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To assess the relationship between the structural position of individuals within their village network and symptoms of depression and postpartum depression, among men and women.
Community-based, observational, cross-sectional study.
176 villages in the Copan region of Honduras.
Village residents, comprising 25 605 adults surveyed in a census-based study; using data collected between October 2015 and December 2019.
Symptoms of depression and postpartum depression, among men and women.
Across all participants, 34.99% reported depression symptoms (40.50% for women and 27.62% for men). Among recent parents with a new child in the last 6 months, 28.89% reported postpartum depression symptoms (31.29% for women and 24.31% for men). Women with higher social intransitivity (ie, a greater proportion of friend-pairs among their friends that were not themselves connected) had higher odds of depression symptoms (OR=1.27, 95% CI 1.14 to 1.41), an association not found for men nor in postpartum parents. Because this coefficient is estimated on a 0–1 scale, it corresponds to approximately 2.4% higher odds of depression per 10 percentage-point increase in social intransitivity. In a signed-network decomposition that also included adversarial ties, only the proportion of incomplete/no-tie friend-pairs was associated with depression in women (OR=1.03, 95% CI 1.01 to 1.04), corresponding to approximately 3% higher odds of depression per 10 percentage-point increase.
We report that structural social network position and connectedness beyond dyadic ties, including the friendships and adversarial ties of a person’s friends, are associated with depression. These findings highlight the importance of linking psychological health to broader social connections in the context of face-to-face relationships.
To analyse the completeness of the COVID-19 vaccination schedule and identify factors associated with vaccine uptake.
Cross-sectional study.
Data were collected through face-to-face interviews conducted in all 26 Brazilian state capitals and the Federal District between 2022 and 2023, using a sequential sampling approach.
A total of 1392 individuals aged 18 years or older experiencing homelessness for at least 6 months were included.
The primary outcome was the completeness of the COVID-19 vaccination schedule (complete vs incomplete), based on self-reported vaccination status. Secondary analyses examined sociodemographic, institutional and behavioural factors associated with vaccine uptake using binary logistic regression.
Completion of the vaccination schedule was positively associated with receiving government aid (OR: 1.58; 95% CI 1.09 to 2.30), visits from street clinic health agents (OR: 3.19; 95% CI 1.95 to 5.36), prior COVID-19 diagnosis (OR: 5.77; 95% CI 3.17 to 11.15), support for mandatory vaccination (OR: 3.76; 95% CI 2.48 to 5.76), trust in vaccine efficacy (OR: 3.92; 95% CI 2.63 to 5.89), seeking information from community sources (OR: 1.91; 95% CI 1.01 to 3.88) and trust in federal authorities (OR: 1.57; 95% CI 1.06 to 2.31).
This study identified structural, social and individual factors associated with complete COVID-19 vaccination among people experiencing homelessness in Brazil. Although overall coverage was substantial, gaps in vaccination completeness persisted. Social support, healthcare outreach and trust in vaccines were associated with higher uptake, highlighting important barriers and facilitators to vaccination in socially vulnerable populations.
Poststroke depression (PSD) affects approximately 33% of stroke survivors and is associated with worse outcomes, poor quality of life (QOL) and mortality. Despite its prevalence and consequences, there is no consensus on the most effective strategy for PSD prevention. Behavioural activation (BA) is an effective intervention for depression across diverse populations and is considered safer, better tolerated and a longer-lasting alternative to antidepressant medications. This study aims to test the effectiveness of a remotely delivered BA intervention to prevent PSD (Tele-BA-S).
