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Medication administration errors are high-risk patient safety issues that could potentially cause harm to patients, thereby delaying recovery and increasing length of hospital stay with additional healthcare costs. Nurses are pivotal to the medication administration process and are considered to be in the position to recognize and prevent these errors. However, the effectiveness of interventions implemented by nurses to reduce medication administration errors in acute hospital settings is less reported.
To identify and quantify the effectiveness of interventions by nurses in reducing medication administration errors in adults' inpatient acute hospital.
A systematic review and meta-analysis was conducted up to 03/24. Six databases were searched. Study methodology quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools, and data extraction was conducted. Meta-analysis was performed to combine effect sizes from the studies, and synthesis without meta-analysis was adopted for studies that were not included in the meta-analysis to aggregate and re-examine results from studies.
Searches identified 878 articles with 26 studies meeting the inclusion criteria. Five types of interventions were identified: (1) educational program, (2) workflow smart technologies, (3) protocolised improvement strategy, (4) low resource ward-based interventions, and (5) electronic medication management. The overall results from 14 studies included in meta-analysis showed interventions implemented by nurses are effective in reducing medication administration errors (Z = 2.15 (p = 0.03); odds ratio = 95% CI 0.70 [0.51, 0.97], I 2 = 94%). Sub-group analysis showed workflow smart technologies to be the most effective intervention compared to usual care. Findings demonstrate that nurse-led interventions can significantly reduce medication administration errors compared to usual care. The effectiveness of individual interventions varied, suggesting a bundle approach may be more beneficial. This provides valuable insights for clinical practice, emphasizing the importance of tailored, evidence-based approaches to improving medication safety.
PRISMA guided the review and JBI critical appraisal tools were used for quality appraisal of included studies.
by David Robert Grimes
BackgroundThe advent of mass-market Light Emitting Diodes (LEDs) has seen considerable interest in potential dermatological applications of LED light photobiomodulation (PBM) for a range of conditions, with a thriving market for direct-to-consumer LED treatments, including red light, blue light, and yellow light wavelengths. Evidence of efficacy is however mixed, and studies report a wide range of irradiances and wavelengths as well as outcome measures, rendering interpretation, comparison, and even efficacy evaluation prohibitive and impeding evidence synthesis.
MethodsThis work establishes a model for comparing patient received doses, applying this to existent studies to ascertain potential inhomogeneity in reported doses and wavelengths employed. Patient doses were contrasted to equivalent solar exposure time needed to achieve fluences reported at specified wavelengths in the red light (RL), blue light (BL), and yellow light (YL) portion of the spectrum, yielding a comparison of reported doses to typical solar irradiance at the Earth’s surface. Methodological aspects including dose validation, blinding, and bias were also analysed.
Results27 relevant studies for dermatological conditions including acne vulgaris (n=9, 33.3%), wrinkle-reduction (n=5, 18.5%), wound-healing (n=3, 11.1%), psoriasis severity (n=3, 11.1%), and erythemal index (n=7, 25.9%) were assessed. Outcome measures were highly heterogeneous between studies, with total patients ranging from 14 – 105 (median: 26). Fluences and wavelengths used in treatment differed over three orders of magnitude across studies even for the same conditions (0.1 J cm−2−126 J cm−2, median: 40.5 J cm−2). Derived equivalent solar time ranged from 0.01-19.35 hours (median: 3.3 hours), with central wavelengths between 405nm (BL) - 660nm (RL). No studies reported any dose validation, 10 (37.0%) were sponsored by the device manufacturer with a further 3 (11.1%) conducted by commercial dermatology practices offering the therapy under investigation. Assessors were unblinded to the treatment/ control groups in 33.3% (n=9), while a further 9 (33.3%) did not have any non-light control group, leaving only 33.3% (n=9) with both control group and blinded outcome assessment.
