Conectar
This study examines factors associated with deep tissue pressure injury and develops interpretable machine learning models for early risk prediction in adult ICU patients. This retrospective observational cohort study included 336 adult intensive care unit patients, of whom 211 developed deep tissue pressure injury and 125 remained pressure injury-free. For patients who developed deep tissue pressure injury, haemodynamic, laboratory and nursing variables from the 24 h before injury onset were analysed using a physiological time-at-risk framework. For pressure injury-free patients, corresponding variables from the first 24 h after intensive care unit admission were used. Six supervised machine learning classifiers were developed and internally validated using cross-validation and hyperparameter optimization. All models showed good predictive performance. Extreme gradient boosting achieved the highest discriminative ability, with an area under the receiver operating characteristic curve of 0.976. The most influential predictors across feature selection methods were low-molecular-weight heparin use, norepinephrine duration, lower blood pressure values, immobility, nutritional risk, antiplatelet therapy and chronic disease profile. Routinely documented nursing and haemodynamic indicators obtained within a clinically relevant 24-h risk window can support accurate early risk stratification for deep tissue pressure injury in adult intensive care unit patients. A physiology-informed and interpretable machine learning approach may improve recognition of patients at imminent risk.
In 2024, 30.4% of the German population had a migration background. People with migration-related language barriers face numerous challenges within the healthcare system, which can negatively impact their health outcomes. While language barriers affect healthcare in general, oncology represents a complex field in which effective communication is crucial. For people with cancer in particular, difficulties in understanding information, treatment options, and the healthcare system itself may hinder access to services. This increases the risk of complications, prolonged hospitalisations and readmissions. At the same time, there is little information about this group, and evaluations of structured services are lacking. This study assesses a nurse-led complex intervention focusing on structured information and ongoing support for people with cancer and migration-related language barriers.
The intervention is designed for people with cancer and migration-related language barriers and comprises three key elements: (a) continuous guidance provided by already existing roles of oncology nurse specialists, (b) a telephone interpreting service and (c) multilingual informational materials. We will assess the intervention’s effectiveness with a controlled before-and-after study. Assuming an effect size of d=0.5 and using a 2:1 allocation ratio with 80% power, we aim to recruit 126 people with cancer and migration-related language barriers (84 intervention; 42 control) for participation. We will assess the primary outcome psychosocial support needs assessed with the Psychosocial Risk Questionnaire (PSR) at admission, discharge, and 3-month post-discharge using paper-based or digital questionnaires. The secondary outcomes, such as knowledge, quality of life, anxiety and satisfaction, are measured alongside the primary outcomes and compare the distribution of items and scores using Student’s t-test (total scores) or the Wilcoxon rank sum test (individual items) at a one-sided significance level of 5%. We will use an embedded process and economic evaluation to examine the feasibility, acceptability and implementation of the intervention in line with the Medical Research Council guidance for process evaluations of complex interventions.
The Ethics Committee of the Faculty of Medicine, University of Cologne (No. 23–1303 and 24–1266), approved the protocol, and the study was registered in the German Clinical Trials Register. We will disseminate the results of the study through peer-reviewed publications and at academic conferences.
German Clinical Trials Register (DRKS00034749).
Approximately 96% of rifampicin resistance/multidrug-resistant tuberculosis (RR/MDR-TB) cases in Rwanda result from direct transmission rather than acquired resistance. However, the nationwide spatial distribution and transmission dynamics of RR/MDR-TB remain poorly characterised. This study aims to analyse spatial patterns of RR/MDR-TB in Rwanda and explore relationships between spatial proximity and RR/MDR-TB strains’ genetic relatedness.
We conducted a retrospective analysis of 249 confirmed RR-TB cases across Rwanda from 2017 to 2024, using the known geolocations of patients’ residences. Spatial and space-time clustering was assessed using Kulldorff’s scan statistics. Demographic and socioeconomic determinants were evaluated using multivariable regression. For 201 cases with whole-genome sequencing data, we performed transmission analysis using a 5-SNP threshold to define recent transmission clusters and investigated spatial relationships within genetically related strains.
