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Responsible forgetting refers to an adaptive process whereby individuals intentionally forget information that does not need to be remembered. This study examined whether responsible forgetting is influenced by the forgetfulness of a partner in collaborative recall. Participants imagined preparing for a camping trip with a hypothetical friend. Each camping item was paired with a cue (You or Friend) indicating whether the participant or friend was responsible for remembering it. Participants in the forgetful condition were told that their friend was forgetful, whereas no information was provided about the friend in the control condition. Results demonstrated that the interaction effect between partner unreliability and memory-responsibility cue on recall performance was statistically significant (OR = 0.39, 95% CI [0.17, 0.90]). Participants in the forgetful condition recalled more friend-assigned items than those in the control condition. These findings indicate that responsible forgetting is flexibly moderated depending on the situation, such as a partner's forgetfulness.

People living in overcrowded conditions, with limited access to healthcare face a myriad of challenges including infectious diseases. The burden of infections in underserved neighbourhoods, and in camps hosting displaced populations (Refugees and Internally displaced populations (IDPs)) is often overlooked. This systematic review evaluates the prevalence of infectious diseases among people living in underserved neighbourhoods (PLIUSN), refugees, and IDPs, to consolidate current evidence and provide baseline information for interventions. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO number CRD 42020193633). A systematic analysis of articles from 1st January 2000 to 31st December 2022 was conducted and 4572 records were identified from PubMed, EMBASE, Cochrane Library and organizational websites (International Organization for Migration (IOM), United Nations High Commissioner for Refugees (UNHCR), United Nations International Children's Emergency Fund (UNICEF), The World Health Organization (WHO)). Title and abstract screening identified 276 articles for full text screening, and 69 articles were included for this review. Out of 142 infectious disease events reported, respiratory diseases were the most reported infections (39, 27.46%), followed by Hepatitis B (25, 17.41%), diarrhoeal diseases (20, 14.08%), parasitic diseases (19, 13.38%), and HIV (18, 12.68%). The remaining 28.73% (21) included other sexually transmitted diseases (excluding HIV), skin infections, Hepatitis E, and helminth infections. Refugees (54.79%, 40) and IDPs (20.55%, 15) had higher rates of infections compared to PLIUSN with 2.74% (2). The review identified four risk factors associated with the burden of infection: disease diagnosis, access/use of health services, living conditions and geographical location, and human factors. These findings emphasize the risk of infectious diseases associated with PLIUSN and displaced populations. It also highlights associated risk among these populations; as such addressing these factors namely, access/utilization of health services, living conditions and geographical factors, and human factors is recommended.

Modifiable factors may influence prognosis in patients with cirrhosis and portal hypertension-related bleeding (PHB). This study characterized metabolic and hematological profiles during and after PHB and evaluated their impact on liver-related events and mortality. Observational, single-center, retrospective cohort study including patients with cirrhosis admitted for PHB and followed for 1 year. Epidemiological, clinical, analytical, and hemodynamic data were collected. Anemia was defined according to World Health Organization criteria, and the hypoalbuminemia threshold was established using receiver operating characteristic (ROC) curves and the Youden index. Risk factors for liver-related events and death were assessed using Cox regression and cumulative incidence functions with competing risks. Forty-eight patients were included (60.4% men; 35.5% alcohol-related cirrhosis), with a median age of 63 years (IQR 55-74). During one-year follow-up, hepatic encephalopathy (HE) was the most frequent liver-related event (21%). Hypoalbuminemia was independently associated with an increased risk of hepatic encephalopathy at 6 months (sHR 5.70, 95% CI 1.36-23.8, p=0.017) and at 1 year (sHR 7.28, 95% CI 1.08-48.8, p=0.041). One-year survival was significantly lower in patients with HE (60% vs. 100%, p<0.001), hypoalbuminemia (60% vs. 96.7%, p=0.005), and anemia (80% vs. 100%, p=0.016). Patients receiving red blood cell transfusion during PHB showed better liver function at 1 year (median MELD 9 [IQR 7-10] vs. 10 [IQR 9.8-12.5], p=0.017). Anemia and hypoalbuminemia are potentially modifiable factors associated with increased risk of HE and mortality within 1 year after PHB. Whether correction of anemia and nutritional status improves prognosis remains to be determined.

