Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13–19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.

The consent process for research studies can be burdensome for potential participants due to complex information and lengthy consent forms. This pragmatic study aimed to improve the consent experience and evaluate its impact on participant decision making, study knowledge, and satisfaction with the In Our DNA SC program, a population-based genomic screening initiative. We compared two consent procedures: standard consent (SC) involving a PDF document and enhanced consent (EC) incorporating a pictograph and true or false questions. Decision-making control, study knowledge, satisfaction, and time to consent were assessed. We analyzed data for 109 individuals who completed the SC and 96 who completed the EC. Results indicated strong decision-making control and high levels of knowledge and satisfaction in both groups. While no significant differences were found between the two groups, the EC experience took longer for participants to complete. Future modifications include incorporating video modules and launching a Spanish version of the consent experience. Overall, this study contributes to the growing literature on consent improvements and highlights the need to assess salient components and explore participant preferences for receiving consent information.

Food poverty is an acknowledged social determinant of health and is associated with significant adverse health outcomes(1,2). It is a growing issue on the Island of Ireland, due to a number of factors, including, the COVID-19 pandemic, chain supply issues, inflation and external geo-political events. As news media play a key role in shaping policy discourse(3)and public attitudes(4) towards health and social issues, understanding how the issue of food poverty is framed on the island of Ireland may help health promoters develop alternate framings to better advocate for effective policy measures. The overall aim of this research was to investigate the discursive construction of food poverty in the news media, and to explore public, policy and key stakeholder perceptions of food poverty.

A series of interlinked studies were conducted, including analysis of policy documents, analysis of print and broadcast news media reporting on food poverty, and qualitative interviews with news media professionals, members of the public, third sector community organisations and policymakers. In analysing how the topic is framed, the research drew on Entman’s Framing Theory. An integrated knowledge translation approach was adopted throughout the research process.

Findings from analysis of policy documents (n = 48), print (n = 81) and broadcast (n = 91) news media, and qualitative interviews with key stakeholders (n = 44) across the island of Ireland revealed four core inter-linked and over-lapping discursive frames, including: political dysfunction, economic dysfunction, social dysfunction, and individual dysfunction. A key finding included differing opinions between participants in the North and the Republic on whether lifestyle (individual dysfunction) or structural (political dysfunction) factors were salient drivers of food poverty. Those who leaned more towards understandings of food poverty that included individual dysfunction showed greater endorsement of individual and community level interventions, while those who leaned more towards understandings that included political dysfunction showed greater endorsement of policy-led interventions. This coherence was not evident in news media reporting, where media discourse more prominently highlighted community-led responses (e.g. charitable food aid), despite acknowledgement of its upstream drivers. Another key finding was the absence of the voices of those experiencing food poverty from news media reporting on the issue. While news media professionals expressed a need for case studies, third sector service providers raised questions about the ethical engagement with vulnerable populations.

The research findings highlight that the problem of food poverty is largely depicted through the lens of charity, which precludes obligations for state actors and says nothing of the right to food. Re-framing discussions of food poverty as a health and human rights issue may be a fruitful strategy in addressing the problem. Health promotors, researchers and other stakeholders interested in food poverty should move towards adopting rights-based messaging when translating knowledge, including to policymakers and the media.

This article outlines a human-centered approach to developing digital patient stories, for sharing their experiences in health care, while preserving patient and others’ privacy. Employing a research-through-design approach, the study proposes a design solution using visualization and digital storytelling to document patients’ and families’ experiences and emotions, as well as their interactions with healthcare professionals in the postnatal unit. By transforming selected observational data into animated stories, this approach has the potential to elicit empathy, stimulate stakeholder engagement, and serve as a practical training tool for clinicians. This work was conducted as part of a broader study that aims to contribute to the existing knowledge base by advancing our understanding of stakeholder needs in birthing facilities and through postpartum discharge. This study primarily focuses on strategies for the development of digital stories and summarizes the factors that contributed to the production of digital stories within the context of sensitive data. It may serve as a valuable resource for students, researchers and practitioners interested in utilizing digital stories to encourage discussions, education and ultimately to enhance systems of health care for respect, equity and support.

Clostridioides difficile infection (CDI) research relies upon accurate identification of cases when using electronic health record (EHR) data. We developed and validated a multi-component algorithm to identify hospital-associated CDI using EHR data and determined that the tandem of CDI-specific treatment and laboratory testing has 97% accuracy in identifying HA-CDI cases.

Maternal pre-pregnancy body mass index is positively associated with offspring obesity, even at adulthood, whereas breastfeeding decreases the risk of obesity. The present study was aimed at assessing whether breastfeeding moderates the association of maternal pre-pregnancy body mass index with offspring body composition at adulthood, using data from 3439 subjects enrolled in a southern Brazilian birth cohort. At 30 years of age, maternal pre-pregnancy body mass index was positively associated with offspring prevalence of obesity, abdominal obesity, as well as body mass index and fat and lean mass index. Breastfeeding moderated the association of maternal pre-pregnancy obesity with offspring adiposity at 30 years of age. For those breastfed<6 months, body mass index was 4.13 kg/m2 (95% confidence interval: 2.98; 5.28) higher among offspring of obese mothers, in relation to offspring of normal weight mothers, whereas among those breastfed≥6 months the magnitude of the difference was small [2.95 kg/m2 (95% confidence interval: 1.17; 4.73)], p-value for interaction = 0.03. Concerning obesity, among those who had been breastfed < 6 months, the prevalence of obesity was 2.56 (95% confidence interval: 1.98; 3.31) times higher among offspring of obese mothers. On the other hand, among those who were breastfed ≥ 6 months, the prevalence of obesity was 1.82 (95% confidence interval: 1.09; 3.04) times higher among offspring of obese mothers. Therefore, among overweight mothers breastfeeding for more than 6 months should be supported, as it may mitigate the consequences of maternal overweight on offspring body composition.

This paper examines the Holy See as a political actor amid hard power conflict. While many debate the legal and religious personalities of the Holy See, few engage with an approach that illustrates the Holy See and its citizen-like laity in light of its combinative religious–political dynamic. This paper argues that resulting from this dynamic, the Holy See's sui generis statehood enables the comprehension of a similar sui generis citizenry. These citizens, which this paper labels pseudo-citizens, are the result of connections between the recognized sovereignty of the Holy See and its role over the Roman Catholic Church. This paper examines this connection contextually amid the Holy See's interaction with the underlying international moral framework on just conflict and the protective motivating factors associated with its pseudo-citizens. This motivation is consistent with historical Holy See positions, and is significant for understanding the Holy See's approach amid future hard power events.

Clinical guidelines recommend device removal for cardiovascular implantable electronic device (CIED) infection management. In this retrospective, nationwide cohort, 60.8% of CIED infections received guideline-concordant care. One-year mortality was higher among those without procedural management (25% vs 16%). Factors associated with receipt of device procedures included pocket infections and positive microbiology.