Conectar
by Siobhán O’Connor, Sandra M. Malone, Joseph Firnhaber, Sinéad O’Keeffe, John McNamara, Anna Donnla O’Hagan
While mental health literacy is an important component to successful help-seeking, rural populations often face gaps in both knowledge and service provision. Informed by the Theory of Planned Behaviour and Self-Efficacy Theory, we designed the ‘Skills for Resilience’ as a brief, once-off, community-based educational intervention to increase Irish farmers’ mental health literacy and help-seeking intentions. We adopted a quasi-experimental between (group: intervention and control) and within-group design (time: baseline [T1], immediately post-intervention [T2], and ≥ 1 month post-intervention [T3]). A total of 72 participants (intervention n = 37; control n = 35) were recruited from knowledge-sharing discussion groups. Although recruitment was also open to women, all discussion groups consisted of men. A trained facilitator delivered a discussion lasting between 30 and 90 minutes. Five intervention participants also participated in a qualitative interview after T3. Our results identified intervention participants’ mental health literacy increased significantly at T2 and T3 compared to T1, but did not increase between T2 and T3. Mental health literacy was also significantly greater in the intervention group compared to the control group at T2 and T3. Help-seeking intentions and self-efficacy in seeking mental healthcare also increased significantly at T2 compared to T1, but did not increase between T1 and T3 or T2 and T3. There were no significant changes in outcome measures for the control group at any time point. Through reflexive thematic analysis we identified that the intervention also addressed stigma against mental health (Theme 1) and provided important resources for participants and their community’s present and future coping (Theme 2). At T3, 100% of participants enjoyed the discussion and would recommend the intervention to other farmers. This intervention provides a successful example of integrating the Theory of Planned Behaviour and Self-Efficacy Theory to improve mental health literacy in farmers using a brief, educational intervention.
Limited evidence exists regarding the effectiveness of learning approaches in supporting interprofessional wound care education transnationally. The aim of this pilot study was to explore the feasibility and preliminary impact of an international, online interprofessional masterclass in supporting baccalaureate health students' learning about wound care. Data were collected using multiple methods including quantitative survey, qualitative focus groups, and interviews with baccalaureate nursing, pharmacy, dietetics, podiatry and paramedicine students from two universities based in Australia and Northern Ireland. A retrospective pre-test design was used. A survey retrospectively assessed students' self-reported confidence and understanding before and after the masterclass, while qualitative methods explored students' experiences of interprofessional learning and wound care. Self-reported improvements in students' understanding of wound assessment and management, as well as heightened awareness of interprofessional contributions to patient care indicated the potential value of this interprofessional and international collaboration in supporting wound care education. Qualitative analysis identified four themes: recognising a wound is a person's wound; comparing international healthcare practices; fostering learner engagement; interprofessional recognition, acknowledgment, and understanding of each profession's roles, contributions and expertise. This pilot study has highlighted key issues to be addressed in future research examining the impact of a collaborative online international initiative on baccalaureate students' interprofessional learning about wound care.
To explore the challenges that visually impaired individuals face in managing their prescribed therapy at home, and to identify the implications for all healthcare professionals involved in medication management and patient safety.
A cross-sectional, descriptive, observational study.
Data were collected from 357 visually impaired adults recruited at the premises of the Union of the Blind and Visually Impaired during their visits for various reasons between October 2022 and June 2023, using an interviewer-administered questionnaire. Variables included demographics, medication practices, and self-reported challenges in medication administration and dosing. Data were analysed using multivariate analysis of variance (MANOVA), a series of Kruskal-Wallis tests, and post hoc Dunn's tests in R (v. 4.4.3).
Respondents faced major problems in differentiating different types of tablets/capsules (56%) and differentiating different packages of drugs (47%); 5% of respondents sometimes take the wrong medicine, 4% sometimes take the wrong dose, and 11% sometimes take medicine at the wrong time. The most frequent problem was applying medications in liquid form. Older participants, those with chronic illness, multiple medications, lower education, or complete blindness reported significantly more difficulties. More than half of the respondents stated that they needed help in recognising drugs (60%), dosing (62%), and the expiration date of the drug (74%).
Visually impaired individuals, particularly those who are older and have complex medication regimens, face substantial barriers to safe and independent medication use. These findings highlight the need for individualised support and practical education strategies.
