Neurodevelopment is a dynamic process involving genetic and environmental factors that influence motor, cognitive (e.g., learning, communication), social, adaptive, emotional, and behavioural domains. This systematic review and meta-analysis aimed to estimate the prevalence of NDDs among preschool children of migrants and refugees in high-income Western countries. Five databases, including Medline, Embase, Scopus, CINAHL, and PsycINFO, were searched for eligible studies from inception until October 1, 2025. Three reviewers independently screened and selected studies, extracted data, and assessed the methodological quality. We have used Stata to estimate the weighted pooled prevalence of autism from crosssectional and cohort study data using random-effects meta-analysis with (I²/Q>50

Food insecurity (FI) is a significant public health issue affecting disadvantaged groups, including migrants and refugees in high-income countries (HICs). FI is associated with increased risk of mortality, coronary heart disease, type 2 diabetes, and some cancers. Despite its impacts, a comprehensive synthesis of the overall weighted pooled prevalence of FI among migrants and refugees in HICs is still lacking. This systematic review and meta-analysis aimed to estimate the pooled prevalence of FI across different migratory groups in HICs. We searched Scopus, Embase, PsycINFO, Medline, and Web of Science for eligible studies published from January 1, 2008 (selected to capture the post-global financial crisis period, when migration patterns changed sharply) to December 16, 2025. Three reviewers independently screened and selected studies, extracted data, and assessed methodological quality. The ‘meta prop’ command in STATA was used to estimate the weighted pooled prevalence of FI among migrants and refugees in high-income countries (HICs). Given the significant heterogeneity among studies (I² > 50

Objective This umbrella review synthesises evidence from systematic reviews to evaluate the effectiveness of workforce model interventions aimed at improving oral health care for older adults in Long Term Care Facilities (LTCFs). Data and sources This review was registered with PROSPERO and conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported using Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. We searched five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane) and identified reviews published before January 2026. Data were extracted using a piloted template, and the methodological quality was assessed using the AMSTAR-2 tool. Outcomes of interest were the oral-health status and behaviour of residents, as well as staff oral-health knowledge and attitudes. Study selection/results We screened 2911 articles, including nine in the final stage. After data extraction, we grouped the findings into four intervention categories: theoretical teaching, train-the-trainer models, oral-health professional (OHP)-led training with or without ongoing support, and direct provision of oral care. Findings suggest that OHP-led interventions with ongoing clinical support produced the most consistent and sustained improvements in the oral-health status of residents and staff oral-health knowledge. In contrast, OHP-led interventions without ongoing clinical support, theoretical teaching, and train-the-trainer models yielded only short-term gains with limited long-term effects. Direct professional care was highly effective in improving the oral health of residents but demonstrated limited feasibility and scalability in the LTCF setting. Conclusion A multicomponent approach combining OHP-led training with ongoing support and a train-the-trainer model may have the greatest long-term feasibility and effectiveness in improving the oral health of adults in aged care. However, further research is needed to investigate multifactorial workforce model interventions in LTCFs to better inform future policy recommendations. Clinical Significance Sustained oral health improvements in aged‑care residents are most achievable when OHP‑led training is paired with ongoing clinical support. One‑off education offers limited long‑term benefit, highlighting the need for continuous, multicomponent workforce models in LTCFs.

