Conectar
This study aimed to systematically delineate the clinical characteristics and identify the key risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) infections in burn patients, thereby informing targeted preventive measures and therapeutic strategies. This retrospective study included 270 burn patients with Staphylococcus aureus (S. aureus) infections at a Chinese centre (2019–2022), comprising 127 MRSA and 143 methicillin-susceptible S. aureus (MSSA) cases. Clinical data were analysed to assess infection profiles, resistance patterns and MRSA risk factors. Amongst the infections, 68.1% (184/270) were caused by multi-drug resistant S. aureus, specifically 47.0% (127/270) by MRSA and 21.1% (57/270) by MSSA. The predominant resistance pattern (penicillin, oxacillin, gentamicin, clindamycin, erythromycin, ciprofloxacin, levofloxacin, tetracycline) accounted for 23.9% (44/184) of multidrug-resistant cases. The overall MRSA detection rate was 47.0% (127/270). Univariate analysis identified multiple factors significantly associated with MRSA infection (p < 0.05). Multivariate analysis identified the use of ≥ 3 types of antibiotics as an independent risk factor for MRSA infection in burn wounds. The detection rate of multi-drug resistant S. aureus (including MRSA) infections in burn wounds is relatively high. A number of variables are the influencing factors for MRSA infections. Medical personnel should adopt infection control measures to block the transmission of multi-drug resistant bacteria (including MRSA).
by Agatha Ribeiro Kalthof, Nikolas Dresch Ferreira, Caio Mateus Silva, Iuri Cordeiro Valadão, Iguaracy Pinheiro de Sousa, Ester Riserio Matos Bertoldi, Vanessa Morais Lima, Lauro Thiago Turaca, Ana Beatriz Ruiz Afonso Barbosa, Miriam Helena Fonseca-Alaniz, Jean-Paul Concordet, Elida Adalgisa Neri, Jose E. Krieger
Generating mature human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) remains a major obstacle to accurate disease modeling and cardiac repair. As the transcription factor Irx3 is a key determinant of ventricular conduction system fate in mice, we hypothesized that suppressing IRX3 expression accelerates human working cardiomyocyte differentiation. Here, we demonstrate that depleting IRX3 enhances hiPSC-CM differentiation. IRX3-knockout (KO) hiPSCs generated a greater number of cardiomyocytes with elevated expression of TNNI1 and CX43. Notably, IRX3-KO cardiomyocytes exhibited improved electrophysiological properties, more uniform mitochondrial distribution, better sarcomere organization, and enhanced intercellular connectivity. We observed that IRX3 expression peaks during the early stages of cardiomyocyte differentiation, whereas IRX3-KO cardiac progenitors have increased expression of GATA4, NKX2–5, and TBX5, as well as enhanced cell proliferation. These integrative analyses indicate that IRX3 influences cardiomyocyte differentiation by modulating the gene regulatory networks driven by GATA4, NKX2–5, and TBX5, providing functional evidence linking gene regulatory networks to the structural and electrophysiological development of cardiomyocytes. Collectively, these findings identify IRX3 as a key regulator of early cardiac commitment and highlight the potential of IRX3 suppression to enhance the molecular and functional phenotype of hiPSC-derived cardiomyocytes.Information anxiety (IA) describes the distress caused by the gap between the information individuals have and what they feel they should possess. In the current digital environment—marked by volatility, uncertainty, complexity and ambiguity—IA has expanded beyond traditional academic and workplace contexts to become a pervasive concern across populations. Mapping the empirical evidence on IA is critical to understanding its prevalence, determinants, impacts and coping strategies.
This protocol outlines a scoping review guided by the Joanna Briggs Institute methodology and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We will systematically search EBSCOhost, Scopus and Web of Science for peer-reviewed empirical studies published from 1 January 2000 to the planned end date of 5 November 2025. Two reviewers will independently screen records, with a third resolving discrepancies. Data extraction will be conducted using a customised tool, and results will be synthesised narratively and visually, structured around bibliometric characteristics, the Population, Concept, Context framework and a Stimulus-Organism-Response model. Subgroup analyses will be conducted across populations, disciplines and regions.
