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To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
Interprofessional socialisation can contribute to collaborative patient care. Although there is research regarding interprofessional socialisation of healthcare students and frontline staff, there is limited literature regarding healthcare educators in practice settings. Our aim was to examine interprofessional socialisation of healthcare educators in the practice setting following an interprofessional simulation facilitator training programme.
Explanatory sequential mixed methods study.
Quantitative provincial simulation programme evaluation data from 2022 and 2023 (n = 87) were analysed and used to inform qualitative interviews (n = 17). Qualitative and quantitative data were integrated following independent analysis.
There was a statistically significant increase in attitudes toward interprofessional socialisation following the simulation facilitator training programme. Qualitative findings revealed themes regarding interprofessional socialisation: (a) benefits gained through interprofessional socialisation, (b) interprofessional, uniprofessional or both, (c) facilitators to interprofessional socialisation, (d) barriers to interprofessional socialisation and (e) opportunities to strengthen interprofessional socialisation.
Despite positive views of interprofessional socialisation, socialisation behaviours may not be consistent in a variety of contexts. Interprofessional education may increase interprofessional socialisation among educators.
It is important to provide interprofessional socialisation opportunities for educators to promote more interprofessional education initiatives.
The findings of this study provided insights into how to foster interprofessional socialisation in existing structures and how new pathways might be built to connect educators.
This study is reported in congruence with the Journal Article Reporting Standards—Mixed Methods, Quantitative, and Qualitative Standards provided on the Equator Network.
Members of the provincial simulation team were consulted regarding study design and data collection to optimise participation.
To identify research gaps by mapping what is known about the barriers and enablers to pre-registration nursing students identifying signs of suicidal distress in healthcare consumers and providing clear pathways of support.
Scoping review.
This scoping review was conducted using Arksey and O'Malley's (2005) five stage framework and the Levec et al. (2010) extensions of this framework.
The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete and Ovid MEDLINE databases were searched to identify relevant articles, keywords and search terms to inform the full search strategy for CINAHL. This search strategy was then adapted for Scopus, PsychInfo, Emcare, Medline and ERIC, searched in November 2024.
Studies eligible for inclusion (N = 28) represented research from 14 countries; most (53.5%, n = 15) used a quantitative design, 11 (39.3%) were qualitative and two (7.1%) used a mixed-methods design. Barriers found from the scoping review included a low level of knowledge of suicidality, stigma preventing students from assessing and acting on suicidal ideation, and a lack of confidence in providing care to healthcare consumers expressing suicidality. Enablers included lived experience, exposure to individuals expressing suicidal ideation and education, simulation and role play. This review also contributes to the existing literature about the relationship of nursing to existing suicide prevention frameworks and suggests revision of these frameworks to address staff attitudes and beliefs, as well as lived and living experience.
Nurses are ideally placed to assess and respond to suicidality among healthcare consumers, and preparation should begin during pre-registration studies. Our scoping review indicates that further research work is needed to address the barriers to working with healthcare consumers expressing suicidality and to enhance the enablers to provide safe care.
Addressing the barriers and enablers to pre-registration nursing students providing safe care for healthcare consumers expressing suicidality is essential. Further research is required to address the barriers and enhance the enablers identified in this scoping review.
What problem did the study address? This scoping review summarised the literature on pre-registration student ability to work with healthcare consumers expressing suicidality, identifying barriers and enablers. What were the main findings? Barriers include poor knowledge of suicidality, stigma, fear and a lack of confidence in working with healthcare consumers expressing suicidality. Enablers include lived experience, exposure to clinical settings where healthcare consumers express suicidality and simulation and education. Where and on whom will the research have an impact? The research will have an impact on providers of pre-registration nursing degrees, where the inclusion of content addressing suicidality and exposure to settings where individuals express suicidal ideation is shown to improve attitudes and knowledge of suicidality assessment.
PRISMA checklist for scoping reviews.
This study did not include patient or public involvement in its design, conduct or reporting.
Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.
In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.
This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.
Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.
Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.
Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.
Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.
No patient or public involvement.
This review explores the roles, competencies, and scope of practice of APNs in critical care based on international literature. It also derives implications for the development of advanced nursing roles in Austria.
Integrative review.
The research team conducted a systematic search of PubMed, CINAHL, and Web of Science to identify relevant peer-reviewed publications from 2007 to 2023.