Significant spatial clustering of RR/MDR-TB was identified in 21 sectors, mainly in Nyarugenge, southern Gasabo and western Kicukiro (relative risk: 10.06; p
RR/MDR-TB in Rwanda shows significant spatial clustering with transmission occurring through both localised and regional networks. Integrating genomic and spatial data reveals transmission patterns that extend beyond household contacts and administrative boundaries. These findings underscore the need to implement geographically targeted interventions that address community-level transmission to control RR/MDR-TB in Rwanda effectively.
This study aimed to evaluate the validity and reliability of the Postpartum Sleep Quality Scale (PSQS) for assessing sleep quality among postpartum women in Vietnam during the COVID-19 pandemic. The major hypothesis is that the PSQS will provide a reliable and valid measure of postpartum sleep disturbances and their correlation with mental health outcomes, particularly postpartum depression (PPD).
A cross-sectional, observational study was conducted from May to December 2023.
The study was carried out at a leading maternal healthcare centre in Vietnam, located in Hanoi, Vietnam.
A total of 223 postpartum women participated in the study, with inclusion criteria specifying women aged 18–45 years, who had delivered within the past 3 months, and were capable of completing the survey. Participants with severe psychiatric or neurological disorders or those experiencing postpartum complications affecting sleep were excluded.
The primary outcome was the psychometric evaluation of the PSQS, including internal consistency (Cronbach’s α), construct validity (through exploratory factor analysis) and concurrent validity (via correlation with the Edinburgh Postnatal Depression Scale and the Perinatal Infant Care Social Support Scale). Secondary outcomes included the relationship between sleep quality and PPD as well as the role of social support in moderating sleep disturbances.
Exploratory factor analysis identified a three-factor structure for the PSQS: (1) sleep efficiency and satisfaction, (2) sleep disruptions and infant-related disturbances and (3) postpartum sleep impairment and daytime fatigue. The PSQS demonstrated strong internal consistency (Cronbach’s α=0.839–0.875). Poor sleep quality was significantly correlated with higher PPD scores (r=0.6890, p
The PSQS is a reliable and valid tool for assessing postpartum sleep quality in Vietnamese women. Its multidimensional structure provides valuable insights into postpartum sleep disturbances. Enhancing social support may improve maternal sleep and mental health. Further research is needed to explore the long-term impact of sleep quality on postpartum recovery and mental well-being.
Despite the availability of a safe and effective vaccine, 2000–3000 neonates die of tetanus yearly, predominantly in low- to middle-income countries (LMICs). Inaccurate coverage estimates and vaccination records, together with variability in vaccine response, make identifying individuals who lack protective immunity and may benefit from vaccination difficult. A more direct measure of protective immunity is widely accepted as anti-tetanus IgG concentration at or above 0.1 IU/mL. This study aims to evaluate the performance of a novel saliva-based point-of-care lateral flow test (CIS-IMMUNE Tet) for the binary classification of tetanus protective immune status (protected/unprotected) against WHO threshold-based classification of IgG concentration.
This is a diagnostic test accuracy study with a cross-sectional design conducted in Rwanda. A total of 390 participants will be prospectively enrolled through direct invitation by health centres and community health workers using a convenience sampling approach. Participants will be enrolled into four groups: children aged 5–10 years, healthy adults aged 18–25 years, pregnant women and adults aged 18–45 years with known immunosuppression. This sample size was estimated assuming a specificity of 85% based on proof-of-concept data, with a lower bound of the 95% CI no less than 65%, a significance level of 0.05 and 80% power using the exact binomial method (SAS POWER procedure). Protective immunity will be determined by analysis of anti-tetanus toxoid IgG concentrations in serum by ELISA and analysis of saliva samples using the CIS IMMUNE® Tet test. Test performance will be evaluated by estimating sensitivity, specificity, positive and negative likelihood ratios, each with CIs, for detecting protective immunity using the serum reference standard.
This study protocol was approved by the Rwanda National Ethics Committee (reference RNEC587/2024) and the University of Birmingham (reference ERN_5194-Oct2025). Results will be published in peer-reviewed medical journals and presented at national and international conferences.
