To assess the frequency and correlates of meal-kit use across five countries using population-level data.

Online surveys conducted in 2022 assessed meal-kit use in the past week. Binary logistic regression models examined sociodemographic and nutrition-related correlates of meal-kit use, including self-reported home meal preparation and cooking skills, commercially prepared meal consumption and healthy eating, weight change and sustainability efforts.

Canada, Australia, the UK, the USA and Mexico.

20,401 adults aged 18–100 years.

Overall, 14 % of participants reported using meal-kits in the past week. Use was highest in the USA (18 %) and lowest in Canada (9 %). Meal-kit use was greater among individuals who were younger, male, of minority ethnicity, had high educational attainment, had higher income adequacy or had children living in the household (P < 0·01 for all). Use was greater for those who participated in any food shopping (v. none), those who prepared food sometimes (3–4 d/week or less v. never) and those who reported ‘fair’ or better cooking skills (v. poor; P < 0·05 for all). Consuming any ‘ready-to-eat’ food (v. none) and visiting restaurants more recently (v. > 6 months ago; P < 0·001 for all) were associated with greater meal-kit use. Eating fruits/vegetables more than 2 times/d and engaging in diet modification efforts were also associated with increased meal-kit use, as was engaging in weight change or sustainability efforts (P < 0·001 for all).

Meal-kits tend to be used by individuals who make efforts to support their health and sustainability, potentially valuing ‘convenient’ alternatives to traditional home meal preparation; however, use is concentrated amongst those with higher income adequacy.

Point-of-care technologies (POCTs) have grown increasingly prevalent in clinical and at-home settings, offering various rapid diagnostic capabilities. This study presents findings from a nationwide survey conducted between November 2023 and January 2024, capturing clinician perceptions of POCTs.

The survey was distributed via email to healthcare professionals through academic and industry listservs and through LinkedIn posts. A total of 159 responses were analyzed.

Core priorities, including accuracy, ease of use, and availability, remain consistently valued over the years. However, several perceived benefits, including continuous patient monitoring, diagnostic certainty, and patient management exhibited significant declines in agreement compared to previous years. Despite this, clinician perceptions of POCTs’ abilities to enhance patient–provider communication remained stable. Evolving concerns may reflect heightened expectations and greater scrutiny as these technologies become commonplace. Agreement that POCTs may undermine clinical expertise increases, while concerns related to reimbursement and usability decline. Pilot questions related to artificial intelligence (AI) and machine learning (ML) indicated moderate openness to adopting AI-enhanced POCTs, particularly with tools offering novel clinical insights.

While POCTs continue to be an asset in clinical settings, the findings of this study suggest a shift in provider attitudes toward a more neutral standpoint. Limitations include a low response rate, self-selection, and missing demographic data from a subset of participants. Future surveys will further integrate AI/ML-related questions while prioritizing broader demographic and geographic reach.

To identify changes in emergency department (ED) use in Houston, TX during the mid-summer Hurricane Beryl-induced power outage to inform future targeted public health interventions.

Syndromic surveillance system ED visit daily counts for total visits, heat-related illness, carbon monoxide poisoning, acute cardiac condition, stroke, dialysis, and medication refills post-hurricane were statistically compared to the 2 weeks prior and plotted alongside the percentage of the population with power outage.

Daily ED visits post-storm were statistically higher (P< 0.05) than the 2 weeks prior for total visits and acute cardiac events (Day 1, 2); heat-related illness (Day 1-3); dialysis (Day 0-3); and carbon monoxide poisoning and medication refill (Day 1-9).

While 50% of the city experienced power outages from high winds, total ED visits, acute cardiac events, and heat-related illness were statistically higher in the first 3 days after Beryl than expected. Houston developed targeted messaging to mitigate these events in future disasters.

A key step toward understanding psychiatric disorders that disproportionately impact female mental health is delineating the emergence of sex-specific patterns of brain organisation at the critical transition from childhood to adolescence. Prior work suggests that individual differences in the spatial organisation of functional brain networks across the cortex are associated with psychopathology and differ systematically by sex.