We will conduct a randomised effectiveness trial of 350 low-income adults (≥ 55 years) within 3 months of ischaemic or haemorrhagic stroke and with subthreshold depression (Patient Health Questionnaire-9 score
Ethical approval was obtained by the University of Texas Health Science Center at Houston’s (UTHealth Houston) Committee for the Protection of Human Subjects Institutional Review Board. The trial protocol, statistical analysis plan and code, and deidentified participant data will be made available via the National Institute of Mental Health Data Archive. The results will be presented at academic conferences and submitted for publication. The authors declare that they have no conflicts of interest relevant to the content of this manuscript.
by Patricia Fiorino, Luigi Fernandes Rosa Cauduro, Danielle Silberspitz Konig, Leonardo Fernandes Rosa Cauduro, Caio de Araujo Santos, Juliana Alves Kavai, Isadora Durigan Duarte, Anna Laura Viacava Américo
Zebrafish (Danio rerio) are widely used as models in cardiovascular research due to their rapid development, optical transparency, and genetic similarity to humans. However, the lack of standardized experimental conditions, particularly regarding developmental stage and microenvironmental parameters, limits reproducibility across studies. This study aimed to characterize cardiovascular function in Zebrafish larvae and evaluate the impact of developmental stage and environmental factors. Wild-type AB embryos were maintained under standard conditions, and heart rate (HR), cardiac output (CO), and ejection fraction (EF) were measured at 24, 30, 48, 52, 56, 72, 78, and 80 hours post-fertilization (hpf). The effects of variations in temperature (27.0, 27.5, and 28.0 °C) and pH (7.0, 7.4, and 8.0) were also assessed. Results showed a progressive increase in HR from 24 to 72 hpf, stabilizing thereafter. CO exhibited two phases of elevation: an early rise between 24–48 hpf and a stronger increase between 48–56 hpf. EF remained generally stable, with a transient reduction at 48 hpf. Cardiovascular performance reached a physiologically stable state after 72 hpf, defining a reliable window for functional studies. Environmental conditions modulated these parameters: temperature variation induced approximately 20% difference in HR and reduced EF, while CO was minimally affected. In contrast, pH variations within the physiological range had no significant impact on HR, CO, or EF. These findings highlight developmental and environmental variables that may influence cardiovascular measurements in Zebrafish larvae and support the development of more consistent experimental approaches in cardiovascular and toxicological research.Primary progressive aphasia (PPA) is a neurodegenerative syndrome associated with Alzheimer’s disease and frontotemporal degeneration. Non-invasive brain stimulation (NIBS) is a promising treatment, especially associated with language therapy, but comparative efficacy and long-term effects between the different techniques (transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS)) remain unknown. The present study aims to investigate the effects of non-invasive brain stimulation, alone or associated (tDCS/TMS/tDCS plus TMS) combined with language therapy delivered during a period of 6 months, in the progression of language impairment in PPA, compared with sham stimulation combined with language therapy.
The study is a randomised, double-blinded, parallel, sham-controlled clinical trial. Patients with PPA in early stages (global Clinical Dementia Rating equal to or less than 1) are eligible. They are to be randomised to one of the four treatment arms of the study (active tDCS-active TMS, active tDCS-sham TMS, sham tDCS-active TMS, sham tDCS-sham TMS). All patients will receive language therapy immediately after each session of NIBS, for 6 months. The primary outcome is the Mini-Linguistic State Examination. The secondary outcomes are naming of trained items, Addenbrooke’s Cognitive Examination, Interview for Deterioration in Daily Living Activities, Clinical Dementia Rating including behaviour and language domains, Neuropsychiatric Inventory and regional brain metabolism. Exploratory substudies will be conducted including blood biomarkers, quantitative electroencephalography and spontaneous speech assessment.
The study is registered (ClinicalTrials.gov: NCT07158216) and approved by the Ethics Committee of the Hospital Clinico San Carlos (code 25/309-IC_P_CE). Patients will be enrolled after signing an informed consent form. Study outcomes will be disseminated through presentations at scientific conferences, publications in peer-reviewed journals and other academic forums.
To examine and map the available literature on outcomes associated with interventions carried out by advanced practice nurses in chronic wound care.
The role of the advanced practice nurses in wound care is identified as a key element in the management of patients with chronic wounds. However, the literature offers fragmented knowledge of the outcomes associated with their practice.
Scoping review.
