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Social enrichment mitigates facial expressions and physiological indicators of short-term stress in horses

by Ana Caroline Bini de Lima, Vanessa Cristini Sebastião da Fé, Maria Simara Palermo Hernandes, Emily Caroline Pfeifer de Cristo, Ana Gabrieli dos Santos Fagundes Euzébio, Maria Vitória e Silva Sousa, Fabiana Ribeiro Caldara, Viviane Maria Oliveira dos Santos

This study aimed to evaluate the ability of social noncontact environmental enrichment to facilitate social buffering and to characterize the emotional experience of horses subjected to restraint in stock by assessing physiological parameters and facial expressions. Pantaneiro horses (n = 11) were evaluated in a crossover design with two treatments: social noncontact enrichment during stock restraint and social isolation during stock restraint. Physiological parameters (heart rate, heart rate variability, respiratory rate, ocular temperature by infrared thermography, and auricular temperature by infrared thermometer) and facial expressions (EquiFACS) were assessed throughout the 24-minute restraint period. When horses were accompanied by a conspecific, heart rate, respiratory rate, and eye temperature were lower (p nostril dilator (AD38), inner brow raiser (AU101), upper eyelid raiser (AU5), eye white increase (AD1), ears forward (EAD101), and ears back (EAD104), was also lower (p 

Convolutional Neural Networks in Chronic Wound Segmentation and Tissue Classification Using Real‐World Images

ABSTRACT

Chronic wounds cause a significant burden to affected patients and to society. Effective and objective diagnostic and monitoring methods are needed in wound care, and artificial intelligence offers one promising alternative. In this study, real-world wound images were used to train a convolutional neural network to automatically segment wound area and wound tissues on an image. The study included altogether 362 images of venous, arterial, vasculitis and pyoderma gangrenosum wounds. The model was based on a convolutional neural network architecture U-Net, and fully supervised learning was utilised during the training phase. Wound area reached a Dice Similarity Coefficient (DSC) of 0.927 and Intersection over Union (IoU) of 0.868 using an augmented dataset with pretraining. Fibrinous exudate and granulation performed fairly well with DSC 0.750 and 0.696, and with IoU 0.659 and 0.601, respectively. Necrosis present in only 56 images achieved lower performance with DSC 0.503 and IoU 0.502. In conclusion, this study suggested that it is possible to train a neural network to perform well with images taken for purely clinical purposes. Besides wound area, several wound structures can be identified, but wound structure identification performance is dependent on the number of images featuring the structure.

Exploring the Perceived Effectiveness, Impact and Benefits of a Work‐Based Cancer Survivorship Peer Support Programme: A Qualitative Descriptive Study

ABSTRACT

Aim

To explore the perceived effectiveness, impact and benefits of a work-based cancer survivorship peer support programme for healthcare employees who have experienced or are experiencing cancer.

Design

A qualitative descriptive study.

Methods

Purposive sampling was used to recruit 33 participants (10 peers, 12 peer supporters, 4 line managers and 7 members of the governance group). Data were collected between October 2024 and February 2025 through individual interviews and focus groups. Data were analysed using reflexive thematic analysis.

Results

Four themes were generated: Programme Reach and Adoption, Implementing the Programme, Programme Effectiveness and Impact and Programme Maintenance and Growth. Challenges included the pilot status of the programme impacting awareness and uptake, potential reluctance to share diagnoses and the impact of cancer on colleagues. The approach of peer supporters was considered central to the programmes' success. Peer supporters valued training and continuous practice development opportunities.

Conclusion

Demonstrated benefits, including satisfaction and the value of peer support, were evident. To ensure programme maintenance, increased recruitment and training of peer supporters and clear communication regarding the programme and referral pathways are essential. Financial support is required to maintain training and address dissemination challenges.

Implications for the Profession

Work-based peer support programmes can help cancer survivors reintegrate into the workforce more effectively, rebuilding confidence, fostering resilience and navigating workplace expectations. Enhanced staff well-being may also positively influence retention, performance and health-related disruptions.

Impact

Findings from this underexplored area of work-based peer support within a healthcare setting have the potential to influence healthcare leaders, policy makers and future research. Improving staff's' quality of life on return to work benefits the individual, the organisation and care delivery by ensuring a healthy, supported workforce.

Reporting Method

The Standards for Reporting Qualitative Research (SRQR) checklist and the Template for Intervention Description and Replication (TiDieR) checklist were utilised.

Patient or Public Contributions

No patient or public contribution.

