Conectar
by Wasim Labban, Juan Forero, Lindsey Westover, Mark Sommerfeldt, Stephanie Nathanail, Lauren Beaupre
ObjectivesTo compare dynamic postural stability, measured by time to stabilization (TTS) and postural stability indices (PSI), after double-leg counter-movement jump (CMJ) landing in individuals 9–24 months following anterior cruciate ligament reconstruction (ACLR) and healthy controls. Additionally, to explore the effect of sex and ACLR status on postural stability.
MethodsThis cross-sectional laboratory-based study included 41 participants: 21 individuals (10 females) 9–24 months post-ACLR and 20 healthy controls (10 females). Participants performed double-leg countermovement jumps (CMJs) on force plates, landed, and maintained the landing position for 10 seconds. Time to stabilization (TTS), defined as the time (s) required for the ground reaction force to reach and maintain a stable state following landing, and postural stability index (PSI), a composite measure of the ability to maintain equilibrium during the transition from dynamic to static conditions, were calculated and compared between groups.
ResultsThe ACLR group exhibited significantly higher TTS values than healthy controls, indicating a longer duration to achieve stability. Specifically, the resultant vector TTS when combined from both force plates (RVTTS-C), and the vertical TTS in the operated leg (VTTS-op) was higher in the ACLR than the healthy controls (p = 0.03, p = 0.02, respectively). Furthermore, males with ACLR demonstrated higher VTTS combined (VTTS-C) and VTTS-op than females post-ACLR (p = 0.03, p Conclusion
Our study revealed significant deficits in dynamic postural stability in individuals post ACLR, with notable sex differences. The findings suggest a need for targeted neuromuscular rehabilitation to improve landing stability post ACLR and reduce the risk of secondary injury. Further research is needed to understand sex-specific postural stability mechanisms for tailored rehabilitation.
Large language model tools are increasingly used in higher education, offering opportunities to support self-directed learning. In nursing education, course-specific AI virtual tutors may provide contextualised support while addressing concerns about content accuracy and alignment; yet empirical evidence remains limited.
This study evaluated the use and perceived impact of a co-designed AI-powered virtual tutor embedded in a graduate-level Master of Nursing (MN) course. We explored how students used the tutor, their perceptions of benefits and limitations, and its influence on learning and engagement.
A pilot study using a mixed-methods explanatory sequential design was employed. The tutor was trained on course-specific materials and integrated into the institutional learning management system. Data included anonymised usage logs and user interactions coded using Bloom's Taxonomy of Educational Objectives, post-course surveys assessing AI self-efficacy, usability, and learning impact, and semi-structured interviews with students and teaching assistants (TAs). Quantitative and qualitative strands were integrated through a joint display.
A total of 651 interactions by individuals within a group of ~120 MN students were logged. Interactions peaked in evenings and around assignment deadlines. Most interactions reflected lower-order education processes, with more application and analysis later in the course. Eleven participants completed surveys; students reported high AI self-efficacy and moderate tutor use. Perceived usefulness was mixed, but most reported the tutor enhanced both lower- and higher-level learning and recommended its future use. Interviews revealed that students valued the tutor's immediacy and course-specific accuracy, while TAs noted efficiency gains. Reported challenges included usability issues, scope limitations, privacy concerns, and risk of over-reliance on the tool.
A co-designed AI virtual tutor was feasible and valued for contextual relevance, though perceived usefulness was variable. Findings support responsible, pedagogically integrated use of AI tutors in graduate nursing education.
The COVID-19 pandemic highlighted the need for alternative healthcare delivery models, leading to the development of Continuous Remote Patient Monitoring (CRPM). CRPM allows for real-time monitoring of high-risk patients, reducing the burden on hospital resources. The integration of virtual nursing into CRPM has enhanced remote care capabilities, though it has also introduced new challenges related to patient safety and staffing, that is, nurse-to-patient ratios.
This scoping review aims to explore the current evidence on virtual nursing using CRPM and identify challenges or barriers that help further future research and healthcare practices.
