Background Japan is experiencing rapid population aging, accompanied by increasing long-term care demand and workforce constraints, particularly in rural and semi-rural regions where rehabilitation professionals are scarce. Many daycare facilities continue to operate within a traditional service culture focused on routine caregiving rather than autonomy-supportive, preventive engagement. To address this practice gap, a quality improvement (QI) initiative introduced a structured dialogical approach designed to support intrinsic motivation and voluntary daily activity among older adults attending a daycare center. Methods This project was conducted as a practice-based QI initiative embedded within routine service delivery at a community daycare (day service) center in Kitami City, Hokkaido, Japan. The initiative was embedded in routine service delivery and consisted of semi-structured dialogues and follow-up conversations at each daycare visit that emphasized value clarification, reflective goal-setting, and self-directed activity planning. Participants who were not receiving external rehabilitation services and who engaged in at least one full dialogue cycle were included. QI outcomes were examined through (1) practice-based observations focusing on intervention adaptation and behavioral change and (2) exploratory quantitative assessment using the Short-Form Berg Balance Scale (SF-BBS) at baseline, six months, and 12 months. Results Thirty-seven users met eligibility criteria; 34 completed the six-month and 14 completed the 12-month follow-up. While guided by a common dialogical framework, practice-based adaptations emerged during implementation, particularly for participants with cognitive impairment, where repetition and simplified reflection appeared to support value recall and engagement. Descriptive observations suggested increased engagement in self-directed activity and voluntary participation in home-based exercise. Non-planned practice-based observations included enhanced peer interaction, autonomous use of the training area, and increased user-initiated requests for functional training. Exploratory SF-BBS analyses suggested a positive functional trend among participants with available follow-up data, within the limitations of a non-controlled QI context. Conclusions This QI initiative suggests that autonomy-supportive, dialogical engagement may represent a feasible practice-based modification of routine daycare interactions even within daycare facilities characterized by traditionally structured caregiving practices. The findings underscore the importance of relational dialogue, contextual adaptation, and practice-based learning in real-world implementation. Such an approach may offer transferable insights for geriatric and preventive care in aging societies, although further replication across multiple settings and with more comprehensive outcome assessment is warranted.
The clinical swallow examination, including palpation of hyo-laryngeal motion, is an important screening technique for dysphagia. However, this method lacks objectivity and precision, and it cannot reliably quantify hyoid movement velocity, which may be more closely associated with the risk of penetration and aspiration. This prospective observational study aimed to evaluate the predictive value of ultrasonographic hyoid motion parameters for identifying penetration, aspiration, and pharyngeal residue across International Dysphagia Diet Standardisation Initiative (IDDSI) food textures. Forty-seven adults with suspected oropharyngeal dysphagia underwent submental ultrasonography alongside either videofluoroscopic swallowing study or flexible endoscopic evaluation of swallowing. Six kinematic parameters, including hyoid displacement and velocity metrics, were measured and compared to instrumental swallowing outcomes. Penetration and aspiration were most prevalent with thin liquids (IDDSI Level 0, 57.4%). At this consistency, reduced maximal hyoid displacement was significantly associated with higher Penetration-Aspiration Scale scores (odds ratio [OR] = 0.75, p = .036). In contrast, in the present study, vallecular residue showed stronger associations with the velocity-based parameters examined. At IDDSI Level 2, lower average velocity of anterior hyoid bone excursion (HBE; OR = 0.18, p = .036) and lower average velocity of maximal HBE (OR = 0.24, p = .036) were associated with increased vallecular stasis severity. Similar associations were observed at Level 5, with area under the curve values up to .69. Pyriform sinus residue showed limited association with hyoid motion parameters. Receiver operating characteristic analysis and ordinal logistic regression demonstrated consistency-dependent associations between specific sonographic parameters and swallowing outcomes. Submental ultrasonography allows noninvasive quantification of hyoid motion during swallowing. Certain kinematic parameters demonstrated associations with airway invasion and vallecular residue at specific food consistencies. However, integration with complementary assessments remains essential for comprehensive evaluation. https://doi.org/10.23641/asha.32616798.
