Conectar
by Chi Peng Chan, Babaniji Omosule, Courtney Lightfoot, Ellesha A. Smith, Ffion Curtis, James O. Burton, Paul Gardner, Sarah Jasat, Sherna F. Adenwalla, Jyoti Baharani, Daniel S. March
BackgroundChronic pain affects up to 60% of people with chronic kidney disease (CKD), yet remains under-recognised and under-treated. Pain management in this population is complicated by altered drug pharmacokinetics, polypharmacy, and the potential nephrotoxicity of conventional analgesics. Despite the high prevalence and significant impact on quality of life, evidence-based guidance specific to pain management in CKD remains limited.
ObjectivesThis systematic review aims to evaluate the effectiveness and safety of both pharmacological and non-pharmacological interventions in reducing chronic pain intensity among people with CKD on dialysis, not on dialysis, and kidney transplant recipients, across all stages of CKD.
MethodsThe primary outcome is the effectiveness of interventions in reducing chronic pain intensity as assessed by pain assessment tools. We will conduct a comprehensive search of MEDLINE, Embase, CINAHL, Web of Science, and ClinicalTrials.gov from their inception to the present date to identify studies for chronic pain management in people living with CKD. Study screening will be conducted independently by two reviewers. One reviewer will extract data from each study, with a second reviewer cross-checking for accuracy and completeness. Data will be extracted on study characteristics, participant demographics, intervention components, pain outcomes, and adverse events. The certainty of evidence will be evaluated independently by two reviewers using the GRADE approach. Where applicable, data will be combined in meta-analyses using random-effects models. Additionally, a network meta-analysis will be performed if enough studies are available.
Expected resultsThis review will synthesise the current evidence for pain management strategies in CKD, by evaluating effectiveness of interventions among people receiving different renal replacement therapy modalities with varying pain and disease phenotypes. Findings will highlight the comparative effectiveness of various interventions while considering their safety profiles specific to the CKD context. The review will identify gaps in the literature and provide recommendations for clinical practice and future research.
SignificanceThis review seeks to deliver a thorough evaluation of pain management strategies for people living with CKD. This systematic review is supported by the UK Kidney Association (UKKA), and findings will inform the upcoming UKKA guideline on symptoms management in people with CKD, alongside the other symptoms including itch, fatigue, and gastrointestinal symptoms. This review will aid clinicians in making well-informed decisions regarding pain management strategies, ensuring a balance between effectiveness and the specific risks associated with CKD.
Keloids are chronic fibroproliferative skin disorders with high recurrence rates and limited treatment options, yet reliable diagnostic biomarkers are lacking. Current classification systems rely heavily on clinical observation, underscoring the need for objective, noninvasive tools. In this exploratory study, serum-based 1H nuclear magnetic resonance (NMR) measurement combined with short-time Fourier transform (STFT) for time-frequency analysis was performed, followed by principal component analysis (PCA), to investigate potential patient subgroups. Serum samples from 29 patients were analysed and PC1 scores suggested two potential patient subgroups. Retrospective analysis showed that these subgroups differed primarily in keloid aetiology: one group predominantly included cases arising from unclear or minimal causes (e.g., acne, folliculitis), whereas the other comprised cases following clear traumatic events (e.g., surgery). Although most clinical variables showed no significant differences, significant differences in aetiology and Japan Scar Workshop Scar Scale (JSS) scores support the biological relevance of this separation of subgroups. These findings suggest that the time-frequency features of NMR signals from serum samples capture systemic characteristics associated with keloid pathophysiology. If validated in larger cohorts, this approach may serve as a noninvasive adjunct to clinical assessment and lay the foundation for objective patient stratification and precision-guided treatment strategies.
