Conectar
The North West London Diabetes Cohort is established to provide systematic characterisation of a large diabetes population as a foundation for complications research and prognostic modelling. Many predictive modelling studies neglect the essential descriptive characterisation of underlying cohorts, focusing narrowly on model accuracy. This cohort profile addresses this gap by comprehensively describing the demographic composition, clinical characteristics and complication incidence patterns. The notably diverse, multiethnic population enables examination of ethnic disparities and supports future development of reliable prognostic models and evidence-based prevention strategies for diabetes complications.
At baseline, 337 271 patients with diabetes were identified. It includes 279 067 patients with type 2 diabetes, 17 638 with type 1 diabetes, 33 590 with gestational diabetes and 6916 with unspecified diabetes. The earliest diabetes diagnosis dates to January 1932, with data updated to 27 May 2025.
This cohort profile describes baseline characteristics of patients with comprehensive data collected on demographics (age, sex, Deprivation Index, ethnicity), clinical measures (glycated haemoglobin, body mass index, blood pressure, lipids and estimated glomerular filtration rate) and 14 major diabetes complications tracked longitudinally. Key findings for patients with type 2 diabetes reveal diabetic retinopathy as the most common complication (74.6 per 1000 person-years), followed by hypertension (51.0) and kidney disease (31.4). Cumulative incidence analyses using the Aalen-Johansen estimator, which accounts for mortality as a competing risk, demonstrated significant ethnic disparities, with black, Asian, mixed and other ethnic groups showing elevated risk compared with white patients. Time-varying Cox models identified strong clustering between cardiovascular and renal complications, confirming a cardiometabolic-renal syndrome. Mental health conditions (depression and anxiety) were prevalent throughout the disease timeline, occurring both before and after diabetes diagnosis.
This cohort will be used as a platform for developing and validating prognostic models for diabetes complications, enabling risk stratification and targeted interventions. Future work will incorporate medication data to refine diabetes type classification, examine the effectiveness of antidiabetic medications in preventing different complications and address demographic differences in prognostic model performance and prediction accuracy. To better characterise lifestyle, further interrogation of electronic health record data will examine recording of advice given, including dietary advice, referral to weight management schemes and presence of alcohol consumption codes.
To compare the effectiveness of different intervention strategies for improving self-care maintenance, self-care management and self-care confidence in adults with heart failure.
Systematic review and network meta-analysis.
Following PRISMA-NMA guidelines, randomised controlled trials evaluating heart failure self-care interventions were included. Self-care was assessed using the Self-Care of Heart Failure Index across the eligible studies. Interventions were classified as knowledge/cognition-oriented, skill/behaviour-oriented, monitoring/feedback-reinforcement, motivation/empowerment-oriented or multicomponent. Risk of bias was assessed with RoB 2. Pairwise meta-analyses and exploratory network meta-analyses were performed.
PubMed, Embase, Scopus, Web of Science, CENTRAL, CINAHL and PsycINFO were searched from inception to March 2025.
Fifty-four trials involving 6508 participants were included, of which 32 contributed to the meta-analysis. In pairwise meta-analysis, motivation/empowerment-oriented and skill/behaviour-oriented interventions improved self-care maintenance, whereas knowledge/cognition-oriented, monitoring/feedback-reinforcement and motivation/empowerment-oriented interventions improved self-care management. Multicomponent interventions improved maintenance, management and confidence, but were not clearly superior to more focused strategies. Subgroup analyses suggested greater benefits from personalised provider feedback than from predominantly automated feedback. Exploratory network meta-analysis showed similar patterns, although rankings should be interpreted cautiously because the network was star-shaped and lacked direct comparisons between active interventions.
Heart failure self-care interventions are not equally effective across domains. Motivation/empowerment-oriented approaches showed the clearest signal for self-care maintenance, whereas knowledge-based and personalised monitoring/feedback strategies appeared more relevant for self-care management. These findings support a more targeted approach to intervention design.
Healthcare professionals should tailor strategies to specific self-care goals, prioritising motivational techniques for maintenance, structured education and monitoring with personalised feedback for management.
No patient or public involvement.