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Internal medicine residents frequently encounter arrhythmias on admission and telemetry, yet studies consistently demonstrate suboptimal electrocardiogram (ECG) interpretation accuracy and inadequate formal training. We implemented a 14-week structured "burst-learning" ECG curriculum at a single safety-net academic internal medicine residency, comprising twelve 15- to 30-minute case-based sessions covering 20 high-acuity rhythms aligned with American College of Cardiology/American Heart Association guidelines.A 20-item knowledge quiz and scenario-linked 5-point Likert confidence survey were administered before and after the curriculum (unpaired cohorts). Twenty-six residents completed baseline and 15 completed postcurriculum assessments. Mean confidence rose from 2.81 ± 0.94 to 3.48 ± 0.87 (P = 0.03); knowledge scores did not change meaningfully (from 7.38 ± 2.35 to 7.87 ± 1.64; P = 0.45). Postcurriculum status independently predicted higher confidence (β = 0.61; 95% CI: 0.04-1.19; P = 0.038). A brief, low-cost burst curriculum was associated with increased resident ECG confidence and was durably incorporated into the residency schedule. However, diagnostic accuracy gains will require a longer dose and paired measurement.
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Studies have shown that use of immunomodulators during the acute phase of SARS-CoV-2 infection may decrease development of post-acute sequelae of SARS-CoV-2 (PASC) or long COVID; however, such studies have not been conducted in children. Evaluate the effectiveness of steroid use during the acute phase of SARS-CoV-2 infection in preventing long COVID in children. We conducted a retrospective cohort study using target trial emulation methodology to compare children and youth who did and did not receive dexamethasone, prednisone, prednisolone or methylprednisolone within 12 days of SARS-CoV-2 infection. Inverse propensity of treatment weighting was used to balance covariates between treated and untreated patients in hospitalized and outpatient groups. The primary outcome was the development of PASC in the 1-6 months following acute infection using a computable phenotype definition. Secondary outcomes included respiratory, musculoskeletal, gastrointestinal and neurological subphenotypes and the PASC ICD-10-CM diagnosis code. We calculated hazard ratios from Cox proportional models with 95% confidence intervals. From a starting cohort of 854,128 children/youth, of whom 768,845 (90.0%) were outpatients and 85,283 (10.0%) were inpatients at the time of SARS-CoV-2 infection, the weighted outpatient cohort included 22,085 steroid-treated children and 20,373 in the non-steroid group. Following weighting, the hospitalized cohort included 11,250 steroid-treated children and 10,340 untreated children. In hospitalized patients, there were no significant treatment differences in the development of PASC in the 1-6 months following acute SARS-CoV-2 infection except for a lower risk of gastrointestinal PASC in treated patients (HR: 0.58; [95% CI: 0.39-0.85], p = 0.01). In outpatients, no treatment differences were observed in the development of PASC subphenotypes. Steroids administered during acute SARS-CoV-2 infection did not lead to a decreased risk of PASC, with the exception of gastrointestinal presentations. Additional studies are needed to confirm the benefit of steroids and other immunomodulators in preventing long COVID.
Globally, there is growing recognition of the need to advance approaches to involve people with lived experience of dementia as collaborators in policy, advocacy and research activities. Involvement is viewed as a right by dementia advocates and others, and some organizations have developed mechanisms to support this collaboration, such as through dedicated resources for infrastructure or as a condition of research funding. However, there is limited literature on how national and international organizations support the involvement of people with lived experience of dementia. In this perspective article, we describe different approaches to involving people with lived experience in policy, advocacy and research activities across national and international network contexts. We outline and compare the approaches taken by the Engagement of People with Lived Experience of Dementia program and advisory group (Canadian Consortium on Neurodegeneration in Aging), Alzheimer Society Research Network (Alzheimer's Society UK), European Working Group of People With Dementia and European Dementia Carers Working Group (Alzheimer Europe), and the Lived Experience Advisory Group (Global Brain Health Institute, Trinity College Dublin). For each example presented, we describe the initiative (e.g., purpose, brief history, structure). We discuss the four initiatives in order to identify common and context-specific barriers and enablers to involvement. We hope that the findings will help others to develop their own initiatives to involve people with lived experience of dementia.
For more than two decades, United States foreign assistance, particularly through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), has been central to Nigeria's HIV response, supporting antiretroviral therapy (ART), laboratory systems, and community-based prevention initiatives. Among these are programs for orphans and vulnerable children (OVC) and the Families Matter! Program (FMP), which equips parents and caregivers to guide adolescents away from behaviours that increase HIV risk and help reduce HIV-related stigma within families and communities.The temporary freeze on U.S. foreign aid announced in January 2025 disrupted these interventions and raised concerns about the sustainability of Nigeria's HIV response. While much attention has focused on the risk of treatment interruptions and ART stock-outs, less attention has been given to the suspension of OVC and FMP programs despite their role in prevention, psychosocial support, and household stability.This paper examines the short-and long-term implications of the aid freeze for Nigeria's HIV response, with particular focus on adolescents, vulnerable children, and family-centred prevention initiatives. It argues that disruptions to these programs may undermine prevention gains and weaken social protection systems, while also highlighting the need for stronger domestic resource mobilisation and institutionalisation of community-based HIV interventions to ensure a more sustainable and resilient response.
