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Dispersal is central to the ecology and evolution of spatially structured communities. While flower microbial communities are spatially structured among floral organs, how dispersal vectors distribute microbes among floral organs is unknown. Pollinators are recognized as key microbial vectors, but effects of their different foraging behaviors on transfer dynamics among flowers or different floral organs are not known. We asked how foraging behaviors of a model pollinator (Bombus impatiens) affect acquisition and dispersal of microbes among flower organs. We used monkeyflowers (Mimulus guttatus) to examine dispersal within a natural context and artificial flowers to test how common bee foraging behaviors (nectaring, buzzing, or scrabbling) shaped dispersal of a green fluorescent protein‐labeled bacteria, Pseudomonas fluorescens. Bees acquired 1% of a flower's microbes and dispersed 31% of acquired microbes to the next flower. All bees acquired microbes, and 85% and 76% of bees dispersed microbes to live and artificial flowers, respectively. Microbes acquired from the corolla were mainly deposited on the corolla, followed by the stamens, and least on the nectary/pistil. Bee foraging behavior affected acquisition, with scrabbling for pollen resulting in 23% more microbes acquired than nectaring, and with buzzing for pollen resulting in a 79% slower rate of microbial acquisition relative to scrabbling. Bee foraging behavior also affected deposition but depended on the floral organ: Scrabbling and buzzing for pollen led to greater deposition than nectaring for corolla and stamen but not nectary. Our results have implications for transmission of beneficial and pathogenic microbes among plants and pollinators, and thus the ecology and evolution of floral microbial communities.

More than one-third of cancer-related health information is unreliable or misleading. With increasing health information seeking, the risks of misinformation exposure are growing. Educational approaches that are delivered clearly and in accessible formats are a promising way to strengthen critical thinking and decision-making skills, thereby helping to reduce the exposure of those impacted by cancer to misleading cancer information. This pilot randomised trial will assess the feasibility and acceptability of conducting a larger definitive trial evaluating the Informed Health Choices-Cancer (IHC-C) programme. The IHC-C is an online evidence-based education programme co-designed by stakeholders, including public and patient partners. It aims to equip people impacted by cancer (i.e., current patients, survivors, caregivers, and loved ones) with the skills and knowledge necessary to think critically about the reliability of health information and claims and make informed health choices. Participants will be randomised to either the IHC-C intervention group or a waitlist control group. The primary outcome of this pilot trial are feasibility (recruitment and retention rates, etc.) and acceptability (participant satisfaction and perceived usefulness, etc.). Demographic and cancer-related data will be collected to characterise the sample and inform recruitment strategies for a future definitive trial. Preliminary measures of critical thinking and decision-making skills will also be gathered to support the selection of key outcomes for the future trial. This pilot trial will inform the design and conduct of a future definitive randomised trial. Insights gained will inform sample size estimations, refine recruitment strategies, optimise programme delivery, and improve data collection processes, ensuring a robust and scalable approach for the definitive trial.

Aims/hypothesis The aim of the study was to assess the cost-effectiveness of screening for gestational diabetes mellitus (GDM) in primary and secondary care settings, compared with a no-screening option, in the Republic of Ireland. Methods The analysis was based on a decision-tree model of alternative screening strategies in primary and secondary care settings. It synthesised data generated from a randomised controlled trial (screening uptake) and from the literature. Costs included those relating to GDM screening and treatment, and the care of adverse outcomes. Effects were assessed in terms of quality-adjusted life years (QALYs). The impact of the parameter uncertainty was assessed in a range of sensitivity analyses. Results Screening in either setting was found to be superior to no screening, i.e. it provided for QALY gains and cost savings. Screening in secondary care was found to be superior to screening in primary care, providing for modest QALY gains of 0.0006 and a saving of €21.43 per screened case. The conclusion held with high certainty across the range of ceiling ratios from zero to €100,000 per QALY and across a plausible range of input parameters. Conclusions/interpretation The results of this study demonstrate that implementation of universal screening is cost-effective. This is an argument in favour of introducing a properly designed and funded national programme of screening for GDM, although affordability remains to be assessed. In the current environment, screening for GDM in secondary care settings appears to be the better solution in consideration of cost-effectiveness.

