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Physicians’ preferences for financial and non-financial incentives significantly influence their job satisfaction and career choices. A comprehensive understanding of these preferences can aid in the optimisation of incentive policies. While prior studies have examined these preferences using discrete choice experiments (DCEs), the effects of intrinsic motivations, such as altruism and job satisfaction, on incentive responsiveness remain poorly understood. Understanding this heterogeneity is essential for designing incentive policies that are effective and tailored to the healthcare context in China. This study aimed to assess how physicians’ altruism and job satisfaction shape their preferences for financial and non-financial incentives.
This study employed a DCE methodology and surveyed 886 physicians from urban tertiary hospitals. The DCE design was based on a comprehensive literature review and focus group interviews, assessing physicians’ preferences regarding attributes such as work environment, workload, career development opportunities and career identity. Mixed logit models were used to estimate the willingness to pay for each attribute and analyse heterogeneity across subgroups based on levels of altruism and job satisfaction.
Financial incentives were the most important factor for physicians, followed by attributes such as work atmosphere and workload. On average, physicians expressed a willingness to sacrifice 4859.035 ¥ for an improved work atmosphere and 4335.008 ¥ in exchange for reduced workload. Subgroup analysis showed that physicians with low- and medium-altruism prioritised improvements related to working conditions, while those with high-altruism placed greater emphasis on intrinsic career development and career identity. Furthermore, physicians reporting low-job satisfaction demonstrated heightened sensitivity to both financial and non-financial incentives, whereas those with high-job satisfaction showed weaker preference for financial incentives and greater preference for improvements in work atmosphere (β=1.002) and work environment (β=0.876).
The findings highlight the need to align incentive policies with physicians’ intrinsic motivations and current job satisfaction. Financial incentives remain a key driver of job preferences. Non-financial factors, including improvements in the work atmosphere, work environment, workload, career development and professional identity, also play an important role in supporting physicians’ job satisfaction and retention. Considering differences in altruism and job satisfaction can help healthcare institutions and policymakers develop more targeted and context-specific incentive strategies.
Robotic rehabilitation on locomotion is a new approach in amyotrophic lateral sclerosis (ALS) and previous studies showed its feasibility. In this study, we aim to evaluate safety, patient’s experience and efficacy of a gait training programme with the Atalante exoskeleton, compared with usual care, on walking ability, functional capacity and other symptoms associated with ALS.
EXALS is a monocentric, prospective, interventional, open trial. 20 slowly progressing patients with gait deficits will be recruited. The study is conducted in three phases, each lasting 6 weeks, following the ABA procedure. Phase B represents the intervention phase, during which patients practise their gait training at a rhythm of three sessions/week, as an add-on to usual care. In the two phases A, patients receive usual care with no additional treatment. An evaluation is planned before, in the middle and at the end of each phase. The primary outcome of the study is safety and tolerability of the Atalante exoskeleton. Secondary outcomes include: participants’ subjective impact and experience, attitude and motivation, efficacy and interactivity of the exoskeleton, walking ability, functional capacity, spasticity, balance, postural stability, lower limb muscle strength, quality of life, pain, fatigue, anxiety and depression. Statistical analyses will include descriptive methods for all variables and adverse events. Quantitative outcomes are analysed using repeated-measures ANOVA (analysis of variance) across the seven visits, with post hoc tests applied when appropriate. Nominal outcomes are evaluated using Cochran’s Q test with McNemar pairwise comparisons when significant. Associations between variables are examined using Spearman correlation coefficients. Missing data will be replaced using linear interpolation, and sensitivity analyses will be planned. Qualitative interview data are analysed using thematic analysis.
This study was approved by the French ethics committee CPP Nord-Ouest I (no. 23.02378.000201). Participant data are anonymised and securely stored in the laboratory’s database, accessible only to the research team. Results will be disseminated through peer-reviewed journals and conferences.
Glaucoma is an optic neuropathy caused by the gradual degeneration of retinal ganglion cells. This study aimed to investigate the knowledge, attitude and practice (KAP) towards glaucoma among ophthalmic inpatients.
A web-based questionnaire.
Local hospital.
Ophthalmic inpatients (n=1238).