Perceptions of Nurses, Patients, and Family Members on Rooming‐In in Adult Care: A Cross Sectional Survey Study

ABSTRACT

Aim

To better develop and understand the practice of rooming-in in adult care, this study aims to explore the perceptions of the three most important stakeholders: nurses, patients, and family members.

Design

A cross sectional survey study in a university medical centre in the Netherlands.

Methods

A convenience sample was drawn from nurses, adult patients, and family members across ten general wards. Data of patients and family members were collected through online questionnaires, developed and validated prior to the study. Their responses were summarised using descriptive statistics. For the nurses, data were obtained by analysing responses to an open-ended question from an existing questionnaire, using thematic analysis.

Results

The sample consisted of 364 nurses, 26 patients, and 35 family members. Thematic analysis of the nursing data revealed four themes: (1) reducing the workload of nurses, (2) optimising patient recovery, (3) unclear policy and inadequate facilities, and (4) complexities for nurses. Regarding the perceptions of patients and family members, more than 75% perceived that rooming-in enhanced patients' sense of safety. Additionally, 54.1% of family members indicated that rooming-in improved their understanding of medical information. For most patients (57.7%) and family members (62.9%), the rules and conditions for rooming-in were not clear. Moreover, 65.7% of family members reported experiencing physical burden. Both patients and family members rated rooming-in with a median of 8 out of 10.

Conclusion

According to nurses, patients, and family members, rooming-in may be beneficial in reducing nurses' workload, enhancing patient safety, and improving family understanding of medical information.

Implications for Clinical Practice

Given the ambiguity surrounding rooming-in policies in adult care, clear guidelines and their implementation are essential for ensuring their success.

Impact

Rooming-in can positively contribute to adult care by facilitating family involvement.

Reporting Method

STROBE statement.

Patient or Public Contribution

No patient or public contribution.

A Nurse‐Led, School‐Based Social and Educational Intervention for Siblings of Children With Cancer (SUPREME): Process Evaluation of Perceived Impacts

ABSTRACT

Purpose

To explore siblings' and parents' experiences of, and perceived impacts of, a nurse-led school-based intervention (SUPREME) for siblings of children with cancer in Denmark.

Design

A qualitative process evaluation.

Methods

Fifteen siblings (aged 6–14 years) and 16 parents were recruited through criterion-based sampling following siblings' participation in the SUPREME intervention. Data consisted of semi-structured interviews and open-ended responses from an evaluation form, and were analysed thematically. Data were collected between May 2024 and February 2025.

Results

The intervention created a sense of normality for siblings by providing age-appropriate and credible information in the familiar school context, thereby strengthening the understanding of the family's cancer journey. The SUPREME nurse played a key role in easing the communication burden on siblings and parents, while also promoting recognition of siblings within the hospital setting as active participants in the family's cancer journey. Additionally, the intervention was perceived to accommodate varying levels of support needs across families.

Conclusion

The SUPREME intervention benefited siblings—and, by extension, their families—by equipping siblings with essential information, guiding their class communities on how to offer appropriate support and fostering siblings' inclusion in the family's cancer journey. The SUPREME intervention constitutes a new strategy for accessible, universal sibling support.

Implications for Profession and/or Patient Care

The healthcare system should formally ensure that professionals working with families affected by severe paediatric conditions provide family-centred care that actively includes siblings.

Impact

What problem did the study address? The position of siblings of children with cancer is often complex, as they may simultaneously serve as visible front figures of the family while remaining overlooked. This study explored how parents and siblings of children with cancer experienced participating in a new sibling support intervention.

What were the main findings? Nurses play a central role in supporting siblings of children with cancer by bridging family, hospital and school contexts.

Where and on whom will the research have an impact? Nurse-led, cross-sectoral interventions such as SUPREME may help normalise siblings' everyday lives and promote their inclusion in the family's cancer journey.

Reporting Method

This study followed the Standards for Reporting Qualitative Research checklist.

Patient and Public Involvement

No patients, participants, or members of the public were involved in the design of this specific study.

Multidimensional associations of physical performance, balance, wellness and daily activities with frailty in older adults with coexisting frailty and diabetes

Abstract

Background

The coexistence of frailty and type 2 diabetes mellitus in the older population heightens the risk of adverse events. However, research on functional and wellness factors associated with frailty in this population is limited.

Purpose

To investigate the associations of physical performance, functional dependency, physical activity, nutritional status, sleep, self-perceived health and depression with frailty in community-dwelling older adults with coexisting frailty and type 2 diabetes mellitus.

Design

Cross-sectional.