-ScR
As this study is based on secondary analysis of published data, ethical approval is not required. Findings will be disseminated through peer-reviewed journals and academic conferences.
by Patricia Fiorino, Luigi Fernandes Rosa Cauduro, Danielle Silberspitz Konig, Leonardo Fernandes Rosa Cauduro, Caio de Araujo Santos, Juliana Alves Kavai, Isadora Durigan Duarte, Anna Laura Viacava Américo
Zebrafish (Danio rerio) are widely used as models in cardiovascular research due to their rapid development, optical transparency, and genetic similarity to humans. However, the lack of standardized experimental conditions, particularly regarding developmental stage and microenvironmental parameters, limits reproducibility across studies. This study aimed to characterize cardiovascular function in Zebrafish larvae and evaluate the impact of developmental stage and environmental factors. Wild-type AB embryos were maintained under standard conditions, and heart rate (HR), cardiac output (CO), and ejection fraction (EF) were measured at 24, 30, 48, 52, 56, 72, 78, and 80 hours post-fertilization (hpf). The effects of variations in temperature (27.0, 27.5, and 28.0 °C) and pH (7.0, 7.4, and 8.0) were also assessed. Results showed a progressive increase in HR from 24 to 72 hpf, stabilizing thereafter. CO exhibited two phases of elevation: an early rise between 24–48 hpf and a stronger increase between 48–56 hpf. EF remained generally stable, with a transient reduction at 48 hpf. Cardiovascular performance reached a physiologically stable state after 72 hpf, defining a reliable window for functional studies. Environmental conditions modulated these parameters: temperature variation induced approximately 20% difference in HR and reduced EF, while CO was minimally affected. In contrast, pH variations within the physiological range had no significant impact on HR, CO, or EF. These findings highlight developmental and environmental variables that may influence cardiovascular measurements in Zebrafish larvae and support the development of more consistent experimental approaches in cardiovascular and toxicological research.by Rena Xu, David Pletta, Caitlynn Feng, Cassandra Morrow, Maya C. Clark, Badar Omar, Alex S. Keuroghlian, Sari L. Reisner
BackgroundDepression is highly prevalent among U.S. young adults and associated with long-term functional impairment and increased suicide risk. While delays in diagnosis and treatment of depression are well documented among older adults, the magnitude and predictors of such delays in the younger population are poorly understood.
ObjectiveTo characterize the time to diagnosis and treatment of depressive disorder and predictors of diagnostic and treatment delay among young adults.
MethodsThis cross-sectional study used a self-reported survey conducted via the online research platform Prolific in May 2025. Eligible participants were U.S. adults aged 18–35 years with a history of at least one depressive episode. Sociodemographic, clinical, and psychosocial characteristics, including age of depressive symptom onset, degree of social support, and frequency of social group engagement, were assessed. Primary outcomes were probability of not receiving a depressive disorder diagnosis despite symptoms, time from symptom onset to diagnosis, probability of not seeking treatment, and time from symptom onset to treatment. Secondary outcomes were perceived treatment effectiveness and current symptom control.
ResultsIn total, 871 respondents met inclusion criteria. Of those with one or more lifetime depressive episodes, 46.2% reported never receiving a depressive disorder diagnosis. Median time from symptom onset to diagnosis was 3 years (IQR: 0–7). Over a quarter (27.4%) never sought treatment; among those who did, 93.5% received care, but 31.4% experienced a delay of 1–4 years, and 28.8% experienced a delay of 5 + years. Symptom onset in childhood (ages 0–12) or adolescence (ages 13–17) was associated with longer time to diagnosis and treatment and lower perceived treatment effectiveness. Greater social support was associated with shorter time to diagnosis; lower probability of never receiving a diagnosis, never seeking treatment, or experiencing prolonged treatment delay; and higher perceived treatment effectiveness and current symptom control. Frequent engagement in social groups was also associated with greater perceived treatment effectiveness.