Through individualised approaches and practical training, with interprofessional collaboration, patient safety can be significantly improved and the risk of medication errors reduced. In a healthcare system with rapid technological advances and a growing shortage of healthcare workers, it is necessary to consider a broader range of support strategies, including efforts to understand the specific needs of people with visual impairments and the use of available assistive devices.
What problem did the study address?: Visually impaired individuals encounter substantial challenges in safely managing their prescribed medications, especially as they age and develop chronic health conditions. Despite the increasing global prevalence of vision impairment, this issue remains underexplored in nursing literature and practice.
What were the main findings?: This study presents evidence on the specific challenges that visually impaired adults face when self-administering medications. It identifies key risk factors—including advanced age, polypharmacy, chronic illness, and complete blindness—and highlights the dosage forms that pose the greatest difficulty. Importantly, it also reveals a widespread need for assistance with medication identification, dosing, and monitoring expiration dates.
Where and on whom will the research have an impact?: The findings highlight nurses' essential role in facilitating safe medication management for visually impaired patients. This involves assessing medication literacy, educating patients and caregivers, and promoting accessible medication labeling. The study highlights the need for nurse-led interventions and policy efforts to reduce disparities in medication safety, while recognising the valuable roles of both pharmacists and physicians in providing a comprehensive, interprofessional approach.
The authors adhered to the STROBE guidelines.
No patient or public involvement.
by Jordan Salomon, Haydee Montemayor, Cassandra Durden, Dorcas Abiara, Rachel E. Busselman, Gabriel L. Hamer, Sarah A. Hamer
Management of tick-borne disease necessitates an understanding of tick phenology, tick-host associations, and pathogen dynamics. In a recreational hotspot outside of one of the largest cities in the United States, we conducted a year of monthly standardized tick drag sampling and wildlife trapping in Sam Houston National Forest, a high use recreation site near Houston in east Texas, US. By sampling 150 wildlife hosts of 18 species, including rodents, meso-mammals, deer, reptiles, and amphibians, we collected 87 blood samples, 90 ear biopsies, and 861 ticks representing four species (Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis and Ixodes texanus). Drag sampling yielded 1,651 questing ticks of three species: A. americanum (921), D. variabilis (10), and I. scapularis (720). Off-host larval A. americanum abundance peaked in July, followed by peak infestations of wildlife, predominantly raccoons, in August. Off-host I. scapularis larvae abundance peaked in spring (March-May), while very few were removed from hosts and only a single I. scapularis nymph was found throughout the study via dragging in June. In contrast, both off-host and on-host adult I. scapularis occurred most frequently in the winter. Overall, tick infections included 25.3% (183/725) with Rickettsia buchneri, 15.5% (112/725) Rickettsia amblyommatis, 8.0% (58/725) Rickettsia tillamookensis, 0.8% (6/725) Rickettsia spp., and a single tick with a hard tick relapsing fever Borrelia spp.; no tick tested positive for Borrelia burgdorferi. Characterizing tick phenology, tick-host associations, and tick-borne bacteria fills important knowledge gaps for the risk of tick-borne diseases in pine-dominated forests of this region.
by Isabel Baltzan, Lisa Merry, William Fraser, Sonia Semenic, Sandra Pelaez, Alexis Edington, Ayesha Baig, Anita Gagnon
ObjectiveWe assessed the extent to which recommended migrant-friendly maternity care (MFMC) components were provided to recently-arrived international migrants giving birth in Montreal, Canada, and the extent to which the provision of MFMC components was related to socioeconomic and migratory characteristics.
MethodsWe conducted a cross-sectional study of migrant women giving birth in four hospitals in 2014–2015. Data were collected using the Migrant-Friendly Maternity Care Questionnaire (MFMCQ), focusing on access to prenatal care, communication facilitation, healthcare provider (HCP) support, and responsiveness to preferences for care. Data were analyzed descriptively and through logistic regression.
ResultsOf 2636 participants, most reported always being kept informed (86.1%) and finding HCPs helpful (90.3%), although 22.9% reported barriers to accessing services during pregnancy, and only 11% or less were asked about care preferences. Of 847 needing interpreters, 84.7% reported not being offered any. Worse access to prenatal care was reported among women who had arrived more recently [OR 0.55, 95% CI 0.36, 0.85], had lower income [0.69 (0.52, 0.90)], or had less education [0.66 (0.47, 0.94)]. Low language ability was most often associated with inadequate MFMC [e.g., worse HCP support during pregnancy [0.56 (0.36, 0.87)] and worse responsiveness to preferences for care during labour [0.55 (0.31, 0.98)]]. Maternal region of birth was associated both positively and negatively with all MFMC components.