by Yaosen Du, Yiyong Yang, Xiaolong Wu, Pengju Gao, Hanchen Ma
To enhance the efficiency, safety, and data accuracy of drilling engineering, this study developed an integrated business management platform for drilling engineering grassroots units based on the Business Model Driven (BMD) approach. The platform is built on a “five horizontal, three vertical” cloud computing architecture, establishing a five-layer system from the infrastructure layer to the user layer horizontally, and supported by standard specifications, safety, and maintenance systems vertically, enabling collaboration across multiple business scenarios and data integration. Currently, four major modules with over 20 functionalities have been developed, supporting applications such as task coordination, engineering supervision, data analysis, and accident handling. Operational results demonstrate that the platform effectively promotes integrated management of drilling engineering through real-time data sharing, full-process quality control, and intelligent decision-making, thereby enhancing operational quality and safety, reducing accident risks, and providing critical technological support for the digital transformation and upgrading of the drilling industry.Acute pain following pulmonary surgery can affect the recovery process of patients. The use of intrathecal morphine (ITM) injections offers a long-lasting analgesic effect, but its clinical application remains controversial. This study aims to investigate the impact of combining bupivacaine with ITM injections on the quality of postoperative recovery in patients who have undergone pulmonary surgery.
This multicentre, randomised, double-blind, controlled trial will enrol 254 patients undergoing elective lung surgery, who will be randomly assigned in a 1:1 ratio to either group IT (receiving an intrathecal injection of 3 mg bupivacaine and 0.25 mg morphine before general anaesthesia induction) or the control group (C group). The primary outcome includes postoperative recovery quality on day 1 (quality of recovery, QoR-15), with secondary outcomes encompassing postoperative recovery quality on days 2 and 3 (QoR-15), pain scores within 72 hours postoperatively, analgesic rescue, intraoperative haemodynamic parameters, opioid consumption, postoperative adverse reactions, recovery metrics, complications, chronic pain incidence and sleep quality.
The results will be disseminated through peer-reviewed publications. This study protocol (V.2.0, 30 October 2024) involves human participants and has been approved by the Ethics Committee of Affiliated Hospital of Yangzhou University (number 2024-08-02-2), Taicang Hospital Affiliated to Soochow University (number 2025 SR-041) and Yichang Central People’s Hospital (number 2024-513-02). Each individual who agrees to participate in the research will provide written informed consent after the objectives and procedures of this study are explained to them.
ChiCTR2400092935. Registered on 26 November 2024.
Deep vein thrombosis (DVT) of the lower limbs has a significantly higher incidence among elderly populations than that observed in other types of fractures, prolonged immobilisation and the systemic inflammatory response triggered by preoperative pain are the main risk factors. Liposomal bupivacaine (LB) single-injection pericapsular nerve group (PENG) block has demonstrated effective analgesia both before and after surgery, while preserving motor function in patients with hip fracture. Although regional nerve block is a well-established component of preoperative multimodal analgesia, its potential role and underlying mechanisms in the prevention of DVT in elderly patients with hip fracture remain largely unexplored.
This study will be conducted as a double-blind, randomised, sham-controlled, prospective clinical trial. On admission, a total of 132 participants will be randomly assigned using block randomisation to receive either treatment group (LB single-injection PENG block) or sham group (saline solution single-injection PENG block). The primary outcome was the incidence of DVT, while secondary outcomes included perioperative inflammatory and immune-related stress levels and functional-based pain scores.
This study protocol complies with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines and has been approved by the Ethics Committee of Shunde Hospital, Guangzhou University of Traditional Chinese Medicine (Approval No KY-2025005). The raw data are planned to be made publicly available on the ResMan raw data–sharing platform (IPD sharing platform) of the Chinese Clinical Trial Registry in December 2027 and can be accessed at http://www.medresman.org.cn.
ChiCTR2500100799.
This study aimed to investigate the network structural characteristics of self-efficacy and professional resilience among emergency nurses, identify core nodes within the network, and elucidate the key interactive mechanisms between these constructs.
Descriptive cross-sectional study.
A multi-center cross-sectional study was conducted from January to February 2025, involving 612 emergency nurses from 20 hospitals in Sichuan, China. Data were collected using a self-administered demographic questionnaire, the General Self-Efficacy Scale, and the Chinese Emergency Nurse Professional Resilience Tool. An adjacent network integrating professional resilience and self-efficacy was developed. Key covariates—including title, position, tenure in the hospital or emergency department, education, and exposure to workplace violence—were included as control variables. Network precision and stability were evaluated using the correlation stability coefficient and confidence intervals for edge weights. To further test the robustness of the network model, sensitivity analyses were performed by adding each significant covariate to the original model. The Network Comparison Test was then used to compare the covariate-adjusted and unadjusted networks, assessing differences in network structure, overall strength, and edge weights.