Implementing integrated One Health surveillance of antimicrobial resistance (OH-AMR) remains a challenge globally, particularly in developing countries. Resource limitations, infrastructural gaps and inadequate technical capacity often hinder adherence to standardised antimicrobial resistance (AMR) surveillance guidelines, resulting in suboptimal data coverage and quality in resource-constrained settings. Moreover, considerable disparities exist in the design and execution of OH-AMR surveillance systems across regions, further complicating global data harmonisation and comparative analyses. Therefore, considering the complex ecosystem of OH-AMR and its effective implementation in the low- and middle-income countries (LMICs), a consensus-based multidisciplinary research agenda should be prioritised. In recent years, the Delphi method has become a popular tool in systematic and bias-free consensus building on a certain research domain or complex topics. Therefore, with the overarching objective of setting an operational standard for OH-AMR surveillance in LMICs, we aim to perform a Delphi study by engaging the experts from relevant domains.
To streamline the traditional time-consuming Delphi technique, we plan to implement a real-time Table-Top Delphi exercise for rapid consensus building. Moreover, to capitalise on the convention of experts from diverse fields in real-time, we propose to conduct the study during an international conference on AMR. With systematic modification in the Delphi technique, the study will be conducted in two rounds where the first round will be performed in real-time followed by a second round online. For this purpose, a set of questions being prepared based on the identified gaps in existing scientific literature, evidence and guidelines for OH-AMR will be used. The questionnaire will be dispatched on an electronic platform to accumulate the responses from the experts in real-time while ensuring the anonymity and controlled feedback. Consensus will be defined as 70% or more of respondents selecting the same option for a given question. Considering the engagement of stakeholders from multiple domains of the trifecta, a total of 50 participants will be recruited in the study to have 70% replicable consensus where responses from at least 40 participants are expected in both rounds. The outcome of this Delphi study will pave the way for the implementation of an optimised OH-AMR surveillance strategy, especially in the global south, leading to actionable outcomes.
The study will be conducted in accordance with the guidelines of the Ethics Advisory Board, Leipzig University, Germany. The Ethics Advisory Board has no concern on the study protocol (2025.08.27_eb_348) in terms of research ethics. Before participating in the survey, individuals will be required to provide informed consent through the Welphi electronic platform (Yes/No options). Participation will be entirely voluntary, and participants may withdraw their consent and discontinue participation at any stage of the study. The findings of the study will be shared with the major stakeholders including the quadripartite organisations, global and regional networks on AMR and presented in international conferences and social media forums on AMR. The outcome of the study will be published in a peer-reviewed journal.
Pilonidal sinus disease (PSD) is a common acquired condition of the sacrococcygeal region; despite numerous described surgical techniques, long-term outcomes remain highly variable. We compared long-term recurrence and postoperative infection among nine surgical techniques in a large single-centre cohort. We retrospectively analysed 2222 patients with primary PSD who underwent surgery between January 2006 and December 2020 at a single tertiary referral centre in Turkey and had a minimum follow-up of 5 years. Patients presenting with recurrent disease were excluded. Nine surgical techniques were evaluated. Recurrence was analysed as a time-to-event outcome using Kaplan–Meier estimates and multivariable Cox proportional hazards regression. The 5-year cumulative recurrence was 7.9% (175/2222) and postoperative infection 6.9% (154/2222); overall recurrence was 10.2% (226/2222). Recurrence and infection differed statistically significantly among surgical techniques (both p < 0.001). The lowest recurrence rates were observed with the Karydakis flap (1.5%), Bascom cleft lift (2.3%) and Dufourmentel flap (2.4%). Most recurrences occurred within the first 2 years, with a median time to recurrence of 20 months (IQR 12–36). Compared with lay-open treatment, the Karydakis flap (HR 0.19, 95% CI 0.12–0.30), Bascom cleft lift (HR 0.25, 95% CI 0.14–0.43), Limberg flap (HR 0.32, 95% CI 0.19–0.53) and Dufourmentel flap (HR 0.26, 95% CI 0.12–0.57) were independently associated with lower risk of recurrence, whereas a higher body mass index (HR 1.05 per 1 kg/m2, 95% CI 1.01–1.09) and current smoking (HR 1.98, 95% CI 1.54–2.55) were independently associated with an increased recurrence risk. Off-midline flap techniques were associated with superior long-term outcomes, with lower recurrence and infection than midline or secondary-healing approaches. Taken together, the findings of this study support the use of the Karydakis flap and Bascom cleft lift as first-line surgical options for PSD management.
