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To evaluate whether information about patients' poor sense of security in hypothetical vignette scenarios increases nurses' projected intent to report safety events.
Quantitative, cross-sectional factorial survey vignette experiment administered online.
A convenience sample of 60 nurses from adult inpatient hospital units at a Midwest academic medical center participated in February 2025. Participants responded to demographic questions and eight factorial vignettes, each describing a patient-reported safety breach and incorporating four patient-related factors. Four vignettes included information that the patient had a poor sense of security, and four did not, presented in random order. Following each vignette, participants rated their level of concern about the patient's report, perceived harm to the patient, and likelihood of reporting the patient's concern. A linear mixed-effects modelling approach, accounting for clustering within participants, was used to estimate the effects of the sense of security information factor on nurses' responses.
The sense of security information was associated with higher ratings of (a) degree of concern, (b) perceived harm to the patient, and (c) intent to report the patient's concern, after adjusting for vignette- and participant-level covariates. The vignette patient's perception of physical harm was positively associated with all three ratings. Nurses' greater hospital experience was associated with lower ratings across outcomes.
Obtaining information that the patient felt insecure was associated with heightened concern about the safety event, greater perceived harm, and increased intent to report the concern.
Sense of security assessment may be a risk-agnostic, patient-centered intervention that nurses can routinely perform, regardless of the safety event circumstances.
Although a system of evidence-based practices within a safety culture is essential to hospital safety efforts, nurses' judgements of and responses to patient safety concerns play a critical role and should not be overlooked.
STROBE guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
Glaucoma is an optic neuropathy caused by the gradual degeneration of retinal ganglion cells. This study aimed to investigate the knowledge, attitude and practice (KAP) towards glaucoma among ophthalmic inpatients.
A web-based questionnaire.
Local hospital.
Ophthalmic inpatients (n=1238).
The primary outcome was the patients’ KAP.
Multivariable logistic regression analysis showed that rural residence (OR=0.488, 95% CI 0.313 to 0.762, p=0.002), college education or above (OR=4.996, 95% CI 2.942 to 8.483, p
Ophthalmic inpatients might have moderate knowledge and attitude, but a proactive practice towards glaucoma. A history of glaucoma, previous glaucoma surgery, education level, residency and alcohol consumption were potentially associated with knowledge and attitudes towards glaucoma among ophthalmic inpatients.
To evaluate the performance of Ghana’s environmental surveillance (ES) system for poliovirus (PV) detection from 2018 to 2022 using standardised indicators developed by the WHO and the US Centers for Disease Control and Prevention.
A retrospective performance evaluation using 10 key indicators benchmarked against global targets for PV surveillance.
Seven regions across Ghana, participating in the national ES programme implemented under the Global Polio Eradication Initiative.
Wastewater sampling was conducted at designated ES sites, supported by field collection teams and laboratory personnel responsible for sample acquisition, processing and reporting of PV detection results.
Detection rates of PV and non-polio enteroviruses (NPEVs), timeliness of sample collection and reporting, data quality and system stability.
A total of 738 wastewater samples were collected. The system demonstrated high sensitivity, detecting circulating vaccine-derived PV type 2 in 51 (6.9%) of samples, Sabin PV types 1 and 3 in 61 (9.5%) and 114 (17.8%), respectively, and NPEVs in 491 (66.5%) of samples. Over 80% of samples met the recommended 21-day collection-to-reporting time frame. Data quality exceeded the ≥80% threshold, and workflows remained stable throughout the evaluation period.
Ghana’s ES system for PV was found to be flexible, stable and effective in generating high-quality data for early detection and public health response. These findings underscore the system’s critical role in supporting polio eradication efforts and highlight its potential as a model for surveillance in similar settings.
This scoping review aimed to explore what is known about Indigenous peoples' experiences with palliative and end-of-life care in Canada.
A scoping review.
