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Fibre-rich Foods to Treat Obesity and Prevent Colon Cancer trial study protocol: a randomised clinical trial of fibre-rich legumes targeting the gut microbiome, metabolome and gut transit time of overweight and obese patients with a history of noncancerou

Por: Hartman · T. J. · Christie · J. · Wilson · A. · Ziegler · T. R. · Methe · B. · Flanders · W. D. · Rolls · B. J. · Loye Eberhart · B. · Li · J. V. · Huneault · H. · Cousineau · B. · Perez · M. R. · O'Keefe · S. J. D.
Introduction

Recently published studies support the beneficial effects of consuming fibre-rich legumes, such as cooked dry beans, to improve metabolic health and reduce cancer risk. In participants with overweight/obesity and a history of colorectal polyps, the Fibre-rich Foods to Treat Obesity and Prevent Colon Cancer randomised clinical trial will test whether a high-fibre diet featuring legumes will simultaneously facilitate weight reduction and suppress colonic mucosal biomarkers of colorectal cancer (CRC).

Methods/design

This study is designed to characterise changes in (1) body weight; (2) biomarkers of insulin resistance and systemic inflammation; (3) compositional and functional profiles of the faecal microbiome and metabolome; (4) mucosal biomarkers of CRC risk and (5) gut transit. Approximately 60 overweight or obese adults with a history of noncancerous adenomatous polyps within the previous 3 years will be recruited and randomised to one of two weight-loss diets. Following a 1-week run-in, participants in the intervention arm will receive preportioned high-fibre legume-rich entrées for two meals/day in months 1–3 and one meal/day in months 4–6. In the control arm, entrées will replace legumes with lean protein sources (eg, chicken). Both groups will receive in-person and written guidance to include nutritionally balanced sides with energy intake to lose 1–2 pounds per week.

Ethics and dissemination

The National Institutes of Health fund this ongoing 5-year study through a National Cancer Institute grant (5R01CA245063) awarded to Emory University with a subaward to the University of Pittsburgh. The study protocol was approved by the Emory Institutional Review Board (IRB approval number: 00000563).

Trial registration number

NCT04780477.

‘There is no justice in nursing school’: A qualitative analysis of nursing students' experiences of discrimination shared on Reddit

Abstract

Aim

To explore nursing students' experiences of stigma and discrimination within nursing programmes as shared on Reddit, and how other Reddit users offer support and guidance.

Design

Qualitative interpretive description.

Methods

Through a critical social theory lens, this study draws on students' posts from three nursing subreddits: r/studentnurse, r/nursingstudent and r/nursing. Data were collected from March 2013 to March 2023. Reflexive thematic analysis was conducted to generate broad themes of nursing students' experiences of stigma and discrimination, and how other Reddit users offered support and guidance.

Results

A total of 43 posts with 1412 associated comments were included in this analysis, which generated three predominant themes of nursing students' experiences. Nursing students faced stigma and discrimination across contexts, including from peers, nurses and other healthcare providers working in clinical practicum sites, and patients. Nursing students' posts described navigating the impacts and consequences of such experiences, including on well-being, and programme and career success. In contexts where students were often alone in their experiences of stigma and discrimination within their programmes and with few identified supports, Reddit users sought support and community through Reddit. While many comments offered validation and support, challenges of this social media platform included conflicting advice and unhelpful, judgmental messages.

Conclusions

Despite widely articulated social justice commitments in the profession, nursing students continue to experience stigma and discrimination across contexts within their nursing programmes.

Implications for Profession

Nurses and nurse educators have a responsibility to acknowledge and make visible such experiences, and take direct action to prevent and remediate stigma and discrimination within nursing education.

Impact

This research contributes to the growing empirical evidence that nursing students' experience stigma and discrimination within nursing programmes and the healthcare system.

Reporting Method

Adherence to COREQ guidelines was maintained.

Patient or Public Contribution

No patient or public contribution.

Wearables for early detection of atrial fibrillation and timely referral for Indigenous people >=55 years: mixed-methods protocol

Por: Henson · C. · Rambaldini · B. · Freedman · B. · Carlson · B. · Parter · C. · Christie · V. · Skinner · J. · Meharg · D. · Kirwan · M. · Ward · K. · Speier · S. N. K. · Gwynne · K.
Introduction

Digital health technologies have the potential to provide cost-effective care to remote and underserved populations. To realise this potential, research must involve people not traditionally included. No research focuses on the acceptability and feasibility of older Indigenous people using wearables for early atrial fibrillation (AF) detection. This protocol compares digital augmentation against standard practice to detect AF, evaluate heart health self-efficacy and health literacy changes and identify barriers in collaboration with Aboriginal Community Controlled Health Organisations. It will establish a framework for implementing culturally safe and acceptable wearable programmes for detecting and managing AF in Indigenous adults ≥55 years and older.

Methods

This mixed-methods research will use the Rambaldini model of collective impact, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology to assess the cultural safety, acceptability, feasibility and efficacy of incorporating wearables into standard care for early AF detection.

Analysis

Qualitative data will be analysed to create composite descriptions of participants' experiences and perspectives related to comfort, cultural safety, convenience, confidence, family reactions and concerns. Quantitative device data will be extracted and analysed via Statistical Product and Service Solutions (SPSS).

Conclusion

Prioritising perspectives of older Indigenous adults on using wearables for detecting and monitoring cardiovascular disease will ensure that the findings are effective, relevant and acceptable to those impacted.

Ethics and dissemination

Findings will be published in open-source peer-reviewed journals, shared at professional conferences, described in lay terms and made available to the public. The AHMRC HREC Reference Number approved 1135/15.

Proceso de enfermería en la asistencia a pacientes en terapia de hemodiálisis

Objetivo: identificar los diagnósticos de enfermería y las intervenciones más frecuentes en la asistencia a los pacientes en hemodiálisis. Método: se realizó un estudio descriptivo, transversal, retrospectivo con un enfoque cuantitativo, realizado con 175 prontuarios de pacientes en hemodiálisis, asistidos en el servicio por un período de seis meses. Para la recolección de los datos, se utilizó la plataforma Google Forms®, generando una hoja de trabajo en Microsoft Excel®, un software que permite organizar, describir y analizar los mismos. Resultados principales: se identificaron tres diagnósticos de enfermería como más frecuentes: Riesgo de sangrado (67,2%); Riesgo de caída (56,5%) y Exceso de volumen de líquido (54,8%), en más de la mitad de los pacientes de acuerdo con los registros en los prontuarios. Las intervenciones de enfermería están dirigidas por el protocolo del procedimiento de hemodiálisis y no por los diagnósticos de enfermería. Conclusión: los diagnósticos más frecuentes se centran en las condiciones clínicas de la población estudiada, y no subvencionan las intervenciones de enfermería, que se definen con base en técnica de hemodiálisis.

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