Women admitted to the hospital early in labor face an increased intrapartum intervention rate, possibly resulting in negative obstetric outcomes. It is well documented that women receiving midwife-led care receive fewer unnecessary medical interventions. However, the impact of midwife-led care during early labor remains poorly understood. The aim of this study was to evaluate the effect of midwife-led care compared to obstetrician-led care regarding medical interventions during early labor. A systematic review of literature published until June 2024 was performed in PubMed, CINAHL Complete, Web of Science Core Collection, and the Cochrane Library following Cochrane guidelines. PICO criteria included the keywords pregnant women, midwife-led care, obstetrician-led care and medical interventions during early labor. Quality was assessed using the RoB 2-tool and the ROBINS-I-tool. Data were extracted by using a purposively designed extraction template and then analyzed descriptively. Of 1057 identified studies, four studies were eligible and included in this review, including two randomized controlled trials and two observational studies. The results regarding birth mode are not entirely clear. Most studies reported that women who receive midwife-led care during the early stages of labor are more likely to have a vaginal birth and less likely to require a cesarean section. However, one study could not find a statistically significant difference regarding birth mode and care model received in early labor. Another study showed increased use of labor augmentation among women receiving obstetrician-led care. There remains a lack of knowledge about the role of midwife-led care during early labor and its impact on early labor interventions and subsequent birth outcomes. More attention should be focused on early labor care to improve outcomes for laboring women and their partners. Recognizing the potential benefits of midwife-led care during this phase could lead to initiatives aimed at promoting such care across various settings.
Pulmonary arterial hypertension (PAH) is a rare, progressive disorder defined by elevated pulmonary arterial pressure and vascular resistance, ultimately leading to right ventricular failure and premature death. Once considered a disease of pure vasoconstriction, PAH is now recognized as a complex vasculopathy involving endothelial dysfunction, inflammation, metabolic dysregulation, and genetic susceptibility. The pulmonary vasculature is dynamically narrowed by vasoconstriction, structurally obstructed by smooth muscle and endothelial proliferation, and pathologically stiffened by fibrosis and extracellular matrix deposition. Multiple cell types including endothelial cells, smooth muscle cells, fibroblasts, and immune cells contribute to this remodeling process. At the molecular level, hyperproliferative, apoptosis-resistant phenotypes emerge through mitochondrial dysfunction, oxidative stress, and endothelial-to-mesenchymal transition, which together drive a Warburg-like metabolic shift favoring glycolysis over oxidative phosphorylation. Chronic immune activation, characterized by cytokine release, T-cell and macrophage infiltration, and disrupted immune regulation, further amplifies vascular injury. Genetic studies have identified mutations in BMPR2, TBX4, SOX17, and other regulators of the bone morphogenic protein (BMP)/transform-ing growth factor-β (TGF-β) pathway as key contributors to heritable and idiopathic forms of PAH, highlighting impaired endothelial repair and aberrant signaling as central mechanisms. Recent translational breakthroughs have yielded novel therapeutic strategies beyond traditional vasodilators. Agents targeting the BMP/TGF-β axis (e.g., sotatercept), growth factor signaling (seralutinib), inflammatory pathways (tocilizumab, rituximab), and metabolic remodeling (pyruvate dehydrogenase kinases [PDK] and fatty acid oxidation [FAO] modulators) are redefining treatment paradigms. Concurrently, large-scale multi-omics initiatives such as PVDOMICS and PHOENIKS enable deep phenotyping, which unravels molecular endotypes and informs precision medicine approaches. This review summarizes the pathophysiology of PAH and the ongoing clinical trials in the PAH field.
