Conectar
by Deye Ge, Liyan Wu, Jingrong Yang, Jingxian Sun, Jinying Wang, Jingxin Wang, Huihui Song, Ran Wei, Zecheng Xu, Binbin Zhao, Rongfei Sun, Yifei Wang
The U.S. Food and Drug Administration (FDA) approved intravenous edaravone for the treatment of amyotrophic lateral sclerosis (ALS) in 2017, followed by the approval of the oral formulation in 2022. This study aims to utilize the FDA#39;s Adverse Event Reporting System (FAERS) to investigate the spectrum and timing of adverse events (AEs) associated with edaravone administration, employing repeatability analysis, the Reporting Odds Ratio (ROR) approach, Weibull distribution, and stratification methods. The investigation focuses on data collected from the first quarter of 2017 through the fourth quarter of 2024, aiming to identify adverse event signals and their temporal patterns related to both intravenous and oral edaravone administration. In total, 3,262 records of edaravone-related adverse reactions were identified; among these, 1,534 incidents were associated with intravenous administration, while 453 incidents pertained to oral administration. The analysis revealed distinct adverse reaction profiles for the two routes of administration. Notably, the spectrum of adverse reactions resulting from oral administration predominantly involved the respiratory system, digestive system, and skin damage. In contrast, intravenous administration was more frequently linked to complications associated with invasive procedures and local tissue damage. Furthermore, the timing of adverse reactions exhibited significant variability between the two routes. Weibull distribution analysis indicated that the median onset time for adverse reactions following intravenous administration was 35 days, whereas for oral administration, it was 27 days. Both analytical approaches identified early failure signals, suggesting that the risk of adverse events diminishes over time.by Meirong Shan, Qian Guo, Ruofei Li, Ni Li, Yanhua Fu, Huanyu Qi, Ge Zhang, Qian Wang, Xingli Xu, Jinchuan Lai
Hypertension is one of the main causes of cardiovascular diseases worldwide, affecting over one billion people. Although aliskiren offers a valuable option for inhibiting the renin-angiotensin system, its safety profile in the real world remains insufficiently explored, especially for rare or under-recognized adverse events (AEs), which have not been fully clarified. Therefore, leveraging large-scale post-marketing surveillance data is crucial for identifying rare AEs and guiding safer clinical practice. This study aims to elucidate pharmacovigilance signals associated with aliskiren (an antihypertensive drug) by systematically analyzing the characteristics of adverse events (AEs) from the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database and WHO-VigiAccess database, which provides a reliable scientific basis for clinical practice and regulatory decision-making. We conducted a retrospective quantitative analysis of aliskiren-related AE reports from the aforementioned two databases, employing the Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS) algorithms for signal detection. The results indicate that there were 5,596 and 5,549 aliskiren-related reports in the FAERS and WHO-VigiAccess databases, respectively. The median duration of these AEs during the observation period was 62 days, with an interquartile range (IQR) of 7–282 days. In both databases, signals for aliskiren were distributed across 28 System Organ Classes (SOCs), among which investigations, cardiac disorders, renal and urinary disorders, vascular disorders, and metabolism and nutrition disorders exhibited significant signals based on specific criteria applied across the four algorithms. A total of 607 preferred terms (PTs) with significant disproportionality signals were detected using the four algorithms, including potential AEs not previously well-documented, such as palpitations, myalgia, proteinuria, muscular weakness, pulmonary edema, and pollakiuria. This study not only confirms the known adverse reactions of aliskiren but also uncovers new potential risks, highlighting the importance of strengthening drug safety monitoring to enhance therapeutic efficacy and reduce the risk of adverse reactions. It provides valuable safety insights for physicians considering the use of aliskiren in the management of primary hypertension.To compare the effectiveness of multifactorial and exercise programs in preventing falls among older adults, with a specific focus on evaluating the individual and combined contributions of their key intervention components.
This study was a systematic review and component network meta-analysis. PubMed, Embase, and Web of Science were searched from inception to February 2025 for randomized controlled trials, focusing on four primary outcomes: fallers, recurrent fallers, injurious fallers, and fractured fallers. Risk of bias was evaluated using the Cochrane tool, and additive component network meta-analysis compared intervention group and component efficacy.
