Conectar
by Nurdiana Mohammad Hussin, Nik Ruzyanei Nik Jaafar, Idayu Badilla Idris, Azmawati Mohammed Nawi
Individuals with breast cancer (BC) experience significant psychological distress, yet their utilization of mental health services remains low. This study identified key factors influencing help-seeking behavior through integrated Theory of Planned Behavior (TPB) and Health Belief Model (HBM) frameworks. We conducted in-depth interviews (IDIs) with eight BC patients and nominal group technique (NGT) with six health professionals, followed by Fuzzy Delphi Method (FDM) to assess expert consensus. The IDIs revealed that the individuals with BC recognized the value of professional psychological support but were reluctant to engage with these services personally. The participants identified emotional thresholds for help-seeking, expressed preference for informal support networks, and demonstrated varied understanding of mental health professional roles. The FDM evaluation demonstrated strong expert consensus across all assessed elements, particularly those related to emotional support mechanisms. Three barrier categories emerged: individual factors (mental health literacy, autonomy preferences), social factors (family support, cultural stigma), and systemic factors (healthcare integration gaps). Expert consensus exceeded 80% agreement across all domains.This study identified a complex interplay between individual psychological barriers and systemic factors affecting mental health help-seeking among individuals with BC. Effective interventions must address psychological barriers and healthcare delivery factors while respecting individual autonomy in coping choices. A multi-level approach targeting individual education, family support systems, and healthcare integration is recommended to improve mental health service utilization among individuals with BC.This research aims to explore the factors that hinder professionals in delivering integrated care for children under 5 in temporary accommodation (TA) and understand their experiences of collaboration during the pandemic to inform recommendations.
Semistructured qualitative interviews.
England, UK.
45 professionals working across health, housing, education and non-profit sectors in England. Purposive and snowball sampling was employed to recruit a representation of key professionals across England. Those not eligible to take part in the study included people who did not work with families and/or children in TA settings.
To explore cross-sector learnings that are applicable to improving integrated care and to tailor recommendations to the needs of families and children under 5 experiencing homelessness in the UK today.
This study highlights the complex, multilevel barriers that professionals face when delivering integrated care to children under 5 in TA. Findings are organised using a framework that distinguishes between practice-level, organisational and systemic challenges. From siloed working practices and limited training to staffing shortages and restrictive data-sharing policies, these challenges collectively hinder service continuity and collaboration.
Although this project was conducted during the COVID-19 pandemic, the challenges identified reflect deeper, long-standing issues in service delivery. As services continue to recover and prepare for future crises, these insights remain highly relevant and can inform more resilient, integrated recovery plans to support children in TA beyond the pandemic context. Addressing these barriers, through improved collaboration, training and data-sharing, is key to strengthening care for this vulnerable population.
Some intensive care unit (ICU) patients develop an extremely deep and sustained immunosuppression that increases the risk of secondary infections and can ultimately compromise survival. Thanks to an easily accessible and simplified immune monitoring to identify immunological failure, a personalised immune restoration approach is now feasible. Among the different therapeutic strategies in this field, interferon gamma (IFN-) is probably the most interesting drug to reduce the burden of secondary infections in the ICU.
This is a two parallel group multicentre blinded add-on randomised trial comparing immunorestoration by subcutaneous injection of IFN- to standard of care in targeted ICU patients. The study will be performed in 23 ICUs in France. Patients hospitalised in the ICU for a week, with multiple organ failure defined by a sequential organ failure assessment score ≥6 during this first week, will be enrolled. If within 96 hours after inclusion, these patients express immunosuppressed features defined by a low absolute lymphocyte count (x109/L) and low expression of human leucocyte antigen-DR (HLA-DR) on monocytes (13 500 antibodies bound per cell and an absolute lymphocyte count >1200 x109/L) at day 10, healthcare costs at day 90 and rate of serious adverse reactions and suspected unexpected serious adverse reaction at day 90. We plan to randomise 326 patients.
The study will be implemented in accordance with European regulations and was independently reviewed and approved by the French Ethics Committee Comité de Protection des Personnes Ile de France III (EUCT number: 2024-516780-93-00). The results will be reported in international peer-reviewed journals and presented at international and national conferences.
To assess the care needs of older adults living in poverty in a high-income country and to analyse their relationship with other outcome variables.
