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Prescription digital therapeutics (PDTx) represent an emerging frontier in healthcare, leveraging software-based solutions to treat or manage specific medical conditions. However, despite rising interest and encouraging evidence of clinical benefits, the policy landscape remains fragmented. Jurisdictions vary widely in their regulatory approaches, reimbursement pathways and processes for clinical integration, thus creating uncertainties for developers, payers and healthcare providers. This protocol outlines an eDelphi study to develop and validate a comprehensive policy maturity framework guiding systematic assessment of national or regional readiness for PDTx adoption.
We will conduct an e-Delphi study with up to three rounds to refine and validate a PDTx policy maturity framework. Experts will be recruited purposively from six stakeholder groups (regulators, healthcare providers, payers/health economists, developers, researchers and patient advocates), prioritising Europe while seeking variation across health system types and levels of economic development; a small number of non-European experts may be invited to broaden perspectives. An optional pilot round will gather initial feedback on the prototype framework, followed by iterative rounds to assess and revise domains, scoring criteria and maturity thresholds. A 5-point Likert scale (from ‘strongly disagree’ to ‘strongly agree’) will collect quantitative data, while open-text prompts will capture qualitative insights. Consensus will be defined as ≥70% agreement and/or an IQR ≤1 for critical items. Quantitative summaries and thematic analysis will guide iterative revisions of the model. This Delphi protocol aims to produce a consensus-driven framework that captures the essential elements of PDTx policy development and implementation. If validated, the framework can serve as a reference for policymakers, industry leaders, healthcare providers and researchers seeking to benchmark or advance the adoption of PDTx within health systems.
Ethical approval for this study was obtained from the Ethics Committee of the Faculty of Medicine of the University of Porto (reference: 320/CEFMUP/2025). Panellists will provide electronic informed consent, and data will be kept confidential. The finalised framework will be disseminated via peer-reviewed publications, conference presentations and policy briefs targeting stakeholders involved in digital health governance.
To explore how people perceive different forms of education for rotator cuff-related shoulder pain in terms of words or feelings evoked by the education and treatments they feel are needed.
We performed a content analysis of qualitative data collected in a randomised experiment.
2237 participants with rotator cuff-related shoulder pain were randomly assigned to receive three forms of education: best practice education, best practice education plus pain science messages and structure-focused education.
After receiving the education, participants answered two questions regarding (1) words or feelings evoked by the education and (2) treatments they felt were needed.
2232 responses for each question were analysed (99.7% response rate). Participants who received best practice education more frequently expressed feelings of unhappiness/frustration. The addition of pain science messages to best practice education resulted in slightly more emotional responses and a greater sense of being validated or cared for. In contrast, participants who received structure-focused education more frequently expressed trust in the clinician’s expertise and the need for medication, activity modification, rest, diagnostic imaging, injections and surgery. These participants also less frequently considered exercise as a viable treatment option.
Participants with rotator cuff-related shoulder pain expressed generally similar emotional responses across groups, with small differences in treatment preferences favouring self-management in the best practice education groups compared with those who received structure-focused education. Those in the best practice education also less frequently reported needing potentially unnecessary treatments (eg, imaging, injections and surgery).
Australia New Zealand Clinical Trials Registry (ACTRN12623000197639).
To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.
Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.
Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.
Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.
This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.
Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.
Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.
This review aims to map oral health plans, programmes and policies worldwide in countries with universal health coverage.
This protocol describes a scoping review that will follow the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review checklist, guided by the PCC framework: Population—countries with universal health coverage (78 globally recognised); Concept—oral health plans, programmes and policies; Context—integration into health systems. Searches will be conducted in MEDLINE (PubMed), Scopus, Web of Science, Embase, Health System Evidence and Epistemonikos, with no restrictions on date, language or study type. Grey literature will be accessed through Google Scholar, OpenThesis and the Brazilian Digital Library of Theses and Dissertations. Official documents from ministries of health and international bodies, including the WHO and the International Monetary Fund, will also be reviewed. Two independent reviewers will screen titles and abstracts; a third will resolve disagreements. Eligible records will undergo full-text review. Data will be extracted into predefined categories reflecting health system components: population, structure, services, governance and oral health indicators. Results will be presented using tables, charts and figures to illustrate strategies and innovations.
This review does not involve primary data collection and does not require ethical approval. Results will be disseminated through a peer-reviewed publication and presentations at academic conferences and scientific events.
Open Science Framework (DOI 10.17605/OSF.IO/RCP8N).
