Conectar
by Omar Muhumed Maidhane, Omran Salih, Abdisalam Hassan Muse, Abdirahman Omer Osman, Muse H. Abdi, Mahdi Hashi Hassan, Nur Mohamud Ali, Shacban Abdilahi Elmi
BackgroundAccess to adequate sanitation remains a critical public health challenge in Somalia, where a large portion of the population relies on unimproved facilities due to persistent conflict, climate shocks, and political instability. This reliance contributes to a high burden of waterborne diseases. This study aimed to assess the spatial distribution of unimproved sanitation and identify its individual and community-level determinants using recent national data to inform targeted interventions.
MethodsThis study is a secondary analysis of the 2022 Somalia Integrated Household Budget Survey (SIHBS), which included 7,212 households. The primary outcome was the use of unimproved sanitation facilities, categorized according to the WHO/UNICEF Joint Monitoring Programme (JMP) definitions. We employed a multilevel logistic regression model to identify individual and community-level determinants associated with unimproved sanitation. To analyze the spatial patterns of unimproved sanitation, we used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi* statistic for hotspot analysis.
ResultsOverall, 36.87% of Somali households use unimproved sanitation facilities. There are significant disparities across residence types, with the highest prevalence among nomadic populations (83.28%), followed by rural (51.10%) and urban (23.88%) residents. The multilevel analysis revealed that households in permanent/formal housing (AOR: 3.42) and those with IDP status (AOR: 3.18) had significantly higher odds of using unimproved sanitation. At the community level, urban residence was paradoxically associated with higher odds of unimproved sanitation (AOR: 7.99) compared to rural areas, while nomadic populations had significantly lower odds (AOR: 0.04), likely reflecting a high prevalence of open defecation not captured as a “facility.” Spatial analysis identified significant hotspots of unimproved sanitation in the Hiraan (90.65%) and Bay (80.39%) regions, and cold spots in Banadir (5.37%) and Lower Shabelle (3.70%).
ConclusionThe findings highlight deep inequalities in sanitation access across Somalia, driven by geographic location, socioeconomic status, and population group. The high prevalence of unimproved sanitation, especially among nomadic, rural, and displaced populations, calls for urgent, geographically-targeted interventions. A multi-pronged approach is necessary, focusing on the specific needs of different communities and addressing the underlying structural and individual-level drivers of poor sanitation to advance public health and sustainable development goals in the region.
Chronic central serous chorioretinopathy (CSC) can cause progressive and permanent vision loss. Although photodynamic therapy (PDT) is a primary treatment option globally, it is not approved for CSC worldwide, limiting therapeutic access. The REPLAY trial is a phase III, investigator-initiated trial to evaluate the efficacy and safety of reduced-fluence PDT (rf-PDT) for chronic CSC to seek the first regulatory approval globally.
This study comprises two cohorts. The ‘untreated cohort’ is a multicentre, randomised, placebo-controlled, double-masked trial involving 60 patients with untreated, fovea-involving chronic CSC, randomised 2:1 to receive a single rf-PDT or placebo treatment. The ‘previously treated cohort’ is a single-arm, open-label trial for up to 10 patients with recurrent CSC after PDT. The primary endpoint for both cohorts is the proportion of eyes with a complete resolution of subfoveal fluid at 12 weeks post-treatment, assessed by optical coherence tomography. Secondary endpoints include changes in best-corrected visual acuity, central choroidal thickness, recurrence rates and incidence of adverse events over a 48 week follow-up.
The study protocol was approved by the Kyoto University Hospital Institutional Review Board, IRB of Chiba University Hospital, Tokyo Women’s Medical University Institutional Review Board and Institutional Review Board of Kansai Medical University Hospital. Written informed consent is obtained from all participants. The results will be disseminated through publication in a peer-reviewed journal and presentations at scientific conferences.
jRCT2051230156 (URL: https://jrct.mhlw.go.jp/latest-detail/jRCT2051230156).
Extrapulmonary tuberculosis (EPTB) poses a significant diagnostic and economic challenge in HIV endemic, low-resource settings due to its complex presentation and current diagnostic tools limitations. While accurate and timely diagnosis is critical for reducing morbidity, mortality and health system costs, economic evaluations of EPTB diagnostics remain sparse and fragmented. This protocol aims to map existing evidence on the economic evaluation of diagnostic innovations for EPTB in low-resource settings.
This scoping review protocol follows the Joanna Briggs Institute (JBI) methodological framework and registered on the Open Science Framework. Peer-reviewed articles, grey literature and official reports published between 2000 and 2025 will be searched in PubMed, MEDLINE, Google Scholar, Scopus and Science Direct. The search strategy is structured using the Population, Intervention, Comparator, Outcome, Time, Study design and Setting (PICOTSS) framework, and will be peer-reviewed using the Peer Review of Electronic Search Strategies (PRESS) guideline. Study selection, data charting and extraction will be performed independently by two reviewers. Data will be charted iteratively, and the methodological quality of selected economic evaluations will be appraised using the Drummond checklist. Results will be synthesised in narrative summaries and tabular formats. Final reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guideline.