CRD420250652676
Malignant biliary obstruction (MBO) is a common complication of pancreaticobiliary and periampullary malignancies and is associated with substantial morbidity and reduced survival. Multiple biliary drainage strategies are available, including endoscopic, percutaneous and surgical approaches, as well as adjunctive therapies. However, direct head-to-head comparisons remain limited, and the relative effectiveness and safety of these interventions are not well established. This study aims to compare the effectiveness and safety of different biliary drainage strategies for MBO using a network meta-analysis, allowing both direct and indirect comparisons and enabling ranking of treatment strategies.
This protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. We will systematically search MEDLINE via PubMed, Embase via Elsevier, Web of Science Core Collection via Clarivate, and the Cochrane Central Register of Controlled Trials via the Cochrane Library from inception to 30 June 2026. Randomised controlled trials (RCTs) and non-randomised comparative studies will be included. Interventions of interest include endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound-guided biliary drainage (EUS-BD), percutaneous transhepatic biliary drainage (PTBD), surgical bypass and adjunctive therapies combined with drainage (eg, photodynamic therapy or radiofrequency ablation). Primary outcomes will include technical success, clinical success and quality of life. Secondary outcomes will include adverse events, reintervention rates, overall survival, 30-day all-cause mortality, stent patency duration and length of hospital stay. Risk of bias will be assessed using the Cochrane Risk of Bias two tool for RCTs and the ROBINS-I tool for non-randomised studies. A random-effects network meta-analysis will be conducted within a frequentist framework. Consistency and transitivity assumptions will be assessed, and treatment ranking will be estimated using the surface under the cumulative ranking curve. Subgroup analyses will be performed according to clinically relevant factors, including obstruction site, stent type, tumour type and treatment setting. The certainty of evidence will be evaluated using the GRADE approach adapted for network meta-analysis.
Ethical approval is not required, as this study is based on published data. Findings will be disseminated through peer-reviewed publication.
CRD420261373097
To synthesize empirical evidence on decision-making factors and emotional outcomes among surrogate medical decision-makers for people with dementia.
Integrative review.
A comprehensive search was conducted following Whittemore and Knafl's integrative review methodology. Eligible studies were appraised using the Mixed Methods Appraisal Tool and synthesized through inductive content analysis, guided by the Transactional Model of Stress and Coping.
PubMed, CINAHL, Embase, Scopus and PsycINFO were searched in August 2025.
Eighteen studies representing 574 surrogate decision-makers for people with dementia were included. Surrogate decision-making unfolded as an iterative process of evaluating clinical and relational demands, mobilizing coping resources and reappraising earlier judgements as conditions changed, consistent with the Transactional Model of Stress and Coping. Decision-making was influenced by informational needs, communication quality, family dynamics, cultural values and organizational barriers. Emotional outcomes ranged from guilt, anxiety and regret to relief, acceptance and growth.
Surrogate medical decision-making in dementia reflects an iterative process of appraisal, coping and reappraisal, shaped by contextual, relational and organizational factors that influence emotional outcomes.
Nurses should assess decision-making contexts and provide tailored informational, relational and emotional support throughout the dementia care trajectory.
Dementia often requires family members and other surrogates to make complex medical decisions, yet limited synthesis has examined how they appraise and cope with these demands. This review found that surrogate decision-making is an iterative process shaped by evolving appraisals, coping resources and communication quality, leading to varied emotional outcomes. Findings highlight the need for research that examines how surrogate decision-makers with multiple competing roles appraise and cope with decisions across the dementia trajectory.
This review adheres to the PRISMA 2020 reporting guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
This study aimed to evaluate the prevalence and metabolic, hormonal and clinical characteristics of metabolic syndrome among women with polycystic ovary syndrome (PCOS) in the Oran region (western Algeria).
Cross-sectional study.
Outpatient endocrinology and gynaecology services in the Oran region, western Algeria.
A total of 313 women aged 16–45 years diagnosed with PCOS according to the Rotterdam 2004 criteria.