A systematic search was performed from database inception to May 2022: CINAHL, Academic Search Complete, ERIC, Cochrane, Medline, PsychINFO, Indigenous Collections, Indigenous Peoples of North America and EMBASE. No date limitations were applied. Unpublished and grey literature was searched using the Google search engine. A search update was conducted in April 2024.
This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Titles, abstracts and full text were screened for inclusion by two reviewers. Mapping and thematic analysis were used to analyse, collate and summarise extracted data.
Fifty-three sources were included in the review. While the methods, locations and context vary across the literature, common themes emerged: Disparities in Indigenous representation in palliative and end-of-life care literature, challenges in accessing palliative and end-of-life care, priorities related to palliative and end-of-life care and experiences specific to end of life.
This scoping review revealed several key insights into Indigenous peoples' experiences with palliative and end-of-life care.
Findings identify the need to enhance cultural safety in palliative and end-of-life care and support community capacity to develop and lead palliative and end-of-life care research and initiatives. Furthermore, findings suggest the need for palliative and end-of-life care initiatives that are Indigenous-led, grounded in Indigenous research methods and distinctions-based.
We have adhered to relevant EQUATOR guidelines. We followed the PRISMA-Scr in the reporting of this scoping review.
No patient or public contribution. This study did not include patient or public involvement in its design, conduct or reporting.
To assess the care needs of older adults living in poverty in a high-income country and to analyse their relationship with other outcome variables.
A cross-sectional study.
Data were collected between September 2022 and February 2024 from 384 older adults in southeastern Spain. Descriptive statistics were calculated to assess older adults' care needs. A multiple linear regression analysis was carried out to determine the percentage by which the socio-demographic or outcome variables could explain the number of met care needs among older adults in poverty.
Around 20% of the care needs amongst older adults living in poverty were unmet. The most frequently unmet care need was related to money (53.6%). Almost 30% of participants were at risk of malnutrition, 18% felt lonely, and 80% perceived a low level of social support. Age, history of falls, emergency room visits, functionality, perceived social support, quality of life and nutritional status significantly predicted the number of needs met.
The health conditions of older adults living in poverty are suboptimal and may negatively influence their care needs. Nurses should consider these factors when designing, implementing and evaluating interventions to promote the biopsychosocial health of this population.
Nursing interventions to promote health amongst older adults living in poverty should focus on identifying unmet care needs, particularly those related to financial and social support. Interventions should prioritise improving nutritional status, enhancing social support networks and addressing loneliness.
Living in poverty increases older adults' vulnerability due to unmet financial, nutritional and social support needs. These unmet needs can negatively affect older adults' physical and mental health.
The study has been reported following the STROBE guidelines.
The study's participants only participated in the data collection process.
To investigate factors affecting the quality of life of parents of children with spina bifida and examine how family resilience mediates between parental depression and quality of life.
Cross–sectional study.
Secondary data analysis was performed using first-year data from a five-year spina bifida cohort project (2022–2026) in South Korea. The study included 162 parents of children aged 4–12 years with spina bifida. Data were collected using the Korean version of the Family Resiliency Scale, the Center for Epidemiologic Studies Depression Scale, and the WHO Quality of Life Scale.
Factors were found to have a statistically significant influence on the quality of life of parents of children with spina bifida: the child's need for enemas, parental stress, parental depression, and family resilience. Baron & Kenny's mediation analysis and bootstrap analysis in SPSS further confirmed that family resilience plays a mediating role between parental depression and quality of life. The indirect effect of parental depression on quality of life through family resilience was statistically significant, with a 95% confidence interval of [−0.2615, −0.0516].
The quality of life of parents with children with spina bifida is significantly influenced by both their child's daily symptom management and their psychological health. Family resilience plays a positive mediating role between parental depression and quality of life.
These findings support a two-track approach to family resilience building programs and the development of core intervention strategies to enhance the quality of life in spina bifida families.
This study adhered to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
There was no direct patient involvement in the study design, data collection, or analysis.