by Thinh Toan Vu, Jo-Anne Caton, Christina Norman
IntroductionThis study investigated how intersecting identities, including race and ethnicity, gender, socioeconomic status, and immigration-related characteristics, impact help-seeking for emotions, nerves, or mental health among New York City (NYC) adults. It also identified primary sources of informal and formal support.
MethodsUsing a citywide representative sample of 43,606 non-institutionalized adults, data were collected between May and September 2023. Log-linear regression models assessed main effects and conditional effects (i.e., interactions) of sociodemographic and immigration-related characteristics on mental health help-seeking in the past 12 months. Predicted probabilities from models with significant interaction terms illustrated intersectional impacts. Sensitivity analyses among participants with past 30-day moderate-to-high psychological distress tested robustness of these findings.
ResultsApproximately 46.6% of adults sought any mental health support, with 36.2% seeking informal support and 24.2% seeking formal support. Family/friend (33.1%) and therapist/counselor (16.8%) were the most common informal and formal sources, respectively. Significant interactions for any help-seeking emerged between race and ethnicity with gender (p = 0.003), employment status (p Conclusions
Mental health help-seeking in NYC varies significantly across intersecting social identities, highlighting disparities linked to race and ethnicity, gender, immigration status, and language proficiency. Addressing these disparities requires improving accessibility and cultural relevance of formal mental health services while recognizing and strengthening trusted informal support systems.
Cancer literacy (CL) is essential for enabling informed decision-making, prevention, early detection and adherence to treatment. However, disparities in CL across Europe, coupled with the spread of disinformation, limit equitable access to cancer care. This protocol describes a collection of scoping reviews to document the state of CL, misinformation narratives and education and training initiatives and identify barriers and facilitators. This work is embedded within the activities of the Beating Cancer Inequalities through Literacy in Europe project and encompasses nine consortium countries across Europe: Romania, Portugal, Belgium, Bulgaria, Montenegro, Ukraine, Italy, Ireland and Moldova.
The protocol follows the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR) checklist, guided by the Population, Concept, Context framework. Searches will be conducted in PubMed, supplemented by grey literature, capturing results from January 2015 to December 2025. Eligible records will undergo full-text review. Data will be extracted into predefined categories reflecting the topics of interest, developed by the research team before extraction to include key study information. Then, sources in local languages are provided by the partners, included and validated by native-speaking team members, adding to the results found by the researchers.
No ethical approval is required. Findings will be disseminated via peer-reviewed publications, project reports and stakeholder workshops.
Open Science Framework (10.17605/OSF.IO/9AQSX).
To explore parents' experiences of psychosocial support in the neonatal intensive care unit (NICU).
A qualitative descriptive study.
The study involved nine individual and three pair interviews; in total, 15 parents described their experiences of psychosocial support in the neonatal intensive care units. The data were analysed using inductive content analysis.
Parents' experiences of psychosocial support consisted of four main categories: (1) supporting parenting; (2) strengthening the sense of security; (3) social support; and (4) mental wellbeing support. Parents described how important it was to receive support in caring for an infant, to be able to participate in decision-making or to feel safe despite a difficult situation.
Even though parents described peer support and trauma-informed care as important forms of support, many NICUs lacked these. The results provide essential information to healthcare professionals, enabling them to understand and support parents. This can increase parental satisfaction and improve the wellbeing of families, as well as support parents during neonatal intensive care and after discharge.
This study provides tailored information on parents' experiences of psychosocial support in neonatal intensive care units. The results can be used in the education of healthcare professionals and to assist them in integrating psychosocial support methods into their practice, such as consistent emotional support.