Potentially inappropriate prescribing (PIP) has been associated with various adverse clinical outcomes, particularly in the context of ageing, multimorbidity and polypharmacy. Despite growing interest in front door frailty initiatives in the emergency department (ED) and acute geriatric units (AGUs), no review has focused specifically on interventions targeting PIP, as defined by validated criteria, across both ED and AGU settings. This scoping review aimed to map the evidence on interventions addressing PIP in older adults attending EDs or AGUs, identify evidence gaps and highlight areas for future research. This scoping review was conducted in accordance with Joanna Briggs Institute (JBI) methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Medline, Embase, CINAHL Ultimate, Web of Science, Cochrane CENTRAL and grey literature sources were searched from 1991 to 2025 for studies evaluating interventions targeting PIP, defined using validated criteria, in adults aged ≥ 65 years attending the ED or AGUs. Our search returned 8643 results. Twenty-one studies were identified for inclusion, four of which were randomised controlled trials. The 18 interventions identified encompassed pharmacist-led medication reviews, clinical decision support systems (CDSS), educational/academic detailing programmes or combined approaches. While PIP was frequently a primary outcome measure, few studies reported clinical outcomes or explored prescriber adherence and experiences of older adults and prescribers. Pharmacist-led medication reviews, CDSS and educational/academic detailing were the main intervention approaches identified. Evidence was heterogeneous and focused mainly on prescribing-related outcomes, with limited assessment of clinical outcomes, prescriber adherence, communication pathways and stakeholder feedback. Future studies should incorporate longer-term follow-up and evaluate patient-centred and implementation outcomes.
The quality of medical services in public hospitals is significantly influenced by managerial styles, which shape organizational efficiency, patient satisfaction, and hospital accreditation outcomes. This study examines the impact of managerial leadership styles and organizational characteristics on accreditation performance in Romanian public hospitals. Using survey data from hospital managers, the study employs a structured analytical approach combining Chi-square tests and cross-tabulations, Kendall's Tau correlations, the Kruskal-Wallis H test, ordinal regression modeling, and exploratory K-means cluster analysis to examine how hospital size, managerial education, employee consultation, team motivation, and access to information are associated with accreditation outcomes. Results indicate that hospital administration type, field of study, and team motivation are significant predictors of accreditation success, while hospital size negatively correlates with accreditation scores, suggesting larger hospitals face greater challenges in meeting accreditation standards. Conversely, employee consultation and information transparency show no statistically significant impact on accreditation performance. These findings highlight the critical role of managerial education and team engagement in achieving higher accreditation outcomes. Strengthening leadership training and team-based quality initiatives could enhance accreditation performance in public hospitals. Policy makers should prioritize managerial development programs and strategic leadership approaches to improve healthcare quality and compliance.
Individuals with diabetes mellitus (DM) show increased susceptibility to COVID-19 infection with higher risk for severe disease and mortality. We investigated whether glycemic-related factors may affect the outcomes of patients with DM hospitalized due to COVID-19. This is a multicenter retrospective cohort study under the initiative of the Philippine College of Endocrinology, Diabetes, and Metabolism involving eight training hospitals in the Philippines from January 2021 to January 2022. Patients with DM hospitalized due to COVID-19 were included. Univariable and multivariable analyses were done to determine whether baseline glycemic control based on glycosylated hemoglobin (HbA1c) and inpatient glycemic control based on capillary blood glucose are associated with composite poor clinical outcome of mortality and end-organ dysfunction. Among 1,093 patients, 54% had HbA1c >7%. Critical COVID-19 disease was greater in patients with poor baseline glycemic control (28.43% vs 19.72%, p = 0.001) and poor inpatient glycemic control (25.7% vs 12.64%, p <0.001). Both poor baseline glycemic (AOR 1.41, p = 0.017) and poor inpatient glycemic control (AOR 2.6, p <0.001) were associated with composite poor clinical outcome of mortality and end-organ dysfunction after adjusting for each other, but lost significance after adjusting for age, COVID-19 severity, and presence of comorbidities. COVID-19 severity had the greatest association with composite poor clinical outcome after adjusting for all other variables. HbA1c >7% increased the odds of poor inpatient control (OR = 3.10, 95% CI: 2.32-4.17, p <0.001), even after adjusting for steroid use. COVID-19 severity had the greatest impact and is the only variable with a statistically significant association with composite poor clinical outcomes after adjusting for all other variables. Poor glycemic control on admission and during hospitalization were associated with more severe COVID-19, although they did not directly impact clinical outcomes. Measures to optimize glycemic control both in the long term and during hospitalization should be considered to prevent severe COVID-19, hence improving clinical outcomes and survival.
