Conectar
To explore the social context of violence for hospital-based and community nurses from different ethnic groups, the types of violence experienced or witnessed both in and outside the workplace, and its impact on mental and physical health.
Cross-sectional, qualitative study using semi-structured interviews.
Semi-structured interviews were conducted online with 12 hospital-based and community nurses recruited from London, England, between May and August 2021. Data were analysed using reflexive thematic analysis.
The sample comprised seven hospital nurses and five community nurses. Four themes were identified: (i) the social context in which nurses from different ethnic groups are exposed to community violence; (ii) types of workplace violence experienced or witnessed by hospital-based and community nurses from different ethnic groups; (iii) perceptions of the factors contributing to workplace violence; (iv) impacts of violence on mental and physical health outcomes. Using the social ecological framework and sociological theory of stress, these findings informed a conceptual stress process model of violence exposure for nurses.
Nurses from different ethnic groups are exposed to violence both in and outside the workplace which negatively affects their mental and physical health. Effective violence prevention requires a multi-factorial approach that addresses the social and institutional factors contributing to violence, shifting the focus from individual measures to systemic organisational changes.
The NHS workforce is currently more diverse than ever, and healthcare leaders must improve access to mental health and well-being resources for staff affected by workplace violence, particularly for those who hold multiple social identities at the intersection of ethnicity, gender and age. Prioritising this support is essential not only to safeguard against negative health outcomes but also to improve the recruitment and retention of healthcare professionals.
No patient or public contribution.
Sickle cell disease (SCD) is due to the mutation of haemoglobin (Hb), from HbA to HbS and characterised by recurrent vaso-occlusive crises (VOC), which can progress to acute chest syndrome (ACS), a leading cause of death in adults with SCD. Hypoxia is a key modifiable factor in the polymerisation of HbS and the pathogenesis of VOC. High-flow nasal oxygen (HFNO) delivers humidified gas at high oxygen concentrations and flow rates: the former may reverse sickling (metabolic effect) to accelerate VOC resolution and prevent ACS, while the latter may reduce the risk of ACS by mitigating hypercapnia and generating positive airway pressure that limits hypoventilation and atelectasis (pulmonary effect). The study hypothesises that HFNO is a safe and effective strategy for treating VOC and preventing secondary ACS, and will assess this using a multi-arm multi-stage (MAMS) trial design.
This is a prospective, multicentre, randomised, open-label controlled trial following an MAMS design with three phases and four arms: one control (low-flow oxygen) and three HFNO intervention arms with varying fraction of inspired oxygen levels (low, intermediate, high). The pilot stage will assess safety and feasibility, using the rate of cardiac and neurological events as the primary endpoint. In the activity stage, arms demonstrating acceptable safety will be compared for efficacy based on the rate of VOC resolution without complications by day 5, allowing selection of the most promising arm. The final efficacy stage will compare the selected HFNO strategy to control, with prevention of secondary ACS by day 14 as the primary endpoint. The study aims to enrol up to 350 VOC episodes in total.
The study has been granted ethical approval (CPP SUD MEDITERRANEE IV). Following the provision of informed consent, patients will be included in the study. The results will be submitted for publication in peer-reviewed journals.
Malawi’s prisons are overcrowded, contributing to tuberculosis (TB) and Human Immunodeficiency Virus (HIV) transmission and service delivery gaps for both conditions. We applied an empirically supported three-stage model of HIV/TB care to guide the improvement of TB/HIV service delivery in select Malawian prisons.
We conducted a pilot implementation research study using multimethods from May 2022 to April 2023.
Two semi-urban prisons in Malawi.
We purposively sampled participants detained at the study sites during the study period.
We collected data on sociodemographics, medical history and screening results for sexually transmitted infections (STIs), HIV and TB results. We conducted in-depth interviews with prison professional staff and used content analysis to explore the feasibility of implementing the three-stage model of HIV and TB care in Malawian prisons.