69 randomized controlled studies were included. In multifactorial interventions, traditional health education could increase fall risk (iRR: 1.10, 95% CI [1.03; 1.67]) and recurrent fall risk (iRR: 1.25, 95% CI [1.06; 1.48]). Medication management can increase recurrent fall risk (iRR: 1.35, 95% CI [1.09; 1.67]) and fracture risk (iRR: 2.11, 95% CI [1.48; 3.00]). Exercise (iRR: 1.24, 95% CI [1.01; 1.53]) increased fracture risk, and environment modification (iRR: 0.56, 95% CI [0.61; 0.79]) reduced it. The additive effect of risk assessment and advice, exercise, and environment modification reduced fall risk. In exercise programs, gait and balance (iRR: 0.58, 95% CI [0.36; 0.93]) can reduce recurrent fall risk. An intervention containing two components (gait and balance + strength and resistance) reduced the risk of falls and fall-related injuries.
Environment modification reduced fracture risk, emphasizing the value of creating safe living spaces. The combination of risk assessment, advice, exercise, and environment modification reduced fall risk, suggesting a holistic approach may be effective in preventing falls. Traditional methods of health education and medication management are in urgent need of updating to synergize with other exercise components and enhance the effectiveness of fall prevention. Prospective clinical trials are needed to optimize combinations of exercise components, particularly integrating gait and balance training with strength and resistance exercises.
The review was registered online in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD42025643530)
Ensuring equity in medical specialist distribution is essential for achieving universal health coverage (UHC). This study explored the changes in the availability and distribution of medical specialists in Thailand from 2015 to 2024 and assessed the equity impacts on workforce.
A retrospective longitudinal analysis of national administrative workforce data.
Public and private hospitals across Thailand, covering 1471 facilities in 77 provinces.
The primary outcomes were specialist-to-population ratios and geographical equity measured using the Gini coefficient (G), where values closer to 0 indicate greater equity. Explanatory variables included specialty type, geographical region and the timing of major workforce policies, including mandatory service and specialty-specific legislative interventions.
Between 2015 and 2024, the GPs and specialists in Thailand expanded significantly, with improvements in both density and distribution. The Gini coefficient for GPs showed the largest equity improvement (G=0.42 in 2015 and G=0.22 in 2024), reflecting the impact of mandatory service programme and rural recruitment programmes. Among specialists, emergency and family medicine have shown rapid growth and significant reductions in distribution inequity, reflecting the success of legislative policies. Sustainability of workforce policies was challenged by the ‘leaking stock’ phenomenon due to attraction of career opportunities and economic drives.
Workforce targeted interventions have led to improvements in the availability and equitable distribution of GPs and medical specialists over the past decade. Further policy, such as retention incentives and assisted technology, is needed to achieve equitable distribution across all specialties, particularly in low-density fields. Thailand’s experience offers the lessons for other low- and middle-income countries as the evidence-based and equity-focused workforce policies for UHC advancement.
Turnover intention among nurses poses a significant threat to both workforce stability and the overall quality of healthcare delivery. However, few studies have comprehensively examined the associations between turnover intention and nurses' individual and team-level resources within a multilevel framework. Our study aims to provide an in-depth exploration of the relationship between turnover intention and nurses' individual and team-level resources.
The multicenter cross-sectional study adopted a stratified convenience sampling approach to enroll 773 clinical nurses from 62 teams across eight hospitals in Shandong Province, China.
We used the 10-item Connor-Davidson Resilience Scale for psychological resilience, the Perceived Social Support Scale for perceived social support, the 51-item Analyzing and Developing Adaptability and Performance in Teams to Enhance Resilience Scale for team resilience, and a single-item turnover intention measure. Multilevel logistic regression modeling was conducted to examine the simultaneous impacts of individual-level (psychological resilience and perceived social support) and team-level (team resilience) factors on turnover intention, while controlling for key demographic and organizational covariates.
The multilevel analysis revealed several key findings: (1) The prevalence of turnover intention reached 35.6%, indicating a substantial workforce stability challenge; (2) Multilevel modeling demonstrated significant between-team variance (ICC = 0.19), confirming the importance of examining nested data structures; (3) At the individual level, both psychological resilience (OR = 0.78, CI: 0.62–0.99) and perceived social support (OR = 0.75, CI: 0.60–0.94) showed significant negative associations with turnover intention; (4) At the team level, higher team resilience predicted lower turnover intention (OR = 0.73, CI: 0.56–0.94). These results were obtained after controlling for key demographic and organizational covariates, highlighting the robust protective effects of multilevel resources against nurses' turnover propensity.
