Conectar
by Clément Joël Lucien Chevret, José Francisco Echegaray, Alexander Walton, Maryam Lo, Olav Rueppell, Hélène Lemieux
Mitochondrial metabolism plays a critical role in determining lifespan across animal taxa. In our study, we used the Western honeybee (Apis mellifera) as a model, capitalizing on the stark lifespan difference between queens, which often live more than two years, and summer workers, which survive only about 30 days, despite sharing the same genetic background. We investigated mitochondrial function in head tissue, thoracic muscle, and abdominal fat tissue of queens and workers, comparing early (7 days) and late adult stages (28–30 days in workers; 2 years in queens). No significant differences in mitochondrial flux control ratio for the NADH- Succinate- and glycerophosphate (Gp) pathways were found in thoracic muscles across castes or age groups. In head and abdominal fat tissues, early-life queens showed reduced reliance on NADH-linked pathways for maximal respiratory flux compared to workers. The decrease in the NADH-pathway was compensated by an increase in the Gp-pathway contribution. Queens exhibited reduced phosphorylation-pathway control over OXPHOS compared to workers, both in head tissue during early life and in abdominal fat tissue later in life. These findings reveal caste- and tissue-specific patterns of mitochondrial regulation that may contribute to dramatic lifespan divergence observed in eusocial insects. They suggest that early-life metabolic flexibility could play an important role in shaping life history evolution in Apis mellifera.
Clinical nurses face notable chronic stress due to work-related stressors, exacerbated by the COVID-19 pandemic, leading to somatic symptoms and low-grade inflammation. Mindfulness meditation has shown promise in reducing stress and improving health outcomes, but its effects on somatic symptoms and inflammatory biomarkers in nurses remain underexplored.
To assess the impact of mindfulness meditation on somatic symptoms and inflammatory biomarkers such as leptin, interleukin-6, and tumor necrosis factor-α among nurses. To explore the secondary effects on perceived stress and trait mindfulness because of the complex interlinked association with the primary outcomes of interest.
A randomized controlled trial was conducted with 102 nurses randomly assigned to a meditation group (8-week mindfulness meditation program) or a non-meditation group. Data were collected using self-report questionnaires (Mindfulness Attention Awareness Scale, Perceived Stress Scale, Patient Health Questionnaire-15) and blood samples for biomarker analysis at baseline and post-intervention.
The meditation group demonstrated notable reductions in perceived stress (p < 0.001), somatic symptoms (p < 0.001), IL-6 (p < 0.001), and leptin levels (p < 0.001) compared to the non-meditation group. Trait mindfulness increased markedly in the meditation group (p = 0.003), while TNF-α levels did not show notable changes.
Mindfulness meditation efficiently reduces perceived stress, somatic symptoms, and inflammatory biomarkers in nurses, highlighting its potential as a holistic intervention to improve both psychological and physical well-being in high-stress healthcare environments.
ClinicalTrail.gove, NCT06635278
by Tahere Seyedhoseinpoor, Ramin Jafari, Zohreh Shafizadegan, Maryam Abbaszadeh-Amirdehi
PurposeThe objective of this study was to systematically review the effectiveness of thoracic-focused interventions, including breathing exercises and thoracic manual techniques (mobilization, high-velocity low-amplitude manipulation, and release techniques), on pain and disability in patients with low back pain (LBP).
MethodsPubMed, Scopus, Web of Sciences, ProQuest, Ovid, Physiotherapy Evidence Database (PEDro), Cochrane Central Register of Controlled Clinical Trials (CENTRAL), and Google Scholar were searched without language restrictions. Clinical trials with control groups on pain and disability in low back pain patients focusing on the efficacy of breathing exercises or thoracic technique were included. In total, 31 studies contributed to the meta-analysis for pain and 24 for disability.
ResultsPooled analyses using Morris’ dppc demonstrated a statistically significant, small effect for pain reduction (dppc = −0.35, 95% CI = −0.46 to −0.23) and a large effect for disability improvement (dppc = −0.71, 95% CI = −0.86 to −0.57) when compared with control groups. Thoracic manual techniques showed larger effects on both pain and disability compare to breathing exercises. However, substantial statistical heterogeneity (I² > 85%) persisted in most analyses.
ConclusionBreathing and thoracic manual techniques may be effective in reducing disability and, to a lesser extent, pain in patients with LBP, but the overall certainty of evidence is low. However, the quality of the evidence is low. Variability in treatment protocols, study quality, blinding, and outcome measures likely contributed to inconsistencies. Further high-quality trials with standardized protocols are needed to confirm these findings and inform clinical practice.
To identify key communication skills for Canadian nursing practice.
Quantitative research using a nationwide survey.
Exploratory confirmatory factor analysis was used to identify factors underlying key communication skills required for nursing practice. Multiple regression analyses were used to examine differences across demographic variables, designations, roles and settings.
Dimensions of effective communication skills were identified. Demographic and contextual variables showed some impact on the perceived importance of communication skills, but low variance suggested that language demands are relatively consistent across roles and settings.
A framework describing the communication demands for Canadian nursing practice is described, contributing to the development of tailored curricula, assessments and policies.
Focusing on communication skills ensures that nurses are equipped to deliver safe healthcare and interact effectively with patients and colleagues, potentially leading to improved health outcomes.