ConclusionsAmong U.S. young adults, prolonged delays in depression diagnosis and treatment are common. Early symptom onset is associated with longer delays and worse outcomes, whereas greater social support is associated with shorter delays and more favorable outcomes. These findings highlight the need for further research to clarify causal mechanisms and for interventions to promote timely diagnosis and treatment among young adults at risk for depression.
Atosiban may confer therapeutic benefits to specific subpopulations in assisted reproductive technology. The Phase I Atosiban study indicated potential improvements in live birth rates among women with previous implantation failure undergoing frozen-thawed blastocyst transfer who exhibited abnormal uterine contractions, although these findings did not reach statistical significance. Therefore, further investigations are warranted to thoroughly elucidate the efficacy of atosiban and to evaluate whether uterine contractions can serve as a reliable biomarker for its targeted application.
This is a single-centre, randomised, triple-blind, placebo-controlled trial aiming to enrol 792 infertile women aged 20–40 years with a history of at least one previous embryo implantation failure and abnormal uterine contractions prior to single blastocyst-stage embryo transfer. Eligible participants will be randomly assigned in a 1:1 ratio to receive either intravenous atosiban or a placebo before embryo transfer. The primary outcome is live birth rate, with secondary outcomes encompassing various pregnancy and perinatal parameters. Randomisation will be stratified by age and transfer type. Intention-to-treat analysis will be performed using generalised linear models. The trial will be monitored by an independent data and safety monitoring committee, including one interim analysis.
This study has been approved by the Institutional Ethics Committee of Northwest Women’s and Children’s Hospital (No. 2025-058-02). Written informed consent will be obtained from all participants. The study results will be disseminated at scientific conferences and published in peer-reviewed journals.
To evaluate the health-related quality of life (HRQOL) of adults with Long COVID 2 years and beyond after COVID-19 illness.
Cross-sectional study.
Health status was assessed using the EQ-5D-5L instrument among 226 adults diagnosed in primary care with mild-to-moderate COVID-19 during the 2021 pandemic. Data were collected through a cross-sectional survey using a standardized questionnaire with a set of validated clinical outcomes for Long COVID. The sample consisted of adults aged ≥ 18 years who attended the specified ambulatory settings, tested positive for SARS-CoV-2, and agreed to be interviewed; the response rate was 70%. Health utility scores were compared between adults with and without Long COVID. Multivariate logistic regressions were applied to investigate the relationship between Long COVID and health-related quality of life outcomes.
Primary data were collected from six public Family Health Care Units in João Pessoa, Brazil, between May 2023 and July 2024.
Adults with Long COVID had statistically significantly lower median utility scores (0.784, IQR: 0.633–0.902) than those without persistent symptoms (1.0, IQR: 0.877–1.0). Poorer HRQOL was more evident among women, older adults, non-White individuals, participants with pre-existing chronic diseases, and those with lower educational attainment. Long COVID was associated with impairments in anxiety/depression, pain/discomfort and usual activities.
Adults with Long COVID experienced poorer HRQOL 2 years or longer after mild-to-moderate infection compared with those without persistent symptoms, regardless of sex, age, ethnicity, education level or comorbidities. These findings support the implementation of targeted interventions and rehabilitation services in primary care for individuals experiencing long-term health problems following COVID-19 illness.
Identifying adults at greater risk of persistent health impairments following COVID-19 may help health professionals, caregivers and policymakers better address the aspects of patients' lives that lack quality and develop a multidisciplinary approach in primary care to managing this condition.
What problem did the study address? ○
This study examined the association between persistent symptoms 2 years or longer after non-severe COVID-19 illness and health-related quality of life.
What were the main findings? ○
Long COVID was associated with poorer health-related quality of life, particularly in the domains of anxiety/depression, pain/discomfort and usual activities.
Where and on whom will the research have an impact? ○
The findings highlight the need for multidisciplinary management of long-term health problems among adult COVID-19 survivors in primary care.
The STROBE checklist was followed.
No patient or public contribution.