ConclusionsResults of this analysis suggest that fluences, wavelengths, and effective dose vary inconsistently between studies with often scant biological justification. This analysis suggests that better dose quantification and understanding of the underlying biophysics as well as plausible biological justifications for various wavelengths and fluences are imperative if LED therapy studies for dermatology are to be informative and research replicability improved.
by Tanya N. Leary, Lyn Kaye, Olivia Chin, Kar Yee Phoon, David Phalen
Sarcoptes scabiei causes a fatal disease (mange) in bare-nosed wombats (BNWs) (Vombatus ursinus) across their range and can threaten isolated populations with extinction. Repeated dosing of moxidectin (Cydectin®) at a dosage rate of 0.5 mg/kg is effective at treating individual BNWs but is difficult to administer on a population basis where treatment success has varied. This paper documents the temporary (~20 month) eradication of mange from a semi-isolated population of BNWs using repeated dosing of Cydectin® administered by burrow flaps. Treated BNWs were marked with nontoxic paint and selected burrows were monitored with camera traps demonstrating that 64–96% of wombats in the population were treated with each dosage. Treatment success was attributed to the installation of burrow flaps on all burrows in the treated area. This treatment program shows that isolated high-density populations can be successfully treated for S. scabiei infection with repeated dosages of Cydectin® (0.5 mg/kg) and questions the need for higher dosages that have been advocated. Mange returned to the population of BNWs after 20 months possibly as the result of migration of an infected BNW from a nearby population, suggesting mange affected populations may require periodic retreatment. Monitoring of burrow entrances confirmed that burrows provide habitat used by many species of birds, reptiles, and mammals, and suggest burrows could be occasional sites of mange spillover among species. Camera trap monitoring also showed when BNWs in this population leave and return to their burrows; how many BNWs enter a burrow and explore the burrow entrances each night; and how these parameters are impacted by season and mange status; variables that are valuable to know when treating populations of BNW for mange.
A novel advanced synthetic bioactive glass matrix was studied in patients with non-healing diabetic foot ulcers (DFUs). Bioactive glasses can be constructed to be biocompatible, with water-soluble materials in multiple geometries including fibre scaffolds that mimic the 3D architecture of a fibrin clot. In this trial, chronic, Wagner Grade 1 DFUs were randomised to receive borate-based bioactive glass Fibre Matrix (BBGFM) plus standard of care (SOC) therapy for 12 weeks or SOC alone. The primary study endpoint was the proportion of subjects that obtained complete wound closure at 12 weeks. Secondary endpoints included time to achieve complete wound closure at 12 weeks. In the modified intent-to-treat (mITT) analysis, 48% (32/67) treated with BBGFM plus SOC healed at 12 weeks compared to 24% (16/66) with SOC alone (p = 0.007). In the per protocol (PP) population, 73% (32/44) of subjects treated with BBGFM plus SOC healed versus 42% (16/38) in the SOC group (p = 0.007). Based on the success of this trial, BBGFM demonstrates faster healing of DFUs compared to SOC and should be considered in the treatment armamentarium for Wagner Grade 1 DFUs. Future trials should investigate the use of BBGFM for healing deeper chronic DFUs, other wound aetiologies, or complex surgical wounds.
To examine whether manpower and expertise understaffing are distinct, and whether they relate similarly to nursing stressors, burnout, job satisfaction and intentions to turnover.
A cross-sectional survey of hospital nurses nested within units was used.
The sample included 402 nurses. Nurses provided ratings of the study's variables using validated self-report measures. The data were analysed both as multilevel and single-level data.
Manpower and expertise understaffing contributed unique explained variance to all of the examined outcomes. Nurses within the same units experience different understaffing levels. Expertise understaffing emerged as a significantly stronger predictor than manpower understaffing for three of the six of the outcome variables (illegitimate tasks, job satisfaction and turnover intentions).
Manpower and expertise understaffing are distinct, and both are associated with nurse outcomes.
We have adhered to the STROBE guideline for cross-sectional studies.
Considering both manpower and expertise understaffing to maintain proper staffing levels in nursing units is crucial.
A Director of Patient Care Services from the hospital where the study was conducted is a member of the research team. This member contributed to designing and conducting the study as well as interpreting the results.