Methods

The study included 123 community-dwelling older adults (73.7 ± 6.0 years) with pre-frailty/frailty and type 2 diabetes mellitus. Physical performance (Short Physical Performance Battery), functional dependency (Barthel Index and Lawton & Brody), physical activity and inactivity (GeneActiv wrist-worn accelerometer), malnutrition risk (Mini Nutritional Assessment), sleep (Pittsburgh Sleep Quality Index), self-perceived health (EuroQoL 5-Dimension 3-Level) and depression (Yesavage 15-item-Geriatric-Depression-Scale) were evaluated through personal interviews. Principal component analysis (PCA) was performed to categorize the variables into components, and logistic regressions were used to propose the best-fitted model for each component.

Results

The PCA identified four components: (i) physical performance, with gait speed and leg mean velocity as the main variables associated with frailty; (ii) balance, showing significant associations with monopodal balance; (iii) daily activities, with moderate to vigorous physical activity and the Lawton and Brody score as the main variables associated with frailty within this component; and (iv) wellness factors, with nutritional status, self-perceived health and depression score as the primary variables associated with frailty.

Conclusions

This research underscores the significance of physical function and daily activities as protective factors against frailty in community-dwelling older adults with coexisting frailty and type 2 diabetes mellitus. The health dimension contributes both protective and risk factors, emphasizing the need for comprehensive assessments in managing frailty in this population.

Reporting Method

The study adhered to the STROBE checklist.

Patient or Public Contribution

No patient or public contribution.

Self‐Care Experiences and Support Needs of Community‐Dwelling Older Adults With Multimorbidity: A Qualitative Study Informed by the Caring Life‐Course Theory

ABSTRACT

Aim

To explore how community-dwelling older adults with multimorbidity experience, enact and navigate daily self-care using the Caring Life-Course Theory to identify opportunities for strengthening self-care and self-management support.

Design

Qualitative descriptive study.

Methods

Semi-structured interviews were conducted with community-dwelling older adults aged ≥ 50 years living with two or more chronic conditions across three Australian states and territories. Data were analysed inductively and deductively using qualitative content analysis. Inductive coding was followed by theory-informed analysis to interpret self-care capability, capacity, care networks and system supports.

Results

Eighteen participants (mean age = 70.9 years) described self-care as an adaptive, experience-based process influenced by lived experience, health transitions, informal care networks and system responsiveness. Participants generally demonstrated agency and resourcefulness in managing complex and changing care needs, often learning through trial and error. Psychosocial and relational needs were frequently under-recognised in healthcare encounters, requiring individuals and informal carers to compensate for fragmented, inconsistent support. Self-care capability and capacity were shaped by experiential learning, health and self-care literacy and access to informal and online resources, particularly where formal education was limited or unavailable.

Conclusion

Self-care for older adults with multimorbidity is shaped by dynamic interactions between personal capability, relational support and system-level factors across the life-course. The Caring Life-Course Theory provides a comprehensive approach for understanding these interdependencies and identifying opportunities for intervention.

Implications for the Profession and/or Patient Care

Findings highlight the need to strengthen coordinated, person-centred and relationally grounded approaches to self-care and self-management in primary and community care, including improved access to evidence-informed resources and anticipatory support.

Reporting Method

This study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies.

Patient or Public Contribution

Participants contributed through semi-structured interviews and provided feedback on study findings.

Impact

What problem did the study address? Community-dwelling older adults living with multimorbidity are expected to engage in self-care, yet little is known about how they experience, enact and sustain daily self-care, particularly when psychosocial and relational needs are inconsistently recognised within health and social care systems. What were the main findings? Self-care was characterised as an adaptive, experiential process shaped by life experience, informal support networks and system responsiveness. Participants frequently compensated for under-recognised psychosocial and relational needs through informal and online supports and resources. Where and on whom will the research have an impact? Findings can inform clinicians, service providers and policymakers in primary, community and aged care settings by identifying opportunities to strengthen coordinated, person-centred and relational self-care and self-management support for older people with multimorbidity.

Maternal Zika virus exposure and neurodevelopmental outcomes: A longitudinal study of preschool children in the ZIKAlliance Colombian Cohort

by Víctor Herrera, María Consuelo Miranda, Anyela Lozano-Parra, Diana Niño, Luis Ángel Villar, Rosa Margarita Gélvez Ramírez, Thomas Jaenisch, Laura Pezzi, Claudia Acevedo, Jürg Niederbacher

Background

Zika virus (ZIKV) infection has been inconsistently associated with neurodevelopmental delay (ND). We aimed to compare the incidence of ND between ZIKV-exposed and ZIKV-unexposed children within the ZIKAlliance (ZA) cohort, in Colombia, assessed 2 years after birth (2018–2021).

