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Authors: Caroline Feldthusen, Magnus Hallström, Erik Hulander, Anna Deminger, Helena Forsblad-d’Elia

Objectives To evaluate the impact of physical function and level of physical activity on health status and health-related quality of life (HRQoL) in patients with long-standing radiographic axial spondyloarthritis (r-axSpA). Methods In total, 141 patients with long-standing r-axSpA were included in this cross-sectional cohort study. Assessments included physical function (Bath Ankylosing Spondylitis Functional Index (BASFI)), spinal mobility (modified Bath Ankylosing Spondylitis Metrology Index (BASMI)), muscle function for leg strength (Timed Stands Test (TST)) and handgrip force (Grippit), amount of self-reported physical activity (vigorous physical activity, moderate physical activity, sedentary behavior), health status by ASAS Health Index (ASAS HI) and HRQoL with Short Form Survey Instrument 36-Item. Multivariable linear regression was used to analyze associations between health status, HRQoL, physical activity, muscle function, and physical function. Results The mean (SD) age was 60 (12) years, diagnosis duration was 25 (10) years, and 57% were male. Physical function and vigorous physical activity were the strongest determinants of health status and HRQoL. The models explained approximately 50% of the variation in ASAS HI and the physical aspects of HRQoL and 21% of the mental aspects of HRQoL. Participants displayed good health status (62%) by ASAS HI ≤ 5, reached the recommended level of health-enhancing physical activity (77%), had normal muscle function (TST 82% and Grippit 91%), and demonstrated physical function (55%), and spinal mobility (45%) within reference values. Conclusion This study highlights the importance of regular vigorous physical activity in older individuals living with long-standing r-axSpA since it was strongly associated with health status and HRQoL.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360248. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Chioma Oringanje, Joshua Meremikwu, Babasola Okusanya, Chukwudi Moses Oringanje, Moriam Chibuzor, Ememobong Aquaisua, Anthony Okoro, Deborah Ndukwu, Martin Madu Meremikwu

Gender norms and bias influence how health workers interpret and deliver sexual and reproductive health and rights (SRHR) services, contributing to stigma, discrimination, and inequities in care. This scoping review aimed to map training tools and educational interventions designed to strengthen health workers’ competencies and address gender bias in SRHR care. This scoping review followed the Arksey and O’Malley framework and PRISMA-ScR guidelines. Searches were conducted across multiple databases and organizational websites for literature published between 2000 and November, 2025. Eligible records included manuals, curricula, toolkits, and educational interventions targeting health workers and addressing gender norms, bias, values, or stigma in SRHR care. Data were extracted and synthesized using descriptive and narrative approaches. A total of 128 sources were included, comprising 25 toolkits/manuals and 103 intervention reports representing 100 unique intervention approaches. Together, they covered diverse SRHR domains and used multi-component pedagogical approaches, including didactic instruction (98.4%), reflective or values-based learning (83.2%), and experiential methods such as role-play, simulation, and case-based learning (92%). Most interventions emphasized equitable, person-centered care (98.4%) and 68.8% incorporated gender-transformative elements, while 74.4% included system-level components. Across the mapped literature, gender-transformative and system-level approaches were incorporated to varying degrees, reflecting variability in their integration across educational interventions. Overall, the review highlights the breadth and characteristics of existing training approaches and identifies opportunities for greater integration of gender-transformative and system-level strategies in future SRHR training and evaluation.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359704. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Xiang Qian, Yanjing Shen, Xianzhong Luo, Siqin Zhang, Li Wang, Hualin He, Bin Wang