A patent processus vaginalis (PPV) is frequently observed during laparoscopic orchiopexy in infants with cryptorchidism. Nevertheless, the decision to primarily close the PPV following laparoscopic orchiopexy remains a subject of debate. This protocol therefore outlines the scope and methodology for a systematic review and meta-analysis that will synthesise the available evidence to evaluate the clinical outcomes associated with primary closure of the PPV after laparoscopic orchiopexy.
A systematic electronic literature search will be conducted across PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov to identify eligible studies published before 31 May 2026. The methodological quality of the included studies will be assessed using the Cochrane Risk of Bias V.2 tool for randomised trials and the Risk of Bias in Non-randomized Studies of Interventions tool for non-randomised studies. The primary outcomes will include postoperative inguinal hernia, testicular atrophy and testicular ascent. Secondary outcomes will comprise operative time, estimated blood loss, length of postoperative hospital stay and overall 30-day postoperative complications. The robustness of the findings will be evaluated through subgroup analyses and sensitivity analyses. All statistical analyses will be performed using Stata19.0 and RevMan Web, with statistical significance defined as a two-sided p
Ethical approval for this study based solely on aggregated and anonymised data is not required. Findings will be disseminated through peer-reviewed journals, conferences and interactive dialogues in this research area.
CRD420261289759.
This study aimed to explore the lived experiences of fear of complications (FoC) among hospitalised people with type 2 diabetes (T2D) in China and to provide insights for targeted nursing interventions.
A phenomenological research approach was employed to conduct semistructured interviews and the Colaizzi’s seven-step analysis method was used for data analysis. This study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
15 people with T2D were purposively recruited between March and July 2025 from the endocrinology departments of two tertiary hospitals in Daqing City, Heilongjiang Province.
Three themes and 11 subthemes were identified: (1) experiencing multiple negative psychological responses (distress from negative emotions, contradictory and painful psychological states, social alienation); (2) the triggers of fear are complex (adverse outcomes of similar patients, illness uncertainty, symptom burden, self-perceived burden, economic burden) and (3) employing diverse coping strategies (negative avoidance, positive self-adjustment, seeking social support).
Healthcare professionals should pay greater attention to FoC among people with T2D. Early psychological assessment, identification of fear triggers, strengthening social support and promoting adaptive coping strategies may help reduce fear and improve quality of life.
To explore pressure injury prevention and management in acute care settings from the perspective of patients, caregivers and families.
Cross-sectional survey.
A convenience sample of patients at risk of pressure injuries and their family or caregivers was recruited from medical, surgical and intensive care units across the province of Alberta, Canada. The custom survey included questions about perspectives on the care they received, involvement in care and preferences regarding involvement. Data were summarised with descriptive statistics and analysed using generalised estimating equations, logistic regressions and Mann–Whitney U-tests.
The response rate was 44%. The survey was completed by 161 participants (80.1% patients and 19.9% caregivers). The participants were 58.4% female, 63.4% from rural locations and 21.1% self-reported a pressure injury. Participants were most involved in repositioning activities and least involved in activities related to exercise. While 80.7% of respondents reported knowing what a pressure injury was, 69.6% reported that they had not heard about or received prevention resources from the healthcare team. Hearing about pressure injury prevention while admitted to hospital was associated with a significantly lower self-reported presence of pressure injuries. Brochures/pamphlets and verbal information were the most preferred educational resources.
Patient and family perspectives should inform pressure injury education and prevention activities in acute care settings. We recommend utilising brochures/pamphlets and verbal information, enhancing activity levels and exercise, encouraging patients and families to actively participate in prevention and maintaining a culture of supporting patient and family advocacy.
Findings provide insight into patient and family perspectives on pressure injury prevention and management in the hospital setting that can be addressed to enhance patient and family-centred pressure injury prevention.
Patient and family advisors informed the design of the survey and provided feedback on content, formatting and readability.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.
This study investigated the knowledge and attitudes (KA) towards perioperative pulmonary embolism (PE) in patients undergoing major orthopaedic surgery, a population at particular risk.
