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This study aims to determine the medico-social factors that predicted workers’ low work ability (LWA) leading to long-term absenteeism and permanent medical unfitness for work.
This was a cross-sectional analysis based on a cohort of workers followed up by an occupational health service in the south of France.
Employees visited by the service completed the Work Ability Index (WAI), a self-administered questionnaire. A score of 26 points or more defines high work ability while a score of 25 points or less defines LWA (scoring from 6 to 50 points). Occupational and medico-social data were obtained from computerised medical records. Logistic regression models were applied.
Of the 2104 WAIs completed the baseline questionnaire, the factors most associated with LWA were mental disorders (OR: 3.46), adaptation of the workstation (OR: 2.88) and long/iterative stoppages (OR: 2.87). Blue collar (OR: 2.50), white collar (OR: 2.34), permanent contracts (OR: 1.79), disability (OR: 2.63), recognition as a disabled worker (OR: 2.37), musculoskeletal disorders of the neck (OR: 2.52) and back (OR: 1.69) also appear to be associated with a risk of LWA.
White-collar and blue collar workers affected by mental disorders and musculoskeletal disorders of the neck and back appear to be significantly associated with a risk of LWA. To adjust LWA preventive measures, future studies are needed to discuss further these risk factors.
by Gianluigi Serio, Consiglia Pacelli, Claudia Piccoli, Nazzareno Capitanio, Giuseppe Cibelli, Anna Antonia Valenzano, Francesca Landini, Leonardo Carlucci, Paola Palladino
The ketogenic diet (KD) is a low-carbohydrate diet that induces and sustains a ketosis state and minimizes somatic glucose levels. Several psychological studies have described the positive effects of ketosis on cognitive functions for a wide range of neuropsychiatric conditions (e.g., Alzheimer’s disease; epilepsy), leading to greater interest in the KD today. However, the psychological and cognitive effects of inducing ketosis via diet remain unclear, especially in healthy people. From an initial pool of thirty participants, eight undergraduate students performed a cognitive assessment before (baseline) and after three weeks (follow-up) of an isocaloric ketogenic diet. Several neuropsychological measures and psychometric tests have been administered to investigate psychological chronotype, sleep quality, eating habits, anxiety and cognitive components of attention, inhibition, and memory. Non-parametric Bayesian analysis showed that the ketogenic diet affected cognitive functions. Participants performed cognitive tests faster at follow-up than at baseline, showing improvements in visual-motor cognitive and processing speed components. However, they were less accurate on working memory tasks, suggesting a decreasing performance of higher cognitive functions. Finally, no differences in anxiety levels were found between baseline and follow-up. The results could have significant implications for identifying specific cognitive models of students based on specific lifestyle habits and nutritional patterns, allowing the implementation of targeted interventions to improve university learning conditions.by María-Angélica Calderón-Peláez, Myriam L. Velandia-Romero, Jaime E. Castellanos
Zika virus (ZIKV) poses a significant threat to neural tissue, causing substantial damage to unborn children exposed to the virus in utero, with consequences that can manifest even after birth, despite being born with a normal head circumference. Regardless of the extensive research, the interactions between ZIKV and the nervous system cells remain insufficiently understood, particularly regarding how neuronal responses influence broader inflammatory and viral dynamics especially in postnatal stages of development. This study evaluated the susceptibility to ZIKV infection, viral replication, immune response, and survival of neurons, astrocytes and microglial cells during postnatal developmental stages, using both in vivo and in vitro mice models. In vivo, a non-lethal but extensive infection of neurons and microglia was shown. The infection caused a robust but controlled immune response with elevated levels of MCP-1, TNF-α, and IL-6, that prevented severe neuronal damage. In vitro, neurons exhibited high susceptibility to ZIKV, with elevated levels of pro-inflammatory cytokines and IFN-β, indicating a strong inflammatory response. In contrast, astrocytes and microglia displayed varied responses, contributing to a pro-inflammatory feedback loop. These findings offer critical insights into the cellular dynamics of ZIKV infection, enhancing our understanding of its effects during postnatal nervous system development. By clarifying the interactions between ZIKV and neuronal cell types, this study deepens the comprehension of the virus’s pathophysiology and its broader implications for neurodevelopmental outcomes, extending beyond the well-documented association with microcephaly.To examine the concept of obstetric violence culture and establish a working definition for application to practice, research, and policy in perinatal care.