A cross-sectional study.
Data were collected between September 2022 and February 2024 from 384 older adults in southeastern Spain. Descriptive statistics were calculated to assess older adults' care needs. A multiple linear regression analysis was carried out to determine the percentage by which the socio-demographic or outcome variables could explain the number of met care needs among older adults in poverty.
Around 20% of the care needs amongst older adults living in poverty were unmet. The most frequently unmet care need was related to money (53.6%). Almost 30% of participants were at risk of malnutrition, 18% felt lonely, and 80% perceived a low level of social support. Age, history of falls, emergency room visits, functionality, perceived social support, quality of life and nutritional status significantly predicted the number of needs met.
The health conditions of older adults living in poverty are suboptimal and may negatively influence their care needs. Nurses should consider these factors when designing, implementing and evaluating interventions to promote the biopsychosocial health of this population.
Nursing interventions to promote health amongst older adults living in poverty should focus on identifying unmet care needs, particularly those related to financial and social support. Interventions should prioritise improving nutritional status, enhancing social support networks and addressing loneliness.
Living in poverty increases older adults' vulnerability due to unmet financial, nutritional and social support needs. These unmet needs can negatively affect older adults' physical and mental health.
The study has been reported following the STROBE guidelines.
The study's participants only participated in the data collection process.
by Donato Koyalta, Zita Aleyo Nodjikouambaye, Jonathan Muwonga Tukisadila, Hachim Djamal Abdoulaye Bargo, Suitombaye Noubaramadji Yamti, Amine Akouya, Ralph-Sydney Mboumba Bouassa, Laurent Belec
BackgroundHigh-risk (HR) human papillomavirus (HPV) infection remains a great concern in sub-Saharan Africa in men who have sex with men (MSM). The prevalence of anal shedding of HPV and associated risk factors was estimated for the first time in a cross-sectional observational study covering MSM living in N’Djamena, the capital city of Chad.
MethodsMSM were recruited from the community in 21 sites in neighborhoods of 5 districts randomly selected in N’Djamena by respondent-driven sampling (RDS) method. Anal Collector V-Veil UP2™ device was used for anal canal self-sampling. Manual silica-extracted DNA was subjected for HPV detection and genotyping using BMRT Human Papillomavirus Genotyping Real Time PCR assay (Jiangsu Bioperfectus Technologies Co., Ltd., Taizhou, China). HIV serostatus was assessed using two rapid tests in series.
ResultsA total of 70 MSM (mean age: 29.9 years; range, 18–50) were included. The overall acceptability to practice veil-based anal self-sampling was 95.9%. The usability of the veil collector device was high (92.3%), with easy understandable instructions for use and correct placement in the anal canal. Satisfaction questionnaire reported high overall feeling, intimacy respect and lack of shame. The majority of MSM (44/70, 62.8%) showed anal shedding of HPV DNA, with HR-HPV frequently detected (38,70, 54.3%), including HPV-33 (30/70, 42.9%) HPV-68 (16/70, 22.9%), HPV-18 (4/70, 5.7%), HPV-35 (3/70, 4.3%), HPV-58 (2/70, 2.9%), and HPV-45 (1/70, 1.4%). The distribution of genotypes in HR-HPV DNA-positive MSM revealed that HPV-33 (30/70; 42.9%) was the predominant genotype, followed by the HPV-68 (16/70; 22.9%), HPV-18 (4/70; 5.7%), HPV-35 (3/70; 4.3%), HPV-58 (2/70; 2.9%), and HPV-45, HPV-51 and HPV-56 (each type, 1/70;1.4%).Among all HPV detected, only 42 HPV (36.8%) were covered by Gardasil-9® vaccine, including the HR-HPV-33, −18, −58 and −45, and the low risk-HPV-6 (5.7%) and HPV-11 (1.4%). The majority of detected HPV were non-covered by Gardasil-9® vaccine (63.1%). Overall HIV prevalence was 5.7%.
ConclusionsTaken together, these observations point the MSM population in N’Djamena as a very particular core group of HIV and HPV transmission. HIV prevalence was higher than that of general adult population, but limited to only one MSM of twenty. The RDS method of recruitment allowed to include MSM likely belonging to the same sexual network of HPV transmission leading to the selection of an atypical and specific profile of anal HPV distribution. The potential efficacy of HPV prophylactic vaccination in this population can be estimated at relatively weak.