For review of previously published data, ethical approval is not required. Findings will be disseminated in professional networks, stakeholder meetings and a peer-reviewed journal.
OSF Registration DOI 10.17605/OSF.IO/BTCPG
To investigate the risk factors for primary non-central malposition of peripherally inserted central catheter (PICC) tip in neonates admitted to the neonatal surgical department, compare the malposition rates across different insertion sites in disease types, and explore whether different diseases affect PICC tip malposition.
A retrospective case–control study conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
A 3A women’s and children’s hospital in South China (Guangdong Province).
A total of 558 neonates aged ≤28 days who underwent PICC insertion between January 2019 and November 2024 were enrolled. Neonates with congenital circulatory system malformations, incomplete clinical data and death or treatment withdrawal before tip positioning were excluded.
The primary outcome was the incidence of primary non-central PICC tip malposition confirmed by X-ray or ultrasound within 24 h after insertion. Secondary outcomes included comparison of primary non-central PICC tip malposition rates across different insertion sites and comparison of primary PICC tip malposition rates by insertion sites across different disease groups.
558 neonates were included in this study, including 460 cases with PICC tip in place and 98 with PICC tip malposition. In binary logistic regression analysis, the PICC insertion site was considered an independent risk factor (OR 2.908, 95% CI 1.748, 4.840, p
Medical staff can choose appropriate upper or lower limb veins for PICC insertion without worrying about the impact of abdominal diseases or thoracic diseases on non-central PICC tip malposition. PICC insertion via the head and neck veins should be performed with caution in neonates, as these sites carry a high risk of primary non-central tip malposition compared with other insertion sites.
Ethnic communities provide an appropriate setting for examining patterns of pregnancy and childbirth. Policy-making aimed at improving maternal health will be rendered ineffective in the absence of knowledge and comprehension of the traditions and beliefs associated with childbirth. The objective of this study was to cross-ethnically compare childbirth experiences.
This research used a cross-sectional methodology and was conducted in 2023. The sampling in the cities of Tabriz (Azeri), Sanandaj (Kurdish), Babol (Mazani), Khorramabad (Lur), Ahvaz (Arab) and Tehran (Fars) was conducted using the cluster random approach. The data collection instruments included questionnaires of sociodemographic and obstetric characteristics and childbirth experience (Childbirth Experience Questionnaire 2.0). In bivariate analysis, a one-way analysis of variance test was employed. In contrast, a general linear model (GLM) was used in multivariate analysis to adjust for the influence of sociodemographic and obstetric characteristics. The data were analysed using SPSS V.24 software. The p value less than 0.05 was considered significant.
Health centres in cities with different ethnic groups all over Iran.
For this purpose, 1331 women from six ethnic groups who were referred to health centres were selected 4 to 6 weeks after giving vaginal birth.
The following are the mean (SD) scores (scoring range: 1–4) for the childbirth experiences of the participating women: Azeri 2.31 (0.32), Kurdish 2.14 (0.31), Fars 2.26 (0.42), Mazani 1.93 (0.38), Lur 2.14 (0.4) and Arab 2.06 (0.18). Results from GLM multivariate analysis showed that while Azeri (B: 0.25; 95% CI 0.16 to 0.35; p
Women of different Iranian ethnicities have varying childbirth experiences. Women of Azeri and Fars ethnic groups report higher satisfaction with childbirth than those of others. Mazeni women had the lowest mean scores for having a positive birth experience. To offer compassionate and effective treatment for their patients, healthcare providers must have a deep understanding of cultural diversity.
To identify and synthesise the ethical, feasibility and acceptability challenges associated with implementing eye-tracking research with clinicians in acute care settings and to explore strategies to address these concerns.
Scoping review using the Joanna Briggs Institute methodology.
Six databases (MEDLINE, CINAHL, EMBASE, Web of Science, APA PsycInfo and ProQuest Dissertations & Theses Global) were searched for peer-reviewed articles. Reference lists of included studies were also hand-searched.
Eligible studies involved clinicians using or interacting with eye-tracking devices in acute care environments and addressed at least one ethical, feasibility, or acceptability consideration. Data were extracted and thematically analysed. Knowledge users, including clinicians, ethicists and a patient partner, were engaged during protocol development and findings synthesis.
Twenty-five studies published from 2010 to 2024 were included. Seven challenges were identified: obtaining ethical approval, managing consent, privacy and confidentiality concerns, collecting data in unpredictable environments, interference with care, participant comfort and data loss or unreliability. Knowledge users highlighted the importance of early institutional engagement, clear protocols, continuous consent and context-sensitive ethical reflection.
Eye-tracking offers valuable insights into clinician behaviour and cognition, but its implementation in acute care raises complex ethical and methodological issues. Responsible use requires anticipatory planning, stakeholder engagement and flexible yet rigorous protocols.
