Conectar
This study aims to investigate the association between physical fitness and markers of cognitive function in adults aged 40 and above in Qatar.
A cross-sectional study.
The Qatar Biobank, data of 1000 adults aged 40 and above.
A population of 1000 adults aged 40 years and older was included. Available data comprised measures of physical fitness including cardiorespiratory fitness, muscular strength, body composition and physical fitness capacity, as well as cognitive function assessed through tests of short-term visual memory and psychomotor coordination.
This paper investigated the physical fitness effect on cognitive functioning through short-term visual memory and psychomotor coordination testing. Logistic regression was used to measure the association between physical fitness and cognitive functioning tests.
Our study showed that lower physical fitness capacity was significantly associated with lower psychomotor coordination in females (OR=1.57, p=0.040) and showed no significant association in males (OR=1.65, p=0.062). For short-term visual memory, the association was significant in females (OR=1.68, p=0.042) unlike in males (OR=1.58, p=0.062). Males with greater muscle strength were about half as likely to have lower psychomotor coordination (OR=0.48, p=0.04). In females, a higher body fat percentage was associated with poorer cognitive function, with each 1% increase in body fat being linked to 6% higher odds of low short-term visual memory (p=0.02) and low psychomotor coordination (p=0.006). Cardiorespiratory fitness showed no statistically significant association with short-term visual memory and psychomotor coordination level in either sex.
Our findings suggest that overall physical fitness capacity is associated with better cognitive function in Qatari adults. The relationship between specific fitness measures and cognitive function varied by sex, with muscle strength having a stronger effect for males and body composition for females. These results highlight the potential importance of maintaining physical fitness for cognitive health in adulthood.
To consolidate evidence on nurse-led models for skin cancer detection by focusing on their roles, comparing their effectiveness to physician-led care and highlighting any value-added benefits.
Systematic review methodology with narrative synthesis.
MEDLINE Complete, PubMed, Embase, CINAHL Complete, ScienceDirect, Scopus, BNI, LILACS, PsycINFO, Trip Medical Database, ERIC, EThOS, CDSR, WoS, Google Scholar, ClinicalTrials.gov, ICTRP, CENTRAL and the website ‘Getting It Right First Time’.
This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies between January 1992 and September 2024 were evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. The search encompassed both peer-reviewed and grey literature; however, no grey literature met the inclusion criteria.
Of the 6680 records screened, six studies met the inclusion criteria, involving 3325 patients across England, New Zealand and the United States. These studies focused on nurse-led models of care for skin cancer, assessing outcomes such as diagnostic accuracy, treatment effectiveness, cost savings, waiting times, access to care and patient satisfaction. While none directly compared nurse-led to dermatologist-led models, one study demonstrated comparable diagnostic accuracy between nurses and ophthalmologists. Nurse-led models were shown to effectively substitute for or complement physician-led care, though only one study was authored by a nurse consultant, highlighting a gap in nursing-led research. Service users favoured community-based, nurse-led care for its accessibility, convenience and cost-effectiveness, with health education noted as an added benefit in one study.
Nurse-led models demonstrate potential for high diagnostic accuracy in skin cancer, effective treatment delivery and enhanced patient education on skin self-examination. While role delineation remains a challenge, nurses play a critical role in supporting dermatologists in addressing the increasing referral demands associated with skin cancer care.
Trial Registration: The systematic review protocol (registration number: CRD42023448950) was developed in collaboration with a patient representative with lived experience of melanoma, alongside academic experts in dermatology nursing and specialist; dermatology clinicians.
A patient representative with lived experience of melanoma contributed to the review protocol.
Training and Competency Development: Completing nationally recognised dermatology nursing qualifications beyond the Advanced Clinical Practice pathway and practical training to extend assessment, diagnostic and treatment skills are essential for autonomous practice in dermatology. Specific skills in nurse-led skin cancer care are vital to ensure clinical competency. Dermatology Nurse Consultant Training Programme: Policies should prioritise nationally recognised Advanced Nurse Practitioner to Dermatology Nurse Consultant Training Programmes focusing on assessment, diagnostic and treatment skills. A structured, portfolio-based approach to training is crucial for achieving competency and enabling autonomous practice in dermatology, supporting the delivery of high-quality care. Support for Community-Based Care: Policy-level support for community-based care is critical, particularly in rural or underserved regions. These models reduce patient travel, improve timely care access and provide training opportunities for rural clinicians, offering a viable alternative to hospital-based services. Standardising Nurse-Led Models: Developing national or international guidelines is essential for scaling nurse-led models. Standardisation allows these models to adapt to the specific needs of local services while maintaining high standards of care. Delivering Comprehensive Care: Nurse-led models show promise in delivering standard care comparable to physician-led services for specific components of the skin cancer care pathway. They also provide value-added care benefits, such as tailored patient education, enhancing outcomes and satisfaction.