The findings emphasise the importance of systematically asking parents about their experiences in order to identify their needs and the various forms of psychosocial support they require. These insights can guide healthcare professionals in providing personalised psychosocial support to parents in NICUs.
The reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Parents contributed to the study through data collected from the national peer support association (Kevyt) in Finland.
South African women are vulnerable to HIV acquisition during the postpartum period which can result in perinatal transmission via breastfeeding; many male partners do not know their HIV status. Biomedical approaches to preventing HIV for postpartum women include pre-exposure prophylaxis (PrEP) and antiretroviral treatment for male partners with HIV. Gaps in implementation include low uptake of PrEP among postpartum women and infrequent testing of men who may be motivated to test for HIV to protect the health of their infant.
We will conduct a randomised pilot trial in KwaZulu-Natal (KZN) Province, South Africa among postpartum women and their male partners. The study will pilot a combination intervention consisting of cognitive behavioural strategies (including communication skills training, motivational interviewing and problem-solving) to promote HIV self-testing (HIVST) for Partners and PrEP uptake for HIV-uninfected Postpartum Women, the ‘H4P’ intervention. The study aims to determine the feasibility, acceptability and preliminary effectiveness of the H4P intervention. We will enrol 60 HIV-uninfected women, aged 18 years and older, in their third trimester of pregnancy and reporting a partner whose HIV-serostatus is unknown. Sixty male partners will also be eligible to enrol. Enrolled women will receive three oral HIVST kits to distribute to their male partners and standard of care information on HIVST and PrEP. Women randomised to the intervention arm will receive additional counselling and reproductive health-centred HIVST information for the male partner, including information about why HIV testing is important during their partners’ postpartum period. To evaluate feasibility, we will calculate screening-to-enrolment ratios for women and men, the number of women who distribute HIVST kits to their male partners and the number of men who test. Acceptability will be evaluated using the Client Satisfaction Questionnaire and qualitative interviews. Effectiveness will be assessed at 3 months by measuring the proportion of women initiating PrEP via self-report and urine tenofovir measurements or receipt of injectable PrEP and the proportion of men who test positive who link to HIV care. Qualitative interviews will explore perceptions of the intervention.
Ethics approval for this study was obtained from the Human Research Ethics Committee at The University of the Witwatersrand, Johannesburg, South Africa (Reference number: 250612) and the Institutional Review Boards at Massachusetts General Brigham (2025P002271, Boston, Massachusetts, USA) and the University of Alabama at Birmingham (300015167, Birmingham, Alabama, USA) in the USA. Site support and approvals were obtained from the health facility and the KwaZulu-Natal Provincial Department of Health. Results will be disseminated through peer-reviewed manuscripts, reports and both local and international presentations.
This scoping review intended to map the existing literature on chronic stroke rehabilitation interventions in primary healthcare (PHC) settings, with a particular focus on intervention dosage—frequency, intensity, type and duration—as well as the mode of delivery, which encompasses intervention location, format and provider.
A scoping review was conducted following the guidelines outlined in the Joanna Briggs Institute Manual for Evidence Synthesis.
A comprehensive search of 16 databases was conducted on the EBSCOhost platform on 10 February 2022. A supplementary Google search was conducted to identify grey literature up to 19 November 2022.
Sources published in English between 2010 and 2022 with full-text availability, addressing interventions for chronic stroke survivors delivered by various stakeholders in PHC, community or home-based settings.
Two reviewers independently screened the identified sources to determine eligibility for inclusion. Data were extracted independently, compared between reviewers, analysed and synthesised narratively with descriptive statistics.
In total 34 sources are included in the review, with most (n=28) originating from high-income countries. Interventions predominantly targeted the body function and structure component of the International Classification of Functioning, Disability and Health framework (n=29) through physical exercise (n=21). However, few interventions addressed the activity (n=17) and participation (n=11) components. Contextual factors (n=9) were seldom considered in intervention design. Intervention dosage varied widely. Most interventions were delivered by the multidisciplinary team (n=9) and were provided either at home (n=16) or in the community (n=13). Individual sessions (n=18) were more commonly offered than group sessions (n=8).