Mean participant age was 35 years (SD 12.2 years). We screened 100 out of 647 (15%) incarcerated people for TB/HIV according to the three-stage model and identified the following: five cases of TB disease; two cases of HIV-associated TB; seven persons living with HIV; eight persons diagnosed and treated for STIs, including genital ulcer disease and syphilis. For those tested for HIV at entry, midpoint and exit screening, there was no documented case of seroconversion during the incarceration period. There was evidence of potential STI transmission during incarceration, as suggested by a 4% rate of new urethral discharge among participants. Qualitative data suggest that it is feasible to implement the three-stage model of HIV/TB in the Malawi prison setting.
We found evidence of HIV, TB and STIs among incarcerated people in two semi-urban prisons in Malawi, with low HIV status awareness on prison entry. It is feasible to implement the three-stage model of HIV/TB in prison settings, although with material support to overcome implementation challenges. Coordination with Ministry of Health officials could facilitate model feasibility and sustainability in Malawi’s prisons.
In critical care, intensive care unit (ICU) staff and physicians often estimate patients' height and weight visually, impacting calculations for cardiac function, ventilation, medication, nutrition and renal function. However, accurate assessment is challenging in critically ill patients. This study evaluates the accuracy of visual estimations by ICU staff.
Descriptive cross-sectional study.
National Institute of Cardiovascular Diseases, Karachi, Pakistan.
We included a convenient sample of adult (≥18 years) cardiac patients admitted to the critical care unit in this study. Patients who refused to give consent, trauma/surgery of lower limbs or patients with below-knee or above-knee amputation were excluded to avoid bias.
A convenient sample of cardiac ICU patients was included. Measured weight (kg) and height (cm) were compared with visual estimations by senior ICU nurse, senior non-ICU nurse, ICU consultants, fellows and residents. Correlation and agreement were analysed using Bland–Altman plots and 95% agreement limits.
A total of 356 patients were evaluated, of whom 204 (57.3%) were male, with a mean age of 55.2 ± 14.3 years. The median SOFA score was 3 [2–5], and 101 patients (28.4%) were on mechanical ventilation. The mean difference between measured and estimated weight by senior non-ICU nurse was 4.7±9.2 [–13.38–22.83] kg, senior ICU nurse was 7.8±9.9 [–11.56–27.12] kg, ICU consultants was 3.0±6.6 [–9.89–15.79] kg, ICU fellow was 3.0±7.1 [–10.88–16.92] kg and ICU resident was 8.0±9.6 [–10.83–26.79] kg. Similarly, the mean difference between measured and estimated height by senior non-ICU nurse was 2.0±7.3 [-12.36–16.34] cm, senior ICU nurse was 2.4±7.5 [–12.19–17.00] cm, ICU consultants was 1.5±5.6 [–9.51–12.48] cm, ICU fellow was 1.1±5.5 [–9.68–11.95] cm and ICU resident was 2.3±8.5 [–14.40–19.01] cm.
The findings indicate that healthcare professionals tend to overestimate both weight and height. The accuracy of these estimations varied among professional groups, underscoring the potential clinical consequences of such errors. This emphasises the need for objective measurements in clinical decision-making.
To map, summarise and analyse the methodologies of corneal nerve fibre imaging in studies using in vivo confocal microscopy (IVCM) in diabetes and assess the potential for standardising methods and reporting.
A scoping review was conducted using five databases, MEDLINE, Embase, Cochrane, Web of Science and Scopus, with search terms related to IVCM, diabetes and corneal nerves. Two researchers independently screened the studies for eligibility. Relevant data were extracted and systematically analysed.
Out of 1533 screened articles, 195 met the inclusion criteria. Spanning from 2000 to 2024, the studies showed high variability in image acquisition, image processing, image analysis and reporting detail. Most studies used laser scanning confocal microscopy, examining the central cornea in both eyes in patients with type 2 diabetes, manually selecting 3–6 images from each eye, and using ACCMetrics and CCMetrics for quantifying corneal nerve fibre length in mm/mm2. Many studies lacked sufficient methodological details for reproducibility.
