BACKGROUND: Individuals at high risk for type 2 diabetes are also at an increased risk for developing cardiovascular disease (CVD). Although there are separate trials examining the effects of lifestyle interventions on absolute CVD risk among people at high risk for type 2 diabetes, a comprehensive evidence synthesis of these trials is lacking.
OBJECTIVE: We will systematically synthesize the evidence on the effects of lifestyle interventions in reducing absolute CVD risk and CVD risk factors among people at high risk for type 2 diabetes.
METHODS: We adhered to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) statement in reporting the details of this protocol. Randomized controlled trials of diabetes prevention that examined the effects of lifestyle interventions for at least 6 months on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes will be eligible. We will systematically search the MEDLINE, Embase, PsycINFO, CENTRAL, and Scopus databases and ClinicalTrials.gov using a mix of Medical Subject Headings and text words. Two authors will independently screen the abstract and title of the articles retrieved from the search, followed by full-text reviews using the inclusion and exclusion criteria and data extraction from the eligible studies. Article screening and data extraction will be performed in the Covidence software. The primary outcome will be the changes in absolute 10-year CVD risk, as estimated by risk prediction models. The secondary outcomes are the changes in CVD risk factors, including behavioral, clinical, biochemical, and psychosocial risk factors, and incidence of type 2 diabetes.
RESULTS: An initial database search was conducted in July 2023. After screening 1935 articles identified through the database search, 42 articles were considered eligible for inclusion. It is anticipated that the study findings will be submitted for publication in a peer-reviewed journal by the end of 2024.
CONCLUSIONS: This study will provide up-to-date, systematically synthesized evidence on the effects of lifestyle interventions on absolute CVD risk and CVD risk factors among individuals at high risk for type 2 diabetes.
BACKGROUND: PROSPERO CRD42023429869; https://tinyurl.com/59ajy7rw.
UNASSIGNED: DERR1-10.2196/53517.

BACKGROUND: Governments and public health agencies worldwide experienced difficulties with social media-mediated infodemics on the internet during the COVID-19 pandemic. Existing public health crisis communication strategies need to be updated. However, crisis communication experiences of governments and public health agencies worldwide during the COVID-19 pandemic have not been systematically compiled, necessitating updated crisis communication strategies.
OBJECTIVE: This systematic review aims to collect and organize the crisis communication experiences of senders (ie, governments and public health agencies) during the COVID-19 pandemic. Our focus is on exploring the difficulties that governments and public health agencies experienced, best practices in crisis communication by governments and public health agencies during the COVID-19 pandemic in times of infodemic, and challenges that should be overcome in future public health crises.
METHODS: We plan to begin the literature search on May 1, 2024. We will search PubMed, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, Communication Abstracts, and Web of Science. We will filter our database searches to search from the year 2020 and beyond. We will use a combination of keywords by referring to the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) tool to search the abstracts in databases. We intend to include qualitative studies on crisis communication by governments and public health agencies (eg, officials, staff, health professionals, and researchers) to the public. Quantitative data-based studies will be excluded. Only papers written in English will be included. Data on study characteristics, study aim, participant characteristics, methodology, theoretical framework, object of crisis communication, and key results will be extracted. The methodological quality of eligible studies will be assessed using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A total of 2 independent reviewers will share responsibility for screening publications, data extraction, and quality assessment. Disagreement will be resolved through discussion, and the third reviewer will be consulted, if necessary. The findings will be summarized in a table and a conceptual diagram and synthesized in a descriptive and narrative review.
RESULTS: The results will be systematically integrated and presented in a way that corresponds to our research objectives and interests. We expect the results of this review to be submitted for publication by the end of 2024.
CONCLUSIONS: To our knowledge, this will be the first systematic review of the experiences of governments and public health agencies regarding their crisis communication to the public during the COVID-19 pandemic. This review will contribute to the future improvement of the guidelines for crisis communication by governments and public health agencies to the public.
BACKGROUND: PROSPERO CRD42024528975; https://tinyurl.com/4fjmd8te.
UNASSIGNED: PRR1-10.2196/58040.

OBJECTIVE: Pregnancy is a known risk factor for Pituitary Apoplexy (PA) but there is a lack of consistency in the literature regarding non-gestational risk factors responsible for PA.
