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Authors: Adriana L. Smit, Robert H. Eikelboom, Yinan Mao, Michael Hunter, Marcus D. Atlas, De Wet Swanepoel, Inge Stegeman

Introduction With the ageing of the global population, disabling hearing loss is a major health concern. While age and sex are established determinants, the relation between general and environmental health factors and the progression of hearing loss remains incompletely understood, particularly in middle-aged adults. Methods We used data from the Busselton Healthy Ageing Study (BHAS), a population-based cohort in Western Australia. Adults aged 45–70 years at baseline (2010–2015) underwent audiometric testing and health assessments with a six-year follow-up. The better-ear four-frequency Pure Tone Averages for 0.5-4kHZ (4FPTA) and for high frequencies (4 & 8 kHz) (HFPTA) were calculated. Hearing loss was classified according to WHO criteria. Demographic, ear-related, general health, and environmental factors were analysed and their association with change in hearing thresholds using linear mixed models. Results 3596 participants with reliable audiometry at baseline and follow-up were included (mean baseline age 57.9 years, 55% female). Over 6 years follow-up, the prevalence of mild-or-greater hearing loss increased from 14% to 26% (4FPTA) and from 53% to 71% (HFPTA). Thresholds worsened across all age categories, with greater deterioration in men and at higher frequencies. In univariate models, older age, male sex, higher BMI, smoking, tinnitus, chronic ear infection, noisy workplace exposure (particularly with inconsistent or absent hearing protection), hypertension and pre-diabetes were significantly associated with faster hearing decline after adjustments for age and sex. Conclusions In this longitudinal population-based study of middle-aged Western Australians we demonstrated that hearing thresholds significantly declined over a six-year period with greater deterioration in men and at higher frequencies. Findings suggest that hearing loss progression in midlife is shaped not only by age and sex, but also by broader metabolic and environmental health profiles. These outcomes highlight the need for future research to further clarify the complex interplay between metabolic health, environmental exposures, and hearing outcomes.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360651. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Gift G. Lukumay, Deodatus Kakoko, B. R. Simon Rosser, Michael W. Ross

Aim To evaluate the effect of a structured sexual health training programme incorporating standardised patients (SPs) on health professions students’ sexual health communication competence, as assessed by SPs, in a Tanzanian setting. Design Single-blind randomised controlled trial with parallel-group allocation. Setting Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Participants A total of 312 undergraduate medical and nursing students were enrolled at the university. Intervention Structured sexual health training incorporating didactic teaching, small-group discussions, role-play, and SP-based practice sessions. Outcome measures Sexual health communication competence was assessed using SP–rated checklists at baseline and at six-month follow-up. Results Of 310 health profession students, 73.5% were in their final year. The mean age was 24.29 years (SD = 2.51). 22.6% were female, and 60.0% reported prior sexual health training. Baseline competence scores were similar across groups. At the six-month follow-up, competence improved in both groups, with greater gains in the treatment group. Mixed ANOVA showed a significant time effect (p < .001) and a time-by-group interaction (p = .002). Exploratory item-level analyses indicated higher scores in the treatment group across most sexual health communication competencies, particularly in rapport, empathy, and information-gathering, with no significant difference observed for clear and understandable language. Conclusion Structured SP-based sexual health training incorporating SPs significantly improved sexual health communication competence during simulated consultations, particularly in patient-engagement domains. These findings support incorporating culturally adapted sexual health training into healthcare education and using SP assessments to evaluate communication competence in sensitive clinical contexts. Trial registration ClinicalTrials.gov, NCT06428058. Registered 30 November 2023.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360630. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Dongxu He, Tao Jiang, Huajing Xu

