Conectar
This single-centre, randomised, controlled study assessed the wound healing efficacy of adhesive bandages in eligible healthy adults (N = 36) aged 25–55 with Fitzpatrick skin types II and III using a model of laser-induced wounds. Here, we report data for wounds that were randomised to treatment with either a hydrocolloid bandage for multi-day use (BAND-AID Adhesive Bandage Hydroseal), standard of care (SoC) (BAND-AID Adhesive Bandage Tru-Stay Sheer) or an uncovered control. Primary endpoints included the time to complete healing and a composite wound healing score. Hydrocolloid bandage-treated wounds healed twice as fast as the uncovered control or SoC-treated wounds. Median time (days) to complete healing was significantly faster for the hydrocolloid bandage-treated wounds (6.9) versus SoC (11.9) and uncovered control (11.8). Hydrocolloid bandage-treated wounds had significantly better composite wound healing scores versus SoC and versus uncovered control over 2 weeks. At Day 28, cosmesis was better with hydrocolloid bandage treatment (0.3) versus SoC (0.6) and uncovered control (2.1) (change from baseline in a composite scar score; higher score = worse outcome). Multi-day wound occlusion with a hydrocolloid bandage promoted faster healing and improved cosmesis compared with daily SoC dressings or uncovered control.
The aim of this study is to assess nurse practitioner students' perceptions and engagement with Isabel's artificial intelligence (AI) based differential diagnosis tool to support their decision-making skills during their theoretical and clinical placement training.
This pilot study used a cross-sectional design.
Twenty-six nurse practitioner students provided feedback on their use of an AI differential diagnosis tool in both academic and clinical contexts. This survey used the Post-Study System Usability Questionnaire to assess the engagement levels and usability of the AI tool. Additional questions were included to evaluate the usage patterns, adequacy in training and confidence in diagnosis.
There were mixed engagement levels: 44.4% (n = 8/18) used Isabel in two subjects—typically one or both clinical placement units—and 27.8% (n = 5/18) in one subject; students most often used the tool to confirm differential diagnoses. Usability was rated positively with the disease ranking, red flag diagnosis and link to national guideline features demonstrating the highest student usage. While most students found the tool beneficial to use during clinical placement and completing university assignments, some reported challenges due to insufficient training, impacting confidence in clinical application.
Isabel has potential as a valuable educational tool in Nurse Practitioner programs, but successful implementation depends on adequate training and support. The findings highlight the importance of comprehensive training and support to maximise AI tool utilisation, with direct implications for programme curricula, clinical education strategies and potential improvements in diagnostic reasoning skills for future nurse practitioners.
This study provides an example of integrating artificial intelligence (AI) guided clinical decision-making training in nurse practitioner (NP) education. The findings can be used by educational institutions to trial similar AI-integrated learning approaches, enhancing diagnostic competence and potentially improving patient care outcomes.
The Study adhered to the STROBE checklist for reporting.
No patient or public contribution was made to this study.
Salutogenic and health-promoting communication techniques – such as positive health, motivational interviewing, solution-focused approaches and health coaching – aim to strengthen patient empowerment, resource activation and self-management in primary care. Despite growing interest, the evidence on how these approaches are implemented in general practice is fragmented. Guided by the Consolidated Framework for Implementation Research (CFIR), this scoping review will map settings, strategies, determinants and outcomes related to the implementation of salutogenic and health-promoting communication techniques in primary care. This review aims to bridge the gap between theory and routine care by identifying context-sensitive strategies for integrating salutogenic and health-promoting dialogue into everyday general practice.
Following the Joanna Briggs Institute guidance for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P), we will search MEDLINE, CINAHL and Embase from database inception to the date of search (no date limits; English/German). Eligibility will be structured by the Population–Concept–Context framework. Two reviewers will independently screen studies via Rayyan and chart data with a piloted form that captures intervention components, implementation strategies and contextual determinants mapped to CFIR domains. We will present descriptive summaries and CFIR-based matrices of barriers/facilitators and strategies, alongside narrative synthesis.