The prevalence of turnover intention was relatively high in this study. Nurses with higher psychological resilience, perceived social support, and team resilience exhibited lower turnover intention. Healthcare administrators need to increase investments in nurses' multilevel resources to stabilize the nursing workforce and ensure the sustainability of the healthcare system.
Understanding the multi-level factors influencing nurses' turnover intention can help nursing managers develop targeted strategies from multiple perspectives in clinical settings, thereby reducing nurses' turnover intention.
Previous studies suggest Ireland has the smallest osteoporosis treatment in Europe and very little inappropriate prescribing, in contrast to our experience. In this study, we examine the osteoporosis treatment gap in Ireland by assessing the prevalence of appropriate and inappropriate prescribing in 2 subgroups of the Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) Project. Treatment eligibility was defined using established intervention thresholds, including prior fracture, femoral-neck T-score ≤–2.5, glucocorticoid use, or Fracture Risk Assessment Tool (FRAX) major osteoporotic fracture risk ≥20% or hip fracture risk ≥3%.
Secondary cross-sectional analysis of a subgroup of the DXA HIP Project Cohort.
3 hospitals in the West of Ireland. DXA referrals come from primary care providers, hospital consultants and the osteoporosis service.
5564 participants of a previously described convenience cohort including: (i) 3474 subjects referred for a DXA scan, and (ii) 2090 patients who completed a DXA scan.
82.4% were female with a mean age of 66.6 years, 59.6% of whom had a prior fracture. Prescribing data of calcium and vitamin D were available for 3738 (67.2%) subjects, and osteoporosis medication for 4157 (74.7%) subjects. Prescribing information was available for more than 99% of the DXA group, but just over 50% of the referral group. When examined in aggregate, the treatment gap is 6% for calcium and vitamin D and 38% for osteoporosis medication, in line with prior publications. However, among those with prescribing information and at least one indication for treatment, only 58.3% were prescribed calcium and vitamin D and 39.1% an osteoporosis medication. Furthermore, among patients without a clear indication for treatment, 50.6% were prescribed calcium and vitamin D, and 32.5% an osteoporosis medication.
These data suggest the majority of patients with osteoporosis or at high risk of fracture in Ireland today do not receive appropriate osteoporosis treatment, while inappropriate prescribing is substantial. These findings suggest that the true treatment gap in Ireland is substantially larger than aggregate estimates imply.
To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.
A quantitative, multicenter cross-sectional design.
A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.
Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789–2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327–2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233–1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182–1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439–0.712) and special patient experience (OR = 0.520, 95% CI: 0.406–0.666) were associated with reduced accuracy.
Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.
Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.
STROBE statement adherence.
No patient or public contribution.
Understanding the patient perspective is crucial for enhancing healthcare delivery and outcomes for chronic conditions like diabetic foot ulcers. This qualitative study examined the perspectives of patients with diabetic foot ulcers to inform clinical strategies for both physicians and current patients to enhance care and prevent lower extremity amputations. Fifteen patients with a history of diabetes and diabetic foot ulcers and/or amputations participated in semi-structured interviews which explored their lived experiences and advice for both physicians and fellow patients to improve diabetic foot ulcer related care. Interview transcriptions were analysed to identify recurring themes. Advice for physicians emphasised increasing patient education, initiating preventive foot care at the time of diabetes diagnosis, providing instructions for managing diabetic ulcers early and demonstrating empathetic bedside manner. Advice for fellow patients focused on adopting healthy lifestyle practices, regular foot self-examinations, consistent blood glucose monitoring, medication adherence and seeking prompt medical attention for new or worsening foot lesions. Participants also stressed the importance of routine check-ups with providers to support prevention and management efforts. This qualitative study highlights the value of incorporating patient perspectives to improve our understanding of diabetic foot ulcer onset, care and outcomes and thereby reduce the risk of lower extremity complications.
Mindfulness-Based Interventions (MBIs) have gained traction in various healthcare settings, particularly for stress reduction among healthcare professionals. This meta-analysis aimed to evaluate the effectiveness of MBIs on reducing stress and depression in obstetrical nurses.
