Save the Children

The Government of Bangladesh's routine data capturing system of health care facilities doesn't adequately capture Robson ten group classification system (TGCS)-related variables required to monitor caesarean section rates. To address this gap, we developed an integrated intervention and assessed its impact on the Robson TGCS-related variables availability and completeness. We conducted implementation research in eight district hospitals in Bangladesh from January 2021 to June 2023, where the primary population was mothers who gave birth within the implementing health care facilities. Our integrated intervention included the introduction of Robson TGCS; development and implementation of 'Robson TGCS Report Form'; capacity development training; a multi-level monitoring and supportive supervision system; and collaborative stakeholders' advisory workshops and review meetings. The primary outcome was the percentage of availability and completeness of TGCS-related data across study phases. The study was divided into five phases. Phase one focused on developing the data-capturing system, while data collection began in Phase two. The average availability of six variables improved significantly (P < 0.001) from 76% (95% confidence interval (CI) = 75.7-76.8%) in phase two to 99% (95% CI = 98.8-99.1%) in Phase five. Similarly, data completeness for these variables increased significantly (P < 0.001) from 53% (95% CI = 52.2-54.2%) to 97% (95% CI = 96.2-97%). Consequently, the percentage of classified groups improved significantly (P < 0.001) from 55% (95% CI = 54.1-56.1%) to 97% (95% CI = 96.8-97.5%). The integrated intervention significantly improved data availability and completeness. Active engagement of stakeholders, including governmental bodies and technical experts from local and central levels, is crucial to ensure data quality for identifying, planning and implementing targeted interventions.

Abstract Objectives Trauma-focused cognitive behavioural therapy (TF-CBT) is the established first-line treatment for paediatric posttraumatic stress disorder (PTSD), but access to evidence-based care remains limited. This study aimed to evaluate the feasibility and acceptability of a therapist-guided, 12-week, internet-delivered TF-CBT (iTF-CBT) programme for adolescents with PTSD, and to explore preliminary changes in PTSD symptoms. Design Single-group feasibility trial. Setting Save the Children, Sweden. Participants Twenty-two adolescents (13–17 years, 82% female) with primary PTSD. Interventions A 12-week, therapist-guided, internet-delivered TF-CBT comprising eight modules and parallel caregiver modules with joint child–caregiver activities. Outcomes Feasibility measures included recruitment pace, participant retention, treatment adherence (module completion), and therapist time. Acceptability was evaluated through satisfaction, credibility, negative effects, and reported adverse events. Preliminary treatment effects were evaluated as within-group changes in PTSD severity using independent evaluator-rated Clinician-Administered PTSD Scale (CAPS-CA-5) and the self-reported Child and Adolescent Trauma Screen 2 (CATS-2). Assessments occurred at baseline, during treatment, post-treatment, and at 1-month follow-up (primary endpoint). Results Recruitment was completed after seven months of active enrolment. Retention and adherence were high, satisfaction and credibility ratings were favourable, and no intervention-related serious adverse events occurred. Clinically meaningful within-group improvements were observed at the primary endpoint, with large reductions on CAPS-CA-5 (Cohen’s d = 1.27) and CATS-2 (Cohen’s d = 1.51). Conclusions Therapist-guided iTF-CBT for adolescents with PTSD was safe, feasible, acceptable, and associated with clinically meaningful symptom improvements. These findings support further evaluation in larger, controlled trials to determine efficacy, cost-effectiveness, and long-term outcomes. Trial registration ClinicalTrials.gov NCT06185244 . Article Summary Strengths and limitations of this study First internet-delivered TF-CBT trial for young people with PTSD Use of clinician-rated PTSD symptoms (CAPS-CA-5) in combination with validated self-report measures. The intervention was developed in close collaboration with clinicians, alongside contributions from young people. Absence of a control group.

Gunungkidul Regency is one of the regions in Indonesia known to have a relatively high rate of suicide, with a tendency for individuals who have previously attempted suicide to be at significant risk of repeating the behavior. This study aims to explore the role of social support systems in preventing the recurrence of suicide attempts among individuals who have previously attempted suicide. The study employed a qualitative approach involving five respondents, all of whom had a history of suicide attempts and were in a recovery phase at the time of the research. Data were collected through in-depth interviews and analyzed using thematic analysis. The findings show that all respondents consistently identified social support—particularly from family, peers, and the community—as a key factor in sustaining their will to live and reducing the urge to repeat suicidal behavior. Social support operates through mechanisms such as strengthening life meaning, reducing social isolation, and enhancing a sense of belonging and social connectedness. These findings underscore the importance of family- and community-based suicide prevention approaches in socially vulnerable areas such as Gunungkidul.