By informing the development of ethically sound study protocols and consent practices, this work contributes to safer, more transparent and patient-centred research that respects participant autonomy and protects clinical workflows.
The protocol was registered with the Open Science Framework (https://osf.io/jn4yx).
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Page et al., 2021) and its Extension for Scoping Reviews (Tricco et al., 2018).
A patient partner was involved in protocol development, interpretation of findings and development of study recommendations. Their contributions included participating in advisory groups and providing feedback alongside clinicians and ethicists during focus groups. This input helped ensure the research addressed patient-relevant priorities and informed the development of ethically responsible practices for conducting eye-tracking research in clinical care settings.
While health research about persons of South Asian ancestry has been conducted for decades in Canada, it often uses pathologising approaches that fail to consider historical, social and political factors shaping health disparities. Further, this research rarely engages South Asian communities in meaningful ways, reinforcing feelings of disconnect and longstanding mistrust. Greater collaboration and transparency are needed to build trust and generate credible findings. The aims of this research protocol are to (1) examine how community engagement has been implemented in health research involving South Asian populations, (2) explore the experiences of both South Asian community members and academics involved in community-engaged research and (3) develop a framework guiding health research with and for South Asian communities in Canada, titled PRinciples to Operationalize Community Engagement, Equity, and Sustainability in South Asian Health Research in Canada (PROCESS).
This ongoing codesigned concurrent multimethods study is being conducted with community partners across Canadian provinces. First, the scoping review is examining how community engagement has been operationalised in health research involving South Asian populations in Canada. We are performing a search in Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Web of Science, Scopus and PsycINFO databases for articles published between 2003 and 2024 referring to the concept of community engagement in South Asian health research. Two reviewers are independently completing abstract and full-text reviews based on preselected eligibility criteria. Data are being extracted from peer-reviewed studies using a data extraction framework. Findings will be aggregated and synthesised using descriptive content analyses. Second, a qualitative descriptive study is being conducted to explore the experiences of diverse stakeholders, including academics and community partners who are partaking in academic health research focused on South Asians. Semistructured interviews are being analysed using an inductive thematic content analysis. Results from the scoping review and qualitative interviews will be triangulated to detect emerging themes and patterns, which will enable the identification of principles to be incorporated within a draft of the PROCESS framework. In the final phase, we will use a modified Delphi process to iteratively codevelop the PROCESS framework with community partners and researchers across Canada.
The Faculty of Medicine and Health Sciences Institutional Review Board at McGill University approved the study’s protocol (24-05-080). Results will be submitted for publication in peer-reviewed journals and presented in academic and community forums. Results will also be shared with diverse audiences across Canada through multiple formats, including articles, conferences, infographics and social media, with the aim of raising awareness and promoting the adoption of research principles and practices for engaging South Asian communities in health research. This research received funding from the Canadian Institutes of Health Research (Grant #507768).
by Tamar Zurashvili, Maia Kajaia, Oluwabusayomi Akeju, Jack DeHovitz, Mamuka Djibuti
People who inject drugs (PWID) are at a heightened risk of contracting and transmitting HIV due to shared needles and unsafe sexual practices. Evidence on what shapes condom use among PWID in Georgia is limited. We conducted qualitative study among PWID recruited from two harm-reduction organizations in Tbilisi and Samegrelo between June-August 2025. Interviews were guided by the COM-B framework and analyzed thematically. Reduced sexual pleasure emerged as a dominant capability-related barrier to condom use. Knowledge of risks, benefits, and where to obtain condoms supported condom use, although participants noted that some community members lacked such knowledge. Opportunity factors were mixed. The convenient access to condoms, whether purchased at pharmacies or available for free at harm-reduction centers, created opportunity for condom access, and facilitated condom use; the factors impeding the use included the cost of purchase as well as long distance to and restricted hours of outlets, and occasional stock-outs and concerns about quality of condoms at harm-reduction centers. Social dynamics emerged as essential factors. Partner pressure, coercion, and persuasion, often intensified by alcohol or drug use, limited condom negotiation, whereas partner support, preparedness, and peer information sharing facilitated condom use. Motivation-related barriers included being under the influence of alcohol or stimulants and “heat of the moment” impulsivity, alongside low perceived risk with regular partners. Motivators included a strong desire for self and partner protection, heightened risk perception with casual or commercial partners, fear of infection, and past negative experiences including infections or unintended pregnancy. Findings indicate that condom use among PWID in Georgia is shaped by interplay of capability, opportunity, and motivation factors. Culturally sensitive, locally adapted strategies addressing pleasure-related concerns through education, strengthening negotiation and refusal skills, including couple-focused approaches can improve consistent condom use in Georgia and may benefit other countries in Eastern Europe and Central Asia.En el marco del XVIII Congreso Internacional de Enfermería Dermatológica, Dermoestética y Heridas, que se celebrará el 23 y 24 de abril en Alcalá de Henares, contamos con la participación del Dr. Raúl de Lucas, referente nacional en el abordaje de la Epidermólisis Ampollosa o Bullosa (EB), una enfermedad minoritaria que en España afecta aproximadamente a 500 personas. Su conferencia, titulada “Epidermólisis Ampollosa: el viaje de la vida”, nos invita a reflexionar no solo sobre la enfermedad, sino sobre el recorrido vital que implica convivir con ella.