This scoping review was conducted following the methodological framework proposed by Arskey and O'Malley, following the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review. PRISMA-ScR Checklist is included in the manuscript. Observational or experimental studies related to patients affected by chronic wounds and cared for by advanced practice nurses in wound care were included.
The following databases were queried: PubMed, CINAHL, Cochrane Library, and Scopus from 01 May 2025 to 31 October 2025.
The search strategy in the consulted databases identified 1956 studies; 31 met the inclusion criteria. Different types of chronic wounds were investigated: diabetic foot ulcers, venous leg ulcers, and pressure injuries. The most frequently measured outcomes were clinical responses (healing, recurrence, complications), organizational efficiency (referrals, resource utilization), and patient-reported outcomes.
Evidence from the included studies suggests that Advanced practice nurses led wound care models may be associated with faster healing, lower recurrence and complication rates, and more efficient care pathways, across different settings. This review highlights the global applicability of APN-led models, showing consistent improvements in clinical, organizational, and patient-reported outcomes through core interventions.
This scoping review follows Arskey and O'Malley's methodological framework and the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review.
No Patient or Public Contribution.
The revision protocol was registered on the OSF (https://doi.org/10.17605/OSF.IO/P9TA4).
Adolescents experiencing emotional distress are at increased risk of developing mental health problems, which can negatively impact their academic performance, social relationships and long-term well-being. Schools provide a key setting for implementing preventive interventions that promote emotional and psychological resilience. This study presents the protocol for a randomised controlled trial designed to evaluate the effectiveness of a multicomponent, school-based intervention grounded in emotional intelligence (EI) in improving mental well-being, EI levels and resilience among adolescents aged 14–16 years experiencing emotional distress.
The trial will be conducted in public and publicly funded secondary schools in Terrassa, Spain, during the 2025–2026 academic year. Eligible participants will be identified using the short version of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). The intervention consists of nine 55-minute group sessions delivered during school hours by a nurse and a physiotherapist, supported by the school’s psychopedagogue. Sessions focus on emotional regulation, self-esteem, mindfulness, assertiveness and other socio-emotional skills. Assessments will be conducted at baseline, postintervention and 24-week follow-up. The primary outcome is mental well-being (WEMWBS); secondary outcomes include EI (Trait Meta-Mood Scale-24 items) and resilience (Child and Youth Resilience Measure-32 items). It is anticipated that adolescents in the intervention group will show significantly greater improvements in mental well-being, emotional intelligence and resilience compared with the control group, with effects sustained at follow-up. This study will provide evidence on the effectiveness of a scalable, school-based intervention led by community health professionals. The programme could be integrated into educational and public health strategies to promote adolescent mental health and reduce emotional distress.
Approved by CEIm Consorci Sanitari de Terrassa (01-24-1CR-102). Low-risk study; predefined procedures are in place for participants at risk (eg, suicidal ideation, abuse) with referral pathways to health/social services. Findings will be disseminated via peer-reviewed publications, conferences and a plain-language summary to schools/stakeholders.
To map factors influencing nurses' engagement in clinical mentorship in nursing education and explore their interactions using network analysis.
Observational cross-sectional study employing an online survey from July 2024 to May 2025.
A total of 261 clinical mentors from healthcare institutions in Catalonia, Spain, completed the survey. Key variables included engagement in clinical mentorship (implication, motivation, satisfaction, compromise), perceived obstacles, ward manager support, emotional intelligence, emotional wellbeing, working and employment conditions. Data were analysed using regularized partial correlation network analyses. Centrality indices were calculated to determine the most influential variables within the network structure.
Motivation, ward manager support, and emotional intelligence emerged as the most central, interconnected drivers of engagement. Motivation showed positive associations with commitment and implication in the mentoring role and a negative association with perceived obstacles. Ward manager support was linked to emotional wellbeing and peer support, reflecting the importance of psychosocial resources. Emotional intelligence appeared to support motivation, work control, and satisfaction with the mentoring role. In contrast, professional experience and employment conditions showed limited influence within the network.
This study provides a comprehensive understanding of how multiple factors interact to shape nurses' engagement in clinical mentorship. Motivation, ward manager support, and emotional intelligence represent key leverage points for strengthening mentorship practices.