Prevalence of metabolic syndrome and differences in anthropometric (body mass index (BMI)), metabolic (fasting glucose and lipid profile), hormonal (gonadotropins, androgens, anti-Müllerian hormone (AMH), progesterone, vitamin D) and clinical features (hyperandrogenism, menstrual irregularity, infertility) between women with and without metabolic syndrome.
Of the 313 participants, 181 (57.9%) met the criteria for metabolic syndrome. These women had significantly higher BMI (26.70±5.93 vs 25.06±6.47 kg/m²; p=0.004), elevated fasting glucose (133.43±28.52 vs 105.41±28.54 mg/dL; p
More than half of women with PCOS exhibited metabolic syndrome, characterised by obesity, dyslipidaemia, insulin resistance and vitamin D deficiency. These findings highlight the need for early metabolic screening and holistic management in women with PCOS to reduce long-term cardiovascular and reproductive risks.
by Xiaodong Zhang, Lan Zou, Dunfu Zhang, Bangtao Yao, Junge Chen, Tianfeng Wei, Zhouping Fu, Xin Chang, Lijuan Chen, Yan Geng
BackgroundForearm radial artery occlusion (RAO) is a common complication after transradial coronary procedures. Traditional patent hemostasis, relying on operator-dependent assessment, results in labor-intensive processes and inconsistent RAO rates.
MethodsThis is a single-center, prospective, randomized, open-label, parallel-group superiority trial. We plan to enroll 818 patients scheduled for transradial coronary angiography. Participants will be randomly assigned (1:1) to either a novel balloon pressure monitoring system (integrating high-precision digital manometry with physiologically-phased decompression) or traditional patent hemostasis. The primary outcome is the incidence of ultrasound-confirmed forearm RAO at 24 hours post-procedure. Key secondary outcomes include rates of access-site vascular complications and bleeding events, as well as objective metrics of hemostasis efficiency. Recruitment Status: Recruitment commenced in September 2024 and is ongoing; the target sample size is anticipated to be reached by May 2026. Analysis will follow the intention-to-treat principle.
Results/ Trial StatusAs a protocol paper, no results are reported. The trial is currently in the recruitment phase.
ConclusionsThis trial will provide the first large-scale randomized evidence on whether digital manometry-guided compression reduces RAO, potentially bridging the efficacy-effectiveness gap between optimized research protocols and routine practice.
Trial registrationThe trial was registered with the Chinese Clinical Trial Registry (ChiCTR) in August 2024, under the registration number ChiCTR2400088258.
Individuals with cardiovascular disease are prone to frailty, while frailty accelerates disease progression and worsens outcomes. Exercise interventions are essential non-pharmacological treatments for frail elderly patients with cardiovascular disease; however adherence remains low and strategies are inconsistent. Telerehabilitation improves accessibility, allows continuous monitoring with timely clinical responses and helps overcome mobility and geographical barriers for frail older adults. Guided by the patient-centred approach, exercise telerehabilitation should consider both clinical effectiveness and patient preferences to enhance acceptance and adherence. However, patient preferences for web-based exercise telerehabilitation remain poorly understood.
This study is designed as a discrete choice experiment to elicit and quantify preferences for key features of web-based exercise telerehabilitation among frail older adults with cardiovascular disease. Candidate attributes and levels were developed through a systematic literature review, patient focus groups and expert consultation. An orthogonal fractional-factorial design will generate the choice sets. A questionnaire survey will recruit older adults with cardiovascular disease who are identified as frail based on validated frailty assessment scales. Participants will be recruited from a cardiovascular specialty hospital in Xiamen, China, with a planned sample size of 157. Final data will be analysed using mixed logit models to estimate attribute importance, quantify preference weights and identify preference heterogeneity.
This study has received ethical approval from the relevant institutional ethics committee (2025–46). All participants will provide informed consent. Findings will be disseminated to patient groups, clinicians and policymakers and published in peer-reviewed journals and presented at national and international conferences.
by Quan He, Xiong Zou, Chunyan Zheng, Jiawei Zhang, Jialing Li, Liping Hu, Ting Zeng, Zijuan Huang, Peipei Zeng, Jinli Wei, Haichen Cui, Yongjian Su, Hai Li
BackgroundResidual mother-to-child transmission (MTCT) of hepatitis B virus (HBV) remains a significant clinical challenge despite standard immunoprophylaxis. Identifying molecular markers is crucial for improved prevention and diagnosis.