We aimed to evaluate the impact of sex on the spatial organisation of person-specific functional brain networks.

We leveraged person-specific atlases of functional brain networks, defined using non-negative matrix factorisation, in a sample of n = 6437 youths from the Adolescent Brain Cognitive Development Study. Across independent discovery and replication samples, we used generalised additive models to uncover associations between sex and the spatial layout (topography) of personalised functional networks (PFNs). We also trained support vector machines to classify participants’ sex from multivariate patterns of PFN topography.

Sex differences in PFN topography were greatest in association networks including the frontoparietal, ventral attention and default mode networks. Machine learning models trained on participants’ PFNs were able to classify participant sex with high accuracy.

Sex differences in PFN topography are robust, and replicate across large-scale samples of youth. These results suggest a potential contributor to the female-biased risk in depressive and anxiety disorders that emerge at the transition from childhood to adolescence.

Cost-effectiveness modeling often requires extrapolation of survival data from clinical trials over a long-term horizon. The choice of extrapolation method is often uncertain and can have a profound impact on the results. We propose a novel Bayesian approach towards incorporating external information (e.g., registry data or clinical opinion) into the extrapolation process as a means of reducing this uncertainty.

Standard parametric survival curves are fitted to immature time-to-event data using maximum likelihood estimation (MLE). Separately, external information on expected cohort-level survival at a future time point is used to specify a prior probability distribution. These are combined to generate posterior distributions of survival curve extrapolations that simultaneously incorporate both observed data and external information. This is done using importance sampling and multivariate normal approximations of the likelihood and posterior distributions; it requires only summary model parameter estimates (and not patient-level data). We apply our method to analyze survival data from the KEYNOTE-426 trial of pembrolizumab+axitinib in advanced renal cell carcinoma.

The method was implemented in R, and outputs survival curve parameters that are compatible with cost-effectiveness models developed in other software (e.g., Microsoft Excel). In all examples considered, our method resulted in extrapolated survival predictions that were more closely aligned with the external information compared with the standard (MLE-based) approach. Incorporation of external information decreased between-distribution variance (reduced structural uncertainty), and generally also decreased within-distribution variance as well (reduced parameter uncertainty). Results were comparable with those obtained from the method of Cooney and White, which uses similar ideas but requires full patient-level data and is more computationally complex.

The extrapolation method we describe can reduce uncertainty when valid external information is available. Only MLE-based parameter estimates are required to implement our method, thus secondary model users such as HTA agencies can adjust survival extrapolations from existing cost-effectiveness models without access to patient-level data. Implementation is straightforward and computationally efficient, and outputs are easily incorporated into existing cost-effectiveness models.

This commentary highlights the release of findings now available in the report International Food Policy Study Youth Surveys: Summary of Findings 2019–2021.

The survey data described in this commentary consist of repeated cross-sectional surveys conducted annually beginning in 2019.

Online surveys were conducted in 2019 to 2021 among respondents living in Australia, Canada, Chile, Mexico, the United Kingdom and the USA.

Survey respondents were youth aged 10–17 years in 2019 (n 12 031), 2020 (n 11 108) and 2021 (n 10 459).

The report described in this commentary summarises findings on food and nutrition behaviours, attitudes and knowledge among youth, including their diet sources and patterns, school nutrition environments, food security, diet intentions, weight perceptions and weight loss behaviours, sugary drink perceptions, awareness of public education and mass media campaigns, perceptions of food labels and exposure to food and beverage marketing.

Results from the IFPS Youth surveys provide important insights into key policies of global interest, including front-of-package nutrition labelling, levies on sugary beverages and restrictions on marketing unhealthy food and beverages to children. As policymakers continue to seek effective strategies to improve adolescent health outcomes, ongoing cross-country monitoring of food and nutrition-related indicators, such as the data from the International Food Policy Study, will be critical in assessing dietary trends and evaluating upcoming policies.