Introduction Rapid identification of severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) infections by testing potentially reduced coronavirus disease‐19 (COVID‐19) cases. Testing strategies varied across countries and during different stages of the pandemic. This scoping review aims to map the available evidence on the effectiveness of SARS‐CoV‐2 testing strategies for suspected cases and asymptomatic populations to inform the development of World Health Organization recommendations for SARS‐CoV‐2 testing strategies. Methods We followed the standard methods for scoping reviews. We searched Medline (OVID), EMBASE (Elsevier), and Europe PMC using a comprehensive search strategy. The search was conducted in January 2023 and covered the period from January 2020 to January 2023. Two review authors independently screened the titles and s, and full texts. Data were extracted onto a pilot‐tested form by a review author and cross‐checked by another review author. We provided a descriptive report summarizing the extracted data around the outcomes and created an interactive map of the available evidence using the evidence for policy and practice mapper. Results We identified 34,550 citations from the databases. After the screening, we included 17 studies from 11 countries for data extraction. The study designs were randomized controlled trials (n = 3), nonrandomized experimental studies (n = 3), cohort studies (n = 3), cross‐sectional studies (n = 4), self‐controlled case series (n = 1), and economic evaluations (n = 3).  Among the included studies, 14 used reverse transcription‐polymerase chain reaction and 10 studies used antigen‐detecting rapid diagnostic test. The settings of the studies were healthcare facilities (n = 8), communities (n = 4), schools, and workplaces (n = 3). Included studies considered symptomatic and asymptomatic individuals, or both, or asymptomatic contacts. Most of the studies (n = 14) reported the COVID‐19 positivity rate as the primary outcome. Other reported outcomes are the number of COVID‐19 cases (n = 11), number of hospitalizations and deaths (n = 3), and cost (n = 3). Conclusion We identified evidence gaps in the effectiveness of SARS‐CoV‐2 testing strategies, particularly in specific settings such as schools and long‐term care facilities. This scoping review provides a foundation for further research, allowing researchers and stakeholders to focus on addressing the identified gaps.

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM). Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants. Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up. Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance. Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

Jurisdictional scans are used to inform policy by systematically comparing how different jurisdictions define problems, design policies, and implement strategies. They provide insights into policy options, implementation experiences, and gaps in preparedness, making them valuable tools for evidence-informed decision-making. However, no established methodological standards exist currently. This article provides an overview of the methodological considerations of conducting jurisdictional scans, drawing on the authors' methodological experience. We outline issues for consideration in conducting jurisdictional scans, drawing on our experience from a recent jurisdictional scan of public health preparedness mechanisms. Our methodological reflections are informed by established evidence synthesis principles, adapted to the unique features of a jurisdictional scan. A worked example illustrates key stages, including defining scope, searching, screening, data extraction, and synthesis. Our experience highlights the importance of applying systematic approaches to maximize transparency, reproducibility, and credibility. We found that policy documents often lacked abstracts, standardized structures, or clear evidence use, making screening and extraction challenging. Iterative refinement of inclusion criteria, piloting of search strategies, keyword searching, and structured frameworks for data extraction were essential for achieving consistency. Importantly, while multiple forms of evidence (eg, guidelines, modeling, evaluations) were cited in preparedness plans, the role of evidence in shaping decisions was often unclear, revealing a key limitation of current practice. With the growing importance of evidence-informed policymaking, there is an urgent need to establish robust methodological standards and reporting guidelines for jurisdictional scans. This paper provides methodological considerations for jurisdictional scans, offering practical guidance while recognizing ongoing challenges. By clarifying the value, limitations, and distinct role of jurisdictional scans, we aim to strengthen their contribution to policy processes and support future methodological development. Future research is warranted to refine the methodological and reporting standards of the process while maintaining flexibility for different policy contexts. Jurisdictional scans are a way to see how different countries, regions, or organizations handle the same problem. They help show what choices governments have, how plans work in real life, and where the weaknesses are. Jurisdictional scans gather information from official documents, rules, and reports to learn from what others are doing. Our paper explains issues to consider in how to do a jurisdictional scan. This includes choosing which places to look at, finding and picking the right documents, pulling out the important information, and then putting it all together. If done well, jurisdictional scans can offer useful lessons to leaders and policymakers. But there are still challenges, like policies being written in very different ways, or not showing clearly how evidence is used. By giving clear instructions, this paper helps make jurisdictional scans more consistent and helpful for better decisions. Key findings•We describe issues to consider for conducting jurisdictional scans in public health.•Many cite evidence but rarely show use; key challenges include unclear, inconsistent reports.What this adds to what is known?•Jurisdictional scans are often ad hoc, lacking systematic and transparent methods.•This paper offers issues to consider for transparent jurisdictional scans.What is the implication and what should we change now?•Use clear and transparent methods for credible jurisdictional scans, and report evidence use in policy clearly