MethodsWe conducted a case-control study using the Guangxi Liuzhou HBV MTCT registry. Peripheral blood RNA sequencing (Illumina HiSeq) was performed on infants from HBsAg-positive mothers: cases (HBsAg-positive, n = 6) and controls (HBsAg-negative, n = 10). All infants receive HBIG and the first dose of hepatitis B vaccine within 24 hours after birth, followed by completion of the three-dose vaccination series. Differentially expressed miRNAs (DEMs; adj-p 1) were identified. Target genes were predicted (miRanda/RNAhybrid) and functionally analyzed (GO/KEGG enrichment, PPI network). HBV-associated target genes were identified by cross-referencing GeneCards/NCBI.
ResultsRNA-seq identified 62 DEMs (19 upregulated, 43 downregulated). Target prediction yielded 5,014 genes. Functional enrichment highlighted key pathways and processes. PPI analysis pinpointed highly connected genes. Integration with HBV databases revealed 3 key target genes potentially modulated by 4 specific DEMs (hsa-miR-6747-3p, hsa-miR-4772-3p upregulated; hsa-miR-4676-5p, hsa-miR-485-5p downregulated).
ConclusionThis study identifies dysregulation of 4 key miRNAs and their association with 3 HBV-linked target genes as potential contributors to residual HBV MTCT. These findings provide novel insights into the molecular mechanisms underlying HBV MTCT and suggest potential targets for intervention.
To analyse the current status of psychological resilience in Parkinson's disease (PD) patients and its correlation with social support and coping style.
A cross-sectional study.
PD patients hospitalized in a tertiary-level hospital in Shijiazhuang, Hebei Province, from March 2022 to March 2023 were selected for the study using the convenience sampling method. A general information questionnaire, psychological resilience scale, Medical Coping Modes Questionnaire and Perceived Social Support Scale were used to investigate 111 cases of PD. SPSS 25.0 software was used for statistical analysis. The data were analysed using independent samples t-test, one-way ANOVA, multiple linear regression analysis and the Pearson correlation coefficient.
Parkinson's disease patients have a moderate level of psychological resilience. The results of the Pearson correlation analyses showed that the level of psychological resilience was positively correlated with social support and confrontation and was negatively correlated with avoidance and acceptance-resignation. The results of multiple linear regression analysis showed that social support and acceptance-resignation were the influencing factors of psychological resilience in PD patients.
The psychological resilience of PD patients is at a moderate level. Social support and acceptance-resignation are the factors influencing the psychological resilience of PD patients.
This study analysed the level of psychological resilience in PD patients and its correlation with social support and coping style from the perspective of positive psychology to provide some reference for targeted clinical interventions. Our study found that social support and acceptance-resignation are influential factors in psychological resilience in PD patients. Medical staff should encourage patients to face the disease positively and their social support should be increased in order to improve their level of psychological resilience.
No patient or public contribution.
To evaluate the maximum number of patients per nurse before quality and safety outcomes deteriorate in medical-surgical settings.
A secondary analysis of cross-sectional survey data.
We analysed data from 609 direct care nurses working in British Columbia's medical-surgical areas. The relationship between nurse-to-patient ratios and quality and safety outcomes was analysed using both two-level and one-level regression models, including visualisations such as boxplots and scatterplots with LOESS curves. The analysis controlled for nurse demographics and hospital clustering effects.
Ratios ranged from 1:1 to 1:9, with outliers above 1:9 excluded. For desirable outcomes, last shift quality of care, unit safety grade, and recommending units to friends/family and to colleagues, the means were generally positive for ratios ranging from 1:2 or 1:3 to 1:4 but negative for ratios ranging from 1:5 to 1:8 or 1:9. This pattern was reversed for adverse outcomes, undone tasks and emotional exhaustion; the means were generally negative for ratios between 1:1 and 1:3 to 1:4 but became positive for ratios between 1:5 and 1:6 to 1:8. A turning point (crossing zero) was found between the ratios of 1:4 and 1:5 for all outcomes except patient adverse events, where the turning point was between the ratio of 1:3–1:4.