Early-life antibiotic (ABX) exposure profoundly disrupts gut microbiota assembly, triggering long-lasting intestinal immune stress. While fecal microbiota transplantation (FMT) is a promising intervention, its immunological and ecological mechanisms in the juvenile gut remain underexplored. In this study, juvenile mice were subjected to a broad-spectrum ABX cocktail for 8 days followed by 4 days of adult-sourced FMT. 16S rRNA sequencing (n = 6/group) revealed that ABX drastically altered the microbial landscape, causing a severe relative reduction of core commensals and an opportunistic expansion of Bacteroides. Subsequent molecular analyses on day 13 (n = 3/group) demonstrated that this dysbiosis significantly upregulated the mucosal TLR4/MyD88 signaling axis and effector cytokines IL-17 and IL-22. Strikingly, adult FMT administration effectively attenuated the TLR4 cascade and reduced pro-inflammatory cytokine transcript levels while immunoregulatory IL-10 transcripts remained partially elevated. Ecologically, FMT did not merely revert the gut to its naive juvenile baseline. Instead, it suppressed Bacteroides overgrowth and established a distinctly new, highly complex community enriched with putative mature, adult-signature taxa such as Parabacteroides, Tannerellaceae, and Desulfobacterota. Interestingly, the downregulation of TLR4 occurred concurrently with the engraftment of these Gram-negative, LPS-bearing taxa. Collectively, adult-sourced FMT ameliorates ABX-induced immune stress not by restoring the original microbiota, but by driving the juvenile gut towards a putatively mature, structurally distinct, and potentially immunologically tolerant ecological state.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0359634. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Francis Dalisay, Wenlin Liu, Masahiro Yamamoto, Haoran Chu, Jay Hmielowski, Young-Rock Hong, Jiawei Liu, Benjamin K. Johnson

This study examined how hurricane stressors and three forms of social capital—bonding, bridging, and linking—are associated with climate anxiety, and whether the three forms of social capital would moderate the relationship between hurricane stressors and climate anxiety. We analyzed data from a cross-sectional survey (N = 1,342) administered in Georgia, North Carolina, and South Carolina following Hurricane Helene and in Florida following Hurricane Milton in 2024. Results showed that hurricane stressors were positively associated with climate anxiety, and these associations held after controlling for symptoms of generalized anxiety. Findings also revealed a nuanced role of social capital. Bonding social capital had a direct negative association with climate anxiety. However, our results suggested that bonding social capital’s protective role is conditional and reverses under high stress. That is, bonding social capital weakened the relationship between hurricane stressors and climate anxiety only when hurricane stressors were low. As stressors accumulated, bonding social capital strengthened the association between stressors and climate anxiety. In contrast, both bridging and linking social capital were positively associated with climate anxiety and strengthened the positive relationship between hurricane stressors and climate anxiety. We discussed theoretical insights and practical implications.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000749. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Bernard Afriyie Owusu, Benedict Weobong

Intimate partner violence (IPV) is a major public health concern and a violation of fundamental human right which disproportionately affects women and profoundly impacts mental health. This study used the 2023 Mozambique Demographic and Health Survey data to examine the association between IPV and common mental disorders (CMDs) among 2,790 reproductive-aged women in union. A composite outcome variable (CMDs), from either probable depression or anxiety, was computed using standardised thresholds. The main exposure was IPV, a composite focused on three forms: physical, emotional, and sexual, stratified by never, past, or recent exposures. A weighted binary logistic regression was performed in STATA 18/MP. Adjusted odds ratios (aOR) and their corresponding 95% confidence intervals were reported. The results show that the prevalence of probable depression and anxiety was 8.6% (95% CI: 7.1–10.5) and 10.7% (95% CI: 8.7–12.9) respectively. Overall, the prevalence of CMDs was 13.5% (95% CI: 11.4–15.9), comorbid symptoms was 5.8% (95% CI: 4.5 – 7.5). The prevalence of emotional, physical, and sexual IPV was 16.1%, 12.0%, and 4.0% respectively. Women who experienced any recent IPV (aOR = 2.05, 95% CI: 1.36 – 3.09), or past IPV (aOR = 1.40 CI: 0.80 – 2.44) had higher odds of CMDs compared to those who did not experience IPV. After adjusting for confounders, emotional IPV (aOR = 2.34, 95% CI: 1.6–3.4) remained independently associated with CMDs; physical (aOR=1.21, 95% CI: 0.73 – 2.03) and sexual IPV (1.67, 95% CI: 0.83 – 3.35) were not. Higher household wealth was protective against CMDs (aOR = 0.34, 95% CI: 0.13 – 0.88), and joint household decision-making was associated with higher odds of CMDs (aOR = 1.84, 95% CI: 1.08 – 3.15). The results demonstrate an interaction between marital status and IPV on CMDs, providing partial empirical support for Intersectionality theory. These findings underscore the need for regular mental health support and targeted IPV campaigns, particularly against emotional abuse among partnered women in Mozambique.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000660. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Ellen Beer, José Chen-Xu, Regina Yuen, Andrea Planatscher, Rebecca Gilmour, Zara Ahmed, Cristina Santamaria-Plaza, Nunzio Zotti, Milena Vasic, Mariam Hachem, Francesco Rosiello, Duha Shellah

