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To examine whether self-reported thriving at work is associated with biomarkers of stress, inflammation, neuroplasticity and neurodegeneration in nurses.
A cross-sectional study.
An online questionnaire measuring thriving at work was administered to nurses in a teaching hospital in Michigan, U.S. over 5 weeks in 2024. A subsample of 100 questionnaire respondents provided blood samples for biomarker analysis. Multiple regression was used to identify self-reported and biomarker predictors of nurse thriving. Cluster analysis was used to distinguish between nurses with high and low levels of thriving based on a combination of self-report and biomarker data.
Higher self-reports of individual and work-related resources predicted higher thriving. Cortisol, a stress hormone, was significantly and inversely associated with thriving. No blood-based biomarkers of inflammation or neuroplasticity predicted thriving. Neurofilament light chain, a marker of neurodegeneration, was not a direct predictor but modified the effects of interpersonal and work resources on thriving.
Biological markers do play a role in nurses' thriving at work and may contribute important complementary information to that provided by nurse self-reports.
Nurses thrive in a work situation characterised by positive reports of individual, interpersonal and work resources and lower levels of stress. Efforts to enhance thriving could positively impact nurses' well-being and conditions for providing high-quality patient care.
This study addressed the question of whether self-reported thriving at work among nurses is reflected in biomarkers of stress, inflammation, and neurocognitive health. A profile of high self-reported work-related resources and low cortisol distinguished higher levels of nurses' thriving from lower levels. Organisational efforts to enhance nurses' thriving can positively impact nurses' health, their work environment, and patient care.
We followed the STROBE checklist in reporting this study.
No Patient or public contribution.
Glaucoma is one of the leading causes of irreversible blindness and is characterised by progressive loss of retinal ganglion cells. While therapies to lower intraocular pressure slow the progression of the disease in most patients, a significant subset still shows progression despite treatment. Transcorneal electrical stimulation (TES) may potentially activate neuroprotective pathways and slow the progression of visual field defects. The OkuStim 2 System is a medical device for TES which was originally developed for the treatment of retinitis pigmentosa and similar retinal dystrophies and shall now be tested for the treatment of glaucoma. Stimulation of the diseased retina with weak currents can activate signalling pathways and the release of substances that have a protective effect on the retinal cells. This neuroprotective effect might preserve physiological functions of the retina for longer and slow down its gradual degeneration. Long-term use is required to maintain this effect. The TES-GPS study is investigating the safety and efficacy of TES in open-angle glaucoma.
TES-GPS (short title for glaucoma pilot study) is a prospective, randomised, double-blind, sham-controlled, single-centre pilot study at the University Medical Center Mainz. 50 patients with progressive visual field loss due to open-angle glaucoma will be randomised 1:1 to receive either TES with the OkuStim 2 System or sham stimulation. The primary endpoint is the change in visual field sensitivity (Humphrey mean deviation) after 18 months. Secondary endpoints include changes in visual acuity, intraocular pressure, optical coherence tomography (OCT) parameters and quality of life (National Eye Institute Visual Function Questionnaire 25, NEI-VFQ 25). The intervention consists of weekly 30 min TES sessions, which are conducted in the patient’s home after initial training in the clinic. The study comprises up to 13 scheduled visits over 18 months.
The study is conducted in accordance with ISO14155, Medical Device Regulation (EU) 2017/745, International Council for Harmonisation Good Clinical Practice and the Declaration of Helsinki. Approval was obtained from the Ethics Committee of the Landesaerztekammer Rheinland-Pfalz in Mainz and from Bundesinstitut fuer Arzneimittel und Medizinprodukte. Results will be published in peer-reviewed journals and presented at scientific conferences.
Pressure injuries present significant challenges in clinical care, leading to severe complications such as infection, pain and delayed wound healing. They are a common chronic wound that contribute to increased morbidity, prolonged hospital stays and substantial healthcare costs. Despite national efforts to enhance chronic wound management, development of optimal treatment strategies remains a priority. The Pressure Injury Treatment Advisory (PITA) Quick Guide was developed to provide an evidence-based guide to support clinicians in pressure injury management. A survey was conducted to evaluate clinician perspectives on the usability and practicality of the Guide in acute care, residential aged care and community settings. A post-test survey was conducted on a convenience sample of healthcare professionals from three healthcare settings across metropolitan, regional and rural Australia. The survey included 5-point Likert-scale items assessing ease of use, effectiveness and integration with workflows. Three hundred and two responses were received (66.7% response rate). Clinicians expressed overwhelmingly positive perceptions, with over 95% agreeing or strongly agreeing on the guide's utility and effectiveness. No respondents strongly disagreed with any item. Residential aged care and rural clinicians rated the tool slightly higher than acute care and medical clinicians. The PITA Quick Guide was well-received across all settings, demonstrating strong potential to enhance evidence-based pressure injury management.