IVCM studies of corneal nerve fibres in diabetes show substantial methodological heterogeneity and inconsistent reporting, limiting reproducibility. We propose a guideline to support standardisation and improve the reliability of future research.
Video games have been linked to a range of positive and negative effects on the mental health of adolescents and young adults. However, to better understand how games affect the mental health of young people, their use and experiences must be situated in the sociocultural and personal life contexts of individuals. Drawing from a cultural-ecosocial approach, this study combines cross-sectional and digital phenotyping measures to examine the effects of video games on the mental health of youth.
Participants will be young people aged 16–25 years from the community and living in the province of Quebec, Canada. An initial sample of 1000 youth will complete a cross-sectional survey online, including measures of socio-demographic context, gaming practices and experiences, streaming practices and experiences, as well as personality and well-being. Qualitative questions will explore personal views on games and mental health. A subsample of 100 participants will be selected for digital phenotyping, including daily surveys of well-being, gaming, streaming and social experiences, combined with passive mobile sensing (eg, geolocation). Analyses will include regression and mixed models for quantitative data, reflexive thematic analysis for qualitative data, and an integration of quantitative and qualitative results using participatory methods.
The study received ethical approval from the Institutional Review Board of McGill University (24-02-015). The dissemination of results will be conducted in partnership with a multi-stakeholder advisory committee, including youth who play video games, and will involve peer-reviewed publications, presentations to policymakers in Quebec, and workshops for clinicians and researchers.
Competency assessment tools are well-recognised as a method to achieve a standardised level of practice for a group of healthcare professionals with similar characteristics. The aim of this study is to develop and pilot a new competency assessment tool to support therapists caring for patients with blunt chest trauma from prehospital care through to long-term follow-up following hospital discharge.
A mixed-methods study will be undertaken, with three distinct phases: (1) an integrative narrative review to examine the literature regarding therapist competencies; (2) focus groups with patients, therapists and key stakeholders to explore opinions regarding important aspects of care (phases I and II will inform the content of the tool), followed by final tool development by an international expert panel; and (3) a multicentre pilot study using questionnaires and elicitation interviews, in which final tool acceptability to therapists will be tested. The total sample size will be between 40 and 50 participants for the focus groups. For the final tool development work, a panel of 10 international experts will be identified, with a subgroup of 3–5 experts who will be recruited to confirm content validity. We will pilot the tool at five health boards in Wales, aiming for 10 therapists from each. Elicitation interviews will be undertaken with a smaller sample size of between 15 and 20 therapists. A mixed qualitative and quantitative data analysis approach will be used.
Proportionate ethics approval has been granted (South Yorkshire Research Ethics Committee, reference number: 24/YH/0231). We will publish the work in an open-access peer-reviewed journal to ensure equitable access and present at relevant conferences. Webinars will be used to achieve a wide audience. The results will be shared with the research participants via an infographic which will be designed and developed with the public research partners.
Integrative review is registered at the Open Science Framework: https://doi.org/10.17605/OSF.IO/CEXNR
Early childhood development (ECD) lays the foundation for lifelong health, academic success and social well-being, yet over 250 million children in low- and middle-income countries are at risk of not reaching their developmental potential. Traditional measures fail to fully capture the risks associated with a child’s development outcomes. Artificial intelligence techniques, particularly machine learning (ML), offer an innovative approach by analysing complex datasets to detect subtle developmental patterns.
To map the existing literature on the use of ML in ECD research, including its geographical distribution, to identify research gaps and inform future directions. The review focuses on applied ML techniques, data types, feature sets, outcomes, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and reported limitations.
Scoping review using the Arksey and O‘Malley framework with enhancements by Levac et al.
A systematic search was conducted on 16 June 2024 across PubMed, Web of Science, IEEE Xplore and PsycINFO, supplemented by grey literature (OpenGrey) and reference hand-searching. No publication date limits were applied.
