Conectar
by Orit Wonderman Bar Sela, Shay Ofir Geva, Gaby S. Pell, Yiftach Roth, Jason Friedman, Afnan Muhana, Silvi Frenkel-Toledo, Nachum Soroker
Unidirectional transcranial magnetic stimulation (udTMS; e.g., via Figure-of-8 coil) depolarizes mainly neurons whose axonal orientation aligns with the direction of the induced electric field. A novel dual H-coil (T360°) TMS system (BrainsWayTM, Israel) generates a rotational magnetic field aimed to recruit a larger neuronal population by induction of a multidirectional electric field (rfTMS). This study aimed to comparatively assess the neurophysiological properties of motor evoked potentials (MEPs) elicited from the first dorsal interosseous (FDI) muscle following udTMS (via Figure-of-8 and H7 coils) vs. multidirectional rfTMS. In this study, 10 healthy adult subjects received TMS via the three coil configurations in a random order. The results showed that rfTMS elicited larger MEPs at a lower resting motor threshold (rMT) compared to the unidirectional coils. These findings suggest that rfTMS is likely to recruit larger populations of neurons compared to conventional udTMS coil configurations. This may be advantageous in efforts to enhance motor recovery following brain damage by treatments using TMS.
Paediatric palliative care (PPC) aims to improve the quality of life of children with life-limiting and life-threatening conditions. PPC addresses the needs of both the child and family and preferably starts immediately after a palliative diagnosis. It includes effective symptom management, psychosocial, spiritual and emotional support. Receiving PPC is often challenging due to the varied and complex nature of conditions and the difficulties in reaching all children who require palliative care. Telehealth offers a promising solution by enabling virtual access to interdisciplinary teams, facilitating real-time consultations, extending care into the home, educating professionals across regions and fostering consistent, collaborative, patient- and family-centred PPC. As this requires a seamless integration into the daily routines of all relevant stakeholders, telehealth may raise complexity in terms of privacy, data protection and regulatory compliance. Nevertheless, studies indicate that parents and children are open to using telehealth applications.
Since the COVID-19 pandemic, telehealth development in paediatrics showed a rapid and substantial scale-up. Evaluating the quality of these new technical solutions remains important. One of the main outcome measures used in telehealth evaluation studies is quality of care. Currently, the literature has no consensus on which quality of care metrics can be used to assess the development, implementation and evaluation of telehealth solutions in home-care PPC. In addition, a timely update on the fast-growing field of telehealth solutions in PPC is required. Therefore, this study aims to update and examine quality of care metrics in telehealth solutions for PPC, contributing to the conceptual foundation for the development, implementation and evaluation of home-based PPC telehealth services. Findings from our review will contribute to a deeper understanding of how children and families can receive timely and accessible palliative care regardless of their location, ultimately informing future telehealth models and research projects.
Our systematic review will evaluate studies that describe telehealth solutions in PPC home-care settings, using the Cochrane handbook, and the reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will include peer-reviewed articles without language or geographical restrictions. The search will be conducted by an information specialist and data synthesis will be documented via a data extraction table in MS Excel. Along with a Mixed-Method-Appraisal-Tool (MMAT) quality appraisal, data extraction will be managed by Covidence. Two reviewers will screen and extract data independently, with a third reviewer resolving discrepancies. We will present a narrative synthesis, using clear language, defining key terms and following open-access standards to ensure accessibility for non-expert audiences.
No primary or clinical data will be collected. Therefore, ethical approval is not relevant. Review findings will be shared via peer-reviewed journal publications, conferences, stakeholder meetings and online presentations.
CRD420251035350.
The Novara Cohort Study (NCS) was established to investigate the biological, psychological and social factors that influence ageing in the general population. The study aims to identify early risk factors for frailty, allostatic load and cognitive decline, and to uncover molecular and functional markers of accelerated biological ageing. NCS addresses the need for detailed life-course data from Southern Europe to support personalised prevention and early diagnosis, and to promote healthy longevity.
NCS is a population-based, longitudinal cohort in the Novara province (Northern Italy), originally enrolling adults aged 35 and older. The inclusion criteria were later expanded to encompass all residents aged 18 and over, facilitating the study of ageing trajectories from early adulthood onward. As of mid-2025, about 1000 participants have been enrolled, and recruitment is ongoing. The cohort’s diversity in age, employment status and health conditions enhances its value for life-course analysis.
