Diagnostic testing remains the backbone of the coronavirus disease 2019 (COVID-19) response, supporting containment efforts to mitigate the outbreak. The severity of this crisis and increasing capacity issues associated with polymerase chain reaction (PCR)-based testing, accelerated the development of diagnostic solutions to meet demands for mass testing. The National Institute for Health Research (NIHR) Innovation Observatory is the national horizon scanning organization in England. Since March, the Innovation Observatory has applied advanced horizon scanning methodologies and tools to compile a diagnostic landscape, based upon data captured for molecular (MDx) and immunological (IDx) based diagnostics (commercialized/in development), for the diagnosis of SARS-CoV-2. In total we identified and tracked 1608 diagnostics, produced by 1045 developers across 54 countries. Our dataset shows the speed and scale in which diagnostics were produced and provides insights into key periods of development and shifts in trends between MDx and IDx solutions as the pandemic progressed. Stakeholders worldwide required timely and detailed intelligence to respond to major challenges, including testing capacity and regulatory issues. Our intelligence assisted UK stakeholders with assessing priorities and mitigation options throughout the pandemic. Here we present the global evolution of diagnostic innovations devised to meet changing needs, their regulation and trends across geographical regions, providing invaluable insights into the complexity of the COVID-19 phenomena.

Suicide is a leading cause of death worldwide. A previous systematic review showed that regulations limiting access to highly hazardous pesticides (HHPs) were successful in preventing suicides. As the WHO strongly supports regulation of pesticides, we aimed to update and strengthen the evidence on the effectiveness of HHP bans. We conducted a systematic review by searching MEDLINE, Embase, and PsycINFO databases in March 2024 for manuscripts published since 2017 that investigated the effects of regulatory changes limiting access to HHPs on pesticide suicide, at the population level. Two reviewers independently screened titles and abstracts, and extracted data using a standardized form, defined a priori. The study protocol was registered in PROSPERO (CRD42023441247). All nine studies in six Asian countries showed reductions in pesticide suicide rates following HHP bans (range 28.0% to 91.9%), of which six applied time series analyses to account for trends prior to the intervention (reductions in pesticide suicide rates ranged 28.0% to 60.5%). Only five studies assessed overall suicides; of those, four reported decreases in overall suicide rates following the intervention, of which three used time series analysis (range 7.0% to 45.1%). Only one study had a low risk of bias in all domains, with five studies having high risk of bias in at least one of the domains. Restricting access to HHPs leads to declines in both pesticide and overall suicide rates. Findings from this and the previous systematic review provide strong evidence to governments and public health officials that are considering implementing bans on HHPs in order to reduce suicides. However, this review only covered studies published since 2017 and there is a need for data from other regions to investigate the generalisability of this approach.

Background: Mental illnesses contribute to a significant burden of disease in low- and middle- income countries (LMICs). Understanding risk factors for poor mental health is essential to reducing the burden, and for preventative measures to be implemented. The role of socioeconomic position (SEP) in poorer mental health is well established in high income countries, but less is known in LMICs. This study aimed to identify and synthesise epidemiological evidence for the associations between SEP and depression and suicidal ideation in LMICs in Southeast Asia, and to describe the strength and direction of any associations identified. Methods: This systematic review identified evidence by searching four databases in February 2023 (Medline, Embase, PsycInfo and Web of Science), grey literature and reference searching of included papers. Papers were included if they were based in a Southeast Asian LMIC general or hospital populations (= 16 years of age) and explored at least one measure of SEP in association with depression or suicidal ideation. Study quality was assessed using the Joanna Briggs Institute tool. A meta-analysis and narrative synthesis were performed. Results: Fifty-nine papers from six out of nine Southeast Asian LMICs were identified, with education the most commonly examined measure of SEP. Several papers explored more than one measure of SEP. Around half of the papers were rated as higher quality. Meta-analyses of education (OR: 1.87, 95% CI: 1.49-2.35) and working status (OR: 1.30, 95% CI: 0.99-1.71) provided evidence of lower levels of education and not being employed being associated with higher odds of depression. Consistent associations between lower SEP and higher odds of depression were also found for financial difficulty and subjective economic status. Three papers used suicidal ideation as their outcome, and there was some evidence of an association with lower SEP and higher ideation. Conclusions: Evidence indicates that lower SEP is associated with higher likelihood of depression, whereas for suicidal ideation, the evidence available is insufficient to reach a conclusion. The lack of longitudinal studies prevents the temporal nature of these associations being established. Systematic review registration: PROSPERO: CRD42023410444.