METHODS: We did a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify the non-gestational risk factors associated with the development of PA in adult patients with pituitary adenoma. Also, we discuss here a case of an elderly female with pituitary macroadenoma who was initially planned for pituitary resection electively but underwent emergency surgery after she developed PA.
RESULTS: As per screening and eligibility criteria, seven studies with 4937 study participants were included in this systematic review out of which 490 (9.92%) patients had PA, including asymptomatic subclinical PA (SPA) and symptomatic clinical PA (CPA). The macroadenomas and negative staining of the tumor were found to be a significant risk factor consistently in multivariate analysis in three and two retrospective studies, respectively. However, the results were varied for any significant difference in the risk factors for apoplexy between SPA and CPA. Similarly, there was no consistency among the studies for risk factors significantly responsible for CPA or PA compared to controls.
CONCLUSIONS: No single non-gestational risk factor is solely responsible for the development of PA in a pituitary adenoma compared to the control population. Tumor size (macroadenoma) and the non-functioning status of the adenoma are the only significant factors contributing independently toward an apoplectic event in most patients. Such patients can be prioritized for early pituitary tumor resection.

BACKGROUND: This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL) and psychological well-being of unaccompanied minors (UM).
METHODS: PubMed, Scopus, Embase, ProQuest, PsycInfo, PsycArticles, and Open Dissertations databases were used to identify quantitative and qualitative studies. The Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Programme (CASP) tools were used for quality assessment. Narrative synthesis and qualitative research synthesis were carried out to collate the findings.
RESULTS: 18 studies were included. Two studies examined QoL, and five studies examined acceptability of interventions. Most quantitative studies (n = 10) were appraised as methodologically weak. Trauma-Focused CBT appears to have the most evidence demonstrating effectiveness in ameliorating symptoms of post-traumatic stress disorder, depression, and anxiety. Promising findings (i.e., increased mindfulness and psychological flexibility) were observed for third wave interventions but further replication is required.
CONCLUSIONS: The literature is tainted by under-powered studies, lacking blinding, and follow-up assessments. Female UM remain largely underrepresented. This review calls for a drastic augmentation of high quality quantitative and qualitative research focusing on augmenting QoL and examining acceptability rather than merely aiming for psychological symptom reduction in UM to enhance overall well-being and functionality. The research protocol was registered in PROSPERO (registration number: CRD42021293881).

OBJECTIVE: Thirst is a symptom of dehydration and one of the main complications affecting postoperative outcomes and comfort. Persistent water scarcity can have a detrimental effect on the cognitive function and psychology of patients. However, the current evidence about the prevalence and risk factors for postoperative thirst is not fully understood. Therefore, this study aims to investigate the prevalence and risk factors of postoperative thirst and provide guidance for clinical practice.
METHODS: Systematic review and meta-analysis.
METHODS: We searched PubMed, Cochrane Library, Web of Science, Embase, Clinicaltrials.gov, China National Knowledge Infrastructure, and Wanfang Database. Eligible studies were evaluated using the Agency for Healthcare Research and Quality. The collected data were pooled and analyzed using Stata15.0.
RESULTS: A total of 11 cross-sectional studies were included involving 20,612 patients. Eight studies reported prevalence and the pooled prevalence of postoperative thirst was 76.8% (95% confidence interval [CI]: 0.664 to 0.858). Five studies contributed to meta-syntheses of risk factors for postoperative thirst. The results indicated that sex (odds ratio [OR] = 1.44, 95% CI = 1.13 to 1.84, I2 = 80.2%, P = .006), anesthesia drug (OR = 1.48, 95% CI = 1.06 to 2.06, I2 = 94.8%, P < .001), surgical type (OR = 0.66, 95% CI = 0.49 to 0.9, I2 = 77.9%, P = .004) were statistically associated with postoperative thirst.
CONCLUSIONS: Our study shows a high prevalence of postoperative thirst. Sex, anesthesia drug, and surgical type are risk factors that influence postoperative thirst. Nurses and other health care professionals should routinely assess the postoperative thirst of patients and perform targeted interventions to alleviate their distressing symptoms and improve the quality of care.