Pultruded carbon/glass-fiber hybrid composite rods are increasingly used as sucker rods, yet the relationship between degradation accumulated during long-term downhole service and subsequent longitudinal splitting during retrieval and drum winding remains insufficiently understood, particularly for rods containing a carbon/glass hybrid transition region. This study compared five specimens sectioned from a pristine 22 mm-diameter parent rod with five specimens sectioned from a service-aged parent rod retrieved after 435 days of actual downhole service. Tensile, compressive, flexural, and apparent horizontal shear tests were combined with Welch’s t-tests, bootstrap-assisted two-parameter Weibull analysis, scanning electron microscopy, dynamic mechanical analysis, and moisture-desorption measurements to characterize mechanical degradation and matrix/interfacial damage. After service, the mean tensile, flexural, and apparent short-beam shear strengths decreased by 10.02%, 19.92%, and 21.98%, respectively. After Holm correction, the reductions in flexural and apparent short-beam shear strength remained statistically significant, whereas the tensile-strength reduction did not (adjusted p = 0.057). The mean compressive strength decreased by only 2.25% and showed no statistically significant difference; however, its coefficient of variation increased from 2.42% to 18.88%, while the Weibull shape-parameter estimate decreased from 41.31 to 5.27, suggesting greater compressive-strength dispersion. For the carbon-fiber core, the storage modulus decreased by 34.3%, whereas the glass-transition temperature increased from 159.5 to 164.76 °C. These changes may reflect competing contributions from residual post-curing and moisture-related effects, although the underlying chemical mechanisms were not directly characterized. The greater equilibrium mass loss of the service-aged specimens during drying was consistent with greater retention of removable moisture. Scanning electron microscopy observations revealed extensive matrix fragmentation, resin loss, fiber–matrix debonding, and longitudinal interfacial cracking. Collectively, the results support a possible two-phase damage-evolution process in which prolonged fluid exposure and repeated operational loading progressively weaken the matrix and hybrid interfaces, while additional bending during retrieval and drum winding may promote the propagation and coalescence of pre-existing cracks, thereby contributing to local longitudinal splitting. These findings provide insight into the relationships among field exposure, loading-mode-dependent degradation, strength dispersion, and interfacial damage in three-region hybrid composite sucker rods.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360408. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Xiaoye Liu, Phoebe Barnett, Patrick Nyikavaranda, Laura Burley, Brynmor Lloyd-Evans

Informal carers play a vital role in supporting individuals with mental health difficulties. To provide an overarching synthesis of available evidence, this umbrella review aimed to synthesise qualitative review evidence on informal carers’ (including family members, friends, or other unpaid supporters) experiences of mental health services regarding supporting the individuals with mental health difficulties they care for and seeking support for their own wellbeing. Following the Joanna Briggs Institute (JBI) methodology, a meta-aggregative umbrella review was conducted. Five databases were searched up to 9th May 2025: CINAHL, MEDLINE, PsycInfo, the Cochrane Library, and Epistemonikos. The quality of primary systematic reviews was assessed using a framework adapted from the work of SmithBattle and colleagues. Findings were extracted from eligible reviews and aggregated into categories, from which higher-order synthesised findings were developed. Twelve eligible qualitative reviews were identified covering a wide range of mental health service contexts. Six synthesised findings were identified: (1) emotional complexity in the caregiving journey; (2) recognition and coping with their loved ones’ mental health difficulties; (3) multiple barriers to accessing mental health support; (4) persistent responsibilities and roles in supporting service users; (5) complex experiences of engaging with services; and (6) relational strain during the caregiving process. While some carers reported positive experiences, most described exclusion, emotional distress, and structural barriers to support. This review highlights the urgent need for mental health services to recognise, involve, and support informal carers.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000740. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ying Shi, Zhihui Cheng

This study examined the cross-sectional associations of self-compassion and psychological distress with mental well-being in a predominantly young student sample and tested whether self-compassion modifies the association between distress and well-being. The dual-continua framework guided the simultaneous consideration of distress and positive mental health. Participants (N = 278) completed the Self-Compassion Scale–Short Form (SCS-SF), General Health Questionnaire-12 (GHQ-12), and Warwick–Edinburgh Mental Well-Being Scale (WEMWBS). The principal analysis used mean-centred continuous predictors in hierarchical multiple regression, followed by simple-slopes and Johnson–Neyman analyses. Heteroscedasticity-consistent standard errors and sensitivity analyses were used to examine robustness. Secondary analyses comprised a median-split ANOVA examining categorical main and interaction effects and stratified Spearman correlations estimating the self-compassion–well-being association within distress groups. Higher self-compassion was associated with greater well-being, B = 0.230, 95% CI [0.126, 0.334], p < .001, whereas greater distress was associated with lower well-being, B = -1.450, 95% CI [-1.685, -1.214], p < .001. The continuous interaction was small, B = -0.028, 95% CI [-0.055, -0.001], ΔR² = .008, p = .039. The negative coefficient indicated that the positive self-compassion–well-being association weakened as distress increased and ran counter to the hypothesised protective buffering effect. The interaction was also sensitive to influential-case exclusions, alternative GHQ-12 scoring, and bootstrap estimation, while the secondary median-split ANOVA interaction was non-significant, p = .875. Higher self-compassion and lower psychological distress were independently associated with greater well-being. The small, specification-sensitive interaction provided no evidence of the hypothesised protective buffering effect. Parallel assessment of distress and well-being is warranted, while causal, clinical, and structural conclusions require longitudinal, experimental, and latent-variable research.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000653. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Jesseca Perlman, Samantha Burns, Esther Yu, Jennifer Jenkins, Michal Perlman