The optimal dosage for chronic stroke interventions remains uncertain, and current interventions, along with their modes of delivery, are often misaligned with PHC settings. Further research is essential to establish best practices in both well-resourced and under-resourced environments to address the current evidence gap and to enable the development of effective rehabilitation protocols that meet the needs of chronic stroke survivors and their families in PHC settings.
Multiple sclerosis (MS) is a common central nervous system disease among young adults worldwide and Finland is one of the high-risk MS regions in Europe. Fatigue affects around 80% of individuals with MS, with prevalence rising to 95% as the disease progresses. Fatigue significantly limits daily activities and is associated with poorer employment outcomes and reduced quality of life. The objective of this qualitative study is to explore the lived experiences of individuals with MS and conceptions of MS-related fatigue among physiotherapists.
This qualitative study is part of a larger research project entitled ‘Building conceptualisation and understanding of momentary fatigue and activity-related fatigability in daily life for people with multiple sclerosis’ (EMA-FAMS), consisting of several studies conducted from 2024 to 2028. For this qualitative study, 10 individuals with relapsing-remitting MS will be interviewed using a phenomenological approach to collect their lived experiences of fatigue. Additionally, 15 physiotherapists with experience in MS rehabilitation will be interviewed using a phenomenographic approach to explore their conceptions of MS-related fatigue. All interviews will be conducted remotely during 2025–2026. Interview data will be analysed in two phases using interpretative phenomenological analysis (IPA) and phenomenographic analysis methods.
The EMA-FAMS study project has obtained ethical approval from the Regional Medical Research Ethics Committee of the Helsinki University Hospital District (HUS/10011/2024), and all the participants will provide written consent. Findings of this study will be shared through peer-reviewed articles, at academic conferences and with public healthcare and healthcare professionals.
Intravenous injection is one of the most frequently performed invasive nursing procedures in hospitals. However, patients may experience pain and anxiety during this procedure, which can affect patient satisfaction.
The aim of this study was to determine the levels of pain, anxiety and satisfaction in patients undergoing intravenous injection and to examine the sociodemographic, clinical and procedural factors affecting these levels.
A descriptive, cross-sectional study was conducted between August and November 2025 in the emergency departments of Atatürk University Research Hospital, a large tertiary care university hospital. This single-centre study was carried out in a high-volume emergency department that provides 24-hour services to a diverse patient population. A total of 405 patients who received intravenous injections and agreed to participate in the study were included. Data were collected using an Information Form, Visual Analogue Scale (VAS) for pain, VAS for anxiety and Post-Injection Satisfaction Scale. Descriptive statistics, t-tests, analysis of variance, correlation analyses and multiple regression analyses were used to analyse the data.
The mean pain VAS score for patients was 4.39±2.33, the mean anxiety VAS score was 4.42±2.14 and the mean Post-Injection Satisfaction Scale score was 3.51±0.77, indicating moderate levels of pain and anxiety on a 0–10 VAS. Women were found to have significantly higher levels of pain and anxiety than men (p
It was found that patients experienced moderate pain and anxiety during intravenous injection and that this situation negatively affected patient satisfaction. The results indicate that individualised nursing approaches in intravenous injection practices and the implementation of pharmacological and non-pharmacological interventions aimed at reducing pain and anxiety may increase patient satisfaction.
The Asia-Pacific Colorectal Screening (APCS) score is a validated tool for predicting advanced colorectal neoplasia (ACN) in the Asia-Pacific region. An adjusted APCS (A-APCS) score was recently developed by incorporating body mass index into the original score and was reported to outperform the original score but lacked external validation. This study aimed to compare the A-APCS score with the original APCS score in asymptomatic Vietnamese individuals.
A cross-sectional study.
Dai Phuoc Polyclinic, Ho Chi Minh City, Vietnam.
Asymptomatic individuals underwent colonoscopy screening.