A single-centre, cross-sectional study.
A tertiary care hospital in Shanghai, China.
454 patients scheduled for major orthopaedic surgery (Grade III or above) were enrolled between February and September 2024. Selection criteria included adult patients undergoing eligible procedures, while exclusion criteria encompassed cognitive impairment or refusal to participate. All enrolled participants completed the study.
The primary outcomes were the total scores on validated knowledge and attitude questionnaires. Secondary outcomes included the identification of demographic factors associated with these scores and the analysis of the direct relationship between knowledge and attitude using structural equation modelling (SEM).
The average knowledge score was 52.9% (23.82/45), indicating poor understanding. The average attitude score was 66.4% (29.88/45), indicating a moderate attitude. The multivariable analysis showed that a college diploma (OR=4.824, 95% CI 2.399 to 9.703, p
Patients undergoing major orthopaedic surgery possess poor knowledge but moderately positive attitudes toward PE. Educational level is a key factor influencing KA. Improving patient knowledge and attitudes is crucial for supporting informed surgical decision-making and enhancing perioperative self-management, though the complex relationship between knowledge and attitude warrants further investigation.
This trial investigates the efficacy of neoadjuvant therapy using rezvilutamide combined with androgen deprivation therapy (ADT), with or without docetaxel, in treating oligometastatic hormone-sensitive prostate cancer (omHSPC).
This prospective, open-label, multicentre trial aims to enrol 100 patients newly diagnosed with omHSPC (defined as ≤5 bone or lymph node metastases confirmed by conventional imaging, without visceral metastasis) who must express a desire to undergo surgery. All patients undergo a prostate-specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scan at enrolment or within 4 weeks before enrolment to assess and confirm the number of metastases at baseline. Scans should be performed before initiating ADT to avoid compromising test sensitivity. Then patients will be allocated into groups in parallel according to their own preferences: one group will receive an LHRH agonist or antagonist for 24 weeks to maintain continuous ADT or have undergone bilateral orchiectomy. Treatment with rezvilutamide will be maintained daily. The other group will be scheduled to complete up to six cycles of docetaxel within 24 weeks, with maintenance of continuous ADT and rezvilutamide for 24 weeks. Both groups will receive a conventional imaging evaluation at the 12th week. After neoadjuvant therapy, patients will undergo conventional imaging and a second PSMA-PET/CT assessment, followed by cytoreductive radical prostatectomy within the subsequent 6 weeks. After surgery, patients may choose to continue with ADT or rezvilutamide at their own discretion, until disease progression. The primary endpoint is pathological complete response, defined as the absence of residual viable tumour cells in the tumour bed on pathological evaluation of the postoperative specimen. Secondary endpoints include 1 year biochemical progression-free survival, overall survival, radiographic progression-free survival, time to prostate-specific antigen progression, quality of life scores (total and subscale) assessed using the Functional Assessment of Cancer Therapy-Prostate questionnaire, time to symptomatic progression, time to deterioration in Eastern Cooperative Oncology Group performance status, the interval from enrolment to an increase in score from baseline, the proportion of patients with a ≥30% reduction in prostate volume on imaging before cytoreductive surgery compared with pre-neoadjuvant therapy, minimal residual disease and major pathological response. The study plans to enrol a total of 100 patients. Patient recruitment for this study is scheduled to begin in May 2025.
This has been approved by the Ethics Committee in Clinical Research of the First Affiliated Hospital of Wenzhou Medical University (number KY2024-231). Results will be published in peer-reviewed publications.
This study is expected to provide prospective evidence on the feasibility and potential clinical value of rezvilutamide combined with ADT, with or without docetaxel, as neoadjuvant treatment for newly diagnosed omHSPC.
Chinese Clinical Trial Registry (ChiCTR2400093262).
Randomised clinical trials (RCTs) are gold standard in evidence-based medicine, but follow-up typically relies on clinic visits and trial-specific data collection. Much of this information overlaps with routinely collected healthcare systems data (HSD), such as electronic health records and national registries. Leveraging HSD for trial follow-up has the potential to reduce cost, time and resource burden. However, concerns remain about data quality and evidence is needed to show that HSD-based outcomes are reported to an equivalent standard to trial-specific data.
