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Journal articleSchmidt J, Carter AW, McGuire A, et al., 2026,
A systematic review of economic evidence of artificial intelligence in healthcare
, Health Policy, Vol: 172, ISSN: 0168-8510Background: Ambitious claims suggest AI could save $200-360 billion annually in US healthcare and €212 billion in Europe, though the empirical evidence base supporting these projections remains unclear. Objective: This systematic review seeks to synthesise the available economic evidence of AI technologies in healthcare and contextualise the available economic evidence against the broader policy expectations surrounding the economic impact of AI in healthcare. Methods: We searched MEDLINE, Embase, Global Health, PsycINFO, and Cochrane Central for scientific sources. The JBI dominance ranking matrix was used to compare and interpret the results of the included economic evaluations. Methodological quality was assessed using the JBI Critical Appraisal tool of Economic Evaluations and the CHEERS-AI reporting checklist. Results: We identified 16,430 academic records and 1,593 grey literature records, of which 91 records met the inclusion criteria, representing 98 unique evaluations. Of these, 36% demonstrate a clear health economic preference for the AI technology, which increased to 44% when only considering the 51 high-quality studies. AI interventions were mainly designed for healthcare providers, with ophthalmology and oncology being the most common. Conclusions: The high-quality studies show definite potential for positive cost-effectiveness and economic impact of AI technologies, though we cannot yet support the ambitious claims that AI technologies can translate to hundreds of billions in cost-savings. When combining our findings with those of randomised controlled trials evaluating AI technologies in clinical practice, it becomes evident that AI technologies frequently yield improvements in terms of clinical and economic outcomes or match the current standard of care.
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Journal articleDemircali AA, Yilmaz A, Keshavarz M, et al., 2026,
Autonomous Navigation of Pollen‐Inspired Magnetic Microrobots for Biomedical Applications
, Advanced Robotics Research, ISSN: 2943-9973<jats:p>Recent advances in microrobotics have expanded opportunities for biomedical delivery, but reliable navigation in complex microvascular environments remains challenging, particularly when continuous imaging is limited. Here we develop a sunflower pollen‐inspired magnetic microrobot for targeted delivery and tissue engineering applications. Fabricated by two‐photon polymerization and coated with nickel and titanium for magnetic actuation and biocompatibility, the 40 µm microrobot features an open, hydrodynamic geometry that facilitates cell adhesion through its surface topology. Finite‐element analysis supported this design rationale, showing 4.45‐fold lower translational drag and 4.1‐fold lower rotational hydrodynamic resistance than a solid spherical microrobot of the same outer diameter. We demonstrated stable rolling under physiologically relevant flow conditions, including upstream motion against opposing flow, and evaluated autonomous navigation in static and dynamic environments using a vision‐based closed‐loop controller combined with reinforcement learning. The system enabled trajectory tracking, shortest‐path selection, and multiturn maze navigation with microrobot‐scale error. By combining efficient rolling locomotion with navigation based on intermittent visual updates, this platform supports microrobot guidancein future minimally invasive interventions where continuous monitoring is restricted.</jats:p>
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Journal articleSousi S, Glynou SP, Hyman S, et al., 2026,
Trends, disparities, and pregnancy outcomes of gestational diabetes mellitus in North West London: a nine-year population-based cohort study
, BMC Medicine, ISSN: 1741-7015Background: Gestational diabetes mellitus (GDM) affects approximately 1 in 20 pregnancies in England. North West London (NWL) serves a diverse population of 2.4 million with substantial ethnic and socioeconomic variation. However, population-level epidemiological evidence from NWL remains limited. This study aims to characterise GDM incidence, temporal trends, risk determinants, and associated pregnancy outcomes.Methods: A retrospective population-based cohort study using routinely collected data from the Whole Systems Integrated Care database included all birth episodes from 2017 to 2025, categorised as GDM or non-GDM. Incidence per 1,000 births was calculated and temporal trends were analysed. Multivariable generalised estimating equation (GEE) logistic regression models were used to examine maternal risk determinants for GDM and pregnancy outcomes associated with GDM, while controlling for confounders and accounting for within-woman clustering across pregnancies.Results: Among 172,332 births from 134,991 women, 18,892 (10.9%) were GDM-affected. Overall incidence was 109.6 per 1,000 births (95% CI: 108.2-111.1), rising from 80.5 per 1,00 births in 2017 to 138 per 1,000 births in 2025. Incidence increased with maternal age and deprivation (119 vs. 85.4 in most vs. least deprived quintiles). Asian women had the highest risk (aOR 2.27, 95% CI: 2.15-2.40) relative to White. GDM was associated with higher rates of labour induction (51% vs. 41%), caesarean delivery (47% vs. 36%), preterm birth (7.3% vs. 5.2%), greater maternity care costs (£4,674 vs. £3,971) and longer maternal length of stay (3 vs. 2 days).Conclusion: The incidence of GDM in NWL substantially exceeds national estimates and has nearly doubled over nine years, with pronounced ethnic and socioeconomic disparities. Targeted culturally appropriate prevention strategies and equity-focused service planning are needed in this population.
