Conectar
by Isabella DeStefano, Adanna Ibeku, Krystal Hunter, Melissa Micallef, Alla Kushnir
“Late preterm” or “LPT” neonates are generally defined as infants born between 34 0/7 and 36 6/7 weeks gestation and constitute approximately 74% of all preterm births. While much effort has been put into evaluating the nutritional needs of early preterm or low birthweight infants, there is a shortage of research on the nutritional needs of LPT infants. This work examined how adherence to current nutrition guidelines and how the use of fortification of feeds affected the growth of LPT neonates in the first year of life. A retrospective chart review was conducted of 898 neonates born between 34 0/7 and 36 6/7 weeks gestation, as identified from electronic medical records. The study site where the data was obtained was an urban hospital in New Jersey. Head circumference, weight, and length at birth, documented as measurements, percent, and z-scores, at discharge, at two months, at six months, and at twelve months post birth, were collected and evaluated. Data regarding the neonate’s feeding regimen, caloric fortification, and type of nutrition at the point of discharge were assessed. Data were analyzed using independent t-tests and Mann-Whittney U tests to assess the relationship between adherence and growth parameters. Of these participants, 50.1% were male, the mean gestational age was 34.91 (±1.19), and the mean birth weight was 2317 (±489) grams. Infants with lower birth weight (BW) were more likely to receive fortification (BW p < 0.001, BW percentile p < 0.001). Participants who followed fortification guidelines had lower birth weight, discharge weight, and weight percentile (p < 0.001), as well as lower z-scores for BW, length, and head circumference (HC) at birth and at discharge. At six and twelve months, weight, weight percentile, length, length percentile, head circumference, and head circumference percentiles were not statistically significant. The results show that adherence to nutritional guidelines recommending fortified feeding is associated with growth within the first year of life of LPT infants. By two, six, and twelve months, there were no differences in z scores in participants with fortification.Oligoprogressive disease (OPD) is a clinically significant pattern of progression observed in patients with oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer treated with endocrine therapy (ET) and cyclin-dependent kinase (CDK) 4/6 inhibitors. Stereotactic ablative body radiotherapy (SABR) is an emerging strategy that may ablate resistant subclones and prolong the benefit of systemic therapy. The AVATAR-II trial investigates whether the addition of SABR to continued systemic therapy can delay the need to change treatment strategy.
AVATAR-II is a multicentre, randomised, open-label, phase II randomised controlled trial enrolling 74 patients with histologically confirmed ER-positive, HER2-negative advanced breast cancer and 1–5 sites of extracranial OPD. Eligible patients must have demonstrated clinical benefit (stable disease or partial response) from ET and CDK4/6 inhibitors for at least 6 months prior to randomisation. Participants will be randomised 1:1 to either SABR to all OPD sites with continuation of current systemic therapy (Arm A) or physician’s choice of systemic therapy (Arm B). The primary endpoint is time to treatment failure, defined as progression not amenable to SABR, cessation of systemic therapy or death. The secondary endpoints include progression-free survival (PFS), PFS2, overall survival, treatment-related adverse events and patient-reported quality of life using the Functional Assessment of Cancer Therapy–Breast score.
This study received ethical approval from the Peter MacCallum Cancer Centre Human Research Ethics Committee (HREC), under approval number 25/45 and HREC reference HREC/105165/PMCC. Results of the study will be disseminated via peer-reviewed presentation at scientific conferences and open-access publication.
To explore bereaved parents' experiences of receiving psychosocial interventions (PSIs) in hospital-based perinatal bereavement care in Ireland.
Descriptive qualitative study.
Fifteen bereaved parents (13 mothers and 2 partners) whose loss occurred within the past three years were recruited via a national parent-led charity. Semi-structured online interviews were conducted between November 2024 and March 2025. Data were analysed using reflexive thematic analysis.
Six themes captured parents' experiences: (1) emotional support as the foundation of feeling cared for; (2) informational support as essential for reassurance and preparedness; (3) practical and inclusive support to ease burdens and extend care; (4) memory-making to reconstruct meaning and connection; (5) sustaining supports beyond hospital; and (6) contextual support for sensitivity, continuity, and consistency. Interpreting these themes through the Socio-Ecological Model reflected multi-level influences shaping parents' experiences of receiving PSIs during hospitalisation.
Key PSIs valued by parents included emotional, informational, practical, inclusive, memory-making, psychological, and peer supports, as well as follow-up and contextual sensitivity. However, variability in how these supports were offered revealed gaps between parents' expectations and practice.
Findings highlight the need for a standardised framework outlining key PSIs, while retaining sufficient flexibility to accommodate individual preferences. Embedding these PSIs within organisational structures, supported by enhanced staff training, improved continuity of care, and minimisation of environmental triggers, has the potential to improve the quality, equity and consistency of perinatal bereavement care.
This study addresses gaps in understanding parents' perspectives on PSIs in perinatal bereavement care and offers practical insights to inform the development of core components of future PSIs for perinatal bereavement.