El título refleja realmente lo que es esta patología. Por un lado, la vida que tienen nuestros pacientes, que nacen con dolor, con ampollas y que siguen muchas veces, sobre todo en los casos más graves, un camino que termina en más sufrimiento y en muerte precoz por carcinomas o por complicaciones infecciosas o nutricionales. Por otro lado, el llegar como profesional, como médico, como dermatólogo a esta patología, me ha supuesto, no sé si una trayectoria profesional mejor, pero sí diferente. No puedo contemplar otra manera de trabajar. Llevo más de veinte años viendo pacientes con Piel de Mariposa o Epidermólisis Ampollosa y el tratamiento de esta enfermedad forma parte de mi vida.
Evidentemente, si hay una patología dermatológica que requiere el conocimiento, la colaboración y el trabajo en equipo con la Enfermería, sin duda, es la Epidermólisis Ampollosa: curas infinitas, elección del tipo de apósito más adecuado, valoración de las heridas desde un punto de vista basado en la experiencia y también en la innovación. Sobre esta patología hay muy pocas cosas escritas. Epidermólisis Ampollosa es sinónimo de curas y también sinónimo de Enfermería.
Personalmente, yo no concibo enfrentarme a un paciente con EB sin un diagnóstico enfermero, que sepa medir y evaluar el impacto familiar y social, el acompañamiento que estos pacientes requieren. Para mí, trabajar con la Enfermería ha supuesto un aprendizaje y, sobre todo, una visión mucho más completa, cercana y adecuada a lo que es la realidad del paciente. No puedo prescindir de esta colaboración.
Nuestra unidad de EB del Hospital La Paz destaca fundamentalmente por el trabajo asistencial. Tenemos más de trescientas familias con Epidermólisis Ampollosa con una plantilla muy recortada. Eso supone muchos días y muchas horas de dedicación e incluso mucho trabajo en casa para estudiar e intentar resolver los problemas de nuestros pacientes.
Por otro lado, también destacaría la innovación, incluso en la cura. La Enfermería de nuestro centro de referencia, del CSUR, ha cambiado completamente el concepto de cura en Epidermólisis Ampollosa. Han sabido pensar fuera de la caja y han luchado contra los estereotipos, contra esas guías y otros intereses, que determinaban que las curas eran individuales para cualquier tipo de paciente. Ahora mismo, los cuidados se individualizan y se eligen los mejores apósitos, desinfectantes e incluso prendas de vestir.
También destacaría la investigación. Hemos aprendido a interpretar la Epidermólisis Ampollosa como una enfermedad sistémica, tremendamente complicada de entender y de tratar, y hemos buscado nuevas estrategias, fármacos y terapias. Estamos realizando ensayos clínicos con terapias avanzadas y tenemos muchos más proyectos en este sentido. Pero, sin duda, lo que destacaría, y así nos lo hacen llegar nuestros pacientes, es el trato, la humanidad y el acompañamiento que hacemos con nuestras familias de la Epidermólisis Ampollosa.
Raúl de Lucas Laguna desarrolla su actividad profesional en el Servicio de Dermatología del Hospital Universitario de La Paz, donde ha impulsado la Unidad de Dermatología Pediátrica. Se formó como médico especialista en este mismo hospital, combinando la atención clínica con la docencia y la investigación traslacional. Su trabajo ha resultado clave en el estudio de enfermedades hereditarias de la piel y en la implementación de protocolos diagnósticos avanzados.
Autor y coautor de numerosos artículos en revistas científicas internacionales, De Lucas ha colaborado en proyectos multicéntricos sobre genodermatosis, ictiosis congénitas y tumores cutáneos infantiles. También participa activamente en congresos europeos de Dermatología y en grupos de trabajo de la Academia Española de Dermatología y Venereología.
Su labor combina la práctica clínica con la divulgación científica, orientada a mejorar la atención dermatológica infantil en España. Es reconocido por su enfoque humanista hacia el paciente pediátrico y por fomentar la colaboración interdisciplinaria entre Medicina y Enfermería.
The post Raúl de Lucas Laguna: “Epidermólisis Ampollosa es sinónimo de curas y también de Enfermería” first appeared on ANEDIDIC.
Evidence-Based Practice (EBP) is essential to healthcare quality and safety, integrating scientific evidence with clinical expertise and patient preferences. Despite its importance, EBP implementation still faces major challenges. Educational interventions have proven effective in strengthening EBP competencies among healthcare.
To evaluate the impact of a personalized educational intervention on EBP competencies among healthcare professionals. Working at a private tertiary general hospital, comparing performance before and after the intervention.