Ethical approval is not required. We will disseminate findings via peer-reviewed publication, conference presentations and make all extraction matrices openly available via the Open Science Framework (OSF).
The protocol is registered on the OSF (https://osf.io/my7sh/overview).
There are many circumstances where individuals with limited mobility are exposed to prolonged postures increasing the risk of pressure ulcers. Technologies have been developed to monitor posture, mobility and pressure exposure; however, their effectiveness in different clinical settings is unknown. The aim of this scoping review was to assess clinical studies using continuous pressure monitoring for the prevention and/or treatment of pressure ulcers. A scoping review of the literature was conducted using the PRISMA-ScR framework. Clinical-based studies were included which used continuous pressure monitoring for assessment and treatment over a minimum of a 2-h period. The outcomes included quantitative measures such as pressure distribution and mobility data, qualitative insights relating to patient comfort and acceptability, and the perceptions of healthcare staff regarding usability and clinical integration of the technology. Twenty-four studies were identified and included in the scoping review, conducted across eight countries spanning three continents. Most studies were undertaken in a hospital setting (67%, n = 16). Following review of the included papers, five core themes were identified: clinical outcomes, pressure metrics, posture and mobility, nurse feedback and patient experience. There was high heterogeneity in study design, outcome measures and different risk of bias limited the scope to synthesise the outcomes. Collectively, the studies indicate that CPM can enhance awareness of interface pressures, support clinical decision-making and inform repositioning strategies for individuals at risk of tissue damage. Reported benefits include greater staff confidence and patient engagement. However, consistent reductions in ulcer incidence have yet to be demonstrated, with larger trials with standardised outcomes required.
Discharge from an intensive care unit (ICU) to the ward has long been recognised as a difficult and dangerous time for patients. This study aims to explore the experiences of patients, family members and staff of ongoing care following discharge from ICU to the ward.
An exploratory qualitative interview study, part of a mixed methods research project exploring post-ICU ward care to inform practice changes to improve outcomes for critical care survivors.
Semi-structured interviews were conducted with 55 purposively sampled patients, family members and multi-professional staff between 2017 and 2018 at three NHS trusts in the UK. Data were analysed thematically.
Three main themes were identified: Being wardable discusses the tension between perceptions of readiness for ICU between ICU and the ward staff; Post-ICU patients as other analyses the characterisation of otherness of post-ICU patients in comparison with other ward patients; and Fear and anxiety considers the impact of this perceived otherness on both patients and staff.
The term wardable is used by staff to indicate the suitability or otherwise of patient transfer. There is a tension between being deemed wardable from an ICU and ward perspective. This exacerbates the perception of otherness and compounds the fear and anxiety related to post-ICU care experienced by both patients and ward staff.
By recognising the tension between being ready for ICU discharge (not requiring organ support) and being wardable (having care needs which can be fulfilled on the ward they are being discharged to), clinicians may better support patients during this transition of care. This has the potential to improve outcomes for post-ICU patients, as well as improve the experience by both patients and the staff and family members caring for them.
The COREQ reporting checklist was used in the reporting of this manuscript.
Patients and public were involved throughout the REFLECT project, from design through to dissemination. This included advising on the approach to patient participants and supporting dissemination of results via social media.
ISRCTN: 14658054
Half of all patients with a hip fracture (HF) do not recover their pre-fracture mobility after 1 year. Mobility and functional capabilities may be impaired by postoperative low haemoglobin levels and iron deficiency. The primary objective of this trial is to compare the effect of a single postoperative dose of ferric derisomaltose 20 mg/kg body weight relative to placebo on the recovery of functional mobility in patients.