This scoping review followed the PRISMA-ScR guidelines. Eligible studies focused on virtual nursing with physiological monitoring in either remote hospital or home-based care settings, with explicit examination of nursing care and its impact on patient and nursing outcomes. Peer-reviewed articles published in the past 10 years in English were included. Four databases (Ovid, PubMed, CINAHL, and Medline) were searched with support from a medical librarian. After screening 207 records using Covidence, 17 studies met the inclusion criteria. Two reviewers independently screened all records, with a third resolving discrepancies. Data was charted using a standardized extraction template.
Seventeen studies were included in this review. CRPM was associated with reported benefits in managing chronic conditions, extending acute care into home settings, and enhancing healthcare system adaptability, particularly during the COVID-19 pandemic. Clinical benefits included early detection of health deterioration, reduced hospital readmissions, and improved patient satisfaction. Nurses played a pivotal role in physiologic data interpretation and intervention, highlighting the importance of continuous oversight in achieving favorable outcomes. However, implementation challenges, such as alert fatigue, data overload, user interface complexity, and financial sustainability were consistently reported. These findings underscore the need for improved data management systems, targeted nurse training, and sustainable funding models to support broader CRPM adoption.
Virtual nursing within CRPM demonstrates strong potential to improve patient outcomes and reduce hospitalizations by extending inpatient-level physiologic surveillance into home-based and hospital-at-home settings through continuous, nurse-led monitoring. Successful integration of this model into routine practice will require addressing challenges related to data management, clinician workload associated with 24/7 surveillance, and sustainable funding mechanisms to support continuous virtual nursing coverage.
by José Manuel García-Moreno, Tyler Adams, Amber Beynon, Janine Vlaar Olthuis, Stephan U. Dombrowski, Richelle Witherspoon, Niels Wedderkopp, Jeffrey J. Hébert
BackgroundRehabilitation and behavior change interventions are commonly used after lumbar surgery to improve recovery, but their effects on physical capacity and physical activity remain unclear. This study aimed to investigate the effectiveness of rehabilitation and behavior change interventions on physical capacity and physical activity behavior in patients following lumbar surgery for degenerative disease.
MethodsEMBASE, MEDLINE, PsycINFO, and CENTRAL were searched from inception to September 2025 and reference lists were hand-searched. Randomized controlled trials assessing rehabilitation or behavior change interventions on physical capacity or physical activity behavior in adults with lumbar degenerative disc disease who underwent lumbar surgery were included. Review author pairs independently extracted data and assessed included studies. Risk of bias was assessed with the Cochrane tool, and study quality with the Grading of Recommendations Assessment, Development and Evaluation classification. Results were pooled using random-effects models and reported as standardized mean differences (SMD) with 95% confidence intervals (CI).
ResultsExercise was more effective than minimal or usual care in improving trunk extension endurance in the immediate term (SMD, 1.54; 95% CI, 0.93–2.16). Supervised exercise outperformed self-directed exercise in improving trunk extension endurance in the immediate term (SMD, 1.28; 95% CI, 0.75–1.81). Psychologically informed rehabilitation was more effective than minimal or usual care in increasing physical activity levels in the intermediate term (SMD, 0.26; 95% CI, 0.02–0.49), but not in the immediate term (SMD, 0.17; 95% CI, −0.14 to 0.49). Physical activity advice did not increase physical activity levels compared to minimal or usual care in the immediate term (SMD, 0.21; 95% CI, −0.13 to 0.55). Prehabilitation was more effective than minimal or usual care in increasing physical activity levels in the intermediate term (SMD, 0.28; 95% CI, 0.03–0.53). Certainty of evidence ranged from low to moderate.
ConclusionsFor adults with lumbar degenerative disease who underwent lumbar surgery, exercise, especially supervised programs, improved trunk extension endurance in the immediate term. Psychologically informed rehabilitation and prehabilitation increased physical activity levels in the intermediate term, while physical activity advice showed no benefit. Findings are limited by low certainty of evidence and high risk of bias.
To compare attitudes and perceptions towards opioid use disorder among people with opioid use disorder and emergency providers, describe interactions between the two groups, and identify barriers to providing and receiving care.
Mixed methods observational study.