To determine the prevalence of burnout and back pain in homecare workers in Switzerland and assess their associations with psychosocial work environment factors.
National multicentre cross-sectional study.
Using paper-pencil questionnaires, data were collected from January 2021 to September 2021 from employees of 88 homecare agencies across Switzerland. Respondents who identified themselves as administrators, apprentices, or trainees, who were in leadership positions, or who were not involved in the provision of care or housekeeping were excluded from this analysis. Burnout was assessed with the Copenhagen Burnout Inventory Scale (possible score range 0–100) and back pain with a single item from the Federal Statistical Office's Swiss Health Survey. Multilevel regression analyses were used to assess burnout and back pain's associations with psychosocial work environment factors.
We included 2514 homecare workers. More than two-thirds (68.6%) reported back pain in the past 4 weeks. The overall mean burnout score was 36.0 (SD 18.3). Poorer work-life balance, higher perceived workload and verbal aggression from clients were positively associated with both outcomes. Better leadership and social support from colleagues were negatively associated with burnout. Higher role conflict levels correlated with higher burnout levels.
Our findings indicate that the psychosocial work environment should be considered when designing interventions to reduce the prevalence of burnout and back pain among homecare workers.
The high reported burnout and back pain prevalences among homecare workers highlight an urgent need to design and implement psychosocial work environment-improving interventions. In addition to contributing to homecare employees' long-term attraction and retention, protecting and promoting their health and well-being will likely not only benefit them, but also contribute to patient safety, quality of care and homecare sustainability.
The study reports the prevalence of burnout and back pain among homecare workers and their associations with psychosocial work environment factors. The results indicate that six psychosocial work environment factors—work-life balance, perceived workload, leadership quality, levels of social support from colleagues, role conflict levels, and verbal aggression from clients—all correlate with burnout and/or back pain in homecare workers. For policy makers, researchers, healthcare managers, and homecare agencies, this study's findings will inform the development of interventions to enhance homecare work environments, leading to improvements both in workers' health and in the quality of their care.
We have adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting checklist for cross-sectional studies.
Our stakeholder group included patient representatives, policy makers, researchers, clinicians and representatives of professional associations. Throughout the study, all provided support and input on topics including questionnaire development, result interpretation and the design of strategies to improve response rates.
To explore the perceptions and experiences of managers in residential aged care settings regarding personal care workers' intention to stay and build a career. Specifically, this study sought to identify enablers and challenges influencing personal care workers' retention and to explore strategies that could improve workforce sustainability.
A qualitative study utilising semi-structured interviews underpinned by the Theory of Planned Behaviour.
The study was conducted in Australia from July 2023 to March 2024. Eleven managers participated in this study. Data were analysed using inductive thematic analysis.
Four themes emerged from the analysis and were conceptualised to illustrate the intricate relationship between recruitment practices, work environment, organisational culture and leadership in influencing personal care workers' intentions to stay in residential aged care. A botanical metaphor was used for each theme. The ‘Diverse Seeds of Varied Potential’ theme highlighted how ad-hoc recruitment processes were a primary driver of workforce instability. Challenging work conditions and differing expectations from personal care workers and management led to ‘Wilting in Adverse Environments’, which also contributed to a broader misalignment between facility culture and values, encapsulated within ‘Mismatched Habitats’. Participants emphasised the need for ‘Building a Greenhouse’, a metaphor for cultivating sustainable leadership and workforce development to address these issues.
This study's findings underscore the critical need for a cohesive approach to workforce development strategies in residential aged care. Transitioning from reactive, ad-hoc recruitment to strategic workforce planning, fostering a supportive organisational culture that aligns with personal care workers' expectations, and prioritising sustainable leadership practices are essential steps. Addressing these interconnected challenges can help build a more stable, committed and skilled workforce, ultimately enhancing the quality and continuity of care for residents.
Strategic workforce planning and sustainable leadership development are essential for building a stable workforce, which directly impacts the quality and continuity of resident care.