The primary outcome was the patients’ KAP.
Multivariable logistic regression analysis showed that rural residence (OR=0.488, 95% CI 0.313 to 0.762, p=0.002), college education or above (OR=4.996, 95% CI 2.942 to 8.483, p
Ophthalmic inpatients might have moderate knowledge and attitude, but a proactive practice towards glaucoma. A history of glaucoma, previous glaucoma surgery, education level, residency and alcohol consumption were potentially associated with knowledge and attitudes towards glaucoma among ophthalmic inpatients.
The overuse of antibiotics for respiratory tract infections in primary healthcare in rural China is a particular challenge and is highly related to antibiotic resistance. Our research team designed a multi-component intervention focusing predominantly on health practitioners to reduce antibiotic prescriptions in rural communities of China. The effects of the intervention were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of the implementation of the intervention and related influencing factors.
Qualitative process study nested in a randomised controlled trial, including observation and semi-structured interviews.
Primary healthcare in rural China.
27 health practitioners from township health centres assigned to the intervention arm.
A complex intervention to reduce antibiotic prescriptions in rural communities of China, which includes the following components: training for health practitioners, a public letter of commitment, patient leaflets, a decision support system and a peer support group.
Not applicable.
Data were analysed using thematic analysis.
The overall multi-component intervention was described as useful in reducing antibiotic prescribing, with a particularly high acceptance and use of patient leaflets and the public letter of commitment among health practitioners. There were mixed views on the decision support system and peer support group. Practitioners reported usability-related barriers to using the decision support system during consultations. Practitioners did not understand the role or benefits of the peer support group and found it difficult to initiate group discussions, due to the lack of any existing clinical team at the primary care level.
The multi-component intervention appears to be acceptable and useful in primary healthcare in rural China. Successful implementation requires a comprehensive understanding of the contextual characteristics of the setting. Interventions to reduce antibiotic prescribing in China in the future could consider wider stakeholders including patients, retail pharmacies and health authorities.
ISRCTN30652037 (01/12/2020).
Patient-reported experience measures (PREMs) are measures of patients’ perceptions of care they receive. PREMs are critical in developing and evaluating programmes that aim to improve patient healthcare experiences and quality of care (QoC) according to patient-defined needs. This review aims to map key domains of PREMs across distinct healthcare technical areas and life stages from globally available literature.
A scoping review adapting Arksey and O’Malley’s framework and Joanna Briggs Institute’s guidelines for the conduct of scoping reviews.
Google Scholar, PubMed, WHO, US Academy of Medicine and USAID Momentum.
PREMs literature from electronic repositories of grey and peer-reviewed publications, published in English historically up to September 2023.
Two lead reviewers with support from the technical working group co-created a review framework of healthcare technical areas, life stages and PREMs domains. We screened eligible articles, prioritising reviews except for technical areas with no reviews, where we then selected individual studies. We charted, analysed and synthesised data from 52 eligible articles.
PREMs literature has recently increased, especially in low-income and middle-income countries (LMICs), although studies in high-income countries (HICs) dominate in proportion (n=38; 73.1%). Out of 52 eligible articles, technical areas with most publications were sexual and reproductive health (n=21; 40.4%) and general outpatient care (n=11; 21.2%). Studies in adulthood (n=24; 46.2%) and from pregnancy and birth to postnatal (n=16; 30.8%) were most represented. PREMs studies reported mostly on communication and rapport (n=33; 63.5%) and respect and dignity (n=42; 80.8%) domains. Nearly a quarter (n=12; 23.1%) of the articles included only validated tools; the rest included a combination of validated and unvalidated measures. Of the tools relating to life stages of babies, younger children and older adults, the majority (n=17; 94.4%) included patient proxies.
PREMs, as an important component of QoC measurement, are increasing across several healthcare technical areas and life stages with commonalities and notable distinctions in measurement domains and tools. Evidence on PREMs largely comes from HICs. Evidence on critical, yet sometimes overlooked domains, highlights key QoC implementation gaps. The adaptation and utilisation of PREMs in programmes, especially in LMICs and under-represented technical areas, present opportunities to close the QoC disparities in those settings. Strategic, concerted efforts towards the harmonisation of PREMs tools across multiple life course stages and technical areas are critically needed in high-level quality improvement efforts.