Concept analysis.
Rodgers' evolutionary method guided the analysis and data organisation into antecedents, attributes, and consequences.
A systematic search using the phrase ‘obstetric violence’ was conducted in CINAHL and PubMed databases. Articles published in English between November 1, 2020, and December 31, 2024, were included.
Sixty-two articles were included. Antecedents reflected the historical medicalisation of birth, professional hierarchies, and structural inequities. Attributes—disbelief of harm, victim blaming, revictimisation, and disempowerment—mirror those identified in rape culture. Consequences spanned birthing people, clinicians, and systems, including mistrust, moral distress, and institutional silence. The resulting definition frames obstetric violence culture as an embedded and normalised set of practices and beliefs that sustain mistreatment in perinatal care.
Obstetric violence culture is not an outlier, but a pervasive and institutionalised framework to be systematically dismantled.
Nurses have an ethical obligation to recognise and disrupt obstetric violence culture. Structural change, clinical education, and institutional accountability are necessary to uphold patient autonomy and dignity.
This study followed Rodgers' evolutionary method and adheres to relevant EQUATOR guidelines for conceptual research.
This study did not include patient or public involvement.
To adapt and validate the HSOPS 2 instrument for the Italian context and to describe the current patient safety culture amongst healthcare personnel working in Italian hospitals.
Cross-sectional study.
We adapted and validated the HSOPS 2 instrument following the COSMIN guidelines: we performed a forward-backward translation, calculated the content validity index, evaluated face validity, acceptability (percentage of participants responding to all items on the questionnaire and to every specific item), construct validity (confirmatory factor analysis), and internal consistency (Cronbach's alpha for each dimension). We then performed a cross-sectional study following the guidelines of the original instrument: we categorised the responses into “positive,” “negative,” and “midpoints.” For each dimension we calculated the average percentage of positive responses. We repeated this process, dividing the responses by various sample characteristics (e.g., profession), and compared them using the chi-square test. Data were collected between April and November 2023.
A total of 633 hospital personnel participated in the survey, and 473 completed the questionnaire in its entirety. The dimensions of “teamwork”, “supervisor”, “manager”, or “clinical leader support”, and “communication about error” emerged as dimensions with higher percentages of positive responses, while those that received lower percentages were “hospital management support for patient safety”, “staffing and work pace”, and “response to error”. We identified statistically significant differences in many dimensions between gender, profession, and clinical inpatient units.
These findings provide a comprehensive overview of challenges and opportunities within the healthcare sector as regards patient safety culture and can inform the development of targeted interventions aimed at improving patient safety across healthcare organisations.
Proper assessment of safety culture, one of the main indicators of patient safety, can inform the development of effective strategies and interventions to enhance patient safety.
What problem did the study address? To effectively assess patient safety culture, it is essential to use valid and reliable tools. It is crucial to proactively assess patient safety culture in hospital personnel, whether employed in clinical units, in management, or in support services, to develop initiatives aimed at improving patient safety.
What were the main findings? The use of the adapted and validated version of the HSOPS 2 will produce valid and reliable evidence on patient safety culture. Perception of patient safety culture differs amongst respondents according to gender, profession, clinical setting. The dimensions of “hospital management support for patient safety”, “staffing and work pace”, and “response to error” were identified as those with the greatest need for improvement.
Where and on whom will the research have an impact? Patient safety heavily impacts care at every level; therefore, this study could have an impact on healthcare organisations as well as healthcare workers, patients, and their families. By making available an instrument that can contribute to a proper assessment of patient safety culture, this study might contribute to the development of appropriate strategies and targeted interventions to improve patient safety, quality of care and satisfaction while decreasing adverse events and related costs.
The COSMIN guidelines were used for the validation of the instrument; the STROBE reporting guidelines were used for the cross-sectional study.
No patient or public contribution.