A comprehensive literature search was done across multiple databases, including Cochrane Library, PsycINFO/PsycNet, PubMed/MEDLINE, Web of Science, and Google Scholar. The risk of bias for each included study was assessed using the Cochrane Risk of Bias Tool. Subgroup analyses were done according to intervention time (less than 8 weeks, 8 weeks, more than 8 weeks) and population. Meta-analysis was done using random-effects models. Effect sizes were calculated using standardized mean differences (SMD). Heterogeneity was assessed using the I 2 statistic.
The sample size in 55 studies was 4612 nurses and midwives (2904 in the intervention group and 1708 in the control group). The meta-analysis showed a significant overall effect of MBIs on reducing stress levels (SMD = −0.71; 95% CI [−0.97, −0.44]; p < 0.001), and depression (SMD = −0.74; 95% CI [−1.35, −0.13]; p < 0.001) among midwives and nurses. Subgroup analysis showed that the effects of intervention duration on reducing stress (X 2 = 3.01, p = 0.220) was not significant, but its effect on depression (X 2 = 61.46, p = 0.000) was significant.
Healthcare organizations should integrate structured MBIs into staff wellness initiatives to promote mental well-being. Nursing education programs can include mindfulness components to strengthen coping skills. Future work should also examine combined mindfulness–CBT programs (e.g., MINDBODYSTRONG) and address organizational factors contributing to burnout for a more comprehensive approach.
by Peiling Zuo, Huanhuan Zhu, Chunying Sun, Xiaohan Ma, Sheng Chen, Rong Tang, Tong Wu, Ding Zhang, Xiao Tang, Wenquan Lv, Wenzhong Chen, Xiawei Wei, Encun Hou, Minsheng Wu, Minghe Jiang
BackgroundEvidence indicates that the Endothelial Activation and Stress Index (EASIX) is a predictor of mortality in endothelium-related conditions; however, its association with mortality risk in atrial fibrillation (AF) remains uncertain. Accordingly, this study examines the relationship between EASIX and mortality risk among patients with AF.
MethodsThis retrospective analysis utilized data from the Medical Information Marketplace in Intensive Care IV (MIMIC-IV) database, which includes critically ill patients diagnosed with AF. To examine the association between EASIX scores and mortality, Kaplan–Meier survival analysis, Cox proportional hazards models, and restricted cubic spline regression were applied to evaluate the relationship between EASIX and all-cause mortality. Subgroup analyses were conducted to explore potential interactions with key patient characteristics, and sensitivity analyses were performed to further confirm the robustness of the results.
ResultsA total of 3,193 patients were included in the analysis. KM survival analysis showed that elevated EASIX levels were associated with a higher risk of both in-hospital and ICU mortality. After adjusting for potential confounders, increased EASIX levels remained significantly associated with in-hospital mortality [HR, 1.09 (95% CI 1.03, 1.15), P = 0.0002] and ICU mortality [HR, 1.10 (95% CI 1.04, 1.17), P = 0.0002]. Stratified analyses revealed a significant interaction between sepsis, respiratory failure, and EASIX in relation to both in-hospital and ICU mortality. To evaluate the robustness of the findings, a sensitivity analysis was performed. After additionally adjusting for metoprolol and heparin as covariates, patients in the highest EASIX group continued to demonstrate the greatest mortality risk: the HR for in-hospital death was 2.08 (95% CI: 1.51–2.85), and the HR for ICU death was 1.83 (95% CI: 1.21–2.65).
ConclusionElevated EASIX levels correlate with higher mortality rates, underscoring its potential as an accessible tool for identifying high-risk patients and informing clinical decisions. However, further studies are needed to explore the underlying mechanisms and validate its applicability across diverse patient populations.