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Journal articleRajput K, Zuberi S, Elhajj M, et al., 2026,
Mapping Machine Learning–Driven Cybersecurity Solutions in Health Care: Scoping Literature Review
, Journal of Medical Internet Research, Vol: 28, Pages: e93950-e93950<jats:title>Abstract</jats:title> <jats:sec sec-type="background"> <jats:title>Background</jats:title> <jats:p>Health care systems face escalating cyberattacks, including the UK Synnovis ransomware attack, which halted pathology services for 14 weeks; the Ascension Health breach affecting 5.6 million patients; and the Change Healthcare breach costing US $2.5 billion. Conventional cybersecurity measures in health care remain reactive and inadequate against evolving threats. Machine learning (ML) offers adaptive, predictive, real-time cyber defense; yet, there is limited clarity on how ML tools are applied across cybersecurity domains, their real-world effectiveness, and where gaps remain.</jats:p> </jats:sec> <jats:sec sec-type="objective"> <jats:title>Objective</jats:title> <jats:p>This study aims to map ML applications in health care cybersecurity against the National Institute of Standards and Technology Cybersecurity Framework version 2.0, summarize ML performance, and identify research gaps and implementation considerations.</jats:p> </jats:sec> <jats:sec sec-type="methods"> <jats:title>Methods</jats:title> <jats:p>A systematic search of Ovid MEDLINE, Embase, and Scopus was conducted on July 30, 2025, for studies between 2019 and 2025. Eligible studies applied ML-based approaches to organizational-level cybersecurity in health care settings, with outcomes related to data privacy or cybersecurity strengthening. Studies on smart devices, blockchain, or those lacking empirical data were excluded. Title and abstract and full-text screening were conducted independently by 2 (KR and SZ) reviewers following the Arksey and O’Malley f
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Journal articleAlagha MA, Gupta R, Jordan C, et al., 2026,
The effect of impaction energy and bone quality on cementless femoral implant fixation and femoral periprosthetic fracture risk
, Bone & Joint Research, ISSN: 2046-3758 -
Journal articleRiley A, Doughty H, Edward Hill J, et al., 2026,
Barriers to and facilitators of the implementation of Community Health Worker programmes in high-income countries: a systematic review
, BMC Health Services Research, ISSN: 1472-6963Abstract Background: Global interest in Community Health Workers (CHWs) is rising as health systems seek to address persistent health inequities and the social determinants of health. However, in high-income countries (HICs), CHW implementation remains fragmented. This systematic review synthesises evidence on the factors that act as barriers and facilitators to the implementation and integration of CHW programmes across HIC primary healthcare settings.Methods: We searched MEDLINE, Scopus, PsycINFO, and CINAHL for studies published between January 2001 and August 2025. Inclusion focused on qualitative, quantitative, and mixed-methods papers regarding CHW implementation in HICs. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Data were synthesised using a ‘Best Fit’ Framework Synthesis and confidence in the findings was assessed via GRADE-CERQual.Results: Seventy-two papers were included (US n=64; UK n=4; Australia n=3; Belgium n=1), primarily comprising qualitative and mixed methods designs. Key facilitators included leadership buy-in, the presence of implementation champions, and established community partnerships that enabled resource sharing. Prominent barriers included precarious, short-term funding models that prioritised quantitative outputs over relational labour; hierarchical medical power dynamics; and disconnected IT systems that necessitated redundant data entry. The COVID-19 pandemic acted as a catalyst, elevating the CHW role within public health infrastructure while simultaneously exposing digital divides and structural fragility. GRADE-CERQual ratings indicated high confidence in findings regarding funding sustainability, training, and integration.Conclusions: The evidence synthesised in this review reveals a fundamental misalignment within current health services: while CHWs are valued for their unique relational capacity, they remain systemically undermined by transactional health system designs. Achie
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Journal articleChapman M, Knikman JE, Mobley A, et al., 2026,
Personalised approach to hypertension treatment: protocol for the HYPERMARKER randomised controlled trial.