Methods

We performed a neurodevelopmental evaluation on normocephalic children (aged 40–72 months) from the ZIKAlliance cohort. Children were classified as ZIKV-exposed (maternal positive RT-qPCR or virus neutralization test – VNT) or unexposed (maternal negative IgG ELISA or VNT in paired antenatal samples). A trained psychologist, blinded to exposure status, administered the Denver Developmental Screening Test II (DDST-II). Children were considered at ND risk if they presented ≥1 delay or ≥2 cautions in one or more areas, within their age range in the DDST-II scale. Inconclusive initial tests were re-evaluated. Adjusted odds ratios were estimated using logistic regression.

Results

We analyzed conclusive DDST-II results from 153 children (mean age: 4.7 years; 53.8% male). Overall, 57.2% (n = 83) were classified as cases of ND. Children with ND were more likely to be male (61.4% versus 43.5%) and less likely to attend daycare or school (42.2% versus 11.3%) than children with normal development. After adjusting for child age, sex, household size, and education, the association between in utero ZIKV exposure and ND was not statistically significant (OR = 0.71; 95% CI: 0.32–1.59, p = 0.320). However, children attending daycare or school had a significantly lower risk of ND compared to those who stayed at home.

Conclusions

Prenatal ZIKV exposure was not associated with ND in this cohort of normocephalic preschool children. Instead, attending a community daycare or school emerged as a significant protective factor against developmental delays.

Hospitalizations associated with endemic and non-endemic mosquito-borne arboviruses in Canada, 2002–2023

by Maria Elizabeth Mitri, Antoinette Ludwig, Joanne Tataryn, Salima Gasmi, Mandy Whitlock, Peter A. Buck, Annie-Claude Bourgeois

Mosquito-borne arboviruses pose a growing public health concern in Canada, particularly in the context of climate change and increased global travel. This study aimed to quantify the burden of endemic and non-endemic mosquito-transmitted arboviral diseases in Canada by examining hospitalization trends from 2002 to 2023. Using administrative hospital data from the Canadian Institute for Health Information (CIHI) and national West Nile virus (WNV) surveillance data, we analyzed patient demographics, temporal and spatial patterns, and disease classification. Hospitalizations were classified as endemic (e.g., WNV) or non-endemic (e.g., dengue, chikungunya, Zika, yellow fever) based on historical presence and vector establishment in Canada. A total of 2,470 unique hospitalizations were identified, with 56.4% attributed to endemic diseases and 39.7% to non-endemic diseases. WNV accounted for over 99% of endemic-related hospitalizations, with peaks in 2003, 2007, and 2012 aligning with national surveillance data. Hospitalizations were highest among males aged 75–79 years, particularly in the southern regions of Saskatchewan, Manitoba, and Ontario. Non-endemic disease hospitalizations, primarily due to dengue and chikungunya, increased after 2010 and were more evenly distributed throughout the year, reflecting travel patterns. Younger adults (20–49 years) were most affected. The study highlights limitations in diagnostic coding and surveillance coverage, particularly the exclusion of Quebec data and underreporting of emerging arboviruses. These findings underscore the utility of hospital administrative data in complementing traditional surveillance systems and identifying populations at risk for severe outcomes. As climate change and travel continue to influence arboviral disease dynamics, integrated data sources are essential for guiding public health planning and response.

Evaluation of Nurse‐Led Triage in the Emergency Department: A Retrospective Observational Study

ABSTRACT

Aim

To assess the quality of the Spanish Triage System performed by nurses according to the triage code assigned to each patient and to examine factors associated with the need for re-evaluation after completion of triage.

Design

Retrospective longitudinal observational study.

Methods

A retrospective analysis was conducted of patients triaged in the emergency department between 2018 and 2023. Patients triaged by other healthcare professionals and those who did not receive a triage priority level were excluded.

Results

493,211 episodes were analysed. Most were low/intermediate acuity (Level IV 65.4%, Level III 23.9%; Level I 0.1%). Mean time-to-first physician record entry increased as acuity decreased (38 min Level I vs. 81 min Level V), yet recorded time-target compliance was lowest in Levels I–II (23.8% and 14.7%). Re-evaluation occurred more often in high-acuity levels and was independently associated with older age, male sex, lower oxygen saturation and longer emergency department length of stay; compared with Level I, Levels II–III and lower adjusted odds of re-evaluation.

Conclusion

Nurse-led triage demonstrated coherent clinical and operational stratification; however, the lowest recorded time-target compliance in the sickest patients suggests a gap between immediate care and electronic documentation.