The findings provide preliminary evidence in support of minimum nurse-to-patient ratios of 1:4 in British Columbia's medical-surgical areas. Policy-makers and decision-makers should augment minimum nurse-to-patient ratios with other nurse-driven tools and nurse-management staffing methods that provide more flexibility to better meet fluctuating environmental, patient and staffing needs.
This study did not include patient or public involvement in its design, conduct, or reporting.
Minimum ratios should be complemented by nurse-driven tools and flexible staffing strategies to account for contextual and resource variability.
This secondary analysis of 2015 survey data from 609 medical-surgical nurses in British Columbia, Canada supported a minimum nurse-to-patient ratio of 1:4 using a series of quality and safety outcomes for patients and nurses. This finding provides important preliminary evidence in support of the specific minimum nurse-to-patient ratios of 1:4 as the province prepares to implement this ratio in medical-surgical settings. Existing staffing models using minimum nurse-to-patient ratios may be augmented by employing additional staffing tools and methodologies that provide more flexible resource allocation.
This study adheres to STROBE guidelines.
To explore the concurrent trajectories of depressive symptoms and insomnia among adolescents and to analyse the individual, familial and social predictors of the concurrent trajectories.
This study tracked depressive symptoms and insomnia in eight secondary schools annually from 2021 to 2023. We also collected data on individual, familial and social factors that may influence these conditions. Group-based multi-trajectory (GBMT) modelling was used to categorise adolescents into depressive–insomnia severity subgroups.
This study included 2822 adolescents, who were categorised into four groups, including the no symptom group, mild symptom group, symptom relief group and symptom increase group. Compared with the no symptom group, predictors of the mild symptom group were gender (OR = 1.30), academic performance (OR = 1.57), subjective well-being (OR = 0.78), anxiety (OR = 1.14), economic status (OR = 1.23) and relationship with teachers (OR = 1.46). Predictors of the symptom relief group were personality (OR = 1.75), academic performance (OR = 2.28), subjective well-being (OR = 0.69) and anxiety (OR = 1.25). Predictors of the symptom-increasing group were personality (OR = 2.45), academic performance (OR = 1.96), subjective well-being (OR = 0.69), anxiety (OR = 1.20), maternal education level (OR = 1.58), family function (OR = 0.93), parental relationship (OR = 2.07) and relationship with teachers (OR = 1.54).
This study provided a comprehensive understanding of the concurrent trajectories of depressive symptoms and insomnia among adolescents, revealing distinct subgroups and identifying predictors across individual, familial and social levels.
This study emphasises the importance of a multi-faceted approach involving family, school and society to promote adolescent mental health and also highlights the need for conducting precise interventions according to adolescents' features.
The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.
STROBE checklist.
None.
by Saleh Abualhaj, Anas Alyazouri, Mosleh M. Abualhaj, Lina Alshadfan, Shadi Hamouri, Obada Alaraishy, Eman Alkhawaja, Amro Mureb, Ali Aloun, Abdallah Arabyat
BackgroundBariclip is an emerging non- resective bariatric device designed to restrict gastric capacity while preserving anatomical integrity. Unlike traditional sleeve gastrectomy, Bariclip implantation does not involve gastric resection, potentially minimizing surgical risk and allowing reversibility. However, data on its early efficacy and safety remain limited.
ObjectiveTo evaluate short-term surgical outcomes, weight loss metrics, and comorbidity resolution among patients undergoing Bariclip implantation.
MethodsThis retrospective observational study included 82 patients who underwent Bariclip placement at a single tertiary care center. Data were extracted from electronic medical records, operative logs, and follow-up notes. Outcomes assessed included total weight loss (TWL%) and excess weight loss (EWL%) at 2 weeks, 1, 2, 3, and 6 months postoperatively. Additional variables included operative time, hospital stay, early postoperative complications (within 30 days), reintervention rates, and changes in obesity-related comorbidities.