Participants were recruited from an academic, tertiary care hospital and a community-based harm reduction agency in New England. Emergency healthcare providers (nurses, physicians, and paramedics) and adult people with opioid use disorder were enrolled. Electronic surveys were administered to providers, and semi-structured interviews were conducted with people with opioid use disorder and a subset of providers. Descriptive statistics were calculated for surveys, and directed content analysis was used to analyse semi-structured interviews.
Sixty-eight providers completed the survey, 11 of whom also completed a semi-structured interview. Twenty-two people with opioid use disorder completed the semi-structured interview. Both providers and people with opioid use disorder agreed that addiction is a disease; however, opinions differed on the extent to which personal choice played a role in the onset of opioid use disorder. Participants described how factors such as experiencing homelessness, alongside other personal or familial challenges, contributed to ongoing substance use and presented barriers to accessing healthcare. There was discordance in priorities between providers and people with opioid use disorder, which often drove conflict and perceived stigma. Both groups described physical and emotional trauma from prior interactions, which shaped expectations of future interactions and biases towards each other.
Educational initiatives should arm providers not only with clinical knowledge about opioid use disorder but with skills to recognize implicit biases, navigate unique barriers related to social determinants of health, and effectively deploy shared decision-making techniques. Healthcare organizations should provide support for trauma that emergency care providers are exposed to in caring for people with opioid use disorder.
Consolidated criteria for reporting qualitative studies (COREQ)–32 item checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
by Elham Ahmadi, Sophia Baierl, Stephan Voss, Ida Asenkerschbaumer, Ursula Berndt, Leonie Bernhard, Anita Hennig, Anna-Lena Würfele, Michaela Coenen
Urban soundscapes, particularly those experienced in green spaces, have been increasingly recognized as factors that influence human mental health. This scoping review explores the existing literature on soundscapes within urban green spaces and their associated mental health outcomes. It aims to classify the methodologies used in this domain, identify mental health outcomes related to urban green space soundscapes, and examine specific soundscape elements and their correlations with mental health. A systematic search of peer-reviewed studies was conducted. After screening titles, abstracts, and full texts, 22 studies met the inclusion criteria. Diverse methodological approaches were identified, with an emphasis on quantitative multi-method designs. Commonly studied mental health outcomes include stress reduction, mood enhancement, perceived restorativeness, and cognitive restoration. Standardized psychometric tools, such as the Perceived Stress Scale (PSS-14), Positive and Negative Affect Schedule (PANAS) and Perceived Restorativeness Soundscape Scale (PRSS) are frequently used as outcome measures. Natural soundscape elements such as birdsong, water sounds, and rustling leaves had a positive association with relaxation and perceived mental restoration throughout all studies, while mechanical sounds, such as traffic noise were linked to adverse mental health outcomes. These findings highlight that natural soundscapes in urban green spaces have a potential positive relationship with mental health by reducing stress and enhancing mood. However, the cross-sectional design and methodological heterogeneity of the included studies limit causal interpretation. Future research should explore multi-sensory experiences and examine soundscapes in diverse urban contexts to provide more robust insights into their relationship with mental health. The practical implications suggest that urban planners should prioritize integrating natural sound elements into urban areas to improve mental health. The study protocol of this scoping review had been registered at OSF (osf.io/4r7gd).by Wenting Yan, Carmel L. Montgomery, Liz Dennett, Stephanie A. Chamberlain
BackgroundThe demographic landscape of Western countries has shifted to a more diverse one. Along with the trend of an aging population, a new problem has emerged, which is the increased linguistic diversity in the aging population in these countries. As people age and their care needs increase, they may not receive optimal care if they don’t speak the same language as their caregivers in long-term care facilities. Culturally and linguistically responsive long-term care services are important to ensure the best care for an aging population, but there is limited evidence in the literature on the scope and practice of these services. The objective of this scoping review is to map out the types of CLR programs in LTC settings and examine their core components and target populations.
MethodsThe Arksey and O’Malley framework, further developed by Levac and colleagues, will be employed in this scoping review. The research question was framed using the PCC framework. A comprehensive systematic search was developed with an experienced librarian and will be conducted in Scopus, CINAHL, Embase, Medline, PsycINFO, and Academic Search Complete. All primary study designs, including quantitative, qualitative, and mixed methods, will be included. Studies must focus on culturally and linguistically responsive care programs used or implemented in long-term care services. There will be no date or language limitations. Findings will be thematically synthesized to answer the research question.
