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To classify the unmet integrated care needs of older adults with multimorbidity and to explore the factors associated with different categories of unmet integrated care needs among the target population.
A cross-sectional survey using the statistical method of latent profile analysis.
From July 2022 to March 2023, 397 older adults with multimorbidity, aged 60 years or older, were recruited from one primary healthcare setting and from four secondary and tertiary hospitals to participate in face-to-face questionnaire surveys. The questionnaire used in this study to assess unmet integrated care needs among older adults with multimorbidity was self-designed through a series of steps, including a scoping review, expert consultation and cognitive interviews. Latent profile analysis was applied to uncover distinct profiles of unmet integrated care needs, and multinomial logistic regression was employed to explore whether the profiles were further distinguished by participants' sociodemographic and health-related covariates. The data were analysed using IBM SPSS v.29.0 and Mplus v.8.0.
The optimal solution was a four-profile model, characterised by high unmet integration needs, high unmet system integration needs, low unmet system integration needs and low unmet integration needs, respectively. Multinomial logistic regression results indicated that profile differences were associated with place of residence, number of coresidents and the presence or absence of complex multimorbidity.
The integrated care needs of older adults with multimorbidity have not yet been fully met. Classifying and characterising unmet integrated care needs profiles is a crucial step in the rational allocation of integrated care resources.
This study was reported based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cross-sectional studies.
All participants were older adults with multimorbidity, and they were informed that they could withdraw from the study at any time.
Commentary on: McCluskey A, Watson C, Nugent L, et al. 'Sometimes You Have No Choice but to Give Them Medication': Experiences of Nurses Caring for People With Auditory Hallucinations in an Acute Unit. Int J Ment Health Nurs. 2024 ;33(6):2193-2202. doi: 10.1111/inm.13380.
Implications for practice and research Nurses require enhanced training in targeted interventions and engagement skills to provide effective, recovery-oriented care for patients experiencing auditory hallucinations. Organizsational support is crucial for re-envisioning ‘"risk’" beyond patient danger, enabling the implementation of recovery-focused therapeutic interventions in high-risk environments.
Auditory hallucinations, commonly associated with schizophrenia, significantly impact individuals’ emotional well-being. With around 24 million people affected globally and notable rates in Ireland, the prevalence is alarming.
by Dandan Feng, Yakun Song, Zuqi Wu, Wuruo Liu, Yuting Pu, Yangcan Gao, Yuying Sun, Jiquan Zhang
Trypsin, a canonical serine protease in crustaceans, plays a crucial role in ontogeny and antibacterial defense. Whether these biological functions correlate with its catalytic characteristics remains unresolved in the freshwater shrimp Neocaridina denticulata sinensis. To address this gap, we characterized a trypsin gene from N. denticulata sinensis (NdTryp) and assessed both its biological roles and its prospective utility. NdTryp was predominantly expressed in the hepatopancreas, where it localized to storage cells (R-cells) and tubule-lining epithelial cells (ECTs). Across development, NdTryp transcripts were essentially absent during early embryogenesis but rose sharply at late stages, temporally coincident with hatching and the onset of feeding. After a challenge with Vibrio parahaemolyticus, the expression of NdTryp was induced, with the expression level significantly increased relative to the baseline expression level. RNA interference-mediated knockdown rendered shrimp more susceptible to infection and was accompanied by extensive hepatopancreatic injury, including epithelial detachment and disruption of the basement membrane. Biochemically, recombinant NdTryp (rNdTryp) displayed proteolytic activity over a broad temperature and pH span. Activity was differentially tuned by metal ions, with several divalent cations producing marked enhancement, whereas ferric iron exerted strong inhibition. Overall, our results showed that NdTryp functions as a multifunctional protease involved in both late embryonic development and innate antimicrobial defense. Furthermore, the robust stability of rNdTryp underscores its potential as an aquafeed additive and candidate for enzymatic biotransformation.To investigate the level of humanistic care ability of oncology nurses, its association with empathy and emotional intelligence, and the mediative role of emotional intelligence on empathy and humanistic caring ability.
This was a cross-sectional study conducted in a cancer hospital in China.
We enrolled a total of 1189 oncology nurses from several cancer hospitals from December 2023 to January 2024. All participants completed three general questionnaires: the Caring Ability Inventory, the Jefferson Scale of Empathy-Health Professionals and the Emotional Intelligence Scale.
The overall scores for the three scales were 202.35 ± 23.89, 112.38 ± 18.85 and 137.49 ± 17.81, respectively. A positive correlation was detected between caring ability, empathy and emotional intelligence (r = 0.741, p < 0.001; r = 0.577, p < 0.001). And emotional intelligence mediates the association between empathy and caring ability in oncology nurses (0.233, p < 0.001). The total and direct effect were also significant (0.825, p < 0.001; 0.592, p < 0.001).
The study findings indicated that oncology nurses exhibit a moderate level of caring ability. Emotional intelligence mediates the relationship between empathy and caring ability, at least in part. Therefore, an increase in the level of emotional intelligence in oncology nurses could improve their caring ability.
When designing training to improve humanistic care, we recommend the integration of specific training relating to empathy and emotional intelligence into the training system.
Oncology patients experience multiple forms of distress and require high-quality humanistic care. This study identified a moderate association between empathy and emotional intelligence. Our findings provide further recommendations for nurse leaders in medical institutions relating to how the humanistic care ability of oncology nurses can be improved by specific training in empathy and emotional intelligence.
This study was reported using the STROBE Checklist for cross-sectional studies.
Nurse leaders organised this survey in their own hospital.
Although multicomponent exercise is a popular nonpharmacological treatment, its effects on cognition vary across studies because of the diversities in exercise combinations. Identifying the most effective combination is of great importance to the prevention and treatment of cognitive impairment.
To compare and rank the efficacy of various multicomponent exercise interventions on cognition in people with cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane, SPORTDiscus and PsycInfo databases up to April 2025 for eligible randomised controlled trials about multicomponent exercise interventions in people with cognitive impairment. Primary outcome was global cognition, with secondary outcomes being executive function and memory. Pairwise and network meta-analyses were performed using random-effects models.
Twenty-five trials involving 2298 participants were included. Pairwise meta-analyses showed multicomponent exercise interventions were effective on global cognition (standardised mean difference (SMD) = 0.59; 95% confidence interval (CI): 0.30, 0.89; p < 0.001) and executive function (SMD = 0.28; 95% CI: 0.12, 0.45; p < 0.001). Network meta-analyses revealed that aerobic exercise (AE) + balance & flexibility (BF) training had the highest probability (70.8%) of being the optimal exercise combination for global cognition (SMD = 1.07; 95% CI: 0.23, 1.90; p = 0.016), and AE + resistance exercise (RE) had the highest probability (43.1%) of being the optimal exercise combination for executive function (SMD = 0.56; 95% CI: 0.03, 0.10; p = 0.042). We did not observe significant effects of multicomponent exercise on memory.
AE + BF training is likely the most effective multicomponent exercise combination for global cognition, while AE + RE showed the optimal effect on executive function in people with cognitive impairment.
Our study contributes to guiding clinical professionals to design and conduct targeted multicomponent exercise interventions as per individual cognitive impairment characteristics to protect individual cognition.
No patient or public contribution applies to this work.
The study protocol was registered with PROSPERO (CRD42023489517).
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