The well-being of Palestinians living under prolonged Israeli occupation is deeply conditioned by the structures of deprivation and control that shape daily life. Using data from 3,000 adults residing in refugee camps and surrounding urban areas of the West Bank, this study examines how deprivation, political violence, and human rights violations relate to well-being as measured by the World Health Organization-Five Well-Being Index. Nearly three-quarters of respondents (73.8%) reported poor wellbeing. Material deprivation showed the strongest association with well-being: Those reporting low or moderate deprivation had 1.7- and 2.4-fold higher odds of poor well-being, respectively. Household exposure to political violence was associated with higher odds of poor well-being with an odds ratio (OR) of 1.35, while human rights violations by the Israeli military and the Palestinian Authority was associated with higher odds of poor well-being with an OR of 1.51 and 1.72, respectively. An interaction between locality and displacement revealed that stable camp residents had lower odds of poor wellbeing, while those displaced from camps had the highest risk. These findings show that in the West Bank of the Israeli-occupied Palestinian territory, well-being reflects the social geography of inequality, where displacement, deprivation, and ongoing political violence transform daily existence into a struggle for security and dignity, rendering the right to health inseparable from the right to live freely and safely.

Since 2021, Rohingya refugee camps in Cox's Bazar, Bangladesh, have experienced a significant and concerning increase in the prevalence of scabies. In response to the massive outbreak, an extensive Mass Drug Administration (MDA) campaign was conducted by WHO Bangladesh, in collaboration with the Government of Bangladesh and Health Sector partners, from November 29, 2023, to February 01, 2024. The objectives of the study were: a) to determine the epidemiological characteristics (i.e., magnitude, age-sex distribution, and attack rate) of the scabies outbreak in the Rohingya refugee camps; and b) to evaluate the impact and durability of MDA in reducing the burden of scabies in the refugee camps. This was a retrospective observational study that utilized deidentified and anonymized data from 35 health facilities of the International Organization for Migration (IOM) spanning the period from January 1, 2021, to December 31, 2024. A total of 384,852 cases of scabies were reported, with an overall attack rate of 5,562.59 scabies cases per 10,000 population over 4 years. Females had a slightly higher case proportion (53.51%) and attack rate (ARR: 1.104, p&#x2009;<&#x2009;0.001). Children under 5 years (36.31%) had the highest burden and attack rate, about twice the overall attack rate. Using this age group as reference, the attack rate declined significantly with increasing age, 5,561.85 among adolescents (ARR: 0.496, p&#x2009;<&#x2009;0.001) to 4,377.88 among individuals over 60 years (ARR: 0.390, p&#x2009;<&#x2009;0.001). 77% of the cases were reported among the Rohingya refugees; however, the attack rate was higher among host communities (7,721.34 per 10,000 vs. 5,138.24 per 10,000 among refugees). Overall, 5.80% of scabies cases were associated with secondary bacterial infections. Interrupted time series (ITS) analysis showed a sharp and immediate decline in scabies cases following MDA initiation, representing a reduction of 1,885 cases per week (p&#x2009;<&#x2009;0.001) - equivalent to a weekly decline of approximately 100% from the pre-MDA peak. The decline persisted for 6 months (decreasing trend of 69.98 cases/week, p&#x2009;<&#x2009;0.001), after which a statistically significant upward rebound was observed (72.04 additional cases per week, p&#x2009;=&#x2009;0.002). The study revealed a high burden of scabies among the Rohingya refugees and the adjacent host community. MDA was an effective approach for a rapid and substantial reduction of the disease burden. However, the impact cannot be sustained unless the underlying factors of the scabies outbreak are addressed.