The IronHip trial is a multicentre, randomised, double-blind, placebo-controlled trial with participants allocated in a 1:1 ratio to receive intravenous iron or placebo. The eligible population is participants aged 65 years or older who have undergone HF surgery and have a haemoglobin concentration below 105 g/L measured between postoperative day 1 and 5. In total, 210 participants will be randomised. Main analyses will be conducted in the intention-to-treat population using a mixed model for repeated measures, including assessments at baseline and at 4, 6 and 12 weeks after randomisation. Treatment effects will be estimated from the treatment-by-time interaction and reported as between-group differences in least-squares mean New Mobility Score with 95% CIs. The secondary outcomes are haemoglobin, red blood cell transfusions, fatigue, quality of life, self-rated health, fear of falls, 30 s sit-to-stand test, activities of daily living, pain, days alive and at home up to 30 days, mortality and serious adverse events. Exploratory outcomes are cost-effectiveness, physical activity, hand grip strength, knee extension strength, cognition, ferritin and transferrin saturation. Recruitment was initiated on 9 June 2025.
The IronHip trial has been approved by the Danish Medicines Agency and the Danish Medical Research Ethics Committee. The protocol follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines, the Declaration of Helsinki and the Good Clinical Practice guidelines. The trial findings will be reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement in peer-reviewed journals.
EU CT number: 2024–5 15 116-42-00, authorised 9 February 2025.
Clinicaltrials.gov: NCT06898814
This study assessed the minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD) and dietary patterns among children aged 6–23 months in Njombe Town Council.
Community-based cross-sectional study.
This study was conducted in the Njombe Town Council, which is located in the Njombe region in the southern part of Tanzania.
A total of 330 caregivers of children aged 6–23 months were recruited using a multistage probability sampling technique. Data were collected from January to March 2021 using a structured questionnaire adapted from the Process for Promotion of Child Feeding (ProPAN) manual.
None.
The primary outcomes were the prevalence of MDD, MMF and MAD, assessed according to the 2021 WHO infant and young child feeding indicators. Secondary outcomes included food group consumption and dietary patterns identified using principal component analysis.
A total of 330 caregivers of children aged 6–23 months participated in the current study. Nearly half (43.9%; n=145) were aged between 30 and 49 years, with a mean age of 30.28 years and an SD of ±6.119 years. Only 26.36% of children aged 6–23 months achieved MDD, 71.5% achieved MMF and 18.48% met MAD, with a mean dietary diversity score of 3.35±1.6. Predominant foods included grains, roots and tubers (80.91%) and breast milk (90%), while dairy products were the least consumed (7.27%). Three dietary patterns emerged: cereals, roots and tubers; dairy products and eggs; and vitamin A-rich fruits and vegetables.
The MDD and MAD attainment in Njombe Town Council are suboptimal, reflecting reliance on staple foods and limited nutrient-rich options. These findings highlight the need for context-specific interventions, including strengthened nutrition education, promotion of diversified diets and agricultural strategies that improve access to nutrient-dense foods to enhance infant and young child nutrition.
To quantify out-of-pocket (OOP) costs and catastrophic health expenditure (CHE) among patients hospitalised with heart failure (HF) and to identify factors associated with CHE during a single index admission in northern Tanzania.
Prospective cross-sectional study.
Medical ward of Kilimanjaro Christian Medical Centre, a tertiary referral hospital in northern Tanzania, from 1 May to 31 October 2024.
Consecutive patients aged 14 years or older admitted with acute decompensated HF diagnosed using Framingham criteria. Of 309 eligible patients, 290 completed the study and were included in the analysis.
The primary outcome was CHE, defined as OOP spending exceeding 40% of household non-food expenditure for the index hospitalisation. Secondary outcomes included total inpatient OOP cost and cost distribution by category. Factors associated with CHE were assessed using multivariable logistic regression.
Among 290 hospitalised patients with HF, 201 (69.3%) experienced CHE during the index admission. The median total cost of hospitalisation was US$229 (IQR 155–405), and the median OOP payment was US$192 (IQR 39–360). Diagnostic investigations accounted for the largest share of OOP expenditure. In multivariable analysis, family income US$≤115 (adjusted OR (aOR) 10.0, 95% CI 4.3 to 23.0) and lack of health insurance (aOR 22.9, 95% CI 9.3 to 56.1) were strongly associated with CHE. Other independent associated factors were non-use of mineralocorticoid receptor antagonists before admission (aOR 4.1, 95% CI 1.5 to 11.1), reduced left ventricular ejection fraction (aOR 3.1, 95% CI 1.2 to 8.0) and length of stay >7 days (aOR 4.1, 95% CI 1.7 to 10.0).
