Conectar
The transition into fatherhood is considered a profound life stage, involving personal development, lifestyle and emotional adjustments. Fathers’ mental health can be adversely impacted by this transition. Fathers express isolation, exclusion and limited support within perinatal services. Restricted emotional support for fathers presents negative consequences for the whole family dynamic. Limited research has explored father and professional input associated with paternal perinatal support and how healthcare services and child and family services can respond to engaging fathers and their mental and emotional support needs. This qualitative study aims to explore fathers’ mental health and well-being experiences (referring to emotional or/and social well-being) and support needs within the perinatal period, as well as current viewpoints of perinatal services (maternity, healthcare and social care services) from both fathers’ and professionals’ perspectives.
In-depth semistructured interviews and focus groups were carried out as part of a qualitative study.
Fathers’ resident within the North East and North Cumbria (NENC) and services and organisations from the voluntary, community and social enterprise (VCSE) sector and social care services across the NENC, who associate with supporting families and children, and perinatal mental health.
Fathers (n=21) and professionals (VCSE and social care services) (n=9).
Reflexive thematic analysis of 30 participants’ accounts identified two main themes and five subthemes: (1) ‘The Pregnant and Postnatal Man’ and (2) Removing the cloak of fatherhood invisibility. These themes centred around the isolation of fathers and limited emotional and mental support within the parenting transition.
The findings suggest that greater father inclusion within perinatal services, policies and antenatal education may help fathers feel more recognised and supported throughout the perinatal journey. Recognition of fathers’ emotional well-being and mental health, by adopting a ‘whole family’ emotional support approach within perinatal services was considered important to support fathers and the family dynamic in facilitating a positive transition for the whole family.
Chronic back pain (CBP), defined as back pain persisting for more than 3 months, is highly prevalent and associated with substantial socioeconomic burden and impaired quality of life. Pain catastrophising is an important cognitive-affective factor in the maintenance of CBP and may fluctuate in daily life. Conventional treatment approaches often do not address these momentary dynamics. Just-in-time adaptive interventions (JITAIs) deliver tailored support at opportune moments based on time-varying information and may therefore complement existing treatments for CBP. In this study, ecological momentary assessment (EMA) is used to capture momentary pain-related states and guide the delivery of adaptive microinterventions. To our knowledge, no JITAI specifically targeting pain catastrophising in CBP has yet been evaluated in a randomised controlled trial.
This pragmatic, two-arm randomised controlled trial will compare a JITAI with enhanced treatment as usual (TAU+). A total of 100 participants will be recruited to obtain an evaluable sample of 86 participants. Eligible participants are adults with CBP persisting for more than 3 months and an average pain intensity over the previous week of at least 3 on a 0–10 Numerical Rating Scale. Participants in the intervention group will receive app-based, adaptive microinterventions, such as relaxation exercises and physical activities triggered by EMA responses on pain catastrophising and pain intensity. Participants in the TAU+ group complete the same EMA assessments but will not receive adaptive micro-interventions. The primary outcome is reduction in pain catastrophising, assessed with the Pain Catastrophizing Scale. Secondary outcomes include pain intensity, pain interference, pain behaviour, pain quality, physical functioning, anxiety, depression, fatigue, sleep disturbance, social participation, fear-avoidance beliefs, pain-related self-efficacy and treatment satisfaction. Primary and secondary outcomes will be analysed using between-group comparisons according to the intention-to-treat principle. Exploratory analyses will examine proximal, short-term effects of microinterventions using dynamic structural equation modelling. Assessments will be conducted at baseline before randomisation (T0), mid-treatment 2 weeks after intervention start (T1), end of treatment 4 weeks after intervention start (T2) and at 3 months (T3) and 6 months (T4) after end of treatment.
This study has been approved by the Ethics Committee of the Charité Universitätsmedizin Berlin (approval number: EA4/207/21, 18 October 2021). Results will be submitted for publication in peer-reviewed journals and presented at conferences.