by Tanaporn Anosri, Soraya Kaewngam, Ram Prajit, Kornrawee Suwannakot, Nataya Sritawan, Anusara Aranarochana, Wanassanan Pannangrong, Jariya Umka Welbat, Peter Wigmore, Apiwat Sirichoat
Methotrexate (MTX) is used in treating several malignancies. However, MTX neurotoxicity remains a significant clinical side effect, leading to cell division malformation, and neurogenesis impairment. Chrysin, a flavonoid compound found in natural products, demonstrates various biological characteristics, including neuroprotective and antioxidant properties. The purpose of this study was to investigate the ameliorative effect of chrysin on oxidative damage and neurogenesis impairment caused by MTX. Male Sprague-Dawley rats were randomly divided into four groups, including the vehicle, MTX (75 mg/kg), chrysin (10 mg/kg), and chrysin+MTX groups. Chrysin was orally administered for 15 days. MTX was administered intravenously on days 8 and 15. The hippocampal neural stem cells were evaluated using sex determining region Y-box 2 (sox2) and nestin immunofluorescence staining. Antioxidant enzyme expression and the levels of oxidative stress marker were assessed. Additionally, the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2), brain-derived neurotrophic factor (BDNF), cAMP-response element binding (CREB), and phosphorylated CREB (pCREB) were evaluated using Western blotting. Results showed that MTX significantly decreased the activity of antioxidant enzymes and produced oxidative stress. MTX also impaired neurogenesis, evidenced by decreased sox2 and nestin-positive cells and decreased expression of Nrf2, BDNF, CREB, and pCREB in the hippocampus and prefrontal cortex. However, chrysin significantly reversed the effects of MTX on these parameters. In conclusion, chrysin exhibits neuroprotective effects against MTX-induced neurogenesis impairment by upregulating antioxidant enzyme activity, reducing oxidative stress, and improving protein expression related to neurogenesis.Labour companionship is a recommendation by WHO that health authorities enable women to choose a companion during labour to ensure a safe and dignified labour experience for the birthing woman. However, most healthcare facilities in low- and middle-income countries do not necessarily consider this maternal need, which hampers a positive maternal experience during labour.
This study aims to examine midwives' perception towards the involvement of male partners in labour companionship.
An exploratory phenomenological approach was chosen and semi-structured interviews were used for this study.
The four main themes identified in this study include ‘Understanding of male partners' involvement in labour companionship’, ‘Involvement of midwives in decision-making’, ‘Barriers to male partners' involvement in labour companionship’ and ‘Facilitators of male partners' involvement in labour companionship’.
This study found a lack of understanding among midwives of the significance of male partners' involvement in labour companionship; and the identification of hierarchical and authoritarian leadership as a barrier to midwives' participation in decision-making highlights the need for transformational leadership styles to empower midwives. Overall, the findings of this study can inform maternity care policy as well as resource development, education and professional training in the field of midwifery.
Temporary childbirth migration (TCM), where women return to their natal homes for pregnancy, delivery or postpartum for a limited duration, is a long-standing sociocultural practice in India. While often motivated by familial support and traditional norms, its implications for maternal and child health and health system engagement remain poorly understood. This study aims to quantify the impact of TCM on maternal and newborn outcomes and to explore how continuity of perinatal care and social support mediate these relationships.
We are conducting a three-site, community-based, prospective cohort study across the Health and Demographic Surveillance System sites of Vadu (Maharashtra), Sevagram (Maharashtra) and DEESHA (Delhi). A total of 3000 pregnant women will be enrolled in pregnancy (
This study has been approved by the Ethics committees at the KEM Hospital Research Centre Pune (KEMHRC/RVM/EC/1931), Society for Applied Studies (SAS/ERC/TCM Study/2024), Mahatma Gandhi Institute of Medical Sciences (MGIMS/lEC/COMMED/8412023) and University of California San Francisco (22-36484). All research activities are conducted in accordance with Indian Council of Medical Research Guidelines for biomedical research and the Declaration of Helsinki. On study completion, findings will be disseminated to diverse local, national and global stakeholders and published in academic journals.
CTRI/2024/02/062881.
To evaluate the research capability of clinical nurses in China and identify the determinants associated with their capability.
As nursing evolves into an increasingly independent discipline, the research capability of clinical nurses has become critical for the development of the profession, advancing evidence-based practice and improving patient care quality.
A multicentre cross-sectional survey was conducted using convenience sampling from September 2023 to February 2024, among clinical nurses in tertiary hospitals across three provinces in China. The Nursing Research Capability Self-Assessment Scale was used to assess the research capability of the nurses. Chi-square tests, one-way analysis of variance and multiple linear regression were used to examine factors associated with research capability. The Strengthening the Reporting of Observational Studies in Epidemiology was followed.
A total of 1074 clinical nurses participated. The mean research capability score was 89.11 ± 27.69, reflecting a moderate level of research capability. However, two dimensions of research questions and literature review received lower scores. Multiple linear regression analysis identified that education level, professional title, administrative position and nursing job title (all p < 0.05) were independent predictors of research capability.