This study addressed the critical issue of high turnover among personal care workers in residential aged care facilities, specifically examining managers' perspectives on retention challenges: an underexplored area that is crucial for developing sustainable workforce strategies. The findings revealed that current ad hoc recruitment practices, misalignment between diverse personal care worker profiles and established organisational cultures, have great impact on long-term engagement and retention. These insights are particularly valuable for residential aged care facilities struggling with staffing stability, industry bodies focused on workforce development and educational institutions preparing future aged care workers. Furthermore, the findings can inform policy development aimed at strengthening the aged care workforce, ultimately benefiting the quality of care received by residents.
The Consolidated Criteria for Reporting Qualitative Research (COREQ).
There was no patient or public contribution.
(1) To analyse individual and institutional-level factors associated with urinary incontinence in older adults living in nursing homes; (2) to estimate the prevalence of urinary, faecal and double incontinence in nursing home residents.
Cross-sectional study.
Residents aged 65+ living in 22 nursing homes in Catalonia (Spain) were included. Descriptive, bivariate, and multilevel analyses were performed.
The final sample comprised 452 residents (75.9% female, mean age of 87.0 years). The prevalence of urinary, faecal and double incontinence was 77.5%, 46.1% and 45.7%, respectively. Urinary incontinence was statistically significantly associated with neurological conditions, moderate cognitive impairment, moderate dementia, severe cognitive impairment, very severe cognitive impairment and age.
Approximately three out of four nursing home residents suffered from urinary incontinence and almost half of the sample from faecal or double incontinence. Individual-level factors (cognition, neurological conditions and age) played a more important role than institutional-level factors for urinary incontinence.
The findings of this study highlight the importance of individual-level interventions to prevent and manage urinary incontinence in nursing homes.
In Catalonian nursing homes, individual factors such as cognitive impairment and neurological conditions were more strongly associated with urinary incontinence than institutional factors. This has implications for improving care provided to older adults, particularly those with dementia and neurological conditions.
STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
Nursing home residents were not involved in this study.
This study examines the relationships between parental efficacy, parental reflective functioning, and parental age among a unique population of internally displaced Israeli parents. Parents were specifically examined to understand the interplay of parental efficacy, parental reflective functioning, and age as protective factors among displaced children. Through examining these variables, we seek to better understand how to buffer the negative effects of war and displacement on families with young children.
A cross-sectional design was employed to gather data pertaining to parents. This research was part of a larger parent–child dyadic intervention. The data presented here were gathered prior to the intervention from January 2024 to June 2024.
In all, 97 displaced parents were met in person by the research team. Data pertaining to basic demographics, exposure to war, parental reflective functioning, parental efficacy, and the parent–child relationship were gathered. Information was gathered through online questionnaires using Qualtrics. One participant's responses were excluded due to missing data.
Younger parents (aged 27–35) exhibited reduced efficacy under high war exposure conditions, while older parents (aged 46–52) demonstrated increased efficacy. These decreases in efficacy became less pronounced in relation to higher age. This association was found to be insignificant for parents aged 35–46. Parental reflective functioning emerged as a protective factor against declining parental efficacy, buffering the effects of low and moderate war exposure, but diminished under high-stress conditions. Lastly, closer parent–child relationships were found to be associated with higher levels of parental efficacy regardless of war exposure levels.
These results underscore the conditional nature of the impact of war on parenting, emphasising the importance of tailored interventions to support parents across different life stages and reflective capacities. This study highlights the need for targeted strategies to enhance parental efficacy and resilience, fostering better outcomes for families affected by conflict and displacement.
Age-appropriate considerations and interventions focusing on parental reflective functioning are imperative when working with parents of different ages affected by war and displacement.