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007482. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Mamadou Ouattara, Huiyu Hu, Mamadou Bountogo, Boubacar Coulibaly, Valentin Boudo, Guillaume Compaoré, Clarisse Dah, Elodie Lebas, Kieran S. O’Brien, Benjamin F. Arnold, Thomas M. Lietman, Ali Sié, Catherine E. Oldenburg

Twice yearly distribution of azithromycin has been shown to reduce all-cause child mortality in several contexts. Azithromycin likely reduces mortality via reduction in clinical or subclinical infections. Treating infections may improve child nutritional status to further reduce mortality risk. Here, we used data from a placebo-controlled cluster randomized trial of azithromycin for prevention of child mortality in Burkina Faso to evaluate the effects of twice-yearly azithromycin on mid-upper arm circumference (MUAC) in children aged 1–59 months and weight-for-age Z-score (WAZ) in infants aged 1–11 months. The Child Health with Azithromycin Trial (CHAT) was a 1:1 cluster randomized trial of twice-yearly azithromycin compared to matching placebo for prevention of all-cause mortality in children aged 1–59 months. Measurements were collected every 6 months, including MUAC measurements in all children and weight measurements in infants aged 1–11 months to calculate weight-based dosing. We evaluated MUAC and WAZ at the community level and longitudinally at the individual child level, accounting for the cluster randomized design of the trial. 80,282 children aged 1–59 months, of whom 26,983 were infants aged 1–11 months, in 284 communities were included in analyses. At the community level, we found no evidence of a difference in mean MUAC or WAZ after 36 months or over time. There was no evidence of a difference in change over time in MUAC (P-value for interaction = 0.94) or WAZ (P = 0.18) at the individual level. We found no evidence to support an effect of twice-yearly mass azithromycin distribution on measures of undernutrition in children in this setting in Burkina Faso. Trial registration ClinicalTrials.gov NCT03676764

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007473. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Swati Srivastava, Tads Ciecierski-Holmes, Christoph Strupat, Divya Parmar, Nishant Jain, Manuela De Allegri

Publicly-funded health insurance schemes, wherein governments subsidize insurance contributions for disadvantaged groups, are a key strategy under universal health coverage. India’s Pradhan Mantri Jan Arogya Yojana (PM-JAY) uses an entitlement-based approach whereby approximately 700 million beneficiaries are automatically eligible for scheme benefits, subject to a simplified identity verification procedure instead of enrolment. This study investigates the determinants of undergoing verification among PM-JAY’s target population to identify underserved groups and inform strategies to expand coverage. We used cross-sectional survey data from 2019-2020, covering 50,002 individuals across five states. We examined individual and household characteristics associated with verification using logistic regression models with district-level random effects, and beneficiary experiences with the verification process. About one-fifth of eligible individuals had verified their status within a year of launch. Verification was more likely among older adults, with those ≥60years having higher odds than those 0–15 years of age (adjusted Odd Ratio [AOR] 2.339; 95% CI 2.071-2.641). Those with higher education had higher odds than those with no formal education (AOR 2.303; 95% CI 2.048-2.590), those with prior PFHI enrolment had higher odds compared to those not enrolled (AOR 1.947; 95% CI 1.827-2.075), and those with chronic illness had higher odds than those without (AOR 1.175; 95% CI 1.071-1.289). Women and household members other than spouses were less likely to verify. Disadvantaged castes and minority religions demonstrated relatively higher verification rates. District-level factors explained nearly one-third of variability, indicating that infrastructure and implementation capacity differences influence uptake. Many beneficiaries reported long wait times, varying documentation demands, and informal payments during verification. Addressing these barriers requires gender-sensitive outreach, streamlined household-wide verification, and strengthened local health system capacity. Policy reforms that simplify verification, ensure equitable access, and strengthen health infrastructure are vital to advancing effective universal health coverage for India’s most vulnerable populations.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007451. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Farhana Akter, Tanjina Rahman, Shakil Ahmed, Md Sajjadul Haque Ripon, Marium Sultana, Nasrin Sultana, Harun-ur Rashid