CHE was common among patients hospitalised with HF in northern Tanzania during a single admission, driven mainly by diagnostic costs and limited financial protection. Expanding insurance coverage, improving access to guideline-directed HF therapy and reducing patient payment for essential diagnostics may lessen the financial burden of HF care.
The soluble FMS-like tyrosine kinase-1 and placental growth factor (sFlt-1/PlGF) ratio has demonstrated impressive predictive test characteristics in women with suspected pre-eclampsia. However, it remains a matter of debate whether the introduction of this novel test can indeed translate to a reduction in pre-eclampsia-related hospital admissions, outpatient visits and can consequently lower overall healthcare costs. The PREPARE II study aims to investigate whether the sFlt-1/PlGF ratio, along with digital self-monitoring, can reduce pre-eclampsia-related healthcare utilisation in the first week following the test for women with suspected pre-eclampsia.
This is a randomised controlled trial across six centres which includes women (≥16 years old) between 20 and 37 weeks of gestation with suspected pre-eclampsia due to one or more identified symptoms. For power calculation, we assumed that the sFlt-1/PlGF ratio including a telemonitoring strategy leads to a de-escalation of care by cumulatively reducing the frequency of pre-eclampsia-related hospital admissions and/or outpatient visits in the first week from 50% in the control group to 35% in the intervention group. Considering a loss to follow-up of 5%, a sample size of approximately 470 women is required with 235 women per arm (α=5%; power=90%). The intervention is an algorithm based on the urine protein/creatinine ratio (PCr)+sFlt-1/PlGF ratio, along with a telemonitoring strategy. The algorithm incorporates a PCr cut-off of 30 (mg/mmol) and a sFlt-1/PlGF ratio cut-off of 38 for risk classification. Subsequent clinical follow-up recommendations are stratified based on this classification: low risk entails no additional follow-up, returning to routine antenatal care; intermediate risk includes telemonitoring; high risk necessitates immediate admission. The primary outcome is the occurrence of pre-eclampsia-related healthcare utilisation in the first week after testing. Secondary outcomes are maternal/perinatal adverse events, total healthcare usage, pre-eclampsia diagnosis, quality of life and productivity losses. A cost-effectiveness analysis from a societal perspective will be performed.
Ethical approval was obtained from the Medical Ethics Committee of Leiden University Medical Centre (METC LDD) on 21 July 2025 (reference NL-009295). The results will be disseminated through peer-reviewed publications and presentations at international conferences.
NL88527.058.24.
Growing evidence suggests that a part of the burden of Parkinson’s disease (PD) can be explained by exposure to environmental factors, including pesticides, heavy metals, solvents, and air pollution. However, several questions remain unanswered, pertaining to the associations with PD of environmental factors that are still in use today; the added risks of co-exposure to multiple environmental factors and gene–environment interactions. Additional questions remain on the relevant time window, duration, and level of environmental exposures in relation to PD risk. Furthermore, it is unclear whether these exposures are associated with clinical progression of PD.
PD-PEST (Parkinson’s Disease–Preventing Emergence of Symptoms by environmental Toxicants) is a nationwide hospital-based case–control study conducted in the Netherlands. The study population consists of 1500 persons with a recent PD diagnosis and 3000 age- and sex-matched controls. Participants will be recruited from four regions across the Netherlands to ensure a representative geographical distribution in terms of urbanisation, industry, and agricultural activity. Cases must have a PD diagnosis, established by a neurologist in the Netherlands according to standard diagnostic criteria. Controls are outpatients with a different neurological condition that is unlikely to be associated with the environmental factors of interest or the risk of PD. We will collect detailed information on historical and current environmental exposures at an individual level. This includes occupational and residential histories (via questionnaires and nationwide registries) and measurements (blood, saliva, faeces, hair, and via silicone wristbands). Based on these multimodal data, we will estimate participants’ individual lifetime exposure to environmental factors. Then, we will examine the associations between these exposures and the risk of PD. In addition, we will assess longitudinal associations between exposures and clinical progression of individuals with PD over 36 months. Analyses will be adjusted for possible confounders and multiple hypothesis testing.