ConclusionThis review protocol provides a transparent process for how it will be conducted. We aim to contribute to a better understanding of what culturally and linguistically responsive care programs exist, how cultural and linguistic responsiveness is currently addressed across diverse care environments, and what gaps remain in long-term care.
by Mireille Jasmin, Geneviève Piché, Aude Villatte, Andrea Reupert, Marie-Ève Clément, Anne Dorothee Müller, Marianne Fournier-Marceau, Darryl Maybery, Marie-Hélène Morin, Stéphane Richard-Devantoy
BackgroundParenting responsibilities can be particularly challenging for patients receiving mental health services, often resulting in a range of negative impacts on children. Incorporating a family-focused approach into the usual care of parents with mental illness has been recommended to promote patient recovery while supporting the well-being of children and the entire family unit. This study aimed to document the family-focused practices undertaken by psychiatrists working with parents who have a mental illness and to explore potential facilitators and barriers to these practices.
MethodsA sequential explanatory mixed-method design was used, combining an online survey and individual interviews. Family-focused practices were reported by 27 psychiatrists through the French version of the Family-Focused Mental Health Practice Questionnaire. Follow-up qualitative individual interviews were conducted with 5 psychiatrists. Item-by-item analysis of the quantitative data was performed, followed by a thematic analysis of the qualitative data, integrating findings from both sources.
ResultsAlthough psychiatrists acknowledge their patients’ parenting role, most are reluctant to provide further support. Key barriers to family-focused practice include the predominantly individual-focused nature of psychiatric care, stigma, consent issues, and limited collaboration between adult and child services. Facilitators include psychiatrists’ professional autonomy, personal experience, and confidence in conducting family meetings.
ConclusionPsychiatrists can play a pivotal role in identifying, acknowledging, and providing appropriate support to parents with mental illness and their families, including children. Developing comprehensive guidelines and targeted training is essential to equip psychiatrists with effective strategies for addressing parenting challenges in patients with complex mental health issues. Additionally, psychoeducational resources for children should be incorporated. Implementing these initiatives may lead to more compassionate, targeted care and improved outcomes for parents and their families.
To quantify medication discrepancies between an outpatient psychiatric service and general practitioners in northern France, and investigate general practitioner identification in psychiatric records.
Quantitative, exploratory, retrospective, descriptive, monocentric study.
Study conducted in 2022 on 112 patients, comparing medication lists between the medical and psychological center and general practitioners through medication reconciliation.
Among the 33 patients (29.5%) with complete data allowing medication reconciliation, 84.8% had at least one discrepancy between medication regimens known to the outpatient psychiatric service versus those known to general practitioners. Discrepancies affected both psychiatric (85.7%) and nonpsychiatric medications (78.6%). 18.8% of the 112 patients did not have an identified general practitioner in the outpatient psychiatric records.
Medication reconciliation in outpatient psychiatry can improve treatment safety and create an opportunity for communication between care providers.
This study highlights opportunities for advanced practice nurses to improve medication safety and interprofessional communication in outpatient psychiatric care through medication reconciliation, which appears to be a reliable indicator for quantitatively assessing communication while actively creating opportunities for dialogue between outpatient psychiatric care facilities and primary care structures. The implementation of these practices could be supported by the advanced practice nurses recently introduced in France, by raising awareness among healthcare professionals, by contributing to the therapeutic education of patients and by supporting the use of digital health tools.
Compliance with EQUATOR RECORDS guidelines, extended from STROBE statements.
This study did not include patient or public participation in its design, conduct, or reporting.
Identify and describe patient engagement interventions used to improve medication management in older adults during transitions of care.
A mixed-methods systematic review.
A comprehensive search of all study designs was conducted. Studies were categorised using the ladder of patient and family engagement, a framework that positions engagement from low (passive) to high (active partnership) patient engagement.
Six databases were searched from inception to April 2024.