Blood pressure (BP) exhibits specific characteristics in elderly patients. We evaluated the association between positional BP changes during orthostatism and the presence of hypertension-mediated organ damage (HMOD) in functionally preserved elderly hypertensive patients. This was a multicenter, cross-sectional study of 156 hypertensive patients with a mean age of 75&#x2009;&#xb1;&#x2009;5.8 years (49% women). Central and peripheral office and 24-h BP were measured using an oscillometric device. Orthostatic BP changes were recorded according to the conventional definition of orthostatic hypotension (OH) and also as a continuous variable obtained by subtracting values (supine BP&#x2009;-&#x2009;orthostatic BP). Treating BP as a continuous variable, patients were divided into two groups based on orthostatic BP changes, below or above the median of the distribution. HMOD was assessed as renal (reduced glomerular filtration rate and/or increased albuminuria), cardiac [left ventricular hypertrophy (LVH)], and arterial (increased aortic pulse wave velocity). OH was present in 33 patients (21%), whereas orthostatic BP change showed a wide distribution. A total of 145 patients (92.9%) presented HMOD (48% kidney disease, 47% LVH, and 81% arterial stiffness). All patients with OH showed HMOD involvement and significantly higher values of all systolic BP estimates. Although OH and HMOD were not significantly associated, analysis of orthostatic BP changes showed greater renal damage in the group with a BP reduction above the median compared with those with a reduction below it, after adjustment for age, office BP, and alpha-blocker treatment (p&#x2009;<&#x2009;0.05). Orthostatic BP reduction is associated with renal damage in functionally preserved elderly hypertensive patients.

We analyzed the 2018-2019 outbreak of measles in Japan, which started with a gathering at a religious youth camp in Mie, a prefecture located in the central part of Japan. A retrospective secondary analysis of cases from December 2018 to January 2019 was carried out. The index case was a Japanese man in his 20s living in Wakayama, a prefecture adjacent to Mie Prefecture. As part of his religious activities, he attended a youth camp in Mie Prefecture held from December 23 to 30, 2018. There were 28 identified secondary cases within the camp deriving from the index case, 2 additional household secondary transmissions from the index after the camp, and 31 additional reported cases from the attendees of the camp, for a total of 62 cases. Analyzing the publicly available data, including the first and last dates of exposure for each case, we calculated the incubation period, relative frequency of secondary transmission, estimated time of exposure during the camp, and effective reproduction number. The incubation period had a mean of 11.2&#x202f;days and variance of 5.3&#x202f;days2. When the relative frequency of secondary transmission was assumed to follow a gamma distribution, the mean and variance were estimated to be 3.0&#x202f;days and 0.3&#x202f;days2, respectively. In the religious camp, the interquartile range (25th to 75th percentile) of infection time was 1.8 to 2.4&#x202f;days prior to the onset of the primary case. The effective reproduction number during the religious camp was in the range of 30 to 32, which quickly dropped to <1 after the camp. We successfully show that a large outbreak of measles may happen in a cluster of unvaccinated individuals, especially in a closed environment such as a teenage camp. Strengthening routine immunization program by targeting unvaccinated populations would be vital.

Beef consumption in Europe has steadily declined due to shifting consumer preferences, health concerns, and growing awareness of environmental and ethical issues. In parallel, interest is increasing in native breeds that support biodiversity, sustainable farming, and differentiated products. The Bruna dels Pirineus, an endangered breed native to the Catalan Pyrenees, is a valuable genetic and cultural resource, yet its potential for premium beef production remains underexplored. This study evaluated the effects of dry- and wet-aging for 4 and 8&#xa0;weeks on the technological, sensory, and microbial characteristics of sirloins from 11 Bruna dels Pirineus cattle. Analyses included technological traits, sensory evaluation, microbial enumeration pathogen screening via PCR, and 16S rRNA gene sequencing. Aging significantly influenced color, tenderness, and texture, with very tender meat achieved after 4&#xa0;weeks. Beef odor and flavor remained stable, while aged notes slightly increased over time. Microbial enumeration revealed higher viable counts in dry-aged meat, increased lactic acid bacteria (LAB) in wet-aged samples, and contrasting trends for Pseudomonas spp. and yeasts/molds. No foodborne pathogens were detected. Metataxonomic analysis revealed distinct communities, with wet-aged meat dominated by LAB (Lactobacillus, Leuconostoc, Carnobacterium) and dry-aged meat by Pseudomonas spp. and Brochothrix thermosphacta. These findings demonstrate that both aging methods enhance meat quality through controlled physicochemical and microbial transformations while maintaining safety. This work supports the valorization of Bruna dels Pirineus beef and highlights the need for further studies linking microbial dynamics to sensory and chemical traits.