Children are particularly vulnerable to road traffic injuries (RTIs) leading to morbidity and mortality. Despite the high incidence of pediatric RTIs in Ethiopia, data on the patterns and consequences of pediatric RTIs are limited. To assess the characteristics and ED disposition among pediatric patients (age ≤ 18 years old) with RTI admitted to emergency department of Addis Ababa Burn, Emergency, and Trauma (AaBET) Hospital, Addis Ababa, Ethiopia. A hospital-based cross-sectional study was conducted, focusing on pediatric patients with RTIs who presented it to the emergency department of AaBET Hospital from December 12, 2021, to December 30, 2023, retrospectively. Data were collected using a standardized structured data collection checklist from hospital data records and medical charts. A sample size of 279 pediatric RTI patients was included from registered hospital records. After data cleaning, data were analyzed using SPSS Version 21. Descriptive statistics were used to describe the dependent variables. Out of 279 patients, the median age was thirteen (IQR: 9-17). A total of 54.1% of the patients were male. One hundred and fourteen (40.9%) of those were from age 15-18. Two hundred and eight (74.6%) patients were pedestrians. Forty-eight percent of the patients sustained injury while in transit to work or school. Seventy six (27.2%) came to the hospital with private cars or trucks, while 63 (22.6%) came with an ambulance. One-hundred thirty five (48.4%) of the patients sustained extremity and pelvis injuries, while 41.9% sustained head injuries. Two-hundred fifty-five (91.4%) patients were discharged home from the emergency department. The emergency department mortality was 0.7%. In this study, children from the ages of 15-18 were more affected by RTIs. Pedestrians and while in transit to school or work were more injured. Head and extremity injuries were the predominant injuries that happened to children. Children and schools should be prioritized in targeted road safety initiatives, supported by stricter enforcement of traffic laws near school zones.
Language access significantly affects patient-provider communication, patient safety, and healthcare outcomes. Eliminating language barriers improves care quality. As a result, the use of professional interpreters or language concordant care is recommended. Yet, persistent barriers remain. We conducted a policy-oriented narrative review of peer-reviewed studies, federal regulations and professional guidelines published between 2004 and 2025 on language access, interpreter services, and U.S. Health System reform. We found there is a solid foundation in place to support several needed steps to strengthen language supports for non-English-preferring patients in the United States. We recommend practical, evidence-based strategies for healthcare organizations, state and federal polices, and joint multi-stakeholder initiatives. To drive meaningful change, both federal and state initiatives that financially incentivize improved language supports are needed, alongside enhanced regulatory and enforcement mechanisms to penalize underperforming providers. Healthcare systems must prioritize professional interpretation, develop systematic methods to assess and utilize the language skills of bilingual providers, and ensure consistent availability of professional high-quality language services. Integrating language access and supports into technology standards is also crucial for effectively mitigating language barriers. Substantial changes are necessary to enhance healthcare experiences and outcomes for patients who communicate in languages other than English.
This study aimed to evaluate the effectiveness of "GEKA-Navi," a collaborative online recruitment event organized by eight surgical departments, and analyze the participant feedback and residency entry data from 2021 to 2025. GEKA-Navi targeted medical students and residents and featured plenary sessions on surgical careers, as well as departmental breakout sessions. The primary outcome was the proportion of newly recruited surgical residents from 2021 to 2025 who had participated in GEKA-Navi. The secondary outcomes were questionnaire-based participant evaluations, including satisfaction and motivation toward surgical careers. Five events were conducted, with annual participation ranging from 82 to 150 individuals. A total of 151 new surgical residents entered the participating departments from 2021 to 2025, of whom 90 (59.6%) had previously attended GEKA-Navi. Secondary outcome analyses revealed consistently high participant satisfaction, with 98% of participants reporting increased interest in joining surgical departments and over 80% reporting increased motivation to become surgeons. GEKA-Navi was associated with high participant satisfaction and increased interest in surgical careers. These findings provide descriptive insights into participants' perceptions and recruitment patterns within a structured multidepartmental recruitment initiative. Such approaches may help inform the design of future recruitment strategies for clinical trials.
Receiving health systems cannot improve refugee clinician integration pathways if no actor is responsible for the denominator, milestones, or stage-specific delays. England is a useful worked example. Published UK initiatives show that already-resident refugee and asylum-seeking doctors can reach NHS employment, supervised placements and professional registration, but they use different denominators, endpoints and follow-up conventions. They demonstrate feasibility without yielding a pathway metric that system-level purchasers, funders or regulators can compare, fund or improve. A minimum time-to-practice (TTP) specification would separate two clocks. A population or pre-pathway clock would record earlier dates, such as arrival, asylum-claim lodgement, first contact or first documentation of professional background, to show upstream delay and attrition. The pathway TTP clock would begin at pathway registration, when a minimum dataset is complete, a named pathway owner can act, and the case enters the reporting denominator. Two auditable milestones would then be measured from registration: TTP-1, the verified start of the first qualifying paid supervised placement; and TTP-2, practice-enabling, profession-equivalent registration. Work-eligibility status, documentation completeness, years out of practice and route complexity should be recorded to interpret variation rather than to exclude people from the denominator. TTP is not a measure of competence, programme effectiveness or speed alone. Its purpose is workforce governance: to define the denominator, milestones, safeguards and funding conditions needed to compare and improve a poorly observed route back into practice, while remaining distinct from active overseas recruitment.