The Blood Cancer Clinical Trials Long-term Follow-up Using Integrated Healthcare Systems platform will link data collected from multiple myeloma clinical trials with HSD to create a research database supporting extended follow-up and further methodological and clinical research.
This data-linkage study includes participants from multiple myeloma RCTs conducted by the University of Leeds between 2008 and 2021. NHS (National Health Service) England will link these participants to HSD, including deaths and cancer registrations, systemic anticancer therapy, radiotherapy and Hospital Episode Statistics.
We will compare trial-collected outcomes with those derived from HSD, including mortality, treatment, second cancer incidence and major adverse events. Long-term overall survival will be estimated using national mortality data. HSD-derived demographic and clinical variables will be used to assess population representativeness relative to the wider myeloma population. Time to next treatment will be derived and evaluated as a surrogate for progression-free survival. HSD-derived frailty measures will be examined for prognostic utility, and radiotherapy and hospital records will be analysed to characterise bone-related treatments and skeletal complications.
Ethical approval has been obtained from the East of England–Cambridge Central Research Ethics Committee, with Section251 support from the Health Research Authority on advice from the Confidentiality Advisory Group. Findings will be disseminated through publications, conference presentations and engagement with stakeholders and patient groups.
To explore the experiences of Emergency Department nurses when caring for patients presenting to the Emergency Department with mental health issues.
Qualitative descriptive study.
Ten nurses with experience caring for mental health patients participated in face-to-face, semi-structured interviews. Nurses were recruited if they were employed at a single tertiary Emergency Department in the Northern Territory, Australia. Interviews were audio-recorded, transcribed, and analysed using thematic analysis. The COREQ checklist guided reporting.
The four key themes were: systemic factors; emotional impact and staff culture; influence of communication; education and training. Systemic factors, such as overcrowding, staff shortages, long stays, and unsuitable Emergency Department environments, restricted therapeutic care and increased patient distress. The emotional impact of caring for mental health patients, combined with reactive workplace culture and stigma, contributed to moral distress and burnout. Clear communication and teamwork supported care, while limited mental health education left nurses underprepared and reliant on informal learning. Participants emphasised the need for clear protocols, targeted training, and structured support to enhance patient outcomes, nurse confidence, and well-being.
Emergency Department nurses face systemic, cultural, and educational barriers that compromise patient care while contributing to stress, fatigue, and burnout. Addressing these challenges through integrated care pathways, targeted education, and staff support is essential to improve patient outcomes and sustain the nursing workforce.
Data from this study identifies there is an urgent need to implement practical strategies to reduce challenges for nurses in caring for patients presenting to the ED with mental health issues.
This study revealed that systemic pressures, emotional fatigue, and limited training hinder effective care. This research can inform hospital leaders, policymakers, and educators to improve support, training, and care pathways within ED settings.
The authors have adhered to the COnsolidated criteria for REporting Qualitative research (COREQ).
No patient or public contribution was made.
Nearly half of patients who receive invasive mechanical ventilation for acute respiratory failure require over 4 days of ventilator support, each day of which is associated with increased morbidity, mortality and cost. Many of these patients develop expiratory muscle atrophy and weakness, which are linked to failed extubation and weaning. We seek to test the hypothesis that exhalation synchronised abdominal functional electrical stimulation reduces mechanical ventilation duration.