ConclusionAlthough some MFMC has been implemented, gaps remain. Addressing language barriers remains a top priority. To deliver optimal MFMC, HCPs and policymakers should provide care that is responsive to women’s socioeconomic and migratory backgrounds.
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.
Providing an overview of the organisation, tasks, and responsibilities of acute and transitional pain services in the Netherlands.
Cross-sectional questionnaire study.
An online questionnaire was sent to representatives of Dutch hospital pain services performing inpatient surgery. It included items on organisation, staffing, education, roles, tasks and responsibilities. Data were analysed descriptively.
Of the surveyed hospitals, 92.2% reported having an acute pain service, while only 6.5% had a transitional pain service. Most pain services (acute pain services 76.3%, transitional pain services 80.0%) are part of the anaesthesiology department. Staffing includes anaesthesiologists, nurses, and/or nurse anaesthetists, with or without pain specialisation. Acute pain service teams monitor complex pain management techniques. Nearly all acute pain services (89.8%) provide pain management training, and 60% monitor hospital-wide pain management quality. All transitional pain services monitored opioid use post-discharge and conducted follow-up calls with patients.
Acute pain services are well established in Dutch hospitals, whereas transitional pain services remain limited. Organisational structures, tasks, and responsibilities vary, with key challenges in staffing, service organisation, and education. Future research should focus on optimising staffing, expanding transitional pain services, the role of the pain nurse, and establishing a national pain management education framework.
This study highlights the significant impact of pain nurses as a central professional within the interdisciplinary team, contributing to quality care and education, ultimately benefiting patients.
This study provides a current overview of pain services in the Netherlands, supporting pain nurses in innovating pain services, highlighting key challenges and opportunities for improvement.
STROBE checklist.
None.
Introducción: El enfoque intercultural en salud reconoce las particularidades de los pueblos en su estilo de vida, valores y creencias, esenciales para la atención sanitaria. Aunque las políticas educativas han avanzado junto al reconocimiento de los derechos de los pueblos, aún falta integrar este enfoque en la formación de profesionales de salud. Objetivo: comprender las experiencias esperadas por los programas de salud y las reconocidas por los estudiantes respecto a la interculturalidad durante las prácticas formativas finales en dos programas. Metodología: investigación cualitativa de estudio de caso, con enfoque hermenéutico y análisis del discurso, se examinaron 126 informes de práctica, 70 microcurrículos, 6 documentos institucionales, nueve documentos de orden nacional y dos internacionales. Resultados:muestran que, aunque la interculturalidad es una prioridad en la atención en salud, no se evidencia su abordaje en las competencias de formación ni en los contenidos académicos. Los estudiantes reportan aprendizajes en atención sanitaria, interculturalidad y su rol profesional, algunos de los cuales no son parte del currículo formal. Conclusión: aunque los documentos institucionales reconocen la importancia de la interculturalidad, su implementación práctica es insuficiente. Las prácticas, entendidas como "aulas de territorio", llenan vacíos curriculares y fomentan la interculturalidad, desafiando la formación tradicional en salud.
by Lilien Schewski, Mathew Magimai Doss, Guido Beldi, Sandra Keller
Speech analysis offers a non-invasive method for assessing emotional and cognitive states through acoustic correlates, including spectral, prosodic, and voice quality features. Despite growing interest, research remains inconsistent in identifying reliable acoustic markers, providing limited guidance for researchers and practitioners in the field. This review identifies key acoustic correlates for detecting negative emotions, stress, and cognitive load in speech. A systematic search was conducted across four electronic databases: PubMed, PsycInfo, Web of Science, and Scopus. Peer-reviewed articles reporting studies conducted with healthy adult participants were included. Thirty-eight articles were reviewed, encompassing 39 studies, as one article reported on two studies. Among all features, prosodic features were the most investigated and showed the greatest accuracy in detecting negative emotions, stress, and cognitive load. Specifically, anger was associated with elevated fundamental frequency (F0), increased speech volume, and faster speech rate. Stress was associated with increased F0 and intensity, and reduced speech duration. Cognitive load was linked to increased F0 and intensity, although the results for F0 were overall less clear than those for negative emotions and stress. No consistent acoustic patterns were identified for fear or anxiety. The findings support speech analysis as a useful tool for researchers and practitioners aiming to assess negative emotions, stress, and cognitive load in experimental and field studies.