Sustainable, high-quality clinical practicums require supportive work environments that recognize and foster mentors' intrinsic motivation, leadership support, and emotional skills.
Clinical mentors are essential to student learning, and so is their engagement in the mentoring role. This study is the first to apply network analysis to this process, revealing that motivation, emotional intelligence, and ward manager support are central to engagement, while professional experience and employment conditions are less relevant. These findings can guide institutional strategies to promote supportive and nurturing clinical learning environments.
The manuscript is based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the enablers of and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil.
A qualitative cross-country comparative study.
Nine focus groups were conducted: 4 in Brazil and 5 in Germany with 48 participants (23 primary health care policy stakeholders and 25 nurses practicing in primary health care and general practitioners) between May 2022 and June 2023. The data were analysed by content analysis using a deductive–inductive approach.
Our findings reveal a need for clarity around the concept, specific roles and responsibilities of advanced practice nurses in primary health care. Although there is still no regulation in place for practising advanced practice nursing in either country, clear drivers can be observed, with Germany strengthening community health nursing and Brazil following clinical protocols in nursing practice. Dialogue among stakeholders—at both the policy and practitioner levels—is essential to bridge communication gaps. Additionally, involving patients in the implementation process is crucial for the holistic integration of advanced nursing roles.
Political, organisational and financial barriers persist, such as the need to establish both legal foundations and regulatory frameworks, enhance political participation within the nursing profession, and involve stakeholders in dialogue and consensus-building efforts. Giving advanced practice nursing a higher priority on political and research agendas—with policy adjustments and input from practitioners—can help integrate advanced practice nursing into primary health care.
Our findings highlight that actively involving nursing as an equal partner in political discourse is seen by stakeholders as crucial to drive the implementation process forward sustainably.
This study addresses the lack of data on the enablers and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil. It underscores the need for clearer definitions of advanced practice nursing in primary health care, as well as sufficient regulation and funding. Dialogue is essential to bridge gaps and foster mutual understanding. The findings support future practice development and research, especially in countries that have introduced advanced nursing practice roles in primary health care.
The COnsolidated criteria for REporting Qualitative research (COREQ).
No involvement of patient and public contribution.
Our study highlights the growing adoption of expanded nursing responsibilities even in countries that have not yet formally implemented advanced practice nursing roles.
To conduct a concept analysis of ‘safe mobility’, with specific application in hospitalised older adults, identifying its defining attributes, antecedents and consequences.
The promotion of safe mobility is essential for maintaining the functionality of hospitalised older adults. However, this idea is not yet clearly defined in the scientific literature, requiring a conceptual analysis for better understanding and applicability in nursing practice.
Concept analysis.
The concept analysis methodology of Walker and Avant was employed, consisting of eight steps. Sources from the scientific literature (BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Thesis and Dissertation Catalogue, as outlined in a scoping review previously published by the authors) and terminologies from dictionaries and nursing practice, such as SNOMED CT, ICNP, NANDA, NIC and NOC, were analysed.
The concept of ‘safe mobility’ does not have a consolidated definition but was identified through three defining attributes: active movement, prevention of fall-related harm and prevention of immobility-related harm. The antecedents include the older adults' conditions, adaptation of the hospital environment, training of the multidisciplinary team, patient behaviour and family involvement. The consequences involve the maintenance of functionality, improvement of quality of life, reduction of hospital length of stay and costs, as well as a decrease in rates of readmission, referrals to long-term care institutions and mortality.
The concept analysis revealed that safe mobility involves promoting active movement and preventing harm related to both immobility and falls.
Strategies based on this concept can improve the quality of life of older adults, reduce complications and optimise hospital costs.
This concept analysis examines existing literature and does not require patient-related data collection. The methodological approach does not necessitate collaboration with the public.
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
Virtual reality-reminiscence therapy (VR-RT) has increasingly been applied to older adults to improve psychological well-being and cognition.