Implications for the Profession and/or Patient Care

Streamline documentation workflows for high-acuity cases and use re-evaluation risk profiles to prioritize monitoring and escalation.

Impact

Evidence on nurse-led Spanish Triage System performance and time-documentation quality is limited. Acuity and flow metrics showed expected gradients, but target-time compliance was lowest in Levels I–II; predictors of re-evaluation were also identified. Findings support emergency department nursing, quality improvement and potential benefits for patients attending emergency departments.

Reporting Method

STROBE guidelines.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Factors Influencing Intention to Leave Among Nurse Managers: A Cross‐Sectional Study

ABSTRACT

Aims

To estimate the proportion of Italian nurse managers (NMs) intending to leave (ITL) their positions and to identify associated socio-demographic, job-related, and psychosocial factors.

Design

Cross-sectional study.

Methods

Between September and November 2023, 464 NMs from 19 public hospitals completed a case-report form and the short version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II). Latent Class Analysis (LCA) identified ITL profiles, and multiple logistic regression assessed factors associated with ITL.

Results

284 NMs (61.2%; 95% CI 57–66) reported an intention to leave within 12 months. LCA identified two classes: (1) Low-ITL (54%)—mainly outpatient NMs from Central regions with strong relationships with management, good support, work–life balance, and autonomy (55.9% probability of being unlikely to leave). (2) High-ITL (46%)—mainly surgical or critical-care NMs, often from Northern regions, marked by poor management relations, low support and high work–family conflict (80.9% probability of being likely to leave). Multiple regression confirmed that stronger management relations reduced ITL (OR 0.60, 95% CI 0.46–0.79) whereas high job demands and work–health conflict increased it (OR 1.56, 95% CI 1.19–2.04). Northern location also predicted higher ITL (OR 1.58, 95% CI 1.03–2.44). Demographics, education, and clinical setting were not significantly associated.

Linking Evidence to Action

These findings suggest that healthcare organizations should prioritize managerial and organizational strategies targeting modifiable work-related factors to reduce nurse managers' intention to leave. Interventions aimed at improving organizational support, work environment, and job satisfaction may contribute to workforce retention at the managerial level. Future research should evaluate the effectiveness of targeted organizational interventions in sustaining nurse manager retention.

Primary cilia in osteoblasts and osteocytes are required for skeletal development and mechano-adaptation

by Mariana Moraes de Lima Perini, Alyssa F. Fayemi, Julie N. Pugh, Elizabeth M. Scott, Karan Bhula, Austin Chirgwin, Olivia N. White, Nicolas F. Berbari, Jiliang Li

Primary cilia play a crucial role in the development and mechanosensation of various tissue types, including bone. In this study, we investigated their role in bone growth and adaptation by targeting two cilia specific genes, IFT88 and MKS5. Conditional knockout (cKO) of IFT88 in osteoblasts significantly reduced body weight and femur length in mice compared to the littermate controls. Additionally, female IFT88 cKO mice exhibited a significant suppression of bone formation rate compared to the littermate controls. To further explore the role of primary cilia in osteocytes, osteocytes specific MKS5 cKO mice underwent axial ulnar loading at a peak force of 2.9N for females and 3.2N for males with 120 cycles per day for three consecutive days. Load induced bone formation rate was significantly decreased by 48% in males and 42% in females compared to the littermate control mice. These findings underscore the critical role of primary cilia in bone development and mechano-adaptation. They suggest that functional primary cilia in osteoblasts are essential for skeletal development, while those in osteocytes mediates mechanically induced bone formation, highlighting its potential as therapeutic targets for bone loss prevention.

Clinical practicum under strain: a mixed-methods study protocol for addressing its quality and sustainability in Spanish nursing education

Por: Escrig-Pinol · A. · Padrosa · E. · Nunez-Doyle · A. · Rodriguez-Monforte · M. · Pedreira-Robles · G. · McGilton · K. S. · Alcover · C. · Allaoui · I. · Ayuso-Marganon · R. · Carrillo-Alvarez · E. · Ciercoles-Santamaria · S. · Graells-Sans · A. · Sanclemente-Dalmau · M. · Insa-Cal
Introduction

The clinical practicum is a critical component of nursing education. In Spain, it is currently facing systemic challenges that compromise its quality and sustainability. A persistent nursing shortage, combined with increasing pressure on healthcare systems and a growing number of students intended to address this gap, is adding strain to clinical learning environments, which may compromise the capacity of nurses to provide adequate supervision and meaningful learning experiences for nursing students. This not only diminishes the quality of the training experiences, but also negatively affects the well-being of both students and nurses, further worsening the situation. This protocol outlines a study aimed at conducting an in-depth analysis of the current challenges affecting the clinical practicum and proposing a new model that effectively addresses them, with significant potential for adaptation and implementation across different health education fields and geographical locations.