Infusions of home parenteral nutrition (HPN) are often cycled at night coinciding with sleep episodes. Adult consumers of HPN are known to experience poor sleep attributed to frequent awakenings and long durations of wakefulness after falling asleep. Consequently, most consumers do not meet recommendations for sleep duration and quality or daytime napping. The primary underlying pathophysiology resulting in sleep problems is nocturia; however, other factors also exist, including disruptions caused by medical equipment (ie, pump alarms), comorbid conditions, dysglycemia, and medication use. Early guidance on sleep is imperative because of the central role of sleep in physical health and wellbeing, including mitigating complications, such as infection risk, gastrointestinal problems, pain sensitivity, and fatigue. Clinicians should routinely inquire about the sleep of their patients and address factors known to perturb sleep. Nonpharmacologic opportunities to mitigate sleep problems include education on healthy sleep practices (ie, sleep hygiene); changes in infusion schedules, volumes, rates, and equipment; and, possibly, behavioral interventions, which have yet to be examined in this population. Addressing comorbid conditions, such as mood disorders, and nutrition deficiencies may also help. Pharmacologic interventions and technological advancement in HPN delivery are also needed. Research on sleep in this population is considered a priority, yet it remains limited at this time.

UNASSIGNED: To conduct a systematic review on the effects of multisectoral interventions for health on health system performance.
UNASSIGNED: We conducted a systematic review according to the preferred reporting items for systematic review and meta-analysis protocols. We searched for peer-reviewed journal articles in PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Database of Systematic Reviews on 31 August 2023 (updating on 28 February 2024). We removed duplicates, screened titles and abstracts, and then conducted a full-text eligibility and quality assessment.
UNASSIGNED: We identified an initial 1118 non-duplicate publications, 62 of which met our inclusion and exclusion criteria. The largest proportions of reviewed studies focused on multisectoral interventions directly related to specific health outcomes (66.1%; 41 studies) and/or social determinants of health (48.4%; 30 studies), but without explicit reference to overall health system performance. Most reviewed publications did not address process indicators (83.9%; 52/62) or discuss sustainability for multisectoral interventions in health (72.6%; 45/62). However, we observed that the greatest proportion (66.1%; 41/62) considered health system goals: health equity (68.3%; 28/41) and health outcomes (63.4%; 26/41). Although the greatest proportion (64.5%; 40/62) proposed mechanisms explaining how multisectoral interventions for health could lead to the intended outcomes, none used realistic evaluations to assess these.
UNASSIGNED: Our review has established that multisectoral interventions influence health system performance through immediate improvements in service delivery efficiency, readiness, acceptability and affordability. The interconnectedness of these effects demonstrates their role in addressing the complexities of modern health care.
UNASSIGNED: Réaliser une revue systématique consacrée à l\'impact des interventions multisectorielles sur la performance des systèmes de santé.
UNASSIGNED: Nous avons procédé à une revue systématique en appliquant les éléments de rapport privilégiés dans les protocoles de revues systématiques et méta-analyses. Nous avons exploré PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature, ainsi que la Base de données Cochrane des revues systématiques le 31 août 2023 (mise à jour le 28 février 2024), à la recherche d\'articles de revue évalués par des pairs. Ensuite, nous avons supprimé les doublons, passé les titres et résumés au crible, puis déterminé la qualité et l\'admissibilité des articles complets.
UNASSIGNED: Nous avons initialement identifié 1118 publications non dupliquées; 62 d\'entre elles répondaient à nos critères d\'inclusion et d\'exclusion. Une grande partie des études examinées portaient sur des interventions multisectorielles en lien direct avec des résultats de santé spécifiques (66,1%; 41 études) et/ou des déterminants sociaux de la santé (48,4%; 30 études), sans toutefois faire explicitement référence à la performance globale des systèmes de santé. La majorité des publications ne mentionnaient aucun indicateur de processus (83,9%; 52/62) et n\'abordaient pas la durabilité des interventions multisectorielles dans le domaine de la santé (72,6%; 45/62). Nous avons néanmoins constaté qu\'en général, elles tenaient compte des objectifs relatifs aux systèmes de santé (66,1%; 41/62): l\'équité en santé (68,3%; 28/41) et les résultats de santé (63,4%; 26/41). Bien que la plupart (64,5%; 40/62) proposent des mécanismes visant à expliquer comment les interventions multisectorielles en matière de santé pourraient amener aux résultats escomptés, aucune n\'avait recours à des évaluations réalistes pour les mesurer.