Homelessness is an important public health issue, and the number of individuals experiencing unsheltered homelessness has increased since 2020. On June 28, 2024, the US Supreme Court issued a 6-to-3 decision in City of Grants Pass v Johnson, which broadened the authority of local governments to prohibit public camping. The National Call Center for Homeless Veterans (NCCHV) offers a 24/7 virtual option for veterans to access services to address housing instability. The objective of this study was to assess whether expanded local enforcement authority affected inflow and characteristics of individuals contacting NCCHV after the Grants Pass decision. We used data from 418 814 contacts to NCCHV from January 1, 2023, through December 31, 2024. We conducted 3 types of analyses: (1) bivariate analysis comparing changes in contact characteristics using Wald &#x3c7;2 tests, (2) direct comparisons of average weekly call volume using paired t tests, and (3) an interrupted time-series analysis using an autoregressive linear regression model. While we did not observe seasonal variations in call volume, we found a significant increase in average weekly NCCHV call volume between the pre- and post-Grants Pass periods, from 3926.6 to 4394.8 calls (mean [95% CI] change in average weekly call volume: 468.2 [216.8-719.6; P&#x2009;=&#x2009;.005). This study provides an indication of the association between the Grants Pass decision and an increase in help-seeking behavior (potentially representing increased needs) among veterans experiencing housing instability. Future work should assess on-the-ground changes in the needs of individuals experiencing housing instability and responses offered by providers of homeless services.

Low dietary diversity in low- and middle-income countries (LMICs) usually results from households basing their diets on a small number of food groups beyond their staple foods. Numerous studies have demonstrated that among people in both developed and developing nations, dietary diversity is a reliable indicator of dietary quality. Humanitarian crises over the past few decades have altered the patterns of food consumption in refugee camps, where the prevalence of food insecurity has significantly grown, resulting in undernutrition and chronic diseases. Therefore, our study determined the factors associated with undernutrition among women of reproductive age living with HIV in Mahama refugee camp, Rwanda. Using a cross-sectional design, our study examined the association between undernutrition (outcome) and household diversity scores, access to kitchen gardens, and chronic illness. The study was conducted at the Mahama refugee camp, which was home to 58,248 people. Yemane's algorithm was used to recruit a sample size of 170 women of reproductive age living with HIV for this study, while utilizing a random sampling technique. Anthropometric measurements (BMI and MUAC) of the respondents were examined; SPSS version 25 was used for data analysis. According to this study, the majority of women in the refugee camp ate grains (98%) and pulses (86%). The majority had a 68% medium diversity score. Additionally, access to kitchen garden (AOR&#x2009;=&#x2009;0.391, p&#x2009;=&#x2009;0.014, 95% CI&#x2009;=&#x2009;0.185-0.825), dietary scores of highest (AOR&#x2009;=&#x2009;0.039, p&#x2009;=&#x2009;0.001, 95% CI&#x2009;=&#x2009;0.033-0.475) and medium (AOR&#x2009;=&#x2009;0.125, p&#x2009;=&#x2009;0.002, 95% CI&#x2009;=&#x2009;0.006-0.242) were found to be significantly associated with lower odds of undernourishment in the camp. Though not statistically significant, having any other chronic illness was associated with a higher risk of undernourishment (AOR&#x2009;=&#x2009;2.359, p&#x2009;=&#x2009;0.102, 95% CI&#x2009;=&#x2009;0.843-6.602). Grains, legumes, fruits, seeds, nuts, and vegetables made up the majority of the food consumed by the 170 sampled women refugees. The risk of undernutrition was also significantly reduced in women who had access to kitchen gardens and showed high and medium dietary scores; a tendency was also observed for the risk of undernutrition to increase in respondents with extra chronic conditions. To enhance dietary scores and promote fair access to the kitchen garden, comprehensive healthcare interventions should be implemented in the camp.