Participants were categorised into three risk groups based on the sum of the APCS and A-APCS scores: average risk (AR), moderate risk (MR) and high risk (HR). The performance of the two scores was compared via receiver operating characteristic (ROC) analysis and McNemar tests.
A total of 714 participants (median age 51 years, range: 18–79; female-to-male ratio: 1:1.46) were included, with an ACN prevalence of 9.0%. Both scores indicated effective predictive ability for ACN in the HR group compared with the AR group, with OR=3.878 (95% CI 1.777 to 8.068) and 3.266 (95% CI 1.617 to 6.595), respectively. The A-APCS score was more effective than the APCS score in predicting ACN in the MR group than in the AR group. However, no significant differences in area under the ROC curve were observed between the two scores for ACN prediction.
Compared with the APCS score, the A-APCS score may not provide improved ACN risk stratification in asymptomatic Vietnamese individuals. Both scores are suboptimal and should be used to prioritise, rather than exclude, candidates for colonoscopy.
by Vu Nhi Ha, Le Chi Cao, Tran Hai Dang, Dao Thi Huyen, Nguyen Tien Dung, Le Huu Song, Nguyen Linh Toan, Truong Nhat My, Thirumalaisamy P. Velavan
BackgroundHepatitis E virus (HEV) causes sporadic outbreaks worldwide, with zoonotic and waterborne genotypes contributing to infections. In Vietnam, HEV genotypes 3 and 4 circulate among humans and swine, but data from remote, ethnic minority populations remain limited.
MethodsA cross-sectional study was conducted among 272 ethnic minority students at Thai Nguyen University of Medicine and Pharmacy (TUMP) to determine HEV infection markers and associated risk factors. Anti-HEV IgM and IgG were tested in serum samples using Wantai ELISA kits, and HEV RNA was detected by nested PCR targeting the ORF1 region. Demographic and exposure data were collected via structured questionnaires. Statistical analyses were performed using binary logistic regression.
ResultsOne participant (0.37%) tested positive for anti-HEV IgM, and 69 (25%) were positive for anti-HEV IgG, while HEV RNA was undetectable. HEV-IgG seroprevalence increased significantly with age (p = 0.004) but showed no sex-related differences. Consumption of tap or mixed water sources (p = 0.043) and raw or undercooked pork liver (p = 0.018) were significantly associated with HEV-IgG positivity. Multivariate analysis confirmed these factors as independent predictors of prior HEV exposure (adjusted OR = 1.6 and 4.8, respectively).
ConclusionsA moderate HEV seroprevalence among ethnic minorities indicates substantial prior exposure in northern Vietnam. Strengthening water sanitation, food safety awareness, and routine HEV surveillance is recommended to mitigate infection risk in vulnerable communities.
Peripheral intravenous catheters (PIVCs) are widely used in hospital settings but are associated with high failure rates and patient safety risks. Various dressing and securement methods have been implemented to mitigate these complications. This systematic review aimed to systematically review the effectiveness and safety of different dressing and securement methods for PIVCs in hospitalised adult and paediatric patients. Randomised controlled trials (RCTs) published between 1959 and 2024 were identified through searches of CENTRAL, CINAHL, Ovid EMBASE, and Ovid MEDLINE. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was evaluated using GRADE. Outcomes included PIVC failure, dislodgement, occlusion, infiltration, extravasation, phlebitis, and catheter-related bloodstream infection (CRBSI), analysed using risk ratios where meta-analysis was feasible. Dwell time was reported descriptively as mean or median values. Fifteen RCTs involving 5542 participants evaluated eight PIVC dressing and securement methods. In adult populations, tissue adhesive significantly reduced PIVC failure compared with transparent polyurethane dressing (risk ratio [RR] 0.83, 95% confidence interval [CI] 0.73–0.95), as well as dislodgement (RR 0.60, 95% CI 0.42–0.84) and occlusion (RR 0.73, 95% CI 0.57–0.94). Transparent polyurethane dressing was associated with lower dislodgement rates compared with gauze in adults. Other comparisons showed no statistically significant differences or were informed by single studies only, limiting the strength of conclusions. Evidence in paediatric populations was sparse and predominantly derived from individual trials. Tissue adhesive appears effective in reducing PIVC failure and mechanical complications in adults. Its effectiveness in pediatric patients remains uncertain, highlighting the need for further adequately powered trials.