Following a pilot phase in 2022–2023, the whole study protocol now includes detailed demographic, clinical, behavioural, cognitive and psychosocial data, along with biological samples stored in the UPO Biobank. The protocol incorporates validated tools, comprehensive physical and cognitive assessments, and over 90 laboratory biomarkers covering inflammation, metabolism, hormonal function and coagulation. Additionally, a subset of participants underwent advanced inflammatory profiling by simultaneous measurement of 92 immune-related proteins and comprehensive genomic profiling using Illumina Single Nucleotide Polymorphism (SNP) arrays, capturing common genetic variation across multiple biological domains. Preliminary results demonstrate the feasibility of integrating deep phenotyping, reveal the roles of frailty in ageing and show initial evidence of age-related changes in inflammatory proteins.
NCS plans to enrol at least 10 000 participants and will conduct long-term follow-up using both passive methods, such as linking with clinical records and administrative health databases, and active in-person reassessments. Future phases will integrate clinical, behavioural and cognitive data with large-scale omics analyses, including genomics, proteomics, metabolomics and transcriptomics. Machine learning techniques will be employed to model biological age, identify early signs of age-related decline and develop personalised prevention strategies. By combining high-resolution phenotyping with multidimensional data, NCS aims to find modifiable risk factors and molecular signatures of ageing, supporting national and European research efforts and encouraging collaborative studies through open data-sharing frameworks.
by Kexuan Chen, Sarah Miller, Kristine Goy, Tina Lam, Marlène Maeusli, Rosemary She, Brad Spellberg, Brian Luna
Metallo-β-lactamases (MBLs) hydrolyze the beta-lactam ring in beta-lactam antibiotics, rendering them ineffective. Infections caused by MBL-harboring bacteria result in higher mortality, more costs and prolonged hospital stays due to the limited treatment options. Recently, antimicrobial susceptibility testing using RPMI-1640 has been found to have more accuracy in predicting in vivo efficacy due to its zinc deficiency. We sought to expand the previous studies of accessing in vivo efficacy using zinc-limited media versus conventional media to more antimicrobial agents and MBL-producing strains. The susceptibility of isolates was determined by performing minimum inhibitory concentration (MIC) assays using traditional cation-adjusted Mueller Hinton broth (CAMHB) or zinc-limited media. In vivo outcomes were evaluated using the Galleria mellonella infection model and neutropenic mouse thigh infection model. The MICs of MBL-harboring strains decreased in zinc-limited media compared to in nutrient-rich media, suggesting susceptibility of a subset of resistant strains when tested in zinc-limited media. Notably, we observed statistically significant MICs decreasing against imipenem, which demonstrated the best efficacy among the six tested antibiotics. Additionally, the outcomes of in vivo tests in both the G. mellonella model and the mouse model were better predicted with in vitro MIC assays performing in zinc-limited media. The use of zinc-limited media may lead to increased accuracy of the prediction of in vivo efficacy of beta-lactams against MBL-harboring bacteria.
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.
by Roberto Germano, Owen Alexander Higgins, Emanuela Cristiani, Alessia Galbusera, Carmen Esposito, Dulce Neves, Carmine Pellegrino, Alessandra Sperduti, Giorgio Manzi, Luca Bondioli, Alessia Nava
This study investigates health, dental development, diet, and human-environment interactions in individuals buried in the necropolises of Pontecagnano (Campania, Italy, 7th-6th century BCE), using an integrated approach merging dental histomorphometry and calculus micro-residue analysis. The sample consists of 30 permanent teeth (canines, first and second molars) from 10 individuals. Histomorphometric analysis of dental thin sections allowed the estimation of crown formation times, initial cusp formation, crown completion, and enamel extension rates. The prevalence of Accentuated Lines, marking physiological stress events, was analyzed chronologically across tooth classes. Dental calculus analysis was performed on five individuals, identifying plant micro-remains and fungal spores. Crown formation times varied by tooth class, with canines forming the longest (mean = 1,977 ± 295 days), followed by second molars (mean = 1,176 ± 179 days) and first molars (mean = 1,094 ± 154 days). Initial cusp formation values, estimated through chronological overlap between teeth, allowed for a more accurate reconstruction of crown completion timing. Accentuated Lines prevalence peaked at 12 and 44 months, likely reflecting early childhood dietary transitions and the differential recording of stress events across different crown regions. Calculus analysis identified starch granules from cereals (Triticeae) and legumes (Fabaceae), fungal spores (Saccharomyces), and plant fibers, indicating diverse dietary practices, food processing, and extra-masticatory activities. This interdisciplinary approach reinforces the validity of combining histomorphometric and micro-residue analyses to reconstruct childhood health, adult diet, and lifestyle. Our findings align with previous research while emphasizing population-specific variations. This study enhances understanding of Iron Age biocultural adaptations, offering insights into developmental and dietary behaviors in this ancient Italian community.