Maternal well-being is shaped by a dynamic interplay of structural, relational, and psychological factors, yet most research has examined risk processes across broad economic ranges rather than within families experiencing persistent disadvantage. Grounded in ecological systems, family stress, and resilience theories, this longitudinal study examined patterns of risk and resilience among 634 very low-income, racially diverse (25.6% White, 36.4% Black, 24.8% Asian, 11.4% Other) families, 43% of whom were single-parent households. Using latent class analysis, we identified four distinct maternal profiles based on mental health symptoms, parenting practices, parental conflict, and economic and demographic characteristics: (1) Cumulative Economic and Family Disadvantage (N = 137), (2) Relational Conflict with Relative Economic Stability (N = 163), (3) Adaptive Functioning Amid Family Disadvantage (N = 185), and (4) Stable Well-Being with Relative Economic Stability (N = 149). Analyses examining change in mental health from Time 1 to Time 2 revealed significant class-by-time interactions, indicating that maternal mental health trajectories varied across classes – some improving despite adversity, others declining despite initial advantage. Findings highlight the dynamic and heterogenous nature of maternal well-being and underscore the importance of contextual factors in shaping mental health trajectories among families experiencing economic disadvantage.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000596. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Seyedeh Tahereh Mirmolaei, Zohreh Mahmoodi, Amirhossein Takian, Zahra Bayat Jozani

Migrant women, particularly those from low-resource settings, often face restricted access to reproductive health services in host countries due to intersecting social, economic, and structural barriers. This study explored these barriers among Afghan migrant women in Iran using the World Health Organization's Social Determinants of Health (SDH) model. This qualitative study employed semi-structured, in-depth interviews with 20 purposively sampled Afghan migrant women of reproductive age and 10 key informants from healthcare, midwifery, NGO, and policy backgrounds. Maximum variation sampling was used to ensure diversity in residency status, socioeconomic background, and service experiences. Data collection took place in Tehran from April 2024 over six months and analyzed using directed content analysis guided by the World Health Organization's Social Determinants of Health (SDH) framework. Prolonged member checking and peer debriefing enhanced the credibility and confirmability of the final categorization of structural and intermediary determinants. Three interconnected levels of determinants shape Afghan migrant women’s reproductive health access. Structural determinants include a restrictive legal and macroeconomic context, undocumented status, banking and communication barriers, and high out-of-pocket costs, compounded by patriarchal norms that limit women’s agency. Intermediary determinants include poor material circumstances, psychosocial stressors, and bio-behavioral responses, with care-seeking delays reflecting legal insecurity. Health system and cross-cutting factors, including the lack of migrant-sensitive facilities, linguistic mismatches, and perceived discrimination, further deter service utilization. Social capital and NGO support provide vital bridges to care, yet the intersection of these determinants creates a vulnerability that perpetuates health inequities and restricts access to essential services. This study clarifies how structural and intermediary determinants interact to shape the barriers Afghan migrant women face in accessing reproductive health services in Iran. These findings can inform targeted, migrant-sensitive policy and programmatic interventions to enhance service equity and lower long-term healthcare costs for both migrant populations and the host country.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007406. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Joseph Wells, Joseph Waiswa, Anifa Vala, Bahtisen Golla, Grace Mwashigadi, Hawanatu Jah, Marleen Temmerman, Robin Okello, Isaac Mwaniki, Herminio Cossa, Moses Mukhanya, Esperança Sevene, Yahaya Idris, Onesmus Wanje, Angela Koech, Anna Roca, Laura Braun, Marie-Laure Volvert, Fatima Touray, Umberto D’Alessandro, Peter von Dadelszen, Wendy Graham, Hannah Blencowe, the PRECISE and PRECISE-DYAD Networks

Placenta-related complications contribute substantially to maternal and perinatal mortality globally, with the greatest burden in low- and middle-income countries (LMICs). However, the potential influence of inadequate household water, sanitation and hygiene (WASH) on these outcomes remains poorly characterised. We investigated associations between household WASH conditions and selected placenta-related complications, including pre-eclampsia, small-for-gestational-age (SGA) and stillbirth, in The Gambia, Kenya and Mozambique. This secondary analysis was nested within PRECISE (PREgnancy Care Integrating Translational Science, Everywhere), a prospective observational cohort of 5,745 unselected pregnant women. Multivariable modified Poisson regression with robust standard errors was used to assess associations between household WASH exposures and pre-eclampsia, SGA or stillbirth. Missing exposure and covariate data were low (<5%) and handled using multiple imputation. Compared with water piped into the dwelling or plot, other improved water sources (adjusted relative risk [aRR] 1.18, 95% confidence interval [CI] 1.07–1.31, p = 0.002) and unimproved water sources (aRR 1.23, 95% CI 1.00–1.50, p = 0.049) were associated with a higher risk of any selected placenta-related complication. Unimproved sanitation facilities, compared with improved facilities, were also associated with increased risk (aRR 1.15, 95% CI 1.02–1.30, p = 0.019). The findings suggest that household‑level WASH conditions may be associated with selected placenta‑related complications through both direct and indirect pathways. Water sources, whether unimproved or improved, may be contaminated, and collection, transport, and storage further increase contamination risks while adding a physical burden to water collectors. Unsafe sanitation may also increase exposure to enteric pathogens. Given the observed associations, targeted WASH interventions warrant investigation as a potential strategy to reduce placenta-related complications and improve maternal and neonatal health outcomes in LMICs. Future research should explore the mechanisms linking WASH to pre-eclampsia, SGA, stillbirth and other placenta-related complications, and assess the effect of comprehensive WASH interventions.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0005004. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Catherine Sutherland, Anthony Odili, Msimelelo Gqaleni, Sibongile Buthelezi, Duduzile Khumalo, Fanelesibonge Magwaza, Bahle Mazeka, Lindani Mtshali, Mary Lawhon