by Ana I. Romero, Serhiy Surkov, Per Wirsén, Graeme Brookes, Linda Bergström, Jan Tejbrant, Elena Dhamo, Sandra Wilks, Catherine Bryant, Jan Andersson
Catheter-associated urinary tract infection is one of the most common healthcare-associated infections, with biofilm formation playing a key role in its pathogenesis. Indwelling medical devices introduce ideal pathways inside the body for pathogens and feature surfaces conducive to biofilm development, often leading to severe clinical infections recalcitrant to antimicrobials. When bacteria and fungi switch to biofilm mode of growth, they produce a matrix in the form of extracellular polymeric substances (EPS). This creates a unique environment for growing virulent colonisers and persisting cells while forming a shielding barrier against immune system attacks, antimicrobial agents and mechanical removal by fluid shear forces. To address this challenge, LubriShieldTM – a novel permanent coating – was invented and evenly applied to both internal and external surfaces of indwelling urinary Foley catheters. Without releasing active substances, it effectively prevented pathogens from producing biofilm. The superhydrophilic coating, incorporating a proprietary anti-fouling ligand, significantly inhibited colonising uropathogens from forming biofilm for up to 14 days in artificial urine medium without microbial killing (up to 99% reduction, P ). In a glass bladder flow model, LubriShieldTM still significantly reduced biofilm formation by 83% (P . Importantly, LubriShield™ maintained its antibiofilm efficacy even after conditioning with fibrinogen, a host-derived protein known to promote bacterial attachment (P = 0.007). RNA-seq analysis revealed significant downregulation of genes associated with microbial EPS formation on the coated surfaces. Additionally, microorganisms adhering to LubriShieldTM coated catheters showed a 78% increased susceptibility to antibiotics compared to those on uncoated catheters (P = 0.004).
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
Diabetes related foot ulcers (DFUs) are complex and costly to manage, with the prevalence of non-healing wounds steadily increasing across the globe. Non-healing wounds can occur when clinicians fail to undertake an appropriate assessment, fail to recognise the importance of systemic or local complications, or provide the optimal treatment. The aetiological causes behind non-healing wounds are multifactorial; however, the purpose of this article is to focus on the role of oxygen in non-healing wounds and to introduce readers to advances in the delivery of topical oxygen therapy (TOT) via a haemoglobin spray. Importantly, this article incorporates a clinical decision support tool (CDST) to help clinicians identify the most appropriate individuals for whom topical haemoglobin may be most beneficial and the most appropriate time for introducing the intervention to improve wound healing outcomes.
To (1) describe the characteristics of patients with advanced cancer receiving home-based care, (2) identify the nursing diagnoses associated with 6-month mortality and (3) explore the predictive power of nursing diagnoses on 6-month mortality for patients with an advanced cancer diagnosis.
Nursing diagnoses have been shown to capture the complexity of patients' experiences and the specific nursing care related to patients' responses to illness, including increased mortality risk. However, there is a lack of studies investigating the relationship between nursing diagnoses and mortality among cancer patients receiving home-based care.
Retrospective cohort study.
Between July 2021 and June 2023, patients with advanced cancer were consecutively admitted to a home-based care service. Medical data, prognostic indexes and nursing assessment data, including nursing diagnoses from NANDA International, assigned during the first home visit, were extracted from patient health records. Survival analysis was performed over the first 6 months using the Kaplan–Meier method and Cox proportional hazards model.
Among 344 enrolled patients, the most frequent nursing diagnoses were chronic pain and constipation. The 45.9% of patients died at home within 6 months after discharge. Multivariate Cox regression identified a Palliative Prognostic Index ≥ 5, palliative status, terminal phase of illness and two nursing diagnoses—imbalanced nutrition: less than body requirements and death anxiety—as significant predictors of 6-month mortality.
Survival in advanced cancer patients receiving home care was primarily predicted by the terminal phase of illness, Palliative Prognostic Index, palliative status and two specific nursing diagnoses: imbalanced nutrition: less than body requirements and death anxiety.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.