UNASSIGNED: Notre revue nous a permis d\'établir que les interventions multisectorielles influençaient la performance des systèmes de santé à travers des améliorations immédiates en termes d\'efficacité, de disponibilité, d\'acceptation et d\'abordabilité des prestations de services. L\'interdépendance entre ces effets témoigne de l\'importance qu\'ils revêtent lorsqu\'il s\'agit d\'appréhender les rouages complexes des soins de santé modernes.
UNASSIGNED: Realizar una revisión sistemática sobre los efectos de las intervenciones multisectoriales en favor de la salud sobre el rendimiento de los sistemas sanitarios.
UNASSIGNED: Se realizó una revisión sistemática de acuerdo con los ítems de informe preferidos para los protocolos de revisión sistemática y metanálisis. Se realizaron búsquedas de artículos de revistas con revisión por pares en PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature y la Base de Datos Cochrane de Revisiones Sistemáticas el 31 de agosto de 2023 (actualización el 28 de febrero de 2024). Se eliminaron los duplicados, se examinaron los títulos y los resúmenes y, a continuación, se realizó una evaluación de la elegibilidad y la calidad del texto completo.
UNASSIGNED: Se identificaron 1118 publicaciones iniciales no duplicadas, 62 de las cuales cumplían los criterios de inclusión y exclusión. El mayor porcentaje de estudios revisados se centró en intervenciones multisectoriales directamente relacionadas con resultados sanitarios específicos (66,1%; 41 estudios) o determinantes sociales de la salud (48,4%; 30 estudios), pero sin referencia explícita al rendimiento general del sistema sanitario. La mayoría de las publicaciones revisadas no abordaron indicadores de proceso (83,9%; 52/62) ni discutieron la sostenibilidad de las intervenciones multisectoriales en salud (72,6%; 45/62). Sin embargo, se observó que el mayor porcentaje (66,1%; 41/62) tenía en cuenta los objetivos del sistema sanitario: equidad sanitaria (68,3%; 28/41) y resultados sanitarios (63,4%; 26/41). Aunque el mayor porcentaje (64,5%; 40/62) propuso mecanismos que explicaban cómo las intervenciones multisectoriales para la salud podían conseguir los resultados previstos, ninguno empleó evaluaciones realistas para evaluarlos.
UNASSIGNED: La revisión que se realizó ha demostrado que las intervenciones multisectoriales influyen en el rendimiento de los sistemas sanitarios a través de mejoras inmediatas en la eficiencia, la disponibilidad, la aceptabilidad y la asequibilidad de la prestación de servicios. La interconexión de estos efectos demuestra su función a la hora de abordar las complejidades de la atención sanitaria moderna.
الغرض إجراء مراجعة منهجية على آثار التدخلات الصحية متعددة القطاعات على أداء النظام الصحي. الطريقة قمنا بإجراء مراجعة منهجية وفقاً للعناصر المفضلة لإعداد التقارير لدى بروتوكولات المراجعة المنهجية والتحليل التلوي. قمنا بالبحث عن مقالات صحفية تمت مراجعتها بواسطة الأقران في قواعد البيانات PubMed®، وScopus، وWeb of Science، وCumulated Index to Nursing (الفهرس التراكمي للتمريض)، وAllied Health Literature (المؤلفات الصحية المساعدة)، وقاعدة بيانات Cochrane للمراجعات المنهجية، في 31 أغسطس/آب 2023 (تم تحديثها في 28 فبراير/شباط 2024). وقمنا بإزالة التكرارات، والعناوين والملخصات التي تم فحصها، ثم أجرينا تقييمًا لجودة النص الكامل ومدى توفر الشروط فيه. النتائج قمنا بتحديد 1118 منشوراً أولياً غير مكرر، استوفت 62 منها معايير الإدراج والاستبعاد لدينا. ركزت النسب الأكبر من الدراسات التي تمت مراجعتها على التدخلات متعددة القطاعات المرتبطة بشكل مباشر بنتائج صحية محددة (%66.1؛ 41 دراسة) و/أو المحددات الاجتماعية للصحة (%48.4؛ 30 دراسة)، ولكن دون إشارة صريحة إلى الأداء العام للنظام الصحي. لم تتناول معظم المنشورات التي تمت مراجعتها مؤشرات العملية (%83.9؛ 52/62)، ولم تناقش استدامة التدخلات متعددة القطاعات في الصحة (%72.6؛ 45/62). ومع ذلك، فقد لاحظنا أن النسبة الأكبر (%66.1؛ 41/62) وضعت في اعتبارها أهداف النظام الصحي: العدالة الصحية (%68.3؛ 28/41) والنتائج الصحية (%63.4؛ 26/41). وعلى الرغم من أن النسبة الأكبر (%64.5؛ 40/62) قد اقترحت آليات تشرح كيف يمكن للتدخلات الصحية متعددة القطاعات أن تؤدي إلى النتائج المنشودة، إلا أنه لم يكن من بين هذه الآليات ما يعتمد على التقييمات الواقعية لتقييم هذه النتائج. الاستنتاج أثبتت المراجعة التي قمنا بها أن التدخلات متعددة القطاعات تؤثر على أداء النظام الصحي من خلال التحسينات الفورية في كفاءة تقديم الخدمة، ودرجة الاستعداد، ودرجة القبول، وإمكانية تحمل تكاليفها. إن الترابط الداخلي بين هذه التأثيرات يوضح دورها في معالجة تعقيدات الرعاية الصحية الحديثة.