Over the past two decades, underweight, overweight, and obesity have increased in Bangladesh, becoming a major public health concern. This study investigated the current prevalence and examined the determinants of underweight, overweight, and obesity among reproductive-aged Bangladeshi women. Using data from a weighted sample of 9,213 women in the 2022 Bangladesh Demographic and Health Survey, we applied multinomial logistic regression to identify factors independently associated with being underweight, overweight, and obese. Among 9,213 reproductive-aged women, the prevalence of underweight, overweight, and obesity was 10.0%, 18.9%, and 36.5%, respectively. Multivariable analysis identified older age as the strongest predictor of overweight and obesity: women aged 35-49 years had nearly double the risk of overweight (ARRR = 2.01; 95% CI: 1.62-2.50) and more than triple the risk of obesity (ARRR = 3.56; 95% CI: 2.90-4.38) compared to those aged 15-24 years. Other significant factors included higher wealth status (ARRR = 1.94; 95% CI: 1.66-2.26 for obesity among wealthy households), media exposure (reading magazines: ARRR = 1.46; 95% CI: 1.14-1.87, watching television: ARRR = 1.28; 95% CI: 1.13-1.46), and parity (ARRR = 1.58; 95% CI: 1.23-2.02 for obesity among women with 1-4 children). Breastfeeding and agricultural/manual work protected against obesity. We also found that currently breastfeeding women (ARRR = 1.40; 95% CI: 1.13-1.72) and women who lived in Sylhet division (ARRR = 1.55; 95% CI: 1.13-2.12) were more likely to be underweight, while women with secondary or higher education, wealthier women, women aged 25 or higher, and women with 1-4 children were less likely to be underweight. Overall, a higher burden of underweight, overweight, and obesity exists in the sample. These findings emphasise the need for age- and context-specific interventions, such as promoting active lifestyles, regulating food environments, and incorporating nutrition education into maternal health programs, to combat rising obesity while addressing persistent underweight.

Migrant women and children can face significant barriers when accessing child and family health services. Child and family health hubs (hubs) represent a potential solution to simplify pathways between maternity, child, and social care services for migrant populations. However, how these hubs operate specifically for migrants remains underexplored. Our study addresses this gap by exploring what helps and hinders the establishment and delivery of hubs across three different contexts in New South Wales, Australia for migrant populations using a case study approach. While all sites found the hub model appropriate and acceptable, its feasibility varied. Challenges included limited resources, particularly the absence of a dedicated hub coordinator, governance issues, and personnel turnover. Success depended on clear leadership, dedicated coordination, systematic referral pathways, cultural sensitivity, and community engagement. The evidence from this study can be used within other contexts to plan and deliver hubs for migrant and potentially other priority population families with young children.

BACKGROUND:Type 2 Diabetes Mellitus (T2DM) presents a major public health challenge globally, disproportionately affecting Indian migrants who are vulnerable to diabetes-related complications due to cultural, linguistic and systemic barriers that can limit access to timely and effective care. Health literacy is a key determinant of T2DM management, yet its association with medication adherence in this population remains underexplored. OBJECTIVE:This study investigates the association between performance-based (objectively assessed) and self-reported (subjectively assessed) health literacy and medication adherence among Indian migrants with T2DM, while accounting for a range of demographic, socioeconomic and health-specific factors. METHODS:A cross-sectional study design was employed. Participants (n = 309) were recruited through multicultural health services, and hospital diabetes clinics across Greater Western Sydney, a socioeconomically and culturally diverse area of Sydney, NSW, Australia. Eligible participants self-identified as Indian, were aged 18 years or older, had been diagnosed with T2DM for at least one year, and were currently prescribed diabetes medication. Data were collected via a structured survey and analysed using multivariate logistic regression. RESULTS:Low health literacy was prevalent among Indian migrants, with over 67.6% demonstrating low performance-based health literacy and 62.5% reporting low self-reported health literacy. Approximately 68.9% of participants had low medication adherence. Lower medication adherence was significantly and positively associated with lower health literacy, both performance-based (adjOR=9.14, 95%CI: 4.24-19.72; p = <0.001) and self-reported (adjOR=12.45, 95%CI: 4.55-34.10; p = <0.001). Key predictors of medication adherence included health literacy, private health insurance, BMI, glucose level, comorbidities and social support. Models differed slightly depending on the type of health literacy assessed. CONCLUSION:Health literacy plays an important role in diabetes self-management for Indian migrants. These findings highlight the need for culturally tailored interventions that address both health literacy support - such as improving understanding of medical information and navigating healthcare systems - and social or family support systems that influence health behaviours and decision-making.