The analysis identified S9 as the central node in the network. The overall network showed satisfactory stability and precision. The Network Comparison Test showed no significant differences in network structure or global strength between the adjusted and unadjusted models, indicating that the network was stable and robust to covariate adjustment.
This network analysis revealed the interaction mechanisms between self-efficacy and professional resilience among emergency nurses through contemporaneous network modelling and identified S9 as the core node, suggesting that this coping strategy plays a key role in regulating psychological resources. The overall network demonstrated good stability and precision, with no statistically significant differences between the adjusted and unadjusted models according to the Network Comparison Test. These findings indicate that the network structure was robust to covariate adjustment and provide a reference for developing and optimising intervention strategies to enhance professional resilience among emergency nurses.
For Emergency Nurses and the Management of Emergency Nursing Practice: What problem does this study address?
This study addresses the gap in understanding how self-efficacy and occupational resilience interact in emergency nurses under high-stress conditions.
A contemporaneous network analysis revealed a central node linking self-efficacy and resilience, highlighting key pathways in their mutual influence.
The findings offer practical guidance for emergency nursing management, supporting the development of targeted strategies to strengthen nurses' resilience, enhance professional competence, and improve the quality of emergency care.
This study is reported using the STROBE guidelines.
No Patient or Public Involvement: This study did not include patient or public involvement in its design, conduct, or reporting.
This study focused on the preferences for psychological assistance and associated factors among Chinese healthcare workers (HCWs) during the COVID-19 pandemic.
Cross-sectional analysis of survey data collected from Chinese HCWs during the COVID-19 pandemic.
Nationwide psychological service platforms in China that facilitated participation of HCWs.
A total of 901 HCWs aged 19–84 years, including doctors, nurses and other medical staff.
Preference for psychological assistance was assessed through survey options, including psychological materials, stress management skills, telephone hotline, online non-video psychological counselling, online video psychological counselling and no need or others. Prevalence of mental health symptoms was evaluated using validated scales: Patient Health Questionnaire-2 (PHQ-2) for depression, Generalised Anxiety Disorder-7 (GAD-7) and Primary Care Post-Traumatic Stress Disorder (PTSD) Screen for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PC-PTSD-5) for stress. Additional measures included sleep disturbance, suicidal ideation and demographic characteristics such as age, education level and occupation.
Among 901 HCWs surveyed, the prevalence of depression, anxiety and stress was 12.32% (PHQ-2 score ≥3), 42.18% (GAD-7 score ≥5) and 28.75% (PC-PTSD-5 score ≥3), respectively. Sleep disturbance and suicidal ideation were reported by 29.41% (cut-off value=2) and 9.32% (cut-off value=1) of participants. Among the 602 respondents who preferred psychological assistance, the most preferred options were stress management skills, psychological materials and online non-video counselling. HCWs with severe suicidal ideation (item 9 of PHQ-9=3) preferred online video counselling (80%). Logistic regression indicated that age was negatively correlated with the preference for psychological materials (β=–0.86, p=0.034) but positively associated with the preference of telephone hotlines (26–35 years: β=1.69, p=0.035; ≥45 years: β=1.90, p=0.031). Higher educational attainment was associated with greater preference for psychological materials (undergraduates: β=0.71, p=0.014; masters: β=1.13, p=0.007) and online counselling (masters: β=1.743, p=0.002). Nurses were more likely to prefer stress management skills (β=0.71, p=0.014), while HCWs with suicidal ideation showed a stronger preference for online video counselling (β=0.66, p
The high prevalence of mental health problems among HCWs highlights an urgent need for targeted psychological support. Distinct characteristics of HCWs were associated with different preferences for psychological assistance, highlighting the importance of tailoring interventions to the specific needs of HCWs.
To explore the network characteristics of symptom clusters in people with type 2 diabetes mellitus through network analysis, identify the core and bridging symptoms within the symptom network, and provide a foundation for targeted interventions and symptom management in people with T2DM.
A cross-sectional survey.
A total of 360 people with T2DM who were hospitalised in the endocrinology departments of two hospitals with Grade A in Daqing City between August 2024 and February 2025 were selected using a convenience sampling method. The symptoms of people with T2DM were measured using the Chinese version of the Diabetes Symptom Checklist-Revised (DSC-R). Symptom clusters were identified through factor analysis, and network analysis was used to identify core and bridging symptoms. This research adhered to the STROBE guidelines.