As non-sewered sanitation (NSS) is being designed, developed, tested and rolled out, there is widespread support for the integration of social science. Yet what, precisely, social science can and should do remains much less clear. This paper explains the specific approach of social assessments, a process for analysing the context in which NSS exists, and how this context might impact NSS. Social assessments can be more resource intensive than more narrow approaches, making it important to understand its contributions and why it might contribute to NSS. Here, we draw on data from six different social assessment processes on NSS in eThekwini Municipal Area, showing how the questions, methodology and contributions changed. What has resulted from our learnings is not a set process, but ongoing experimentation with and adoption of diverse methods that respond to the particular goals of research teams in specific sites. We explain five potential contributions of social assessment: a) it can improve technologies; b) it can enable users to better understand technologies and interventions, enabling a deeper form of participation; c) broadens the framing of what matters for NSS, showing the relevance and potential changes of factors such as governance arrangements, gender dynamics, and resource costs; d) it offers specialist analysis of technologies’ relationship with the wider context; and e) it impacts relationships, potentially shifting power and building trust. We conclude by urging more explicit attention to the diverse ways of undertaking social science how it can contribute to NSS.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000527. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Yarrow Linden, Erin Kowalsky, Kevin Zhu, Christine Fagnant-Sperati, Sandra McGunegill, Arnaldo Cumbana, Magalhães Mangamela, Rassul Nalá, Matthew C. Freeman, Karen Levy, Joe Brown, The PAASIM Study Authorship Consortium

While nearly three-quarters of the globe use safely managed drinking water services, water quality can deteriorate between the point of service provision and point of consumption due to intermittent supply and the need to store water at the household level. To test if water storage contributes to waterborne pathogen hazards, we estimated prevalence and concentration of enteric pathogens in piped and stored drinking water samples in Beira, Mozambique, using large-volume sampling methods. We assessed water sample concentrates for microbial contamination from bacterial, protozoan, viral, helminthic, antimicrobial resistance (AMR), and microbial source tracking targets with RT-qPCR using a custom TaqMan Array Card. We found that enteric pathogens, AMR targets, and human mtDNA were more prevalent in stored drinking water compared to household tap water. We also detected enteric pathogens— including Cryptosporidium, Giardia, pathogenic Escherichia coli, and rotavirus— directly from 13% (11/87) of piped sources connected to a well-managed, but intermittent, water supply system, albeit less frequently than in stored water. These findings suggest that without continuity in service delivery combined with effective filtration treatment in piped supplies and safe storage microbial contamination of drinking water at the point of use may continue to occur.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000523. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Bing Li, Li Wang, Cundong Li, Zhanyuan Lu, Li Zhang, Hongbo Liu, Juan Li, Dejian Zhang

Post-wheat green manure incorporation can improve fallow-season resource use and crop productivity, but species-specific effects on soil greenhouse gas emissions and subsequent wheat yield remain unclear in spring wheat systems. A field experiment was conducted from 2022 to 2023 in the Yellow River Basin of Inner Mongolia, China, with five green manure species, namely common vetch, hairy vetch, sesbania, forage rapeseed, and forage oat, and a fallow control. Soil CO2, CH4, and N2O emissions, global warming potential (GWP), greenhouse gas intensity (GHGI), wheat growth, and grain yield were evaluated. The system acted as a source of CO2 and N2O and a sink for CH4. Compared with fallow, green manure incorporation numerically increased cumulative CO2 emissions by 7.29%−44.30% and GWP by 7.44%−39.64%, although treatment differences in GWP were not significant, with CO2 contributing more than 85% of total GWP. It also increased grain yield by 2.96%−11.95%. Despite the numerical increase in GWP, GHGI differed among species. Hairy vetch achieved the highest yield and lowest GHGI, common vetch reduced GHGI relative to fallow, and forage oat showed high yield with the lowest cumulative N2O emission. These results suggest that hairy vetch, common vetch, and forage oat are suitable for post-wheat incorporation in this region.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360932. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.