, BMJ Open, Vol: 16INTRODUCTION: Blood pressure treatment response is variable in individual patients, and the choice of medical therapy is often dependent on clinician experience. Treatment choices could be personalised by patient empowerment and metabolomic profiles, and augmented by machine learning, but robust evaluation is lacking on how these can be combined to enhance clinical effectiveness. The HYPERMARKER trial will evaluate how an individualised choice of medication class can address the avoidable global health and economic burdens of hypertension. METHODS AND ANALYSIS: The HYPERMARKER trial is a proof-of-concept, pragmatic, multicentre, adaptive, open-label strategy trial embedded into routine clinical practice with stratified individual patient randomisation. The trial was co-designed with a patient and public involvement team. The intervention is a digital portal that supports shared decision-making on hypertension therapy class using clinical features plus metabolomic profiles determined with liquid chromatography-mass spectrometry.Eligible patients are aged≥18 years with a systolic blood pressure≥140 mm Hg and a clinical indication for antihypertensive therapy. 400 participants will be randomised to the usual standard of care for treatment selection or to the intervention group. Remote follow-up will occur through a patient smartphone application and linked blood pressure monitor to assess the primary outcome of change in home systolic blood pressure during a 4-week period after medication changes. Secondary outcomes will include patient-reported adverse effects and quality of life, treatment withdrawal, healthcare utilisation and a health economic analysis. In the second phase of the trial, all participants will receive an updated version of the intervention regardless of the original randomised group. ETHICS AND DISSEMINATION: Ethical approval will be obtained for all sites. Approval in England: North West - Greater Manchester West Research Ethics Committ
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Journal articleSounderajah V, Guni A, Liu X, et al., 2026,
Author Correction: The STARD-AI reporting guideline for diagnostic accuracy studies using artificial intelligence.
, Nat Med -
Journal articleAsfand-E-Yar B, Jafar AJN, Harris M, et al., 2026,
Frugal and reverse innovations in emergency medicine: a concepts piece.
, Emerg Med JWe suggest that low-cost innovations, termed as frugal, when diffused from low-income and middle-income countries to high-income countries, offer an opportunity to diversify sources of ideas and solutions in emergency medicine. We outline examples from a preliminary search of the literature, consider the barriers faced by such innovations and suggest what needs to be done to improve their chances of being considered for use in emergency medicine.