UNASSIGNED: 针对多部门卫生干预措施对卫生系统绩效的影响开展系统评价。.
UNASSIGNED: 根据适用于系统评价和荟萃分析方法的首选报告项目，我们开展了系统评价。2023 年 8 月 31 日，我们在 PubMed®、斯高帕斯 (Scopus)、Web of Science、护理和联合卫生文献累积索引 (CINAHL) 以及 Cochrane 系统评价数据库中搜索了经同行评审的期刊文章（2024 年 2 月 28 日更新）。我们删除了重复项，筛选了标题和摘要，然后实施了全文合格性和质量评估。.
UNASSIGNED: 我们初步确定了 1,118 份不重复的期刊文章，其中有 62 份符合我们的纳入和排除标准。在接受系统评价的研究资料中，绝大部分侧重于与特定健康结果直接相关的多部门干预措施（占 66.1%；41 项研究）和/或健康社会决定因素（占 48.4%；30 项研究），但并未明确提及卫生系统的总体绩效。大多数接受系统评价的期刊文章并未提及过程指标（占 83.9%；52/62），或未讨论多部门卫生干预措施的可持续性（占 72.6%；45/62）。但是，据我们观察，绝大部分期刊文章考虑了卫生系统目标（占 66.1%；41/62）：卫生公平（占 68.3%；28/41）和健康结果（占 63.4%；26/41）。尽管绝大部分期文章（占 64.5%；40/62）建议采用解释多部门卫生干预措施如何实现预期结果的机制，但所有文章均未使用现实评估方法来评估这些机制。.
UNASSIGNED: 通过开展系统评价我们可以确定的是，多部门干预措施可立竿见影地提高服务提供效率、推动准备工作、提高可接受性和可负担性，从而影响卫生系统的绩效。这些影响的相互关联性表明了其在解决现代卫生保健复杂性方面所起的作用。.
UNASSIGNED: Провести систематический обзор влияния межотраслевых мероприятий в области здравоохранения на эффективность системы здравоохранения.
UNASSIGNED: В соответствии с предпочтительными пунктами отчетности для протоколов систематических обзоров и метаанализов был проведен систематический обзор. По состоянию на 31 августа 2023 года (обновление на 28 февраля 2024 года) был проведен поиск рецензируемых журнальных статей в базах данных PubMed®, Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature и Cochrane Database of Systematic Reviews. Были удалены дубликаты, проверены названия и резюме статей, а затем была проведена полнотекстовая оценка приемлемости и качества.
UNASSIGNED: Было обнаружено 1118 недублированных публикаций, 62 из которых соответствовали критериям включения и исключения. Наибольшая часть рассмотренных исследований была посвящена межотраслевым мероприятиям, непосредственно связанным с конкретными результатами мероприятий по охране здоровья (66,1%; 41 исследование) и/или социальными детерминантами здоровья (48,4%; 30 исследований), но без прямого указания на общую эффективность системы здравоохранения. В большинстве изученных публикаций не рассматривались показатели процесса (83,9%; 52/62) и не обсуждалась долгосрочная перспектива воздействия межотраслевых мероприятий в сфере здравоохранения (72,6%; 45/62). Однако в наибольшей доле (66,1%; 41/62) из них рассматривались цели системы здравоохранения: обеспечение равенства в вопросах здравоохранения (68,3%; 28/41) и результаты мероприятий по охране здоровья (63,4%; 26/41). Хотя в наибольшей степени (64,5%; 40/62) были предложены механизмы, объясняющие, как межотраслевые мероприятия в сфере здравоохранения могут привести к достижению намеченных результатов, ни в одном из них не использовались реалистичные оценки для их анализа.