This study focused on parenting in wartime, specifically parental efficacy, reflective functioning, and parental age. We found younger parents demonstrate reduced efficacy under conditions of high war exposure, while older parents demonstrate increased efficacy under the same conditions. Additionally, parental reflective functioning buffers the negative effects of reduced parental efficacy among parents of all ages, but only under conditions of low war exposure. These findings are relevant to displaced families around the globe, in addition to families affected by exposure to war.
We adhered to the STROBE guidelines for reporting cross-sectional studies in this manuscript.
No patient or public contribution.
by Quynh Anh Tran, Hien Duy Pham, Dung Boi Ly, Minh Quang Ngo, Nhung Thi Nguyen, Liem Thanh Nguyen, Quang Thanh Nguyen
BackgroundEarly definitive surgery for Hirschsprung disease (HD) in neonates is increasingly adopted to reduce preoperative morbidity and preserve long term bowel function. However, comparative data across minimally invasive approaches in neonates with short segment disease remain limited. This study compared outcomes of single incision laparoscopic assisted endorectal pull through (SILEP), conventional laparoscopic assisted endorectal pull through (CLEP), and complete transanal endorectal pull through (TERPT) for rectosigmoid HD.
MethodsWe conducted a retrospective cohort study of 55 neonates who underwent one stage definitive surgery before 28 days of age at a high volume center between January 2019 and December 2021. The primary outcome was long term bowel function assessed using the Rintala Bowel Function Score (BFS) after a minimum of 4 years of follow up. Secondary outcomes included operative parameters, postoperative complications (Clavien Dindo classification), and cosmetic outcomes using the Manchester Scar Scale (MSS) in the laparoscopic groups.
ResultsAll patients successfully underwent surgery at a mean age of 22.4 ± 4.3 days. Operative time differed across approaches and was shorter for SILEP (53.8 ± 11.9 minutes) and TERPT (52.1 ± 18.3 minutes) than for CLEP (70.2 ± 22.5 minutes, p = 0.036). At follow up (mean 54.0 ± 7.7 months), the overall BFS was 17.5 ± 2.5 with no significant differences among groups (p = 0.32). MSS was numerically lower for SILEP than for CLEP (6.2 ± 1.1 vs 6.8 ± 1.9, p = 0.53). Complications were infrequent, with 14 minor and 7 major events, and there was no mortality or Clavien Dindo grade IV or V morbidity.
ConclusionSILEP, CLEP, and TERPT are feasible one stage options for neonates with rectosigmoid HD, with comparable long term bowel function and low rates of major complications. SILEP and TERPT were associated with shorter operative times, and SILEP showed a trend toward improved cosmetic scores compared with CLEP. These findings support an individualized approach to technique selection based on intraoperative requirements and institutional expertise.
by Eléna Payen Schalkens, Maxime Acien, Andrée-Anne Marchand, Pier-Luc Isabelle, Jacques Abboud, Gabriel Moisan
BackgroundChronic metatarsalgia (CM) causes significant pain and disability, affecting quality of life. Foot orthoses (FOs) including medially wedged designs with a metatarsal pad decrease excessive plantar pressure under the metatarsal heads, which is a suggested risk factor for developing CM. This FOs model may be effective in diminishing pain and improving function in these individuals. Thus, the objective of this trial will be to compare the effects of medially wedged FOs with a metatarsal pad and sham FOs on pain and foot function in individuals with CM.
Methods/designThis participant- and assessor-blinded superiority randomized controlled trial (RCT) with two parallel groups will be conducted in Trois-Rivières, Canada. Sixty-four participants with CM will be recruited from the Université du Québec à Trois-Rivières outpatient podiatry clinic and via social media invitations. They will be randomized into intervention (customized FOs) or control (sham FOs) groups and will be evaluated at baseline and after 6 and 12 weeks. The primary outcome will be: (1) mean pain during walking for the most painful foot during the past week. The secondary outcomes will be: (1) Foot Function Index, (2) Global rating of change and (3) the 5-level EQ-5D.