To describe obstacles and ideas for improvement for the delivery of cardiopulmonary resuscitation and basic life support to wheelchair users.
A descriptive qualitative study underpinned by constructivism was conducted.
Semi structured interviews were completed with 26 participants from three cohorts: formal and informal carers, wheelchair users and healthcare professionals. Data were collected via online and in person interviews between February and June 2024. All participants were located in Australia, with the exception of one who was located in the United Kingdom. Data were analysed using thematic analysis.
Two major themes were identified: (1) obstacles to providing cardiopulmonary resuscitation and basic life support to a wheelchair user and (2) aspirations for improving cardiopulmonary resuscitation and basic life support for wheelchair users.
Participants shared ideas for how to improve emergency care for wheelchair users, highlighting a need for further research, testing and development of an education intervention.
Improving knowledge about providing emergency care to a wheelchair user could improve outcomes, save lives and reduce the life expectancy gap experienced by people with disability.
Approximately 2% of the global population use a wheelchair. Wheelchair use complicates the delivery of cardiopulmonary resuscitation and basic life support. There are currently no guidelines informing emergency care for wheelchair users available globally. Recognition of common symptoms of distress exhibited by wheelchair users, and options for the delivery of practical emergency care are required for wheelchair users.
The paper adheres to the EQUATOR reporting guidelines utilising the SRQR checklist.
Patients and the public were the driving force in recognising the gap in knowledge regarding the delivery of CPR to wheelchair users. Questions from patients and the public shaped the aims and methodological choices for this study.
To explore the concurrent trajectories of depressive symptoms and insomnia among adolescents and to analyse the individual, familial and social predictors of the concurrent trajectories.
This study tracked depressive symptoms and insomnia in eight secondary schools annually from 2021 to 2023. We also collected data on individual, familial and social factors that may influence these conditions. Group-based multi-trajectory (GBMT) modelling was used to categorise adolescents into depressive–insomnia severity subgroups.
This study included 2822 adolescents, who were categorised into four groups, including the no symptom group, mild symptom group, symptom relief group and symptom increase group. Compared with the no symptom group, predictors of the mild symptom group were gender (OR = 1.30), academic performance (OR = 1.57), subjective well-being (OR = 0.78), anxiety (OR = 1.14), economic status (OR = 1.23) and relationship with teachers (OR = 1.46). Predictors of the symptom relief group were personality (OR = 1.75), academic performance (OR = 2.28), subjective well-being (OR = 0.69) and anxiety (OR = 1.25). Predictors of the symptom-increasing group were personality (OR = 2.45), academic performance (OR = 1.96), subjective well-being (OR = 0.69), anxiety (OR = 1.20), maternal education level (OR = 1.58), family function (OR = 0.93), parental relationship (OR = 2.07) and relationship with teachers (OR = 1.54).
This study provided a comprehensive understanding of the concurrent trajectories of depressive symptoms and insomnia among adolescents, revealing distinct subgroups and identifying predictors across individual, familial and social levels.
This study emphasises the importance of a multi-faceted approach involving family, school and society to promote adolescent mental health and also highlights the need for conducting precise interventions according to adolescents' features.
The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.
STROBE checklist.
None.
To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.
A cross-sectional study.
A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.
The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).
Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.
Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.
No patient or public contribution.
To explore how classmate ‘ambassadors’ experienced and engaged in social interaction while visiting a hospitalised peer undergoing cancer treatment.
A phenomenological-hermeneutic inspired exploratory study.
Using on-the-go semi-structured interviews and participant observations from January to December 2023 in Denmark, we included 27 school-aged ambassadors aged 6–18 years old; 18 participated in pre- and post-visit interviews, while all 27 took part in observations during 19 visits. Van Manen's phenomenological-hermeneutic approach guided thematic analysis.
Six themes emerged: (1) visiting the hospital, (2) being supportive, (3) aligning expectations, (4) being unsure, (5) safeguarding the relationship and (6) leaving the hospital. Ambassadors were eager to visit, seeking to be good friends by offering social, emotional and physical support. They were mindful of the information shared to prevent the hospitalised children from feeling excluded. Social interactions often involved allowing the hospitalised children to take on decision-making roles, recognising their well-being as a priority.