BackgroundIn the context of ongoing conflict and socioeconomic instability in Palestine, economic exploitation remains a significant yet underexamined dimension of gender-based vulnerability. Structural inequalities, displacement, and war-related pressures may intensify financial control and abuse against women, particularly those in marginalized settings.ObjectivesThis study investigates the prevalence and forms of economic exploitation among Palestinian women and examines how education level, residential location, and marital status shape vulnerability. It also explores how conflict conditions influence women's financial experiences and coping strategies.DesignA convergent mixed-methods design was employed, integrating quantitative survey data with qualitative interview findings to provide a comprehensive understanding of economic exploitation in a conflict-affected context.MethodsFifty-four women aged 20-50 completed the Arabic-translated Scale of Economic Abuse (&#x3b1; = 0.957). Descriptive and comparative analyses were conducted to assess levels and patterns of economic exploitation. Additionally, twelve purposefully selected participants representing diverse socioeconomic backgrounds were interviewed. Thematic analysis was used to explore lived experiences and coping mechanisms.ResultsFindings indicate low-to-moderate levels of economic exploitation (M = 2.41, SD = 0.67). Indirect financial abuses-such as coerced borrowing (41%), unauthorized use of savings (39%), and theft of personal funds (38%)-were most prevalent. Vulnerability was higher among women residing in refugee camps, those with lower educational attainment, and divorced or separated women. Qualitative findings revealed that war-related instability intensified financial control, prompting adaptive strategies including secret savings, rotating loan circles, and strict budgeting practices.ConclusionEconomic exploitation in Palestine is shaped by intersecting structural and conflict-related factors. While women demonstrate resilience through adaptive financial coping strategies, systemic interventions are needed. Financial literacy initiatives, strengthened legal protections, and gender-responsive economic policies are essential to enhance women's autonomy and reduce vulnerability in conflict-affected settings.

Managing diabetes during exercise remains challenging, particularly in settings of sustained physical activity such as diabetes-camps. This study aimed to evaluate the efficacy and safety of a diabetes-camp protocol including an adaptive algorithm for prandial bolus reduction and the use of automated insulin delivery (AID) exercise modes in children with type 1 diabetes (CwD). Data from two 7-day camps for 77 CwD aged 8-14&#x2009;years using 780G, Control-IQ, or CamAPS were evaluated. Exercise modes were active throughout each camp, and meal boluses were adjusted by an adaptive algorithm. Continuous glucose monitoring metrics were evaluated and compared among AID systems and the 14-day pre-camp period. Hypoglycemia episodes and carbohydrates were recorded. Median time in range (TIR) was 80% during the camps, with time below range 3% (level 1; TBR1) and 1% (level 2; TBR2). Participants experienced a median of 2 hypoglycemia episodes/day. No severe hypoglycemia or diabetic ketoacidosis occurred. Median prandial bolus reduction in comparison with the calculated bolus was 45% (range 10-110%). Outcomes were similar across AID systems. TIR increased (80% vs. 78%, p&#x2009;=&#x2009;0.015) and TBR rose modestly (TBR1 3% vs. 2%, p&#x2009;<&#x2009;0.001; TBR2 1% vs. 0%, p&#x2009;=&#x2009;0.002) compared to the pre-camp period. The protocol provided a safe and effective option to achieve glycemic targets across assessed AID systems during sustained physical activity at diabetes camps.