DiscussionMedially wedged FOs with a metatarsal pad are expected to provide a greater reduction in pain and improvement in foot function compared to sham FOs. This trial will help guide FOs prescription recommendations for managing foot pain in individuals with CM in the future.
Trial registrationClinicalTrials.gov NCT06962475
Although neurofilament light chain (NfL) is used as a biomarker of neurodegenerative decline, its application in surgery- and anaesthesia-induced acute cognitive dysfunction remains uncertain. We aimed to synthesise existing evidence to evaluate the potential of NfL as a biomarker for perioperative neurocognitive disorder (PND).
Systematic review and meta-analysis.
PubMed, EMBASE, MEDLINE, the Cochrane Library and the Cochrane Central Register of Clinical Trials were systematically searched up to March 2024.
Observational studies—including cohort, case-control and cross-sectional designs—were included if they reported cerebrospinal fluid (CSF) or blood NfL levels in individuals with and without PND.
Three independent reviewers assessed each article. Quality scoring was conducted, and the extracted data were analysed using STATA. Risk of bias was evaluated using the Newcastle–Ottawa Scale. Meta-analytical model selection was guided by the I2 statistic, with I2≤40% indicating low heterogeneity and the use of a fixed-effect model; random-effects models were used when this threshold was exceeded.
Within-group analyses showed significant postoperative increases in blood NfL levels in both the postoperative delirium (POD) group (standardised mean difference (SMD) = 0.49; 95% CI 0.34 to 0.64) and the no-POD group (SMD=0.67, 95% CI 0.53 to 0.81). Between-group comparisons revealed significantly higher preoperative CSF NfL levels in the POD group (SMD=0.27, 95% CI 0.07 to 0.47). Both preoperative and postoperative blood NfL levels were also significantly elevated in the POD group (SMD=0.53, 95% CI 0.40 to 0.66, and SMD=0.58, 95% CI 0.43 to 0.73, respectively).
This meta-analysis suggests that NfL may be a potential biomarker for POD. Further research is needed to clarify the association between CSF and blood NfL levels and other forms of PND.
CRD42024516907.
Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.
This project will involve the analysis of individual participant data (researcher-collected or administrative). To identify eligible datasets with GWG data, a literature review will be conducted and a global call for data will be launched by the WHO. Eligible individual datasets obtained from multiple sources will be harmonised into a pooled database. The database will undergo steps of cleaning, data quality assessment and application of individual-level inclusion criteria. Heterogeneity of maternal weight and GWG will be assessed to verify the possibility of combining datasets from multiple sources and regions into a single database. Generalized Additive Models for Location, Scale and Shape will be applied for the construction of the centile curves. Diagnostic measures, internal and external validation procedures will also be performed.
This project will include an analysis of existing study de-identified data. To be included in the pooled database, each included study should have received ethics approvals from relevant committees. Manuscripts will be submitted to open-access journals and a WHO document will be published, including the GWG charts and cut-offs for application in antenatal care.
Heart failure (HF) remains a major global health challenge, particularly in low-resource settings where access to comprehensive cardiac rehabilitation (CR) is limited. Yoga, a culturally contextualised mind-body intervention, holds promise as an adjunctive therapy in CR. The Yoga-EndOmics study aims to evaluate the effects of Yoga-based cardiac rehabilitation (Yoga-CaRe) on gene expression, endothelial function, vascular biomarkers and clinical outcomes in systolic HF, providing mechanistic insights into its potential integration into conventional cardiac rehabilitation.
This is a prospective, randomised, open-label, blinded-endpoint (PROBE) mechanistic trial enrolling 78 patients with HF with reduced ejection fraction (HFrEF). Participants will be randomised in a 1:1 ratio to receive either a structured Yoga-CaRe intervention or enhanced standard care for 3 months. The Yoga-CaRe group will attend 20 supervised sessions with guided home practice involving tailored asanas, pranayama and meditation. Primary outcomes are changes in endothelial-dependent flow-mediated dilation (FMD) and functional exercise capacity at 3 months. Secondary outcomes include changes in arterial compliance and stiffness, circulating biomarkers of endothelial dysfunction, oxidative stress and inflammation, and immediate changes in global gene expression profiles in peripheral blood mononuclear cells following the Yoga-CaRe intervention. Data will be analysed using analysis of covariance (ANCOVA) for between-group comparisons and significant analysis of microarray (SAM) for global gene expression profiles.