Six symptom clusters were obtained from factor analysis, which were psychological-behavioural symptom cluster, ophthalmological-neuropathy symptom cluster, cardiovascular symptom cluster, metabolic symptom cluster, body symptom cluster and nephrotic symptom cluster. Symptom network analysis revealed that ‘Deteriorating vision’ exhibited the highest strength centrality and expected influence. The top three symptoms with the highest bridge strength and bridge expected influence were ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’.
People with T2DM commonly exhibit a range of symptoms. ‘Deteriorating vision’ is the most core symptom in people with T2DM. ‘Aching calves when walking’, ‘Queer feeling in the legs or feet’ and ‘Sleepiness or drowsiness’ are identified as the bridging symptoms in the network analysis. Healthcare professionals can design targeted interventions based on symptom clusters, core symptoms and bridging symptoms, thereby improving the efficiency of symptom management and optimising outcomes for people with T2DM.
No patient or public contribution.
Adenoid hypertrophy (AH) is a prevalent otolaryngological condition that primarily affects children aged 3–10 years and may adversely impact their growth and development. The choice of treatment largely hinges on the severity of hypertrophy. Currently, the main diagnostic modalities for AH include nasal endoscopy, lateral nasopharyngeal radiography, CT and MRI. In recent years, ultrasonography has emerged as a novel diagnostic tool for AH. This review aims to comprehensively evaluate the diagnostic performance of ultrasonography for detecting AH in children.
We will conduct a systematic literature search in five databases—PubMed, MEDLINE, Embase, the Cochrane Library and CNKI—to identify studies evaluating the use of ultrasonography for the diagnosis of paediatric AH. The search period will span from database inception to 31 March 2025. Only studies published in Chinese or English will be considered. All retrieved records will be independently screened by two reviewers at the title and abstract level to identify eligible studies. Data extraction will also be independently performed by two reviewers. The methodological quality of the included studies will be evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. To synthesise diagnostic accuracy, pooled estimates of sensitivity, specificity and likelihood ratios will be obtained through a bivariate random-effects approach in combination with the hierarchical summary receiver operating characteristic model. When notable heterogeneity is detected, subgroup analyses and meta-regression will be conducted to examine whether estimates of diagnostic accuracy differ according to country, ultrasound probe type or operator experience.
As this review is based exclusively on previously published studies, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals and presentations at academic conferences.
PROSPERO, CRD420251080754.
Acute kidney injury (AKI) is a significant challenge in hospital settings, and accurately differentiating between intrinsic and prerenal AKI is crucial for effective management. The fractional excretion of urea (FEUN) has been proposed as a potential biomarker for this purpose, offering an alternative to traditional markers such as fractional excretion of sodium. This study aimed to assess the diagnostic accuracy of FEUN for differentiating intrinsic from prerenal AKI in hospitalised patients.
We conducted a systematic review and bivariate random effects meta-analysis of diagnostic accuracy studies. The study followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
PubMed, Embase and Cochrane databases were searched from inception to 1 November 2023.
We included observational studies that focused on patient with AKI and reported FEUN data sufficient to reconstruct a complete 2x2 contingency table (true positives, true negatives, false positives and false negatives) for evaluating its diagnostic accuracy.
Two reviewers extracted data, assessed risk of bias with Quality Assessment of Diagnostic Accuracy Studies-2 and graded certainty of evidence using the GRADE approach. Pooled sensitivity, specificity, positive and negative likelihood ratios, and the area under the summary receiver operating characteristic curve (SROC) were calculated; heterogeneity was measured with I². A prespecified subgroup restricted to patients receiving diuretics served as a sensitivity analysis.
12 studies involving 1240 patients were included, with an overall occurrence rate of intrinsic AKI of 38.8%. FEUN had a pooled sensitivity of 0.74 (95% CI 0.60 to 0.84) and specificity of 0.78 (95% CI 0.66 to 0.87), with positive predictive value and negative predictive value of 0.76 (95% CI 0.68 to 0.83) and 0.74 (95% CI 0.66 to 0.81), respectively. The SROC curve showed a pooled diagnostic accuracy of 0.83. Heterogeneity was substantial (I²>90%) for sensitivity and specificity. In a diuretic-only subgroup (six studies) specificity rose to0.87 and heterogeneity declined (I²=56%). Overall certainty of evidence was low owing to inconsistency.