This review aims to identify (1) the design characteristics of conducting a VR-RT and (2) the effects of VR-RT on the user experience, cognitive outcomes and psychological well-being.
Systematic review.
Eligible studies were sourced across nine electronic databases, trial registries, grey literature and hand-searching of the reference list. A narrative synthesis was conducted. Twenty-two studies were included, and most were appraised as high quality. Most of the VR-RTs were highly immersive and personalised, with participants having the autonomy of control. VR-RT has the potential to improve anxiety and depression, and cognitive outcomes for older adults. Overall, VR-RT was reported to be an enjoyable experience for older adults.
VR-RT is a promising innovation that can improve older adults' psychological well-being and cognition without significant side effects, including cybersickness and with the potential for scalability across various settings. More randomised controlled studies are needed to evaluate the effectiveness of VR-RT and its features and treatment dosage. These studies could also examine the effectiveness of VR-RT as an intervention to promote independence in activities of daily living and physical rehabilitation.
VR-RT is a promising intervention for older adults in community settings to enhance psychological well-being and cognition. VR's versatility enables personalised experiences within dynamic virtual environments, possibly enhancing engagement and therapeutic outcomes.
This systematic review did not directly involve patient or public contribution to the manuscript.
by Víctor Herrera, María Consuelo Miranda, Anyela Lozano-Parra, Diana Niño, Luis Ángel Villar, Rosa Margarita Gélvez Ramírez, Thomas Jaenisch, Laura Pezzi, Claudia Acevedo, Jürg Niederbacher
BackgroundZika virus (ZIKV) infection has been inconsistently associated with neurodevelopmental delay (ND). We aimed to compare the incidence of ND between ZIKV-exposed and ZIKV-unexposed children within the ZIKAlliance (ZA) cohort, in Colombia, assessed 2 years after birth (2018–2021).
MethodsWe performed a neurodevelopmental evaluation on normocephalic children (aged 40–72 months) from the ZIKAlliance cohort. Children were classified as ZIKV-exposed (maternal positive RT-qPCR or virus neutralization test – VNT) or unexposed (maternal negative IgG ELISA or VNT in paired antenatal samples). A trained psychologist, blinded to exposure status, administered the Denver Developmental Screening Test II (DDST-II). Children were considered at ND risk if they presented ≥1 delay or ≥2 cautions in one or more areas, within their age range in the DDST-II scale. Inconclusive initial tests were re-evaluated. Adjusted odds ratios were estimated using logistic regression.
ResultsWe analyzed conclusive DDST-II results from 153 children (mean age: 4.7 years; 53.8% male). Overall, 57.2% (n = 83) were classified as cases of ND. Children with ND were more likely to be male (61.4% versus 43.5%) and less likely to attend daycare or school (42.2% versus 11.3%) than children with normal development. After adjusting for child age, sex, household size, and education, the association between in utero ZIKV exposure and ND was not statistically significant (OR = 0.71; 95% CI: 0.32–1.59, p = 0.320). However, children attending daycare or school had a significantly lower risk of ND compared to those who stayed at home.
ConclusionsPrenatal ZIKV exposure was not associated with ND in this cohort of normocephalic preschool children. Instead, attending a community daycare or school emerged as a significant protective factor against developmental delays.
by Tadgh Connery, Sofija Kukulite, Conor Farrell, Rosa Horgan, Karen Barry, Megan Doyle, Annalisa Setti, Mike Murphy
BackgroundDeath anxiety is fast becoming recognised as a transdiagnostic construct across myriad mental health conditions. Though existing clinical treatments of death anxiety, such as Cognitive Behaviour Therapy type interventions, have been shown to be effective, Terror Management Theory (TMT) proposes self-esteem as a protective factor against death anxiety by endowing individuals with a feeling of significance in life and helping them to process the nature of death and its inevitability. Despite the centrality of self-esteem to TMT, however, extant research examining its relationship with death anxiety has yet to be synthesised. The current study aims to systematically review peer-reviewed, quantitative research examining the association between death anxiety and self-esteem and, where possible, to test the strength of these associations through meta-analysis.