The study has received ethical clearance from the Institutional Ethics Committee of the SDM College of Medical Sciences and Hospital, India (SDMIEC/2025/1072) and is registered with the Clinical Trials Registry of India. Findings will be disseminated through peer-reviewed journals, scientific conferences and stakeholder engagement platforms to inform future integrative strategies in HF management.
CTRI/2023/12/060758
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by impairments in social interaction, communication and the presence of repetitive behaviours. Recent advancements in brain-computer interface (BCI) technologies have demonstrated potential benefits in enhancing cognitive, social and communication skills in individuals with ASD. However, the effectiveness of BCI-based interventions in ASD rehabilitation remains inconsistent across studies. Therefore, this protocol outlines a systematic review and meta-analysis to synthesise the evidence on the effectiveness of BCI-based interventions for ASD rehabilitation.
We will conduct a comprehensive literature search across multiple databases, including MEDLINE Ovid, Embase Ovid, Cochrane Central Register of Controlled Trials (CENTRAL), Conference Proceedings Citation Index-Science (CPCI-S), Science Citation Index Expanded (SCI-EXPANDED) and so on, to identify relevant studies published from inception to the present. The search will be supplemented by screening the reference lists of included studies and relevant systematic reviews. Two independent reviewers will screen the titles, abstracts and full texts of identified studies for eligibility based on predefined criteria. Data extraction will be performed using a standardised form, and the risk of bias (RoB) will be assessed using the Cochrane RoB tool. Heterogeneity will be evaluated using the I² statistic, and a random-effects or fixed-effects model will be selected for meta-analysis based on the degree of heterogeneity. Subgroup analyses will be conducted to explore potential sources of heterogeneity, including participant age, ASD severity, type of BCI intervention and duration of the intervention. The review will be conducted from January 2026 to April 2026.
Ethical approval is not required for this study, as it does not involve the collection of primary data from individual patients. Findings will be disseminated through peer-reviewed publication and conference presentations.
CRD420251010496.
Women experiencing infertility employed various coping strategies to overcome the diverse stressors encountered. These coping strategies had their peculiar consequences or outcomes. This study aimed to explore the outcomes deduced from the coping strategies employed by women with infertility.
The study employed a qualitative descriptive research design to gain an in-depth understanding of the outcomes of coping strategies used by women with infertility. In-depth interviews were conducted using a semi-structured interview guide.
The study was carried out at a private fertility and specialist hospital within the Kumasi Metropolitan Assembly, where 15 women diagnosed with primary infertility were interviewed for 45 min to 1 hour each. With all participants completing the study, interviews were audiotaped with consent, transcribed verbatim and analysed using content analysis.
The findings revealed that women with infertility used various coping strategies to mitigate the psychosocial stressors encountered. The coping strategies employed had a varying impact on the well-being of women with infertility, from long-term (physical health, mental health and life satisfaction) to short-term (composure and reduced state anxiety) coping outcomes. The result of the coping strategy employed had a varying impact on the well-being of women with infertility.
Women with infertility shared how they experienced good physical health, mental health and life satisfaction after employing adaptive coping strategies like seeking social support. They also shared how they exercised composure and had reduced state anxiety after using some maladaptive coping strategies, such as self-control and avoidance.