A randomized controlled trial involving healthcare professionals was conducted. Eligible and consented participants were randomly assigned to either an Intervention Group (IG) receiving an Evidence-Based Practice (EBP) course or a Control Group (CG) not receiving the course, stratified by job level, role, and work shift. From the completers, 18 participants were randomly selected for the IG, and all 7 available CG participants were included in the final sample for analysis. All study participants completed two validated instruments: the Assessing Competencies in Evidence-Based Medicine (ACE) and the Fresno Test. The educational intervention consisted of a seven-week course with weekly three-hour sessions, for a total of 21 h. Comparative analyses were conducted using a Linear Mixed Model, adjusted for educational level, job level, time working at the hospital, and weekly workload.
A statistically significant increase in general EBP knowledge was observed in the IG following the intervention, with a mean gain of 19.1%. Separate analysis showed improvements of 10.8% in ACE and 24.2% in Fresno Test scores. No statistically significant changes were observed in the CG. Furthermore, after the intervention, the IG outperformed the CG for both general EBP knowledge and Fresno Test scores on both pre- and post-intervention comparisons.
The educational intervention had a positive statistically significant impact on EBP knowledge and skills among healthcare professionals in the IG compared to the CG. These findings underscore the potential of structured educational initiatives to enhance the quality of clinical practice through improved EBP competencies.
UTN U1111-1322-8443
Suicide is a major public health concern among youth in Canada and worldwide. The most rapid increases in suicidal ideation, self-harm, and suicide attempts have been observed among adolescent girls, particularly since the COVID-19 pandemic. Recent studies report disproportionately high rates of emergency department visits and hospitalisations for suicide-related concerns among adolescent girls. Despite these concerning trends, limited evidence exists on the life trajectories, needs, and service pathways of adolescent girls who attempt suicide. This protocol describes a qualitative suicide audit focused on adolescent girls aged 12–17 who were hospitalised following a suicide attempt in two regions of the province of Québec, Canada. The aim is to understand developmental trajectories, document services received and identify individual, relational and systemic factors influencing these trajectories to generate recommendations that inform suicide prevention.
Using a narrative qualitative design and a community-based research approach, data will be collected from semi-structured interviews with adolescents and parents, parent questionnaires and hospital health records. These data will be integrated to develop anonymised case vignettes. A multidisciplinary panel, including clinicians, health system stakeholders, community partners and individuals with lived experience, will review each case to identify gaps and strengths in care and generate case-level and cross-case recommendations for clinical practice, health policy and professional training.
Ethics approval was obtained from the research ethics committee (REC) of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, which serves as the reviewing REC, with administrative reviews underway at two other health authorities. Findings will be disseminated through peer-reviewed publications, conference presentations and collaborative knowledge-mobilisation activities with clinical and community partners, including practice-oriented tools and accessible materials for adolescents and parents.
Pressure injury represents a significant but preventable health problem, especially in clinical settings characterised by a high degree of risk. Despite the critical role played by nurses in pressure injury prevention, evidence suggests that inconsistencies remain concerning their knowledge and skill levels. This study aimed to determine the level of knowledge amongst nurses regarding pressure injury prevention and the factors associated with this level. The sample of this cross-sectional study consisted of 346 nurses reached through convenience sampling. The research data were collected online using the nurse descriptive form and the Pieper–Zulkowski Pressure Injury Knowledge Test, accessed through a Google Forms link shared on various social media platforms between December 2023 and February 2025. Most of the 346 nurses who participated in the study were female (89.0%), and the mean age was 36.19 years (±8.52 years). Most participants had a bachelor's degree (76.8%), and 35.6% had more than 20 years of professional experience. The pressure injury knowledge test score of the nurses was 43.00 (10.50). There was a significant difference in knowledge scores between clinical units (p = 0.009); the highest scores were found in nurses working in high-risk units (e.g., operating theatre) (p = 0.029). The study demonstrated that the implementation of unit-specific, practise-based training programmes is imperative to enhance nurses' knowledge. It is suggested that future studies utilise a combination of methods in order to address the individual, environmental and organisational factors that have a bearing on knowledge levels.
To validate the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) using item response theory (IRT), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).
Cross-sectional psychometric validation.
Manufacturing companies registered in Malaysia.
A total of 137 factory workers participated in the exploratory phase and 300 in the confirmatory phase. Inclusion criteria were Malaysian nationality and ability to read Malay.
The knowledge domain was examined using the two-parameter logistic IRT model in two stages: an exploratory IRT analysis in phase 1 to screen items and a confirmatory IRT analysis in phase 2 to evaluate the final item set. The stigma domain was analysed using EFA followed by CFA. Reliability was assessed using Cronbach’s alpha and McDonald’s omega (). The development process and content and face validity results were previously published.
14 knowledge items were retained after exploratory IRT and formed the final knowledge scale evaluated in confirmatory IRT. For these final items, discrimination parameters ranged from 0.77 to 3.17 and difficulty values from –4.47 to 0.23, with unidimensionality supported (p=0.644). EFA supported a three-factor stigma structure (stereotype, fear, prejudice), and CFA confirmed excellent model fit (2=8.91, df=11, p=0.630; root mean square error of approximation=0.00; Comparative Fit Index=1.00; Tucker-Lewis Index=1.00; standardised root mean square residual=0.021). Composite reliability by McDonald’s omega ranged from 0.691 to 0.893.