The search yielded 29 reports, with 25 classified as studies. Most interventions (n = 19, 76%) were low-level interventions that comprised informing patients in a passive manner. Interventions that facilitated high-level engagement (n = 6, 24%) where patients were integrated in the decision-making process were associated with consistently improved patient and healthcare long-term outcomes.
While low and high-level engagement interventions were associated with significantly decreased hospital readmission rates, high-level interventions consistently demonstrated positive patient outcomes. Interventions supporting older adults beyond discharge achieved meaningful and lasting patient and healthcare outcomes for older adults.
Findings provide clinical reference for designing engagement interventions, highlighting long-term benefits of partnership-based approaches and continuity beyond discharge.
Engagement in medication management during transitions of care varied significantly. High-level engagement was consistently linked to improved patient and healthcare outcomes but was often resource intensive. This review identifies the need to design balanced interventions that align with the preferences of older adults and real-world contextual healthcare settings.
PRISMA guidelines.
No patient or public contribution.
PROSPERO (registration number CRD42024557385).
To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures.
Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game.
Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure.
A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety.
Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older.
Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal.
This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older.
We adhered to the CONSORT checklist for reporting results.
A patient partner reviewed the study design, methods and final manuscript.
NCT03680625
To explore the optimal timing of patient-reported outcome assessment, defined as the collection and use of patient-reported outcomes at clinically meaningful points such as before or during encounters, treatment initiation and follow-up, and to identify the facilitators and barriers to timely use.
A qualitative analysis of semi-structured interviews with healthcare professionals across diverse US health systems.
Thematic analysis was used to identify key themes related to the timing and implementation of patient-reported outcomes assessments. Interviews were analysed iteratively to develop a coding framework and synthesise overarching themes.
Fourteen healthcare professionals, including nurse practitioners, cardiologists and health informatics experts across seven U.S. health systems from academic and community hospitals, were interviewed in February 2024. Three major themes emerged: (1) value proposition of timely patient-reported outcome data collection (2) key facilitators for timely implementation and (3) multilevel barriers. The value proposition focused on the use of patient-reported outcomes for prevention and active disease management. Critical facilitators for the timely implementation of patient-reported outcomes included the involvement of research and clinical coordinators, strategies for pre-visit and on-site patient-reported outcome collection, the use of standardised templates within EHRs and the alignment of patient-reported outcome collection with patients' long-term treatment goals. Finally, multilevel barriers included time constraints, patient-level challenges (e.g., fatigue, literacy, language) and systemic issues (e.g., technical limitations, lack of reimbursement and unclear guidelines).
Timely collection and use of patient-reported outcomes is critical for improving symptom monitoring and supporting patient-centered clinical decision-making. However, multilevel barriers hinder consistent implementation across health care settings.
Integrating patient-reported outcomes into clinical workflows can improve the patient-centeredness of patient-healthcare professional interactions, and provide a more holistic picture of a patient's health status. Addressing barriers to patient-reported outcome implementation, including lack of time, poor health literacy and workflow integration barriers, is crucial for improving clinical outcomes.
This study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist, in accordance with EQUATOR Network guidelines.
No patient or public involvement: This study did not include patient or public involvement in its design, conduct or reporting.
To describe a sample of healthcare professionals' responses to the valid and reliable Climate and Health Tool and compare participant characteristics relating to Climate and Health Tool subscales.
Observational, cross-sectional, multi-site study.
An electronic survey containing the Climate and Health Tool was administered to healthcare professionals across a large, multi-state health system in the Western United States with a committed effort to reducing carbon emissions.
One thousand three hundred and sixty-three participants reported moderately elevated levels of awareness and concern around climate impacts on health and motivation to participate in climate protective actions. Respondents reported moderate levels of climate-protecting behaviours at home and low levels at work. Females were more concerned and motivated. Medical staff and respondents reporting familiarity with system environmental initiatives reported more awareness and behaviours at home to preserve climate health.
Healthcare professionals are concerned and motivated to decrease climate impacts on health yet take little action at work to preserve the climate. Because of the intersection of climate change, health, and healthcare, healthcare organizations should prioritize and support meaningful action for healthcare professionals to meet community climate health needs.