DRKS00028494.
To evaluate the feasibility and acceptability of an online research capacity-building (RCB) education programme for the health and care workforce and explore its preliminary outcomes.
Mixed-methods pilot study incorporating quantitative survey data and a qualitative group interview.
Single Health Innovation organisation in England’s North West region.
Staff working in research, evaluation and innovation-related roles.
16 one-hour online RCB education sessions, informed by the Research Capacity and Culture Tool (individual domain), were delivered weekly via Microsoft Teams between February 2024 and October 2024.
The primary outcomes were feasibility and acceptability of the programme, assessed through attendance and a participant group interview. The secondary outcome was change in behaviour intention measured pre–post education sessions using the Continuing Professional Development Reaction (CPD-R) questionnaire.
Attendance per RCB education session ranged from 2 to 11 participants. Post-session CPD-R completion was low, limiting matched pre–post analysis, but median scores were generally higher post-session across most constructs. Four themes and eight sub-themes were identified from qualitative data. The four core themes were: establishing a common ground for research capacity building; creating pathways for meaningful involvement; translating knowledge within organisational contexts; and bridging individual development and collective momentum. The online format was received well for its accessibility and convenience, fitting within busy working schedules. Participants also reported increased confidence and perceived skill development.
This pilot study demonstrates initial feasibility and acceptability of an online format for RCB education within the health and care workforce. The format has potential for delivery at scale, where time and service pressures limit access to face-to-face programmes. Session length and content support require refinement in future iterations. Further research should examine implementation across diverse settings with larger samples.
Discharge from an intensive care unit (ICU) to the ward has long been recognised as a difficult and dangerous time for patients. This study aims to explore the experiences of patients, family members and staff of ongoing care following discharge from ICU to the ward.
An exploratory qualitative interview study, part of a mixed methods research project exploring post-ICU ward care to inform practice changes to improve outcomes for critical care survivors.
Semi-structured interviews were conducted with 55 purposively sampled patients, family members and multi-professional staff between 2017 and 2018 at three NHS trusts in the UK. Data were analysed thematically.
Three main themes were identified: Being wardable discusses the tension between perceptions of readiness for ICU between ICU and the ward staff; Post-ICU patients as other analyses the characterisation of otherness of post-ICU patients in comparison with other ward patients; and Fear and anxiety considers the impact of this perceived otherness on both patients and staff.
The term wardable is used by staff to indicate the suitability or otherwise of patient transfer. There is a tension between being deemed wardable from an ICU and ward perspective. This exacerbates the perception of otherness and compounds the fear and anxiety related to post-ICU care experienced by both patients and ward staff.
By recognising the tension between being ready for ICU discharge (not requiring organ support) and being wardable (having care needs which can be fulfilled on the ward they are being discharged to), clinicians may better support patients during this transition of care. This has the potential to improve outcomes for post-ICU patients, as well as improve the experience by both patients and the staff and family members caring for them.
The COREQ reporting checklist was used in the reporting of this manuscript.
Patients and public were involved throughout the REFLECT project, from design through to dissemination. This included advising on the approach to patient participants and supporting dissemination of results via social media.
ISRCTN: 14658054
Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid.
Systematic review and meta-analysis.
PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026.
We included randomised controlled trials and pre–post studies of patients with long covid reporting on fatigue, quality of life, cognitive symptoms or function and other long covid symptoms.
Two independent reviewers used standardised methods to search, screen and select included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models.
Of 397 titles and abstracts screened, no randomised controlled trials were identified. Four observational pre–post studies from the USA and Ireland (n=155) met inclusion criteria. LDN doses varied from 1 mg/day to 6 mg/day. Pooled pre–post analyses showed moderate effects for reducing fatigue (Hedges’ g=–0.74; 95% CI –1.11 to –0.37; p
Limited evidence from small pre–post studies suggests LDN may improve fatigue, cognition, sleep, pain and functioning in long covid. However, certainty of evidence is low. Well-powered trials are needed to confirm efficacy, determine dosing and duration and identify subgroups most likely to benefit.