Methods and analysis

The study will employ a sequential mixed-methods design comprising two integrated phases. In phase I, quantitative, qualitative and scoping review methodologies will be combined to identify current challenges and opportunities. Quantitative data will be obtained by administering questionnaires to nursing students and clinical mentors (CMs) tutoring them in Catalonia, examining potential barriers and facilitators to their mentoring role. Data will be analysed through descriptive and inferential statistics. Qualitative data will emerge from semistructured interviews with CMs and nurse coordinators, as well as from a visual elicitation technique, the ‘Emojional’ Calendar, conducted with students to understand their clinical practicum experiences. These will be analysed through an inductive thematic analysis approach. The scoping review, following the Arksey and O’Malley framework, will identify best practices in clinical practicums in nursing and other health studies globally. Phase II will involve a three-round qualitative Delphi study in which all preceding results will be presented to stakeholders and decision makers in order to redesign the clinical practicum model.

Ethics and dissemination

Ethical approval for this study was obtained from Hospital del Mar Clinical Research Ethics Committee (Ref #2023/11123). Results will be disseminated through peer-reviewed journals and conference presentations, as well as via strategic actions (forums and meetings with healthcare managers, deans and policymakers) and general outreach (talks, social media and websites) targeted at professionals, students and the public.

Depresión y ansiedad asociadas con el rendimiento académico en estudiantes de enfermería

Objetivo. Evaluar si existe asociación entre depresión y ansiedad con el rendimiento académico en estudiantes de enfermería de la Universidad Villasunción, Aguascalientes, México. Metodología. Estudio cuantitativo, observacional, descriptivo-correlacional y de corte transversal. La población estuvo conformada por 273 estudiantes de la Licenciatura en Enfermería. Se seleccionó una muestra de 161 participantes mediante muestreo estratificado. Para evaluar la depresión se utilizó el Inventario de Depresión de Beck II (BDI-II) y para ansiedad el Inventario de Ansiedad de Beck (BAI). El rendimiento académico se obtuvo a partir del promedio general acumulado. Los datos se analizaron mediante estadística descriptiva y prueba de chi-cuadrado de Pearson utilizando SPSS versión 27, con un nivel de significancia de p ≤ 0.05. Resultados. El 54.7% de los estudiantes presentó niveles mínimos de depresión, mientras que el 16.1% reportó niveles graves. En cuanto a la ansiedad, el 30.4% mostró niveles mínimos y el 20.5% niveles graves. El rendimiento académico predominante fue “Bueno” (59%). Mediante la prueba de chi-cuadrado de Pearson se identificó una asociación estadísticamente significativa entre depresión y rendimiento académico (p= 0.030). En contraste, la ansiedad no mostró una asociación significativa con el rendimiento académico (p= 0.506). Discusión. La depresión se asocia significativamente con el rendimiento académico en estudiantes de enfermería, lo que evidencia la importancia de considerar la salud mental como un factor relevante en el desempeño académico universitario.

ABSTRACT

Objective. To evaluate whether there is an association between depression and anxiety and academic performance among nursing students at Universidad Villasunción in Aguascalientes, Mexico. Methodology. A quantitative, observational, descriptive-correlational, cross-sectional study was conducted. The population consisted of 273 undergraduate nursing students. A sample of 161 participants was selected using stratified sampling. Depression was assessed using the Beck Depression Inventory II (BDI-II), and anxiety was measured using the Beck Anxiety Inventory (BAI). Academic performance was obtained from the students’ cumulative grade point average. Data were analyzed using descriptive statistics and Pearson’s chi-square test with SPSS version 27, considering a significance level of p ≤ 0.05. Results. A total of 54.7% of students presented minimal levels of depression, while 16.1% reported severe levels. Regarding anxiety, 30.4% showed minimal levels and 20.5% severe levels. The predominant academic performance category was “Good” (59%). Pearson’s chi-square test identified a statistically significant association between depression and academic performance (p = 0.030). In contrast, anxiety did not show a significant association with academic performance (p = 0.506). Discussion. Depression is significantly associated with academic performance among nursing students, highlighting the importance of considering mental health as a relevant factor in university academic outcomes.