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Journal articleChen S, Banstola A, Junghans Minton C, et al., 2026,
Decision analytic models in the economic evaluation of community health worker programmes globally: a systematic review
, BMJ Global Health, Vol: 11, ISSN: 2059-7908Introduction: Economic evidence on Community Health Worker (CHW) programmes is crucial for scaling these initiatives. Although Decision-Analytic Models (DAMs) are essential for projecting long-term value, it is unclear how rigorously they have been applied to CHW evaluations, potentially compromising the reliability and comparability of cost-effectiveness estimates used for policy decisions.Methods: A systematic review was conducted to identify full economic evaluations of CHW-led or CHW-integrated interventions that employed a DAM. Following PRISMA guidelines, six databases (Medline, Embase, Global Health, CINAHL, Web of Science and Scopus) were searched from inception to June 2025. Eligible studies were full economic evaluations assessing CHW-led or CHW-integrated interventions using DAMs. Study selection and data extraction were conducted independently by two reviewers. Methodological quality was appraised using the Philips checklist, and data were extracted on model type, data sources, and validation practices. Findings were synthesised narratively across model structures, income groups, and quality domains.Results: Thirty-seven studies met the inclusion criteria. Decision trees were used in 32% of studies and Markov models in 30%, with the remainder applying microsimulation, dynamic transmission or hybrid approaches. Most evaluations were undertaken in low- and middle-income countries (LMICs), with few from low-income or high-income settings. Data constraints in low-income settings limited model complexity, whereas models in high-income settings tended to adopt more sophisticated structures but narrower intervention scopes. The mean quality score was 67%, with substantial gaps in model validation and limited exploration of structural uncertainty. Overall, 84% of studies concluded that CHW-led interventions were cost-effective, with ICERs generally favourable across settings.Conclusion: Although CHW interventions are generally cost-effective, the strength of thi
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Journal articleBatcup C, Almukhtar A, Menon A, et al., 2026,
Exploring the overuse of non-sterile gloves in operating theatres: a cross-sectional survey and interview study
, BMJ Open, Vol: 16, ISSN: 2044-6055Objectives: To identify factors influencing unnecessary non-sterile glove use in operating theatres, and to estimate how common these factors are across the UK.Design: Mixed-methods study using interviews and a cross-sectional survey.Setting: Imperial College Healthcare Trust for interviews, and nationally across the UK for the survey. Participants: 19 interviewees and 329 survey respondents, all clinical staff working in UK operating theatres.Outcome measures: Barriers and facilitators to unnecessary non-sterile glove use in operating theatres.Results: The findings highlight a combination of key drivers leading to the unnecessary use of non-sterile gloves: (1) lack of prioritisation of sustainability, (2) fears around negative patient outcomes, (3) strong social influences such as norms to use gloves, (4) the absence of clear guidelines and limited training on glove use, (5) availability of alternatives and quality of gloves, and (6) beliefs about personal safety and habitual glove use. Respondents also suggested potential intervention strategies.Conclusions: 67% of participants reported using gloves unnecessarily. Our findings highlight the role of habitual behaviour, social influences and unclear guidelines in driving this practice. Interventions should address these factors, for example by clearly communicating when gloves should and should not be worn, encouraging changes to local social norms towards waste reduction, improving access to hand gel, and supporting habit change to reduce unnecessary glove use and associated environmental impact.
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Journal articleReka H, van Kessel R, Mossialos E, et al., 2026,
Private health insurance in Gulf Cooperation Council countries: A scoping review.
, Health Policy Open, Vol: 10Private Health Insurance (PHI) in Gulf Cooperation Council (GCC) countries has experienced rapid growth over the past two decades, driven by demographic and economic changes. Although various analyses at the country level have been reported, no study has reviewed PHI systems in the GCC through a methodological approach. We provide a conceptual framework to review, describe and document the development of PHI in the GCC, based on literature from the scoping review. As of December 2023, all GCC countries have laws in place or have promulgated laws establishing mandatory PHI schemes. Most of these schemes are designed for expatriate populations residing in these countries, but there is a trend to extend them to nationals working in the private sector. The health system context plays a role in how PHI emerged and is designed in terms of role, eligibility, and coverage. PHI markets in the region are concentrated and dominated by local companies with performance levels that could be further improved. These markets are maturing and subject to more robust technical and prudential regulations as governments seek to enhance competition. Governments in the region must ensure the sustainable growth of these schemes and a more strategic alignment with health system objectives. Lessons learned from more mature markets are critical for future developments.
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Journal articleKyriopoulos I, Mossialos E, 2026,
Patient-physician sex concordance in cardiovascular care: context matters.