This study aimed to identify the predictors of burnout, anxiety and depression among healthcare professionals during the COVID-19 pandemic.
A secondary quantitative analysis of data from the Mental Health Research Canada (MHRC).
Healthcare professionals across Canada during the COVID-19 pandemic.
1439 Canadian healthcare professionals.
Data from MHRC, collected between April 2020 and January 2024, including sociodemographic factors and measures of burnout, anxiety and depression.
In total, 1439 participants were included in the analysis. Women (OR: 2.25; 95% CI 1.46 to 3.48), younger workers (OR: 2.29; 95% CI 1.29 to 4.06) and mental health professionals (OR: 2.59; 95% CI 1.11 to 6.01) were more likely to experience burnout. Meanwhile, men (OR: 2.05; 95% CI 1.40 to 3.00), younger workers (OR: 8.58; 95% CI 4.12 to 17.86) and physicians (OR: 2.01; 95% CI 1.16 to 3.46) had an increased likelihood of being diagnosed with anxiety. Similar findings were obtained for depression, where men (OR: 1.74; 95% CI 1.18 to 2.56), young workers (OR: 5.22; 95% CI 2.68 to 10.18), physicians (OR: 2.11; 95% CI 1.22 to 3.64), visible minorities (OR: 2.29; 95% CI 1.55 to 3.38) and those with a physical impairment (OR: 4.79; 95% CI 2.55 to 8.97) were more likely to receive a diagnosis since the COVID-19 pandemic.
These findings underscore the need for targeted clinical interventions among healthcare professionals during and beyond public health emergencies. Specifically, healthcare institutions should implement accessible mental health programmes, regular psychological assessments and workload management strategies for those who face increased vulnerabilities to mental health struggles.
Metabolic bariatric surgery (MBS) can lead to substantial fat-free mass loss (FFML) due to malnutrition, decreased protein intake and insufficient physical activity. Disproportional FFML has been associated with an increased risk for adverse health outcomes. Resistance training (RT) combined with protein intake contributes to maintenance and increase of fat-free mass (FFM) in healthy individuals. However, it is unclear whether RT and protein supplementation can prevent FFML after MBS.
In the EffectiveNess of pRotein supplementatIon Combined witH resistance Exercise training to counteract Disproportional fat-free mass loss following metabolic bariatric surgery (ENRICHED) randomised controlled trial, 400 patients scheduled to undergo MBS will be randomised in a 1:1 ratio to the ENRICHED perioperative care programme (intervention group) or the standard perioperative care programme of the Dutch Obesity Clinic (control group). The study is currently recruiting participants at two centres in the Netherlands: Nieuwegein and Amsterdam. The postoperative standard programme consists of 13 group sessions spread over a period of 18 months. As part of the ENRICHED programme, RT and protein supplementation will be added 3 weeks after MBS. Additional whole-body RT consists of home-based training sessions two to three times a week, and supervised RT sessions of 45–60 min once weekly, performed at 60–75% of one-repetition maximum (1-RM). Protein supplementation will start by adding 20 g of whey protein to the daily intake. The supplementation will be gradually increased with 20 g every 4 weeks until a total of 60 g whey protein a day is reached. After 12 weeks of protein supplementation, the focus shifts towards incorporating protein-rich food products into the daily dietary intake. The primary endpoint is the prevalence of disproportional FFM loss, defined as FFML/total weight loss ≥30%, at 3 months post-MBS. Secondary endpoints are differences in body composition, muscle strength and function, cardiorespiratory fitness, (cardio)metabolic health, health-related quality of life, gastrointestinal discomfort, cost-effectiveness of the intervention and treatment satisfaction. Outcomes will be assessed preoperatively and at 3, 6 and 12 months postoperatively.