COREQ.
Bereaved parents and midwives formed a steering group, advising on study design, recruitment materials and interview guides, ensuring sensitivity and grounding in lived experience.
Musculoskeletal (MSK) conditions affect over 20 million people in the UK and account for one in seven General Practitioner (GP) consultations. To address capacity challenges, First Contact Physiotherapists (FCPs) now manage MSK patients in primary care. However, FCPs working in isolation from physiotherapy teams exhibit broad variation in decision-making that could pose risks to care quality. PRimary Care Individual Social Norms MSK Data Dashboard (PRISM) is a clinician-facing behaviour change digital dashboard that provides individualised social norms feedback such as, ‘you are in the top 10% of those referring to secondary care’ or ‘in the bottom 10% of those referring to social prescribing’. It aims to nudge FCPs towards evidence-based norms, including more effective and cost-efficient treatments, thereby reducing unwarranted variation in care and improving patient outcomes. Social norms interventions have been shown to positively influence clinician behaviour, but their application in MSK services remains unexplored.
To determine the feasibility of evaluating PRISM’s effectiveness and cost-effectiveness in a future clinical trial.
A pragmatic feasibility cluster randomised controlled trial will be conducted across four UK primary care sites with FCP services. Sites will be allocated 1:1 to intervention (PRISM dashboard, guidebook and structured clinical supervision) or control (usual care). Data on clinical decision-making will be collected monthly and anonymised for dashboard generation and compared to an existing dataset of over a million FCP consultations. Patients seen by FCPs will be invited to provide patient-reported outcome measures and experience measures. Feasibility outcomes include recruitment and retention of sites, FCPs and patients; dashboard engagement and completeness of data collection.
The primary outcome is recruitment feasibility. Secondary outcomes include retention, dashboard usage, patient-rated outcome measure/experience measure (patient-rated outcome measures/patient-rated experience measures) completion and supervision engagement. Descriptive analyses will summarise feasibility metrics and missing data. Health economic and carbon reduction data collection will also be assessed for future trial planning.
IRAS number 361 359. REC reference: 25/EM/0256, Approved: 10 December 2025 based on PRISM Protocol V.9. Dated 25 November 2025.
Findings from the PRISM feasibility trial will be disseminated through peer-reviewed publications, conference presentations and stakeholder engagement. Results will also be shared with participating sites, patient and public involvement representatives and professional bodies such as the Chartered Society of Physiotherapy to inform clinical practice and policy. Additionally, lay summaries will be produced for patients and the public and digital channels will be used to maximise reach.
This qualitative study aims to explore the experiences and preferences of Hispanic men participating in the National Diabetes Prevention Program (NDPP), an intensive lifestyle change intervention that effectively reduces diabetes risk, considering Hispanic men experience diabetes disproportionately yet remain underrepresented in the NDPP.
Individual semi-structured interviews were conducted over the phone in English or Spanish between June 2023 and February 2024. Transcripts were analysed using a framework analysis.
17 Hispanic men engaged in the NDPP for ≥4 sessions. The majority were foreign-born (n=11) and self-identified as English proficient (n=11).
Through three major themes, Hispanic men reflected on their experiences: (1) Going into the NDPP: despite not knowing what to expect from the NDPP, their fear of diabetes motivated them to enrol in the programme; (2) During the NDPP: they felt relief from gaining critical knowledge about diet, exercise and diabetes prevention; and finally (3) Impressions of the NDPP: they appreciated the NDPP’s informational resources, personalised coaching, group format and acknowledgement of traditional cultural diets and found men-only groups often offered additional emotional safety but had mixed feelings about the programme’s virtual format.
Findings suggest that Hispanic men appreciate the knowledge and skills attained from the NDPP and value its resources, group format, culturally-tailored content and gender-tailored structure. Recruitment efforts may benefit from emphasising how the programme reduces uncertainty about prediabetes and from more clearly conveying the structure of the programme. Strategies to improve sustained engagement should consider how to feasibly offer delivery formats that accommodate diverse preferences.