To explore experiences of LGBT+ individuals in accessing and receiving healthcare in Ireland, and to identify opportunities for more inclusive and equitable healthcare delivery.
A descriptive qualitative study using asynchronous online focus groups.
Asynchronous online focus groups were conducted using the MURAL collaborative platform over a three-week period in 2023. Participants (n = 43) self-selected into one of three focus groups based on gender and sexual identity. Data were analysed using reflexive thematic analysis to generate key themes.
Four themes were identified: (1) Culturally aware healthcare professionals; (2) Access and information; (3) Specialist versus universal services; and (4) Mental health support. Participants reported frequent experiences of misgendering, heteronormative assumptions, and provider inexperience. Geographic inequities, unclear referral pathways, and a lack of centralised, inclusive information were also key barriers. While specialist services were valued, participants advocated for a dual approach that integrates LGBT+ competence into all healthcare settings.
Despite legal and social progress, LGBT+ individuals in Ireland continue to encounter significant barriers to equitable healthcare. The findings highlight a need for improved cultural competence, better access to inclusive services, and systemic reform.
Healthcare providers must receive comprehensive training in LGBT+ health to ensure respectful, appropriate, and inclusive care. Enhanced visibility of inclusive providers and improved service pathways are needed to address current inequities, particularly in mental health and gender-affirming care.
This study identifies key gaps in provider competence, service accessibility, and mental health provision. Findings will inform healthcare education, policy development, and service design to improve experiences and outcomes for LGBT+ individuals in both urban and rural contexts.
This study adhered to the Standards for Reporting Qualitative Research (SRQR).
No patient or public contribution was involved.
by Michael Seid, David Bridgeland, Christine L. Schuler, David M. Hartley
Improving the healthcare system is a persistent and pressing challenge. Collaborative Learning Health Systems, or Learning Health Networks (LHNs), are a novel, replicable organizational form in healthcare delivery that show substantial promise for improving health outcomes. To realize that promise requires a scientific understanding that can serve LHNs’ improvement and scaling. We translated social and organizational theories of collaboration to a computational (agent-based) model to develop a computer simulation of an LHN and demonstrate the potential of this new tool for advancing the science of LHNs. Model sensitivity analysis showed a small number of parameters with outsized effect on outcomes. Contour plots of these influential parameters allow exploration of alternative strategies for maximizing model outcomes of interest. A simulated trial of two common health system interventions – pre-visit planning and use of a registry – suggested that the efficacy of these could depend on LHN current state. By translating heuristic theories of LHNs to a specifiable, reproducible, and explicit model, this research advances the scientific study of LHNs using tools available from complex systems science.
To describe diagnostic categories and comorbidities associated with increased risk of readmission within 28 days among older adults.
Retrospective observational study of all hospital admissions following ED attendance by patients aged ≥ 60 years between July 2020 and June 2023. Index and subsequent 28-day readmission were identified using ED data and hospital discharge records. ED diagnosis, Australian Refined Diagnosis-Related Group (AR-DRG) discharge codes, and ICD-10-AM comorbidities were extracted. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 28-day readmission. The study and findings have been reported against the STROBE-RECORD guideline.
Of the 28,730 initial patient visits, 7.9% re-presented within 28 days. The most common ED diagnoses at initial and readmission were chest pain (5.4% vs. 4.6%), falls (5.2% vs. 4.1%), dyspnoea (3.5% vs. 3.1%), abdominal pain (3.1% vs. 3.3%) and cerebrovascular accident (1.7% vs. 1.7%). The most frequent AR-DRGs were respiratory infections/inflammations, kidney and urinary signs/symptoms, and other digestive system disorders. Key ICD-10-AM codes associated with a higher likelihood of readmission within 28 days were obstructive/reflux uropathy (OR 2.66, 95% CI 1.78–3.96), urinary retention (OR 1.84, 95% CI 1.38–2.46), chronic ischaemic heart disease (OR 1.57, 95% CI 1.10–2.25), delirium (OR 1.35, 95% CI 1.07–1.71) and disorders of fluid, electrolyte, and acid–base balance (OR 1.29, 95% CI 1.09–1.54).