by Takashi Kitagataya, Anuradha Krishnan, Kirsta E. Olson, Florencia Gutierrez, Michelle Baez-Faria, Maria Eugenia Guicciardi, Kevin D. Pavelko, Adiba I. Azad, Gregory J. Gores
AimThe underlying mechanisms contributing to cholestatic liver injury remain unclear. The pro-inflammatory leukocyte-restricted cytokine interleukin-17A (IL-17A) has been implicated in human cholestatic liver injury. However, mechanistic insights are lacking and require further exploration in preclinical models. Herein, we examined the effect of IL-17A genetic ablation in a mouse model of cholestatic liver injury.
MethodAge and gender-matched littermate wild type (WT) and Il-17a-/- C57BL/6 mice were fed an intermittent 0.1% 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet for 21 days to induce cholestatic liver injury or a control diet.
ResultsAs compared to WT littermates, Il-17a-/- mice displayed more abundant desmin-positive myofibroblasts and increased fibrosis. NanoString analysis of intrahepatic leukocyte populations using a fibrosis-related gene panel identified upregulation of Tnfsf14 (encoding the protein LIGHT) in the DDC-fed Il-17a-/- mice. Although mass cytometry identified an increase in myeloid cells in both genotypes of the DDC-fed mice, we could not identify LIGHT expression in this cell lineage. Instead, the upregulation of LIGHT expression was largely restricted to a CD4+ T cell population as assessed by flow cytometry. Enhanced LIGHT expression was observed in a Th1+ CD4+ T cell population. LIGHT activated primary human hepatic stellate cells in vitro, suggesting that LIGHT stimulation of hepatic fibrogenesis may be direct.
ConclusionTaken together, these data suggest that IL-17A restrains expression of the profibrogenic cytokine, LIGHT, by Th1-polarized CD4+ T cells, and implicate a role for LIGHT in cholestatic fibrogenesis in DDC-fed mice; a finding which requires validation in additional models.
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.
La formación del profesional de enfermería incluye tradicionalmente teoría y práctica estructurada en entornos hospitalarios y/o ambulatorios, con la finalidad de que desarrollen las habilidades necesarias para interpretar, intervenir y cuidar a los pacientes. Para el presente estudio se describen las Experiencias del Aprendizaje de la Práctica Clínica en Pasantes de la Licenciatura en Enfermería del periodo 2024-2025. Estudio de tipo cualitativo con enfoque fenomenológico, con nueve pasantes de servicio social seleccionados de 110 de forma aleatoria, a quienes se les realizó entrevista de 20 minutos promedio. El presente estudio se apegó a los lineamientos de la secretaria de Salud en materia de investigación en seres Humanos y a la declaración de Helsinki. Los resultados van desde las experiencias, vivencias, aprendizaje auténtico, escenarios clínicos, habilidades, profesores del área clínica. Se puede concluir que se divide las experiencias en dos momentos primer y segundo semestre, el primero, los estudiantes percibían la pasantía como una oportunidad esencial para aplicar conocimientos teóricos y desarrollar habilidades prácticas en un entorno real. Sin embargo, esta visión inicial estaba acompañada de emociones como miedo y ansiedad, reflejo de la inseguridad ante las exigencias del ámbito clínico y las expectativas de aprendizaje técnico y adaptación a nuevas responsabilidades; en la segunda mitad de la práctica clínica, los participantes valoran la pasantía como una experiencia transformadora, donde adquirieron competencias técnicas como el manejo de equipos médicos y habilidades socioemocionales como la empatía y la resolución de conflictos.