A systematic search of electronic databases was undertaken, following Whittemore and Knafl's five-step methodology. The included publications met the defined inclusion criteria and were appraised for quality using the Joanna Briggs Institute critical appraisal checklists. Relevant data were extracted and thematically analysed.
The analysis of 14 international studies revealed recurring themes related to APN core competencies and scope of practice in critical care. These were structured according to Hamric's model. However, Austria faces several challenges, including limited legal frameworks, missing educational structures, and a lack of role clarity. These factors hinder the implementation of APN roles.
Internationally, APNs demonstrate advanced clinical skills, provide leadership in team-based care, and integrate evidence-based practice. These attributes enhance patient outcomes and system efficiency. In Austria, restrictive regulations, limited education, and unclear roles hinder these competencies. Reform is needed to align with international standards, and further research should explore their implementation in Austria.
A gap exists between internationally demonstrated APN competencies and the current state of advanced nursing practice in Austria. This highlights the need for clearer role definitions, regulatory frameworks, and educational strategies. Addressing this gap would strengthen APN roles and improve healthcare quality. This study highlights the need to bridge this disparity.
This review follows the PRISMA 2020 guidelines for systematic reviews Page et al. (2021).
No patient or public contribution.
This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.
This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.
An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.
Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.
This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.
The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.
No patient or public contribution.
This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.
This study is reported according to STROBE guidelines.
by Andrea C. Aplasca, Peter B. Johantgen, Christopher Madden, Kilmer Soares, Randall E. Junge, Vanessa L. Hale, Mark Flint
Amphibian skin is integral to promoting normal physiological processes in the body and promotes both innate and adaptive immunity against pathogens. The amphibian skin microbiota is comprised of a complex assemblage of microbes and is shaped by internal host characteristics and external influences. Skin disease is a significant source of morbidity and mortality in amphibians, and increasing research has shown that the amphibian skin microbiota is an important component in host health. The Eastern hellbender (Cryptobranchus alleganiensis alleganiensis) is a giant salamander declining in many parts of its range, and captive-rearing programs are important to hellbender recovery efforts. Survival rates of juvenile hellbenders in captive-rearing programs are highly variable, and mortality rates are overall poorly understood. Deceased juvenile hellbenders often present with low body condition and skin abnormalities. To investigate potential links between the skin microbiota and body condition, we collected skin swab samples from 116 juvenile hellbenders and water samples from two holding tanks in a captive-rearing program. We used 16s rRNA gene sequencing to characterize the skin and water microbiota and observed significant differences in the skin microbiota by weight class and tank. The skin microbiota of hellbenders that were housed in tanks in close proximity were generally more similar than those housed physically distant. A single taxa, Parcubacteria, was differentially abundant by weight class only and observed in higher abundance in low weight hellbenders. These results suggest a specific association between this taxa and Low weight hellbenders. Additional research is needed to investigate how husbandry factors and potential pathogenic organisms, such as Parcubacteria, impact the skin microbiota of hellbenders and ultimately morbidity and mortality in the species.by Carol Kotliar, Lisandro Olmos, Martín Koretzky, Ricardo Jauregui, Tomás Delía, Oscar Cingolani
ObjectiveTo evaluate the effectiveness of the Mental Training Tech 24.5 (MTT24.5) cognitive stimulation program, designed to enhance cognitive performance and neuroplasticity in healthy adults.
BackgroundCognitive decline is a significant concern in aging populations, with research suggesting that neuroplasticity and cognitive reserve can be enhanced through targeted cognitive training. The MTT24.5 program aims to stimulate brain function through a combination of new knowledge acquisition (DATA) and learning techniques (TECHS), organized into a systematic algorithm. This approach may offer a novel way to prevent or mitigate age-related cognitive decline.
DesignPilot clinical study, active-controlled, open randomization.
SettingAdults from the general population with no clinical cognitive deterioration, recruited from three sites within the Autonomous City of Buenos Aires and its metropolitan area.
Participants120 volunteers were enrolled, of which 76 participants (56 in the intervention group, 20 in the control group) met the study requirements and selected a site closest to their residence.
MethodsThe MTT24.5 program consists of 12 weekly in-person sessions (totaling 24.5 hours), during which participants learned 40 knowledge units (DATA) and 100 learning techniques (TECHS). These were organized into binomials, where each unit of DATA was paired with 3–4 TECHS. Pre- and post-intervention assessments included medical history, lifestyle factors, cognitive reserve scale, Addenbrooke’s Cognitive Examination-Revised (ACE-R), and Mini-Mental State Examination (MMSE).