Clinical nurses exhibit moderate research capability, with notable deficiencies in formulating research questions and conducting literature reviews. Key factors influencing research capability include education, professional title, administrative position, and job title. Targeted training and development programmes should address these factors to enhance nurses' research competence and advance nursing science.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
Thirst is the most common self-reported symptom in intensive care unit (ICU) patients. There is evidence that oral cooling interventions may alleviate thirst symptoms in ICU patients. However, the evidence needs to be critically evaluated.
To investigate the effect of oral cooling interventions on alleviating thirst symptoms of ICU patients and explore the effectiveness of different types of oral cooling by subgroup analysis.
The PubMed, Ovid Embase, the Cochrane Library, Wanfang Data and China National Knowledge Infrastructure databases were searched from inception to 29 October 2023. Randomised controlled trials (RCTs) that reported thirst intensity or thirst distress as outcomes were included. The certainty of the evidence was evaluated by the GRADE approach.
The meta-analysis comprised eight RCTs that included 813 ICU patients. The pooled analysis from eight RCTs showed that oral cooling interventions had significant beneficial effects on thirst intensity (weighted mean difference [WMD] = −2.73, 95% confidence interval [CI] = −3.62 to −1.85, p < 0.01; moderate certainty). The pooled analysis from four RCTs showed that oral cooling interventions could significantly lower the thirst distress scores (standardised mean difference = −0.80, 95% CI = −1.13 to −0.47, p < 0.01; low certainty). Subgroup analysis indicated that cold stimulation (WMD = −3.12) and cold combined with menthol stimulation (WMD = −1.72) could significantly lower the thirst intensity scores.
Oral cooling interventions including cold and menthol had beneficial effects on thirst intensity and thirst distress in ICU patients. The high heterogeneity in methods should be considered when interpreting the results.
This study provides references for the application of oral care strategy in the ICU care field, and encourages nurses to apply the oral cooling plan to improve patients' comfort.
This was a meta-analysis based on data from previous studies.
PROSPERO: CRD42023416059
The incidence of cancer continues to increase, and cancer patients still suffer from a range of burdens, leading to decreased quality of life. AI has been increasingly studied in the field of cancer care, demonstrating its enormous potential. However, most AI applications in cancer care are still in the developmental stage, and the strength of evidence from randomized controlled trials is not yet sufficient.
To evaluate the effects of AI-enhanced interventions in randomized controlled trials conducted in clinical settings and the impact of AI-enhanced interventions on the health outcomes of adult cancer patients.
Meta-analysis of randomized controlled trials.
Nine databases (MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Web of Science, CNKI, VIP, and Sinomed) were systematically searched, and metadata analysis was performed using R software and R Studio. The quality of the included studies was evaluated using the Cochrane Risk of Bias tool (RoB2) and the GRADE approach. The process was independently completed by two authors. The intervention effect was estimated by calculating the standardized mean difference (SMD) and 95% confidence interval (CI) using a random-effects model.
A total of ten articles were included. Meta-analysis results showed that AI-enhanced interventions can significantly improve the quality of life (SMD 0.89, 95% CI 0.06–1.73), symptom burden (SMD −0.81, 95% CI −1.44 to −0.18), anxiety (SMD −0.20, 95% CI −0.32 to −0.07), and self-efficacy (SMD 0.55, 95% CI 0.06 to 1.03) of cancer patients. The type of AI application and the duration of the intervention had an impact on the quality of life of cancer patients: the effect of algorithm recommendations (SMD 1.49, 95% CI 0.04–2.93) was better than that of risk alerts (SMD 0.33, 95% CI 0.03–0.63), and the effect of short-term interventions (< 3 months) (SMD 1.49, 95% CI 0.04–2.93) was better than that of long-term interventions (≥ 3 months) (SMD 0.19, 95% CI −0.04 to 0.43). Sensitivity analysis showed that the results of this study were stable and reliable.
AI-enhanced interventions are effective tools for improving patient outcomes. When integrating AI into clinical practice for cancer patients, priority should be given to the type of technology involved, ensuring its acceptability by enhancing perceived usefulness. AI technology should be adopted to relieve clinical nurses from documentation and low-complexity tasks, thereby addressing concerns about the loss of “humanistic care.” We recommend the formal integration of AI literacy frameworks, such as N.U.R.S.E.S., into nursing education and practice.
Trial Registration: PROSPERO (registration number: CRD420251040938).
FreshRSS 