by Michelle Lauge Quaade, Mikael Leijon, Mikhayil Hakhverdyan, Thomas Bruun Rasmussen, Charlotte Kristiane Hjulsager, Lars Andresen, Karin Mundbjerg, Anne Sofie Vedsted Hammer
Diarrhea outbreaks significantly affect the health and growth of farmed mink, posing economic and welfare challenges. While various pathogens have been linked to mink diarrhea, the causes during the weaning period remain unclear. Sporadic associations of mink coronavirus (MCoV), Campylobacter, and gastrointestinal disease in mink have been suggested. This study investigates the occurrence and levels of MCoV and Campylobacter in fecal samples from Danish farm mink (Neogale vison) and their potential association with post-weaning anorexia diarrhea syndrome (PADS), growth-period diarrhea (GPD), or pre-weaning diarrhea (PWD). The focus of the study is on PADS, studied through two case-control setups where case farms had known problems with PADS and control farms without such problems. Animals were also diagnosed based on necropsy pathological findings. Seventeen MCoV genomes were determined from five Danish farms. This data facilitated the development of an MCoV RT-qPCR and was applied across three study groups. Results showed high prevalence of both MCoV and Campylobacter spp. in all groups. No link was found between MCoV presence or levels and PADS diagnosis on the individual level; however, farm-level analysis revealed that MCoV was 2.35 times more likely (95% CI 1.027; 5.056) on PADS case farms than controls. Mink with PWD exhibited higher MCoV levels compared to GPD cases, suggesting a role at this developmental stage. Phylogenetic analysis revealed diverse and farm-specific MCoV strains, with sequences from healthy controls forming a distinct subclade, hinting at strain-specific pathogenicity. Campylobacter spp. presence was not significantly associated with PADS, but higher levels were observed in mink with PADS versus those without (not tested for PWD). These findings highlight the importance of surveillance and rigorous hygiene practices on mink farms to address risks from MCoV and Campylobacter spp., calling for further research to clarify their roles in PADS and overall mink health.Type 2 diabetes is a growing global health challenge that requires effective prevention strategies. Public health and community-based approaches play an essential role in reaching vulnerable populations and addressing broader determinants of health. This protocol outlines a scoping review aimed at systematically mapping the existing evidence on lifestyle-based diabetes prevention interventions implemented in public health and community contexts.
A systematic literature search will be conducted to identify relevant studies published in English or German from 1 January 2014 onwards. The following databases will be searched: PubMed, Web of Science Core Collection, CINAHL (via EBSCO), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews (via OVID) and ClinicalTrials.gov. Relevant websites and grey literature sources will be searched to identify further eligible studies. (Cluster-)randomised controlled trials, non-randomised controlled trials and clinical trials will be included. These must examine nutrition-based, physical activity-based or lifestyle-based interventions aimed at preventing type 2 diabetes in healthy adults or individuals with pre-diabetes, implemented in public health or community settings. Case reports and studies involving medical therapies or pharmacological interventions will be excluded. The literature search started in May 2025 and is expected to be completed by the end of December 2025.
As this scoping review is based on the secondary analysis of publicly available data, no ethical approval is required. Our dissemination strategy includes publication in peer-reviewed journals, presentations at academic conferences and targeted dissemination to relevant interest holders.
This project has been registered at Open Science Framework (https://osf.io/zafg5/), as PROSPERO does not accept registrations for scoping reviews.
Venous leg ulcers (VLU) account for the majority of chronic wounds, with an estimated rise in prevalence due to demographic change. Care often does not comply with evidence, and patients remain passive and uninformed. To support general practice VLU care, the ‘UlcusCrurisCare’ (UCC) project developed a multimodal intervention comprising provider training, software-supported case management and standardised patient education. Experts from the medical community (physicians, nurses, association of medical assistants), health insurance and patient representatives provided their assessment of barriers in VLU care, requirements for intervention components and their expected effects. Semi-structured interviews and questionnaires were used at two measuring points. Qualitative data analysis was based on the Theoretical Domains Framework. Quantitative data were analysed descriptively. Ten experts named a lack of knowledge and application regarding compression therapy, reluctance to assume role as primary care provider, and inadequate remuneration as barriers for evidence-based VLU care. To effectively address these barriers, interventions are required to foster the use of compression therapy and patient education. A multimodal approach such as pursued in UCC is expected to effectively address deficits in VLU care at general practitioner level by promoting provider knowledge about evidence-based treatment and supporting patient adherence.