The study protocol V.2.0 was approved by the Medical Research Ethics Committee Oost-Nederland (NL-OMON57119) on 9 April 2025. All participants will provide written informed consent prior to enrolment. Study findings will be disseminated through peer-reviewed publications and conference presentations. Insights gained in this study will provide evidence for a patient-tailored intervention that could be implemented in clinical practice.
To examine how gender differences in the nursing work environment shape nurses' perceived quality of care and to identify gender-specific predictors and evaluative mechanisms.
A mixed-methods design was employed, integrating quantitative data analysis with qualitative in-depth individual interviews.
This study was conducted in two phases: The first phase was a quantitative analysis, based on a large national dataset from the 2017 Chinese Nursing Work Environment Survey (N = 16,382), in which secondary analysis was performed using hierarchical linear regression, relative importance analysis, and network analysis to identify key predictors. The second phase was a qualitative study, in which in-depth individual interviews were conducted with 30 clinical nurses (15 male and 15 female), and thematic analysis was applied to explore gender-differentiated experiences.
The core finding of this study is that gender-differentiated factors within the work environment significantly shape nurses' perception of care quality. Quantitative results showed that the strongest predictor for female nurses was professional development, whereas recognition of value was most salient for male nurses. Qualitative results corroborated these findings: female nurses emphasised continuing education and emotional support, while male nurses emphasised fair evaluation and professional identity. Both groups reported that high-intensity workloads hindered the delivery of ideal humanistic care, inducing moral distress and emotional suppression and exposing ethical gaps in organisational support.
Gender differences in the nursing work environment shape pathways to perceived care quality and expose deeper managerial and ethical challenges. A gender-sensitive, ethics-oriented management approach can enhance nurse satisfaction and care quality, providing empirical support for optimising workforce allocation and sustaining healthcare systems.
Findings direct nurse leaders to tailor improvement strategies—enhancing professional-development infrastructure for women and strengthening recognition mechanisms for men—while embedding explicit ethical support to reduce moral distress and improve both workforce well-being and patient outcomes.
No patient or public contribution.
This study compares the emotional expressions and structural characteristics of workplace violence (WPV) against Chinese nurses in social media comments and news reports, highlighting differences and focal points in dissemination.
A quantitative study utilising text mining and social network analysis.
Data containing the keywords ‘nurse violence’, ‘nurse workplace violence’, ‘nurse bullying’, ‘nurse workplace bullying’ were collected from social media platforms (e.g., Xiaohongshu, Zhihu, Weibo) and news platforms (e.g., Baidu News, People's Daily, Xinhua News) between January 1, 2016, and October 31, 2024. Using Python 3.8.9, time trends and sentiment analyses were performed, while Ucinet 6.0 was used for social network analysis to explore dissemination patterns and keyword structures. A total of 5431 social media comments and 89 news reports were analysed.
Temporal analysis showed that social media attention to WPV against nurses significantly exceeded that of news reports, with a peak in 2024. Sentiment analysis revealed predominantly negative emotions (52.75%) on social media, while news reports exhibited a more positive tone (62.92%). Social network analysis revealed stark differences in keyword structures between platforms. Social media exhibited a dense and decentralised network, with keywords like ‘head nurse’, ‘leader’ and ‘bullying’ highlighting internal professional conflicts. In contrast, news reports showed a centralised network focusing on external violent incidents, with keywords such as ‘violence’, ‘assault’ and ‘patient’ dominating.
Social media and news reports demonstrated significant differences in describing WPV against nurses. Social media focused on emotional expressions of interpersonal conflicts, whereas news reports prioritised factual accounts of violent incidents and proposed solutions.
This study offers insights into how WPV against nurses is communicated through different media, helping nursing administrators and policymakers understand the complexity of these narratives. The findings can inform the development of targeted communication strategies to address WPV and enhance public awareness.
Not applicable.
To estimate condition-specific patient travel distances and associated carbon emissions across common chronic diseases in routine National Health Service (NHS) care, and to assess the potential carbon savings of modal shifts in transportation.