Motor neuron disease (MND) is a progressive, fatal, neurodegenerative condition that affects motor neurons in the brain and spinal cord, resulting in loss of the ability to move, speak, swallow and breathe. Acceptance and commitment therapy (ACT) is an acceptance-based behavioural therapy that may be particularly beneficial for people living with MND (plwMND). This qualitative study aimed to explore plwMND’s experiences of receiving adapted ACT, tailored to their specific needs, and therapists’ experiences of delivering it.

Semi-structured qualitative interviews were conducted with plwMND who had received up to eight 1:1 sessions of adapted ACT and therapists who had delivered it within an uncontrolled feasibility study. Interviews explored experiences of ACT and how it could be optimised for plwMND. Interviews were audio recorded, transcribed and analysed using framework analysis.

Participants were 14 plwMND and 11 therapists. Data were coded into four over-arching themes: (i) an appropriate tool to navigate the disease course; (ii) the value of therapy outweighing the challenges; (iii) relevance to the individual; and (iv) involving others. These themes highlighted that ACT was perceived to be acceptable by plwMND and therapists, and many participants reported or anticipated beneficial outcomes in the future, despite some therapeutic challenges. They also highlighted how individual factors can influence experiences of ACT, and the potential benefit of involving others in therapy.

Qualitative data supported the acceptability of ACT for plwMND. Future research and clinical practice should address expectations and personal relevance of ACT to optimise its delivery to plwMND.

1. (1) To understand the views of people living with motor neuron disease (plwMND) and therapists on acceptance and commitment therapy (ACT) for people living with this condition.

2. (2) To understand the facilitators of and barriers to ACT for plwMND.

3. (3) To learn whether ACT that has been tailored to meet the specific needs of plwMND needs to be further adapted to potentially increase its acceptability to this population.

Very Late-Onset Schizophrenia-Like Psychosis (VLOSLP) is a condition resembling schizophrenia, which has a first onset in individuals at age 60 or later. Understanding the risk factors associated with the development of this condition is crucial, given the increasing ageing population and the elevated mortality rate in VLOSLP patients compared with the general population. This scoping review aims to explore and map the risk factors associated with VLOSLP development and begin to identify potential mechanisms linking these factors through comprehensive literature searching, screening and data extraction.

Conducted as a scoping review; MEDLINE, Embase and APA PsycInfo were searched using the terms: “Very-Late Onset Schizophrenia-Like Psychosis”, “VLOSLP”, “Geriatric Psychosis” and “Geriatric Schizophrenia”. Inclusion criteria focused on psychosis with onset at 60 years or older and the identification of at least one potential risk factor. Studies were excluded which did not specifically refer to age of onset or concerned psychosis with an attributable organic cause. Thematic analysis was used to categorise risk factors into biological and psychosocial themes, followed by further organisation into specific subthemes.

Out of 326 initial results, 41 studies met inclusion criteria and underwent data analysis. Key risk factors included female gender, sensory impairment, social isolation, and migration, with potential interconnections identified between factors. Postulated mechanisms for the role of a risk factor in VLOSLP development recorded in the literature were included in the review. Mechanisms showed potential co-linkage between subthemes of risk factor. Migration status was also shown to impact gender as a risk factor, with male migrants experiencing higher rates of VLOSLP than their female counterparts. Thematic analysis highlighted how social isolation, a prominent risk factor, might be linked to, or reinforced by, sensory impairment, trauma, bereavement, and premorbid personality traits.

The scoping review revealed that risk factors for VLOSLP span across biological, social, and psychological domains, with the findings contributing to the broader understanding of schizophrenia-like psychoses in the elderly population. Social isolation emerged as a widely-cited factor, reiterating the importance of managing risk factors for VLOSLP in vulnerable individuals via a holistic and multidisciplinary approach. Results bring attention to the bi-directional relationships between risk factors and psychotic illness, with perceived risk factors a potential consequence of the psychosis. In response to this, future work may involve large-cohort longitudinal studies to outline temporal relationships between risk factors and symptom development.