Venous leg ulcers occur due to chronic venous insufficiency in the lower extremities and are often difficult to heal. Platelet-rich plasma and platelet-rich fibrin are products that contain high concentrations of platelets. This systematic review evaluated the effectiveness, safety and cost-effectiveness of these products for the treatment of venous leg ulcers. Guided by the 2020 Joanna Briggs Institute systematic review of effectiveness guideline, this review included original studies that investigated platelet-rich plasma and platelet-rich fibrin in the treatment of venous leg ulcers from databases including the Cochrane Library, Embase, Medline, CINAHL, PubMed, World Health Organisation International Clinical Trials Registry, Clinical Trials.gov and Australian New Zealand Clinical Trials Registry. Methodological quality was assessed using relevant appraisal checklists. Information related to general characteristics of included articles and relevant outcomes of interest were extracted and synthesised narratively. Of thirty-six eligible studies, 24 studies used platelet-rich plasma, eleven investigated fibrin-rich plasma and one study used both platelet-rich plasma and fibrin-rich. Most studies reported these products were effective in promoting wound healing, reducing other symptoms, and were safe to use. The use of platelet-rich plasma and platelet-rich fibrin resulted in significantly higher healed venous leg ulcers compared to control using conventional treatment (RR: 2.93, 95% CI, 1.90–4.53, p = 0.01). These products were safe to used topically and promoted to wound healing, reduced pain, either along or combined with other treatments. Platelet-rich plasma and fibrin-rich plasma improves wound healing and appears to be safe to use in the treatment of venous leg ulcers.
A new surgical technique for ray amputation of the diabetic foot is described. The procedure provides soft tissue reconstruction using a local flap in combination with negative pressure wound therapy to close these wounds safely and effectively. This article reports on 12 patients treated with this technique in a Tertiary Hospital/General Hospital in Singapore and compares their outcomes to those of 12 comparative cases from neighbouring institutions under the same health group who received conventional dressings. The new technique led to a higher number of healed wounds (12 vs. 4) and a shorter median time to healing (46.5 vs. 196.5 days). No major amputation or further minor amputation of the target limb occurred in the group treated with the new technique, whereas one major amputation and two further minor amputations took place in the comparison group. Our results suggest that the new technique is promising in this diabetic population with concurrent comorbidities.
To characterise nurses' perspectives on factors that influence their ability to provide patient-centered nursing care for autistic patients in a large urban hospital setting.
Qualitative exploratory study.
We conducted semi-structured interviews via Zoom with nurses from a large urban hospital serving primarily adult patients. We analysed interviews using codebook/template analysis. Two researchers coded each interview and resolved discrepancies through discussion.
Twelve nurses (3 males) with 2–20 years of professional experience across research, management, and patient care roles were interviewed. Three primary themes were generated: (1) barriers to patient-centered care, including lack of formal autism education, factors related to the hospital setting, and specific nurse characteristics, such as inflexible adherence to care routines; (2) facilitators of patient-centered care, including experiential autism knowledge, caregiver involvement, and specific nurse characteristics, such as showing respect for all patients; and (3) missed opportunities for patient-centered care, including underuse of behavioural care teams, inadequate time for planning and preparation, and reliance upon restraints and security personnel for behaviour management.
Nurses identified several areas where consistent implementation of existing processes could improve care. A key finding was the need to explore more patient-centered alternatives to the use of restraints and security personnel in response to aggressive or self-injurious behaviour. Overall, our results support the need for competency training to facilitate increased nursing comfort and ability to provide patient-centered care for autistic patients.
This work suggests nurses gain much of their autism-related knowledge through patient care experiences. Despite providing the majority of hands-on care, nurses receive little to no formal training about caring for the growing autistic population.
This work has identified targeted areas to improve education and processes in caring for autistic patients.
No patient or public contribution.
by Tatiana Petukhova, Maria Spinato, Tanya Rossi, Michele T. Guerin, Cathy A. Bauman, Pauline Nelson-Smikle, Davor Ojkic, Zvonimir Poljak
Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) is endemic in many pig-producing countries and poses significant health and economic challenges. Enhanced surveillance strategies are essential for effective disease management. This study aimed to evaluate and compare the performance of different time-series modeling techniques to predict weekly PRRSV-positive laboratory submissions in Ontario, Canada. Ten years of PRRSV diagnostic data were obtained from the Animal Health Laboratory at the University of Guelph and were processed into a weekly time series. The dataset was analyzed with autoregressive integrated moving average (ARIMA), exponential smoothing (ETS), random forest (RF), and recurrent neural network (RNN) models. Two validation strategies were employed: a traditional train-test split and a simulated prospective rolling forecast. Model accuracy was evaluated using common predictive error metrics. Descriptive analysis indicated a gradual increase in PRRSV positive submissions over time, with no consistent seasonal pattern. ARIMA and ETS models generally overpredict case counts, while RF and RNN tended to underpredict them. Among the evaluated models, the RF regression model most accurately captured the underlying time-series dynamics and produced the lowest prediction errors across both validation approaches. Despite outperforming other models, the RF model’s high relative prediction errors limit its suitability for accurate forecasting of PRRSV-positive submissions in Ontario’s routine surveillance system. Further data refinement and algorithm improvements are warranted.This paper discusses data errors and offers guidance on data cleaning techniques, with a particular focus on handling missing values and outliers in quantitative datasets.