Optimal nutrition is a central to the care of people receiving maintenance hemodialysis, yet dietary intake in these patients is usually measured by self-report, and self-report is known to be unreliable. Evidence from resource-limited dialysis settings is scarce. This cross-sectional study assessed dietary intake among 181 adults receiving maintenance hemodialysis at four hospital-based units in Bangladesh, and examined how screening reported intake for plausibility changes conclusions about guideline adherence. Intake was measured by three non-consecutive 24-hour recalls and compared with the Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations. Reporting plausibility was classified from the ratio of energy intake to estimated basal metabolic rate. Appetite was assessed using the Appetite and Diet Assessment Tool. Of 178 participants with complete data, 65.2% reported acceptable, 32.0% under-reported and 2.8% over-reported energy intake. In the cohort as a whole, only 20 of 176 (11.4%) met the energy target of 30–35 kcal/kg/day and 58 (33.0%) met the protein target of at least 1.0 g/kg/day. Screening changed these estimates in opposite directions according to the type of target. For intake targets, adherence rose once implausible reports were excluded: energy from 11.4% to 15.5% and protein from 33.0% to 47.4%. For restriction targets the reverse occurred: apparent adherence to the sodium limit fell from 73.6% to 65.5% and to the phosphorus limit from 88.2% to 84.5%. The phosphorus-to-protein ratio exceeded 12 mg/g in all but five participants. Poor appetite was common (42.0%) but did not correspond to lower measured intake, and was instead associated with reporting plausibility (p = 0.024). Unscreened self-reported intake simultaneously overstates dietary inadequacy and understates dietary excess, and should not be used unfiltered to guide nutritional decisions in this population.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360654. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Wei Sen Yim, Bala Murali Sundram, Amirah Azzeri, Yin Cheng Lim, Rama Krishna Supramaniam, Suriya Kumareswaran Vallasamy, Siti Nurani Hassan

Background Mental health problems lead to the loss of about 12 billion workdays worldwide each year. This creates a major economic burden. In food manufacturing, workers often face various psychosocial stressors. These include high workload, time constraint, repetitive tasks, and low autonomy. These conditions can affect both mental health and work performance. Workplace mental health interventions have shown promising results in mental health improvement. However, most studies come from high-income countries and service sectors. There is still limited evidence from industrial settings in middle-income countries. To address this gap, a structured Worksite Mental Health Program (WMHP) was developed. Method This study will employ a quasi-experimental two arm repeated measures design among workers from food manufacturing factories in Malaysia. The intervention group will receive an eight week WMHP including psychoeducation, mindfulness practices, progressive muscle relaxation, and breathing exercises. The comparison group will continue with routine workplace practices and receive a general mental health information pamphlet. Assessments will be carried out at baseline, one month post intervention, and at three months follow up. Primary outcomes include depression, anxiety, stress, and burnout. Secondary outcomes include job satisfaction, absenteeism, presenteeism, and economic outcomes. Changes over time will be analysed using Generalised Estimating Equations (GEE). A cost–benefit analysis (CBA) will also be conducted to assess economic impact. Anticipated results The program is expected to improve mental health and work performance, while simultaneously reducing absenteeism and presenteeism. The economic evaluation is expected to demonstrate positive productivity gains associated with the program. Conclusion This study will provide evidence on the effectiveness and economic value of a workplace mental health intervention in an industrial setting, informing workplace health strategies in Malaysia and similar contexts. Trial registration Thai Clinical Trials Registry (TCTR): TCTR20241217003

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360481. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Rohit Raj, Jarina Begum, Syed Irfan Ali, Manasee Panda, Vani Lakshmi R