ResultsThe cohort had a mean age of 37.6 ± 9.9 years, with the majority being female (76.8%) and obese (mean BMI = 36.6 ± 4.7 kg/m²). Most patients (91.5%) underwent surgery for obesity management. Postoperatively, patients reported low pain scores (mean = 5.2), with no need for opioid analgesia and early mobilization in 62.2%. Complication rates were low (3.6%). Repeated measures ANOVA revealed a significant reduction in BMI over time (p Conclusion
Bariclip surgery demonstrated favorable short-term safety and efficacy, with substantial weight loss and low complications rate observed within six months. These findings support Bariclip as a promising minimally invasive option for weight management in select patient populations.
by Dongli Huang, Huan Zou, You Zhang
BackgroundThe Framingham Steatosis Index (FSI) is a diagnostic indicator of hepatic steatosis. Although prior studies have established associations between hepatic steatosis and chronic kidney disease (CKD) and between FSI and CKD, the association between FSI and proteinuria remains unexplored. This study investigated the association between FSI and albuminuria, addressing this research gap.
Patients and methodsData were obtained from the National Health and Nutrition Examination Survey (NHANES) database. The association between FSI and albuminuria was examined using multivariable logistic regression and stratified analyses. Nonlinearity was assessed using smoothing curves, and inflection points were located with a recursive algorithm. Subgroup analyses were conducted to evaluate the consistency of the association between FSI and albuminuria across different strata. Finally, propensity score matching (PSM) was applied to reduce potential confounding and enhance the robustness of the findings.
ResultsIn model 3, which adjusted for all covariates, the odds ratio (OR) for the association between FSI and albuminuria was 1.13 (95% CI: 1.09–1.18). Smooth curve fitting demonstrated a U-shaped relationship between FSI and albuminuria. Threshold analysis identified an inflection point at an FSI value of −3.22 to further characterize this relationship. Subgroup analyses showed directionally consistent associations across strata. The U-shaped relationship between FSI and albuminuria remained robust after applying PSM.
ConclusionOur study identified a U-shaped relationship between FSI and albuminuria.
by Bo Zou, Fengchan Xi, Tao Gao, Wenkui Yu
BackgroundThe role of early enteral nutrition (EEN) in septic shock remains unclear. This study aimed to evaluate the association between EEN and clinical outcomes in septic patients requiring vasopressor therapy and invasive mechanical ventilation.
MethodsThis retrospective cohort study used the MIMIC-IV database and included adult septic patients receiving vasopressors and mechanical ventilation at ICU admission. EEN was defined as enteral nutrition initiated within 48 hours. The primary outcome was 28-day mortality. Secondary outcomes included ICU and hospital length of stay, and duration of mechanical ventilation. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline confounders. Vasopressor dose was stratified based on the maximum norepinephrine-equivalent dose in the first 48 hours: low (0.5). Multivariable regression models were used to assess associations.
ResultsA total of 4,673 patients were included, of whom 997 (21.3%) received EEN. Before weighting, EEN was associated with higher 28-day mortality (21.9% vs. 15.3%). After IPTW adjustment, early feeding remained significantly associated with increased mortality (adjusted odds ratio 1.80; 95% confidence interval, 1.42 to 2.27). In stratified analyses, EEN was associated with increased mortality in the medium-dose (odds ratio 1.66; 95% confidence interval, 1.26 to 2.19, p Conclusions
In critically ill septic patients receiving vasopressors and mechanical ventilation, EEN was associated with increased 28-day mortality, particularly among those receiving medium- or high-dose vasopressor therapy.
To synthesise literature about horizontal violence or workplace bullying among Intensive Care Unit nurses, exploring its awareness, factors, impacts, and strategies.
Following PRISMA standards, a mixed systematic review using a narrative synthesis approach and thematic analysis design of the Joanna Briggs Institute.
Four electronic databases from 2013 to 2023 studies published were searched.
Eight studies were included: three qualitative and five quantitative. Four key themes emerged: (i) awareness and understanding of horizontal violence or workplace bullying, (ii) factors affecting horizontal violence or workplace bullying, (iii) impacts of horizontal violence or workplace bullying, and (iv) strategies to address horizontal violence or workplace bullying.
