To assess the prevalence and associated factors of dietary practices among antenatal women in Colombo district, Sri Lanka.
This descriptive cross-sectional study examined dietary practices among antenatal mothers in four Medical Officer of Health areas in Colombo, Sri Lanka. A total of 422 participants were selected using stratified random sampling. Data were collected via a validated Food Frequency Questionnaire and analysed using SPSS V.26. Dietary diversity, food variety and animal-source food consumption were assessed. Poisson regression identified predictors of dietary practices, adjusting for socio-economic and pregnancy-related factors. The statistical significance was set at p
Of the 380 antenatal mothers (mean age: 30.72±3.96 years), most were married (98.2%) with 73.7% living in urban areas. Regarding dietary practices, 64.7% had high dietary diversity, while 35.3% had low diversity. Of the sample, 52.1% had a high food variety score and 64.7% had a high animal-source food score. More than half (64.7%) had appropriate dietary practices. Fruits, vitamin A-rich vegetables and rice were the most consumed foods. Key factors influencing dietary practices included age, religion, education, employment and geographical location.
This study highlights the prevalence and factors influencing dietary practices among antenatal mothers. Although the predominant mothers had fair dietary diversities, a considerable number were found to have poor dietary practices. Better dietary practices were associated with major educational attainment, formal employment status and selected residential areas, while younger age, low educational qualification and housewife status were associated with poorer nutrition. The findings indicate that there is an urgent need for interventions related to nutrition for specific vulnerable groups so that they can improve their maternal nutrition and produce better pregnancy outcomes through education and support programmes.
This study aimed to examine the association between the neutrophil-to-lymphocyte ratio (NLR) and the prognosis of patients with breast cancer (BC) in southern Ethiopia.
We conducted a hospital-based retrospective cohort study.
The study was conducted at Hawassa and Wolaita Sodo University Comprehensive Specialized Hospital.
A total of 492 women with BC diagnosed from January 2020 to December 2022 were enrolled. Follow-up extended from the date of diagnosis until the occurrence of an event (death), loss to follow-up or the study end date.
Data were collected using a structured data collection tool through medical record review and exported to Stata V.16 for analysis. Unweighted and weighted Kaplan-Meier survival curves were used to estimate death-free survival time. Inverse-probability-weighted regression adjustment was employed to estimate the association of NLR with time to death. At a statistical significance level of p
The incidence of mortality in patients with BC with a higher NLR was 4.2 (95% CI 3.3 to 5.2) per 100 person-month observation (PMO); it was 1.9 (95% CI 1.5 to 2.4) per 100 PMO for those with a low NLR. When everyone in the population of interest has a low NLR, the average time to death is estimated as 17.2 (95% CI 11.4 to 23.0) months. For women with a higher NLR, the average time to death is estimated as 10.8 (95% CI 8.93 to 12.8) months. For women with a higher NLR, the average time to death was shorter by 6.3 months (coefficient: –6.3, 95% CI –12.5 to –0.082). Furthermore, the effectiveness of exposure to high NLR (ratio of average treatment effect to low NLR potential outcome means) was a 36.7% (95% CI 12% to 61%) reduction in mortality rate.
A high NLR was associated with significantly higher mortality in BC patients, independent of baseline clinicopathological variables. Patients with elevated NLR more often presented with advanced stage disease and distant metastases. These findings indicate that NLR, a simple and accessible biomarker, may help to identify patients at increased risk of poor prognosis.
Implementation of low-intensity, evidence-based psychological interventions can help meet the mental health and psychosocial needs of people with cancer, especially in low-resource settings where there is a dearth of mental health specialists. In this study, we will conduct a feasibility randomised controlled trial (RCT) of the stress management intervention Self-Help Plus, which has been translated and adapted to Vietnamese, vSH+, among people newly diagnosed with breast or gynaecological cancer in Viet Nam.
At six participating hospitals, individuals diagnosed with breast or gynaecologic cancer within the past year will be recruited, consented and randomised into either enhanced usual care (EUC) or EUC plus the vSH+ intervention, which consists of four sessions each lasting approximately 75 min. Quantitative surveys will be administered at three time points: enrolment/baseline (T0), after 6 weeks (T1) and after 4 months (T2). A qualitative evaluation component, which will include in-depth interviews with patients, implementers and healthcare staff and managers, as well as focus group discussions with caregivers, will assess the acceptability and feasibility of the vSH+ intervention.
Ethical reviews for the study were obtained from Boston University, Hanoi University of Public Health (HUPH) and all the participating hospital sites. On completion of data collection and analyses, the research team will prepare and submit abstracts to scientific conferences as well as manuscripts to peer-reviewed journals. We will also conduct dissemination events to report the trial results to relevant stakeholders.
Despite efforts to implement lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) inclusive practices to address health disparities faced by LGBTQ+ individuals, factors that facilitate the uptake of these practices remain underexplored. Informed by the Consolidated Framework for Implementation Research (CFIR), this study explores nurse leaders’ perspectives across diverse US healthcare systems regarding the facilitators and barriers to implementing LGBTQ+ inclusive practices.
We used a qualitative descriptive design. Semistructured interviews guided by the CFIR framework were conducted from October to December 2023. The data were analysed using thematic analysis.