Severidad de síntomas prostáticos y factores adheridos en adultos mayores del Hogar de Ancianos “San José de las Canoas” del cantón Catamayo

Introducción. Los síntomas prostáticos abarcan alteraciones en el vaciado, llenado, posmicción y volumen urinario, su aparición está influida por factores de riesgo como la edad, la raza, la predisposición genética y los hábitos dietéticos. Objetivo. Analizar la severidad de los síntomas prostáticos con los factores epidemiológicos y clínicos de los residentes del del Hogar de Ancianos “San José de las Canoas”, del cantón Catamayo. Metodología. Se realizó un estudio descriptivo, cuantitativo, no experimental, y corte transversal, con una muestra de 30 participantes. Para la recolección de datos se utilizó el cuestionario “International Prostate Symptom Score” (IPSS) destacándose por su alta confiabilidad y validez. El estudio contó con la aprobación de un Comité de Ética en Investigación en Seres Humanos y se llevó a cabo respetando los principios bioéticos establecidos. Resultados. 18 de los pacientes estudiados presentaban síntomas moderados. Se obtuvo una asociación estadística entre la severidad de los síntomas síntomas prostáticos y la edad (p= 0,007) y el grado de instrucción (p= 0,046). En cuanto a la presencia de comorbilidad (diabetes, hipertensión arterial/cardiopatía), se observó una relación significativa en la muestra (p= 0,043) en términos generales. Discusión. Los datos revelan que los síntomas prostáticos moderados se asocian con factores sociales y clínicos críticos, como el aislamiento, la falta de educación y enfermedades relacionadas con el estilo de vida, este panorama exige acciones integrales para mejorar la salud y calidad de vida de esta población vulnerable.

ABSTRACT

Introduction. Prostatic symptoms include alterations in voiding, filling, postvoiding and urinary volume, their appearance is influenced by risk factors such as age, race, genetic predisposition and dietary habits. Objective. To analyze the severity of prostatic symptoms with epidemiological and clinical factors in the residents of the “San José de las Canoas” Elderly Home in Catamayo. Methodology. A descriptive, quantitative, non-experimental, cross-sectional study was carried out with a sample of 30 participants. The “International Prostate Symptom Score” (IPSS) questionnaire was used for data collection, standing out for its high reliability and validity. The study had the approval of a Human Research Ethics Committee and was carried out respecting the established bioethical principles. Results. 18 of the patients studied had moderate symptoms. Statistical association was obtained between severity of prostatic symptoms and age (p= 0,007) and education degree (p= 0,046). Regarding the presence of comorbidity (diabetes, arterial hypertension/cardiopathy), a significative association was observed in the sample (p= 0,043). Discussion. Data reveal that moderate prostatic symptoms are associated with critical social and clinical factors, such as isolation, lack of education and lifestyle-related diseases, this scenario calls for comprehensive actions to improve the health and quality of life of this vulnerable population.

Evaluación de la actitud de las enfermeras ante el dolor crónico en psiquiatría: desarrollo de un nuevo cuestionario

Introducción. El dolor crónico en una condición multidimensional con elevada prevalencia que afecta en la calidad devida, entorno sociolaboral y predispone a enfermedades de Salud Mental. Metodología. Este estudio de metodologíamixta pretende hacer frente a la carencia de herramientas de valoración específicas en este contexto. La construcción delcuestionario se llevará a cabo mediante un proceso riguroso compuesto por un panel de expertos, grupo de discusión y prueba piloto, con el objetivo de analizar el manejo de las enfermeras. Los aspectos por evaluar serán suficiencia,claridad, coherencia y relevancia para obtener la versión definitiva del cuestionario. Con ello se busca conseguir una herramienta sólida que permite una mayor visibilización y desarrollo de las enfermeras en el manejo de esta comorbilidad.Relevancia. La importancia del estudio radica en desarrollar uno nuevo cuestionario que permita valorar los conocimientos de las enfermeras de Salud Mental respecto al dolor crónico, con el objetivo de detectar posibles áreas de mejora para proporcionar unos cuidados de mayor calidad basados en un enfoque enfermero biopsicosocial y la evidencia científica actual.