Nurse-led models demonstrate diagnostic accuracy in identifying skin lesions, including skin cancer, while contributing to treatment, patient education and follow-up care. Despite their growing role in skin cancer management, greater dissemination and publication of their outcomes are needed to inform clinical practice. This review highlights the importance of standardising nurse-led approaches into scalable frameworks to support dermatologists, enhance patient outcomes and ensure consistent care standards in skin cancer. Further evaluation is required to assess their efficiency, cost-effectiveness and implementation across diverse healthcare settings.
by Moayad Subahi, Fahda Alshaikh, Eyad Dahlawi, Feras Zafar, Tamim Alsulimany, Nawaf Alnefaie, Abdulrahman Almalki
Knee osteoarthritis (KOA) is a prevalent condition that reduces physical function and quality of life. Physical activity is foundational to KOA management; however, patient engagement and perceptions of treatment remain underexplored, particularly in Middle Eastern populations. This study evaluated physical activity (PA) levels among individuals with KOA and explored their perceptions, awareness, and experiences with management strategies, especially physical therapy. A sequential explanatory mixed-methods design was employed. Quantitative data were collected using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) from 60 adults with physician-diagnosed KOA (mean age 55.5 ± 6.4 years; 50% female) recruited from clinics and community programs in Saudi Arabia. Semi-structured interviews with 24 purposively selected participants further explored experiences and perceptions. Descriptive statistics summarized quantitative data, and thematic analysis guided qualitative interpretation. Ninety percent of participants recorded low PA levels (≤600 MET-min/week), with only 10% achieving moderate or high activity levels. Qualitative themes revealed multiple barriers including emotional distress, logistical difficulties, and misconceptions about KOA as well as facilitators such as family support and patient education. Integration of findings highlighted how contextual and psychosocial factors influence PA engagement. Adults with KOA in this study reported markedly low levels of PA, shaped by cultural, psychological, and environmental factors. Our findings highlight the importance of addressing these barriers through patient-centred education and improved access to physical therapy.To examine nursing experiences and perspectives regarding conscientious objection in healthcare practice.
Qualitative Systematic Review.
The studies were identified, screened and appraised using the Joanna Briggs Institute (JBI) model and appraisal tools to assess the quality of the data and ensure rigorous evaluation.
Five databases, including PubMed, CINAHL, Emcare, Scopus and PsycINFO, were searched from September 2024 to December 2024 to identify existing qualitative studies on nurses' experiences and perspectives on conscientious objection.
15 studies from 1998 to 2024 were included in this review from 11 different countries. The synthesised findings identified five themes related to nurses' experiences and perspectives of conscientious objection: (1) Conflict with Moral, Ethics, Religious and Personal Beliefs and Values; (2) Conflicts with Policy and Law; (3) Work Expectations, Team Decisions and Dynamics; (4) Conflict over Care Dilemmas; (5) Forms of Conscientious Objection.
Nurses from various clinical settings reported various perspectives on conscientious objection, identifying different clinical care experiences, personal ethical and religious conflicts, and ways in which they managed forms of conscientious objection in practice. The various conflicts may impact nurses by promoting burnout, stress and emotional exhaustion.
Understanding nurses' perspectives on conscientious objection allows clinical managers, stakeholders and policymakers to give nurses an opportunity to object conscientiously based on ethical and religious beliefs and create clear guidelines for ethical decision-making. Such guidelines allow nurses to conscientiously object while still maintaining professional standards and minimising adverse effects on the care provided to patients. Allowing conscientious objection has important implications for nursing practice, particularly in balancing professional responsibilities with personal and religious convictions.
This qualitative systematic review was reported in accordance with the PRISMA 2020 guidelines.
PROSPERO number: CRD42024599651
FreshRSS 