Conectar
Palliative care supports the physical, emotional, social and spiritual needs of people with serious life-limiting illness. Future research must align with the priorities of people approaching the end of their lives, and those close to them.
To undertake a refresh of the James Lind Alliance Palliative and End of Life Care Priority Setting Partnership, to identify and prioritise areas for future research.
The James Lind Alliance process was applied, between May 2023 and February 2025. An initial online survey collected areas for future research from participants. These were synthesised into a long list of questions and shortlisted through a second online survey. Final ranking of priorities was achieved using an adapted Nominal Group Technique within a prioritisation workshop.
People living with serious life-limiting illnesses, carers, friends and family members supporting them, bereaved people, health and social care professionals, volunteers working in palliative and end-of-life care and members of the public.
1032 and 626 responses were received to survey 1 and 2, respectively. 20 people with lived and professional experience attended the prioritisation workshop. An updated list of 24 priorities for palliative and end-of-life care research was produced.
The priorities reflect the range of issues shaping end-of-life experiences and serve as a call to action for researchers and funders.
To identify the barriers and facilitators to accessing services for neurodevelopmental disorders (NDDs) among the carers of individuals from Black, Asian and minority ethnic groups in the UK.
A scoping review.
Seven databases: PubMed, Cochrane, MEDLINE Full Text, APA PsycINFO, Scopus, CINAHL and Web of Science were searched for relevant studies up to the end of March 2025. Titles and abstracts and, where appropriate, full-text articles were screened based on predefined inclusion and exclusion criteria. Two reviewers independently screened the 6454 studies, with data extraction carried out by two reviewers. A narrative synthesis of the findings was undertaken.
A total of 15 studies were included in the review, the majority of which were qualitative (n=9; 60%). Among the Black, Asian and minority ethnic populations represented, South Asians comprised the predominant group. The review underscores that the barriers faced by Black, Asian and minority ethnic communities are multifactorial, which includes: (1) language and communication barriers, (2) cultural and religious influences, (3) stigma, (4) formal and informal support systems and (5) experience with healthcare services.
Access to neurodevelopmental care for carers from Black, Asian and minority ethnic groups in the UK is shaped by complex, multifactorial barriers. These communities are not homogeneous, and evidence gaps make it unclear whether challenges are shared or distinct. Greater understanding is needed to inform culturally appropriate, evidence-based policy and practice. Further research is essential to address disparities and improve equitable access across all groups.
Drug and vaccine safety information relevant to pregnant individuals is typically insufficient, especially so for persons living in low- and middle-income countries (LMICs). Pregnancy exposure registries (PERs) and similar systems are used to monitor medical products safety. A better understanding of the landscape of PERs in LMICs can support medicines regulatory system strengthening and preparation for new vaccine and drug introductions.
To identify PERs and related health data collection platforms in LMICs that systematically record pregnancy exposures to medical products and pregnancy outcomes to inform how future efforts, such as new vaccine introductions and treatment programmes, can better support maternal populations in these countries.
Scoping review based on methodology outlined in the Joanna Briggs Institute manual for scoping reviews.
Electronic search of Medline/PubMed, Embase, CINAHL and Global Index Medicus in June 2022, and key informants via online survey in July 2022 and interviews.
Eligible resources included registries, surveillance systems and databases that collect information on exposures to medical products during pregnancy and on subsequent maternal, perinatal and neonatal outcomes in populations located entirely or partially in LMICs. Eligible records were published from January 2000 through June 2022.
Search results were screened and data extracted using a standardised form by two independent reviewers. Instances of discordance were resolved by a third reviewer. Identified systems were categorised by resource type.
A total of 7515 records from electronic searches were screened, with 396 selected for full-text review and 47 additional records obtained from other sources. From these, 45 data collection systems located in African, Asian and Latin American LMICs were identified, with 36 currently in operation. These resources were grouped into six categories based on structure and approach and summarised according to key features, strengths and weaknesses.
This scoping review identified several resources in LMICs dedicated to drug and vaccine safety in pregnancy, but findings indicate that more investment will be needed to ensure such efforts are widespread and sustainable. Understanding the current landscape of such resources in these settings is an important step towards improving safe, world-wide access to life-saving interventions for pregnant populations.
The protocol for this review has been registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/FU5AT).
To assess the feasibility and acceptability of three SMS-delivered safer gambling interventions (goal setting (GS), descriptive norms (DN), injunctive norms (IN)) aimed at reducing the transition from low or moderate risk of gambling harm to problematic gambling, and the feasibility of a full-scale randomised controlled trial evaluating their effectiveness and cost-effectiveness.
Four-arm, parallel-group, pragmatic, randomised controlled feasibility study with a nested qualitative study.
The study was conducted in the UK. Participants were recruited online via UK-licensed gambling operators’ websites.
Adults aged ≥18 years, gambling online at least weekly, with low-to-moderate gambling risk levels.
Participants were block randomised in equal proportions to a delayed intervention control group or one of three 6-week text message interventions delivered via the secure messaging app WIRE: (1) GS: weekly prompts to set gambling-related goals with personalised feedback; (2) DN: weekly messages challenging misperceptions about peer gambling behaviours and (3) IN: weekly messages addressing misperceptions about peer attitudes towards gambling.
Feasibility was assessed through recruitment and retention rates, intervention adherence, data completeness and feasibility and acceptability of the interventions and study procedures. Secondary outcomes included gambling risk behaviours and cognitions, anxiety, depression, quality of life, healthcare use and productivity, measured at baseline, 7-weeks, and 3- and 6-months post-randomisation.