Background Women lacking social support during pregnancy often have worse mental health, but we know little about the influence of social support on child development, or the impact for migrant women. We aimed to investigate the association between maternal social support during pregnancy and child development using the Born in Bradford birth cohort. Methods Social support was evaluated using a composite score of items from the baseline pregnancy questionnaire. Outcomes were Communication and Language and Personal, Social and Emotional development school-readiness assessments from the Early Years Foundation Stage Profile (EYFSP, age 4–5 years) and the Strengths and Difficulties Questionnaire (SDQ, age 7–11 years), with associations tested using logistic and linear regression models. We explored the modifying effect of maternal migrant status. Results 3257 and 1413 cohort participants had EYFSP and SDQ outcomes, respectively. Higher levels of social support were associated with better EYFSP outcomes and SDQ scores. One SD higher social support score was associated with 13% lower odds of missing any EYFSP communication and language target (95% CI 0.79 to 0.95); 17% lower for EYFSP personal, social and emotional development (95% CI 0.75 to 0.92) and 0.65 (95% CI −0.98 to –0.32) lower overall SDQ scores, after adjustment for all variables. There was some evidence that maternal migrant status modified associations with SDQ, but not with EYFSP outcomes. Conclusions Greater attention to the role of social support in pregnancy, and its social and cultural context, may be helpful in developing and implementing interventions aiming to improve early childhood development.

Previous work has shown that children 'left-behind' as a consequence of parental migration experience worse outcomes, although the majority of this evidence focuses on short- rather than long-term effects. Using data from the Cebu Longitudinal Health and Nutrition Survey cohort (n = 1651), we assessed the association of paternal emigration (identified based on evidence of remittances sent back by mother's spouse) during childhood with the mental health and educational attainment at age 18 of Filipino children, adjusted for sex, socioeconomic position and paternal education. We explored whether timing of emigration, and household composition modified associations observed. Children who had migrant fathers were found to be 1.24 times more likely to have high educational attainment at age 18 than children who did not have migrant fathers, although the association was imprecise (95 % confidence intervals: 0.83-1.85). We found no statistical evidence of a difference between children who experienced paternal migration compared to those who did not in terms of depressive symptoms or suicidal ideation at age 18. There was evidence that experiencing paternal migration in older childhood (≥10 years) was associated with better mental health. We found evidence that household composition modified associations for depressive symptoms. This study does not suggest a detrimental long-term impact of paternal emigration on children 'left-behind, either for educational attainment or mental health. This may reflect beneficial effects of paternal migration and/or pre-existing socioeconomic and health differences amongst families who do and do not experience paternal migration.

Evidence suggests that associations between educational attainment and mental health may vary according to educational mobility (i.e., changes in educational attainment across generations). This evidence is largely limited to high-income countries. Using data from an ongoing birth cohort (Cebu Longitudinal Health and Nutrition Survey), we assessed the associations with mental health for both own educational attainment and intergenerational educational mobility (i.e., the difference in educational attainment between parents during pregnancy and the offspring aged 18 and 35 years) in 2,038 Filipino individuals. Primary mental health outcomes were depressive symptoms, suicidal ideation and psychological distress at age 35 years, with the former two measures used as secondary outcomes at age 18 years. We used logistic regression models, adjusting for sex and urbanicity at birth. Lower levels of educational attainment at age 35 years were associated with higher odds of depressive symptoms (Odds Ratio (OR): 1.68; 95% CI: 1.11-2.52) and psychological distress (OR: 1.54; 95% CI: 1.09-2.17), but confidence intervals for suicidal ideation crossed the null (OR: 1.43; 95% CI: 0.91-2.26). Participants who had lower educational attainment than their parents at age 35 years (downward educational mobility) had higher odds of depressive symptoms compared to participants where both they and their parents had higher levels of educational attainment (OR: 3.12; 95% CI: 1.46-6.66). There was no statistical evidence of this association for the other outcomes. We also did not find statistical evidence that upward educational mobility was associated with mental health outcomes. Filipino individuals who had lower educational attainment than their parents showed higher levels of depressive symptoms compared to those whose parents and own education were both in the higher education category. We found limited evidence of these associations for other measured mental health outcomes.