UNASSIGNED: Результаты обзора свидетельствуют о том, что межотраслевые мероприятия влияют на эффективность системы здравоохранения путем непосредственного повышения эффективности предоставления услуг, готовности, приемлемости и доступности. Взаимосвязь этих эффектов свидетельствует об их роли в решении сложных проблем современного здравоохранения.

Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. The burden of the disease is heavier in Nigeria than in other endemic countries in Africa. This occurs with increasing morbidity and mortality at different locations within the country, the World Health Organization recommended treatments for lymphatic filariasis include the use of Albendazole (400mg) twice per year in co-endemic areas with loa loa, Ivermectin (200mcg/kg) in combination with Albendazole (400mg) in areas that are co-endemic with onchocerciasis, ivermectin (200mcg/kg) with diethylcarbamazine citrate (DEC) (6mg/kg) and albendazole (400mg) in areas without onchocerciasis. This paper covered a systematic review, meta-analysis, and scoping review on lymphatic filariasis in the respective geopolitical zones within the country. The literature used was obtained through online search engines including PubMed and Google Scholar with the heading \"lymphatic filariasis in the name of the state\", Nigeria. This review revealed an overall prevalence of 11.18% with regional spread of Northwest (1.59%), North Central and North East, (4.52%), South West (1.26%), and South-South with South East (3.81%) prevalence. The disease has been successfully eliminated in Argungu local government areas (LGAs) of Kebbi State, Plateau, and Nasarawa States respectively. Most clinical manifestations (31.12%) include hydrocele, lymphedema, elephantiasis, hernia, and dermatitis. Night blood samples are appropriate for microfilaria investigation. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.

Air pollution is an urgent concern linked to numerous health problems in low- and middle-income countries, where 92% of air pollution-related deaths occur. Particulate matter 2.5 (PM2.5) is the most harmful component of air pollutants, increasing inflammation and changing gut microbiota, favoring obesity, type 2 diabetes, and Alzheimer\'s Disease (AD). PM2.5 contains lipopolysaccharides (LPS), which can activate the Toll-like receptor 4 (TLR4) signaling pathway. This pathway can lead to the release of pro-inflammatory markers, including interleukins, and suppressor of cytokine signaling-3 (SOCS3), which inhibits leptin action, a hormone that keeps the energy homeostasis. Leptin plays a role in preventing amyloid plaque deposition and hyperphosphorylation of tau-protein (p-tau), mechanisms involved in the neurodegeneration in AD. Approximately 50 million people worldwide are affected by dementia, with a significant proportion living in low-and middle-income countries. This number is expected to triple by 2050. This mini-review focuses on the potential impact of PM2.5 exposure on the TLR4 signaling pathway, its contribution to leptin resistance, and dysbiosis that exacerbates the link between obesity and AD.

Grounded in human rights approaches, truth and reconciliation commissions (TRCs) explore an event or process that did widespread and systematic intentional harm to a group of people. Health as a fundamental right is an important component addressed by TRCs. Yet despite TRCs often having recommendations for health care systems, it is unknown how well these recommendations are being translated within health care settings. Therefore, the overarching purpose of our scoping review was to identify academic articles that discussed health care system discourse or responses to TRCs in the context of Indigenous Peoples. Our thematic analysis of the included articles identified three main themes for health care system responses to TRCs: (1) the acknowledgment of multiple ways of knowing, being, and doing in health systems; (2) current interventions as responses within health systems; and (3) suggestions for change within health systems. Although a TRC may create a specific road map and mandate for health care systems, we found considerable variability in the uptake of these actions across institutions. Concerted efforts within and around health care systems and across sectors are therefore necessary to achieve large-scale, meaningful change for Indigenous Peoples post-TRCs and to maintain accountability as a foundational human rights principle.