Feeding strategies such as P and Ca depletion and repletion have been proposed to reduce the use of phosphate or improve P utilisation efficiency in pig diets, thereby contributing to the sustainability of the sector. A total of 48 entire male pigs (18.47&#xa0;&#xb1;&#xa0;3.18&#xa0;kg BW) were fed a control diet (C&#xa0;=&#xa0;100% of requirements) and a restricted diet (R&#xa0;=&#xa0;80-90% of digestive requirements of P and Ca, respectively) in three growth phases, with the following feeding strategies: CCC, RCC, RRC and RRR. At each phase, growth performance and bone characteristics (proportion of low-, medium-, high- and very high-density bones, and total density) of live animals were analysed, as well as carcasses and individual bones, using computed tomography equipment. Additionally, carcass and meat quality were evaluated at slaughter. Although there were differences in some phases, the overall analysis showed that P and Ca depletion-repletion did not affect the animals' growth. Reducing dietary Ca and P caused an increase in the proportion of low-density bones, a decrease in the proportion of medium- and high-density bones, and a decrease in total bone density in depleted pigs compared with control animals at each phase. At the end of phase 2, bone characteristics of RC pigs tended to follow a similar pattern observed in RR pigs when compared with CC animals. However, at the end of phase 3, RCC and RRC pigs exhibited similar bone characteristics than CCC animals, due to the recovery in bone mineralisation. Additionally, body characteristics measured on tomograms of the repleted animals showed a quadratic effect, where RCC pigs exhibited a decrease in total body area, central subcutaneous fat thickness, and loin eye area in some body regions, demonstrating that P and Ca depletion-repletion affected the anatomical regions in different ways. On the other hand, carcass, head, 1st rib, and 4th last rib bone characteristics were affected by the R diet, where the RRR strategy showed significantly lower density than the CCC strategy. In the conditions of this study, the application of P and Ca depletion-repletion strategies, or full depletion (RRR), could be an alternative to reduce the use of phosphate in pig diets without impacting performances and bone characteristics.

To explore how Dutch adults with rheumatoid arthritis (RA) perceive their oral health around the diagnostic process and the early disease course. The primary objective was to describe these perceptions in depth, and a secondary objective was to identify areas for future patient-centred research. A phenomenological qualitative study was conducted at Reade, a specialized rheumatology clinic in Amsterdam, The Netherlands. Adults (&#x2265;&#x2009;18&#x2009;years) diagnosed with RA within 5&#x2009;years prior to the start of recruitment, without multimorbidity and irrespective of oral complaints, were eligible. After completing brief sociodemographic/RA and oral-care questionnaires, semi-structured interviews in Dutch (face-to-face or virtual) were conducted with a trained interviewer with lived RA experience. Data were coded inductively in ATLAS.ti using thematic analysis. Eleven adults (7&#x2009;women, 4&#x2009;men; median&#x2009;age&#x2009;68&#x2009;years) were interviewed. Five themes were identified: (1) fluctuating symptoms demanded continual lifestyle adjustments and, for some, financial losses from reduced work hours; (2) the diagnosis carried a wide emotional burden-humour and symptom-downplaying helped, yet most still camped with accepting the disease, its medication and side-effects; (3) relationships with healthcare professionals varied-participants adhered to rheumatologists' recommendations but followed dental advice less consistently, and they viewed dentists and hygienists as having distinct roles; (4) oral hygiene ability varied-hand- or wrist-flare ups briefly hindered routines for some, and awareness of RA-related oral health risks (e.g., temporomandibular-joint involvement) was low; and (5) tailored information linking RA and oral health was scarce, and participants preferred clear guidance from clinicians while firmly rejecting oral hygiene guidance from friends and family. This exploratory study of Dutch adults with RA showed that perceptions of oral health, particularly around the diagnostic process and early disease course, highlighted five patient-centred research areas: determining the optimal timing and provider of RA-oral health information, mapping educational gaps among dental and rheumatology professionals and students, refining ergonomic toothbrush design, addressing socioeconomic barriers to dental care and validating routine TMJ screening tools. These findings may also serve as a foundation for the development of dental guidelines that reflect the patient perspective.