This pivotal superiority trial will be performed in up to 30 intensive care units (ICUs) in the USA, France, the Netherlands and Australia. Adults (≥22 years old) who have been mechanically ventilated for 24–96 hours and are expected to remain ventilated for another 24+ hours are potentially eligible. We will recruit participants until 150 successful liberations from mechanical ventilation occur. To achieve this, we estimate that a maximum of 272 participants will be randomised in a 1:1 ratio to receive 30 min of active exhalation synchronised abdominal functional electrical stimulation (vs sham). The intervention will be applied using the VentFree Respiratory Muscle Stimulator two times per day, a minimum of 5 days per week, for a maximum of 28 days or until ICU discharge. The primary outcome is time from first intervention to successful liberation from mechanical ventilation. Secondary outcomes include cough peak flow (CPF) and maximum expiratory pressure (MEP) at 24 hours post-extubation, hospital and ICU length of stay, reintubations, complications, ICU readmissions, 90-day mortality and quality of life. The participant, clinical team and outcome assessor are blinded to group allocation. A positive outcome has the potential to improve patient-centred outcomes in ICUs.
This study was approved by local ethics institutions in the USA, Australia, France and the Netherlands. We describe the methods herein using the Standard Protocol Items for Randomised Trials framework and discuss key design decisions. The results will be disseminated through peer-reviewed journal publications, conference presentations and clinicaltrials.gov updates. Individual country-level approvals are as follows:
France:
Ethics committee: Comité de Protection des Personnes Ile-de-France X. Reference numbers: CPP 27-2024; RCB 2024-A00559-38. Initial approval date: 14 May 2024.
Australia:
Ethics committee: South Eastern Sydney Local Health District Human Research Ethics Committee. Reference number: 2022/ETH02724. Initial approval date: 21 March 2023.
Netherlands:
Ethics committee: Medisch Ethische Toetsings Commissie Erasmus MC. Reference numbers: MEC-2023-0364; NL84195.000.23. Initial approval date: 30 April 2024.
USA:
Ethics committee: WCG IRB. IRB tracking number: 20214073. Initial approval date: 13 March 2023.
All participating sites are currently approved and operating under protocol version 09 or later.
NCT05759013. Registered 8 March 2023.
To explore how community-dwelling older adults with multimorbidity experience, enact and navigate daily self-care using the Caring Life-Course Theory to identify opportunities for strengthening self-care and self-management support.
Qualitative descriptive study.
Semi-structured interviews were conducted with community-dwelling older adults aged ≥ 50 years living with two or more chronic conditions across three Australian states and territories. Data were analysed inductively and deductively using qualitative content analysis. Inductive coding was followed by theory-informed analysis to interpret self-care capability, capacity, care networks and system supports.
Eighteen participants (mean age = 70.9 years) described self-care as an adaptive, experience-based process influenced by lived experience, health transitions, informal care networks and system responsiveness. Participants generally demonstrated agency and resourcefulness in managing complex and changing care needs, often learning through trial and error. Psychosocial and relational needs were frequently under-recognised in healthcare encounters, requiring individuals and informal carers to compensate for fragmented, inconsistent support. Self-care capability and capacity were shaped by experiential learning, health and self-care literacy and access to informal and online resources, particularly where formal education was limited or unavailable.
Self-care for older adults with multimorbidity is shaped by dynamic interactions between personal capability, relational support and system-level factors across the life-course. The Caring Life-Course Theory provides a comprehensive approach for understanding these interdependencies and identifying opportunities for intervention.
Findings highlight the need to strengthen coordinated, person-centred and relationally grounded approaches to self-care and self-management in primary and community care, including improved access to evidence-informed resources and anticipatory support.
This study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies.
Participants contributed through semi-structured interviews and provided feedback on study findings.
What problem did the study address? Community-dwelling older adults living with multimorbidity are expected to engage in self-care, yet little is known about how they experience, enact and sustain daily self-care, particularly when psychosocial and relational needs are inconsistently recognised within health and social care systems. What were the main findings? Self-care was characterised as an adaptive, experiential process shaped by life experience, informal support networks and system responsiveness. Participants frequently compensated for under-recognised psychosocial and relational needs through informal and online supports and resources. Where and on whom will the research have an impact? Findings can inform clinicians, service providers and policymakers in primary, community and aged care settings by identifying opportunities to strengthen coordinated, person-centred and relational self-care and self-management support for older people with multimorbidity.