ABSTRACT

Introduction. Chronic pain is a multidimensional condition that impacts quality of life, socio- occupational environment, and predisposes individuals to mental health disorders. Methodology. This mixed-method study aims to address the lack of specific assessment tools in this context. The questionnaire was developed through a rigorous processinvolving an expert panel, a focus group, and a pilot test, with the objective of analyzing nurses' management of chronic pain. The evaluation will focus on assessing the adequacy, clarity, internal consistency, and relevance of the items in order to obtain the final version of the questionnaire. This process aims to produce a psychometrically sound instrument that contributes to enhancing the professional role and visibility of mental health nurses in the assessment and management of this comorbidity. Relevance. The relevance of this study lies in the development of a new questionnairespecifically designed to evaluate the level of knowledge that mental health nurses possess regarding chronic pain. The ultimate goal is to identify potential knowledge gaps and areas for improvement, thereby facilitating the delivery of higher-quality, evidence-based care grounded in a biopsychosocial nursing framework.

Which Aspects of Abortion Care Do Healthcare Practitioners in Britain Think Nurses/Midwives Should Provide? Findings From the SACHA Study

ABSTRACT

Aim

To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.

Design

An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).

Methods

Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.

Results

Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.

Conclusion

There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.

Implications for the Profession and/or Patient Care

Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.

Impact

This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.

Reporting Method

This study adheres to the STROBE guidelines for reporting observational studies.

Patient or Public Involvement

In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.

Assessing Hand Function Post‐Burn: A Systematic Review of Surgical vs. Enzymatic Debridement Using DASH/Quick‐DASH and MHQ Questionnaires

ABSTRACT

Hand burns, although often limited in surface area, have a major impact on function and quality of life. Debridement—surgical or enzymatic—is a key component of treatment, with enzymatic debridement increasingly used for its selectivity and potential to preserve viable dermis. To evaluate and compare the functional outcomes of hand burns treated with surgical versus enzymatic debridement, using the DASH/Quick-DASH and Michigan Hand Questionnaire (MHQ) assessment tools. A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251034408). Searches were performed in PubMed, Scopus, and Web of Science without date restrictions. Inclusion criteria focused on studies evaluating hand burn function using DASH, Quick-DASH, or MHQ after enzymatic or surgical debridement in patients aged 16 or older. Methodological quality was assessed using the ROBINS-I tool. Of 547 studies identified, 7 met inclusion criteria: 4 surgical and 3 enzymatic. Functional recovery was generally better in cases where enzymatic debridement preserved viable dermis and avoided grafting. DASH and MHQ scores favoured enzymatic approaches, especially when conservative management followed debridement. However, methodological limitations and clinical heterogeneity limited direct comparison. Enzymatic debridement, through preservation of viable dermis and reduced grafting need, appears associated with improved functional outcomes in hand burns. Whilst surgical debridement remains essential for deeper burns, enzymatic methods may offer functional advantages and support early rehabilitation in appropriate cases.

‘Fend for yourself’: Nurses’ experiences transitioning to Family Care Team practice settings in Newfoundland and Labrador

by Robin Devey-Burry, Julia Lukewich, Dana Ryan, Myuri Sivanthan, Maria Mathews, Marie-Eve Poitras, Cheryl Etchegary, Shabnam Asghari, Margot Antle

Background

Family Care Teams were introduced in Newfoundland and Labrador (NL) as a strategy to strengthen primary care through team-based models that optimize interprofessional collaboration. Nurses, including nurse practitioners (NPs), registered nurses (RNs), and licensed practical nurses (LPNs), play critical roles in these models; however, little is known about nurses’ transition to these settings or the supports shaping their integration and effectiveness. To address this gap, we explored nurses’ experiences transitioning into Family Care Teams, including supports for integration and the barriers and facilitators influencing this process.

Methods

As part of a qualitative descriptive study, we conducted semi-structured interviews with 25 nurses (6 NPs, 13 RNs, 6 LPNs) employed in Family Care Teams across five NL health zones. During the interviews, nurses described their experiences working in Family Care Teams, available practice supports, current roles, and barriers and facilitators to maximizing scope of practice. Interviews were transcribed and analyzed using qualitative content analysis and constant comparison.

Results

Participants described their transition to Family Care Teams in two stages: 1) orientation and 2) supportive learning relationships. Orientation was highly variable, ranging in length and structure. Learning in this area was often self-directed, technology-focused, and asynchronous, with limited emphasis on clinical preparation or role expectations. Mentorship and shadowing opportunities were inconsistently available, with many nurses lacking access to experienced role models within the newly established teams. These gaps contributed to role ambiguity, underutilization of nursing scope of practice, and prolonged adjustment periods.

Conclusions

Our findings reveal gaps in orientation and mentorship during nurses’ transition into Family Care Teams in NL. A common yet adaptable transition framework, expanded student placements, and structured mentorship are critical to optimizing nursing roles in team-based care. Strengthening practice supports and clarifying nursing contributions can improve access and care quality while informing broader initiatives to support nurses’ transition into primary care.

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