MethodA systematic search of quantitative and mixed-methods studies will be conducted across six databases: MEDLINE; PsycINFO; PubMed; Web of Science; CINAHL and; EMBASE. Google Scholar will also be searched and the first 200 records by relevance will be screened for eligibility. Searches will be conducted by TC, and records will be screened by TC, SK, CF, RH and KB, so that each record is screened for eligibility by at least two authors. Data extraction and quality assessment, using the Joanna Briggs Inventory Risk of Bias tools, will be performed by TC, SK, CF, RH and KB, so that each record is assessed by at least two authors, with doubts and discrepancies being resolved through discussion with AS and MM. A narrative synthesis of relevant data will be presented and, where sufficient data are available, meta-analysis will be conducted using the MAJOR extension for Jamovi to establish an overall effect size for the association between death anxiety and self-esteem. Should sufficient data be available, demographic factors, such as gender and age, and clinical population status (clinical vs. non-clinical population) will be examined as moderators of the effect. This protocol was developed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and has been registered in PROSPERO (CRD42024591775).
DiscussionThe current review will systematically examine the relationship between death anxiety and self-esteem. Should sufficient data be available, an overall effect size of the relationship will be generated. By better understanding how death anxiety is related to self-esteem, and by establishing the size and significance of the relationship will aid firstly in systematically validating TMT and, secondly, identify whether self-esteem may be targeted in future death anxiety interventions to reduce death anxiety and improve individuals’ overall mental health.
by Aino Kitayama, Yu-Tai Liu, Ai Shibata, Sayaka Kurosawa, Koichiro Oka
BackgroundChronic musculoskeletal pain is a significant symptom among workers. 24-hour movement behaviours comprising sleep, sedentary behaviour, light-intensity physical activity, and moderate-to-vigorous-intensity physical activity are associated factors. However, the relationships between these behaviours and workers’ chronic musculoskeletal pain, considering the interrelationship between the behaviours, are still unclear. This study aimed to investigate the associations of 24-hour movement behaviours with workers’ low-back and neck/shoulder pain.
MethodsIn 2023, cross-sectional survey was conducted targeting adults who registered for a Japanese Internet survey system. Time for 24-hour movement behaviours and other demographic characteristics (age, gender, marital status, education, household income, height, weight, smoking, alcohol, chronic disease, work hours, and job activity) were self-reported. The intensity of low-back and neck/shoulder pain was evaluated using the numerical rating scale and a score of ≥4 was considered as moderate-to-severe pain. Compositional logistic regression and isotemporal substitution were performed to examine the associations of 24-hour movement behaviours and time reallocations between the behaviours with moderate-to-severe low-back and neck/shoulder pain, adjusted for all the demographic variables.
Results1,665 full-time workers (women: 35.8%, mean age: 42.1 ± 10.2 years) were analysed. Increased sleep and decreased light-intensity or moderate-to-vigorous-intensity physical activity were associated with lower odds of moderate-to-severe low-back (adjusted odds ratio [AOR] = 0.54, 95% confidence interval [CI] = 0.40–0.72; 1.45, 1.25–1.69; 1.17, 1.06–1.30, respectively) and neck/shoulder pain (AOR = 0.60, 95% CI = 0.45–0.80; 1.37, 1.19–1.60; 1.12, 1.01–1.24, respectively). Reallocating sleep from the other behaviours was associated with decreased probabilities of low-back and neck/shoulder pain, whereas replacing sedentary behaviour or light-intensity physical activity with more intense activity was associated with increased probabilities. However, the results of moderate-to-vigorous-intensity physical activity reallocation were no longer significant when restricted to complete cases.
ConclusionsConsidering the interrelationship of 24-hour movement behaviours, sleep was favourably associated with workers’ low-back and neck/shoulder pain.
To estimate the proportion of Italian nurse managers (NMs) intending to leave (ITL) their positions and to identify associated socio-demographic, job-related, and psychosocial factors.
Cross-sectional study.