Recruitment took place between April 2021 and August 2022 with final follow-up in February 2023. 167 participants (mean age 51.5; 36% male) were randomised (GS=43; DN=41; IN=42; Control=41). Retention at 6-months was 95.2%, with >95% completion for all outcome measures. Intervention adherence was high, with >95% of DN and IN participants responding to ≥4 messages and 93% of GS participants setting ≥4 goals. Qualitative findings indicated broad acceptability of the interventions and study procedures.
The study was feasible to conduct, interventions and study procedures acceptable to participants, and predefined progression criteria met. Findings support proceeding to a full-scale randomised controlled trial of effectiveness and cost-effectiveness, focusing on the social norms interventions.
To examine the personal characteristics, promoting factors and organisational barriers to the professional realisation of diabetes nurse practitioners in Israel.
A descriptive study using quantitative and qualitative data.
The participants self-completed an electronic questionnaire, which included questions on demographic and professional characteristics and a self-realisation questionnaire constructed by the authors. Researcher-led focus groups were conducted, guided by a semi-structured guide. The discussions were recorded, transcribed and analysed by qualitative methods.
Forty-one diabetes nurse practitioners (median age 50 years, 98% females) participated in the study. On average, the participants reported a relatively high self-realisation of their professional role, especially those who have been working in this role for many years. While some of them work independently and are supported by their organisation, their managers and other healthcare team members, specifically physicians, many feel that there are barriers to the full implementation of the role and achieving professional realisation. These include multitasking challenges and insufficient remuneration. Self-realisation was viewed by the participants as an opportunity to provide excellent care to patients as well as being professional beyond caring for patients. They wanted to expand their knowledge as well as guide and teach. Furthermore, they also associated self-realisation with the autonomy to carry out procedures and make decisions independently of physicians. Internal motivation was perceived as an important factor for personal self-realisation, which stems from personal creativity, aspiration for excellence, a subjective sense of freedom, self-guidance, desire for self-development and aspiration for personal growth at the highest levels.
Recognition and fostering of diabetes nurse practitioners' role contribute to nurses' self-realisation and professional growth.
Personal and organisational factors should be aligned to support diabetes nurse practitioners in delivering high-quality care to patients with diabetes.
COREQ (COnsolidated criteria for REporting Qualitative research).
No patient or public contribution.
To estimate the prevalence of established atherosclerotic cardiovascular disease (eASCVD) and the prevalence of ASCVD high-risk patients as defined by the European Society of Cardiology (ESC) among the Egyptian population of the Prevalence and Clinical Management of Atherosclerotic Cardiovascular Diseases in Patients With Type 2 Diabetes (PACT)-Middle East and Africa study.
An observational, multicentre, cross-sectional study.
Eight secondary care centres in Egypt.
550 adult males and females who provided informed consent and had been diagnosed with type 2 diabetes mellitus (T2DM) for at least 180 days. Participants were excluded if they had participated previously in the study, had been diagnosed with T1DM, experienced mental incapacity, were unwilling to participate, had a known language barrier precluding adequate understanding or cooperation or had a known congenital heart disease or malformation.
The primary outcome was the proportion of patients with eASCVD, while the secondary outcome was the proportion of patients with T2D with high risk of ASCVD and without eASCVD.
Prevalence of eASCVD was 108/550 (19.6%, 95% CI 16.5% to 23.2%), and the prevalence of high risk for ASCVD in the population without eASCVD was 378/442 (85.5%, 95% CI 81.9% to 88.5%). Approximately 99% of the study population was categorised as ESC very high risk or high risk for CVD. On assessing utilisation of antidiabetic medications with cardiovascular benefit, only 20% were receiving sodium-glucose cotransporter-2 inhibitors, and 3% were receiving glucagon-like peptide-1 analogues.
The prevalence of eASCVD and high risk for ASCVD in Egypt is alarming, and the inadequate pharmacological control increases the ASCVD burden in the T2DM population. This calls for immediate, comprehensive action to reassess T2DM care.
Pre-eclampsia (PEC) is a morbid and potentially lethal complication of pregnancy and is more common in women with risk factors such as hypertension, diabetes, autoimmune disease, kidney disease or multifetal pregnancies. Low dose aspirin (ASA) is currently the only prophylactic therapy known to decrease PEC in this patient population. However, currently, there is no prospective literature comparing various low-dose ASA formulations in the risk reduction of PEC. In the USA, the currently available low-dose ASA is over-the-counter and found in 81 mg tablets. Therefore, when clinicians initiate low-dose ASA therapy, they may prescribe one or two tablets of 81 mg per day without comparative evidence to guide their decision. Our objective is to prospectively compare pregnant patients on 81 mg vs 162 mg of ASA and determine a possible dose response in the prevention of PEC.
We designed a pragmatic phase 3 prospective randomised open label blinded-end point clinical trial with parallel assignment between two groups of pregnant people at high risk for PEC, as defined by the US Preventive Services Task Force and American College of Obstetricians and Gynecologists (ACOG). The primary outcome is the incidence of preterm (
Our research protocol and safety monitoring protocol have been approved by the Weill Cornell Medicine institutional review board (IRB) and the Office of Human Research Protection. Evaluation for adverse events will be monitored throughout the study period. Adverse events will be assessed at each study visit.
FreshRSS 