Ambassadors found hospital visits meaningful as they wanted to make a difference and sought to support their hospitalised peers. Their role was shaped by their understanding of friendship and the disease trajectory. Social interactions were largely conflict-free due to the pre-visit alignment of expectations.
Classmates found visits meaningful and wished to make a difference. Healthcare professionals should facilitate visits to strengthen social connections between the hospitalised child and their surroundings as a part of family-centred care within paediatric oncology.
Problem: Cancer treatment often causes social disruption for children with cancer, making the transition to everyday life more difficult post-treatment.
Classmates were eager to visit hospitalised peers, demonstrating awareness of cancer and a desire to support them.
Facilitating classmate visits may enhance classmates' understanding of cancer and aid hospitalised children's reintegration into everyday life.
The COREQ checklist was used.
Ambassadors contributed to designing the interview guides.
Enhances knowledge of supporting social relationships between hospitalised children and their classmates during cancer treatment. However, the RESPECT study is rooted in the Danish cultural context, where it is common to attend local volunteer activities after school. Although getting diagnosed with a life-threatening illness such as cancer may be difficult to talk about with peers and even a taboo in some countries, we do expect that interventions with structured possibilities for social interactions are an important step towards normalisation of communicating about childhood cancer.
To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures.
Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game.
Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure.
A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety.
Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older.
Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal.
This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older.
We adhered to the CONSORT checklist for reporting results.
A patient partner reviewed the study design, methods and final manuscript.
NCT03680625
To explore the lived experience of young people aged 16–24 years diagnosed with melanoma and that of their significant other in England.
Interpretive phenomenological analysis.
Data were collected between August 2023 and January 2024 from one specialist cancer centre in England. Thirteen young people were approached, and 10 took part. Each young person was asked to nominate a significant other. Five nominated a significant other, and five nominated no one. Although interviews were offered face-to-face, virtual was the preferred method. In-depth semi-structured interviews were audio-recorded with the participant's consent. Interview data were transcribed verbatim and analysed.
The core conceptual thread woven throughout the findings was ‘It's like being on a rollercoaster,’ which is representative of the ups and downs of the treatment trajectory, often without the support of age-appropriate specialist care. Four superordinate themes were identified: ‘Is something wrong?’, ‘Suddenly it's serious’, ‘Out on a limb’ and ‘Finding our place’.
Although most young people were treated in a primary treatment centre for adults with cancer, their experience was challenging from route to diagnosis through their treatment and beyond. Few received age-appropriate care to support their physical, emotional, and social wellbeing to help them navigate the experience.
There is limited evidence exploring the experiences of teenagers and young adults living with melanoma or that of their significant other. This enriched understanding supports improvement of the care pathway and service delivery for these young people and their families.
One young person with lived experience was paid as a consultant to be part of the research team. He helped develop the grant application and research questions, data analysis, and writing this paper.
To explore and gain a deeper understanding of how registered nurses in palliative care develop personal and professional approaches in confidential conversations with patients.
A qualitative study using focus groups.
Between March and May 2024, 22 registered nurses working in specialised palliative care in the northern region of Sweden participated in five focus groups. The discussions were recorded, transcribed verbatim and analysed using interpretive description.
Registered nurses pursued meaningful, supportive interactions during confidential conversations. Their reflections revealed vulnerabilities and the importance of continuous self-reflection, fostering growth, resilience and professional development. They sought ways to process emotional challenges, from individual reflection to peer discussions and structured supervision, refining their approaches. Four themes emerged: balancing external demands with inner motivation, recognising personal limitations, managing compassion with professional responsibility and gradually building trust.
Reflection and continuous professional development are essential for navigating confidential conversations in palliative care. These practices help registered nurses balance empathy with boundaries whilst managing emotional and professional challenges. Peer support and shared learning, as well as fostering self-awareness and emotional resilience can enhance care quality and promote sustained professional growth across healthcare settings.