ResultsThe mean age was 59 years for both groups. Baseline ACE-R scores were comparable (91.3). The global cognitive score increased by 4.6 points (5%) in the intervention group compared to a decrease of 0.5 points in the control group (p Conclusions
The MTT24.5 program, based on a systematic algorithm for acquiring new knowledge and skills, significantly enhances cognitive reserve and overall cognitive performance, particularly in individuals with lower baseline cognitive scores. These findings suggest that structured cognitive stimulation could play a critical role in preventing cognitive decline and promoting cognitive health in healthy adults. Given the promising results, future studies involving larger populations and long-term follow-up are essential to validate these effects and explore the potential for mitigating age-related cognitive decline and enhancing quality of life.
RegistrationThe study was registered in accordance with local regulations at the National Council for Scientific and Technological Research (CONICET) – Institute of Biomedical Research (BIOMED), and also in the National Ethics Committee, and at clinicaltrials.gov (NCT06549517).
by Mireia Solé Pi, Luz A. Espino, Péter Szenczi, Marcos Rosetti, Oxána Bánszegi
A long-standing question in the study of quantity discrimination is what stimulus properties are controlling choice. While some species have been found to do it based on the total amount of stimuli and without using numerical information, others prefer numeric rather than any continuous magnitude. Here, we tested cats, dogs, and humans using a simple two-way spontaneous choice paradigm (involving food for the first two, images for the latter) to see whether numerosity or total surface area has a greater influence on their decision. We found that cats showed preference for the larger amount of food when the ratio between the stimuli was 0.5, but not when it was 0.67; dogs did not differentiate between stimuli presenting the two options (smaller vs. larger amount of food) regardless of the ratio between them, but humans did so almost perfectly. When faced with two stimuli of the same area but different shapes, dogs and humans exhibited a preference for certain shapes, particularly the circle, while cats’ choices seemed to be at chance level. Furthermore, cats’ and dogs’ reaction times were equal across conditions, while humans were quicker when choosing between stimuli in trials where the shape was the same, but the surface area was different, and even more so when asked to choose between two differently sized circle shapes. Results suggest that there is no universal rule regarding how to process quantity, but rather that quantity estimation seems to be tied to the ecological context of each species. Future work should focus on testing quantity estimation in different contexts and different sources of motivation.by Linlin Bao, Haibo Zhao, Haiyue Ren, Chong Wang, Su Fang
Hair follicle stem cells (HFSCs) play critical roles in adult hair regeneration, owing to its self-renewal and multipotent differentiation properties. Emerging evidence has shown that long noncoding RNAs (LncRNAs) are implicated in biological processes such as proliferation, differentiation and apoptosis. However, the specific role of LncRNA RP11-818O24.3 in regulating HFSCs remains unclear. To explore the effect of LncRNA RP11-818O24.3 on HFSCs, stable LncRNA RP11-818O24.3 overexpression and knockdown HFSCs were established using a lentivirus vector system. The effect of LncRNA RP11-818O24.3 on proliferation was evaluated by Cell Counting Kit-8 (CCK8) and EdU incorporation experiments. The differentiation of HFSCs into neurons and keratinocyte stem cells was detected by immunofluorescence staining. We showed that LncRNA RP11-818O24.3 overexpression promoted the proliferation and inhibited cell apoptosis in HFSCs. High levels of LncRNA RP11-818O24.3 promoted the differentiation of HFSCs into CD34+K15+ keratinocyte progenitors and CD34+Nestin+neuron-specific enolase (NSE)+ neural stem cells. Additionally, LncRNA RP11-818O24.3 increased fibroblast growth factor 2 (FGF2) expression and the subsequent activation of the PI3K/AKT signaling pathway. These data demonstrated that LncRNA RP11-818O24.3 promotes self-renewal, differentiation, and the capability to inhibit apoptosis of HFSCs via FGF2 mediated PI3K/AKT signaling pathway, highlighting its potential role as a therapeutic strategy for treating hair loss diseases.This study explored how Structured Medication Reviews (SMRs) are being undertaken and the challenges to their successful implementation and sustainability.
A cross-sectional mixed methods online survey.
Primary care in England.
120 clinical pharmacists with experience in conducting SMRs in primary care.