The PD-PEST study aims to overcome the limitations of previous studies by examining a large, representative study population, incorporating detailed information on clinical PD diagnosis, conducting extensive assessments of historical and current environmental risk factors and collecting detailed information on possible confounders. The results are expected to enhance our understanding of the role of environmental factors in the aetiology of PD and inform preventive strategies.
The Medical Ethical Committee Oost-Nederland approved this study (NL86526.091.24). Informed consent will be obtained from each participant prior to participation in any of the study procedures. Findings of this study will be disseminated through publications, conferences, stakeholder briefings, and tailored communication materials for participants and the wider Parkinson community.
Open Science Framework, January 2025 (osf.io/4q9vs).
As Tanzania experiences a rapid demographic transition towards an ageing population, the burden of geriatric malnutrition is increasing. The capacity of the health workforce to effectively screen and manage nutritional status in the elderly is critical. However, the preparedness of undergraduate health students regarding geriatric nutrition assessment remains underexplored.
This study assessed knowledge, attitudes and perceived challenges regarding geriatric nutrition assessment among undergraduate health students in Dodoma, Tanzania.
A cross-sectional analytical study involving 384 undergraduate health students, selected through simple random sampling, was conducted. Data were collected using a structured questionnaire and analysed using SPSS V.27. All independent variables with p≤0.2 were included in the multivariable logistic model. Independent variables with p≤0.05 and 95% CI were considered statistically significant.
A total of 384 participants with a mean age of 23.61 years and an SD of ±2.00 years were included in the study. The study highlighted that 47.7% (n=183) had inadequate knowledge, 53.1% (n=204) had positive attitudes and 58.9% (n=226) experienced significant challenges. Factors such as age (20–23) years (adjusted OR (AOR)=6.998, 95% CI 2.222 to 22.038, p=0.001), marital status (AOR=6.413, 95% CI 1.279 to 32.139, p=0.024), geriatric training (AOR=0.380, 95% CI 0.222 to 0.650, p=0.001) and living with older adults (AOR=0.619, 95% CI 0.392 to 0.977, p=0.039) were significantly associated with knowledge. However, having already conducted an assessment of older adult nutritional status (AOR=1.748, 95% CI 1.085 to 2.814, p=0.022) was significantly associated with attitudes.
Undergraduate health students in Tanzania show moderate knowledge and attitudes but substantial challenges in geriatric nutrition assessment, largely due to limited training and exposure. Integrating dedicated geriatric nutrition modules and practical experiences into curricula is urgently needed to prepare the workforce for Tanzania’s ageing population.
by Karin Törnbom, Dominique Hange, Eva-Lisa Petersson, Irene Svenningsson
BackgroundDespite increasing attention to youth mental health, children and adolescents in Sweden experience fragmented, inequitable care with regional variation. Delays in diagnosis, limited preventive interventions, and poor inter-sectoral collaboration contribute to significant unmet needs. This study investigates system-level challenges and stakeholder perspectives on opportunities to enhance care pathways.
MethodsWe conducted a qualitative study in the Västra Götaland region, Sweden. Fourteen purposively selected participants – including senior executives, healthcare professionals, and parents took part in semi-structured interviews. We used systematic text condensation, according to Malterud, and the four steps involved in this method for analysing the interviews.
ResultsA central theme across interviews was the requirement for a formal diagnosis before children can access mental health support, particularly in school and primary care settings. Participants described this as a major barrier that delays early intervention and leaves children and young people with complex or atypical presentations without adequate support. Primary care professionals reported increasing mental health caseloads without corresponding increases in staffing or funding, limiting preventive work. Child and adolescent psychiatry (BUP) was described as overwhelmed, with long waiting times and limited continuity of care. A care manager within primary care was proposed as a way to help families navigate fragmented services and improve collaboration, although participants emphasised that such a role would need to be part of broader structural reform.