Nearly 8% of older adults are readmitted within 28 days. Our described approach offers a potential framework to identify at-risk groups and intervene to reduce avoidable representations and/or admissions.
The results reported here create the opportunity for clinicians to identify areas for improvement in clinical practice, care coordination, and service delivery. Our approach and methodology can be replicated in other health services.
No patient or public contribution.
Chronic wounds represent a substantial socioeconomic, financial, and psychological burden. We examine preclinical and clinical evidence assessing the impact of chronic wounds on negative affect, cognition, and quality of life and discuss potential mechanisms underlying the link between chronic wounds and negative affect and cognition. There is limited preclinical evidence examining negative affect and wounds, but anxiety-related behaviour has been reported in a rat incisional wound model. The incidence of anxiety and depression in people with chronic wounds varies considerably. Potential mechanisms underlying the link between chronic wounds and negative affect include the immune system, pain, metabolic dysfunction, inflammation, and vascular damage. There is a paucity of both preclinical and clinical studies examining the effect of chronic wounds on cognition, highlighting a need for more studies in this area. Research suggests that there are deficiencies in the management of anxiety, depression, and cognitive impairment in people with chronic wounds, but developing and administering therapies that target these comorbidities may have a positive impact on quality of life and wound healing. Integration of mental health and cognition screening into wound care protocols would provide substantial benefits both socioeconomically and to individuals with chronic wounds.
To clarify the definition and evolution of Patient and Public Involvement and Engagement (PPIE) and identify its attributes, antecedents, and consequences in health-related research.
This study follows Rodgers' evolutionary concept analysis with a seven-step framework.
Datasets were searched using terms related to PPIE and key categories (i.e., attributes, antecedents, and consequences). Data were sourced from CINAHL, PsycInfo, Scopus, PubMed, and Web of Science covering publications from inception to October 31, 2024. Document titles, abstracts, and keywords were manually screened to identify relevant studies for full-text review.
A total of 1751 documents were screened, resulting in 38 eligible studies included in the final analysis. PPIE has evolved from a narrow focus on patient inclusion and participation, where patients had minimal influence on research and researchers resisted sharing control of research, to a collaborative model emphasising sustained partnerships, shared contributions, equitable power distribution, and active involvement across research stages. This shift has been driven by research innovation, a growing emphasis on healthcare equity and patient-centred care, technological advances, and stakeholder advocacy (e.g., patients, funders, ethics committees). While PPIE enhances research relevance and impact, barriers, such as resource constraints, power imbalances, patient limited research capabilities and increased researcher workload persist. Facilitators, such as training programmes, standardised guidelines, flexible arrangements and transparent communication can enable meaningful partnerships.
The concept of PPIE is evolving toward greater clarity and consistency in research, positioning patients and the public as active, essential contributors rather than passive participants. Barriers and facilitators were identified to inform its utilisation in research.
This study clarifies the conceptual ambiguities of PPIE, informs theory development, and provides actionable insights. Healthcare and nursing researchers can draw on its findings to utilise PPIE to enhance collaborative and inclusive research practices that align with the needs of patients and the public.
This study adheres to the PRISMA (2020) reporting guidelines for systematic reviews.
One of our co-authors is a patient with lived experience of cancer, who contributed valuable comments and suggestions to enhance this paper.
To provide an in-depth description of an innovative Doctor of Nursing programme which prepares nurses for senior roles in healthcare and related organisations. This programme provides nurse leaders with the knowledge and skills to advance systems through healthcare innovation design, implementation, and evaluation.
A comparison of doctoral nursing programmes, highlighting the unique aspects of the University of Calgary Doctor of Nursing programme.