Survey responses were received from clinical pharmacists working in 15 different regions. The majority were independent prescribers (62%, n=74), and most were employed by Primary Care Networks (65%, n=78), delivering SMRs for one or more general practices. 61% (n=73) had completed, or were currently enrolled in, the approved training pathway. Patient selection was largely driven by the primary care contract specification: care home residents, patients with polypharmacy, patients on medicines commonly associated with medication errors, patients with severe frailty and/or patients using potentially addictive pain management medication. Only 26% (n=36) of respondents reported providing patients with information in advance. The majority of SMRs were undertaken remotely by telephone and were 21–30 min in length. Much variation was reported in approaches to conducting SMRs, with SMRs in care homes being deemed the most challenging due to additional complexities involved. Challenges included not having sufficient time to prepare adequately, address complex polypharmacy and complete follow-up work generated by SMRs, issues relating to organisational support, competing national priorities and lack of ‘buy-in’ from some patients and General Practitioners.
These results offer insights into the role being played by the clinical pharmacy workforce in a new country-wide initiative to improve the quality and safety of care for patients taking multiple medicines. Better patient preparation and trust, alongside continuing professional development, more support and oversight for clinical pharmacists conducting SMRs, could lead to more efficient medication reviews. However, a formal evaluation of the potential of SMRs to optimise safe medicines use for patients in England is now warranted.
To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.
A retrospective cohort study.
University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.
We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.
The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.
Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.
The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.
Objetivo. Evaluar el grado de satisfacción con los cuidados brindados durante el parto y el posparto en el Hospital Álvaro Cunqueiro (HAC) y explorar su posible relación con variables sociodemográficas y obstétricas. Metodología. Se realizó un estudio observacional descriptivo transversal. La población incluyó mujeres con partos entre enero y octubre de 2024 en el HAC. El muestreo fue no probabilístico y de tipo consecutivo. Para la recolección de datos, se utilizó un cuestionario ad hoc que recopiló información sobre variables sociodemográficas y obstétricas, complementado con el instrumento “Care in Obstetrics: Measure for Testing Satisfaction” (COMFORTS) en su versión validada en español. Resultados. La muestra estuvo compuesta por 319 mujeres. La mediana de satisfacción global obtenida con el cuestionario COMFORTS fue de 171 (RIC: 155–186), lo que indica un alto nivel de satisfacción general. Sin embargo, las áreas de cuidados en el posparto [Me: 46 (RIC: 40–53)] y al recién nacido [Me: 40 (RIC: 30–46)] fueron identificadas como susceptibles de mejora. Se encontró una relación estadísticamente significativa entre la paridad y la percepción de la calidad de los cuidados neonatales, así como entre el modo de finalización del parto y el grado de satisfacción materna con la experiencia del parto. Discusión. Aunque la satisfacción general con los cuidados obstétricos en el HAC es alta, existen áreas de mejora en el posparto y en la atención al recién nacido. Además, variables como la paridad y el modo de finalización del parto influyen en la percepción materna de los cuidados.
ABSTRACT
Objective. To assess the degree of satisfaction with the care provided during labor and postpartum at the Hospital Álvaro Cunqueiro (HAC) and to explore its possible relationship with sociodemographic and obstetric variables. Methodolgy. A cross-sectional descriptive observational study was conducted. The population included women with deliveries between January and October 2024 at the HAC. Sampling was non-probabilistic and consecutive. For data collection, an ad hocquestionnaire was used to obtain information on sociodemographic and obstetric variables, complemented with the instrument Care in Obstetrics: Measure for Testing Satisfaction (COMFORTS) in its validated Spanish version. Results.The sample consisted of 319 women. The median overall satisfaction with the COMFORTS questionnaire was 171 (IQR: 155–186), indicating a high level of overall satisfaction. However, the areas of postpartum [Me: 46 (IQR: 40–53)] and newborn care [Me: 40 (IQR: 30–46)] were identified as areas for improvement. A statistically significant relationship was found between parity and perceived quality of neonatal care, as well as between the mode of delivery and maternal satisfaction with the birth experience. Discussion: Although overall satisfaction with obstetric care at the HAC is high, there are areas for improvement in postpartum and newborn care. In addition, variables such as parity and mode of delivery influence maternal perceptions of care.