ConclusionsOur findings highlight persistent systemic issues in mental health care for children and young people, including inequitable access, insufficient prevention, and fragmented collaboration across sectors. Strengthening primary prevention, reallocating resources to primary and school-based mental health care and implementing well-defined care coordination roles within broader restructuring may improve continuity and equity in service delivery. Comprehensive policy reform is needed to support person-centred, integrated care pathways for children and young people with mental health needs.
by Gunnhild Helmsdal, Marnar Fríðheim Kristiansen, Eyðbjørg Klemmentsen Gaard, Barbara Joensen Eysturoy, Pál Weihe, Eina Hansen Eliasen, Maria Skaalum Petersen
BackgroundSix years since the emergence of SARS-CoV-2, the newer variants of the virus continue to have long-term health effects.
ObjectivesThe aim of the study was to investigate persistent symptoms, cognitive impairment, and clinical and paraclinical predictors of long COVID in individuals infected during the Omicron wave.
MethodsWe conducted a clinical case-control study including participants with persistent symptoms up to 13 months after confirmed SARS-CoV-2 Omicron infection (long COVID or LC group) and antibody-verified never-infected controls (NI group).
ResultsA total symptom score based on a 24-item questionnaire was strongly associated with increased odds of long COVID (adjusted odds ratio (aOR) 1.21, 95% CI 1.13–1.30, p Conclusions
One year after Omicron infection, a subset of people continue to experience a substantial symptom burden, particularly fatigue, cognitive impairment, and mental well-being, and a higher frequency of intercurrent infections.
In current practice, fluid volumes administered to children following kidney transplant vary widely. Up to 52% of children experience fluid overload-related complications. Current fluid guidelines are not evidence-based and the optimal amount of fluid for children after transplant is not known. The aim of Randomised multiple centre trial of conservative versus LIberal fluid adMInisTration for children receiving a kidney tranSplant (LIMITS) is to determine whether relative limitation of fluid volume administered to children receiving kidney transplants is superior to liberal fluid volume administration.
LIMITS is a pragmatic, open-label, UK-based, multicentre randomised controlled trial, with an internal pilot phase and integrated economic evaluation. A total of 140 children receiving kidney transplants will be randomised to receive either conservative postoperative fluid administration (maximum of 150 mL/m2/hour for no longer than 18 hours, followed by a fixed daily target of maximum 1.5 L/m2/day thereafter) versus the comparator of liberal postoperative fluid administration (fluid volume administered to replace urine output and insensible losses for at least 48 hours with target urine output >2 mL/kg/hour). The primary outcome is mean days at home in the first 30 days after kidney transplant. The primary outcome will be analysed using a mixed linear regression model adjusted for donor type (living vs deceased donor) and participant weight (
The trial received Health Research Authority approval on 20 August 2025 (REC reference: 25/EE/0161, IRAS project ID: 354370). Findings will be presented to academic groups via national and international conferences and peer-reviewed journals. The patient and public involvement group will play an important part in disseminating the study findings to the public domain.
This paper explores the experience of general practice nurses implementing a nurse-led social prescribing intervention to improve older people's social connectedness.
Qualitative descriptive study within a multi-phase mixed methods project.
Eight Australian general practice nurses working in a health connector role participated in semi-structured interviews at implementation-end (n = 8) and 12 months later (n = 5), and two focus groups, held during implementation. Interviews addressed participants' reasons for engaging in the intervention, perceptions of training, the experience of intervention delivery and sustainability. Focus groups explored participants' views of challenges and achievements. Data were analysed inductively using thematic analysis.
Participants reported ‘alignment between their current nursing role and the additional health connector role’ regarding their scope of practice and philosophy of care. ‘Preparedness to be a health connector’ explained how participants' primary care nursing skills equipped them to intervene, however, additional training and resources were essential. Older people were positively impacted by the intervention, and this motivated participants to sustain elements of the intervention. With support, participants leveraged existing skills and worked to their full scope of practice. This resulted in practice improvements in caring for older people at risk of loneliness and social isolation, and professional gains for nurses.
Despite challenges in sustaining the intervention as designed, participants integrated the health connector intervention into their practice within the context of their nursing role and continued this work with older people and other patient groups.