To our knowledge, this study is the first to develop a framework for communication skills and identify key language skill factors across nursing professional designations and practice settings. The research provides a framework for developing curricula and training programmes that focus on essential communication skills.
No patient or public contribution.
To identify the barriers and facilitators to accessing services for neurodevelopmental disorders (NDDs) among the carers of individuals from Black, Asian and minority ethnic groups in the UK.
A scoping review.
Seven databases: PubMed, Cochrane, MEDLINE Full Text, APA PsycINFO, Scopus, CINAHL and Web of Science were searched for relevant studies up to the end of March 2025. Titles and abstracts and, where appropriate, full-text articles were screened based on predefined inclusion and exclusion criteria. Two reviewers independently screened the 6454 studies, with data extraction carried out by two reviewers. A narrative synthesis of the findings was undertaken.
A total of 15 studies were included in the review, the majority of which were qualitative (n=9; 60%). Among the Black, Asian and minority ethnic populations represented, South Asians comprised the predominant group. The review underscores that the barriers faced by Black, Asian and minority ethnic communities are multifactorial, which includes: (1) language and communication barriers, (2) cultural and religious influences, (3) stigma, (4) formal and informal support systems and (5) experience with healthcare services.
Access to neurodevelopmental care for carers from Black, Asian and minority ethnic groups in the UK is shaped by complex, multifactorial barriers. These communities are not homogeneous, and evidence gaps make it unclear whether challenges are shared or distinct. Greater understanding is needed to inform culturally appropriate, evidence-based policy and practice. Further research is essential to address disparities and improve equitable access across all groups.
To explore the process of how nurses experience and deal with workplace violence based on nurses' perceptions and experiences in Iran.
An exploratory qualitative study was conducted using grounded theory approach. Participants included 17 nurses working in 4 hospitals in 2 urban areas in Iran with at least 1 year of clinical experience in emergency departments and intensive care units. Data were collected through in-depth, semi-structured individual interviews conducted between August 2024 and March 2025. The constant comparative analysis approach was used for data analysis. This research method was carried out in five stages: open coding to identify concepts; development of concepts in terms of their characteristics and dimensions; contextual analysis; integration of the process to data analysis; and final category integration.
The main concern of participants in dealing with workplace violence was a ‘multidimensional security threat’. ‘Perpetrator response to nursing care’ (at the individual level) and ‘organisational inefficiency’ (at the organisational level) provided the context for this threat. A general theme entitled ‘tensive adaptation’ was the core category in this research and included four main categories: ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ were the outcomes.
The theoretical model of ‘tensive adaptation’ provides a new perspective on ‘what’ and ‘how’ nurses experience and manage workplace violence. Effective strategies for managing violence such as effective communication, empathy, providing appropriate care, anger management, self-care, effective teamwork and requesting support can be considered by nursing administrators and incorporated into training programmes for nurses and nursing students. The adverse consequences of nurses' exposure to workplace violence should receive greater attention, as the entire healthcare system is affected by this exposure.
Workplace violence leads to physical and psychological problems, reduced job satisfaction, diminished performance, negative effects on personal and family life and decreased quality of patient care. The main concern of participants in dealing with workplace violence was ‘multidimensional security threat’. This concept includes three characteristics: ‘psychological health threats’, ‘physical health threats’ and ‘professional position threat’. ‘Perpetrator response to nursing care’ (individual level) and ‘organisational inefficiency’ (organisational level) served as contextual conditions that expose nurses to workplace violence. In ‘tensive adaptation’, nurses attempt to respond to workplace violence through strategies such as ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ are the consequences of nurses' exposure to workplace violence.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this study.
This study did not include patient or public involvement in its design, conduct, or reporting.
With ambient listening systems increasingly adopted in healthcare, analyzing clinician-patient conversations has become essential. The Omaha System is a standardized terminology for documenting patient care, classifying health problems into four domains across 42 problems and 377 signs/symptoms. Manually identifying and mapping these problems is time-consuming and labor-intensive. This study aims to automate health problem identification from clinician-patient conversations using large language models (LLMs) with retrieval-augmented generation (RAG).
Using the Omaha System framework, we analyzed 5118 utterances from 22 clinician-patient encounters in home healthcare. RAG-enhanced LLMs detected health problems and mapped them to Omaha System terminology. We evaluated different model configurations, including embedding models, context window sizes, parameter settings (top k, top p), and prompting strategies (zero-shot, few-shot, and chain-of-thought). Three LLMs—Llama 3.1-8B-Instruct, GPT-4o-mini, and GPT-o3-mini—were compared using precision, recall, and F1-score against expert annotations.
The optimal configuration used a 1-utterance context window, top k = 15, top p = 0.6, and few-shot learning with chain-of-thought prompting. GPT-4o-mini achieved the highest F1-score (0.90) for both problem and sign/symptom identification, followed by GPT-o3-mini (0.83/0.82), while Llama 3.1-8B-Instruct performed worst (0.73/0.72).
Using the Omaha System, LLMs with RAG effectively automate health problem identification in clinical conversations. This approach can enhance documentation completeness, reduce documentation burden, and potentially improve patient outcomes through more comprehensive problem identification, translating into tangible improvements in clinical efficiency and care delivery.
Automating health problem identification from clinical conversations can improve documentation accuracy, reduce burden, and ensure alignment with standardized frameworks like the Omaha System, enhancing care quality and continuity in home healthcare.
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