FEUN is a biomarker with moderate diagnostic accuracy for differentiating between intrinsic and prerenal AKI in hospitalised patients. Its application could enhance AKI management; however, the high heterogeneity observed in our study highlights the need for further research to evaluate its utility across diverse patient populations and clinical settings.
CRD42024496083.
Diabetes is highly prevalent in older women worldwide. This study explores the associations of psychosocial factors with both health service utilisation and self-management in older women aged 68 to 73 years with type 2 diabetes (T2D) or pre-diabetes.
This cross-sectional study used data from the Australian Longitudinal Study on Women’s Health (ALSWH), which is a national population-based cohort study that has collected information on factors related to women’s health and well-being over 20 years.
Women aged 68–73, born between 1946 and 1951, participated in ALSWH and self-reported their diagnosis of T2D or pre-diabetes.
Resilience, dispositional optimism and perceived control were the measures of psychosocial factors. The associations between these factors and diabetes self-management behaviours, healthcare visits and preventive service use were examined by numerous regression models.
There were 939 women aged 68–73 years with T2D or pre-diabetes. Women with T2D who exhibited higher dispositional optimism had significantly higher odds of participating in moderate/vigorous physical activity (OR: 1.06), visiting a dentist (OR: 1.07) and a lower rate of general practitioner (GP) visits (rate ratio (RR): 0.99). Women with T2D with greater resilience were likely to have a lower rate of consulting with mental health professionals (RR: 0.63) and higher odds of blood sugar level checks (OR: 1.68). The rate of GP visits within a year decreased by 16% for women with pre-diabetes who had a higher resilience score (RR: 0.84), and women with pre-diabetes with greater resilience had a 13% lower rate of visits to a nurse (RR: 0.87).
Psychosocial aspects of diabetes care may be important for supporting the physical and mental well-being of older women with T2D or pre-diabetes. Healthcare providers may consider whether integrating assessments of resilience and optimism into routine diabetes management might help identify older women who could benefit from targeted psychosocial support.
This study assessed the global burden of glaucoma using data from the Global Burden of Disease (GBD) 2021 study. The analysis of epidemiological trends aimed to inform future public health prevention strategies.
Retrospective cross-sectional study.
None.
Analysis of 1990–2021 GBD data on glaucoma prevalence, disability-adjusted life years (DALYs), age-standardised prevalence rates (ASPR), and age-standardised DALY rates (ASDR). Estimated annual percentage changes (EAPC) were calculated, Joinpoint regression identified trend changes, and Autoregressive Integrated Moving Average (ARIMA) modelling projected the burden for the year 2050.
Globally, the number of prevalent glaucoma cases increased from 4 072 106.59 (95% uncertainty interval (UI) 3 489 888.7 to 4 752 867.3) in 1990 to 7 587 672.9 (95% UI 6 522 906 to 8 917 725.4) in 2021. Concurrently, DALYs increased from 467 600.4 (95% UI 323 490.5 to 648 641.6) in 1990 to 759 900.2 (95% UI 530 942.9 to 1 049 127.2) in 2021. In contrast, the ASPR and ASDR declined to 90.1 per 100 000 population (95% UI 77.8 to 105.5) and 9.1 per 100 000 population (95% UI 6.3 to 12.5) in 2021, respectively. During the COVID-19 pandemic period (2019–2021), the slowest growth rates in crude case numbers and overall disease burden were observed, accompanied by the most pronounced decline in annual percentage change of ASPR. The highest estimates for both case counts and DALYs were identified in the 70–74 age group, with males demonstrating higher prevalence rates than females. Furthermore, regions with lower Sociodemographic Index (SDI) values bore a disproportionately higher burden of glaucoma.
These findings underscore the need to strengthen early screening and treatment of glaucoma, particularly in ageing populations, male groups and low SDI regions. We urge cautious interpretation of COVID-19 related data and vigilance against potential post-pandemic surges in burden. Critical strategies include enhanced screening and intervention for high-risk groups, targeted prevention measures and integration of ophthalmic care into public health emergency frameworks to alleviate the disease burden.