Healthcare organizations committed to contributing to climate solutions can use this research to increase healthcare professionals' education, engagement, and impact to preserve the climate and health of communities.
Healthcare is a major contributor to carbon emissions, yet healthcare professionals' awareness, motivation, concern, and behaviours related to climate change and health were not clear. Our research showed healthcare professionals are aware and concerned about climate impacts on health but reported low levels of workplace behaviours to protect the climate. The findings of our research will impact healthcare professionals and healthcare organizations to focus efforts on climate-preserving behaviours.
This manuscript followed the STROBE guidelines.
None.
by Véronique Gille, Flore Gubert, Camille Saint-Macary, Stéphanie Dos Santos, Franck Houffoué, Hugues Kouadio, Epiphane Marahoua, Petanki Soro, Alexander van Geen
Lead (Pb) exposure is a major global health concern, particularly for young children, yet awareness of the risks is low. Pb-based paint remains a significant source of exposure in many low- and middle-income countries, despite existing regulations. We investigate whether personalized information on lead in paint can increase awareness and encourage preventive behaviors. As part of a pilot study in Abidjan, Ivory Coast, painted surfaces in pregnant women’s homes were tested using a low-cost Pb detection kit, followed by confirmatory testing with an X-ray fluorescence (XRF) device. Among the final sample of 153 women, those living in homes that tested positive for Pb were 33-35 percentage points more likely to acknowledge their exposure risk. This increased awareness led to self-reported behavioral changes among mothers of young children, including a higher likelihood of preventing children from ingesting paint chips and washing their hands more frequently. We find no impact on self-reported home-cleaning or renovation behaviors. Our findings highlight the potential of personalized information to drive behavioral change in environmental health.To describe telephone-triage nurses' perceptions of their well-being and the system factors that influenced their well-being while conducting telephone-triage for COVID-19 during the pandemic.
This descriptive, qualitative study applied both inductive and deductive analysis to generate themes.
We interviewed a convenience sample of 27 nurses from two health systems about their perceptions of well-being when triaging patient calls about COVID-19 and reasons for those perceptions. Data collection occurred between November 2020 and June 2021. Themes were organised using the National Academies of Science, Engineering and Medicine framework.
Telephone-triage nurses' well-being was significantly impacted by COVID-19. Uncertainty regarding evolving COVID-19 guidance, increased call volumes and difficult patient responses were some of the key work system challenges that impacted nurses' well-being.
Our findings suggest the need to revisit work system factors that impact the well-being of telephone-triage nurses and develop organisational interventions to support nurses to provide optimal care during crisis situations.
Organisational information infrastructure should be bolstered for future pandemic responses to minimise impacts on nurses' well-being. Additionally, leaders need to realign tasks, workflows and workload of telephone triage during pandemic surges to prevent excessive demands on nurses.
This work contributes to understanding telephone-triage nurses' well-being during COVID-19. The increased demands they faced and impact on their well-being point to opportunities for organisational well-being interventions and development of crisis standards for tele-triaging to support nurses during high-stress, crisis situations.
The authors have adhered to COREQ guidelines for reporting.
No patient or public contribution.
To increase Chlamydia trachomatis screening in adolescents 15–19 years of age from 7.8% to 15% following a 6-week implementation of universal chlamydia screening at three paediatric primary care (PPC) sites.
Pre-implementation (1 January 2022–19 October 2022) and post-implementation (20 October 2022–1 June 2023) screening rates were tracked through run charts and compared via Chi-square testing. Universal opt-out chlamydia screening with universal urine collection for 15- to 19-year-old was implemented at well visits, along with patient and staff education, and sexually transmitted infection treatment protocols.
Chlamydia trachomatis screening increased from 7.8% to 34.1% with implementation of universal opt-out chlamydia screening. Proportions of patients screened increased significantly among White individuals, males and privately insured individuals.
A universal C. trachomatis screening project can be feasibly implemented in pediatric primary care and successfully increase adolescent chlamydia screening rates.
Implementing a universal opt-out C. trachomatis screening project is feasible in PPC and can help achieve the public health goal of chlamydia identification and treatment.