The potential link between proton pump inhibitors (PPIs) and hypertension remains unclear. It is uncertain whether such an association exists, whether it represents a class-of-PPI effect and whether a dose–response relationship is involved. This study aimed to investigate the potential class-of-PPI effect associating PPIs with hypertension reporting and evaluate whether the association follows a dose-dependent pattern.
A disproportionality analysis was conducted within VigiBase to identify signals of hypertension reporting associated with individual PPIs by calculating adjusted reporting ORs (aRORs) within a multivariate case/non-case study design. Additionally, the presence of a dose–response relationship was explored.
Real-world data from VigiBase, the WHO pharmacovigilance database, was used.
All individual case safety reports with PPI use were included.
Incident hypertension cases were identified using the Medical Dictionary for Regulatory Activities V.26.1 related to at least one PPI administration that were systematically collected until 28 October 2024. Pharmacovigilance signals between the use of PPIs and hypertension reported and dose dependence between PPI posology and onset or worsening hypertension were analysed.
The database contained 26 587 reports of PPI-associated hypertension (2.3%), predominantly among women (63.3%). Hypertension was most frequently reported in the group aged 45–64 years (41.4%). A significant reporting OR (ROR) was observed for almost all PPIs in both univariable (RORs, 1.32–1.97) and multivariate analyses (aRORs, 1.09–1.35) after adjustments for age group, sex, concurrent antihypertensive medication and drugs known to induce hypertension, with the exception of lansoprazole (aROR 0.99, 95% CI 0.96 to 1.03). A potential trend suggestive of a dose–response relationship was identified, with doses lower than the median associated with a lower aROR for hypertension than doses higher than the median for all PPIs. However, this trend was not statistically significant, potentially due to insufficient statistical power.
This investigation indicates a notable pharmacovigilance safety signal associating PPI usage with hypertension reporting. Although a potential dose–response trend was observed, it was not statistically significant, possibly due to limited statistical power. Further longitudinal studies are warranted.
Despite a lack of evidence relating to effectiveness and safety, the use of apps in the field of mental health is increasing due to their ease of use and accessibility. The aim of the EvalDepApps project is to develop and validate an assessment tool for evaluating depression management apps based on scientific evidence, expert judgement and end-user needs.
The purpose of this study was to determine the most relevant criteria for evaluating apps intended to manage depression through consensus-based assessment.
A total of 43 individuals were invited to participate in an online modified Delphi study of 51 criteria identified from the literature. In Round 1, participants rated criteria according to relevance and three levels of consensus were defined: high level when ≥80% of respondents scored the criterion at 5 or 6; medium when 60%–79% of respondents scored the criterion at 5 or 6 and low when
The response rate was 59.0% (26/43) in Round 1 and 53.4% (23/43) in Round 2. In Round 1, 24 criteria (47.1%) attained the maximum level of consensus, 20 (39.2%) the medium level and 7 (13.7%) the lowest level. In Round 2, 4 out of 20 criteria (20.0%) attained the maximum consensus. Participant comments reinforced the relevance of the selected criteria. The final list consisted of 28 criteria, the majority relating to Safety and Privacy and Clinical Effectiveness (25.0% each), followed by Usability and Functionality (17.9%).
By prioritising criteria relating to data safety and clinical effectiveness, participants in this study emphasised that the assessment of apps for depression management must take both these aspects into full consideration. Despite some limitations of the study (eg, lack of participant sociodemographic data and its implications for generalisation, not face-to-face inter-round), the results of this study will enable the EvalDepApps project to develop an assessment tool for depression management apps that incorporates the most relevant criteria.
EvalDepApps will support healthcare professionals and users in identifying safe, effective and user-friendly depression management apps.
The aim of review was to describe and synthesise the evidence on the use of tourniquets to control haemorrhages, summarising both civilian and military use.
Trauma-related haemorrhage constitutes one of the most preventable deaths among injured patients, particularly in multi-casualty incidents and disasters. In this context, safe instruments such as tourniquets are essential to help healthcare professionals to minimise loss of life and maximise patient recovery.
An integrative review was conducted in Medline, Nursing & Allied Health Premium, and Health & Medical Collection, using published data until March 2021 and following the PRISMA guidelines.
