but mothers had slightly better perceptions than fathers (p = 0.004).

Perceptions of research were positive and slightly better for parents. Study teams and compensation were key contributors to positive perceptions. Study burden and testing were viewed less favourably. Future studies should consider families’ preferences and potential barriers to participation.

Prior reports of healthcare-associated respiratory syncytial virus (RSV) have been limited to cases diagnosed after the third day of hospitalization. The omission of other healthcare settings where RSV transmission may occur underestimates the true incidence of healthcare-associated RSV.

Retrospective cross-sectional study.

United States RSV Hospitalization Surveillance Network (RSV-NET) during 2016–2017 through 2018–2019 seasons.

Laboratory-confirmed RSV-related hospitalizations in an eight-county catchment area in Tennessee.

Surveillance data from RSV-NET were used to evaluate the population-level burden of healthcare-associated RSV. The incidence of healthcare-associated RSV was determined using the traditional definition (i.e., positive RSV test after hospital day 3) in addition to often under-recognized cases associated with recent post-acute care facility admission or a recent acute care hospitalization for a non-RSV illness in the preceding 7 days.

Among the 900 laboratory-confirmed RSV-related hospitalizations, 41 (4.6%) had traditionally defined healthcare-associated RSV. Including patients with a positive RSV test obtained in the first 3 days of hospitalization and who were either transferred to the hospital directly from a post-acute care facility or who were recently discharged from an acute care facility for a non-RSV illness in the preceding 7 days identified an additional 95 cases (10.6% of all RSV-related hospitalizations).

RSV is an often under-recognized healthcare-associated infection. Capturing other healthcare exposures that may serve as the initial site of viral transmission may provide more comprehensive estimates of the burden of healthcare-associated RSV and inform improved infection prevention strategies and vaccination efforts.

It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.

To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.

Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.

IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).

Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.

Recent research highlights the dynamics of suicide risk, resulting in a shift toward real-time methodologies, such as ecological momentary assessment (EMA), to improve suicide risk identification. However, EMA’s reliance on active self-reporting introduces challenges, including participant burden and reduced response rates during crises. This study explores the potential of Screenomics—a passive digital phenotyping method that captures intensive, real-time smartphone screenshots—to detect suicide risk through text-based analysis.

Seventy-nine participants with past-month suicidal ideation or behavior completed daily EMA prompts and provided smartphone data over 28 days, resulting in approximately 7.5 million screenshots. Text from screenshots was analyzed using a validated dictionary encompassing suicide-related and general risk language.

Results indicated significant associations between passive and active suicidal ideation and suicide planning with specific language patterns. Detection of words related to suicidal thoughts and general risk-related words strongly correlated with self-reported suicide risk, with distinct between- and within-person effects highlighting the dynamic nature of suicide risk factors.

This study demonstrates the feasibility of leveraging smartphone text data for real-time suicide risk detection, offering a scalable, low-burden alternative to traditional methods. Findings suggest that dynamic, individualized monitoring via passive data collection could enhance suicide prevention efforts by enabling timely, tailored interventions. Future research should refine language models and explore diverse populations to extend the generalizability of this innovative approach.

The EMT-ATG achieved a significant milestone with its inaugural deployment during the SIDS4 Conference in Antigua. The EMT2030 strategy and Global Health Emergency Corps (GHEC) approach underscore the importance of collaborative leadership and joint efforts among all the networks to provide a comprehensive response.

The primary objective of the deployment was to ensure the health and safety of SIDS4 conference attendees through a coordinated and effective emergency medical response. It also aimed to demonstrate the capability of small island countries to establish and deploy fully operational and self-sufficient EMTs in coordination with other rapid response capacities, fostering a model of collaborative leadership.

Training programs, conducted in collaboration with PAHO, focused on disaster response, triage, and mass casualty management. PAHO capacity building included the procurement of medical equipment, establishment of mobile medical units, and enhancement of communication systems for seamless coordination.

In preparation for deployment, ATG-EMT conducted simulation exercises and drills which involved various stakeholders, including local health authorities, security agencies, prehospital EMS, public health rapid response teams, and community volunteers.

The successful deployment of ATG-EMT during the SIDS4 Conference demonstrated the team’s capability to provide high-quality medical care and support at a high-profile international event. This contributed to the health and safety of over 4,500 delegates.

The deployment highlights the importance of continuous training, robust capacity building, meticulous preparation in developing an effective emergency medical response system and serves as a model for small island countries aiming to enhance their disaster response capabilities.

The Red Cross Red Crescent Health Information System (RCHIS) is an electronic medical record (EHR) and health information management system (HIS) which has been designed for international disaster responses with a cloud-based server and a local server to bridge temporary internet outages. This architecture allows for remote information management and operational support should data processing agreements allows it.

Describe adapting a cloud-based health information system to a fully offline setting and improve business continuity in case of a system failure.

An analysis of the existing architecture of RCHIS was conducted to identify components and procedures that only work on the cloud-based server with an existing internet connection. Offline alternatives were identified and developed to ensure full offline operational capacity and redundancy.

A mechanism to set up a second local server for redundancy improves business continuity planning, and having locally stored backup allows the recovery of data without an internet connection. Instead of creating new user accounts in the cloud and emailing a one-time password (OTP), a mechanism to create accounts on the local server and display the OTP was added. The offline generation of the WHO EMT MDS report was embedded.

Adding the capability to work fully offline to RCHIS meant significant software architecture changes. Despite losing some of the benefits, such as remote information management, RCHIS is now a robust offline tool for deployment in settings without any internet connectivity. Having a local server also means that we can comply with data sovereignty rules where they exist.