These findings will be impactful for both paediatric primary care and adolescent patients. The universal, opt-out C. trachomatis screening approach facilitated screening increases, improved equity in screening and led to increased case detection and treatment which has vast significance for those patients.
This manuscript is submitted using the SQUIRE 2.0 guidelines for quality improvement reporting.
Patient contribution included de-identified data collection of chlamydia screening rates of eligible adolescents 15–19 years old who attended routine well visits at the three PPC locations. The data were reviewed on a dashboard, then stratified by race, ethnicity, payor and sex assigned at birth.
To explore the social context of violence for hospital-based and community nurses from different ethnic groups, the types of violence experienced or witnessed both in and outside the workplace, and its impact on mental and physical health.
Cross-sectional, qualitative study using semi-structured interviews.
Semi-structured interviews were conducted online with 12 hospital-based and community nurses recruited from London, England, between May and August 2021. Data were analysed using reflexive thematic analysis.
The sample comprised seven hospital nurses and five community nurses. Four themes were identified: (i) the social context in which nurses from different ethnic groups are exposed to community violence; (ii) types of workplace violence experienced or witnessed by hospital-based and community nurses from different ethnic groups; (iii) perceptions of the factors contributing to workplace violence; (iv) impacts of violence on mental and physical health outcomes. Using the social ecological framework and sociological theory of stress, these findings informed a conceptual stress process model of violence exposure for nurses.
Nurses from different ethnic groups are exposed to violence both in and outside the workplace which negatively affects their mental and physical health. Effective violence prevention requires a multi-factorial approach that addresses the social and institutional factors contributing to violence, shifting the focus from individual measures to systemic organisational changes.
The NHS workforce is currently more diverse than ever, and healthcare leaders must improve access to mental health and well-being resources for staff affected by workplace violence, particularly for those who hold multiple social identities at the intersection of ethnicity, gender and age. Prioritising this support is essential not only to safeguard against negative health outcomes but also to improve the recruitment and retention of healthcare professionals.
No patient or public contribution.
Coronary artery bypass grafting (CABG) remains one of the most commonly performed cardiac surgeries worldwide. Despite surgical advancements, a significant proportion of patients experience psychological distress following surgery, with depression being particularly common. Current evidence regarding the effectiveness of preoperative psychological interventions in improving postoperative mental health outcomes remains inconclusive. There is a critical need for predictive models that can identify patients at risk of developing clinically significant depressive symptoms (CSDSs) and related psychological conditions after CABG. This multicentre observational study aims to develop and validate prognostic models for predicting CSDSs and other psychological outcomes, including anxiety, post-traumatic stress symptoms and quality of life, 6 weeks after elective CABG surgery.
The study will recruit 300 adult patients undergoing elective CABG (with or without valve intervention) across two Swiss hospitals. Data collected will include demographic, clinical, psychometric, inflammation-related and interoceptive variables. A training set (n=200) will be used to develop predictive models using machine learning, while a held-out test set (n=100) will be used for model validation. The primary outcome prediction will focus on CSDSs, assessed using the Patient Health Questionnaire-9 (PHQ-9), with analyses conducted both categorically (PHQ-9 total score ≥10) and continuously as complementary approaches. Secondary models will address anxiety, using the General Anxiety Disorder Scale-7, post-traumatic stress, using the post-traumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders-5 and health-related quality of life, using the 12-item Short Form Survey. A simplified ‘light solution’ model with fewer predictors will also be developed for broader applicability. This study will address an important gap in perioperative mental healthcare by identifying key predictors of psychological morbidity following CABG, particularly CSDSs. The resulting models may inform future screening and preventive strategies and improve postsurgical outcomes through early identification and intervention in high-risk individuals.
The responsible ethics committee has reviewed and approved this project (Kantonale Ethikkommission Zürich, BASEC number: 2023-02040). The study minimises participant burden by integrating brief validated instruments and limiting psychiatric interviews to relevant outcomes, while ensuring ethical safeguards and respect for participant rights (including written consent). Results will be shared through peer-reviewed publications, conference presentations and stakeholder meetings involving clinicians and mental health professionals. Findings will also be communicated to participating centres and patient communities in accessible formats.
FreshRSS 