Investigate the epidemiological characteristics of outpatients initially diagnosed with skin ulcers who were ultimately confirmed to have cutaneous malignant tumours, and provide a diagnostic and therapeutic basis for the occurrence of secondary diseases in chronic wounds. We conducted a retrospective study analysing clinical data from patients initially diagnosed with skin ulcers at our hospital between July 2021 and February 2025, and analysed the epidemiological characteristics of malignant transformation in these ulcer cases. Among 128 patients initially diagnosed with skin ulcers, 16 cases (12.5%) were confirmed with cutaneous malignancies. The malignant group had a significantly higher mean age (69.44 ± 11.30 years) compared to the non-malignant group (58.39 ± 17.88 years; t = 5.752, p = 0.01). The distribution of lesion sites differed significantly between the malignant and non-malignant groups (χ2 = 30.498, p < 0.01). In the malignant group, the head and neck (41.2%) and trunk & extremities (41.2%) were the predominant sites. The most common malignancy was squamous cell carcinoma (SCC). The trunk & extremities was the most frequent site (62.5%). The second was basal cell carcinoma, which mainly occurs in the head and neck (80.0%). The mean duration of ulceration was 4.5 years. The primary treatment modality was surgical excision (11 cases, 68.8%). Approximately one-seventh of skin ulcer cases were confirmed as cutaneous malignancies. This finding underscores the significance of skin ulcers as potential malignant lesions, highlighting the need for clinicians to maintain a high index of suspicion and promptly perform histopathological examinations to improve early detection rates of skin cancers.
by Yu-Ting Chi, Naomi C. Hamm, Shih-Hao Lee, Minkyung Shin, Yuki Liu, I-Fan Shih, Feibi Zheng, Ben Forrest, Peng-Lin Lin
IntroductionSurgical staplers are essential tools in minimally invasive surgery (MIS), enabling tissue division, hemostasis, and secure anastomoses. With the growth of robotic-assisted surgery, robotic staplers such as SureForm have recently become available. These staplers offer precise articulation and real-time tissue compression monitoring. However, the clinical advantages of robotic staplers over bedside staplers remain uncertain. Studies show mixed results across specialties, mainly due to small sample sizes, outdated data, and data heterogeneity. This study protocol proposes a series of future analyses that will evaluate the clinical outcomes and resource utilization of robotic versus bedside staplers in robotic-assisted surgeries across multiple specialties using recent real-world data.
Methods and analysisThis retrospective cohort study will use data from the Premier Healthcare Database (PHD), a large hospital-based database covering patients with varied payers across the United States. Adult patients (≥18 years) who underwent elective, fully robotic-assisted lung, colorectal, gastric, or bariatric surgeries from 2019 to 2023 will be included. Each surgical specialty will be analyzed in a separate paper. Patients will be categorized into two groups based on the type of surgical stapler used: robotic staplers (SureForm) and bedside staplers (manual or powered). The primary outcome will be postoperative leak (air leak for lung resection; anastomotic leak for colorectal, gastrectomy, and bariatric). Key secondary outcomes are other complications, conversion to open surgery, operative time, transfusion requirements, length of stay (LOS), and cost. Overlap weighting will be applied to minimize bias.
DisseminationResults will be disseminated through peer-reviewed surgical journals and presentations at relevant surgical meetings.
To develop a comprehensive decision-making checklist for paediatric advance care planning tailored to the needs of terminally ill children and their families.
A Delphi Study.
Underpinned by Delphi methodology, a four-phase procedure was adopted: (1) drafting items by the working group, (2) refining items based on an experts' survey, (3) further refining based on the same experts, and (4) final adaptations and approval. This study was initiated by the Paediatric Palliative Care Subspecialty Group of the Paediatrics Society of the Chinese Medical Association. The process involved 60 healthcare providers (physicians, nurses, and social workers) from 14 paediatric palliative care teams.
The developed checklist included 5 topics, 24 subtopics, and 45 items. Five topics were (1) medical and nursing decision-making, (2) social support planning, (3) psychological support planning, (4) spiritual support planning, and (5) posthumous affairs planning. This checklist addresses symptom management for terminally ill children, integrating support for their psychological, social, and spiritual well-being, and addresses the care needs of their family members.
The study provided a paediatric advance care planning checklist derived from the expert consensus that includes key elements and items.