Included studies applied ML or its variants (eg, deep learning (DL), natural language processing) to developmental outcomes in children aged 0–8 years. Studies were in English and addressed cognitive, language, motor or social-emotional development. Excluded were studies focusing on robotics; neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder and communication disorders; disease or medical conditions; and review articles.
Three reviewers independently extracted data using a structured MS Excel template, covering study ML techniques, data types, feature sets, outcomes, outcome measures, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and limitations. A narrative synthesis was conducted, supported by descriptive statistics and visualisations.
Of the 759 articles retrieved, 27 met the inclusion criteria. Most studies (78%) originated from high-income countries, with none from sub-Saharan Africa. Supervised ML classifiers (40.7%) and DL techniques (22.2%) were the most used approaches. Cognitive development was the most frequently targeted outcome (33.3%), often measured using the Bayley Scales of Infant and Toddler Development-III (33.3%). Data types varied, with image, video and sensor-based data being most prevalent. Key predictive features were grouped into six categories: brain features; anthropometric and clinical/biological markers; socio-demographic and environmental factors; medical history and nutritional indicators; linguistic and expressive features; and motor indicators. Most studies (74.1%) focused solely on prediction, with the majority conducting predictions at age 2 years and above. Only 41% of studies employed explainability methods, and validation strategies varied widely. Few studies (7.4%) conducted external validation, and only one had progressed to a clinical trial. Common limitations included small sample sizes, lack of external validation and imbalanced datasets.
There is growing interest in using ML for ECD research, but current research lacks geographical diversity, external validation, explainability and practical implementation. Future work should focus on developing inclusive, interpretable and externally validated models that are integrated into real-world implementation.
Prescribing patterns for hyperopia in children vary widely among eye care providers worldwide. This scoping review aims to identify and map the current literature on optical correction and catalogue outcomes reported, particularly in the domains of vision, vision-related functional outcomes and quality of life (QoL) in school-aged children with hyperopia.
This protocol was developed in accordance with the Joanna Briggs Institute’s Manual for Evidence Synthesis. We will include studies involving school-aged children with hyperopia without restrictions on sex, gender, race, ethnicity, type of optical correction, length of intervention, publication date or country of origin. We will include studies with internal or external comparison groups. We will exclude studies associated with myopia control treatments, ocular and visual pathway pathologies affecting vision or visual function. We will search Cochrane CENTRAL, Embase.com and PubMed. Examples of data to be extracted include population demographics, visual acuity, study-specific definitions for refractive error, treatment regimens for optical correction, vision and vision-related functional outcomes and QoL (general or vision-related) as quantified by validated instruments.
Informed consent and Institutional Review Board approval will not be required, as this scoping review will only use published data. The results from the scoping review will be disseminated by publication in a peer-reviewed scientific journal and at professional conferences.
Asthma is a leading cause of morbidity and healthcare use among children. Risk factors of childhood asthma include atopic predisposition and severe wheezing episodes caused by rhinovirus infection in early life. In children with first-time rhinovirus-induced wheezing, we aim to study the response of a short corticosteroid treatment to prevent recurrent wheezing and asthma.
This is a double-blind, randomised, placebo-controlled, phase IV, international multicentre trial involving eight sites in Norway, Sweden and Finland. Two hundred and eighty 3–23 months old steroid-naïve children are randomised 1:1 to receive oral dexamethasone (0.3 mg/kg/day) versus placebo in 3 days for their first wheezing episode and rhinovirus infection. Rhinovirus is diagnosed with multiplex PCR. The two co-primary outcomes are time to next physician-confirmed wheezing episode, and time to asthma, within 24 months from inclusion. Asthma is defined as fulfilment of the 2007 National Asthma Education and Prevention Program—criteria for initiating asthma controller medication in children aged 0–4 years. Primary interaction analyses are age, gender, atopic predisposition, risk genotypes and viral co-detection. The optimal cut-off on the rhinovirus genome load used to define a true rhinovirus infection will be assessed by exploring interactions between rhinovirus genomic loads and study drug on the co-primary outcomes. Secondary outcomes are number of wheezing episodes, duration and severity of each wheezing episode, bronchial hyperreactivity, quality of life and safety (height/weight development) at 24 months from inclusion.