A total of 25 articles were included. Evidence has been synthesised to understand the use of different types of tourniquets, environment of application, indication for their placement and potential complications associated with tourniquet placement.
Commercial tourniquets such as Combat Application Tourniquet or Emergency Tourniquet models are a valuable and safe instrument for haemorrhage control in both military and civilian out-of-hospital care settings. Nurses, as part of emergency teams, and other professionals should be aware that there is a possibility of adverse complications, but they are directly proportional to the time of tourniquet placement and generally temporary. In addition, national and international guidelines ensure the need for all civilian emergency services to be equipped with these devices, as well as for the training of healthcare professionals and first responders in their use.
Despite the lack of complications in the use of tourniquets in these cases, their use has been a matter of debate for decades. In this sense, this review yields up-to-date guidelines in the use of tourniquets, their recommendations and their significance among professionals to manage complicated situations.
To describe the features and rates of emergency department (ED) presentations identified as related to violence against women (VAW) and of confirmed cases of family domestic violence (FDV) inpatient admissions and to compare these across geographic locations in New South Wales (NSW) Australia.
A retrospective data linkage study.
Routinely collected public hospital data from approximately 180 designated public hospital EDs in NSW, Australia.
Cases were included if female, aged ≥15 years, presenting to any NSW ED between 2015 and 2022 and with one or more criteria indicating VAW, leading to 21 219 cases being included.
The age-standardised rate of VAW ED presentations per year and confirmed FDV inpatient admissions within metropolitan and non-metropolitan areas in NSW, Australia.
Women presenting with VAW were more likely to be aged 25–44 years (n=9705, 45.7%), with almost 20% of presentations from women who identified as Indigenous (n=4153, 19.6%). Indigenous presentations were greater in non-metropolitan areas (n=2675, 30.9%) compared with metropolitan areas (n=1478, 11.8%). Indigenous women in NSW represent only 4.2% of the estimated residential population. VAW presentation rates by age group varied over time, a gradual increase being seen in the 65–84 year-old age group who experienced 45 VAW presentations per year in 2015 to 79 presentations per year in 2022 with an annual rate of change of 7.3%.
VAW accounts for a substantial burden of ED presentations across NSW; the greatest impact on women aged 25–44 years and Indigenous women, particularly in non-metropolitan areas. Rising presentations among older women further highlight the need for strengthened ED screening and referral pathways and for targeted resource allocation to address inequities in family, domestic and sexual violence.
Self-harm and suicide are common among prison inmates, but less is known about these phenomena in those with psychosis.
The aim of this study was to examine self-harm behaviour in New South Wales (NSW) prisons in Australia among inmates diagnosed with psychosis. This study also examined self-harm-related alerts applied by Corrective Services to assist staff with the management of the security and well-being of inmates.
A retrospective case-control data-linkage study was conducted using administrative data collections in NSW, Australia.
The study included all individuals diagnosed with psychosis and incarcerated between 2001 and 2020 in NSW as cases and an age and sex matched control group with no such diagnosis with a record of incarceration in the same time period.
The primary outcome measure was self-harm among the cases and controls. The secondary outcome measure was the application of alerts by Corrective Services in relation to self-harm incidents.
Multivariate regression analysis was used to examine predictors of self-harm in prison. Prisoners with psychosis (n=14 900) were more likely to self-harm than controls (n=2713), with 15.0% versus 3.6% engaging in self-harm (highest odds of self-harm observed in those with schizophrenia and related psychoses, aOR=4.84, 95% CI: 3.93 to 5.98). Those of Aboriginal heritage had an increased risk of self-harm (aOR=1.58, 95% CI: 1.43 to 1.75). Factors associated with a lower risk of self-harm were male sex and older age (≥25 years) at the time of their first incarceration. 35.6% of those released from prison with a prior psychosis diagnosis had at least one alert applied during incarceration compared with 10.1% of prisoners without a diagnosis of psychosis. Overall, 35 individuals with psychosis and 1 individual from the control group died while in prison between 2001 and 2020. 17 prison suicides were recorded from the study population; all occurred in the psychosis group.