No Patient or Public Contribution.
To describe the cumulative incidence and characteristics of hospital-acquired pressure injury in acute palliative patients.
Secondary data analysis of hospital-acquired pressure injuries during 2019–2022.
The setting was a palliative care unit at a tertiary hospital in Queensland, Australia, including adult (≥ 18 years) acute-phase palliative inpatients. Retrospective data from four databases were used to identify and analyse hospital-acquired pressure injury cases from 2019 to 2022. Clinical characteristics of patients with and without hospital-acquired pressure injury were compared.
The incidence of hospital-acquired pressure injury in acute palliative care patients was 3.9% over the 4 years. These patients were predominantly male, with an average age of 74 years, with 66 of 78 cases developing in the deteriorating palliative care phase. Using the Waterlow Score, 51.3% of patients were assessed as at very high risk of pressure injury. Ninety-five hospital-acquired pressure injuries were reported in 78 patients; 16.8% were medical device-related, 40% were Stage 1 injuries, and the most common injury sites were the sacrum, heels and genitals. Patients with hospital-acquired pressure injury had significantly higher (worse) scores on both the palliative care Resource Utilisation Group-Activities of Daily Living and Problem Severity Scores. Regression analysis identified a high Problem Severity Score on admission as a significant predictor for hospital-acquired pressure injury development.
The incidence of hospital-acquired pressure injury in acute palliative patients is lower than in previous studies. However, many injuries occurred in those in the deteriorating phase, with higher scores for severity of symptoms. These findings suggest that acute palliative patients do require nursing care for pressure injury prevention, as well as for symptom management and activities-of-daily-living. Overall, this research contributes to a deeper understanding of pressure injury incidence and characteristics for acute palliative care patients. Future research should focus on population-specific pressure injury risk assessment to explore risk factors in greater detail.
Current pressure injury risk assessment tools, like the Waterlow Score, may not provide the comprehensive evaluation needed for the acute palliative care cohort. To better address the unique needs of this cohort, it may be necessary to refine existing tools or develop new instruments that integrate palliative-specific assessments, such as the Resource Utilisation Group-Activities-of-Daily-Living (RUG-ADL) and Problem (symptom) Severity Score (PSS). These adaptations could help improve pressure injury prevention care planning and enhance outcomes for patients in this setting.
This study separated acute palliative care patients from those at end-of-life and found a 3.9% cumulative incidence of pressure injuries. There were no significant differences in age, gender, or cancer diagnosis between patients with and without injuries. Patients without injuries were more likely to be in the deteriorating phase, while those with injuries had higher (worse) RUG-ADL scores. Regression analysis showed that each one-point increase in the PSS (symptom severity) made patients 1.2 times more likely to develop a pressure injury. The findings suggest that combining a validated risk assessment tool with the RUG-ADL and PSS tools could provide a more accurate risk assessment for hospitalised acute palliative care patients.
STROBE reporting guideline.
No patient or public contribution.
To assess the validity of a modified Neonatal Skin Risk Assessment scale (Dev-NSARS) for neonatal pressure injuries (PIs) in the neonatal intensive care unit (NICU) and neonatal sub-intensive care unit (NICU-Sub) environment.
Medical devices are the leading cause of pressure injuries (PIs) in neonates, a key cause of morbidity in neonatology, significantly impacting the length of stay (LOS) and public hospital resources.
The Dev-NSRAS scale, considering the presence of medical devices, was tested on a national multicenter prospective study on newborns. The discrimination power of the Dev-NSRAS scale was compared to that of the more commonly used Glamorgan scale.
Nine newborns (6.6%) developed PIs, with a total of 16 injuries, 75% (12 out of 16) of which were device related. Newborns with postconceptional age ≤ 30.8 weeks were at higher risk of developing PIs. First 24-h total Dev-NSRAS scores were compared with first 24-h Glamorgan scores, to obtain and compare respective sensitivity and specificity. During the first 24 h from admission, a very good discriminative performance was evidenced for Dev-NSRAS ≤ 11 (AUC 0.921, 95% CI: 0.899–0.940, p < 0.0001; 81.6% sensitivity and 93.6% specificity) as compared to a moderate discriminative performance shown by a Glamorgan score > 28 (AUC 0.752, 95% CI: 0.634–0.660, p < 0.0001; 92.1% sensitivity and 65.5% specificity).