, Eur Heart J Qual Care Clin Outcomes -
Journal articleOdedra R, Mayer E, 2026,
Understanding how language barriers in the paediatric emergency care setting influences safety of care delivery: a scoping review
, Emergency Medicine Journal, ISSN: 1472-0205Background: Communication in a family’s primary language can support safe care. Vital steps within the care delivery process are contingent upon successful communication, including reporting symptoms, clinical decision-making, informed consent, discharge communication, and follow-up coordination. The importance of effective information exchange is particularly pronounced in paediatric emergency care, and complex interactions may arise as parents or carers advocate on behalf of children. This scoping review aimed to identify and map existing research indicating where along the care journey communication-related risks for safety lie during paediatric emergency care and what strategies exist to mitigate them. Methods: We searched MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library for studies which examined the influence of language barriers on patient safety in paediatric emergency care, as well as studies that evaluated interventions. Bibliographic database searches were executed on 18/12/2024; retrieved records were independently screened by two authors at title and abstract level followed by full text level. Data on study objectives, population characteristics, study design, and their key findings were extracted. Results: 1578 articles were identified, of which 33 were included and mapped according to (i) studies reporting safety risks linked to language barriers in paediatric emergency care (n = 24) and (ii) existing interventions designed to mitigate these risks (n = 9). Studies highlighted that language barriers can influence safety at multiple stages of the emergency care pathway, with discharge most frequently reported as a point of risk for paediatric patient safety. Interventions focused primarily on usage, uptake, and documentation of professional interpreter services.Conclusion: Addressing misunderstandings around follow-up and home-care advice during medical safety netting are priority areas for intervention. Future research should
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Journal articleLatif A, Al Janabi N, Joshi M, et al., 2026,
Feedback from wearable devices accelerates recovery after breast cancer surgery.
, Eur J Surg Oncol, Vol: 52BACKGROUND: Axillary surgery for breast cancer is frequently associated with upper-limb morbidity, impacting quality of life. Structured exercise improves outcomes, but access to physiotherapy is inconsistent. Wearable devices offer objective post-operative monitoring and the potential for real-time rehabilitation support. This study aims to assess the impact of wearable-driven feedback on upper-limb recovery after axillary surgery, and to evaluate the usability, adherence, and acceptability of wearables during post-operative rehabilitation. METHODS: In this prospective observational cohort study, patients undergoing axillary surgery at a tertiary breast unit were equipped with wearable devices to monitor upper-limb activity. Participants were allocated to basic-feedback (BF; fixed 60-min goal) or dynamic-feedback (DF; personalised weekly clinician-adjusted goals). Recovery was defined as post-operative activity relative to pre-operative baseline. An earlier prospective no-feedback (NF) cohort served as comparator. RESULTS: Forty-nine patients were included: 10 DF, 10 BF, and 29 NF. Adherence was high (mean compliance 89.4%, SD 17.9). By postoperative day (POD) 8, DF patients exceeded baseline activity (103.2%, SD 30.6), outperforming BF (80.2%, SD 13.9) and NF (86.2%, SD 55.8). Recovery plateaued earliest in DF (POD 4), followed by BF (POD 5) and NF (POD 7). Among SLNB-only patients, DF recovered faster than NF, while BF and NF showed similar trajectories. CONCLUSIONS: Clinician-guided, wearable-driven feedback significantly accelerates upper-limb recovery following axillary surgery. These findings support further evaluation of this approach in larger randomized trials to determine clinical and cost-effectiveness.
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Journal articlevan Kessel R, Anderson M, McMillan B, et al., 2026,
Omission and hallucination prevalence of clinical guidelines in diagnostic large language model outputs.