BackgroundLow birth weight (LBW) and preterm birth significantly contribute to increased risks of neonatal mortality, particularly in sub-Saharan Africa. Early identification of and timely intervention for these vulnerable infants remains challenging. Simple anthropometric measurements, such as foot length (FL), have emerged as potential alternatives to identify small and vulnerable newborns. This study aims to assess the accuracy of FL as a screening tool to identify LBW and preterm babies and to establish appropriate cut-off points for the local context.MethodsA facility-based cross-sectional study was conducted at Hawassa University Comprehensive Specialised Hospital and Bushulo Mother, Newborn and Child Health Specialty Centre and Primary healthcare from 15 May 2024 to 6 July 2024; 396 mother-newborn dyads were included using a consecutive sampling technique. Data were collected through interview, medical record review and FL measurement using digital calliper. Birth weight was measured using calibrated digital weight scales. Descriptive statistics, correlation analysis and receiver operating characteristic (ROC) curves were used to assess the distribution of measured characteristics and determine optimal FL cut-off points for identifying LBW and preterm babies.ResultsThe study included 61 (15.4%) LBW and 48 (12.3%) preterm babies. FL showed a strong correlation with birth weight (r=0.79) and moderate correlation with gestational age (r=0.62). The optimal cut-off point for identifying LBW babies was 70.65 mm, yielding 93.4% sensitivity, 91.6% specificity and an area under receiver operator curve (AUC) of 0.97 (95% CI: 0.95 to 0.98). For preterm babies, the optimal cut-off was 69.95 mm, with 76.7% sensitivity, 91.1% specificity and an AUC of 0.91 (95% CI: 0.86 to 0.96).ConclusionFL has demonstrated excellent diagnostic accuracy to identify LBW and preterm newborns. Optimal accuracy of identifying LBW and preterm babies in similar populations can be achieved at 70.65 and 69.95 mm cut-off points, respectively. In designing FL-based screening tools, appropriate cut-off points for the required level of accuracy should be considered.

This study explores the challenges affecting unaccompanied refugee children in Jewi refugee camp, located in Gambella, Ethiopia, and it examines the institutional responses to these challenges. Employing a constructivist philosophical stance and a single case study design, the research utilized purposive sampling to collect data from unaccompanied children, their caregivers, and social work practitioners. Data were collected through interviews with twenty unaccompanied refugee children and five key informants, supplemented by a focus group discussion involving twenty-four children, equally divided by gender (twelve males and twelve females). Thematic analysis identified tribal conflict, geographical proximity, and family disintegration as the primary drivers of child migration to Ethiopia. Although the children have access to education and basic healthcare, the findings indicate persistent hardships. These include environmental and psychological challenges, restrictions on extracurricular engagement, cultural disparities, rigid gender norms, limited training opportunities, and inadequacies in health services. The study advocates for sustained stakeholder engagement to safeguard child rights and facilitate family reunification. It also calls for unified coordination among service providers to enhance their delivery mechanisms. Additional recommendations include gender-sensitivity training, psychosocial support, and vocational programs for refugee children.

Abstract Introduction Excessive sodium intake is a well-established risk factor for hypertension and cardiovascular disease (CVD). Processed foods (PFs) and ultra-processed foods (UPFs) have become a primary source of dietary sodium, particularly in low- and middle-income countries (LMICs) undergoing rapid nutritional transitions. Bangladesh is experiencing an increasing prevalence of hypertension, paralleling the rising consumption of PF and UPF. Purpose This study analyzes the sodium levels in commonly consumed PFs and UPFs, evaluates their compliance with WHO sodium benchmarks, and investigates discrepancies between labelled and laboratory-measured sodium content to inform CVD prevention strategies. Methods A cross-sectional, population-based survey was conducted across eight administrative divisions of Bangladesh, including metropolitan, urban, and rural areas. 974 participants were surveyed to determine consumption patterns. Commonly consumed PF and UPFs were identified and collected for laboratory sodium analysis using Mohr’s titration method. Sodium content was compared against the WHO South-East Asia Regional Sodium Benchmarks. Labelled discrepancies were analyzed, with a deviation of &amp;gt;20% considered non-compliant. Sodium intake was estimated relative to WHO guidelines. Results Among 974 participants surveyed, 50% were female, 25% were adolescents, 25% were children, and 50% were adults. The prevalence of PF and UPF consumption was high (97%), with urban (99%) exceeding rural (94%). Children consumed 21 times per week, adolescents 16, and adults 11 times. Sodium analysis of 16 major food categories showed significant variations, with instant soups (3149.6 mg/100g), instant noodles (1515.8 mg/100g), and pickles (1378.6 mg/100g) having the highest sodium content. Soft drinks had the lowest (5.9 mg/100g). Compliance with WHO Southeast Asia region sodium benchmark for packaged foods varied widely, with 80% of instant noodles and 62.5% of crackers/savoury biscuits meeting the targets. In contrast, extruded snacks, nuts, seeds, kernels, and dry soups showed no compliance. One serving of instant noodles contributed 50%, and instant soup covered one-third of WHO’s daily sodium limit. Among products analyzed, 42% under-reported sodium content beyond the 20% deviation threshold, while 8.6% provided no sodium information, and only 26% adhered to accurate labeling. Conclusions This study highlights a critical epidemiological concern regarding excessive sodium intake from PFs and UPFs and the inaccuracy of sodium labelling, both posing significant CVD risks in Bangladesh. Despite the 2017 Packaged Food Labelling Regulation, compliance is poor, highlighting the urgent need for stronger policy enforcement, sodium reduction strategies, public health awareness, and improved surveillance to reduce diet-related CVD burdens in LMICs. Disable Ginger in this text fieldDisable Ginger on this website×