Proactive deprescribing is the process of stopping a medicine and comprises four steps: (1) identify a patient for potential stop of a medicine, (2) evaluate a patient for potential stop of a medicine, (3) stop a medicine and (4) monitor after stopping.
The CHARMER (CompreHensive geriAtRician-led MEdication Review) trial is a stepped-wedge design to evaluate the effectiveness and cost-effectiveness of a behaviour change intervention to increase proactive deprescribing in hospitals. The CHARMER intervention comprises a deprescribing action plan, deprescribing briefings, videos of successful deprescribing consultations, deprescribing case studies workshop and a deprescribing performance dashboard. The process evaluation will explore trial processes, CHARMER intervention implementation, CHARMER behavioural mechanisms of action and contextual factors influencing these aspects.
The convergent parallel design process evaluation will follow the UK Medical Research Council guidance. We will interview: staff involved in CHARMER implementation, geriatricians and pharmacists who receive the intervention and research delivery staff involved in patient/carer recruitment and data collection. We will also interview patients/carers and primary care practitioners. Interviews will be supplemented with recordings of implementation activities and completed implementation manuals. Questionnaires will capture the extent to which the four proactive deprescribing steps are enacted by intervention recipients, measure the behavioural mechanisms by which the CHARMER intervention operates and capture the patient experience of proactive deprescribing. Qualitative data will be analysed thematically and then mapped to Normalisation Process Theory to explore implementation and the Theoretical Domains Framework to explore behaviour change. Most quantitative data will be analysed descriptively; however, changes in staff questionnaire responses preintervention and postintervention will be analysed using a Mann-Whitney test. We will triangulate qualitative and quantitative findings to explain intervention effects.
Ethical and governance approvals have been obtained by the Wales 2 Research Ethics Committee and the Health Research Authority, respectively. The dissemination strategy will be underpinned by the evidence-based Guide to Disseminating Research (GuiDiR) targeting healthcare practitioners, policy makers and patient-facing organisations.
Each year over 130 000 patients in the UK are discharged from an intensive care unit (ICU), with many experiencing poor outcomes such as in-hospital mortality, emergency ICU readmission and/or significant morbidity. Despite current national guidance and the availability of follow-up services, post-ICU care remains variable. Critical Care Outreach Teams (CCOTs) are key in supporting this patient group, yet practice differs considerably. Recovery pathways have been successfully employed in other patient populations and are a potential option to standardise post-ICU care. Understanding how care is currently delivered by CCOT throughout the UK is essential to inform future development of an evidence-based recovery pathway for this patient group. Our primary aim is to understand how post-ICU follow-up care is delivered within the wider remit of CCOT workloads.
This is a pragmatic multicentre qualitative study of post-ICU follow-up care. The study will be split into two sub-studies: semi-structured interviews and ethnographic observations. Semi-structured interviews will be conducted with three groups of individuals: multi-professional staff members involved in the care of patients discharged from ICU to the wards, patients discharged from ICU to the wards and their family members. Direct participant observations alongside ad hoc informal discussions will be undertaken with members of the CCOT at participating sites focusing on their workflow to generate an understanding of the CCOT role and how post-ICU support fits within this. An overarching thematic analysis approach will be taken to analyse data from both sub-studies to clearly identify the barriers and facilitators to providing post-ICU support within the CCOT role.
Ethical approval has been obtained through the London—Chelsea Research Ethics Committee (25/PR/0773). We aim to disseminate the findings to local teams, at regional and international conferences, in peer-reviewed journals and through social media.