WoCKSS is a reliable and valid instrument for assessing workplace COVID-19 knowledge and stigma in industrial sectors in Malaysia.
To evaluate the association between non-steroidal anti-inflammatory drugs (NSAIDs) and miscarriage, which remains elusive in the actual literature, using modelling approaches to mitigate time-related bias.
Nationwide, population-based retrospective cohort study.
The study used data from the French National Mother-Child Register (EPI-MERES), developed from the French National Health Data System containing the health information (hospital admissions, drug dispensing, comorbidities, etc.) of about 99% French population.
4 857 907 pregnancies ended in a live birth, a stillbirth or a miscarriage from 2013 to 2019.
Exposure to NSAIDs from 2 weeks before conception to the 20th week of pregnancy.
Miscarriage (ie, spontaneous abortion before the 20th week of pregnancy) from the sixth week of pregnancy. The Cox regression with a time-dependent exposure that incorporated a 3-day lag was used to estimate HRs and their 95% CIs adjusted for maternal characteristics. The 3-day lag period allows for addressing protopathic bias.
In total, there were 163 666 (3,37%) miscarriage cases, and 349 294 (7.19%) pregnancies were exposed to NSAIDs. Unexposed pregnancies were used as the reference category in all analyses. In the main analysis, exposure to NSAIDs increased the risk of miscarriage (HR, 1.83; 95% CI 1.81 to 1.86). The effect of individual drugs was heterogeneous, with 7 of the 19 drugs evaluated shown to increase the risk (flurbiprofen had the highest risk (HR, 3.28; 95% CI 3.15 to 3.41) and naproxen the lowest (HR, 1.09; 95% CI 1.01 to 1.18)). In the sensitivity analyses, increasing the lag time decreased the estimated HR (from HR, 2.25; 95% CI 2.21 to 2.28 with no lag to HR, 1.56; 95% CI 1.54 to 1.59 with a 7-day lag). Overall, the risk of miscarriage remained statistically significant in all the analyses.
Our study found that early exposure to NSAIDs could increase the risk of miscarriage. This finding contributes to the body of evidence on their safety profile and may help inform future recommendations for their use in pregnant women.
Skin-to-Skin Contact or Kangaroo Mother Care is an evidence-based intervention proven to enhance breastfeeding rates, improve cardiorespiratory stability and promote neurodevelopment in neonates. While established as a standard of care for stable term infants and increasingly recognised for preterm infants, the implementation of sustained skin-to-skin contact faces significant systemic and clinical challenges, particularly within the intensive care environment. This editorial argues that the focus must shift from when skin-to-skin contact is permitted to how sustained skin-to-skin contact can be universally integrated as a non-negotiable core practice, even for extremely preterm infants. Addressing practical barriers, such as staff training, equipment design, parental support and perceived clinical instability, is essential to realise the full potential of sustained skin-to-skin contact to optimise neurodevelopmental and physiological outcomes for all neonates, closing the gap between compelling evidence and inconsistent global practice.
To translate, culturally adapt and validate the Italian version of Fundamentals of Care Framework and the Fundamentals of Care Practice Process.
Qualitative tool validation study.
The study followed internationally recommended procedures, including forward–backward translation, expert committee review, content validation through cognitive interviews and face validity testing with nurses and nursing students. Data were collected between January and October 2023.
Key terms were culturally and linguistically adapted to enhance clarity and contextual relevance, with changes informed by expert feedback. Content validation confirmed conceptual equivalence, and face validity testing demonstrated that Italian versions were perceived as clear, appropriate and applicable across clinical and educational settings.
Cultural adaptation of theoretical frameworks is essential for ensuring their relevance and usability in local contexts. The Italian versions of the Fundamentals of Care Framework and the Fundamentals of Care Practice Process will provide a robust, evidence-based foundation for person-centred care across education, research and clinical practice.
By making these tools accessible in Italian, this study supports the integration of fundamentals of care into national nursing education and practice, promoting international consistency in person-centred care. It lays the groundwork for curriculum reform, clinical implementation and global collaboration in nursing.
Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
This study did not involve any patient or public contribution.
ClinicalTrials.gov identifier: NCT05177627
Así de clara se muestra Manuela Monleón Just, Enfermera familiar y comunitaria en el Equipo de Soporte de Atención Domiciliaria Legazpi (Madrid), y Doctora en Cuidados de la Salud por la Universidad Complutense de Madrid, al hablar sobre la importancia de poner el foco en el cuidado de los pacientes al final de su vida. Un aspecto que tratará con mayor profundidad en su intervención en el XVIII Congreso Internacional de Enfermería Dermatológica, Dermoestética y Heridas que ANEDIDIC celebrará los días 23 y 24 de abril en Alcalá de Henares. Esta profesional participará en la Mesa 5, “Abordaje global del paciente con heridas”.