This study highlights the emotional challenges registered nurses face in confidential conversations with patients at the end of life. Reflection and support help them handle these challenges and promote person-centred care by enabling patients to express their inner thoughts and wishes. The findings apply to palliative care and other settings caring for patients at the end of life.
Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To explore mothers' specific discharge preparation needs for preterm infants born before 32 gestational weeks, providing a foundation for developing effective discharge education programmes.
A qualitative descriptive design.
A semi-structured interview was conducted of 16 mothers of preterm infants less than 32 weeks gestation within 1 week post-discharge in March–June 2024. Directed content analysis was conducted using the Integrated Theory of Health Behaviour Change framework to code, categorise, and identify themes within the interview data.
Mothers provided rich, practical, experience-driven feedback regarding discharge preparedness needs. The interview resulted in three emergent themes related to the theory's constructs: maternal needs for knowledge acquisition, multifaceted social support, and adjusting learning strategies. These encompass sub-themes such as observing infant behaviour and health status, basic care knowledge, complex medical care guidance; support from medical staff, family members, fellow parents, community healthcare providers, and Wechat platform tools; learning time arrangement, and preferred learning approaches.
This study explored the discharge preparation needs of mothers with premature infants less than 32 weeks gestation. A nurse-led multidisciplinary team should tailor education programmes, emphasising care knowledge, multifaceted social support, and flexible learning. Future research should assess programme effectiveness on maternal and infant outcomes.
The study's results provided targeted guidance for clinical nursing education, enhancing mothers' readiness for preterm infant discharge and facilitating a smoother NICU-to-home transition.
These findings provide important guidance for nurse-led tailored discharge education and preparation services, thereby promoting improvements in clinical nursing practice and the development of nursing education.
The COREQ checklist was used for reporting.
Four mothers of premature infants (< 32 weeks gestation) provided feedback on the interview guide in the design phase, refining it for the target population, without joining the main study.
The aim of this study was to investigate factors affecting psychosocial adaptation in intestinal stoma patients and to identify central symptoms that might guide future interventions through network analysis.
A multicenter cross-sectional study.
All intestinal stoma patients were evaluated for psychosocial adaptation using the Ostomy Adjustment Inventory-20 (OAI-20). Univariate and multivariate linear regression were used to analyse the potential relationship between the level of psychological adjustment of intestinal stoma patients and individual factors. By network analysis, we calculated the centrality indicators for each node in the ostomy psychosocial adaptation network at different levels of low, medium and high, respectively.
This study ultimately enrolled a total of 19,909 intestinal stoma patients from 202 Chinese hospitals, out of which 6408 reported low psychosocial adaptation. It was found that there is a negative association between being female, partially self-care, completely dependent on others for care and having no medical insurance with psychosocial adaptation scores. In the low-level psychosocial adaptation network, no. OAI-14:limited activity, no. OAI-9: worried about ostomy, and no. OAI-11:always like a patient were identified as central indicators.
Being female, partially self-care, completely dependent on others for care, and having no health insurance can be considered characteristics of patients with lower psychosocial adaptation. Network analysis results provide intervention targets to improve adaptation.
Individualised and precise interventions can be carried out in terms of both the influencing factors and the most influential nodes of psychosocial adaptation in order to improve the level of psychosocial adaptation in intestinal stoma patients.
No patient or public contribution.
by Quynh Anh Tran, Hien Duy Pham, Dung Boi Ly, Minh Quang Ngo, Nhung Thi Nguyen, Liem Thanh Nguyen, Quang Thanh Nguyen
BackgroundEarly definitive surgery for Hirschsprung disease (HD) in neonates is increasingly adopted to reduce preoperative morbidity and preserve long term bowel function. However, comparative data across minimally invasive approaches in neonates with short segment disease remain limited. This study compared outcomes of single incision laparoscopic assisted endorectal pull through (SILEP), conventional laparoscopic assisted endorectal pull through (CLEP), and complete transanal endorectal pull through (TERPT) for rectosigmoid HD.
MethodsWe conducted a retrospective cohort study of 55 neonates who underwent one stage definitive surgery before 28 days of age at a high volume center between January 2019 and December 2021. The primary outcome was long term bowel function assessed using the Rintala Bowel Function Score (BFS) after a minimum of 4 years of follow up. Secondary outcomes included operative parameters, postoperative complications (Clavien Dindo classification), and cosmetic outcomes using the Manchester Scar Scale (MSS) in the laparoscopic groups.