Rhinovirus positive children with acute wheezing fulfilling inclusion and exclusion criteria are enrolled after informed consent from both caregivers. This trial has received ethical approval from all sites. Results will be submitted to Competent Authorities and disseminated via peer-reviewed publications and conferences within paediatrics and other relevant fields. If proven effective, findings may be implemented directly into paediatric clinical guidelines.
To describe the available literature on the epidemiology and factors associated with osteoporosis, falls and fractures in four chronic inflammatory rheumatic diseases (CIRD): rheumatoid arthritis (RA); psoriatic arthritis (PsA); ankylosing spondylitis (AS); and systemic lupus erythematosus (SLE).
Scoping review, using the Joanna Briggs Institute framework.
MEDLINE, Embase and CINAHL from January 2000 to December 2023.
Observational studies reporting on the epidemiology and/or associated factors for osteoporosis, falls and fractures in RA, PsA, AS or SLE.
Two independent reviewers used a standard data extraction form including report methods, definitions, outcomes and associated factors. Results are summarised with descriptive statistics.
288 studies met inclusion criteria, with 170 studies on RA, 19 on PsA, 49 on AS and 60 on SLE. Most studies were cross-sectional, with Europe and Asia having the greatest output. Most papers reported on osteoporosis and fractures as outcomes, with only 27 reporting falls, of which 24 were in RA. Participants’ demographics and disease-related parameters were the most frequently explored potential associated factors.
RA was the most well-studied CIRD with regard to the epidemiology and associated factors for osteoporosis, fractures and falls. Cross-sectional was the most common study design, with a higher proportion of cohort studies in RA. There is a paucity of studies assessing falls in CIRDs other than RA. Future observational research should be conducted with large prospective CIRD cohorts, with falls as an outcome and associated factor for fractures. This may enable better understanding of the risk and consequences of osteoporosis, fractures and falls, which may improve preventive care.
European cardiovascular guidelines recommend systematic atrial fibrillation (AF) screening in community-dwelling high-risk patients. However, little is known about the impact of abnormal screening findings, including AF and non-AF incidental findings on the target population. This gap highlights the need to assess both the benefits and potential harms from patients’ perspectives to fully understand the impact of AF screening. Therefore, the aim of this study is to explore patients’ experiences with AF screening among those who received abnormal findings from ambulatory ECG monitoring.
We conducted a qualitative study using semistructured interviews, analysed thematically. Participants in the PATCH-AF trial, based in Amsterdam primary care, were purposively sampled based on their screening results (AF or non-AF incidental findings), sex and socioeconomic status.
We achieved data saturation after conducting 16 interviews (6 with interviewees diagnosed with AF and 10 with non-AF incidental findings). Participants had a median age of 76 (73–79) years, and 56% were male. Their experiences, whether positive or negative, fluctuated throughout the screening process and depended on their initial motivations for participation in AF screening (seeking extra health checks, finding explanations for pre-existing symptoms or contributing to medical research), expectations and perceived benefits from clarification, diagnostic workup or treatment. Influencing factors included the type of finding (AF or non-AF incidental finding), healthcare provider communication and individual characteristics such as age, socioeconomic status and medical history.
This qualitative study highlights both positive and negative AF screening experiences from the patients’ perspective. It underscores how patients’ motivations and expectations for participation, the type of ambulatory ECG finding and communication and follow-up by healthcare providers shape their overall experiences. Healthcare providers should be aware of these factors to optimise screening consultations. Clear guidelines on communicating abnormal ambulatory ECG findings, especially incidental findings, are warranted.
The Netherlands Trial Register (NTR) number NL9656.
Enhancing empowerment and self-care practices during pregnancy reduces complications for women during this critical period. Health literacy stands as a crucial component in empowering pregnant women. Without a sufficient grasp of healthcare information, making informed decisions and choices for desired health outcomes becomes challenging. This study will assess the effectiveness of virtual group counselling based on health literacy in enhancing empowerment and self-care among pregnant women.