BackgroundAlthough diabetes and oral health share a bidirectional relationship, there is little emphasis on oral health promotion by diabetes care providers despite global guidelines and recommendations. In Australia, diabetes educators are well-placed to promote oral health among their clients; however, comprehensive training programs tailored for diabetes educators are lacking.AimsTo develop and evaluate a diabetes oral health training program to assess the potential impact in improving oral health knowledge and confidence of diabetes educators, and the acceptability, feasibility, and sustainability of integrating the training into practice.MethodsGuided by the Medical Research Council framework for complex interventions, a mixed-methods, quasi-experimental one-group pretest-posttest design was used. The development led to a three-module training program, which integrated videos, a screening tool, and resources to support oral health referrals. A pre-post knowledge and confidence questionnaire was analysed using a paired-sample t-test. To assess acceptability, feasibility and sustainability, qualitative semi-structured interviews were conducted and analysed using directed content analysis.ResultsThirty diabetes educators from the states of New South Wales and Victoria were recruited. There was an overall significant difference in the knowledge scores pre-test (mean = 23.24, SD 4.4) compared to post-test (mean = 29.67, SD 2.01), (t = −6.11), p < 0.001) (n = 21), and across all confidence variables on discussing, screening and referring clients to oral health services (p < 0.001). Most participants agreed with the trainings perceived acceptability, feasibility, and sustainability, although some recommendations were made to improve long-term sustainability.ConclusionsUsing online training modules and tailored resources to support clinical practice has shown preliminary improvements in oral health knowledge and confidence among diabetes educators, and was acceptable, feasible, and sustainable for integration into clinical practice.

Patient satisfaction is crucial for quality service in referral services, but in developing countries, healthcare managers often ignore patients’ perceptions. This study aims to assess satisfaction levels among patients in Gurage Zone, central Ethiopia. A facility cross-sectional study was conducted among 319 patients from four public hospitals in Gurage Zone from June 1 to July 10, 2023, using systematic sampling and structured questionnaires. The study utilized structured questionnaires to collect quantitative data, which was then analyzed using Epi Data Version 4.6 and SPSS Version 25. Variables with a p-value less than 0.25 in binary logistics analysis were considered for multivariable analysis, with p-values less than 0.05 indicating statistical significance. Out of 319 patients interviewed, around 122 (38.2

BACKGROUND:Food insecurity (FI) is a recognised determinant of mental health, yet its specific impact on depression, anxiety, and stress among migrants and refugees in high-income countries (HICs) remains underexplored. This systematic review and meta-analyses examine the association between FI and mental health outcomes in these vulnerable populations. METHOD:A systematic search of five databases (Medline, Scopus, Web of Science, PsycINFO, and Embase) was conducted for observational studies published between January 1, 2008, and December 16, 2025. Inclusion required studies to report on food insecurity and mental health using standard, validated measures. Three independent reviewers screened the studies, extracted the data, and assessed the methodological quality using the Joanna Briggs Institute checklist. Most included studies were cross-sectional. The association between food insecurity and mental health outcomes (depression, anxiety, and stress) was estimated using random-effects models due to substantial heterogeneity (I² > 50%). Funnel plots and Begg's test were employed to assess potential publication bias. RESULT:We identified 17 eligible studies, totalling more than 4.3 million participants. Overall, FI was significantly associated with higher odds of depression (aOR = 1.44; 95% CI: 1.32-1.57), anxiety (aOR = 2.43; 95% CI: 1.82-3.23), and stress (aOR = 5.9; 95% CI: 2.95-11.94) among migrants and refugees in HICs. Other significant factors were women (aOR = 1.44; 95% CI: 1.32-1.57), Unmarried individuals (aOR = 1.7; 95% CI: 1.49-1.83), and those with poor self-rated health (aOR = 3.6; 95% CI: 2.97-4.36). Moreover, higher household income was significantly associated with lower odds of depression compared to their counterparts (aOR = 0.90; 95% CI: 0.84-0.98; P = 0.007). CONCLUSION:Food insecurity was consistently associated with higher odds of depression, anxiety, and stress among migrants and refugees in high-income countries. These findings support the implementation of enhanced screening and integrated social and mental health responses that address food access and psychological well-being. TRIAL REGISTRATION:PROSPERO CRD42024525690.