La OMS dice que los Cuidados Paliativos son el enfoque que mejora la calidad de vida de pacientes y familias que se enfrentan a los problemas asociados con enfermedades amenazantes para la vida, a través de la prevención y alivio del sufrimiento, por medio de la identificación temprana y la impecable evaluación y tratamiento del dolor, y otros problemas físicos, psicosociales y espirituales.
Esto se resume en ser un momento de la vida de las personas que precisa de una mirada y atención integral, como persona única, viviendo un proceso nuevo, que es el suyo y de la familia, y que necesita del cuidado físico, psicoemocional, social y espiritual.
Lo que oímos en la actualidad es que debemos “humanizar” la asistencia sanitaria. Y yo me pregunto: “¿cómo hemos llegado a deshumanizarla?”. Parece que a mayor tecnología y conocimiento, no te aseguran una atención más humana. Tendemos a compartimentar a las personas: “eso no es mío”; “ese cuidado es de la enfermera familiar”; “eso es hospitalario”; ”atención telefónica de las lesiones y heridas de la piel”… Situaciones que hacen que perdamos la esencia de una adecuada atención humana, cara a cara.
Una atención que escucha, que se acerca al sentir de la persona, sospecha la repercusión en las distintas esferas humanas, hace partícipe a la persona que atendemos. Y esto es el cuidado paliativo. Yo no puedo diferenciar el cuidado paliativo de una herida del cuidado paliativo de la persona.
El final de la vida de las personas en cuidados paliativos, suele llegar tras un largo recorrido de una enfermedad crónica. Esa persona además de los síntomas generales de su enfermedad, puede sufrir de una comorbilidad que haga peor su permanencia y calidad de vida. Sabemos que la fragilidad y la dependencia aparece en este avance de la enfermedad, donde el riesgo de lesiones por presión aumenta, incluso dando buenos cuidados.
Estas lesiones cutáneas pueden transformarse en sentimientos de culpa por parte de las personas cuidadoras y familiares, repercutiendo en el proceso de duelo que se inicia antes del fallecimiento de la persona enferma. El apoyo y cercanía en estos momentos a los cuidadores es imprescindible. Por otro lado, el propio duelo del profesional puede llevarle a alejarse de la atención que necesita, por no saber abordar la situación emocional suya con el paciente.
Es importante explicar que muchas de estas lesiones no son evitables, al igual que el sufrimiento. Nuestra atención puede aliviar la situación, pero siempre habrá un sufrimiento inevitable propio de la pérdida.
He vivido situaciones de un cuidado excelente por parte de la familia, y en la situación de últimos días, aparecer un fallo cutáneo propio del órgano que se acerca al final, modificando la vascularización de la piel, apareciendo hematomas, úlceras de Kennedy, etc., que han frustrado a la persona más próxima al cuidado diario del enfermo. La comunicación honesta y la información sincera y adaptada, son herramientas indispensables en este momento del final de vida.
Va a depender del tipo de lesión, y del pronóstico de vida. Si hablamos de lesiones tumorales, de un cáncer externalizado a piel, o una metástasis cutánea, a simple vista una piensa que el riesgo más importante es el sangrado y el dolor. Pero ¿sabemos el significado que tiene para el paciente? Muchas veces una lesión tumoral dolorosa, les lleva a pensar que el cáncer está creciendo, un miedo o sufrimiento en vano, cuando lo más seguro es que sea por la afectación neurológica que existe alrededor de estas heridas.
Se precisa más formación profesional en el cuidado de estas lesiones, y no aplicar un “exceso de limpieza” y ponerse a desbridar quirúrgicamente este tipo de heridas. De la misma forma, es importante conocer cómo tratar el dolor, el exudado, el olor, etc., tan frecuente en las lesiones tumorales.
Por otra parte, las lesiones por presión, humedad, etc., se cuidan del mismo modo que una persona que no esté en Cuidados Paliativos. Ahora bien, el sentido común nos lleva a tener en cuenta el pronóstico y la situación de la persona; es decir, si el pronóstico de vida es corto, prima el confort de la persona, y entre nuestros objetivos no estará curar la lesión.
En España, podríamos decir que solo el 40 % de las personas que necesitan cuidados paliativos especializados llegan a recibirlos. Además, existen notables desigualdades en recursos de cuidados paliativos, entre Comunidades Autónomas y territorios. Esto sitúa a los ciudadanos en dos bandos: “los de 1ª” (atención adecuada) y “los de 2ª” (atención deficiente o nula). Según donde vivan, tendrán una atención u otra. Esta realidad implica que miles de pacientes con enfermedades avanzadas, o en situación de final de vida, continúan sin disponer de una atención paliativa integral que asegure el acompañamiento profesional hasta el final.