This checklist provides healthcare providers with a structured framework to set paediatric advance care planning and ensure that all aspects of children's well-being and their families' needs are considered. This study also lays an evidence-based foundation for the design of related documents.
This study developed a comprehensive paediatric advance care planning checklist with 5 topics, 24 subtopics, and 45 items. This study provides a comprehensive decision-making checklist for healthcare providers and families, ensuring that critical decisions are addressed timely.
This article is presented in accordance with the CREDES guidelines.
Limited patient and public involvement was incorporated, focusing on reviewing the initial checklist draft.
This study aims to determine the mediating effect of emotional exhaustion on the relationship between lateral violence in nursing and turnover intentions.
A cross-sectional survey.
This research project involved the enrollment of 314 nursing professionals from two tertiary medical facilities associated with academic institutions in Changsha, Hunan Province, China. To measure the variables, a series of self-administered questionnaires was used. The data were analysed using SPSS 25.
Lateral violence and emotional exhaustion were positively correlated with turnover intention. Emotional exhaustion partially mediated the relationship between lateral violence and turnover intention.
Emotional exhaustion serves as a partial mediator in the relationship between lateral violence and turnover intention. Reducing lateral violence and avoiding emotional exhaustion can help to reduce the turnover intention of nurses.
When developing targeted programs or policies aimed at decreasing nurses' turnover intention, it is important to consider the issue of lateral violence among nurses, as well as their negative emotions.
The study provides us with a more fine-grained understanding of the relationship between lateral violence among nurses and turnover intention. Insights to enhance nurse retention are also provided, which can support the development of future relevant policies and guidelines.
The study adhered to the STROBE guidelines.
No patient or public contribution.
To summarise peer support in digital use and digital health interventions for older adults.
The following databases were searched (from 2010 to 2024): PubMed, Embase, Web of Science, the Cochrane Library and EBSCOhost.
This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. All articles selected and extracted were double-checked. The data were analysed using the inductive descriptive approach and presented in table and narrative form.
This review included 21 studies involving adults aged 60 or older, primarily from developed countries, and focused on the post-21st century. Peer support included peer digital support through face-to-face or online, peer-led or coached in digital intervention, peer motivation and companionship in digital health interventions, group-based mutual support through social media and online health platforms through websites or apps. The social cognitive theory was the common theoretical framework. Most studies indicate high feasibility, acceptability and effectiveness in six health domains. It facilitated information and behaviour exchange, improved mental health, enhanced social support, increased cost-effectiveness and adherence. However, some studies have shown ineffectiveness, influenced by peer support design issues, negative social norms, technological issues, network size and study design limitations. Besides, qualitative results indicated positive experiences enhanced personal worth and social connection, while negative experiences involved technological barriers, emotional burdens, privacy issues and lack of recognition.
Peer support represents a valuable complement to existing digital use and digital health interventions for older adults, with important implications for practices in healthcare and outcomes.
Further research should optimise peer support, maintain bi-directional relationships, explore mechanisms of influence, analyse cost-effectiveness, utilise machine-learning algorithms, apply digital peer support to more health domains and call for healthcare providers to develop relevant policies or strategies.
No patient or public contribution.
To investigate, in a prospective cohort study, the association between cognitive impairment and cardiovascular disease (CVD), to quantify the extent to which uncontrolled risk factors mediate this association, and to explore whether the mediation effect varies across sex and age groups.
Prospective cohort study.
UK Biobank, a large population-based cohort study in the UK.
A total of 152 155 participants without prevalent CVD or dementia at baseline were included. The mean age was 56.3±8.2 years, and 44.0% were male.
Cardiovascular death and composite cardiovascular outcomes, assessed using Cox proportional-hazards models and mediation analyses.
During a median follow-up of 13.03–13.87 years, 1474 cardiovascular deaths and 21 518 composite cardiovascular outcomes were recorded. Participants with cognitive impairment (n=23 146; 15.2%) exhibited higher proportions of lifestyle, metabolic and psychological risks (p
Cognitive impairment is associated with increased risks of cardiovascular death and composite cardiovascular outcomes. Uncontrolled lifestyle, cardiometabolic and psychological risk factors partially mediate this association, highlighting the importance of comprehensive management to improve cardiovascular prognosis in this population.
FreshRSS 