PURPOSE:Physical activity (PA) and sedentary behavior (SB) are associated with many diseases, including Alzheimer disease and all-cause dementia. However, the specific biological mechanisms through which PA protects against disease are not entirely understood. This study aims to address this gap, with a specific focus on all-cause dementia. METHODS:We first assessed the conventional observational associations of three self-reported and three device-based PA/SB measures with circulating levels of 2911 plasma proteins measured in the UK Biobank ( nmax = 39,160) and assessed functional enrichment of identified proteins. We then used bidirectional Mendelian randomization to further evaluate the evidence for causal relationships of PA/SB with protein levels. Finally, we performed mediation analyses to identify proteins that may mediate the relationship of PA with incident all-cause dementia. RESULTS:Our findings revealed 41 proteins consistently associated with all PA measures and 1027 proteins associated with at least one PA measure. Both conventional observational and Mendelian randomization study designs converged on proteins that appear to increase as a result of PA, including integrins such as ITGAV and ITGAM, as well as MXRA8, CLEC4A, CLEC4M, LPL, and ADGRG2; and on proteins that appear to decrease as a result of PA such as LEP, INHBC, CLMP, PTGDS, ADM, OGN, and PI3; and on proteins that are more responsive to high-intensity PA, such as CA14, CA6, CA4, KIT, and ANGPT2. Functional enrichment analyses revealed processes such as cell-matrix adhesion, integrin-mediated signaling, and collagen binding. Finally, GDF15, ITGAV, ITGAM, ITGA11, HPGDS, GFAP, ADM, AHNAK, and DPP4 were among 21 unique proteins found to mediate the relationship of PA with all-cause dementia, implicating processes such as synaptic plasticity, neurogenesis, and inflammation. CONCLUSIONS:Our results provide insights into how PA affects biological processes and protects against dementia, and provide avenues for future research into the health-promoting effects of PA.

Despite the high prevalence of type 2 diabetes (T2D), research exploring the inter-relationship of diabetes self-management, culture and religion in South Asian migrants is minimal. This systematic review aimed to investigate the influence of cultural and religious beliefs and practices on the self-management behaviours of South Asian migrants with T2D. A mixed-methods systematic review was conducted. Five electronic databases, Medline (Ovid), Embase (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), Scopus, and Web of Science (Clarivate), were searched systematically using predetermined inclusion criteria. Two reviewers independently assessed the full texts of the articles retrieved. The methodological quality of articles was assessed using the Mixed Methods Appraisal Tool. Data synthesis was guided by thematic analysis. A total of 22 studies (18 qualitative and four mixed-methods) were included in this systematic review. Five themes are presented: (1) Adapting to diabetes: impacts on food habits and dietary choices; (2) Diabetes threatens cultural conventions and identity; (3) Religious beliefs, practices, and prohibitions complicate diabetes management; (4) Social support and awareness to promote self-care; and (5) Individuals seek multiple sources for diabetes management. Numerous complexities surround South Asian migrants with T2D and impact their self-management behaviours. Understanding these complexities could facilitate improved patient care and health outcomes for this population.

IntroductionFormula and bottle feeding behaviours can increase obesity and tooth decay (early childhood caries, ECC) in early childhood, through non-responsive feeding and prolonged exposure to sugar. Parents’ beliefs can be barriers to behaviour change for obesity and ECC prevention. Understanding these beliefs towards children's teeth and weight can address parents’ priorities and develop prevention messages. This qualitative systematic review (PROSPERO registration #CRD42022348783) aimed to identify parent or carer perspectives on obesity and ECC in children aged ≤6 years.MethodsDatabase searching of CINAHL, Medline and EMBASE, with hand searching, was undertaken. Included papers were qualitative research publications, focused on parent or carer beliefs and attitudes towards overweight, obesity or ECC in infants and children. Inductive thematic analysis was undertaken to generate themes, with a strengths-based approach focused on parents’ lived experience. Quality appraisal was undertaken with the CASP Qualitative Checklist. Descriptive characteristics of the study and participants, and qualitative findings, were extracted qualitatively in NVivo.Results7,365 references were identified from database and hand searching, with 98 references included for analysis. Three research themes were generated: (1) parenting to support child wellness, including healthy teeth and weight; (2) parents’ response to unwellness, including identifying symptoms, causes and protective factors for unhealthy weight and teeth; (3) information and resources needed to support healthy weight and teeth. There was high or potential risk of bias in qualitative methodology when studies did not address researcher-participant relationships or rigorous data analysis processes.DiscussionFindings highlight the need for strength-based messages for children's teeth and weight, increased understanding of formula and bottle feeding as obesity and ECC risk factors, and holistic approaches to care by dental and primary care professionals.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42022348783, PROSPERO CRD42022348783.