, BMJ Health Care Inform, Vol: 33OBJECTIVE: Meaningful assessments of how large language models (LLMs) incorporate clinical guidelines require large-scale testing over many queries. Here, we evaluate the prevalence of clinical guideline omissions and hallucinations in a large sample of diagnostic LLM outputs. METHODS: We used simulated case vignettes and zero-shot prompting to generate diagnostic outputs and rationales from GPT-4.1 and DeepSeek-V3. English case vignettes were created for hypercholesterolaemia and type-2 diabetes mellitus. Each vignette contained identical medical information, while sociodemographic characteristics varied in terms of sex, ethnicity and location. We calculated the prevalence of existing and hallucinated clinical guidelines in LLM outputs across disease, LLM and sociodemographic characteristics. RESULTS: We analysed a total of 12 197 LLM outputs, which quantifies three hazard areas: omissions (up to 97% for DeepSeek-V3 and 46% for GPT-4.1), hallucinations (up to 9%) and inconsistencies (guideline citation rate ranging from 0% to 78.39% across sociodemographic vignettes). Omission and hallucination rates were generally similar across vignettes with different sex or ethnicity data, yet were particularly sensitive to patient location. DISCUSSION: This study highlights significant variability in clinical guideline prediction across two different diseases, three different sociodemographic variables and two LLMs, even when the LLMs were instructed by identical prompts, establishing clinical guideline prediction in LLM outputs as a stochastic event. CONCLUSION: The stochastic nature of LLMs creates a unique challenge for evidence generation and clinical deployment. Being able to measure and capture this stochasticity within high-quality research designs will be a prerequisite to advancing the responsible deployment of LLMs in healthcare.
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Journal articleMachado S, Bobotis S, Loupy A, et al., 2026,
Best practices along the kidney transplantation clinical journey
, Frontiers in Transplantation, Vol: 5, ISSN: 2813-2440Background: Kidney transplantation (KTx) practices vary across healthcare systems, yet the operational components of best practice (BP) along the clinical pathway remain incompletely defined. This study aimed to identify key best practice elements across the kidney transplantation journey in four European countries.Methods: A mixed-methods study was conducted across France, Germany, Italy, and Spain. A structured survey (n = 253 respondents, including patients, living donors, nephrologists, transplant surgeons, transplant coordinators, and hospital administrators) assessed clinical practice and patient experience across four domains: CKD management, kidney donation and transplantation, transplant recipient care, and service governance. Semi-structured focus group interviews were performed in each country to contextualise survey findings. Ethics approval was obtained in accordance with national requirements.Results: Key elements for best practices along the KTx clinical journey were identified: (1) development of protocols to standardise the variable monitoring of CKD, to minimize urban-rural differences in clinical practice due to limited resources and follow-up care; (2) enhanced primary care training and targeted resource allocation to diagnose and monitor early-stage CKD; (3) donor coordination and promotion of living donation, addressing gaps in patient awareness and access to care; (4) development of communication protocols on living donation; (5) implementation of targeted patient and donor educational campaigns on living donation; (6) enhanced post-transplant follow-up care by nephrologists; (7) integration of quality-of-life assessments and psychological donor support post-transplantation; (8) increased availability of transplant coordinators to promote equitable resource allocation and the adoption of innovative practices; (9) streamlined governance structures along clinical journey; and (10) equitable funding models with consistent reimbursem
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Journal articleBatcup C, Almukhtar A, Menon A, et al., 2026,
Barriers and enablers to sustainable anaesthetic practice: a mixed-methods study
, British Journal of Anaesthesia, Vol: 136, Pages: 1190-1201, ISSN: 0007-0912BackgroundAnaesthetic practices contribute significantly to the environmental impact of healthcare. Using local or regional anaesthesia instead of general anaesthesia, and TIVA instead of inhalation anaesthesia, can reduce this impact. This study investigated why general anaesthesia is sometimes used over local and regional anaesthesia, and why inhalation agents are often chosen over TIVA.MethodsWe conducted a mixed-methods study in the UK (June 2023–April 2024), underpinned by the Theoretical Domains Framework. Semi-structured interviews (n=19) with anaesthetists, surgeons, and nurses of differing seniority were analysed using Framework Analysis. A national survey (n=347), distributed via posters and professional networks, was developed from early interview findings. Quantitative data were analysed descriptively and open-text responses were coded using the qualitative framework.ResultsFour key themes were identified: (1) contextual factors affecting anaesthesia decision making; (2) patient differences and preferences; (3) influence of key decision makers on anaesthesia choice; and (4) default practices and lack of confidence in alternatives. These encompassed 17 subthemes and mapped to 9 of 14 Theoretical Domains Framework domains.ConclusionsThis study provides new insights into behavioural influences underlying anaesthetic practice, which can inform the design of interventions to improve the sustainability of anaesthesia, without compromising patient safety and comfort. Addressing systemic and behavioural barriers through dedicated local anaesthesia operating lists, improved patient communication, targeted training, and supportive technologies may enhance efficiency while promoting safe, sustainable, patient-centred practice. Future interventions should be co-designed with surgeons, anaesthetists, and patients to ensure clinical acceptability, feasibility, and sustainability.