Group Problem Management Plus (gPM+) is a scalable psychological intervention designed to be delivered by non-specialist mental health workers and has been widely implemented in humanitarian contexts. As part of the ongoing process of integrating refugees into routine national care systems, competency-based training and supervision were implemented in Duhok, within the Kurdistan Region of Iraq. Twelve participants from the Directorate General of Health (DoH), working in Syrian refugee camps, took part in a seven-day training programme, followed by supportive supervision over a six-month period. The programme aimed to enhance participants' skills in delivering the group intervention to individuals experiencing psychological distress. The training programme consisted of a seven-day (56 hours), structured in-person course combining theoretical input, demonstration, and intensive role-play practice, followed by a six-month supervision (30 hours) phase that included regular group supervision sessions and individual on-site coaching focused on real-life implementation challenges. Individual and group-level competency improvements were assessed using the EQUIP (Ensuring Quality in Psychosocial Support and Mental Health Care) methodology, which provides a structured approach to monitoring and tracking participants' progress in facilitation and intervention skills, enabling trainers to identify skill gaps and tailor supervision sessions effectively. This was supplemented by qualitative evaluations from both participants and trainers. Participants showed notable reductions in harmful behaviours and improvements in competencies. Supervision sessions and role-playing exercises further reinforced learning and skill application. Participants also reported increased confidence, with feedback highlighting the value of problem-solving strategies and coping techniques. EQUIP proved effective in monitoring and guiding improvements among non-specialist staff delivering psychological interventions. The EQUIP platform may serve as a valuable tool for strengthening mental health and psychosocial support (MHPSS) training and interventions, and for facilitating the integration of programmes developed in humanitarian contexts into routine systems of care in low-resource settings.

Background/Objectives: Although food literacy is extensively studied in schools, the concept is less explored in the context of summer camps, which are also interesting learning environments. This qualitative study aimed to explore the clarity, usefulness and relevance of an adapted food literacy model for summer camps with camp counselors, camp managers and registered dietitians (RDs). Methods: Six semi-structured focus groups with counselors (n = 28) were conducted at summer camps located in the provinces of Quebec and Ontario, Canada. Semi-structured individual interviews were carried out online with camp managers (n = 5) and RDs (n = 6). Through an inductive approach, a thematic content analysis of transcribed verbatim was performed. Using a bottom-up approach, second and third final versions of the adapted food literacy model were developed. Results: Counselors and managers showed their intention to use an easy-to-use food literacy model. To improve their understanding, they proposed clarifying who will use the model and adding pictures. They expressed the need to be supported by incorporating concrete activity ideas and training to enhance the model's usefulness. RDs highlighted that the model covered essential themes of food literacy. They expressed the need to clarify certain model components to make them easier to understand and more applicable to youth. Conclusions: This study contributed to the co-creation with participants of a clear, useful and relevant food literacy model tailored to the context of summer camps. Such a model will help camp counselors to implement relevant healthy eating actions and multiply opportunities to promote healthy habits among youth.

To assess population-level trends in malnutrition among Rohingya refugee children in Cox's Bazar, Bangladesh, from 2017 to 2024, and examine associations with age, sex, seasonality and food assistance purchasing power. A retrospective repeated cross-sectional study analysing anthropometric and economic data from 2017 to 2024. Two primary health clinics in the Kutupalong and Balukhali refugee camps in Cox's Bazar, home to over one million Rohingya refugees including over 440&#x2009;000 children facing ongoing food insecurity and limited healthcare access. 13&#x2009;219 refugee children aged 6-60 months with recorded weight-for-height z-scores (WFZ) and mid-upper arm circumference (MUAC) data in electronic health records. The majority (>80%) of the data were from routine, non-illness-related visits. Prevalence and severity of global acute malnutrition (GAM), measured by first-visit WFZ and MUAC. Secondary outcomes included seasonal variation, sex and age disparities and trends in e-voucher purchasing power. From 2017 to 2024, population-level trends in GAM prevalence significantly increased, peaking at 38.4% in 2021. Male children showed poorer nutritional outcomes (mean WFZ: -0.96 vs -0.89 for females; p=0.005), and malnutrition severity rose with age (p<0.0001). Seasonal nutritional declines occurred during monsoon months, particularly among children aged 25-36 months, independent of infectious disease trends. E-voucher purchasing power declined significantly over time due to inflation, correlating with declining WFZ scores (p<0.0001). Agreement between WFZ and MUAC was limited, indicating measurement method discrepancies. Child malnutrition in the Rohingya refugee population remains above WHO emergency thresholds for GAM (15% or higher) despite ongoing aid. Economic inflation was associated with challenges in food assistance, with relatively greater nutritional risk observed among males and children aged 25-36&#x2009;and 37-60 months. Seasonal vulnerabilities exacerbate risks during monsoons. Policy responses must adjust food assistance for inflation, prioritise age-specific and gender-sensitive nutritional strategies, and strengthen seasonal preparedness.