In the UK, a range of services provide same day, urgent and emergency care (UEC). Urgent medical needs can be addressed through pharmacy services, same day general practice (GP) appointments, phone or online triage services, out-of-hours GP appointments and urgent treatment centres (or equivalents). For emergency medical needs, patients can access emergency departments (EDs) and ambulance services. These services are highly vulnerable to excessive strain due to rising, unpredictable demand and limitations in patient flow across the system. The workforce operates in time-critical situations, often with limited resources, which can lead to staff burnout, low job satisfaction and retention and poor health. The organisation of services and their workforce continues to evolve in response to local and national pressures and varies considerably across the UK, where there are four distinct, publicly funded healthcare systems managed separately in each country. This makes it difficult to describe and compare services within and across regions and understand the impact of workforce organisation on service delivery, staff well-being and patient care. This study aims to develop a comprehensive understanding of the range and types of UK UEC services, the relative experiences of the workforce and the available workforce data.
This mixed-methods study includes two components, integrated through an explanatory sequential design. Study 1 will use data on NHS service availability and direct enquiry to map UEC services and populate a structured database, which will facilitate the generation of a UEC typology of the range and types of services and regional variation across the UK. Multiple case studies will be conducted in a subset of services using qualitative interviews (n=136–220) with service leaders (n=3–5), workforce (n=10–12), and patients or carers (n=4–5), as well as document analysis where relevant, in each service of interest (n=8–10). Study 2 will create a metadata catalogue of workforce data and produce descriptive summaries of key metrics (eg, staffing levels and skill mix). The study will be supported by our Community Inclusion and Engagement (CIE) panel and Patient and Public Advisory Group (PPAG) to ensure relevance, inclusivity and impact.
This study received ethical approval from Yorkshire and The Humber - Sheffield Research Ethics Committee (04/08/2025, IRAS ID: 357276, REC Reference: 25/YH/0125) and HRA and Health and Care Research Wales approval (12/08/2025). Data collection poses minimal risk, informed consent will be obtained, and participants may withdraw at any time. Dissemination will follow knowledge mobilisation principles to maximise impact. We will build on our existing networks and work with our CIE panel and PPAG to tailor study outputs to different audiences. The outputs will improve understanding of the variation in how UEC services and workforces are organised across the UK, as well as the type and format of available workforce data, and provide benchmarks for future research.
Research Registry (REF: researchregistry11555; https://www.researchregistry.com/register-now/%23home/registrationdetails/68d402672341e502cd0ce888/)
To explore staff and patient perception of the newly co-developed wearable monitoring system (WMS), including acceptability of use in clinical practice.
Pragmatic qualitative descriptive study.
Semi-structured interviews were conducted with 12 patient participants and eight staff members between June 2023 and August 2024, and were analysed thematically.
Three themes were identified, building on previous qualitative work around the use of WMS on hospital wards. The first theme—centralised continuous monitoring enhances care—explores how WMS provides staff with a means to provide safe, efficient care with the ability to see the vital signs away from the patient. Patients reported feeling safer, knowing they were being monitored when staff were not at the bedside. The second theme—human connection at the bedside—considers how both patients and staff emphasised that the system should not replace nurse/patient interactions and face-to-face care, even though it provided patients with a stronger sense of independence. The final theme—system usability and integration into care—focuses on use of the system in clinical practice and implications for the future.
Wearable monitoring systems have the potential to support nurses to provide safer, more efficient care, whilst providing reassurance to patients. However, centralised monitoring should not replace face-to-face clinical contact, and careful consideration should be given to who would benefit most from the technology.
This study extends existing knowledge of the impact of WMS from being a tool to enhance patient safety to an intervention to improve nurse efficiency and patient experience, within the context of a high-demand surgical ward.