The University of Calgary Doctor of Nursing programme addresses key gaps that currently exist within nursing education. Few existing programmes directly support the development of nurses as healthcare leaders and innovators. This programme enables nurse leaders to leverage their front-line experience into senior system-level leadership roles. Each core course includes a building block assignment that develops key doctoral skills: framing research questions, appraising literature, selecting methods and data, planning ethically sound projects, and translating evidence into persuasive arguments for policy or system change.
Nurses play a vital role in healthcare around the world. The University of Calgary Doctor of Nursing programme recognises the value of investing in nursing leaders and emboldening them to leverage their frontline leadership experience to advance data-driven change, innovation, and policy development in the complex healthcare systems in which they work and lead.
Currently, there is a dearth of programmes available to prepare nurses for senior leadership roles in healthcare or related organisations, despite significant demand from prospective students and employers alike. The University of Calgary Doctor of Nursing programme meets the workforce demand for a programme focused on nursing leadership, to advance health systems through skill development in systems innovation, appraisal of evidence and implementation science, as well as quality assurance/quality improvement and programme evaluation. This programme focus also better equips students to examine and evaluate systemic inequities and challenges currently facing healthcare systems, practitioners and users.
by David Majuch Kunjok, John Gachohi Mwangi, Salome Kairu-Wanyoike, Johnson Kinyua, Susan Mambo
IntroductionKenya ranks among the top 30 countries with a high tuberculosis (TB) burden globally. With a TB prevalence of 558 per 100,000, only 46% of TB cases are diagnosed and treated, leaving 54% undiagnosed and at risk of spreading the disease. This study analyzed the spatial distribution of tuberculosis diagnostic delays and their association with health care accessibility and socioeconomic inequalities in Nairobi County, Kenya.
Materials and methodsThe cross-sectional study included 222 newly diagnosed bacteriologically confirmed Mycobacterium tuberculosis (Mtb) patients from Mbagathi County Hospital (MCH), Mama Lucy Kibaki Hospital (MLKH), and Rhodes Chest Clinic (RCC) in Nairobi County, Kenya. Patients were recruited consecutively through census sampling and categorized into two groups: delayed diagnosis (≥21 days from symptom onset) and non-delayed ( Result
Spatial analyses identified 28 statistically significant clusters of delayed TB diagnoses within Nairobi County. Spatial autocorrelation analysis using Moran’s I revealed a significant clustered distribution (Moran’s Index = 0.471, z-score = 3.370, p 2.58, p Discussion and conclusion
The study revealed significant spatial clustering of delayed TB diagnoses in Nairobi County, particularly in informal settlements. In contrast, timely diagnoses were predominantly clustered in high-income areas like Lang’ata and Karen. These clusters were significantly associated with lower household income and increased travel time to health facilities which underscored the need for targeted implementation of TB diagnostic services and control measures in the wards with the highest delays.
To identify the minimum effective dose of a multi-behaviour change technique (BCT) intervention to increase physical activity among individuals on primary statin therapy using the time-to-event continual reassessment method (TiTE-CRM).
A large New York metropolitan area healthcare system comprising approximately 85 000 employees and 5.5 million patient encounters annually.
42 participants enrolled in 13 cohorts of 3 participants, 1 cohort of 2 participants and 1 cohort of 1 participant. The sample was composed of 16.7% individuals aged 66 and older (n=7), 64.3% women (n=27), 69.0% white individuals (n=29) and 7.1% Hispanic individuals (n=3).
A variable-duration, four-BCT text message intervention and a 2-week follow-up. Dose assignment relied on TiTE-CRM to adjust the duration of the intervention based on adherence of participants in prior cohorts. Five mechanisms of action (MoAs) were assessed: self-efficacy, intrinsic regulation, discrepancy in behaviour, motivation and barriers to activity.
The primary outcome measure was the proportion of participants who achieved a 2000 step/day increase between baseline and follow-up. The secondary outcomes were within-participant changes in daily steps (examined as a continuous variable at the daily level) and potential MoAs for increased physical activity.