Introduction Menstrual health is a critical yet neglected public health issue among tribal adolescent girls in India, influenced by socio-cultural, economic, and infrastructural determinants. This review aimed to explore the key menstrual health challenges, barriers, and associated outcomes among tribal adolescent girls in India. Methods This systematic review was conducted in accordance with PRISMA 2020 guidelines. A comprehensive literature search was performed across PubMed, Scopus, and Google Scholar for studies published between January 2015 and March 2026. Quantitative, qualitative, and mixed-methods studies focusing on menstrual health among tribal adolescent girls in India were included. Study selection, data extraction, and quality appraisal were conducted independently by multiple reviewers. Methodological quality was assessed using the Joanna Briggs Institute (JBI) tools. Due to heterogeneity, a narrative synthesis approach was adopted. Results Out of 197 identified records, 28 studies met the inclusion criteria. The findings reveal significant disparities in menstrual health management driven by socioeconomic status, education, cultural taboos, and infrastructural limitations. Key challenges included limited access to sanitary products, inadequate WASH facilities, and poor awareness. Cultural stigma and restrictive practices contributed to psychological distress and unsafe hygiene behaviours. These barriers were associated with adverse outcomes such as reproductive tract infections and increased school absenteeism. The quality appraisal indicated overall moderate to high methodological rigour, with most studies demonstrating acceptable quality despite some limitations related to study design and reporting. Conclusion Menstrual health among tribal adolescent girls remains a significant public health concern in India. Addressing these challenges requires integrated, culturally sensitive interventions focusing on education, improved infrastructure, and equitable access to menstrual health services to enhance health outcomes and well-being.

Source: PLOS ONE. DOI: 10.1371/journal.pone.0360401. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Kwame Shanaube, Suwilanji Simwanza, Buumba Tapisha, Dennis Ngosa, Lucheka Sigande, Isaac Mshanga, Choongo Mulungu, O’jay Mwenya, Jane Grace Mwamba, Lihlizulu Thabo Moyo, Charles Moyo, Temwani Mbambara, Gabriel Lungu, Madalitso Mbewe, Given Moonga, Brian Maila

Mental health disorders (MHDs) are prevalent among adolescents and young people living with HIV (AYPLHIV) and can adversely affect wellbeing, antiretroviral therapy adherence and engagement in care. We aimed to determine the prevalence of common MHDs and associated factors among AYPLHIV receiving routine HIV care in Lusaka, Zambia. We conducted a cross-sectional survey embedded within the AdoMinds mixed-methods implementation study. The study was conducted from September 2023 to May 2024 at Chipata Level 1 Hospital, Lusaka. All AYP aged 15–24 years enrolled in ART care during the study period were invited to participate. A trained research assistant administered a tablet-based questionnaire including validated screening tools for depression, anxiety, post-traumatic stress disorder and substance use. Logistic regression was used to determine factors associated with MHDs. We enrolled 416 AYPLHIV (71.4% of 583 registered in care); 268 (64.4%) were female and the median age was 20 years (IQR: 18, 23). Overall 71.4% (297/416) screened positive for at least one MHD. Depression was most prevalent at 67.1% (279/416), followed by anxiety at 35.3% (147/416). Having at least one MHD was associated with feeling stigmatised because of HIV (AOR = 1.99, 95% CI: 1.10-3.63, p = 0.024). There was borderline evidence that a history of smoking was associated with higher odds of having at least one MHD (AOR = 4.24, 95% CI: 0.98-18.30, p = 0.053). Compared with participants with both parents alive, having lost one parent (AOR = 0.46, 95% CI: 0.21-0.97, p = 0.042) or both parents (AOR = 0.38, 95% CI: 0.18-0.80, p = 0.010) was associated with lower odds of having an MHD. Common MHDs were highly prevalent among AYPLHIV receiving routine HIV care, with HIV-related stigma associated with higher odds of MHDs. Integrating mental health screening and referral pathways into adolescent HIV services may support earlier identification and care.

Source: PLOS Mental Health. DOI: 10.1371/journal.pmen.0000710. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.