Retrospective population-based cohort study.
NHS Greater Glasgow and Clyde, Scotland.
6599 patients aged 50–55 years at diagnosis, including cardiovascular disease (n=1711), epilepsy (n=1044), cancer (n=716), rheumatoid arthritis (RA; n=172) and a matched control group based on age, sex and area-level deprivation (n=2956).
Annual home-to-clinic distances and associated carbon emissions modelled under four transport modes (petrol car, electric car, bus, train) across five time points: 2-year prediagnosis, diagnosis year and 2-year postdiagnosis.
Mean annual travel distances to hospital varied by condition and peaked at diagnosis. Patients with cancer had the highest travel distances (161 km/patient/year for men; 139 km/patient/year for women), followed by RA (approximately 78 km/patient/year). The matched control group travelled 2/patient/year to 8.0 kg CO2/patient/year. Bus travel resulted in intermediate emissions, estimated between 10.5 and 8.0 kg CO2/patient. When travel was modelled using electric vehicles, emissions dropped between 3.5 and 2.7 kg for all conditions. Train travel produced similarly low emissions. Reducing petrol car travel from 100% to 60% lowered emissions up to 6.6 kg CO2/patient.
Condition-specific estimates of healthcare-related travel emissions provide baseline understanding of the opportunities and challenges for decarbonising healthcare. Emission reduction is most achievable through modal shift, yet such shifts depend on factors beyond NHS control—such as transport infrastructure, digital access and social equity. Multisectoral strategies, including targeted telemedicine and integrated transport and urban planning, are critical to achieving net-zero healthcare while maintaining equitable access to care.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple body parts. With a fluctuating range of symptoms, SLE imposes significant challenges and limitations on individuals at work. The objective of this review is to synthesise the existing literature on work disability in patients with SLE and identify factors associated with work disability and facilitators of returning to work (RTW).
This systematic review is registered with PROSPERO (CRD420251011567). This protocol followed the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols) guidelines. The search will be conducted using Business Source Premier, CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science from inception to March 2025. At least two independent reviewers will complete screening, data extraction and critical appraisal. Eligible studies will focus on individuals with SLE and examine the barriers and facilitators to RTW. Eligible studies will be peer-reviewed, published in English or available in English translations. Unpublished research, opinion pieces, conference papers, abstracts, book chapters, knowledge syntheses, commentaries and grey literature will be excluded.
This study does not require ethics approval. The results of the completed review will be published.
CRD420251011567.
Ageing impairs the respiratory system, increasing hospitalisation rates for respiratory problems in older adults. In cases of bronchial congestion, a weak cough in older inpatients challenges respiratory physiotherapy. Mechanical insufflation-exsufflation (MI-E) is one of the promising solutions. However, its effects have not yet been evaluated in this population. Therefore, we aim to compare the effects of MI-E and manual respiratory physiotherapy on cough peak flow (CPF), spirometry measures, dyspnoea and session discomfort in hospitalised older adults.
We will conduct a multicentre randomised controlled trial in four hospitals in France. A total of 120 older inpatients with bronchial congestion and a weak cough will be recruited from either intensive care units or conventional wards. All participants will receive three sessions of respiratory physiotherapy over one and a half days: MI-E for the experimental group and conventional manual respiratory therapy for the control group. Assessments will include CPF, forced vital capacity (FVC), maximum inspiratory and expiratory pressures, forced expiratory volume in one second (FEV1), FEV1/FVC ratio and the modified Borg scale for dyspnoea, measured before and immediately after each session. Discomfort will be assessed using a numerical (0–10) scale immediately after each session. Between-group comparisons will be performed using a linear mixed model for continuous outcomes and a generalised linear model for categorical variables.
The study was approved by the referred ethics committee (Comité de Protection des Personnes Ile de France XI, Identifier: 24.04832.000282) on 27 November 2024. Study results will be disseminated in peer-reviewed publications and at scientific meetings.
Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.
NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.
In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.
Chinese-speaking immigrants in Australia have a higher risk of type 2 diabetes and face more barriers to accessing quality healthcare compared to non-culturally and linguistically diverse populations. This study aimed to explore the self-management experiences of Chinese-speaking Australians with self-reported lived experience of prediabetes following immigration.