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Journal articleChen F, Cooper J, Acharya A, et al., 2026,
The Impact on Audience Engagement of Coordinating a Public Health Campaign on Antimicrobial Resistance Through a Network of Health Content Creators: Longitudinal Observational Study.
, JMIR Public Health Surveill, Vol: 12BACKGROUND: Antimicrobial resistance (AMR) is a significant global health threat. Several public health campaigns aimed to raise AMR awareness and inspire related behavioral changes have been delivered in a time-specific, coordinated manner, while others have placed less emphasis on campaign timing. Social media platforms can be leveraged as key vehicles for delivering public health campaigns, particularly by collaborating with health content creators who serve as influential messengers. Increasingly, organizations such as the World Health Organization and TikTok have created health content creator networks; however, the impact of such networks in public health campaigns, especially when delivered in a coordinated, time-specific manner, remains uncertain. OBJECTIVE: This study aimed to investigate whether mobilizing an established health content creator network to create social media content on the topic of AMR, released in a coordinated, time-specific manner, can have an impact on audience engagement. METHODS: We conducted a longitudinal observational study evaluating the effect of a coordinated social media campaign ("Pulse") on YouTube, delivered by an established health content creator network during an international event on AMR. Members of the network prepared and coordinated the release of AMR-related videos. Engagement analytics were evaluated 6 months after release. The engagement with each campaign video was compared with that for a similar noncoordinated video and with the average engagement of the same creators. RESULTS: Around the day of the Pulse campaign on September 26, 2024, 18 campaign videos were released across 14 YouTube channels. Compared with paired videos, Pulse videos were not associated with higher view counts (incidence rate ratio [IRR] 0.98, 95% CI 0.44-2.13; P=.95) or like counts (IRR 1.10, 95% CI 0.48-2.41; P=.81) but were associated with significantly higher comment counts (IRR 2.99, 95% CI 1.02-8.52; P=.03). When compared wi
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Journal articleCosta Marinho M, Aldossary H, Nair P, et al., 2026,
From Brazil to the UK and back: Bidirectional learning through community health worker partnerships.
, BMJ LeadBACKGROUND/AIM: Bidirectional learning as a means to mutually benefit the exchange of knowledge across settings is a powerful approach for strengthening health systems globally. This paper presents a case study of bidirectional learning through community health worker (CHW) programmes, focusing on the long-established Brazilian Family Health Strategy, particularly CHWs and their adaptation in the UK as Community Health and Wellbeing Workers. METHODS: We explore the central role of equitable collaborative partnerships and inclusive leadership in enabling effective bidirectional learning, emphasising principles of coproduction, shared capacity building and cultural competency. Drawing on experiences from the Brazilian and UK stakeholders, including health ministries, academic institutions and local governments, we highlight practical strategies to navigate challenges such as power imbalances, differing health system contexts and operational barriers. RESULTS: Key facilitators of successful bidirectional learning include establishing clear shared goals, cultivating trust, creating spaces for continuous dialogue and enabling joint learning opportunities such as exchange visits, workshops and training. These findings advance understanding of how global health partnerships can foster innovation, enhance equity and support sustainable health system strengthening. This is the first documented case of formalised CHW bidirectional learning between Brazil and the UK, offering a novel case for global health collaboration. CONCLUSION: Our experience highlights the importance of intentional, structured and ethically grounded partnerships that respect diverse knowledge systems and ensure mutual benefit. This approach has broad applicability for international health and leadership collaborations, aiming to improve community health outcomes worldwide.
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