Facilitating general practice nurses to undertake a social prescribing intervention had benefits for nurses and patients.
Nurse-led social prescribing interventions can support older people to reactivate or maintain their social connections within the context of their health.
Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist.
No patient or public contribution.
Diabetic foot ulceration (DFU) contributes significantly to diabetes-related morbidity and amputation. In Barbados, where amputation rates are among the highest globally, the influence of socioeconomic factors on ulceration outcomes remains underexplored. Educational attainment, a social determinant of health, may influence health behaviours, engagement with healthcare services, and ultimately clinical outcomes. This study examines whether educational attainment is associated with diabetic foot ulcer severity, as measured by the SINBAD scoring system, and six-week healing outcomes among inpatients with DFU. A prospective observational study was conducted over 6 months at Barbados' sole public hospital. A total of 176 participants admitted with a diagnosis of DFU were recruited. Baseline demographics, comorbidities, and ulcer characteristics were collected, and SINBAD scores were determined. Random forest modelling was employed to evaluate predictors of complete healing at 6 weeks and to assess ulcer severity stratified by educational attainment. Of the cohort, 17.5% reported primary education as their highest attainment level, compared with 2.9% of the general adult population. The mean SINBAD score was 2.45 among those with primary education and 2.51 among those with secondary education (p > 0.05). No statistically significant association was found between educational attainment and healing outcomes at 6 weeks. Educational attainment in this inpatient DFU cohort was lower than that of the general Barbadian population; however, it was not significantly associated with ulcer severity or six-week healing outcomes. In a universal healthcare setting, equitable access to care may attenuate the effect of educational attainment on clinical outcomes. These null findings highlight the need for future adequately powered studies incorporating health literacy assessment and key clinical confounders. Nonetheless, the observed disparity in educational attainment among DFU inpatients suggests that foot health education initiatives should be designed to be accessible to individuals across all educational levels.
Acute kidney injury is a global health concern with significant implications for morbidity and mortality when it comes to children. High morbidity and mortality result from consequences such as metabolic acidosis, hyperkalaemia, fluid overload and cardiovascular issues. Good clinical outcomes among children with acute kidney injury can be achieved through early recognition and initiation of management to prevent disease progression. However, evidence on early recognition and management of acute kidney injury in children is lacking, especially in low-resource settings such as Tanzania. This study explores healthcare providers’ experiences with early recognition and management of acute kidney injury among children attending primary healthcare facilities.
This exploratory qualitative case study aims to capture contextual experiences using semi-structured interviews to gain thematic insights. The estimated sample size for this study is 20 informants and will be selected purposively. Data will be collected through individual interviews using an interview guide with predetermined questions followed by probing questions. Each interview session will last for about 30–60 min. Data analysis will begin during the data collection period using the six-phase thematic analysis approach by Braun and Clarke.
Ethical approval has been provided by the Muhimbili University of Health and Allied Sciences Senate of Research and Ethical Committees with reference number DA.282/298/01.C/2630. In accordance with the Declaration of Helsinki (1964) and its later amendments, all respondents will provide verbal and written informed consent and will be free to participate voluntarily with no incentives. The findings will be shared with participating healthcare facilities, district and regional health authorities and relevant stakeholders through presentations and summary reports. Findings will also be presented at national and international scientific conferences and submitted for publication in peer-reviewed journals.
Intracerebral haemorrhage (ICH) accounts for approximately 15% of all strokes in Denmark and remains associated with high mortality and morbidity. It is challenging to distinguish neoplastic from non-neoplastic causes of ICH in the acute setting, and CT findings that may aid early differentiation have not been fully characterised. Existing ICH-classification systems (SMASH-U, H-ATOMIC and CLAS-ICH) have not been directly compared for diagnostic accuracy in this setting. Identifying radiological and clinical factors associated with underlying aetiology may support faster diagnosis, reduce time to workup related to potential underlying cancer and facilitate early targeted treatment of the underlying cause of ICH.