Introducción. La transición del hospital al domicilio en pacientes oncológicos es un momento crítico que puede generar ansiedad y depresión debido a la autogestión de cuidados. Objetivo. evaluar el impacto emocional de los pacientes oncológicos al recibir el alta de enfermería. Metodología. Estudio observacional descriptivo. Se utilizará el cuestionario HADS para medir los niveles de ansiedad y depresión en una muestra de pacientes hospitalizados próximos a recibir el alta. Los resultados permitirán diseñar estrategias de apoyo emocional y educación sanitaria para mejorar la adherencia terapéutica y la calidad de vida post hospitalaria.
ABSTRACT
Introduction. The transition from hospital to home for oncology patients is a critical moment that may generate anxiety and depression due to self-management of care. Objective. To assess the emotional impact of oncology patients upon receiving nursing discharge. Methodology. Descriptive observational study The HADS questionnaire will be used to measure anxiety and depression levels in a sample of hospitalized patients close to discharge. The results will guide the development of emotional support strategies and health education to improve post-hospital therapeutic adherence and quality of life.
Chagas disease (CD) is one of the most neglected diseases in the world. In Latin America, CD is endemic in 21 countries, with an estimated 70 million people at risk of infection. Current treatments are limited to two nitroheterocyclic compounds: nifurtimox and benznidazole (BZN). Each has significant limitations, including long duration and safety concerns. However, data from recently completed studies suggest that reduced-duration regimens may be equally effective while enhancing safety.
NuestroBen is a phase III, randomised, multicentre clinical trial designed to assess whether shorter (2- and 4-week) regimens of BZN are non-inferior to the standard 8-week treatment. A total of 540 adult participants with no evidence of organ damage (the indeterminate form) or with mild cardiac progression (mild electrocardiographic alterations and without systolic dysfunction or symptoms), all in the chronic phase of CD, will be recruited at six study sites in Argentina and two study sites in Bolivia. Participants will be randomised to receive one of the two shortened regimens of BZN (300 mg per day for 2 or 4 weeks) or standard treatment (300 mg per day for 8 weeks). The primary endpoint is sustained elimination of parasitaemia from the end of treatment through 12 months of follow-up. Secondary endpoints will assess sustained clearance of parasitaemia at 1, 4, 6 and 8 months of follow-up from the end of treatment, drug tolerability and adherence to treatment. NuestroBen will also evaluate whether two shortened regimens of BZN improve drug tolerability and treatment adherence compared with the current standard treatment while maintaining efficacy in participants with the indeterminate form of CD or with mild cardiac involvement.
In Argentina, this study was approved by Fundación de Estudios Farmacológicos y Medicamentos ‘Luis M. Zieher’ for its conduct at the Instituto de Cardiología de Corrientes ‘Juana Francisca Cabral’ (reference: NuestroBen-2020/2021) and the Instituto Nacional de Parasitología ‘Dr. Mario Fatala Chaben’ (reference: NuestroBen-2020/2021) by Comité Institucional de Ética de Investigación en Salud for the Centro de Chagas y Patología Regional de Santiago del Estero (reference: NuestroBen-2020-088/2021), by Comité de Ética en Investigación for the Hospital de Infecciosas F.J. Muñiz (reference: NuestroBen-2020–4037) and the Hospital General de Agudos D.F. Santojanni (reference: NuestroBen-2020–4039) and by Comité de Bioética for the Fundación Huésped (reference: NuestroBen-2020/2021). In Bolivia, it was approved by Comité de Ética en Investigación en Salud from the Universidad Autónoma Juan Misael Saracho (reference: NuestroBen-2020/2025). All participants are asked to provide written informed consent to participate. Recruitment processes started in July 2023, and as of 15 June 2025, 140 participants have been recruited. Findings will be shared with Argentinian and Bolivian public health officials and with the Chagas and tropical medicine communities via international conferences. Findings will also be published in medical journals.
The primary objective of this study is to investigate the perceived need and attitudinal perspectives regarding menstrual leave policies among young women in rural South India. The secondary objective was to determine the socio-demographic, menstrual and workplace-related factors associated with attitudes towards menstrual leave among young women.
An analytical cross-sectional study was performed from May 2023 to August 2023.
In a rural district of Tamil Nadu, South India.
The study encompassed 955 young female students above 18 years of age enrolled in educational institutions in a rural district of Tamil Nadu, India. Participants were pursuing diverse professional programmes including medical, dental, allied health sciences, pharmacy and engineering courses.