Patients and members of the public were involved in study design and data collection. Their contributions included participating in advisory groups, ensuring the research addressed patient-relevant priorities.
by Andrea Lopez-Soto, Esmeralda Ramírez, Duyen H. Vo, Aigerim Alpysbekova, Seo Woo Lee, Maria Duque, Lawrence Watkins, Cory L. Cobb, Beyhan Ertanir, Alejandra Garcia Isaza, Evelyn Gualdron, Sumeyra Sahbaz, Collette Steed, Neel Devan Youts, Shriya Senapathi, Seth J. Schwartz, Pablo Montero-Zamora
There is a limited understanding of how different subgroups of Latin American immigrant parents experience cultural stressors, as well as its impact on family dynamics, health behaviors, and mental health. The present study aimed to (1) identify latent cultural stress profiles among Latin American immigrant parents in the U.S. and (2) examine differences among these profiles concerning family intimacy, democratic parenting style, family conflict, hazardous alcohol use, and depressive and anxiety symptoms. Participants consisted of a sample of 1,351 parents (61.9% female; M age = 39.83, 62% first-generation; North America [61%], Central America and the Caribbean [21%], and South America [19%]) of children aged 8–16. We used latent profile analysis to identify subgroups of cultural stress, defined by perceived discrimination (PDS) and negative context of reception (NCR). Multinomial logistic regression was conducted to examine key correlates of profile membership. Five latent profiles were identified (1) Low PDS/NCR (22.2%), (2) Low PDS/Elevated NCR (14.8%), (3) Moderate PDS/NCR (18.7%), (4) Elevated PDS/NCR (33.5%), and (5) Highest PDS/NCR (10.8%). Compared with Profile 1 (Low PDS/NCR), parents in Profiles 2–5 generally reported lower family intimacy (RRR = 0.93–0.97). Parents in Profile 5 (Highest PDS/NCR) reported more family conflict (RRR = 1.13), hazardous alcohol use (RRR = 1.20), depressive symptoms (RRR = 1.31), and anxiety symptoms (RRR = 1.29), with markedly elevated depressive (RRR = 22.94) and anxiety symptomatology (RRR = 17.48) compared with Profile 1. Our findings suggest the presence of vulnerable subgroups due to cultural stress among Latin American parents in the United States. A better understanding of cultural stress patterns may improve current and future interventions tailored for Latin American families, addressing health disparities within this population.
Background
The state of New Jersey has a large Black/African American (AA) versus White racial disparity in infant mortality and educational level at childbirth. This disparity, measured by rate ratio, increases with greater maternal education among varied racial–ethnic groups. The nature of this disparity measured by rate differences has not been explored.
Objectives
Infant birth and mortality data were used to examine whether racial or ethnic disparities in infant mortality increased with greater maternal education, comparing rate differences and rate ratios. Racial and ethnic variations in the association between maternal education and infant mortality were examined.
Methods
Data were from the New Jersey State Health Assessment Data for all New Jersey births between 2014 and 2018 stratified by race and ethnicity, maternal education, and infant mortality (n = 481,333). R software was used to create a data set and estimate additive and multiplicative interactions, rate differences, and rate ratios for infant mortality by maternal race/ethnicity and educational levels among four racial–ethnic groups.
Results
Infant mortality was significantly greater for Black/AA and Hispanic mothers than for White mothers. At all educational levels, Black/AA mothers had the highest prevalence of infant mortality compared to other racial or ethnic groups. Rate differences in infant mortality showed a decrease in Black/AA–White differences for mothers with a high school education or less compared to mothers with a college degree. However, rate ratios showed an increase in Black/AA–White ratio with increasing education levels for mothers with high school education or less than mothers with a college degree. Risk ratios comparing infant mortality for Black/AA versus Hispanic or Asian mothers showed more than a twofold greater risk at all education levels for Black/AA infants. Finally, college-educated Black/AA mothers had significantly higher rates of infant mortality than White or Hispanic mothers with a high school education or less.
Discussion/Implications
Black/AA mothers with a college degree had a higher infant mortality rate than White, Hispanic, or Asian mothers with a high school education or less. Future research should address contextual/systemic contributors to this disparity. 
FreshRSS 