by Stefan Saverimuttu, Kate McInnes, Kristin Warren, Lian Yeap, Stuart Hunter, Brett Gartrell, An Pas, James Chatterton, Bethany Jackson
The ability to efficiently derive insights from wildlife necropsy data is essential for advancing conservation and One Health objectives, yet close reading remains the mainstay of knowledge retrieval from ubiquitous free-text clinical data. This time-consuming process poses a barrier to the efficient utilisation of such valuable resources. This study evaluates part of a bespoke text-mining application, DEE (Describe, Explore, Examine), designed for extracting insights from free-text necropsy reports housed in Aotearoa New Zealand’s Wildbase Pathology Register. A pilot test involving nine veterinary professionals assessed DEE’s ability to quantify the occurrence of four clinicopathologic findings (external oiling, trauma, diphtheritic stomatitis, and starvation) across two species datasets by comparison to manual review. Performance metrics—recall, precision, and F1-score—were calculated and analysed alongside tester-driven misclassification patterns. Findings reveal that while DEE (and the principals underlying its function) offers time-efficient data retrieval, its performance is influenced by search term selection and the breadth of vocabulary which may describe a clinicopathologic finding. Those findings characterized by limited terminological variance, such as external oiling, yielded the highest performance scores and the most consistency across application testers. Mean F1-scores across all tested findings and application testers was 0.63–0.93. Results highlight the utility and limitations of term-based text-mining approaches and suggests that enhancements to automatically capture this terminological variance may be necessary for broader implementation. This pilot study highlights the potential of relatively simple, rule-based text-mining approaches to derive insights natural language wildlife data in the support of One Health goals.by Helen W. Li, Jesse Kiprono Too, Sarah Nyanchama Nyariki, Charles Nathan Nessle, Sara Malone, Rachel Matsumoto, Teddy Ashibende Aurah, Jeffrey A. Blatnik, JoAnna Hunter-Squires, Ivan Seno Saruni
BackgroundCapacity for elective general surgical care is an important reflection of a health system’s ability to meet a population’s surgical needs and is currently known to be inadequate in many low- and middle-income countries. Patient agency is a key, understudied factor which shapes how and when patients ultimately decide to engage with formal care. Understanding factors which influence patient care seeking activity can have important implications for how current and future health systems may be utilized. This study aims to explore how patients approach the navigation and triage of their elective hernia condition within the Kenyan surgical care system.
MethodsWe conducted a qualitative study of 38 convenience-sampled patients diagnosed with an elective hernia condition at a tertiary referral hospital in Kenya between November 2023 and March 2024. We utilized Braun and Clarke’s six-step model of thematic analysis to generate key themes across the phases of care seeking, reaching and receiving as modeled in the Three Delays Framework.
ResultsWe identified three main cross-cutting themes including (1) the flow of power from patients to providers, and vice versa, take the form of consent or knowledge, respectively; (2) trust is a limited currency required for patients to engage with formal care; and (3) internal and external contextual factors remain the foundation for patient-provider care activities. We incorporated these themes together in a framework which illustrates the cyclical nature by which each factor feeds back on the others, ultimately affecting patient care.
ConclusionsFluctuating flows of patient power and trust interacts with existing infrastructural context to influence the ability of a health system to generate care. Recognizing the interaction of these key factors may have important bearing on the successful implementation of any larger systemic efforts or policies to improve access to elective surgical care.
To understand nurses' personal and professional experiences with the heat dome, drought and forest fires of 2021 and how those events impacted their perspectives on climate action.
A naturalistic inquiry using qualitative description.
Twelve nurses from the interior of British Columbia, Canada, were interviewed using a semi-structured interview guide. Thematic analysis was employed. No patient or public involvement.
Data analysis yielded three themes to describe nurses' perspective on climate change: health impacts; climate action and system influences. These experiences contributed to nurses' beliefs about climate change, how to take climate action in their personal lives and their challenges enacting climate action in their workplace settings.
Nurses' challenges with enacting environmentally responsible practices in their workplace highlight the need for engagement throughout institutions in supporting environmentally friendly initiatives.
The importance of system-level changes in healthcare institutions for planetary health.
To explore midwives' experiences of providing psychosocial interventions to parents following perinatal bereavement in maternity care settings.
A descriptive qualitative study.
Twenty-two midwives were recruited from three maternity services in Ireland using purposive and snowball sampling. Semi-structured interviews were conducted between July and November 2024. Reflexive thematic analysis was used to analyse the data.
Four themes were identified: (1) Building relationships as a foundation for psychosocial intervention delivery; (2) Psychosocial intervention as the core element of perinatal bereavement care; (3) Negotiating intervention delivery in a constrained system; and (4) Navigating emotional labour and professional growth. Midwives advocated provision of compassionate and relationship-based psychosocial interventions, but often faced systemic barriers, limited guidance, and insufficient training. Supportive structures and psychosocial intervention focused training were seen as critical to sustaining care quality and midwives' wellbeing.
Applying the Socio-Ecological Model (SEM) revealed that midwives' delivery of PSIs to support grieving parents after perinatal bereavement is influenced by multi-level factors, underscoring the need for policy integration, institutional support, and contextually grounded, midwife-led approaches.
Integrating SEM into intervention design can guide the development of multi-component PSIs that address multilevel influences and align with both parents' needs and midwives' capacities.
This adds to the understanding of how midwives deliver psychosocial interventions in perinatal bereavement care. Midwives view the delivery of these interventions as central to their role, while acknowledging the need for the development of, and training in structured, midwife-led psychosocial interventions in perinatal bereavement care.
COREQ.
Patients and members of the public were involved in study design, data collection and validation of findings. Their contributions included reviewing protocols and recruiting materials, facilitating recruitment and participating in advisory groups, ensuring the relevance and sensitivity of the research.
This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.
This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.
An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.
Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.
This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.
The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.
No patient or public contribution.
This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.
This study is reported according to STROBE guidelines.
FreshRSS 