The cost and complexity of phase 2 randomized-controlled trials (RCTs) hinder further development of promising treatment candidates for Alzheimer disease (AD). The Simon Two-Stage futility trial design, originally developed for oncology, offers a streamlined approach to evaluate potential disease-modifying therapies by comparing single-arm outcomes with historical controls, but is predicated on identifying outcome measures that reliably worsen with the natural history of the disease, with minimal risk of improvement. We sought to determine the feasibility of such futility trials in AD-associated dementia and mild cognitive impairment (MCI) using a large prospective cohort. We analyzed longitudinal data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive decline was assessed using AD Assessment Scale-Cognitive Subscale (ADAS-Cog 11 and ADAS-Cog 13), Clinical Dementia Rating-Sum of Boxes (CDR-SB), and Mini-Mental State Examination (MMSE) at 6, 12, and 24 months using different thresholds for worsening vs improvement. Binary logistic regression models examined baseline factors associated with cognitive worsening using different thresholds of worsening for each outcome of interest to assess what additional selection criteria may be needed for futility trials in AD-associated dementia vs MCI. Sample size estimates were derived based on expected rates of decline. Among 2,665 participants (mean age 73.4 years [SD: 7.5], 1,260 [47.3%] female, 424 with AD-associated dementia), the CDR-SB exhibited the largest percentage of decline in AD-associated dementia and MCI, with 60.6% of patients with AD-associated dementia showing worsening when using a threshold of ≥1.0 points at 12 months vs 6.2% showing improvement. ADAS-Cog 11 and 13 showed similar decline patterns; for example, 41.7% with AD-associated dementia worsened by ≥ 5 points at 12 months on ADAS-Cog 13, whereas 5.8% improved. MMSE exhibited lower sensitivity; 25.8% with AD-associated dementia worsened by ≥ 5 points at 12 months, whereas 2.9% improved. Shorter trials (6-12 months) with 35-62 participants seemed feasible in AD-associated dementia, whereas MCI trials seemed to require 24 months and specific entry criteria based on age, apolipoprotein E ε4 status, and baseline CDR-SB performance. Futility trials seem feasible in AD-associated dementia, offering a faster, cost-effective alternative to traditional phase 2 RCTs. CDR-SB seems to be the optimal primary outcome. Further validation in clinical trial data sets is warranted.
In the aftermath of the Second World War, Poland faced immense public health challenges amidst widespread destruction and political transformation. This article explores the largely overlooked medical mission of the Unitarian Service Committee (USC) in Poland, situating it within both humanitarian and geopolitical contexts. Drawing on archival research and press accounts, the study reconstructs the USC's multifaceted aid efforts, including its Medical Teaching Mission, the establishment of the Piekary Śląskie hospital, and tuberculosis control initiatives. The analysis highlights how the USC combined direct medical assistance with educational outreach, aiming to support long-term recovery. However, operating behind the Iron Curtain, the Committee's activities were subject to both surveillance and propaganda, revealing the entanglement of health and politics in Cold War Europe. This case offers new insights into the role of non-governmental actors in shaping postwar public health and diplomacy in Eastern Europe.
Personalised medicine represents a key direction of modern healthcare, enabling the adaptation of prevention, diagnosis and treatment based on individual patient characteristics. The European Partnership for Personalised Medicine (EP PerMed) was established as a strategic European Union initiative to coordinate research, innovation and implementation of personalised medicine across Member States. This article provides a comprehensive overview of the origin, objectives, programmes and major challenges of EP PerMed, with a particular focus on its relevance for clinicians and researchers and on the participation of the Czech Republic. Special attention is dedicated to the role of the Czech Health Research Council (AZV ČR) as a key national coordinating and funding body facilitating the involvement of Czech teams in EP PerMed joint transnational calls. The article discusses benefits and future perspectives of personalised medicine in both the European and Czech contexts.