ResultsAll patients successfully underwent surgery at a mean age of 22.4 ± 4.3 days. Operative time differed across approaches and was shorter for SILEP (53.8 ± 11.9 minutes) and TERPT (52.1 ± 18.3 minutes) than for CLEP (70.2 ± 22.5 minutes, p = 0.036). At follow up (mean 54.0 ± 7.7 months), the overall BFS was 17.5 ± 2.5 with no significant differences among groups (p = 0.32). MSS was numerically lower for SILEP than for CLEP (6.2 ± 1.1 vs 6.8 ± 1.9, p = 0.53). Complications were infrequent, with 14 minor and 7 major events, and there was no mortality or Clavien Dindo grade IV or V morbidity.
ConclusionSILEP, CLEP, and TERPT are feasible one stage options for neonates with rectosigmoid HD, with comparable long term bowel function and low rates of major complications. SILEP and TERPT were associated with shorter operative times, and SILEP showed a trend toward improved cosmetic scores compared with CLEP. These findings support an individualized approach to technique selection based on intraoperative requirements and institutional expertise.
by Nasrin Akter, Farhana Faruque Zerin, Bilkis Banu, Fatema Afrin Kanta, Shahnaz Begam, Sarder Mahmud Hossain
BackgroundTo combat growing prevalence of hypertension in Bangladesh, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. In the recent COVID-19 pandemic the QOL of hypertensive people got downsized. This study aimed to measure QOL among hypertensive people in a selected tertiary hospital in Dhaka city, and its association with the basic characteristics of the patients.
MethodsThis study was conducted among randomly selected 300 hypertensive patients from two departments of Square Hospitals Limited, using the patient register record. Data were collected through face-to-face interview methods. The WHOQOL-BREF questionnaire was used to assess the QOL of the subjects. Descriptive statistics were used to examine mean scores of quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analysis was used to measure the association between QOL domains and independent variables.
ResultsBoth overall WHOQOL-BREF and each domain had a good internal consistency, (r = 0.13–0.77, p Conclusion
The results revealed low QOL in psychological and social domain, including significant factors associated with the poor QOL in all domains. Planning and implementation of effective interventions are needed to improve QOL among hypertensive patients targeted towards aged, diabetic, lower income group who had positive COVID-19 infection and poor lifestyle through health system strengthening.
by Qiaoling Li, Jing Zhang, Shasha Meng, Fengxiang Tian, Qinqin Mei, Hui Wang, Hong Qi
BackgroundSelf-regulated fatigue is often assessed in studies of chronic diseases. Research is needed on the self-regulation of fatigue and physical activity in lung cancer patients undergoing treatment, and the impact of these factors on this population.
ObjectiveThe goal of this study is to investigate the current status, influencing factors, and correlation between self-regulatory fatigue and physical activity in lung cancer patients undergoing comprehensive treatment.
MethodsWe used a convenience sampling method to enroll 188 lung cancer patients admitted to two tertiary hospitals in Chengdu from October 2024 to April 2025. Data were collected using a general information questionnaire and two scales: the Self-Regulatory Fatigue Scale (SRF-S) and The International Physical Activity Questionnaire-long form (IPAQ-L).
ResultsThe mean self-regulatory fatigue score was 42.19 ± 9.06. The total metabolic equivalent (MET) of physical activity was 544.00 (0.00, 1386.00) MET-min/week, with leisure-time activity accounting for 429.00 (0.00, 1188.00) MET-min/week (data presented as median and interquartile range). Significant negative correlations were observed between Self-Regulatory Fatigue total scores and energy expenditure from housework, leisure activities, as well as total physical activity expenditure. Furthermore, self-regulatory fatigue was negatively correlated with both moderate-intensity and low-intensity physical activity, but positively correlated with high-intensity physical activity (P P R² = 0.306).