Qualitative study.
Semi-structured interviews were conducted with 10 purposively selected Australian Chinese-speaking immigrants aged over 40 years. Data collection was undertaken in Perth, Western Australia between April and August 2024. Data were analysed using reflexive thematic analysis.
Three themes are presented in this paper: (1) An acculturation journey: Reshaping cultural identity and social connections in immigrant lives, (2) Embodying prediabetes: Cognitive reconstruction and emotional adaptation in the transition to the patient role and (3) Decision-behaviour dynamics: Mapping agency and adaptiveness in self-management processes. Participants demonstrated dynamic adjustment through the processes of self-awareness, adaptive behaviours, self-reflection and self-attribution of health outcomes.
Chinese-speaking Australians navigating prediabetes following immigration underwent a complex process of reconstruction across cognitive, cultural and psychological domains. Prediabetes self-management was shaped by cultural values, acculturation, dietary preferences, emotional resilience, local and distant social networks and resource availability. These findings underscore the importance of empowering both individuals and communities through evidence-based and culturally appropriate strategies.
Participants experienced profound transformations in their cultural adaptation, prediabetes cognition, social support networks and emotional–psychological landscape. Future interventions must address identified barriers (e.g., cooking burden, comorbidities, stress), facilitators (e.g., leisure travel, family support), motivations (e.g., cultural heritage, health risk perception) and challenges (e.g., knowledge–behaviour gap, digital health information) that shape self-management behaviours. A community empowerment approach, utilising evidence-based content, flexible delivery formats and existing cultural networks, should be adopted to offer promising pathways for prediabetes health education.
The study adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines.
Limited patient and public involvement was incorporated, with two community representatives providing feedback on interview questions and recruitment strategies.
To assess atrial fibrillation (AF) burden, symptoms and quality of life (QoL) in endurance athletes with paroxysmal AF.
Prospective cohort study.
Otherwise healthy endurance athletes with paroxysmal AF in Norway, Australia and Belgium. The current study presents baseline measurements collected before the intervention of a randomised controlled trial on effects of individually tailored training adaptation.
AF burden (percentage time in AF) was measured by insertable cardiac monitors (Confirm Rx, Abbott). AF-related symptoms and QoL were assessed using the Atrial Fibrillation Effect on QualiTy-of-Life Questionnaire (AFEQT) with any score
43 athletes (age 57±10 (mean±SD), range 33–75 years, 3 women) were included. The athletes were monitored for 50±18 days. Median AF burden was 0.18% (IQR 0%–2.6%). Out of 29 athletes with at least one AF episode, 21 (72%) had AF episodes >60 min. 13 athletes (30%) had AFEQT overall score 60 min were associated with reduced QoL (mean AFEQT score 78 vs 90, p=0.001 and 78 vs 90, p=0.001, respectively). There were large individual variations between the athletes concerning AF burden, symptoms and QoL.
Although most athletes were still competing, more than half had troublesome symptoms. One-third had reduced QoL, which was associated with higher AF burden and longer duration of AF episodes. Variations between the athletes highlight the need for individually tailored AF management in athletes with paroxysmal AF.
Autism and neurodevelopmental disorders (NDDs) are complex conditions that manifest as significant impairments in social communication and behaviour. Early detection and intervention play a pivotal role in improving outcomes, largely due to the high brain plasticity in infants. The PRECO-TSA study aims to validate the effectiveness of systematic use of the Prévention de l’Autisme (PREAUT) grid for early screening and referral strategies for autism and NDDs in infants, focusing on a coordinated approach that integrates maternal and child protection centre with medical-psychological centres. The goal is to evaluate a streamlined referral system to improve early detection and facilitate effective interventions for children at higher risk of autism.
The PRECO-TSA study is a prospective, pragmatic, multicentre, cluster-randomised controlled trial using an incomplete stepped-wedge design, which maximises external validity. The study includes a 6-month baseline phase, a 3-month semiobservation phase and a 6-month follow-up phase. The 36-month patient inclusion period is followed by a 48-month passive follow-up through the National Health Data System, data collection includes demographic and clinical information, with hierarchical mixed models used to analyse the impact of early screening and referral for autism and NDDs.