Of the 40 participants who completed follow-up, 7 (17.5%) achieved the goal of 2000 or more steps per day during their follow-up period. Though participants did increase the number of steps they walked during the intervention (B(SE)=373.1 (154.7) steps; p=0.016), there was no association between increased intervention duration and increased daily average steps. The intervention was also associated with increases in self-efficacy (p=0.002), intrinsic regulation (p=0.037), discrepancy in behaviour (p
The results of this trial did not show a traditional dose-response curve to increasing the length of a multicomponent BCT intervention. Results did show that the intervention successfully increased steps during the intervention period and that the benefit of the intervention dwindled during follow-up. Further, potential MoAs for the intervention were confirmed.
This study aimed to co-design a model of brilliant care for older people that provides clear, actionable principles to guide how brilliant care for older people can be realised.
As the demand for and international importance of care for older people grows, so too does the negative discourse about care for older people. This ongoing focus on deficiencies can have implications for patients, carers, clinicians, health services, and policymakers, overshadowing opportunities for innovation and positive change.
Experience-based co-design informed this study, grounded in the lived experiences of key stakeholders.
Three scaffolded co-design workshops were facilitated, involving lived experience experts, managers, professionals, clinicians, and an academic (n= 13). The data collected during these workshops were analysed using a qualitative descriptive method and documented according to COREQ guidelines to optimise rigour and transparency.
The participants co-designed a model of brilliant care for older people, comprising principles to promote connection and innovation. To promote connection, the model includes protecting staff member time to deliver meaningful care and demonstrating that everyone matters. To promote innovation, it encourages role flexibility, curiosity, small improvements, and the recognition of brilliant practices.
This article presents a co-designed model of brilliant care for older people, incorporating principles of connection and innovation that can be enacted through simple, resource-efficient practices.
For those who manage and deliver care for older people, the model encompasses simple, accessible, and cost-effective principles to: positively deviate from norms within the sector, offering care to older people; and to deliver brilliant care for older people. Furthermore, given that the model was co-designed with lived experience experts, managers, professionals, and clinicians, its principles are imbued with their experiential insights, which served to bring particular priorities to the fore.
The co-designers, who included lived experience experts, were invited to participate in workshops to co-design a model of brilliant care for older people, during which they discussed and critiqued the findings constructed from the data and co-designed the model.
Introducción: La motivación cumple un rol fundamental sobre todo en el desempeño laboral del profesional de Enfermería. Esta motivación representa un factor protector tanto para el profesional de Enfermería como también al paciente que se encuentra a su cuidado. Se objetivó analizar la relación existente entre factores motivacionales y desempeño laboral del profesional de Enfermería quienes ejercen funciones en dos hospitales del departamento Central 2023. Metodología. Estudio observacional descriptivo transversal realizado en dos centros asistenciales de referencia nacional, de alta complejidad de la República del Paraguay, muestreo no probabilístico por conveniencia. El instrumento, un cuestionario pre-elaborado y validado. Resultados. Respeto al desempeño laboral, predominó el nivel alto. En referencia a las dimensiones del desempeño laboral, ha predominado mayoritariamente el nivel alto, no registrándose ningún participante en el nivel bajo. Al relacionar los factores motivacionales con el desempeño laboral, se encontró asociación estadísticamente significativa, con lo que se acepta la hipótesis de investigación que indica que existe asociación entre factores motivacionales y el desempeño laboral de profesionales de enfermería. Discusión. Al relacionar los factores motivacionales con el desempeño laboral, se observó una asociación estadísticamente significativa. Esto se respalda en un estudio realizado en Perú, cuyos resultados sugieren que el desempeño laboral de los profesionales de enfermería estaría influenciado por la dependencia de factores motivacionales extrínsecos. Conclusión: Se recomienda fortalecer programas de reconocimiento y mejora de condiciones laborales para estimular la motivación extrínseca, como implementar oportunidades de desarrollo profesional y participación en la toma de decisiones.