This randomised controlled trial will be conducted in parallel groups on 84 pregnant women. Eligible participants will be randomly assigned to either the control or intervention group using a permuted-block-randomised allocation method with four blocks. The intervention group will engage in five structured online sessions, lasting 30–40 min with 5–8 participants. The study’s primary endpoints are the empowerment and self-care of pregnant women, which will be assessed using questionnaires administered before and 1 month after the intervention. The study is planned to start on 20 April 2024 and end on 22 September 2024. The primary outcome analysis will use analysis of covariance (ANCOVA or multivariate ANCOVA), with preintervention scores entered as covariates and the intervention group as a fixed factor.
The Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1402.202) approved this protocol. The study findings will be disseminated through peer-reviewed journal publication and scientific conferences.
This trial is prospectively registered on 4 April 2024 at the Iranian Registry of Clinical Trials (IRCT20221109056451N1).
To assess the impact of opening a large community-based asynchronous review ophthalmic clinic on attendance delays among patients with stable chronic eye disease attending a London teaching eye hospital network.
Interrupted time-series analysis of routine electronic health records of appointment attendances.
A large eye hospital network with facilities across London, UK, between June 2018 and April 2023.
We analysed 69 257 attendances from 39 357 patients, with glaucoma and medical retina accounting for 62% (n=42 982) and 38% (n=26 275) of visits, respectively. Patients over 65 made up 54% (n=37 824) of attendances, while 53% (n=37 014) were from the more deprived half of the population, and 51% (n=35 048) were males.
An asynchronous review clinic opened in a shopping centre in London, in autumn 2021, following the COVID-19 lockdown in spring 2020.
Average attendance delays (days), calculated as the difference between follow-up attendance date and the latest clinically appropriate date determined at the preceding attendance.
Pre-COVID-19, attendance delays for chronic eye disease monitoring were increasing by 0.9 days per week (95% CI, 0.8 to 0.9) on average, worsening to 2.0 days per week (95% CI, 2.0 to 2.0) after the first COVID-19 national lockdown, mid-March 2020. Opening the asynchronous review clinic increased appointment capacity, with delays decreasing on average by 8.1 days per week (95% CI, 8.1 to 8.2) shortly after opening. The rate of decrease slowed to 0.3 days per week (95% CI, 0.3 to 0.3) after 5 months. We found no significant differences in average attendance delays by age, gender or level of deprivation.
The asynchronous review clinic significantly reduced attendance delays across the hospital network, addressing pre-existing backlog for stable chronic eye diseases. The reduction appeared to be maintained after the initial backlog had been cleared.
This study aims to assess the level of mental health literacy (MHL) and identify its associated factors among undergraduate university students in Lebanon. A secondary objective is to evaluate the Global Barriers to Counselling scores, their associated factors, and to examine their relationship with MHL.
Cross-sectional study using an online self-administered questionnaire.
University-level educational settings in Lebanon, including students from both public and private institutions across multiple regions.
This study enrolled undergraduate students of all academic disciplines using a convenience sampling technique. Inclusion criteria included being 18 years and above, currently enrolled at university, able to comprehend the English language and consenting to participate.
Primary outcomes: MHL scores, using the Mental Health Literacy Scale (MHLS); and Global Barriers to Counselling score, using the Revised Fit, Stigma and Value Scale (RFSV). Secondary analysis examined factors associated with MHLS score and Global Barriers to Counselling scores using multivariable linear regression.