Adolescence and youth are periods of significant maturational changes, which seem to involve greater susceptibility to disruptive events in the brain, such as binge drinking (BD). This pattern—characterised by repeated episodes of alcohol intoxication—is of particular concern, as it has been associated with significant alterations in the developing brain. Recent evidence indicates that alcohol may also induce changes in gut microbiota composition and that such disturbances can lead to impairments in both brain function and behaviour. Moreover, there is evidence suggesting that microbiota-targeted interventions (psychobiotics) may help mitigate alcohol-induced damage in individuals with chronic alcohol use, positively influencing cognitive and brain functioning. However, the triadic relationship between BD, gut microbiota and brain structure/function, as well as the therapeutic potential of gut microbiota-targeted interventions in young binge drinkers, remains largely unexplored.
This double-blind, parallel, randomised controlled study aims to evaluate whether a BD pattern disrupts gut microbiota diversity in young college students (primary outcome). Additionally, it seeks to determine whether alcohol-induced alterations in the microbial composition and function are associated with immunological, cognitive, neurostructural and neurofunctional impairments (secondary outcomes). A total of 82 college students (36 non/low drinkers and 46 binge drinkers (BDs)), matched for age and sex, will be recruited from the University of Minho (Portugal). During the pre-intervention phase, all participants will undergo a comprehensive assessment protocol, including gut microbiota profiling, measurement of inflammatory markers, neuropsychological testing and structural and functional MRI. BDs will then be randomly assigned to a 6-week intervention with either a prebiotic (inulin) or a placebo (maltodextrin). Post-intervention assessment will mirror the baseline protocol, and craving and alcohol use will be monitored for 3 months.
The present protocol was approved by the Ethics Committee for Social and Human Sciences of the University of Minho (CEICSH 078/2022), ensuring compliance with national and international ethical guidelines, including the Declaration of Helsinki. Participation is voluntary and preceded by informed consent, with confidentiality and data processing safeguarded in accordance with the General Data Protection Regulation. All procedures are safe and non-invasive, and the prebiotics used are recognised as food ingredients in Europe, hold Generally Recognized as Safe status in the USA and are classified as dietary fibres by the Food and Drug Administration. Findings will be disseminated in national and international scientific forums, with preference for publication in open-access, peer-reviewed journals.
Approximately 25% of the Brazilian population suffers from mental disorders, a prevalence exacerbated by systemic and cultural factors such as socioeconomic inequalities, underfunded mental health services, regional disparities, and persistent stigma. These conditions significantly impact hospital care. Nurses, due to their direct contact with these patients, face challenges ranging from managing physical conditions to handling verbal aggression and psychiatric crises. This study aimed to assess the scientific evidence regarding nursing care for hospitalized patients with psychiatric disorders.
A systematic review with a mixed-methods approach was conducted, registered in PROSPERO (#CRD42022359288) and guided by PRISMA standards. Databases, such as MEDLINE, LILACS, PubMed, Web of Science, Scopus, and BDEnf, were searched using keywords like “Mental disorder,” “Psychiatric health,” “Nursing care,” and “Hospital.” Methodological quality was assessed using JBI and SQUIRE tools. The integration of quantitative and qualitative components occurred through meta-aggregation of qualitative data and frequency-based coding of quantitative themes, allowing thematic convergence across study designs.
Six studies were included. Meta-aggregation revealed frequent terms, such as “Nurse,” “Emergency,” “Screening,” “Patient,” and “Care.” Similarity analysis linked “Nurse” with “perception” and “experience” and “Emergency” with “Screening” and “Mental health,” highlighting the importance of experience and training. Five categories emerged: (1) professional experience (19.05%, showing skill gaps despite experience); (2) caring process (19.05%, stressing efficient screening); (3) barriers and challenges (19.05%, revealing difficulty with comorbidities); (4) training process (19.05%, identifying training deficiencies); and (5) therapeutic interventions (23.81%, discussing restraint use). These percentages refer to the proportional frequency of themes identified across the total number of studies analyzed. For thematic classification, only statistically significant chi-square values (p < 0.05) were considered in the grouping of content.
Nursing care for psychiatric patients in hospitals faces challenges like insufficient training and difficulty managing psychiatric comorbidities. Recommendations include incorporating structured mental health content into nursing curricula and hospital-based continuing education programs. These strategies may guide future healthcare policies in Brazil by improving patient safety, reducing hospital readmissions, and promoting more humane, evidence-based therapeutic interventions.
The findings emphasize the urgent need for targeted education and training to improve nursing care for psychiatric patients in hospital settings.