by Cecilia Aguilar-Vega, Jaime Bosch, Satoshi Ito, Benjamin Ivorra, Hyunkyu Jeong, José Manuel Sánchez-Vizcaíno
African swine fever (ASF) is a lethal disease of swine that has spread across Asia since its introduction in 2018. South Korea first reported the disease in September 2019 in domestic pigs, and since then, more than 4,000 cases have been reported in wild boars during its expansion up to August 2024. Due to the high number of ASF notifications in wild boars in South Korea, contrasted with their scarcity in most Asian countries, analyzing the spatiotemporal spread of the disease in a setting with active surveillance provides valuable insights. In this study, we performed a trend-surface analysis on temporally gridded case data to characterize the overall geographic spread and direction of ASF in wild boars across South Korea, from its emergence to August 2022. Additionally, we propose a novel approach distinct from previous studies, to estimate spread velocity by incorporating an upper threshold to avoid unrealistic values. The model described the spread of ASF in the study area. The disease showed greater expansion in the east of the country. Initially, a south and eastward direction was estimated. The estimated median velocity was 19.53 km/month, with cell-level velocities ranging from 2.45 to 69.99 km/month. Velocity increased notably from autumn 2021 onward and varied substantially across years. Our results show the dynamics of ASF in wild boars of South Korea, providing new evidence of their role in the epidemiology of the disease.To explore the practical experiences and perceived needs of healthcare professionals in fostering resilience among bereaved parents.
A qualitative descriptive study was conducted.
Twenty-seven healthcare professionals were recruited from the Paediatric Palliative Care Special Group of the Paediatrics Society of the Chinese Medical Association. The participants included 9 physicians, 7 nurses and 11 social workers from 22 hospitals and 5 community-based services. In-depth interviews were conducted between July and December 2022. Data were analysed using content analysis.
Guided by the Society-to-Cells Resilience Theory, this study identified 10 categories of practical experiences and seven of perceived needs, encompassing multiple levels: society (integrating multidisciplinary resource; preserving relevant cultural tradition; advocating for system enhancements; raising public awareness), community (establishing an accessible support network; fostering an inclusive community; offering proactive community support), family (providing anticipatory guidance; enhancing family cohesion; navigating bereavement resources; providing ongoing follow-up and support), individual (evaluating grief-related experiences; offering tailored personal support; sustaining connections; addressing spiritual needs) and physiological (managing body reactions; maintaining physical well-being).
This study provides insights from healthcare professionals, highlighting practices and identifying significant gaps in current approaches to building resilience in bereaved parents. The findings suggest that resilience is a socially constructed, multidimensional process that can be nurtured through a holistic approach to better support this vulnerable group.
The study's findings lay the foundation for developing targeted interventions to foster resilience among bereaved parents. A holistic, empowering approach is essential to strengthen their coping mechanisms and facilitate healing at multiple levels, ultimately contributing to the creation of a robust, effective support system for this resilient yet vulnerable population.
This study was about the experiences and perceptions of healthcare providers. It was designed and conducted by researchers who were both researchers and healthcare providers.
To assess the global burden of pressure injuries from 1990 to 2021 and project trends to 2050.
A cross-sectional survey.
Using the Global Burden of Disease 2021 data from 204 countries (1990–2021), we performed a multilevel analysis incorporating age-period-cohort modelling, stochastic frontier analysis and Bayesian projections to 2050. Key metrics included age-standardised incidence rates, disability-adjusted life years and socio-demographic index stratification.
Global incident cases increased by 160.3%, from 1.22 million to 3.18 million. By 2050, cases are expected to reach 8.4 million, with 72.4% in low-middle socio-demographic index areas. Mortality among those aged 95 and older may triple.
The study emphasises the need for global collaboration to address the burden of pressure injuries through equitable prevention and improved healthcare infrastructure, especially in ageing and resource-limited regions.
The escalating global burden of pressure injuries in geriatric populations necessitates evidence-based approaches to optimise healthcare resource allocation and advance nursing-led prevention frameworks.
The STROBE checklist guided reporting.
Global Burden of Disease collaborators extracted the data and analysed it.
FreshRSS 