Actualmente, se nos ha reconocido con un Diploma Acreditativo en Cuidados Paliativos a los profesionales enfermeros, médicos, psicólogos y fisioterapeutas, pero cada Comunidad Autónoma lo implementa como considera, poniéndolo en marcha o no. No existe unanimidad…, partiendo que tampoco la hay en los recursos de cuidados paliativos, como decía anteriormente.
Hablamos de “Cuidados”…. ¿cómo no va a tener responsabilidad en este campo la profesional del cuidado? Las enfermeras cuidamos la respuesta humana, más allá de la enfermedad; cuidamos la respuesta de cada persona en su entorno, en cualquier momento de la vida; desde esa mirada integral.
Hablamos de “heridas”; otro campo donde la enfermera es la garante del buen cuidado, desde la prevención hasta la cura o el cuidado paliativo.
Solo nos falta que no olvidemos nuestra esencia, de atender a la persona como un ser único, que necesita de un cuidado humanizado, cara a cara y que, utilizando todos los avances que la ciencia y el conocimiento nos dan, nos sigamos sentando al borde de su cama.
Manuela Monleón Just es enfermera con amplia experiencia en atención domiciliaria y cuidados paliativos, especialmente en el abordaje de pacientes con enfermedades crónicas avanzadas y en situación de final de vida.
Ha desarrollado gran parte de su trayectoria en el ámbito de la Atención Primaria, donde ha trabajado de forma cercana con pacientes y familias, abordando el cuidado desde una perspectiva integral y centrada en la persona. Su práctica clínica se caracteriza por el manejo del dolor y otros síntomas complejos, así como por el acompañamiento emocional y la educación a cuidadores. Además, participa en actividades formativas y divulgativas, contribuyendo a visibilizar el papel de la enfermería en los cuidados paliativos y en la mejora de la calidad de vida de los pacientes.
En el XVIII Congreso Internacional de ANEDIDIC, centrará su intervención en el cuidado paliativo de las heridas, poniendo el foco en aquellos casos en los que el objetivo pasa a ser el confort y la dignidad del paciente.
The post Manuela Monleón Just: “En España, solo el 40 % de las personas que necesitan cuidados paliativos especializados llegan a recibirlos” first appeared on ANEDIDIC.
by Wafa Dhouib, Meriem Kacem, Oumayma belghayeb, Meriem Oumaima Beji, Cyrine Bennasrallah, Ameni Maatouk, Imen Zemni, Hela Abroug, Ines bouanene, Haythem Sriha, Maha Mastouri, Mourad ghali, Asma Sriha Belguith, Manel Ben Fredj
BackgroundUnderstanding post-infection immunity with the first SARS-CoV-2 variant may provide valuable insights into the duration and effectiveness of the humoral immune response. This study aims to characterize the serological profile of naïve individuals infected with the first SARS-CoV-2 variant.
MethodsA prospective study with repeated measures was conducted in Tunisia, from March to October 2020, during the first wave of COVID-19. Adults confirmed with confirmed COVID-19 were monitored during the first wave of the pandemic. ELISA blood tests were conducted at multiple intervals: day 7, day 14, and at 1, 2, 3, 4, and 6 months post-infection.
Results173 serum samples were collected from immunologically naïve individuals infected with the first circulating SARS-CoV-2 variant, ranging from 7 days to 6 months post-RT-PCR confirmation. The study revealed a robust humoral immune response in most participants, with 94.1% testing positive for IgM anti-N, 88.2% for IgM anti-S, 98% for IgG anti-N, and 100% for IgG anti-S antibodies. Anti-N IgM antibodies peaked at days 14 and 30 with high positive values (>0.260), while anti-S IgM antibodies showed elevated levels (>0.990) at days 7 and 14. For IgG, anti-N antibodies reached their highest levels (>0.810) at month 4, while anti-S IgG antibodies maintained high positive values (>0.490) at days 7 and 14, and remained elevated at months 4 and 6. No significant differences in antibody levels were observed based on gender, age, comorbidities, or symptoms presence.
ConclusionA typical adaptive immune response was observed in naïve individuals infected with the initial SARS-CoV-2 variant, showing typical IgM and IgG antibody production from day 7 to month 6. We specifically investigated immunologically naïve individuals infected with the first circulating SARS-CoV-2 variant, from the earliest stage of infection, a context that is no longer reproducible.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, multisystem condition that often emerges after viral infections and affects physical and cognitive function. Severely affected patients are underrepresented in research due to immobility and exertional intolerance.
This is a prospective, non-interventional observational study investigating the feasibility and tolerability of home-based diagnostics in patients with severe and very severe ME/CFS. Phase 1 includes remote identification using validated questionnaires. Phase 2 involves home visits for physiological, cognitive and biological assessments. The primary outcome is feasibility; secondary outcomes include tolerability and methodological barriers.
The study protocol was approved by the Ethics Committee of the University of Freiburg (No. 25-1031-S1). Written informed consent is obtained from all participants. Results will be disseminated via peer-reviewed publications and patient support groups.
DRKS00035231; FRKS005506.
by Deema Rahme, Hania Nakkash Chmaisse, Pascale Salameh
FreshRSS 