This study is a retrospective observational cohort including all patients admitted with acute ICH to the Department of Neurology, University Hospital of Southern Denmark, Aabenraa between January 2014 and December 2024 (estimated approximately n=610). Medical records and initial non-enhanced CT scans will be reviewed. Two neurologists and two radiologists, blinded to final diagnosis, will independently extract clinical presentation, topographical and volumetric haemorrhage characteristics, and classify each case using the abovementioned ICH-classification systems. Primary analyses will assess associations between clinical and radiological features and underlying neoplastic vs non-neoplastic aetiology. Secondary analyses will compare diagnostic performance of classification systems using sensitivity, specificity and receiver operating characteristic curves. Multivariate logistic regression models will be applied with Holm correction for multiple comparisons.
The study has been submitted to the National Danish Research Ethics Committee and the Danish Data Protection Agency. As data derive from completed disease courses, no patient contact is expected. Results will be disseminated through peer-reviewed journals, conferences and scientific presentations.
To identify and report how gender justice is conceptualised and discussed in contemporary health literature in relation to the Triple Planetary Crisis of climate change, pollution and biodiversity loss, with a particular focus on the experiences of women and gender-diverse populations, and the representation of nurses and other healthcare professionals dominated by women.
Scoping review.
Searches were conducted across MEDLINE (Ovid), Scopus, CINHAL, Embase and ProQuest, focusing on studies published from January 1 2000–23 September 2024.
The review was conducted in accordance with the JBI methodology for scoping reviews and reported against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Data were extracted according to a pre-specified extraction framework, developed a priori, encompassing components of gender justice and intersectionality.
A total of 39 studies were included: 17 (43.6%) qualitative, 17 (43.6%) quantitative and 5 (12.8%) mixed methods. The focus of the studies included gendered experiences of climate change (30.8%), decision-making and governance (20.5%), health and wellbeing (17.9%), women's economic participation (15.4%), cultural and spiritual connections to land (7.7%), and intersectionality and human rights (7.7%). Gender-diverse populations, nurses and other healthcare professions dominated by women were not represented in the literature.
The literature reported that women experienced differentiated exposure to the Triple Planetary Crisis. The underrepresentation of gender diverse people and nurses in recent studies remains a significant barrier to advancing understanding of gender justice. Integrating gender justice into health systems is increasingly important to prevent women from being disproportionately impacted by the Triple Planetary Crisis.
More attention to inclusion of frontline healthcare professionals, including nurses, in governance, policy discussions and leadership roles could strengthen the response to systemic environmental threats.
No patient or public involvement.
We designed the Optimising Care in Critically Ill at the UCHealth by Liberalising the Target O2 in Mechanically ventilated intensive care unit (ICU) Patients to determine the effectiveness of a multimodal educational and electronic health record order panel intervention in limiting occult hypoxaemia and hyperoxaemia in patients receiving invasive mechanical ventilation by targeting a prespecified oxygen saturation (SpO2 90%–96%) range.
This trial is a pragmatic electronic health record-embedded, multisite, cluster-randomised, stepped-wedge implementation of a multimodal educational and electronic health record order panel intervention aimed at achieving a standardised intermediate target range of SpO2 (90%–96%) or partial pressure of oxygen (PaO2 60–100 mm Hg) in mechanically ventilated adult patients admitted to the ICU across a 10 hospital health system that includes a large academic centre and smaller community hospitals.
The primary endpoint is ventilator-free days to day 30, defined as the number of days alive and not receiving support through invasive mechanical ventilation following the first initiation of invasive mechanical ventilation in a participating ICU during the hospitalisation. Secondary outcomes include a variety of clinical endpoints: hospital-free days to day 30, all-cause mortality to day 90, need for supplemental oxygen at discharge and incidence of occult hypoxaemia and hypoxaemia. We will analyse primary and secondary endpoints using a mixed effects modelling framework, with specific distributions chosen depending on the type of outcome (eg, binary, count, ordinal, time-to-event).
Research is performed under a waiver of informed consent for minimal-risk research, as approved by Colorado Multiple Institutional Review Board (24-0065). Results will be disseminated in peer-reviewed publications and at national and international conferences.
FreshRSS 