A total of 572 participants (65.0% female; mean age 21.1±3.7 years) were included. Most were Lebanese (87.4%). The median MHLS score was 86 (IQR 77–95), indicating generally good MHL. Factors associated with lower MHLS were male gender (β=–4.17, 95% CI –7.18 to –1.16, p=0.007) and being of non-Lebanese nationality (β=–6.26, 95% CI –11.06 to –1.46, p=0.011). Presence of a previous mental health diagnosis was associated with a higher MHLS score (β=5.32, 95% CI 1.43 to 9.22, p=0.008). The Global Barriers to Counselling score had a median of 28.7 (IQR 23.21–36.21). Male gender was significantly associated with a higher barrier score (β=3.44, 95% CI 4.85 to 5.04, p
This study highlights good overall MHL among undergraduate university students in Lebanon, with variations based on gender, nationality and prior mental health exposure. Higher mental health literacy was associated with fewer perceived barriers to seeking counselling. These findings emphasise the need for tailored mental health initiatives in Lebanese universities that promote literacy, reduce stigma and enhance help-seeking behaviour across diverse student populations.
Adolescent idiopathic scoliosis (AIS) is an acquired deformity that develops in 2–4% of otherwise healthy children during adolescent growth, substantially reducing their quality of life and creating a life-long burden of disease. Despite many years of dedicated research, the cause and mechanism of AIS are still unknown and no effective curative treatments are available for children suffering from this spinal and chest deformity. To date, all etiological studies focused on children with an already established scoliosis. EARLYBIRD aims to uncover the earliest pathoanatomical changes in AIS, by studying longitudinal spinal growth in children at increased risk for scoliosis development with MRI, starting before adolescence.
This prospective observational cohort study will follow two groups: 60 adolescent girls (8–10 years old) who have an older sibling or parent diagnosed with AIS (cohort 1) and 60 adolescents with 22q11.2 deletion syndrome, a genetic microdeletion associated with 50% scoliosis prevalence (cohort 2). Data collection will be completely radiation-free and occur at baseline and yearly during adolescence up to 15 years of age in girls and up to 16 in boys. A comprehensive physical examination, a dedicated spine and chest MRI as well as a standing three-dimensional (3-D) spinal ultrasound will be obtained at each time point. The main parameter will be the longitudinal changes in segmental axial rotation during growth in subjects that do and do not develop AIS. Secondary endpoints are longitudinal changes in 3-D morphology of the bone and intervertebral discs (IVDs) during normal spinal development and during scoliosis development, determining biomarkers for bone growth, implementing radiation-free imaging methods for spinal monitoring in adolescent patients at risk for scoliosis development and use these for spinal skeletal maturity and patient-specific spinal biomechanical analyses.
This protocol has been approved by the Medical Ethics Committee NedMed and is registered on clinicaltrials.gov (NCT05924347). Written informed consent will be obtained from all parents/legal representatives. Key findings will be disseminated via peer-reviewed journals and presentation at conferences. This study is funded by the European Research Council.
Patient and public involvement (PPI) was sought in the development of the protocol for the Cognitive Decline after Brain Radiosurgery (CoDe B-Rad) study, which aims to identify potential side effects of stereotactic radiosurgery (SRS). PPI served to refine the research question and methodology.
PPI.
PPI conducted online with people based in the UK. The CoDe B-Rad study is running in regional National Health Service tertiary care in the UK and is currently nearing recruitment completion.
Patients and carers with lived experiences of brain radiotherapy. Contributors were identified through national charities.
Initial focus groups were planned, but participation proved challenging. Instead, online questionnaires, one-to-one discussions and participation in support groups were completed.
All contributors experienced changes to their cognition and/or quality of life (QoL) after radiotherapy. Quantifying the side effects of SRS and minimising them were identified as a research gap. Discussion group participation proved challenging. PPI plans were altered to accommodate the physical and mental needs of contributors. It was decided to combine the Montreal Cognitive Assessment along with European Organisation for Research and Treatment in Cancer QLQ-C30 and BN20 to capture cognitive status and QoL of patients with brain metastases and meningiomas after SRS. Patients/carers recommended for sessions to be restricted to 30 min and testing to be offered face-to-face, online, in hospital or at patients’ homes. Coproduction was not achievable with our patient population but that did not diminish the input of contributors nor the impact it had on designing the study protocol.