Regular physical activity (PA) is important for people with rheumatoid arthritis (RA). Poor sleep is a common complaint among people with RA, which may have an influence on their PA levels. There is a lack of objective information regarding total sleep time (TST) and PA duration in this population. A cross-sectional study design was used. SenseWear Pro3 Armband(R)TM is used to measure TST and total PA duration. Four valid days, with 95% wear time necessary for inclusion in final results. Disease activity and function were measured using the DAS-28, HAQ and VAS. Data analysis carried out using SPSS v22. Seventy-five (75) participants completed monitoring period, with 51 (68%) meeting modified PA duration guidelines. Data with 95% wear time over a minimum of 4 days were available for 32 recorded participants, with a mean TST of 5.7 (SD_1.11) hours per night and a median 1.25 (IQR_1.88) hours of daily PA. TST had a positive significant relationship with PA (p = 0.018); PA demonstrated a negative significant relationship with functional limitations (p = 0.009) and correlated with lower CRP levels; CRP levels had in turn a significant relationship to global health (p = 0.034). Total sleep time was low for people with RA. People with RA who are more physically active have longer TST. These findings provide an objective profile of TST and PA duration in people with RA and suggest a relationship between increased PA duration and longer TST. Further research is needed to confirm these novel findings.

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Aims/hypothesis It is postulated that uptake rates for gestational diabetes mellitus (GDM) screening would be improved if offered in a setting more accessible to the patient. The aim of this study was to evaluate the proportion of uptake of GDM screening in the primary vs secondary care setting, and to qualitatively explore the providers’ experiences of primary care screening provision. Methods This mixed methods study was composed of a quantitative unblinded parallel group randomised controlled trial and qualitative interview trial. The primary outcome was the proportion of uptake of screening in both the primary and secondary care settings. All pregnant women aged 18 years or over, with sufficient English and without a diagnosis or diabetes or GDM, who attended for their first antenatal appointment at one of three hospital sites along the Irish Atlantic seaboard were eligible for inclusion in this study. Seven hundred and eighty-one pregnant women were randomised using random permutated blocks to receive a 2 h 75 g OGTT in either a primary ( n  = 391) or secondary care ( n  = 390) setting. Semi-structured interviews were conducted with 13 primary care providers. Primary care providers who provided care to the population covered by the three hospital sites involved were eligible for inclusion. Results Statistically significant differences were found between the primary care ( n  = 391) and secondary care ( n  = 390) arms for uptake (52.7% vs 89.2%, respectively; effect size 36.5 percentage points, 95% CI 30.7, 42.4; p  < 0.001), crossover (32.5% vs 2.3%, respectively; p  < 0.001) and non-uptake (14.8% vs 8.5%, respectively; p  = 0.005). There were no significant differences in uptake based on the presence of a practice nurse or the presence of multiple general practitioners in the primary care setting. There was evidence of significant relationship between probability of uptake of screening and age ( p  < 0.001). Primary care providers reported difficulties with the conduct of GDM screening, despite recognising that the community was the most appropriate location for screening. Conclusions/interpretation Currently, provision of GDM screening in primary care in Ireland, despite its acknowledged benefits, is unfeasible due to poor uptake rates, poor rates of primary care provider engagement and primary care provider concerns. Trial registration http://isrctn.org ISRCTN02232125 Funding This study was funded by the Health Research Board (ICE2011/03)