Given the heightened risk of self-harm in those with histories of psychosis, consideration should be given to sharing mental health information between agencies to improve the care and management of this group during incarceration. Prison alerts may be a useful tool to help staff manage inmates’ well-being if used appropriately.
Background
Females with autism often receive late diagnoses—especially those with average or above-average intellectual abilities—highlighting the need to explore the unique experiences of this population for better health care support.
Objective
To explore the experiences and perceptions of females who received a late diagnosis on the autism spectrum in terms of coping and managing their diagnosis.
Methods
A descriptive qualitative study was conducted from December 2022 to March 2023 using semistructured interviews with 14 late-diagnosed autistic female subjects. Purposive and snowball sampling were employed, and thematic analysis of the interview data was performed using ATLAS.ti v.9 software. Findings were reported following standards for reporting qualitative research guidelines.
Results
Two main themes emerged: (a) getting a diagnosis: fitting into the norm, and (b) navigating the distinct significance for autistic females. The findings indicated that masking strategies contribute to delayed diagnoses, and social and health care stigma surrounding autism in females was evident. Areas for improving access to resources and support programs were identified.
Discussion
The results show that masking and camouflaging are predominant strategies among autistic females, contributing to delayed diagnoses and exposing them to additional risks. Enhancing resources and training for health care professionals is necessary to address the specific needs of this population. Introducción. Las intervenciones de música en directo pueden ayudar a mejorar el bienestar tanto psicológico como físico, emocional y espiritual. El presente proyecto nace de un trabajo colaborativo e interdisciplinar entre dos titulaciones de grado: Enfermería e Interpretación Musical. Objetivos. Analizar la efectividad de una intervención musical en directo en el bienestar de pacientes oncológicos. Metodología. Se plantea un estudio de diseño mixto. Un estudio cuasiexperimental sin aleatorización para evaluar el efecto de la intervención con grupo un control (N=33) y experimental (N=33) durante la administración del tratamiento en un hospital de día oncológico. Se recogerán variables sociodemográficas y clínicas (nivel de ansiedad, afectividad y signos vitales). También se analizarán los niveles de ansiedad y variación en los signos vitales en los intérpretes (estudiantes de música) antes y después de los ensayos y de la intervención. Se diseña un estudio cualitativo fenomenológico-hermenéutico para conocer las experiencias de los pacientes y los intérpretes tras la intervención musical. Aplicabilidad práctica. En este proyecto se destaca la importancia de la colaboración entre estudiantes de dos disciplinas complementarias en contextos sanitarios reales.
ABSTRACT
Introduction. Live music interventions can help enhance psychological, physical, emotional, and spiritual well-being. This research project stems from a collaborative and interdisciplinary effort between two undergraduate programs: Nursing and Musical Performance. Objectives. To analyze the effectiveness of a live music intervention on the well-being of oncology patients. Methodology. A mixed-methods study design is proposed. A quasi-experimental study without randomization will evaluate the effect of the intervention with a control group (N=33) and an experimental group (N=33) during chemotherapy treatment administration in a day hospital. Sociodemographic and clinical variables (anxiety levels, affectivity, and vital signs) will be collected. The levels of anxiety and changes in vital signs in the performers (music students) will be analyzed before and after rehearsals and the intervention. A phenomenological-hermeneutic qualitative study is designed to understand the experiences of the patients and performers after the musical intervention. Practical Applicability. This project emphasizes the importance of collaboration between students from two complementary disciplines in real healthcare settings, starting from their formative stages.
Este artículo contempla una actualización con base a los diez puntos establecidos por el consenso Skin Changes at the Life's End [Cambios en la Piel en el Final de la Vida] (Scale, por su sigla en inglés) y tiene por objetivo discutir la evaluación de las condiciones y el cuidado de la piel en el final de la vida. Acerca de los pacientes y familiares, se propone la construcción de un plan de cuidados basándose en sus deseos que deben ser debidamente registrados. Para los profesionales de salud, las recomendaciones buscan la educación para la evaluación de los signos clínicos de falla e insuficiencia de la piel. Así pues, la prioridad es la comodidad del paciente. Se concluye que la utilización del consenso Scale va al encuentro de la filosofía de los cuidados paliativos y puede así mejorar los aspectos multidimensionales involucrados en la calidad del proceso de morir.
Rev Enferm;41(2): 135-138, feb. 2018. [Artículo]
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