Fecal Sludge (FS) is a well-known reservoir for multiple pathogenic organisms and antimicrobial-resistant E. coli. Contaminated drinking water (DW) is the primary route through which fecal-oral diseases are spread. This study examined the prevalence of Extended-spectrum beta-lactamase (ESBL)-producing E. coli in FS and adjacent DW samples collected within the Rohingya Camps. The DW and treated FS samples were screened for thermotolerant E. coli and the isolates were characterized for their ESBL-production ability, presence of major antibiotic resistance (AMR) genes, pathogenic genes, biofilm formation ability and phylogenetic clustering. Among the samples, 88.1% FS and 40.2% DW contained E. coli. From the selected isolates, 32.3% of FS and 12.5% of DW were ESBL-positive. Subsequently, 113 ESBL-FS and 56 ESBL-DW isolates were characterized based on their concurrent presence. Upon screening, blaCTX-M (81.1%) was the most prevalent AMR gene, followed by blaTEM (23.7%) and blaNDM-1 (14.8%). Enteroaggregative E. coli (EAEC) (17.2%) and enterotoxigenic E. coli (ETEC) (12.4%) were the most prevalent diarrheagenic pathotypes and 4.7% were extra-intestinal pathogenic E. coli (ExPEC) strains. Antimicrobial susceptibility testing (AST) revealed that 98.2% of isolates were multidrug-resistant. At 25&#xa0;&#xb0;C, 34.3% of isolates formed strong biofilm. The ERIC (Enterobacterial Repetitive Intergenic Consensus sequences) phylogenetic clustering generated 16 clusters at a 70% similarity index. The detection of pathogenic isolates highlights the risk of severe infections within susceptible populations and a high percentage of multidrug resistance limits the treatment options.

Adolescence is a critical developmental stage marked by physical, psychological, and cognitive growth, increasing autonomy, social exploration, and risk-taking behaviors. However, these natural transitions in displacement settings are overshadowed by heightened vulnerabilities such as gender-based violence. In many displacement settings, recurrent exposure to violence leads to its acceptance as an unavoidable part of daily life. Sometimes, violence is normalized, leading to further exacerbation of the crisis. Our study explored the in-depth experiences and normalization of abuse and existing barriers to reporting within the internally displaced persons settlement in Cross River State, Nigeria. Our qualitative study included adolescents and young people aged 15-24 years residing in the Bakassi Internally Displaced Persons camp within the Bakassi Local Government Area. Participants were selected via purposive sampling. Data were collected through 12 individual interviews and 3 focus group discussions. Data were transcribed verbatim, and thematic analysis was conducted using NVivo 14 to identify key themes. Findings from the study reveal participants' experiences with sexual exploitation, abuse, harassment, and gender-based violence, as well as their perceptions of abuse and how it is normalized. Contextual factors such as self-blame, societal pressure to accept advances from men, and limited accountability contribute to heightened vulnerability within the camps, which result in emotional and psychological impacts. Barriers to reporting and seeking help included fear of repercussions, lack of trust in authorities or services, and stigma associated with victimhood. Our study demonstrates that normalization of abuse, alongside systemic barriers such as fear of repercussions, stigma, and limited trust in authorities, significantly constrains reporting and help-seeking behaviors. Furthermore, our study identifies weak and largely absent accountability mechanisms as a key structural factor enabling continued abuse. To enhance accountability and safeguard vulnerable populations, appropriate legal penalties and enforcement measures should be applied to all forms of abuse. Additionally, future interventions should also address the underlying vulnerabilities that predispose individuals to abuse, ensuring a more comprehensive approach to prevention and protection.