Between September and November 2023, 464 NMs from 19 public hospitals completed a case-report form and the short version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II). Latent Class Analysis (LCA) identified ITL profiles, and multiple logistic regression assessed factors associated with ITL.
284 NMs (61.2%; 95% CI 57–66) reported an intention to leave within 12 months. LCA identified two classes: (1) Low-ITL (54%)—mainly outpatient NMs from Central regions with strong relationships with management, good support, work–life balance, and autonomy (55.9% probability of being unlikely to leave). (2) High-ITL (46%)—mainly surgical or critical-care NMs, often from Northern regions, marked by poor management relations, low support and high work–family conflict (80.9% probability of being likely to leave). Multiple regression confirmed that stronger management relations reduced ITL (OR 0.60, 95% CI 0.46–0.79) whereas high job demands and work–health conflict increased it (OR 1.56, 95% CI 1.19–2.04). Northern location also predicted higher ITL (OR 1.58, 95% CI 1.03–2.44). Demographics, education, and clinical setting were not significantly associated.
These findings suggest that healthcare organizations should prioritize managerial and organizational strategies targeting modifiable work-related factors to reduce nurse managers' intention to leave. Interventions aimed at improving organizational support, work environment, and job satisfaction may contribute to workforce retention at the managerial level. Future research should evaluate the effectiveness of targeted organizational interventions in sustaining nurse manager retention.
The clinical practicum is a critical component of nursing education. In Spain, it is currently facing systemic challenges that compromise its quality and sustainability. A persistent nursing shortage, combined with increasing pressure on healthcare systems and a growing number of students intended to address this gap, is adding strain to clinical learning environments, which may compromise the capacity of nurses to provide adequate supervision and meaningful learning experiences for nursing students. This not only diminishes the quality of the training experiences, but also negatively affects the well-being of both students and nurses, further worsening the situation. This protocol outlines a study aimed at conducting an in-depth analysis of the current challenges affecting the clinical practicum and proposing a new model that effectively addresses them, with significant potential for adaptation and implementation across different health education fields and geographical locations.
The study will employ a sequential mixed-methods design comprising two integrated phases. In phase I, quantitative, qualitative and scoping review methodologies will be combined to identify current challenges and opportunities. Quantitative data will be obtained by administering questionnaires to nursing students and clinical mentors (CMs) tutoring them in Catalonia, examining potential barriers and facilitators to their mentoring role. Data will be analysed through descriptive and inferential statistics. Qualitative data will emerge from semistructured interviews with CMs and nurse coordinators, as well as from a visual elicitation technique, the ‘Emojional’ Calendar, conducted with students to understand their clinical practicum experiences. These will be analysed through an inductive thematic analysis approach. The scoping review, following the Arksey and O’Malley framework, will identify best practices in clinical practicums in nursing and other health studies globally. Phase II will involve a three-round qualitative Delphi study in which all preceding results will be presented to stakeholders and decision makers in order to redesign the clinical practicum model.
Ethical approval for this study was obtained from Hospital del Mar Clinical Research Ethics Committee (Ref #2023/11123). Results will be disseminated through peer-reviewed journals and conference presentations, as well as via strategic actions (forums and meetings with healthcare managers, deans and policymakers) and general outreach (talks, social media and websites) targeted at professionals, students and the public.
La Estrategia Española de Salud Global 2025-2030 y la Enfermería Familiar y Comunitaria comparten un objetivo común: garantizar una atención sanitaria integral, equitativa y sostenible. Desde la promoción de la salud hasta la respuesta ante emergencias sanitarias, la enfermería comunitaria es un pilar fundamental en la transformación del sistema de salud en España y en la consolidación de un modelo de atención centrado en la persona y la comunidad.
La inversión en enfermería comunitaria no solo fortalece los sistemas sanitarios, sino que contribuye a una sociedad más justa, saludable y resiliente ante los desafíos globales.