This study was funded by the French Ministry of Health (PREPS-20-0186) and was approved by Ile de France I Ethics Committee CPP (number CPPIDF1-2023-DI29-Cat2). The results will be submitted for publication in peer-reviewed journals.
Cardiac amyloidosis (CA) is a rare and underdiagnosed disease associated with a high mortality rate. Although, in the last decade, there has been increasing attention in the literature to the relationship between CA and psychological distress in patients, the evidence on this association has not yet been systematised. Therefore, this study aims to fill this gap.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted.
PubMed, ScienceDirect, Scopus and Web of Science were searched, with the last update conducted on 23 September 2024, and no time restrictions were applied.
Studies had to meet the following inclusion criteria to be included: (1) original quantitative research; (2) published in peer-reviewed journals written in English; (3) explore and report the relationship between CA and psychological distress or compare a clinical group with a control group and (4) investigate psychological distress through reliable and validated measures.
One author extracted the data, which was then double-checked by another, and data were reported both in tabular and textual form. The included studies were critically evaluated using the Appraisal Tool for Cross-Sectional Studies.
Through the research process, a total of 14 articles were selected. The quality assessment scores ranged from 12 to 18 (M=16.21±1.42). Overall, the results underline a significant presence of psychological distress in patients with CA. Moreover, while disease severity was not found to be associated with psychological distress in CA patients in all studies considered, more heterogeneous results emerged regarding the association between the severity of cardiac symptoms and psychological distress.
Results suggest that psychological distress is an important aspect to be considered when dealing with CA patients. Integrating psychological assessment and support may improve patient outcomes by reducing disease burden and enhancing treatment adherence.
CRD42023446913.
Objetivo principal: Analizar la influencia del contacto piel con piel (CPP) en el éxito de la lactancia materna exclusiva (LME) hasta los 6 meses de vida. Metodología: Estudio analítico descriptivo y prospectivo, realizado mediante entrevista directa con 500 puérperas seleccionadas por muestreo de casos consecutivos. Resultados principales: Cuando se realizó el CPP de manera ininterrumpida la LME a los 6 meses de vida fue del 17,40% y la de lactancia artificial del 12,60%. En los casos en que no se realizó, eran mayores las tasas de lactancia artificial (10,80%) frente a las de LME (4,40%). Las variables con mayor influencia en el éxito de la lactancia materna exclusiva a los 6 meses de vida, el tipo de alimentación en hijos anteriores y el tipo de alimentación al alta hospitalaria. Conclusión principal: Se deben evitar rutinas hospitalarias que interrumpan el CPP así como procurar que al alta hospitalaria la LME esté correctamente establecida.
Objetivo principal: Los profesionales sanitarios fueron los trabajadores más afectados por Covid-19, especialmente durante las primeras oleadas. El objetivo del estudio es evaluar la percepción del riesgo de exposición al Covid-19, información recibida y participación laboral entre enfermeros, médicos y auxiliares de enfermería. Metodología: Se realizó un estudio transversal mediante una encuesta epidemiológica entre enfermeras, médicos y auxiliares de enfermería de un hospital universitario. Se realizó una validación de aspecto y contenido, un pretest cognitivo y un pilotaje de la encuesta epidemiológica con treinta sujetos. Se realizó un análisis descriptivo utilizando media y desviación estándar (DE) para las variables cuantitativas y las frecuencias absolutas (n) y relativas (%) para variables cualitativas. Se aplicó el test chi-cuadrado y el test ANOVA para evaluar la asociación de las respuestas con las variables: sexo, tipo de trabajador, área de trabajo y actividad en Unidades Covid-19. Resultados principales: Las enfermeras, médicos y auxiliares de enfermería trabajaban principalmente en áreas asistenciales y en unidades de alto riesgo de exposición. Los auxiliares de enfermería y las enfermeras tenían una mayor percepción de riesgo. Las enfermeras estaban menos implicadas en la organización, pero se sentían más apoyadas por sus compañeros. Los médicos se sentían más apoyados por sus superiores y mejor atendidos cuando tenían problemas de salud. Conclusión principal: Las enfermeras y auxiliares de enfermería presentaron mayor percepción de riesgo, las enfermeras se implicaron menos en la organización de la atención sanitaria, mientras que los médicos se sintieron más apoyados por sus superiores.
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