ConclusionEngaging in appropriate leisure and household activities at moderate-to-low intensity may help alleviate the severity of self-regulatory fatigue in lung cancer patients undergoing comprehensive treatment. Healthcare providers should encourage appropriate activity to reduce the psychological burden and conserve self-regulatory resources.
by Panawit Hanpinitsak, Tatpong Katanyukul, Norrawit Tonmitr, Chanon Suntra, Sora-at Tanusilp, Arthit Phuphaphud
Monitoring cattle behavior plays an important role in improving farm productivity, maintaining animal welfare, and supporting efficient management practices. This study presents a multi-view behavior recognition system that uses synchronized top-view and front-view CCTV footage, combined with deep learning techniques. The system includes four main components: cow identification, behavior classification, identity-behavior association using Intersection-over-Union (IoU), and a decision-level ensemble to combine information from both views. YOLOv8 models are applied separately to each camera angle to detect individual cows and classify six key behaviors: drinking, eating, standing, lying, riding, and chin resting, with the latter two being relevant for estrus detection. The system matches cow identities to their behaviors within each view and then integrates the results to produce a final activity label for each cow.
by Ploy Khongrungjarat, Chonnikan Tothong, Chanyanut Pankaew, Suchada Phimsen, Nopawit Khamto, Nutthamon Kijchalao, Warissara Wongkham, Piyathida Wongkham, Wipaporn Chuaymaung, Adsadayu Thonnondang, Apinun Limmongkon
Prenylated stilbenoids, particularly trans-arachidin-1 (Ara-1) and trans-arachidin-3 (Ara-3), have gained attention for their notable bioactivities and potential health-promoting properties. This study presents the first comprehensive investigation into the stability and biological efficacy of these compounds in both peanut hairy root culture crude extracts (PCE) and partially purified fractions derived from elicited peanut hairy root cultures. PCE stored at –20 °C and 4 °C maintained higher antioxidant capacity, total phenolic content compared to samples stored at room temperature. In cytotoxicity assays using SW480 colon cancer cells, the extract stored at –20 °C retained bioactivity with only minor changes in IC₅₀ values over three months, demonstrating superior stability under frozen conditions. Over a six-month period, partially purified fractions of Ara-1 and Ara-3 showed a time-dependent decline in compound content. However, Ara-3 maintained strong cytotoxicity against KKU-100 cholangiocarcinoma cells, while Ara-1 exhibited a significant loss in activity. These findings demonstrate that low-temperature storage, particularly at –20 °C, is crucial for preserving the chemical integrity and bioactivity of stilbenoid-rich extracts. The study underscores the importance of optimizing storage conditions to ensure consistent bioactivity, supporting the potential application of these compounds in the development of stable and effective pharmaceutical or nutraceutical products.
by Eléna Payen Schalkens, Maxime Acien, Andrée-Anne Marchand, Pier-Luc Isabelle, Jacques Abboud, Gabriel Moisan
BackgroundChronic metatarsalgia (CM) causes significant pain and disability, affecting quality of life. Foot orthoses (FOs) including medially wedged designs with a metatarsal pad decrease excessive plantar pressure under the metatarsal heads, which is a suggested risk factor for developing CM. This FOs model may be effective in diminishing pain and improving function in these individuals. Thus, the objective of this trial will be to compare the effects of medially wedged FOs with a metatarsal pad and sham FOs on pain and foot function in individuals with CM.
Methods/designThis participant- and assessor-blinded superiority randomized controlled trial (RCT) with two parallel groups will be conducted in Trois-Rivières, Canada. Sixty-four participants with CM will be recruited from the Université du Québec à Trois-Rivières outpatient podiatry clinic and via social media invitations. They will be randomized into intervention (customized FOs) or control (sham FOs) groups and will be evaluated at baseline and after 6 and 12 weeks. The primary outcome will be: (1) mean pain during walking for the most painful foot during the past week. The secondary outcomes will be: (1) Foot Function Index, (2) Global rating of change and (3) the 5-level EQ-5D.
DiscussionMedially wedged FOs with a metatarsal pad are expected to provide a greater reduction in pain and improvement in foot function compared to sham FOs. This trial will help guide FOs prescription recommendations for managing foot pain in individuals with CM in the future.
Trial registrationClinicalTrials.gov NCT06962475
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