The primary outcomes included assessment of basic menstrual characteristics (age of menarche, regularity, product usage and pain experiences), pain evaluation using the WaLIDD scale (which measured working ability, anatomical pain location, pain intensity via Wong Baker scale and pain duration) and attitude assessment through a 10-dimension Likert scale. The attitude assessment explored both supportive factors (pain management, environmental considerations, medical leave allocation, menstruation normalisation and performance impact) and potential concerns (medicalisation, perceptions of fragility, stigma, disclosure issues and abnormal leave usage). Secondary outcome measures encompassed the analysis of factors influencing these attitudes, followed by a multivariable linear regression model to identify significant predictors.
Among 955 female students (mean age 19.56±1.33 years), the majority supported menstrual leave for maintaining hygiene (82.3%) and managing dysmenorrhoea (75.8%). A substantial proportion (64.4%) viewed it as a means of normalising menstruation discourse, while 61.6% believed it could enhance workplace performance. However, concerns existed about medicalising menstruation (47.9%) and reinforcing gender stereotypes (43.4%). Multivariate analysis revealed that medical students (B=0.67, 95% CI: 1.34 to 2.00), those with graduate-educated fathers (B=1.64, 95% CI: 0.31 to 2.97), earlier age at menarche (B=–0.23, 95% CI: –0.45 to –0.01) and participants reporting menstrual interference with daily activities (B=0.96, 95% CI: 0.02 to 0.89) held significantly more positive attitudes.
While young women generally support menstrual leave policies, particularly for hygiene and pain management, there are significant concerns about workplace stigmatisation and gender stereotyping. Educational background, parental education and personal menstrual experiences significantly influence attitudes toward menstrual leave. These findings suggest the need for carefully structured menstrual leave policies that balance biological needs with workplace/student place equality concerns.
Influenza is a major global health concern, responsible for up to 650 000 respiratory-related deaths annually. Although influenza is often perceived as mild in healthy adults, it can cause severe outcomes in high-risk groups, such as older adults, young children, pregnant women and those with underlying medical conditions. Various clinical, sociodemographic and environmental factors influence the progression to severe outcomes, whereas resilience factors, such as vaccination, may reduce risks. Despite growing research, the evidence base regarding risk and resilience is spread across many different aspects of the literature. This umbrella review will synthesise evidence from existing systematic reviews and meta-analyses to identify key risk and resilience factors associated with the progression of influenza to severe outcomes in the general population.
This umbrella review follows the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will include systematic reviews and meta-analyses reporting host-related risk or resilience factors for severe influenza outcomes. Four databases (EMBASE, Scopus, Medline and CINAHL) will be searched for English-language publications. Study quality will be assessed using AMSTAR 2, and the body of evidence will be evaluated using Grading of Recommendations Assessment, Development and Evaluation. Due to heterogeneity, findings will be analysed narratively. Risk and resilience factors will be grouped into demographic, clinical, behavioural, social and psychological domains.
No ethical approval is required. The completed review will be shared through peer-reviewed journals and conference presentations.
CRD420250644475.
Inherited retinal diseases (IRDs) are a broad range of diseases associated with abnormalities/degeneration of retinal cells. We aimed to identify the top 10 Australian research priorities for IRDs to ultimately facilitate more meaningful and potentially cost-effective research.
We conducted a James Lind Alliance priority setting partnership that involved two Australian-wide surveys and online workshops.
Australia-wide.
Individuals aged 16 years or older were eligible to participate if they had an IRD, were caregivers of an individual with an IRD or were health professionals providing care to this community.
In Survey 1, we gathered participants’ unanswered questions about IRDs. We grouped these into summary questions and undertook a literature review to verify if they were truly unanswered (ie, evidence uncertainties). In Survey 2, participants voted for the uncertainties that they considered a priority. Top-ranked uncertainties progressed for discussion and final prioritisation in two workshops.
In Survey 1, we collected 223 questions from 69 participants. We grouped these into 42 summary questions and confirmed 41 as evidence uncertainties. In Survey 2, 151 participants voted, with the 16 uncertainties progressing to final prioritisation. The top 10 priorities, set by the 24 workshop participants, represented (1) treatment/cure; (2) symptoms and disease progression; (3) psychosocial well-being and (4) health service delivery. The #1 priority was for treatment to prevent, slow down or stop vision loss, followed by the #2 priority to address the psychological impact of having an IRD.
The top 10 research priorities highlight the need for IRD research that takes a whole-person, systems approach. Collaborations to progress priorities will accelerate the translation of research into real-world benefits.
FreshRSS 