The utilisation of online evidence-based written educational resources is crucial in addressing problematic alcohol and other drugs (AOD) use through prevention, treatment, and intervention strategies. However, low health literacy among one in five Australian adults raises concerns regarding the effective understanding of health information. This study aims to evaluate the content, suitability, and readability of AOD resources in New South Wales (Australia), recognising the importance of accessible and informative resources in supporting AOD demand reduction strategies. In this research, a comprehensive desktop search was conducted to analyse one to two-page AOD resources readily accessible through the internet in New South Wales, published by government and not-for-profit organisations. The content was thoroughly analysed for its coverage of key AOD topics. The Suitability Assessment of Materials (SAM) instrument evaluated visual and written elements, examining aspects like layout, typography, and illustrations. Readability was assessed using Flesch -Kincaid Grade Level (FKGL), Gunning Fog Index (FOG), Simplified Measure of Gobbledygook (SMOG), and Flesch Reading Ease tools. Descriptive statistics, including frequency, percentage, and standard deviation were calculated. The study analysed 88 AOD resources. Most resources had a target audience, but only three resources involved consumers in the development process. The content analysis showed 66

Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare. Methods: This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists’ involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136). Results: The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices. Conclusions: Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes.

High-risk fertility behaviour (HRFB) remains a significant public health concern in Nigeria, contributing to increase in maternal and child morbidity and mortality. The existence of HRFB presents significant barrier to accomplishing the Sustainable Development Goals. The objective of this study was to examine the prevalence and contextual factors of HRFB among Nigerian women. In this study, cross-sectional data with national representativeness from the 2018 Nigeria demographic and health survey (NDHS) were used. The sample was made up of 21,792 women aged 15–49 years selected from 1389 enumeration areas. A multilevel multivariable binary logistic regression model was utilised to examine the factors associated with HRFB. The weighted prevalence of HRFB was 64

OBJECTIVE:Bottle feeding to sleep may increase early childhood caries (ECC) and overweight risk through sugar exposure and overfeeding. This study examined the association between feeding to sleep at 24 and 36 months on both ECC and overweight at 3-4 years. METHODS:Participants were children in the Healthy Smiles Healthy Kids longitudinal birth cohort. Exposure was bottle feeding to sleep at 24 and 36 months. Outcomes were ECC (prevalence; number of caries-affected tooth surfaces, dmfs) and overweight at 3-4 years. RESULTS:718 and 729 children had dental examinations and anthropometric measurements, respectively. 30.3% and 21.7% of children were bottle-fed to sleep at 24 and 36 months, respectively. Feeding to sleep at 24 months was associated with higher odds of overweight (OR 1.90, 95%CI 1.06-3.38) and moderately associated with higher caries (dmfs 1.48, 95%CI 1.00-2.20). Feeding to sleep at 36 months was associated with higher caries (dmfs 1.88, 95%CI 1.22-2.91). CONCLUSIONS:Feeding to sleep was associated with higher odds of overweight and higher numbers of caries-affected tooth surfaces. Communicating appropriate sleep, settling and bottle cessation methods throughout early childhood may prevent ECC and overweight. IMPLICATIONS FOR PUBLIC HEALTH:Early interventions addressing bottle feeding could reduce the dual burden of ECC and obesity.