Early application (i.e., in the first day from hospital admission) of Dev-NSRAS by the nursing personnel shows excellent accuracy in predicting the risk of developing PUs in newborns admitted to NICU and NICU-Sub, as compared to the Glamorgan scale.
The STROBE statement for cohort observational studies was used as the reference reporting method.
The study addressed the lack of a risk assessment scale for pressure injuries in neonates. Development and testing of a scale that demonstrated high sensitivity and specificity in the early prediction of pressure injury risk in neonates within the first 24 h. The research will have an impact in NICUs and NICU-Sub units, enabling nurses to plan personalised care to prevent pressure injuries in neonates, thereby reducing the length of hospital stays and overall healthcare costs.
Introduce a validated scale for improving neonatal pressure injury prevention worldwide. Enhance early detection tools, reduce hospital stays and global costs.
The study protocol has been approved by the Paediatric Tuscany Region Ethical Committee (date: 18 January 2021; protocol code 18/2021).
To determine prognostic factors of disability in multiple sclerosis (MS), that is, (1) identify determinants of the dynamics of disability progression; (2) study the effectiveness of disease-modifying treatments (DMTs); (3) merge determinants and DMTs for creating patient-centred prognostic tools and (4) conduct an economic analysis.
Individuals registered in the French Observatoire Francais de la Sclérose en Plaques (OFSEP) database were included in this OFSEP-high definition cohort if they had a diagnosis of MS, were ≥15 years old and had an Expanded Disability Status Scale (EDSS) score
A cohort of 2842 individuals, 73.4% women, mean (SD) age of 42.7 (11.6) years, median disease duration of 8.8 years, has been recruited from July 2018 to September 2020. The course of MS was relapsing remitting in 67.7%, secondary progressive in 11.9%. The mean annual relapse rate was 0.98. The disease-modifying treatment received was highly effective therapy in 50.3% and moderately effective therapy in 30.7%.
The participants will be followed until December 2026. Disease course up to four landmarks will be examined as predictors of disease progression: (1) diagnosis of MS; (2) relapse activity worsening and independent progression; (3) any recent disease activity and (4) any visit with absence of disease activity in the past 5 years. The marginal effectiveness and tolerability of treatments will be assessed. Stratified algorithms will be proposed for medical decision-making. Economic evaluation of disease cost and cost-effectiveness of new DMTs will be conducted from a public payer perspective.
by Luca Ghirotto, Eugenio Paci, Claudia Bricci, Silvia Marini, Valentina Bessi, Matías Eduardo Díaz Crescitelli, Ermanno Rondini, Francesco Pistelli, Giuseppe Gorini, Sandra Bosi, Paolo Giorgi Rossi, the Working Group
BackgroundLung cancer screening (LCS) combined with smoking cessation programs is a critical strategy for reducing lung cancer mortality. Understanding the perspectives of cigarette users and former ones on these interventions is essential for enhancing their acceptability and effectiveness. This study aimed to explore, in Italy, the perceptions and experiences of individuals eligible for LCS within the context of a smoking cessation program.
Methods and findingsThis multicenter qualitative study was conducted in two Italian regions as part of a larger project the Italian League against Cancer promoted. Using purposive sampling, we included (a) cigarette users and former ones who participated in an Italian trial, ITALUNG study, and (b) cigarette users who had been offered individual or group smoking cessation interventions and were theoretically eligible for screening in the following years (aged 50–70, ≥15 pack-years). Data were collected through open-ended semi-structured interviews and focus group meetings and analyzed using reflexive thematic analysis. The data analysis yielded six themes covering participants’ views on the interactions between the two types of interventions (screening and smoking cessation program). Across their data, we generated the following themes: (i) depreciation and fatalism toward the risk of smoking, (ii) self-blaming and ethicality, (iii) ambivalent impact of the screening on smoking, (iv) LCS-related information and concerns, (v) teachable and motivating moments, and (vi) non-stigmatizing communication and testimony by professionals.
ConclusionsOur study underscores the importance of avoiding stigma and respecting the dignity of cigarette users in implementing LCS and smoking cessation programs. Clear communication and supportive interactions with healthcare providers are crucial for enhancing the acceptability and effectiveness of these interventions. Future research should focus on quantifying these findings and exploring additional factors influencing the acceptability and effectiveness of combined LCS and smoking cessation programs.
FreshRSS