Addressing horizontal violence or workplace bullying requires hospitals should adopt conflict resolution policies, stress management programs, and supportive supervision to improve nurse retention. Nurse management should establish confidential reporting mechanisms, provide training on interpersonal respect, and implement supportive structures to promote psychological safety. Intensive care unit nurses are encouraged to take proactive steps to address workplace bullying, ensuring improved staff well-being and care quality.
This paper addresses a significant gap in the literature regarding horizontal violence or workplace bullying among Intensive Care Unit nurses.
The findings will impact on healthcare administrators, policymakers, and educators. By understanding horizontal violence or workplace bullying, strategies can be implemented to improve workplace environment, support nurses' well-being, increase nurse retention, and improve the quality of patient care.
This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review methodology, including data selection, extraction, and synthesis, follows PRISMA standards to ensure clarity, transparency, and reproducibility.
This study did not include patient or public involvement in its design, conduct, or reporting.
There is a protocol that does not require registration, it made accessible at: https://doi.org/10.17605/OSF.IO/CFNEJ.
by Oumarou I. Wone Adama, Iman Frédéric Youa, Alexandra Bitty-Anderson, Arnold Junior Sadio, Rogatien Comlan Atoun, Yao Rodion Konu, Hezouwe Tchade, Martin Kouame Tchankoni, Kokou Herbert Gounon, Kparakate Bouboune Kota-Mamah, Abissouwessim Egbare Tchade, Godonou Amivi Mawussi, Fiali Ayawa Lack, Fifonsi Adjidossi Gbeasor-Komlavi, Anoumou Claver Dagnra, Didier Koumavi Ekouevi
IntroductionIn Togo, the syndromic approach is used for the diagnosis and management of sexually transmitted infections (STIs). The aim of this study was to evaluate the syndromic approach for diagnosis of STIs among female sex workers (FSW) in Lomé, Togo.
MethodsA cross-sectional study was carried out from September to October 2023 among FSW in Lomé (Togo). FSW aged 18 years and above were included. A gynecological examination was performed for syndromic diagnosis, and the Xpert® CT/NG were used to screen vaginal swabs for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). The performance (predictive values) of the syndromic approach to STI diagnosis was evaluated using the Xpert® CT/NG test as the gold standard.
ResultsA total of 357 FSW were recruited. The median age of FSW was 32 years (IQR: [26–40 years]) and 8.2% had attained a higher level of education. The prevalence of syndromic STI among FSW was 33.3%. Vaginal swabs were positive for CT (8.4%) and NG (8.7%), with a prevalence of bacterial STIs (CT and/or NG) of 14.3%. The syndromic approach to STI diagnosis demonstrated a positive predictive value of 24.3%.
ConclusionThe prevalence of STIs is relatively high among FSW in Lomé. According to this study, the diagnosis of STIs using the syndromic approach has limited relevance. National STI screening and management policies urgently need to be rethought, incorporating recent technological advances.
by Xinfeng Xu, Xinyao Jiang, Meng Zou, Jinyan Hui, Guang Huang, Qian Wu
Perfluorinated compounds (PFCs) are persistent environmental pollutants with near-universal human exposure, yet their respiratory health impacts during adolescence remain insufficiently explored. This investigation evaluated single and combined effects of serum PFCs on pulmonary function and respiratory morbidity in a nationally representative adolescent cohort (n = 976, ages 12–19 years) utilizing 2007–2012 NHANES data. Advanced analytical approaches including multivariable regression, mixture modeling (BKMR and WQS), and mediation analysis were employed to assess associations with spirometric parameters (FEV1, FVC, FEV1/FVC) and respiratory symptoms while examining inflammatory and oxidative stress pathways. Computational approaches integrating network toxicology and molecular docking identified key protein targets. Analytical results demonstrated significant associations between specific PFC congeners (PFOA, PFHS, PFOS) and pulmonary function measures, with age-stratified effects observed for wheezing symptoms. Mixture analyses revealed PFOA as the predominant contributor to observed respiratory effects, partially mediated through oxidative stress pathways (6.8–8.2% mediation). Molecular investigations identified critical signaling nodes (INS, AKT1, TP53, TNF, IL6, ALB and PPARγ) potentially linking PFC exposure to respiratory outcomes. These findings provide mechanistic insights into PFC-induced pulmonary effects during adolescence, highlighting the need for continued investigation of these environmentally persistent compounds’ impact on developing respiratory systems. The integrated epidemiological-computational approach demonstrates the utility of combining population-level data with mechanistic modeling to elucidate environmental health effects.To evaluate bioecology and environmental influences of patients presenting with alopecia regarding decisions made for hair camouflage.