RESUMEN
Introducción: El cine moderno debuta en la década de 1940, contradiciendo la estética clásica en sus producciones y dando lugar a una reflexión sobre su validación como teoría artística. Así, esta investigación busca un acercamiento histórico-social a la enfermera religiosa retratada en la filmografía de Hollywood en este período. Objetivos: Describir y analizar el imaginario social sobre la representación de la enfermera religiosa retratada en la película “Uma Historia de una Monja”, de 1959, contextualizada en el período del cine moderno, considerando el contexto cultural, histórico y técnico. Metodología: Se trata de una investigación sociocultural cualitativa, analítica e histórica, sustentada en el marco teórico del "Imaginario Social" y el marco filosófico de la Teoría de los Valores, de Max Scheler, que tiene como objetivo refrendar el carácter emocional y racional de los religiosos. enfermera retratada en la película “Uma Historia de una Monja”, de 1959, desde una perspectiva modernista. Resultados: La enfermera religiosa asume la postura clerical en el cuidado como núcleo del cuidado caritativo. El cine llevó su narrativa emocional propensa al afecto cristiano, pero en la corriente moderna el racional actúa consciente de las limitaciones que le impone el dogma, interfiriendo en su ejercicio científico profesional. Conclusión: El lenguaje del cine nos permite transponer figuras verosímiles a sus narrativas bajo la tutela del imaginario social, la enfermera es una de ellas. En esta producción, la libertad ficcional analiza en formato visual sus valores morales en la sociedad actual, destacando el cine como un arte único por representar contextos atemporales de sus actores sociales.
Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.
Objetive: analizar las percepciones, motivaciones y dificultades de los técnicos de enfermería titulados en enfermería. Metodología: Me-todología: Se trata de una investigación cualitativa, exploratoria descriptiva, la recolección de datos se realizó en un Hospital Municipal del Noroeste de Paraná, durante el primer semestre de 2020, mediante la aplicación de un guión semiestructurado con preguntas orien-tadoras y un cuestionario sociodemográfico. Resultados: El conocimiento adquirido en la graduación de enfermería fue uno de los facto-res facilitadores que contribuyó a una mejor ejecución de la atención brindada, y la mayor dificultad está relacionada con la aceptación de los colegas y supervisores, en relación a las opiniones y sugerencias sobre los procedimientos u organización de la Servicio. Las razones que llevaron a los técnicos de enfermería a cursar una carrera en el área en la que trabajan se deben a la necesidad de cono-cimientos y la búsqueda de un mejor futuro financiero. Conclusión: cuando el profesional tiene un título, se desarrolla con mayor destreza y eficacia en la asistencia proporcionada.
Objetivo: caracterizar las producciones científicas sobre atención integral de salud, promovidas a través de políticas públicas para perso-nas que conviven con el Virus de Inmunodeficiencia Humana. Metodología: Revisión integrativa de literatura, a través de la búsqueda en las bases de datos PUBMED, LILACS y la biblioteca virtual SCIELO, utilizando los descriptores “Políticas Públicas de salud”, “Síndrome de inmunodeficiencia adquirida”, “Atención integral de salud” y el operador booleano “Y”, resultando en una muestra, después de leídos, de 12 artículos. Los resultados de este estudio nos permitieron identificar y clasificar el estado de las políticas públicas para la atención de esta población, en tres categorías: A: políticas y / o directrices insuficientes; B: Necesidad de mejoras e inversiones en políticas existentes; C: éxito de los programas, siendo imprescindible una articulación internacional de gobiernos y organismos no gubernamentales para la elaboración de políticas más ajustadas a las realidades y objetivando la atención integral de salud de esta población.
Objetivo: Identificar en la producción científica los tipos de riesgos para enfermidades y agravos para acidentes em trabajadores de la pesca artesanal. Metodología: Revisión integrativa, realizada entre enero y marzo de 2018, por medio de la combinación de los descriptores "Occupational Health" y "Fisheries", en las bases de datos, Medline, LILACS, Scopus, SciELO e internet. Se encontraron 123 artículos. Después de la lectura y evaluación de los mismos, se obtuvo un resultado final para el análisis de 16 artículos. Resultados principales: La mayoría de los estudios se indexaron en la base de datos Medline (56,3%), en el idioma inglés (43,8), con un nivel de evidencia VI (100%). Se constató que los trabajadores de la pesca artesanal están expuestos a riesgos ergonómicos, químicos, físicos y de accidentes. Conclusión: Se constató carencia de publicaciones en el área de la pesca artesanal, inexistencia de publicaciones científicas realizadas por la enfermería y brechas en el conocimiento.
FreshRSS 