Diverse healthcare settings (eg, acute care hospitals and public health centres) across the USA.
We purposively recruited 21 nurse leaders, such as chief nursing officers or chief nurse executives, who oversee nursing strategy, staffing and quality across their organisations.
Consistent with prior frontline-focused studies, nurse leaders confirmed key inner setting and individuals facilitators (eg, LGBTQ+ specific training, electronic health record adaptation, visible executive engagement). Our findings add system-level detail from an executive perspective. Leaders identified actionable levers such as establishing LGBTQ+ clinical and social services, allocating protected time and budgets, and deploying dedicated implementation teams. We also identified a cross-cutting barrier: a reactive, crisis-driven organisational culture that hinders proactive inclusion efforts. Beyond the organisation, sociopolitical and legal climates shaped readiness and resourcing, with anti-LGBTQ+ laws influencing inclusion initiatives. Finally, nurse leaders highlighted the need for rigorous multilevel evaluation (eg, patient, staff, institution) and noted that common surveys inadequately capture LGBTQ+ inclusion, revealing measurement gaps that impede continuous improvement.
Implementing LGBTQ+ inclusive practices in healthcare is essential for optimal health outcomes and social justice. Understanding the context of implementation at multiple levels is crucial. Future research should focus on testing implementation strategies, developing inclusive healthcare surveys, and supporting the role of organisational culture and leadership in promoting LGBTQ+ inclusivity.
To determine progression in adult patients with early-stage chronic kidney disease (CKD) attending tertiary hospitals in Dodoma, Tanzania.
Prospective longitudinal study.
This study was conducted in two tertiary hospitals in Dodoma, Tanzania.
The population in this study was adult patients aged ≥18 years with early-stage CKD who were attending nephrology and medical outpatient clinics at Benjamin Mkapa Hospital and Dodoma Regional Referral Hospital, which are tertiary hospitals in Dodoma, Tanzania, from November 2020 to March 2022. Inclusion criteria included: patients aged ≥18 years of age, attending the clinic for at least 3 months with baseline clinical data on their files, estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 and who gave a written informed consent. A total of 352 patients were enrolled, of whom 182 were males and 170 were females.
The dependent variable in this study was CKD progression, which was assessed after 12 months of follow-up.
A total of 352 participants with a median age of 54 (47–59) years were enrolled; the prevalence of progression of early-stage CKD was 28.0% (97/346). For patients with CKD progression, the baseline median eGFR was 43 (41–49) mL/min/1.73 m2, urine protein creatinine ratio was 0.099 (0.025–0.158) mg/g, and haemoglobin was 11.7 (9.7–12.6) g/L. Of the patients with CKD progression, 75.3% (73/97) had diabetes mellitus, 72.2% (70/97) of the patients had hypertension, 58.8% (57/97) of the patients had significant proteinuria, and 58.8% (57/97) of the patients had anaemia. Variables associated with CKD progression after multivariate logistic regression analysis were; diabetes mellitus (OR=7.02, 95% CI 3.01 to 16.39, p=0.001), use of local herbs (OR=27.98, 95% CI 11.08 to 70.70, p=0.001), anaemia (OR=2.49, 95% CI 1.32 to 4.68, p=0.005), proteinuria (OR=7.51, 95% CI 3.49 to 16.19 p=0.001). Half, 52.5% (51/97) of the patients with CKD progression were found to have left ventricular hypertrophy (LVH), 26.8% (26/97) of the patients had evidence of coronary artery disease (CAD) on non-invasive testing, and 11.3% (11/97) of the patients died during the study period.
A substantial portion of adult patients with early-stage CKD were found to have progression after 12 months of follow-up. Diabetes mellitus, proteinuria, anaemia and use of local herbal medicines were significant predictors for CKD progression. Of the patients with CKD progression, more than half of the patients were found to have LVH, almost one third of the patients had evidence of CAD on non-invasive testing, and few patients died.
Osteoarthritis (OA) is a degenerative and progressive joint condition causing pain and disability. Physical exercise is recognised as the most effective intervention since individuals with this condition often experience muscle weakness, balance deficits and chronic pain. Additionally, knee osteoarthritis (KOA) is associated with central sensitisation, contributing to chronic pain conditions. Transcranial Direct Current Stimulation (tDCS), a non-invasive neuromodulation technique, has been employed to induce changes in pain perception by altering cortical excitability, potentially reducing chronic pain.
This is a protocol for a randomised controlled trial. Participants will be allocated to two groups: G1 (active tDCS combined with exercise) and G2 (sham tDCS combined with exercise). The intervention protocol will last for 5 weeks, with two sessions per week on non-consecutive days. Pain intensity will be assessed as the primary outcome using the Numeric Rating Scale (NRS). The sample size was calculated based on a minimum clinically important difference of 3 points on the NRS between groups, with a statistical power of 80% and a significance level of 5%. Secondary outcomes will include physical function and global perceived change.
This protocol was approved by the Research Ethics Committee of the Trairi School of Health Sciences, Federal University of Rio Grande do Norte (Approval Number: 6.801.827), and it is in accordance with the Declaration of Helsinki for human research. Results will be published in peer-reviewed journals and presented at scientific events. This trial is registered in the Brazilian Clinical Trials Registry.
Brazilian Clinical Trials Registry (RBR-5pb2g33).