A descriptive qualitative design was used.
Sixteen adult patients with alopecia were purposefully recruited from two specialised trichology clinics across the Jiangsu Province, China. Surveys and in-depth semi-structured interviews were conducted between October 2024 and December 2024. Practical thematic analysis of transcribed data was informed through Bronfenbrenner's ecological systems theory.
Five major facilitators (camouflaged demands drive, camouflaged psychological resilience, habituation and dependence, family resilience and cross-border support, social acceptance) and four major barriers (limited future orientation, perceived coordination barriers, marginalisation of camouflage-related information, runaway costs) to hair camouflage were identified. These themes align with different levels of the ecological systems theory.
This study captures the complex ecological and intersectional nature of choice, experience and decision-making in patients' views on hair camouflage amid alopecia. Nursing professionals must understand these complexities to provide informed support and evidence-based interventions throughout patients' experiences with alopecia.
This study uses patient voices to offer ecological insights for a holistic understanding of their experiences. It provides knowledge relevant to nursing practice and alopecia patient support. Understanding patient-identified barriers and facilitators in alopecia camouflage is essential to inform more patient-centred approaches to choice, decision-making and psychological adaptation. Nurses are pivotal in this process, making enhanced understanding crucial for improving patients' psychological wellbeing and quality of life.
Our research reveals factors that equip nurses and the broader healthcare team to develop targeted counselling strategies, educational programs and resources related to camouflage for patients with alopecia. The hair-camouflage industry can use these insights to create more personalised and accessible products, better addressing patients' concealment needs and preferences.
Standards for Reporting Qualitative Research.
No patient or public contribution.
To offer a student-focused critical evaluation of the content and use of a digital competencies discipline-specific toolkit that was co-designed with students, offering ideas for training and development across several digital skills areas, such as digital creation, research, communication, innovation, and wellbeing.
A cross-sectional empirical study.
The toolkit was evaluated based on clarity, level of comprehension, accessibility, perceived relevance, and future implementation through a survey, which collected quantitative and qualitative data from 339 undergraduate nursing students in a single school and university in Scotland. Original research data were collected in June 2023.
Students evaluated the toolkit positively for its clarity, comprehensive nature, and practical resources, but suggested improvements for neurodivergent learners. Most students recommended implementing the toolkit early in their course and emphasised its benefits in continuous use. The toolkit was found to be relevant for practice placements and career development. Despite study workload concerns, students were positive about upskilling, highlighting the utility of the toolkit.
Digital literacy is essential as healthcare increasingly relies on digital tools, behaviours and processes. This study employed co-design strategies, supporting students to act as co-producers, change agents, and partners in learning.
The study highlights the need for continuous education in digital skills with suggestions for incorporating advanced skills for future practice, such as data analytics and artificial intelligence, and discusses the value of digital skills development in higher education to enhance student learning and future practice.
The research offers insights of international relevance into the development of a digital competencies toolkit that proposes nursing-specific educational digital skills interventions. The work fosters inclusivity, continuous digital skills improvement, and professional readiness.
The work followed the Equator Standards for Quality Improvement Reporting Excellence in Education.
No patient or public contribution.
Muchos pacientes que requieren cuidados paliativos a menudo visitan el servicio de urgencias. Debido a que este departamento está enfocado en salvar vidas, el tratar a pacientes en estas circunstancias puede acarrear gran cantidad de problemas, y esencialmente problemas de pérdida de dignidad. Así pues, comprender el punto de vista de los profesionales puede ser muy beneficioso a la hora de atender las necesidades de este tipo de pacientes y mejorar su atención [fragmento de texto].
FreshRSS 