Methodological discussion.
This paper provides an overview of various techniques for identifying and addressing data anomalies, which can arise from incomplete, noisy, and inconsistent data. These anomalies can significantly affect data quality, leading to biased model parameter estimates and evidence-based decisions. Data cleaning, particularly the appropriate handling of missing values and outliers, is essential to improving data quality before analysis. Data cleaning includes screening for anomalies, diagnosing errors, and applying appropriate corrective measures.
Proper handling of missing values and the identification and correction of outliers are crucial aspects of data cleaning in ensuring data quality and the reliability of statistical analyses. Effective data cleaning enhances the validity and accuracy of research findings for evidence-based decision making that leads to optimal patient outcomes.
The quality of study results depends on how a dataset and its complexities are processed or handled before the analysis. Nursing researchers must use a framework to identify and address important data anomalies and produce reliable results.
This paper describes data cleaning, often overlooked during the data mining process, as a crucial step before conducting data analysis. By addressing missing values and outliers, identifying and fixing data anomalies, and enhancing data quality prior to analysis, data cleaning techniques can produce precise research findings for evidence-based decision making.
In this methodological paper, no new data were generated.
No patient or public contribution.
This paper explores the methodological challenges associated with cross-cultural validation of clinical assessment measures and proposes strategies to enhance the validity and reliability of these assessments.
Methodological discussion.
Three main phases require consideration in the cross-cultural validation of assessment instruments: (1) Linguistic translation of the assessment instrument and confirmation of its equivalence, which includes conceptual, item, semantic and operational equivalence; (2) Empirical validation of the translated version's accuracy; (3) Adjusting the scores to fit the cultural context.
Achieving cross-cultural equivalence of assessment instruments is a complex and challenging process that can only be achieved through methodological rigour. It requires interdisciplinary collaboration of both linguistic and subject experts with strong statistical knowledge and a willingness to explore the nuances of the target population. By enhancing methodological rigour, we can improve the validity of clinical assessment measures across cultures, ultimately leading to better health outcomes for diverse populations.
The implications of cross-cultural validation of clinical assessment measures/tools for nursing are significant and multifaceted. Overcoming challenges to cross-cultural validation contributes to the professional growth of nurses by equipping them with greater cultural awareness and confidence in the tools' reliability for patient assessment and evaluation. This not only aids in their clinical practice but also fosters a commitment to evidence-based practice, enhancing their overall effectiveness as healthcare providers. Reliable and valid assessment tools enable nurses to confidently engage in research literature that reflects the realities of diverse populations. This can inform healthcare policies and practices, ensuring they are inclusive and equitable.
While researchers endeavour to reach a consensus on the definition of cross-cultural equivalence and how it should be determined, this practical introduction discusses challenges and proposes strategies to enhance the validity and reliability of these measures/tools.
No patient or public contribution.
To report how person-centred care principles are applied to care planning and to explore the contextual factors affecting their implementation in older adult care homes in England.
A combined framework analysis and quantitative content analysis study.
Using a semi-structured questionnaire, we interviewed 22 care home managers in England, exploring topics around care planning processes. Audio recordings were transcribed verbatim. Transcripts were analysed through a combined framework approach and content analysis.
Most care home managers discussed person-centred care planning in terms of understanding residents' values and preferences and their engagement in decision-making. Factors facilitating person-centred planning implementation included accessible planning tools, supportive care home leadership, effective communication and collaborative partnerships. Inhibiting factors included regulatory and care practice misalignment, time constraints and adverse staffing conditions.
Differences between care home practitioners' understanding and practice of person-centred care planning require further examination to improve understanding of the sector's complexity and to develop suitable care planning instruments.
Findings demonstrate a need for improved staff access to specialised person-centred care training and an opportunity for care home nursing practitioners to lead the co-development of digital person-centred care planning tools that reflect the reality of long-term care settings.
Identifying factors influencing the implementation of holistic approaches to care planning makes clear the need for modernising long-term care policy and practice to adapt to the contemporary challenges of the care home sector.
Study reporting was guided by the Standards for Reporting Qualitative Research.
Two public involvement advisors with lived experience of caring for a relative living in a care home contributed to the development of the interview guide, advised on care home engagement, guided the interpretation of the findings and commented on the drafted manuscript.
FreshRSS 