ABSTRACT
Introduction: Motivation plays a fundamental role, especially in the work performance of nursing professionals. This motivation represents a protective factor for both the nursing professional and the patient under their care. The objective was to analyze the existing relationship between motivational factors and work performance of nursing professionals who work in two hospitals in the Central department 2023. Methodology. A cross-sectional, descriptive, observational study carried out in two national reference, highly complex healthcare centers in the Republic of Paraguay, using a non-probabilistic convenience sampling. The instrument was a pre-prepared and validated questionnaire. Results. Regarding work performance, a high level predominated. Regarding the dimensions of work performance, the high level predominated, with no participants registered at the low level. When relating motivational factors with work performance, a statistically significant association was found, thereby accepting the research hypothesis that indicates an association between motivational factors and the work performance of nursing professionals. Discussion. When relating motivational factors to job performance, a statistically significant association was observed. This is supported by a study conducted in Peru, whose results suggest that nursing professionals' job performance may be influenced by their dependence on extrinsic motivational factors. Conclusion. Strengthen recognition programs and improve working conditions is recommended to stimulate extrinsic motivation, such as implementing opportunities for professional development and participation in decision-making.
by Kaylee R. Jacobs, Caleb M. Ardizzone, Arkaprabha Banerjee, Evelyn Toh, Xiaoli Zhang, David E. Nelson
Chlamydia are obligate intracellular bacterial pathogens that infect a wide range of vertebrate hosts. Despite having highly conserved genomes, closely related Chlamydia species can exhibit distinct host and tissue tropisms. The host tropisms of the human pathogen Chlamydia trachomatis and the closely related mouse pathogen Chlamydia muridarum are influenced by their ability to evade host immune responses, particularly those mediated by interferon gamma. However, there is evidence that tissue tropism is driven by additional poorly understood host and Chlamydia factors. In this study, we used a forward genetic approach to investigate the mechanisms that mediate C. muridarum tissue tropism. We conducted a tropism screen using a randomly mutagenized C. muridarum library and murine cell lines representing different tissues. We identified a mutant isolate whose growth was restricted in murine rectal and oviduct epithelial cells in an interferon gamma-independent manner. This phenotype was mapped to a missense mutation in tc0237, a gene that mediates the affinity of C. muridarum for cultured human epithelial cells. Our analysis of growth dynamics showed that the tc0237 mutant exhibits a developmental delay in rectal epithelial cells. Together, these results suggest that TC0237 plays a role in C. muridarum tissue tropism.
by Olga Amberger, Dorothea Lemke, Hardy Müller, David Schwappach, Max Geraedts, Beate S. Müller
In recent years, public perceptions of patient safety have evolved significantly, driven by media coverage, healthcare reforms, and greater awareness during the coronavirus disease 2019 (COVID-19) pandemic. The present study aimed to examine trends in public perceptions of patient safety, knowledge and self-efficacy in Germany during this pandemic between 2019 and 2023. A repeated cross-sectional study was conducted, using data from TK Monitor of Patient Safety. TK Monitor of Patient Safety in a nationwide survey assessing public perceptions of safety in medical treatment and diagnosis. Self-reported data were collected annually from a randomly selected sample of 1,000 different adults aged 18 and older residing in Germany. Statistical analyses included descriptive statistics, chi-square tests, and linear regressions for trend analyses. Our results revealed high perceived patient safety risk during the years of the study. Up to one third of respondents considered it very likely or somewhat likely that patients would be harmed when receiving medical treatment in hospital or ambulatory care, with lower perceived levels of risk before the COVID-19 pandemic. Regarding perceived prevalence of preventable adverse events, over half of respondents considered it very likely or somewhat likely that an illness of theirs would be diagnosed incorrectly, or that they would contract a nosocomial infection, at some stage in their lives. The majority of respondents considered themselves overall well informed about patient safety and reported higher levels of self-efficacy with regard to error prevention before and after the pandemic than during it. Given the facts that patient safety remains an important issue and that the German public perceives the level of patient safety risk but also of patient safety knowledge, and self-efficacy as high, actively involving patients in safety initiatives is essential for shaping positive public perception.
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