Childhood cancer accounts for a significant proportion of global childhood mortality, especially in low-income and middle-income countries (LMICs). Unlike many adult malignancies, primary prevention of childhood cancers is not possible. Improving survival requires a two-pronged strategy: earlier diagnosis and effective treatment. Our study aims to establish the feasibility, clinical and implementation effectiveness of an adapted early warning signs and symptoms (EWSS) intervention in Cameroon and Kenya. It will equip healthcare workers, Ministry of Health (MOH) representatives and National Cancer Institute leaders with evidence-informed guidance on implementing context-adapted interventions to improve the early detection and referral of childhood cancers in these countries.
The study is a quasi-experimental, hybrid type 2 implementation effectiveness study based on a Ghanaian adaptation of the ‘Saint Siluan’ EWSS campaign. Our protocol proposes context-specific adaptation and evidence-based implementation of the EWSS intervention through iterative engagement with country-level implementation teams to train healthcare workers and improve referral pathways for earlier childhood cancer diagnoses in each study country. Training effectiveness will be measured through pretraining and post-training tests of knowledge and application, as well as training satisfaction surveys. Clinical effectiveness will be assessed by using a REDCap database to track the number of newly diagnosed childhood cancer cases in the study regions and counties, healthcare timelines and paths to diagnosis, and the stage and proportion of metastatic disease at diagnosis. Implementation effectiveness will be evaluated through interviews with senior and mid-level health system partners and clinicians, tracking fidelity to the implementation process as laid out in The Implementation Roadmap Workbook, and analysis of meeting minutes from monthly local implementation team meetings.
This study has received ethical approval from The Hospital for Sick Children (REB # 1000080092) and all participating sites. We have received National Ethical Clearance from the Cameroon Ethical Board (#1699) and Regional Administrative Authorizations from our piloting regions (Centre and West). We have also received ethical clearance from Kenyatta National Hospital (KNH) (ERB# KNH-ERC/RR/955) and our National Commission for Science, Technology and Innovation in Kenya licence from the counties we are piloting in Kenya. As clinical data will be collected from existing health registries and patient charts, patient consent will not be required; however, we will obtain consent from all members of the leadership implementation teams and operational implementation teams for their participation in the implementation meetings and from all individuals participating in the semistructured interviews. We will disseminate findings to build awareness and share findings among various target audiences: (1) key county and regional parties (eg, clinical societies, advocacy groups, country MOHs and regional bodies such as the East African Community, Economic Community of West African States); (2) international bodies such as the WHO; and (3) the academic community.
To describe the prevalence of cardiovascular disease (CVD) at the time of diagnosis of adult-onset type 1 (T1D) and type 2 (T2D) diabetes, in a recent cohort and compare to a previous cohort from the same region. Further, to explore factors influencing the prevalence of pre-existing CVD, including age, sex, body mass index (BMI) and C-peptide; in the later cohort also heart failure, hyperlipidaemia, tobacco use and physical activity.
Two prospective cross-sectional cohort studies compared.
All primary health care centres and hospitals in Kalmar and Kronoberg counties in Southeastern Sweden.
Adults with newly diagnosed T1D or T2D (classified by combination of islet antibodies and C-peptide) in 1998–2001 and 2016–2017.
Prevalence of hypertension and CVD at diagnosis of diabetes, and associations with beta-cell function, in two cohorts collected 15 years apart. Further, to explore factors influencing the prevalence of hypertension and CVD, and level of C-peptide.
In patients with newly diagnosed T2D, mean age-at-onset had decreased (66±14.1 years vs 63±12.6, p≤0.001) and mean BMI had increased (29.0±5.4 vs 31.4±5.8 kg/m2, p≤0.001). Prevalence of pre-existing myocardial infarction had decreased in both T1D (18% vs 7%, p=0.03) and T2D (25% vs 11%, p≤0.001). Pre-existing hypertension had increased in both T1D (23% vs 40%, p=0.01) and T2D (44% vs 61%, p≤0.001). C-peptide level was lower and was associated with several cardiovascular conditions in newly diagnosed T2D in 2016–2017 (p=0.048 p≤0.001).
Patients with newly diagnosed T2D were younger, with higher BMI, compared with 15 years earlier, a challenge for diabetes care. Prevalence of pre-existing myocardial infarction had decreased notably, in line with, but still less than in the general population; while pre-existing hypertension had increased, in both diabetes types. C-peptide was associated with several cardiovascular conditions in newly diagnosed T2D in the recent cohort, which warrants further investigation.
FreshRSS 