In cancer research, diligent considerations are required to ensure the suitability of involvement methods for this vulnerable population. Flexibility and adaptability of draft PPI plans are essential to achieve meaningful contributions. The protocol of the ongoing CoDe B-Rad study was positively shaped by people with lived experiences of brain radiotherapy.
NCT06466720 (CoDe B-Rad study).
African, Caribbean and Black (ACB) communities experience disparities in health outcomes, with higher rates of chronic diseases, such as heart disease and stroke, and lower self-reported health status compared to their White counterparts. Barriers to timely access to healthcare services further exacerbate these inequities. Some studies link racialisation to surgical disparities and subpar surgical outcomes. However, the findings are diverse, and there is no synthesis of the evidence on disparities in surgical care for ACB patients in high-income countries with universal healthcare systems. The objective of the scoping review is to systematically describe, characterise and map the existing literature on disparities in the access to and quality of surgical care among ACB patients in high-income countries with universal healthcare systems, and to identify gaps in the literature on surgical access and quality of surgical care in ACB patients.
The scoping review will follow the Joanna Briggs Institute methodology and report according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The search strategy will be customised for each database (MEDLINE, Embase, CINAHL, APA PsycINFO and Cochrane Library) using terms for ACB and surgery. Grey literature and references from included studies will be searched for additional sources, with no limitations on publication date or language. All study designs will be eligible. Two independent reviewers will screen titles, abstracts and full texts in duplicate for eligibility. One reviewer will chart data, with a second reviewer validating the data charted. The findings will be synthesised, quantitatively summarised using descriptive statistics and qualitatively analysed through thematic analysis.
Ethics approval is not required as the study utilises published data. The dissemination of the findings will inform future research and improve understanding of the surgical care experiences of ACB patients. Dissemination will target academics and healthcare professionals through publications, presentations and workshops.
Commentary on: Russell JL, Chen HC, Jensen FB, Nichols ND. Nursing students' perceived attitudes toward addressing sexual health in their future profession: A longitudinal quantitative study. Nurse Educ Today. 2023 Nov;130:105953. doi: 10.1016/j.nedt.2023.105953. Epub 2023 Aug 25.
Nursing students have positive attitudes towards addressing sexual health in future practice and this should co-inside with educational opportunities to enable the development of competence and confidence. Further research is required to establish the learning gaps between educational opportunities available to nursing students and that of sexual health-related competence within nursing practice.
Sexual health can be defined as one’s physical, emotional, mental and social well-being.
Research on therapeutic mobility is abundant but the field of cancer has not yet been investigated thoroughly. This scoping review aims to examine the existing evidence on global therapeutic mobility and cancer, providing a comprehensive overview of the subject.
We conducted a scoping review and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodological guidelines. We developed a comprehensive search strategy and discussed it with the research team. We searched for peer-reviewed papers on Medline, Embase, ERIC and American Psychological Association via the Dialogue interface and Google Scholar and CAIRN bibliographic database for peer-reviewed articles. We also included grey literature, such as unpublished work and relevant reports from Érudit. We considered studies that employed quantitative or qualitative methods.
Among the 1615 references initially selected, 767 duplicates were excluded. Then, 849 studies were screened on title and abstract and 800 were excluded as they did not meet inclusion criteria. 49 studies were fully screened and 21 were excluded as they did not meet inclusion criteria based on full-text assessment. Ultimately, 28 references were included in the data synthesis. This scoping review has shown that publications on therapeutic mobilities have multiplied in recent years, with a turning point in 2019. A range of academic disciplines and research methodologies are currently employed to describe them. A significant proportion of fieldwork is concentrated in Asia, Africa, Europe and North America. Despite the heterogeneity of the approaches and fields, there are certain common features that emerge: first, the decision to migrate for healthcare is primarily made by the patient themselves and is perceived by them as being non-choice; second, the family plays a central role at all stages of the migration; and third, the migration has a catastrophic impact in terms of social and financial burden.
In conclusion, this scoping review highlights the underexplored relationship between global therapeutic mobility and cancer, emphasising the need for increased research efforts to understand the global dynamics of cancer care mobility.
FreshRSS 