by Esin Kavuran, Erkan Denk
This study was conducted using a Sequential Explanatory Design, in which the quantitative phase was carried out first, followed by a qualitative phase to examine the influence of nursing students’ attitudes toward purchasing Geographical Indication (GI)–certified products and their mindful eating practices on their healthy eating attitudes. The study population consisted of 1.385 nursing students enrolled in a faculty of nursing. The quantitative component included 392 students who met the inclusion criteria, while the qualitative component comprised 15 students. For data collection, the quantitative phase employed a sociodemographic data form, the Healthy Eating Attitude Scale (HEAS), the Mindful Eating Scale (MES), and the Attitude Scale for Purchasing GI-Certified Products (ASP-GICP). In the qualitative phase, data were collected using a Semi-Structured Interview Form. Quantitative findings showed that younger students (17–25 years) and females had significantly higher scores in GI product attitudes and mindful eating (pTo explore how parents perceive health care encounters related to their child's higher weight and to interpret these experiences within the broader societal context shaped by cultural norms and representations.
A qualitative design was employed using semi-structured interviews to capture parents' experiences. The study was informed by a conceptual framework that views weight as both a personal and socially constructed phenomenon.
Eighteen parents from Finland were interviewed between May 2022 and June 2023. The data were analysed using reflexive thematic analysis to identify key themes in parents' experiences and perceptions.
Three main themes were identified. The relational dimension highlighted the importance of individualised care, where health care professionals take time to get to know the family and recognise each member as an individual. The emotional dimension emphasised the need to protect the child, strengthen parental self-efficacy and provide sensitive, skilled support that fosters a sense of safety. The practical dimension focused on the need for active and targeted care, including structured weight-related routines, multidisciplinary collaboration and services that respond to the everyday realities of families.
The study highlights the need for health care encounters that are individualised, emotionally safe and sensitive to the diverse realities of families. Moving beyond weight-centric approaches, care should offer a range of supportive options that reflect parents' varied expectations, concerns and needs.
This study responds to the need for a deeper understanding of how parents experience health care encounters related to their children's higher weight. The findings highlight the importance of designing care interactions that provide professionals with adequate time, expertise and training to deliver individualised, stigma-sensitive care.
COREQ.
No patient or public contribution.
by Nguyen Thien Duc, Nguyen An Ninh, Nguyen Phi Trinh, Le Quang Tuyen, Nguyen Van Hung, Dinh Hoang Khanh, Nguyen Van Luat, Nguyen Huu Phuc Dai, Tran Duc Huy, Chu Duc Hoa, Tran Vuong The Vinh
PurposesAnatomy is fundamental in medical education, yet cadaveric dissection faces challenges including limited specimens, high costs, and chemical hazards. Interactive anatomy tables such as the Pirogov system offer innovative alternatives, but evidence from Southeast Asia is limited.
MethodsIn a prospective cohort, 188 medical students (139 in Y1 and 49 in Y2) were randomly assigned to the Pirogov table group (Group A, n = 99) or the cadaveric dissection group (Group B, n = 89). Knowledge acquisition was measured using a validated 20-item multiple-choice test before and after the intervention. Student perceptions were evaluated with a 10-item Likert-scale questionnaire covering four domains: knowledge and understanding, spatial visualization and relationships, learning experience and engagement, and effectiveness and practical value. Data were analyzed using paired and independent t-tests and Welch’s t-test.
ResultsBoth groups showed significant knowledge gains (Group A: 4.3 ± 1.65 to 5.2 ± 1.75, p Conclusion
The Pirogov table and cadaveric dissection were associated with similar short-term improvements in anatomy knowledge. Students valued the Pirogov table for visualization and engagement. These findings support integrating digital tools with cadaveric dissection to enhance anatomy education, particularly in resource-limited contexts.
FreshRSS 