Objetivo. Evaluar si existe asociación entre depresión y ansiedad con el rendimiento académico en estudiantes de enfermería de la Universidad Villasunción, Aguascalientes, México. Metodología. Estudio cuantitativo, observacional, descriptivo-correlacional y de corte transversal. La población estuvo conformada por 273 estudiantes de la Licenciatura en Enfermería. Se seleccionó una muestra de 161 participantes mediante muestreo estratificado. Para evaluar la depresión se utilizó el Inventario de Depresión de Beck II (BDI-II) y para ansiedad el Inventario de Ansiedad de Beck (BAI). El rendimiento académico se obtuvo a partir del promedio general acumulado. Los datos se analizaron mediante estadística descriptiva y prueba de chi-cuadrado de Pearson utilizando SPSS versión 27, con un nivel de significancia de p ≤ 0.05. Resultados. El 54.7% de los estudiantes presentó niveles mínimos de depresión, mientras que el 16.1% reportó niveles graves. En cuanto a la ansiedad, el 30.4% mostró niveles mínimos y el 20.5% niveles graves. El rendimiento académico predominante fue “Bueno” (59%). Mediante la prueba de chi-cuadrado de Pearson se identificó una asociación estadísticamente significativa entre depresión y rendimiento académico (p= 0.030). En contraste, la ansiedad no mostró una asociación significativa con el rendimiento académico (p= 0.506). Discusión. La depresión se asocia significativamente con el rendimiento académico en estudiantes de enfermería, lo que evidencia la importancia de considerar la salud mental como un factor relevante en el desempeño académico universitario.
ABSTRACT
Objective. To evaluate whether there is an association between depression and anxiety and academic performance among nursing students at Universidad Villasunción in Aguascalientes, Mexico. Methodology. A quantitative, observational, descriptive-correlational, cross-sectional study was conducted. The population consisted of 273 undergraduate nursing students. A sample of 161 participants was selected using stratified sampling. Depression was assessed using the Beck Depression Inventory II (BDI-II), and anxiety was measured using the Beck Anxiety Inventory (BAI). Academic performance was obtained from the students’ cumulative grade point average. Data were analyzed using descriptive statistics and Pearson’s chi-square test with SPSS version 27, considering a significance level of p ≤ 0.05. Results. A total of 54.7% of students presented minimal levels of depression, while 16.1% reported severe levels. Regarding anxiety, 30.4% showed minimal levels and 20.5% severe levels. The predominant academic performance category was “Good” (59%). Pearson’s chi-square test identified a statistically significant association between depression and academic performance (p = 0.030). In contrast, anxiety did not show a significant association with academic performance (p = 0.506). Discussion. Depression is significantly associated with academic performance among nursing students, highlighting the importance of considering mental health as a relevant factor in university academic outcomes.
To critically examine the policy logic of the EU-funded WHO Nursing Action Initiative and assess its capacity to address the structural drivers of Europe's nursing workforce instability, with a specific focus on retention governance as the missing determinant of sustainability.
Although Europe reports high aggregate numbers of nurses, persistent workforce shortages are driven not by insufficient supply but by systemic governance weaknesses that undermine retention. The Nursing Action Initiative provides the first coordinated, multi-country framework aligned with the WHO's 2023–2030 strategic priorities, yet several structural gaps, including the absence of binding retention metrics, enforceable safe staffing standards, harmonized advanced practice pathways, interoperable workforce intelligence, and mandatory accountability, limit its transformative potential. A shift from production-centric policies to a retention-driven governance architecture is therefore essential.
The Nursing Action Initiative represents an important step toward strengthening European nursing workforce policy, but its success will depend on Member States' willingness to implement structural reforms that ensure safe staffing, protect nurses' well-being, expand autonomous practice roles, and stabilize workforce distribution. Without a robust architecture of retention governance, neither the sustainability of Europe's nursing workforce nor the resilience of its health systems can be assured.
This commentary advances the policy debate by framing retention as the central determinant of workforce sustainability. It calls for urgent political commitment to move the Nursing Action Initiative beyond aspirational coordination and toward enforceable, system-level reform capable of delivering lasting improvements in workforce stability and quality of care across the European Union.
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