The substantial case detection gap in the field of child tuberculosis (TB) disease is largely driven by inadequate diagnostic tools and approaches. Chest radiographs (CXRs) remain a key component in the evaluation of children and young adolescents (0–15 years) with presumptive TB, aiding clinicians in making the diagnosis and discriminating children with TB from those with other diseases. Widespread use and optimal interpretation of CXR is hampered by a lack of access to well-trained specialists to interpret images. Artificial intelligence CXR interpretation software, termed computer-aided detection (CAD), is now well developed for adults, yet few products have been evaluated in children. The CXR features of child TB are different from those of adults, and as a result, the performance of these CAD algorithms, largely developed for use in adults, will be suboptimal when used in children. Adapting, or fine-tuning adult CAD algorithms, using CXR images from children with presumptive TB, could allow optimisation of these products for use in children. We, therefore, set out to develop a large image and data repository collected from children evaluated for TB (called Catalysing Artificial Intelligence for Paediatric Tuberculosis Research, CAPTURE) with the purpose of evaluating current CAD products and then working with developers and other partners to optimise CAD algorithms for use in children.
We identified approximately 20 studies, from which potentially up to 11 000 CXRs could be used for the proposed project. CXRs and data were eligible for inclusion in the CAPTURE repository if collected from high-quality child TB diagnostic studies that enrolled children with presumptive TB and if CXRs were obtained as part of the baseline assessment. All lead investigators of these studies are members of the CAPTURE consortium. The images and metadata contributed are centrally collated and the key variable of TB case classification as confirmed, unconfirmed or unlikely TB, using an established consensus case definition, is available. All CXRs included in the CAPTURE repository have a consensus radiological interpretation allocated by a panel of independent expert child TB CXR readers who have classified them as ‘unreadable’, ‘normal’, ‘abnormal typical of TB’ or ‘abnormal not typical of TB’. To determine diagnostic performance of existing CAD products, we will evaluate these against a primary composite clinical reference standard (confirmed TB and unconfirmed TB vs unlikely TB), as well as other secondary microbiological and radiological reference standards. A subset of images will be subsequently allocated to a ‘training set’ and made available to developers, academic groups or other parties to either develop novel paediatric CAD products or fine-tune existing adult ones, which will then be re-evaluated by the CAPTURE team using an image subset (‘validation set’) that is independent of the training set.
The CAPTURE study has been approved by Stellenbosch University Health Research Ethics Committee (N22/09/113), with additional ethics approval or waivers by relevant local authorities obtained by consortium members contributing data if required. The final pooled, harmonised and cleaned dataset, as well as the deidentified, renamed CXR images, is stored on a secure cloud-based server. All analyses of existing CAD products, as well as the paediatric-optimised products, will be published in peer-reviewed publications and shared with other stakeholders like the WHO and donor and procurement organisations to guide policy updates and procurement pathways to ensure widespread uptake.
Students enrolling in higher education often adopt lifestyles linked to worse mental health, potentially contributing to the peak age onset of mental health problems in early adulthood. However, extensive research is limited by focusing on single lifestyle behaviours, including single time points, within limited cultural contexts, and focusing on a limited set of mental health symptoms.
The UNIversity students’ LIFEstyle behaviours and Mental health cohort (UNILIFE-M) is a prospective worldwide cohort study aiming to investigate the associations between students’ lifestyle behaviours and mental health symptoms during their college years. The UNILIFE-M will gather self-reported data through an online survey on mental health symptoms (ie, depression, anxiety, mania, sleep problems, substance abuse, inattention/hyperactivity and obsessive/compulsive thoughts/behaviours) and lifestyle behaviours (ie, diet, physical activity, substance use, stress management, social support, restorative sleep, environment and sedentary behaviour) over 3.5 years. Participants of 69 universities from 28 countries (300 per site) will be assessed at university admission in the 2023 and/or the 2024 academic year and followed up for 1, 2 and 3.5 years.
The study was first approved at a national level in Brazil (CAE:63025822.8.1001.5346). Study sites outside Brazil obtained additional ethics approval from their institutions using the main approval. Results from the UNILIFE-M cohort will be disseminated through scientific publications, presentations at scientific meetings, press releases, the general media and social media.
FreshRSS 