Subjective cognitive decline (SCD) and sleep disturbance form a vicious cycle, accelerating neurodegeneration. Cordyceps militaris (CM), a traditional medicinal fungus rich in nucleosides, possesses potent neuroprotective and adenosinergic (sleep-promoting) properties. We investigated the efficacy of a standardized CM extract on this cognition-sleep nexus in adults with SCD. This 12-week, single-center, randomized, double-blind, placebo-controlled, parallel-group trial was conducted in Palembang, Indonesia. We randomized 120 adults (aged 45-65) with SCD to receive 300 mg/day of a standardized CM mycelial extract (3% cordycepin) or a matching placebo. The primary outcome was the change from baseline in the Montreal Cognitive Assessment-Indonesian (MoCA-INA) score. Key secondary outcomes (Bonferroni-corrected) were the Pittsburgh Sleep Quality Index (PSQI), Rey Auditory Verbal Learning Test (RAVLT) Delayed Recall, and polysomnography (PSG)-derived Sleep Efficiency (SE). Analyses were performed on the Intention-to-Treat (ITT) population (N=120) using a Linear Mixed-Effects Model (LMM). The LMM analysis revealed a significant group-by-time interaction for the primary outcome, MoCA-INA (Adjusted Mean Difference [AMD]: +1.95 [95% CI: 1.10, 2.80], p &lt; 0.001). The CM group also showed significant improvements in all three key secondary outcomes: PSQI (AMD: -2.90 [95% CI: -3.81, -1.99], p &lt; 0.001), RAVLT Delayed Recall (AMD: +2.15 [95% CI: 1.30, 3.00], p &lt; 0.001), and Sleep Efficiency (AMD: +5.8% [95% CI: 3.1, 8.5], p &lt; 0.001). After FDR correction, significant benefits were also seen for processing speed, %REM sleep, and serum BDNF and hs-CRP. The intervention was well-tolerated. In conclusion, twelve weeks of supplementation with a standardized C. militaris extract significantly improved cognitive function, episodic memory, and both subjective and objective sleep in adults with SCD. These benefits were associated with enhanced neuroplasticity and reduced systemic inflammation, supporting its potential as a multi-target, disease-modifying intervention for this at-risk population.

On August 29 and 30, 2024, eight researchers and six expert practitioners within wellbeing and youth sport were gathered in Copenhagen to reach evidence-based consensus on how to promote wellbeing in and through youth sports. The consensus process integrated international research-based knowledge with practice-based knowledge into statements about key factors influencing wellbeing in youth sport. Based on this knowledge, practice and policy directed statements on how wellbeing in and through sport can be promoted were formulated. The consensus process and the resulting statements were based on a system approach to wellbeing in youth sport and how it can be promoted. Four system levels (the individual, interpersonal, community, and policy levels) were addressed in answering the following questions: (1) What characterizes wellbeing in sport for children and adolescents? (2) What characterizes sport environments that promote children and adolescents' wellbeing? (3) Which factors are important to consider in efforts to develop wellbeing promoting youth sport environments? (4) How can wellbeing in youth sport be promoted? In total, 19 consensus statement sentences were formulated on how young sports participants (3), parents/caretakers (5), coaches and leaders/managers (5), local sport communities (3) and sports federations (3) can promote wellbeing in youth sport.